The COVID-19 outbreak exposed serious weaknesses that existed in many areas, including the provision of PPE, testing facilities, critical care capacity and the ability to protect older people living in care homes.
That is the conclusion of the Senedd’s Health Committee that today launches a wide-ranging report outlining failures during the pandemic and a set of recommendations for the Welsh Government to prevent the events of the last four months having the same impact again.
Dr Dai Lloyd MS, chair of the Senedd’s Health, Social Care and Sport Committee:
“We must be better prepared, on all fronts, for the challenges ahead, especially during the coming winter period. A second wave does not have to be inevitable if lessons are learned from the past four months.
“When the virus took hold, there was a palpable sense of fear amongst NHS and care home staff who were all too aware of the effects of Covid-19, but they battled on in the most difficult of circumstances.
“Society has discovered who the true keyworkers are. Health and social care staff have been heroic in their response to this pandemic. Under the most extreme pressures, they have shown an unwavering determination to tackle the extraordinary challenges presented by the virus. Sadly, for some, this cost them their lives.
“This has been an epic team effort, involving public health officials, all key workers and unpaid carers. Local authorities have moved mountains to protect and support the most vulnerable. Within our communities, huge number of volunteers have mobilised, doing everything from distributing food and medicines to making scrubs, gowns and masks. The public has also played its part, sacrificing contact with family and friends in the interests of the greater good.
“Today we are outlining clear recommendations for the Welsh Government to learn from mistakes and move forward so that never again do we have to face the horrors of the last four months.”
The Committee’s Recommendations
There has been a complete lack of clarity about the testing programme in Wales, with uncertainty about who was leading, managing and coordinating the work. The importance of having a streamlined and clear process for testing in place cannot be understated.
One of the main lessons from the last few month is that access to testing, as and when it is needed, is paramount.
The Committee is calling on the Welsh Government and its partners to ensure that there is local access to testing for anyone who needs it, as and when they need it. GPs and primary care need to be an integral part of these arrangements.
Contact tracing is a tried and tested weapon against infectious diseases. In the absence of a vaccine, it is the only real weapon to fight the virus. It is vital that there is an efficient and effective contact tracing system in full operation. The turnaround time for test results, and the accuracy of those results will be critical to the success of the Test, Trace, Protect Strategy.
The current turnaround times for test results in Wales are unimpressive and the Committee believes that the Welsh Government should focus on reducing the turnaround time for test results.
The Committee is calling on the Welsh Government, working with Public Health Wales, to aim for all test results to be returned within 24 hours.
The Committee is deeply concerned by the number of Covid-related deaths in care homes. Care homes look after some of our oldest and most vulnerable members of society. They deserve to be protected in the event of a national health emergency, yet they have been badly let down during this crisis.
The Committee’s view is that the Welsh Government’s initial approach to testing in care homes was flawed, and that it was too slow in responding to the mounting crisis that has seen deaths in care homes account for 28 per cent of all coronavirus deaths in Wales.
The Committee is calling on the Welsh Government to ensure that testing within care homes takes place on a regular and systematic basis and for tests to be administered by suitably trained individuals rather than using home testing kits.
Personal Protective Equipment
The lack of appropriate PPE was one of the biggest issues during the early part of the outbreak. It is extremely concerning that Wales, on occasions, came within days of running out. The position has improved over time, but the system remains ‘stable but fragile’.
The approach within the UK of relying on overseas providers for PPE and securing supplies ‘just in time’ for when they are needed has been found wanting in the face of a global pandemic and the pressures that arose from that.
The Committee is calling on the Welsh Government, as a matter of urgency:
- to publish a strategy for securing a resilient supply of PPE;
- to stockpile appropriate PPE in sufficient quantities for any future outbreak;
- to keep under review the PPE it has stockpiled to ensure that it remains of adequate quality and is fit for purpose, including the design and fit is appropriate for all wearers and suitable for staff, patients or carers who are deaf or hearing impaired;
- publish a strategy for ensuring resilience of distribution arrangements for PPE;
- work with partners to ensure that guidance on PPE is kept up to date in the light of the most recent scientific advice, and communicate this advice clearly to staff.
Support for people shielding
The Committee is not persuaded that the decision to link letters to advise people to ‘shield’ with the provision of services, like online food shopping and delivery of medicines, has proven to be effective. For a great many, it has been the source of considerable anxiety. Major supermarkets in England were provided with the details of those shielding but this was not the case in Wales.
The Committee is calling on the Welsh Government to re-examine the arrangements with major supermarkets to ensure it can satisfy itself that there will be sufficient capacity for online food shopping and home delivery to meet demand, particularly during the coming winter period
The general public has made huge sacrifices during the outbreak. Families and friends have been separated, and the most vulnerable have been isolated. Their collective efforts in adhering to the lockdown rules have significantly suppressed the spread of the virus.
Going forward, public trust in, and compliance with, the Test, Trace, Protect strategy will be vital. There will be a need for clear and repeated public messaging about the social responsibility that every person must take in self-isolating on symptoms and referring themselves urgently for testing.
The Committee is calling on the Welsh Government to ensure there is a system of clear and repeated public messaging – at a national and local level - about individual responsibilities to self-isolate on symptoms, and the importance of urgent self-referral for testing.
The Committee's recommendations will now be considered by the Welsh Government.