Institutions are the hardest hit area of the fifth wave of the new crown epidemic. More than half of the deceased came from institutions. Chief Executive Carrie Lam Cheng Yuet-ngor announced last Saturday (26th) that the government established an inter-departmental working group to comprehensively review the anti-epidemic capabilities of institutions and propose improvement measures. Check the ventilation facilities and epidemic prevention guidelines first.
The first meeting was held this week.
A review is necessary, but people from all walks of life expect the recommendations to be effective and implemented as soon as possible. After all, over the past month or so, everyone has witnessed the elderly sleeping outside the hospital waiting for a bed. Some citizens even complained that they could not visit their elders in person for more than two years. The hospital saw their relatives for the last time; some caregivers said that they watched the residents pass away before the ambulance could reach the hospital, and believed that the incident showed the problems of Hong Kong's medical care and elderly care system.
Especially when the fifth wave is not over, scholars have predicted that the sixth wave will come in two or three months. The most urgent task is to minimize the lethality of the new epidemic on the vulnerable.
It is reasonable for the government to list ventilation and epidemic prevention guidelines as the primary inspection items, but ventilation alone does not mean changing and installing ventilation systems.
Because as early as the third wave broke out, the government and the Jockey Club had already launched relevant support and subsidies to all residential institutions in Hong Kong, but the result was still unable to prevent the fifth wave.
Is the reason for the fall from the fact that the original plan was not enforced, and some institutions did not follow it?
Or is it because of a lack of knowledge about improving ventilation in homes?
If it is the latter, can the Government assist the RCHE to carry out the project?
A representative of the elderly care industry suggested that the government should revise the regulations to allow residential homes to raise the partitions in their rooms to reduce the chance of the virus spreading through droplets.
This opinion has merit, but at the same time it will reduce the chance of residents getting fresh air. The government must balance the pros and cons.
Under the fifth wave of the epidemic, many nursing homes have confirmed cases.
(Photo by Luo Guohui)
It was said earlier that paying attention to ventilation can prevent the outbreak of the epidemic
In addition to the ventilation problem, the overcrowded environment, tight manpower, and the lack of coordination with the hospital are nothing new. The new crown epidemic is only the last straw that broke the camel's camel's back because of the elderly care problem.
Rather than reviewing individual provisions of the guidelines for epidemic prevention, the government should vaccinate residents of residential homes, provide protective equipment, and increase the number of staff in residential homes to prevent residents from going back and forth between residential homes, hospitals and quarantine facilities.
In the event that a resident is infected, they can call a doctor or send them to the hospital according to their condition. In short, the time for diagnosis and treatment is faster.
Recently, the government announced to improve the referral process. Residents of residential care homes with mild or stable conditions of the new crown can go to the respite care center without first going to the hospital. It also plans to allocate some respite care centers for quarantine. The action is correct.
When quarantine resources increase, the government will make good use of them.
The United States and Canada also lost a large number of elderly residents in the early stage of the new crown epidemic, and the two places have also entered into in-depth reviews and recommendations.
Many Canadian scholars also pointed out that the quality of care in private institutions is poor. One of the reasons is that they have to cut staff to maintain profitability, and demand that privatized services be stopped and public investment be increased.
So, is there a similar situation in Hong Kong?
Is there any difference in the rate of infection and death among the elderly and employees under the epidemic in subsidized, purchased and privately owned institutions?
If private institutions perform the worst, the Government should consider whether to allow private operation again, or at least eliminate the worst group.
Carrie Lam and Law Chi-kwong attended the anti-epidemic press conference, announcing that the review of residential homes will take the lead.
(file picture)
Long-term plan: the government increases the number of dormitories, the public pays attention to health
However, the authorities have been slow to improve the quality of local institutions.
Increasing the per capita living area of residential homes to 8 to 9.5 square meters and the prescribed nursing staff ratio are still in the process of amending the proposed amendments, and it will take eight years to fully implement, and the professional staffing of doctors and physiotherapists has not yet been stipulated , that is, the current residents cannot witness the improvement of their lives.
In the short term, the manpower can be solved reliably by improving salary packages, and the workload will decrease with the increase of manpower, promoting a virtuous circle in the industry.
Social welfare scholar Zhou Yongxin proposed to write an article a few days ago to "buy places" in private residential care homes in order to subsidize the level of regulation.
In the long run, in the face of an aging population, the government will require residential projects to be attached to residential care homes for the elderly, improve the layout of residential care homes, and even require residential care homes to hire resident doctors according to the number of residents.
Of course, the cost of care in residential care is high. Even if there is universal retirement protection, the amount may not be able to fully cover the expenses of residential care in old age. Therefore, some countries outside the country will share part of the national medical insurance, and insurance companies have also launched private insurance plans.
If we look further afield, in fact, all the problems of the elderly should be behind the consideration of encouraging people to focus on prevention before they get old.
The young and middle-aged groups usually pay attention to their diet and rest, do more exercise and physical examination, and treat illnesses as soon as possible, so that they can maintain their vitality and self-care ability when they are old, and enhance their ability to fight against diseases. Ultimately, the cost of long-term care and the overall social needs for residential care will be saved, but if more people in the society can do this, the government will definitely need to regulate the labor system and promote primary medical care.
The fifth wave of the epidemic｜Vaccinating the elderly as soon as possible is at stake