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‘We learned the hard way’: inside the war room to contain Victoria’s aged care Covid outbreak

Epidemiologist Hassan Vally said he felt like he had “walked into a war room” when he began work at the Victorian Aged Care Response Centre at the beginning of August.

At that time, there were more than 1,000 Covid-19 cases in the state’s aged care facilities and double-digit numbers of aged care deaths being announced day after day.

“About one-third of the people working in the response centre were from the defence force, wearing their army fatigues and air force uniforms,” Vally told Guardian Australia. “So it felt like you were walking into a room to prepare for battle. It was very surreal – and it was just quite overwhelming to begin with.”

Vally, an associate professor in public health and an epidemiologist with La Trobe University in Melbourne, received the call asking him to join the response centre from Australia’s deputy chief medical officer, Professor Paul Kelly, in late July. At the time, the state’s aged care sector was in crisis. Covid-19 cases and spread in aged care and health facilities were a significant driver of deaths and new cases in the state.

Aged care residents were being transported to hospitals, the homes unable to accommodate or care for them, and struggling to put in place adequate infection control measures. Hundreds of aged care staff were infected or furloughed due to being a close contact of a Covid-19 case. Homes lacked the expertise to handle increasingly unwell patients. Patients without the virus were not receiving basic care, due to the mass furloughing of staff. The system was collapsing, doctors warned.

Concerned family members gather at the entrance of Epping Gardens aged care facility in Melbourne on 29 July as authorities rushed to evacuate residents by ambulance.

Concerned family members gather at the entrance of Epping Gardens aged care facility in Melbourne on 29 July. Photograph: Speed Media/REX/Shutterstock

Kelly wanted Vally to work with the investigations and data arm of the Victorian Aged Care Response Centre, which was first announced by the federal government on 25 July to help Victoria more rapidly respond to outbreaks, find staff to replace furloughed and infected ones, and better prepare homes to prevent outbreaks.

“My initial reaction to getting that call was anxiety, because I knew how important this work was,” Vally said. “I was part of the intelligence unit which was really responsible for making sure that the data we needed to understand and get on top of this was available, so we could do the epidemiological analysis, and help people work out what their priorities were.

Vally said he along with most other people working at the centre worked 12-hour days trying to gain control of the situation. He said he quickly realised that obtaining the data he needed was not going to be a simple exercise.

“It’s really hard to convey the stress and anxiety inside the centre in those first few weeks,” he said.

“The biggest challenge for the team that I was involved in, in those early days, was getting timely and accurate data that was specific to what was happening in aged care centres so that decisions could be made on a daily basis as to where our resources and effort should be directed to. It was a very difficult task because of the complexities of the aged care sector where you’ve got the commonwealth government involved in various aspects of it, as well as the state. You’ve got data that was going to the commonwealth, and then also data from the state government, all collected on different timelines from different sources and this creates confusion.

“We needed to get what we called ‘a single point of truth’, essentially making sure that we had one set of data that everyone agreed on.”

More than 150 staff from 28 agencies were brought in to work on the response. Vally was working alongside airline staff, who had been repurposed to work in the aged care sector in admin and other roles to address shortages, and with infectious diseases physicians, gastroenterologists, public servants and army personnel.

He said staff looked exhausted and strained, and by the time many of them finished work at 8pm, it was also too late for them to exercise or get fresh air due to the state’s curfew in place at the time. Vally said they were reminded daily that aged care facilities were peoples homes, “that there was a face behind every number”.

“That’s a pretty good motivation to get out of bed in the morning,” he said. “But there was exhaustion. No one wants to go through this again. And no one wants the most vulnerable older people in our society to have to experience what they did again.”

The latest report from the Victorian Aged Care Response Centre shows how successful Vally and his colleagues at the centre have been. There have been no new cases in an aged care resident since 26 September. As of Monday, there were 29 active cases in aged care, which included 13 residents, 11 staff and five close contacts of these cases. Vally’s contract ended on 27 September, and he said he is still recovering from the experience, and still processing what he went through now cases are under control.

Staff wear personal protective equipment inside Doutta Galla Yarraville Village in Melbourne in August.

Aged care staff wear personal protective equipment inside Doutta Galla Yarraville Village in Melbourne in August. Photograph: Darrian Traynor/Getty Images

But the real question is whether Victoria, as the premier talks cryptically about lifting some restrictions and reopening, will be able to avoid another aged care catastrophe if a third wave of virus takes hold.

“This virus shone a light on all the problems within this sector that need to be improved,” Vally said.

“But there were lots of amazing things that were done during this response; there were was a systematic effort made to go to each of the facilities to make sure that they were prepared for an infection, that involved actually visiting facilities and going through checklists. More PPE [personal protective gear was supplied. Data reporting was improved. There is so much that we’ve done in a short period of time.

“This was a first, having this aged care response centre created, and a lot of effort has been put into learning the lessons from this response centre. We know what worked and how to set one up quickly if another state needs to set up similar. There are just so many lessons that were learned the hard way. And there is just no way we won’t be better prepared for having been through this experience.”

Read the original article at The Guardian

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