Many care home physicians stopped visiting when the numbers of infected people increased during the first wave of the Covid-19 epidemic in Belgium, the Covid Committee of the Brussels parliament has heard.
The committee yesterday heard three experts on the subject of access for care home residents to medical care.
“It’s a fact that there were fewer nursing home patients admitted to hospital during the first wave,” said Paul Cosyns, a professor of psychiatry. “Some missed a chance to seek treatment while intensive care was never saturated.”
All three experts denied reports that residents of care homes were systematically turned away from hospitals due to fears their numbers would overwhelm intensive care units.
“There have been cases, it is clear, but those cases were still relatively rare,” said Guy Lebeer, sociologist at the Free University of Brussels (ULB), who chairs a commission on the issue within the bioethics committee.
What happened instead, he said, is that residents were simply not pointed in the direction of hospital care.
“The onset of the crisis was a moment of panic and great confusion, characterised by a surge of messages conveying the type of information that many directors of nursing homes had received: It is not useful to send your nursing home residents to the hospital, since what you are doing already, we won’t do any better in hospital,” Lebeer said.
In fact, rather than turning away home residents for fear of overcrowding, the problem was more a case of excess caution on the part of the homes themselves.
The problem was exacerbated by a lack of medical staff at the homes. Some doctors were refused entry for fear of contamination, the committee heard. Others simply took it on themselves to stay away.
The coordinating physicians of the homes were faced with the decision by many visiting doctors to stay away, according to Sandra De Breucker, head of the geriatrics department of the Erasmus hospital in Brussels.
“I won’t mince my words: I have had coordinating physicians weeping to me when they could no longer bear the burden of care because their colleagues had decided not to come and help them for fear of Covid,” she said.
“That’s a human response, but sometimes it’s simply a matter of dereliction of duty.”
The result, according to Guy Lebeer: “Decisions were taken when there was no longer any medical expertise on site.”
Too many sick residents were unable to access the hospital care they needed. Residents were held prisoner by structures lacking crucial resources: material, staff, in particular adequately trained staff, a global infection plan or a testing policy.