Australia’s slow vaccine rollout in aged care prompted one provider to go it alone


Australia’s progress in vaccinating some of its highest-priority citizens has been slower than anyone wanted, but one Melbourne aged care provider is streets ahead of the rest.

In the next few weeks, private provider TLC Aged Care is likely to become the first residential aged care company to have all residents and staff fully vaccinated against COVID-19.

They’ve got there by taking matters into their own hands.

“We really didn’t want our residents, staff or contractors to endure another winter with the nervousness and trepidation that they have endured over the last 16 months,” CEO Lou Pascuzzi said.

“We’ve got immunisation capabilities and primary care capabilities.

“We decided to approach the government …  and ask for permission to administer phase 1a ourselves.”

The federal government agreed to send Pfizer doses, and TLC Aged Care started immunising in the second week of March.

“We’re now three weeks away from completing double doses for all of our 1,500 residents and 2,000 staff and contractors,” Mr Pascuzzi said.

The company is also claiming a high uptake rate for the vaccine, with 91.25 per cent of staff and residents taking up the opportunity to get a shot.

But the TLC model is not one that can be rolled out widely in aged care, as most residential homes don’t have the medical facilities or expertise to deliver immunisations.

Nationally, around 153,000 doses have been administered in the Commonwealth aged care rollout as of yesterday.

That represents around a quarter of the vaccination program for just residents of aged care homes.

Vaccinations have taken place in at least 1,121 sites, representing around 40 per cent of all residential aged care homes.

Many homes still don’t know when they’ll get a visit from Commonwealth vaccination teams, including Alwyndor aged care in Adelaide’s south.

“The rollout has been slower than we’d anticipated — a number of care homes in the surrounding areas have had theirs,” said general manager Beth Davidson-Park said.

The vast majority of the doses in the sector have so far gone to residents, with workers in the sector waiting on the sidelines.

They may be waiting some time.

The changed advice for the administration of the Oxford-AstraZeneca vaccine to those under 50 means those workers no longer have a timeline on which they’ll be inoculated.

“Our advice to staff has been to contact their GP and get their vaccination independently of work,” Ms Davidson-Park said.

The Prime Minister said his priority is still to vaccinate those most vulnerable in our community in phases 1a and 1b, “particularly those Australians aged over 70”.

“Right now, our focus is on vaccinating people for whom the AstraZeneca vaccine does not present a challenge,” Scott Morrison said yesterday.

“Those supplies are continuing to roll out.”

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Aged care centres lead vaccinations


Homestead Estate in Wallington has administered the first dose of the Pfizer vaccine to 144 residents (97 per cent) and 175 staff and contractors (92 per cent), according to operator TLC Healthcare.

The company provided the Department of Health with a formal proposal to administer phase 1a of the program itself, Mr Pascuzzi explained.

“Rather than criticising or lobbying the government to close that gap, TLC put its hand up to support the government’s efforts.”

Following a rigorous qualification process, TLC received 7000 doses of the Pfizer COVID-19 vaccine to immunise residents, staff, and contractors.

The measure enabled TLC to provide the first dose to 91.25 per cent of its 3500 residents, staff and contractors, Mr Pascuzzi said.

“What has really surprised me is the 91.2 average take up rate of the vaccine across our residents, staff, and contractors.

“Most of those not participating are as a result of their clinical profile, or other personal reasons.

“We are on schedule, thanks to the Department of Health, and their transport contractor DHL, delivering all the required vaccines and consumables on time.

“We have also begun to administer the second doses, and expect everyone to be fully vaccinated by May 4.”

TLC’s announcement came as federal government this week formally abandoned its target to vaccinate every Australian against COVID-19 by the end of October.

Prime Minister Scott Morrison conceded previous vaccination timelines were “not possible” given “uncertainties” facing the rol-lout following concerns about rare side effects from AstraZeneca’s COVID-19 vaccine.

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Aged care providers in the dark about when they'll receive doses




Most aged care residents are yet to get a visit and staff have been largely left out of the rollout so far. Casey Briggs explains.

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Shire closes door on family day care



MORNINGTON Peninsula Shire Council has decided to stop providing family day care on the peninsula and in the Frankston area. The shire says “a steady decline in the service” has over the past five years  coincided with the rising number of family day care providers in the market. Families using the “home away from home” service have been given 12 weeks to find alternative care for their children. “We are confident these [alternate] services will provide a varied choice for all educators when selecting a new provider to transfer to with little to no disruption to them or the families and the children they care for,” said an unattributed statement issued last Thursday by the shire. “All our educators and families have been notified and we are committed to supporting each educator to find a preferred provider to ensure a smooth transition for themselves and their families over a period of 12 weeks.” The shire it was “working on redeployment options” for its two children services officers. Late last week the shire’s website was still advertising its family day care services which “is exceeding the national quality standards”. The service provided “high quality home-based education and care option that is flexible and affordable”. Eligible families could claim government child care subsidies “to reduce the cost of care”. “Care is provided in the homes of our licensed educators and is designed to meet the needs of children and families,” the website stated. It said the shire was “committed to the safety, participation and empowerment of children”. “We can provide you with a home away from home child care environment in a family home where children celebrate the magic of childhood in a quality education and care setting.” Day care could be arranged “24 hours a day, 7 days a week; including full-time, part time, casual, occasional care, weekend and overnight care, respite care, emergency care, before and after school care and school holiday care”. Transport could also be arranged to and from pre-school and school. “Our educators [who were given ongoing training and support] can provide your children with real community experiences by attending local library, music and play sessions.” First published in the Southern Peninsula News – 6 April 2021

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Care home residents ‘barred’ from voting in local elections because of Covid rules



But Ms Rayner said this should be a choice, and not because other opportunities have been removed.

She said: “As soon as it became apparent that everyone would not be able to share full access to the voting options, then the elections should have been paused, or we should have found a way where the opportunities for all to vote were equalised.

She added that it “should not be acceptable” that residents cannot vote in their local polling station without having to isolate for 14 days, when the rest of the population is out going to the pub, shopping and even socialising in gardens.

A previous version of the DHSC guidance, introduced on March 8, limited visits out of care homes to residents of working age.

It was updated last week, dropping restrictions preventing people over the age of 65 from taking trips outside the home.

It followed a legal challenge by the group John’s Campaign, which argued that the Government was acting unlawfully by imposing a blanket ban regardless of the health of the individual.

The group said at the time that it wants to see the 14-day self-isolation requirement amended.



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French COVID-19 intensive care numbers resume upward trend


FILE PHOTO: ICU for COVID-19 patients in Vannes
FILE PHOTO: Medical staff members work in the Intensive Care Unit (ICU) where patients suffering from the coronavirus disease (COVID-19) are treated at ELSAN’s private hospital Clinique Oceane in Vannes, France, April 7, 2021. REUTERS/Stephane Mahe/File Photo

April 9, 2021

PARIS (Reuters) – The number of people in intensive care units (ICU) with COVID-19 in France increased by 52 to 5,757 on Friday, a nearly five-month high, after dipping on Thursday, health ministry data showed.

The ministry also reported 301 new deaths in hospital, compared to 343 on Thursday. Including deaths in retirement care homes, the seven-day moving average of COVID-19 deaths stood at 343 on Friday.

France also reported 41,243 new infections, down from 46,677 a week earlier.

(Reporting by GV De Clercq; Editing by Gareth Jones)

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France reports 5,705 people in intensive care units with COVID-19


FILE PHOTO: ICU for COVID-19 patients in Vannes
FILE PHOTO: A medical staff member works in the Intensive Care Unit (ICU) where patients suffering from the coronavirus disease (COVID-19) are treated at ELSAN’s private hospital Clinique Oceane in Vannes, France, April 7, 2021. REUTERS/Stephane Mahe/File Photo

April 8, 2021

PARIS (Reuters) – The French health ministry on Thursday reported the number of people in intensive care units with COVID-19 fell by 24 from Wednesday, to 5,705, the first decrease in eight days.

France also counted 71,944 deaths in hospitals due to the virus, up 343 from the previous day, while the number of people in hospital for COVID-19 was down by 349 to 30,555.

France also reported 84,999 new infections, although the total was from several days following recent data collection problems.

It said the figure included 30,785 new cases from Wednesday, 49,754 from Tuesday and 1,542 from Monday, which was a public holiday in France. The rest were from previous days.

The ministry has repeatedly struggled to publish up-to-date data on the outbreak and vaccinations.

(Reporting by Benoit Van Overstraeten, Jean Terzian and Leigh Thomas; Editing by Chris Reese and Dan Grebler)

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Qld aged care worker given wrong second dose of COVID-19 vaccine


Queensland health authorities have confirmed that an aged care worker received the wrong second dose of the COVID-19 vaccine.

The woman was given a Pfizer dosage for her first jab but received AstraZeneca for the second this week, not realising the error until she was given a pamphlet after the injection.

The employee of the Ipswich aged care facility, west of Brisbane, was monitored for an hour by healthcare professionals at the clinic before being sent home with an ice pack for a headache, 9 News reported.

She was told to watch for any adverse reactions and to call an ambulance if she became unwell.

On Friday afternoon, Queensland chief health officer Jeannette Young confirmed the woman had received the wrong dosage.

“I’m sure the place where it happened will look at how that occurred, but she’s fine today, which is very good news,” she told reporters.

The mix-up comes after the Prime Minister on Thursday night revealed new medical advice for the AstraZeneca jab, recommending Australians under 50 not receive the vaccine due to the rare possibility of blood clots.

Scott Morrison said the guidance was based on advice from the Australian Technical Advisory Group on Immunisation (ATAGI).

The AstraZeneca vaccine will continue to be issued to those when the benefits outweigh the risks of the deadly virus.

Those include elderly Australians, who are more likely to become seriously ill from coronavirus than young people.

Administration of the Pfizer vaccine will not be affected.

ATAGI considered evidence from colleagues in Europe, where there were a small but concerning number of cases where people developed blood clots after receiving the AstraZeneca vaccine.

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We should be funding stress leave and high-quality PTSD care for all victims of abuse | Richard Dennis | Opinion


Practical support for the thousands of Australian women who are sexually or physically assaulted by men is not simply woefully inadequate, it is nonexistent. If you are a casually employed woman in Australia who is raped or assaulted you are entitled to five days unpaid leave. In short, just beginning to recover from an attack would cost a woman on minimum wage more than $700 a week.

Imagine having to go to work in the days after a physical or sexual assault because you couldn’t afford not to. There is no rent holiday for victims of violence, nor is there a discount at the supermarket. Imagine having to front up at Centrelink, or for a job interview, in the days after an assault because you feared being “breached” and losing your unemployment payments.

But of course, if you are a government minister who is accused of failing to support an employee who alleges to have been raped on your watch, or a minister accused of committing rape, you could be placed on taxpayer-funded medical leave and paid $7,000 a week.

Christian Porter has strenuously denied the allegations that have been made against him and is entitled to the presumption of innocence.

But no one can deny that MPs suffering stress and anxiety are provided with far more taxpayer support than women who have been the victim of violence.

And while no one doubts the genuine pressure that Porter is under, does anyone believe that those who are the victims of physical or sexual violence are in less need of help?

There should be significant government spending on paid leave and mental health support services for the victims of assault that affect more than 100,000 women each year.

Providing all victims of sexual or domestic violence with the kind of support offered to highly-paid ministers would cost billions of dollars a year. And – let’s be clear – employers don’t want to pay for such support and neither does the Morrison government. But let’s also be clear that the money is there. Australia is one of the richest countries in the world and, as described below, we never struggle to find the money when tax cuts for high-income blokes are on the table. It’s not just leave for women recovering from violence that we need to adequately fund and fairly distribute, it’s mental health care as well.

When soldiers, emergency service workers or medical professionals experience post-traumatic stress disorder (PTSD) as a result of what they endure in the workplace, the government (rightly) picks up the very expensive tab for treating their condition and helping them heal. But when women and children develop PTSD because of what they endure at the hands of violent men there is far less such support. We know how to help people with PTSD, but we choose to provide far more help to those who develop it at work than those who develop it at the hands of a violent man.

It would cost a lot of money to help hundreds of thousands of women and children heal the scars that men gave them and, to be blunt, it looks like the government has no interest in spending that much money on a “women’s problem”. It is not that the government “can’t afford” to spend billions helping women and children – it’s that it has quite different priorities.

In 2018 it was reported that sexual assault victims were waiting up to 14 months for counselling as specialist support services were so desperately underfunded and under-resourced.

Each year the government spends around $41bn on superannuation tax concessions to help some of us have a more comfortable retirement. Around $21bn of that goes to those in the top 20%, most of whom are blokes. But I bet you have never heard a Morrison government minister say that the government “can’t afford” to help rich blokes retire even richer.

Then there’s the looming tax cuts. By July 2024 people earning more than $200,000 a year (or $3,900 a week) will reap a more than $9,000 a year windfall in the form of Stage 3 tax cuts. And, you guessed it, 74% of people earning that much are blokes. Despite these tax cuts costing almost $19bn a year, again, we have not heard a peep from the Coalition about these enormous and permanent tax cuts being “unaffordable” or “unsustainable”. Such negative adjectives are only ever used to describe spending on those in need.

Australia is so rich that even in the middle of a pandemic we can afford to spend $500m extending the Canberra war memorial and $1.2bn subsidising half-price flights to north Queensland and other tourist hotspots. But, despite our wealth and despite recognising the benefits of stress leave for members of his cabinet, the PM does not seem to think that his government should be funding stress leave and high-quality PTSD care for all victims of abuse.

We all know how hard people find it to tell Scott Morrison what is going on. But we also all know that conversations with his ministers have clearly made him understand the benefits of letting those who have experienced severe stress recover before they return to work.

If only the prime minister would have a conversation with women who had to return to work just days after they were raped, or with students who have to go back to school with those who raped them. Perhaps he would stop trying to “draw a line” under this crisis, and start trying to help those who have been harmed by it.

Richard Denniss is chief economist at independent thinktank The Australia Institute @RDNS_TAI

In Australia, the crisis support service Lifeline is 13 11 14. If you or someone you know is impacted by sexual assault, family or domestic violence, call 1800RESPECT on 1800 737 732 or visit www.1800RESPECT.org.au. In an emergency, call 000. International helplines can be found via www.befrienders.org.

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Comfort care beneficial for hospitalized stroke patients, yet disparities in use persist


Micrograph showing cortical pseudolaminar necrosis, a finding seen in strokes on medical imaging and at autopsy. H&E-LFB stain. Credit: Nephron/Wikipedia

Receiving palliative or hospice care services was found to improve quality of life for hospitalized ischemic stroke patients, however, disparities persist in which patients are prescribed or have access to these holistic comfort care options, according to new research published today in the Journal of the American Heart Association, an open access journal of the American Heart Association.

Prior to the COVID-19 pandemic, stroke ranked No. 5 among all causes of death in the U.S. Nearly 9 in 10 strokes are ischemic strokes caused by a blockage in a blood vessel that carries blood to the brain. Despite advances in acute stroke treatment and management, stroke remains a leading cause of serious long-term disability in the U.S.

“Stroke death rates have declined over the past decade, however, as more people survive stroke, many face lingering consequences including varying levels of disability,” said lead study author Farhaan S. Vahidy, Ph.D., M.B.B.S., M.P.H., FAHA, an associate professor of outcomes research and the associate director of the Center for Outcomes Research at Houston Methodist, in Houston, Texas. “Many stroke patients are candidates for comfort care, including palliative or hospice care, which can improve outcomes and quality of life. It is important that stroke patients who could benefit with better quality of life from comfort care have these options available.”

Palliative care provides holistic support to patients with stroke and other chronic conditions to relieve symptoms and improve quality of life. Hospice care is end-of-life care and is usually reserved for patients among whom most treatment options are no longer feasible. And like palliative care, hospice care also aims to relieve symptoms and improve quality of life.

To better understand comfort care use among ischemic stroke patients in the U.S., researchers examined hospital patient data from 2006 to 2015 from the Agency for Healthcare Research and Quality. They found:

  • Of the nearly 4.3 million stroke hospital discharges, 3.8% received hospice or palliative care.
  • Prescribing comfort care increased during the 10-year period. Ischemic stroke patients were almost five times more likely to receive a comfort care intervention in 2014 to 2015, compared to 2006 to 2007.
  • The increasing trend in patients’ comfort care use was evident even among patients who had acute stroke treatments, including with intravenous clot busting medications, called thrombolytic therapy, and mechanical clot removal, or endovascular thrombectomy.
  • Some hospital types, including large hospitals and urban teaching hospitals, had higher rates of comfort care.
  • The average length of hospital stays for ischemic stroke patients who received comfort care was longer than stays for patients who did not receive comfort care, yet the average hospitalization costs for patients who received comfort care were lower.
  • Although comfort care continues to be associated with higher in-hospital deaths, 10-year outcome trends among patients receiving the services showed a significant decline in in-hospital deaths and a significant increase in the proportion of patients either discharged home or transferred to long term care facilities.

Comfort care use was notably lower among people who identify with non-white racial and ethnic groups. For example, use was 41% lower among Black stroke patients compared to white patients. Other factors independently associated with higher comfort care utilization were older age, female sex, non-Medicare (private) health insurance and higher incomes.

“Disparities in the prescribing of comfort care interventions among ischemic stroke patients was an important finding that needs to be carefully examined. To our knowledge such disparities have not been previously reported,” Vahidy said. “And, while more stroke patients are getting comfort care, overall use is still low, especially among people from underrepresented racial and ethnic groups.”

A limitation of the study is that the investigators examined information that did not differentiate between palliative care and hospice care usage.

“Our work provides a preliminary framework to ensure optimal use of comfort care services among ischemic stroke patients. More work needs to be done to improve access and availability to more stroke patient, to enhance communication with patients and their care providers and to empower patients to make decisions about their care as they recover from and adjust to such a life-altering health event,” Vahidy said.


More stroke patients receiving mechanical clot removal, yet racial disparities persist


More information:
Journal of the American Heart Association (2021). DOI: 10.1161/JAHA.120.019785

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American Heart Association

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Comfort care beneficial for hospitalized stroke patients, yet disparities in use persist (2021, April 7)
retrieved 7 April 2021
from https://medicalxpress.com/news/2021-04-comfort-beneficial-hospitalized-patients-disparities.html

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