Royal College of Physicians of Edinburgh’s report highlights ‘inadequate response’ to protecting care home residents

Doctors and epidemiologists from the Royal College of Physicians of Edinburgh say Scotland will need to be better prepared against any future pandemics or another wave of coronavirus, particularly with regard to protecting vulnerable groups such as care home residents.
Dr Susan Pound, vice-president for Scotland (Royal College of Physicians of Edinburgh)Dr Susan Pound, vice-president for Scotland (Royal College of Physicians of Edinburgh)
Dr Susan Pound, vice-president for Scotland (Royal College of Physicians of Edinburgh)

With Scottish health secretary Jeane Freeman due to give evidence at the Scottish Parliament on the state of readiness before the coronavirus crisis tomorrow (Wednesday), the college has said the country was unprepared, particularly with regard to protecting healthcare staff.

College vice-president Dr Susan Pound said: “While we acknowledge that planning was done from government level down, we think that it would have been helpful to have focused more on wider public health and the health and social care system as a whole, rather than concentrating so heavily on secondary care and the NHS.

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“The heavy focus on secondary care and the NHS was a factor in the inadequate response to protecting care home residents and staff.

“We are concerned that the MERS and SARS outbreaks were seen in the UK as being largely confined to countries in Asia, resulting in a view that an epidemic originating in Asia would be highly unlikely to ever cause an outbreak in the UK.

“This affected the UK’s level of preparedness.

“We have seen evidence that nations such as South Korea, Taiwan and Hong Kong learnt from their response to MERS and mounted an effective response to Covid-19, and it is vital that we are in a position to learn from what has and has not been successful, in order to be better prepared in responding to a second wave of the coronavirus, or a future pandemic.

 “We must have arrangements in place for provision of PPE, treatment and testing capacity, protecting the most vulnerable and key workers, and surveillance monitoring to stay ahead of the curve should new viruses emerge – or re-emerge.

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“During pandemics, healthcare workers must be protected with the best available PPE, social distancing for respiratory diseases, and quick and effective antigen testing.”

The doctors say the Scottish Government relied too much on pandemic flu modelling and herd immunity-based strategies, which led to a focus on mortuary capacity and secondary care beds. The college is also calling for a more coordinated approach from the four nations of the UK, albeit while taking local variations  into account.

The college has set out a five-point action plan which it says could help the UK as a whole in the event of future outbreaks. This includes putting “sleeping” contracts in place to ensure provision of essential supplies such as PPE, medicine and laboratory facilities, a clear testing strategy, earlier shielding of vulnerable people, forward planning to protect key workers and prioritise testing them for infection, and studying the responses of other countries, both good and bad, to learn from the experiences of healthcare systems around the world.

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