1/n
Thread
SOLUTIONS to avoid the disproportionate burden of Covid19 on elderly care.
The vast majority of Covid19 deaths are in nursing homes and to a lesser degree in at home care.
@LTCcovid @SwissScience_TF @keiserolivia @MBattegay @eggersnsf @EicherManuela @curaviva_ch
Thread
SOLUTIONS to avoid the disproportionate burden of Covid19 on elderly care.
The vast majority of Covid19 deaths are in nursing homes and to a lesser degree in at home care.
@LTCcovid @SwissScience_TF @keiserolivia @MBattegay @eggersnsf @EicherManuela @curaviva_ch
2a/n nursing homes make up roughly ~1% of the overall population.
It MUST be possible to focus resources on this tiny population minority and achieve better outcomes.
We have 100'000 beds in Switzerland = 1.2% of population. Death share >>50%
gateway.euro.who.int/en/indicators/…
It MUST be possible to focus resources on this tiny population minority and achieve better outcomes.
We have 100'000 beds in Switzerland = 1.2% of population. Death share >>50%
gateway.euro.who.int/en/indicators/…
2b/n
we have made multiple threads with data and questions as to how and potentially why elderly care was/is hit so hard by Covid19
First: The patterns are similar all over the Western world and have WORSENED in many countries in the 2nd wave
we have made multiple threads with data and questions as to how and potentially why elderly care was/is hit so hard by Covid19
First: The patterns are similar all over the Western world and have WORSENED in many countries in the 2nd wave
https://twitter.com/CoronaReduit/status/1336322824152104960
2c/n
Second: #Frailty is a major risk to
A. get infected due to care needs (unavoidable contacts) and institutional settings
B. have a severe progression due to weak immune systems
Second: #Frailty is a major risk to
A. get infected due to care needs (unavoidable contacts) and institutional settings
B. have a severe progression due to weak immune systems
https://twitter.com/CoronaReduit/status/1348620398536126464/
3a/n
Data availability, depth and quality is diverse.
Only 6/26 Swiss cantons publish Covid19 nursing home data.
Without good data, you are flying blind @BAG_OFSP_UFSP
We need:
A. Transparency, not tabooization
B. A standardized reporting system
C. Inclusion of at home care
Data availability, depth and quality is diverse.
Only 6/26 Swiss cantons publish Covid19 nursing home data.
Without good data, you are flying blind @BAG_OFSP_UFSP
We need:
A. Transparency, not tabooization
B. A standardized reporting system
C. Inclusion of at home care
3b/n
On data standardization: most jurisdictions report on locations of DEATH, not of infection. Since some nursing home residents and virtually ALL home care recipients are hospitalized, this leads to UNDERcounting.
Home care data is even less commonly reported.
On data standardization: most jurisdictions report on locations of DEATH, not of infection. Since some nursing home residents and virtually ALL home care recipients are hospitalized, this leads to UNDERcounting.
Home care data is even less commonly reported.
3c/n
the lack of easily and broadly available elderly care data has led to scientific, political and journalistic misunderstandings.
@SwissScience_TF @BAG_OFSP_UFSP @srfnews @Blickch
If the elderly care community wants help, they need to provide any data they have.
the lack of easily and broadly available elderly care data has led to scientific, political and journalistic misunderstandings.
@SwissScience_TF @BAG_OFSP_UFSP @srfnews @Blickch
If the elderly care community wants help, they need to provide any data they have.
4a/n
Infection risk comes from personnel and visitors since frail elderly persons are largely immobile. It is noscomial.
Therefore a test trace STOP (TTS) concept is needed using QUICK tests. PCR is too slow. you need instant, DAILY results. Cost/benefit is VERY favorable.
Infection risk comes from personnel and visitors since frail elderly persons are largely immobile. It is noscomial.
Therefore a test trace STOP (TTS) concept is needed using QUICK tests. PCR is too slow. you need instant, DAILY results. Cost/benefit is VERY favorable.
4b/n Switzerland is apparently using most of its quick testing capacity on @SwissCovid app alerts. WRONG PRIORITY.
How many nursing home residents use the app?
One could lay a prepaid phone next to their beds and ask all personnel/visitors to install it. @marcelsalathe
How many nursing home residents use the app?
One could lay a prepaid phone next to their beds and ask all personnel/visitors to install it. @marcelsalathe
4c/n voluntary quick testing is NOT sufficient.
Apparently many personnel REFUSE to get tested.
1200/2500 in rural Basel.
Make it MANDATORY but AVOID STIGMATIZATION of positives. Look at legal basis for mandate @samiahurst
Apparently many personnel REFUSE to get tested.
1200/2500 in rural Basel.
Make it MANDATORY but AVOID STIGMATIZATION of positives. Look at legal basis for mandate @samiahurst
https://twitter.com/CoronaReduit/status/1345856543170953216
4d/n stigmatization contributes to hesitance, resistance and tabooization. Stop blaming people (personnel) for being/getting infected.
This lesson was learned a long time ago during the early years of HIV.
You have to work WITH and FOR practitioners NOT blame them.
This lesson was learned a long time ago during the early years of HIV.
You have to work WITH and FOR practitioners NOT blame them.
5a/n
If infectious personnel are identified with quick tests, there need to be temporary replacements, sick leave without threat of termination and continued compensation. Legal issue @samiahurst
Incentives to keep working while sick are DEADLY.
Solutions in following tweets
If infectious personnel are identified with quick tests, there need to be temporary replacements, sick leave without threat of termination and continued compensation. Legal issue @samiahurst
Incentives to keep working while sick are DEADLY.
Solutions in following tweets
5b/n
A. cantonal health departments @GDK_CDS should have outbreak RESPONSE TEAMS
B. Swiss military @vbs_ddps has medical corps, loan it out
C. Hospital capacity usage outside ICU is 15% below average of 85%, see frequent videos of dancing crews. Loan nurses to care homes
A. cantonal health departments @GDK_CDS should have outbreak RESPONSE TEAMS
B. Swiss military @vbs_ddps has medical corps, loan it out
C. Hospital capacity usage outside ICU is 15% below average of 85%, see frequent videos of dancing crews. Loan nurses to care homes
5c/n another factor to increase available personnel and motivation is pay which drives supply and demand. Switzerland pays it's nursing staff worse than other countries when compared to the national wage level and other professions.
@rlalive @samiahurst
oecd-ilibrary.org/sites/a44d2e24…
@rlalive @samiahurst
oecd-ilibrary.org/sites/a44d2e24…
5d/n for auxialiary tasks, volunteers might be considered, so educated professionals can spend less time on repetitive easy tasks. Swiss civil society is very engaged, reach out! @curaviva_ch @prosenectute
5e/n A study in Connecticut, USA, nursing homes found that available personnel per BED is strongly correlated with outbreak risk and severity. More staff, LESS infections and vice-versa.
https://twitter.com/CoronaReduit/status/1338513977748443137
6a/n vaccination hesitance of nursing home personnel needs discourse NOT pressure
Test personnel for antibodies @davidstadelmann
Many already have antibodies since seroprevalence in NHs must be much higher given high death share of >50% with bed capacity just 1.2% of population
Test personnel for antibodies @davidstadelmann
Many already have antibodies since seroprevalence in NHs must be much higher given high death share of >50% with bed capacity just 1.2% of population
6b/ vaccination of residents is slowed by consent requirements for (mostly demented) people with legal guardians. elderly care associations should provide blueprints and automation of outreach where possible
https://twitter.com/CoronaReduit/status/1347521908456239105
7/n there should not be a shortage of personal protective equipement (PPE) anymore. But if there is one, it needs to be communicated better and fixed.
8/n there are trade-offs between strict hygiene and overall wellbeing of elderly care recipients
Incontinence, unplanned weight loss, cognitive decline etc.
This shortens life expectancy
Practitioners mentioned this repeatedly. Connecticut data confirms it
Incontinence, unplanned weight loss, cognitive decline etc.
This shortens life expectancy
Practitioners mentioned this repeatedly. Connecticut data confirms it
https://twitter.com/CoronaReduit/status/1345683869870206976
9/n a more scientific approach to the fundamental understanding of infection patterns is outlined here
https://twitter.com/CoronaReduit/status/1336322824152104960
10/n
Finally, we are offering free support to anyone willing to work on these matters, including private fundraising.
We do NOT care about acknowledgement, publications etc.
Private conversations will be kept strictly private if you wish so.
Contact us
coronareduit@gmail.com
Finally, we are offering free support to anyone willing to work on these matters, including private fundraising.
We do NOT care about acknowledgement, publications etc.
Private conversations will be kept strictly private if you wish so.
Contact us
coronareduit@gmail.com
@threadreaderapp unroll please
• • •
Missing some Tweet in this thread? You can try to
force a refresh
