Surrey care group asks people not to visit relatives in care homes this Christmas

Surrey Care Association (SCA) is urging people not to visit their loved ones in care homes this Christmas.

They worry the “flawed” rapid test kits mean people may unwittingly infect their elderly relatives.

The health secretary promised that lateral flow tests, which return a result within half an hour, would allow people to “have meaningful contact with their loved ones by Christmas”.

Families could be reunited thanks to the “unprecedented strides made in testing technology”, said Matt Hancock, and care homes would have enough to test two visitors for every resident, twice a week.

But Simon Carter, chair of SCA, said they have “grave reservations”. They said the “harsh reality” was “at odds with that being portrayed by topline government messaging”.

“We of course recognise the huge importance of visits from family members and the positive impact they have, but the consequences of relaxing our guard and getting this wrong are so dire that we need to proceed with the utmost caution,” he said.

The organisation, which supports social care providers in the county, worries providers are being put under pressure to allow visits, and has asked Surrey County Council to write to the families of care home residents to advise them of the risk.

Research by the University of Liverpool on people without symptoms, released on Friday (December 11) by the Scientific Advisory Group for Emergencies (Sage), revealed the US-made Innova tests most widely used in care homes only had a 48.89% detection rate.

So more than half of people in the study who were in fact carrying the virus, believed after taking the test that they were not infected.

The research paper reveals that the Liverpool Health Protection Board last month postponed plans to use the test to allow people to visit their relatives in care homes “due to the accuracy statistics”.

Professor of biostatistics Jonathan Deeks wrote in the British Medical Journal: “If a test misses 50% of infections, people with a negative result are not in the clear – their chances of active infection are simply half what they were before the test.

“Allowing half of infected people, and one third of those with high viral loads, to unwittingly take the virus into hospitals, family homes, and care homes will not reduce the spread of the infection and could put lives at risk.”

Mr Carter said: “Knowing this, and understanding too that the manufacturers of the lateral flow tests advise against using the tests in care settings, it would be reckless and irresponsible for our members to admit visitors simply because they’ve returned a negative test result.”

Individual care homes have put their own measures in place, so whether visits can go ahead does depend on the particular provider.

Age UK have warned: “The impact of taking visitors away from people on a prolonged basis has been closely observed all over the country, with people and organisations commenting on the raw reality of residents going downhill fast.”

The SCA said, with the end in sight thanks to the vaccine, they are making a plea for patience.

“For months, our members, and their staff, have worked tirelessly to create safe environments for their residents, shielding them from undue risk,” said Mr Carter. “Their wellbeing and safety is our absolute priority.

“With the vaccine at the point of roll-out across the care sector, we’re on the cusp of being able to gain control of the virus.

“Taking risks at this stage then, purely for short term benefit when long term relief is in reach, is something we simply cannot countenance.”

How has the government responded to Surrey Care Association’s plea?

The government says it has “sent out millions of tests, provided free PPE and issued guidance to help bring families back together”.

A Department of Health and Social Care spokesperson said: “Extensive testing has shown lateral flow devices are suitable for use in care homes where they can help to identify people who are the most likely to spread the virus further and therefore support the prevention of transmission of the disease from staff and visitors.

“Testing is only part of the approach and it’s essential visitors wear PPE and follow all infection control methods to keep their loved ones, other residents and staff as safe as possible.

“Care home residents in all tiers will have the chance to see their relatives before Christmas and homes across the country are arranging visits now.”

An earlier University of Oxford and Public Health England study of rapid tests including Innova’s found detection rates to be around 79% when tested by Porton Down laboratory scientists, but falling to around 58% when tested by Boots test centre employees.

When questioned by the select committee, the health secretary said he did not recognise the 58% figure.

Dr Susan Hopkins, senior medical adviser to PHE and NHS Test and Trace, said: “No test will detect every single case but these lateral flow devices are proving to be accurate and reliable.”

What is the public health authority’s view on using the rapid tests to facilitate care home visits?

The council will not intervene by writing to families but said it has received a number of requests for guidance, and will support care homes in whatever decisions they make.

An SCC spokesman said: “It is important to recognise that lateral flow tests (LFTs) are just one of a range of methods that can contribute to safe visiting and this includes the use personal protection equipment (PPE), hand hygiene, taking temperatures, screens, cleaning etc.

“Published materials place the sensitivity (whether the tests can identify those without the disease) of the LFT tests at about 50-75%. For this reason it is very important that a negative LFT does not result in a reduction in appropriate Covid infection control precautions including PPE, hand hygiene and social distancing in either staff or visitors.

“Registered providers and registered managers are responsible for doing everything that they can to ensure that residents and staff are safe and that they maintain a Covid secure environment.

“As each service is so different the registered manager is best placed to risk assess if they will undertake LFTs for visitors to their service. They will need to take into account, when they are assessing this, all of the guidance, including if they have sufficient staff to undertake and oversee the testing of visitors, if they have the space needed to undertake the tests, a designated area for people who have had the test to wait for the result, adequate supplies of PPE, and so on.

“Different services and registered managers may come to different conclusions regarding the use of LFTs to facilitate visiting and provided this is based upon a robust risk assessment we will support their decisions.”

Public health authorities in Greater Manchester are now requiring people to take two separate tests before a care home visit, firstly a PCR test, then within three days a lateral flow test carried out by care home staff.

PCR is the standard test used at NHS testing sites and involves taking a swab of the nose and throat, sent to a laboratory for analysis.

A systematic review by the University of Bristol found the PCR detection rate to be between 71-98%.

Martin Barrett, managing director of Nellsar, a care home group in Kent, Surrey and Esssex, said: “This definitely helps with accuracy, but does require self-