Sara Charlesworth, RMIT University, and Lee-Fay Low, University of Sydney

The full report is available here:

Key findings

• The first COVID-19 outbreak in Australian residential aged care occurred on March 4 2020 at Dorothy Henderson Lodge, an 80 bed facility in Sydney with a second large cluster in April in Newmarch House, a 102 bed facility also in Sydney. 
• After the initial containment of COVID-19 in Australia in May, in June a second wave of COVID-19 in Victoria spread rapidly through Melbourne-based nursing homes.
• To date, there have been 2,050 nursing home residents diagnosed with COVID-19. Of those residents, 677 have died and 1,170 recovered with 52 active cases. Nursing home residents represent 7.5% of all COVID-19 cases in Australia and 75.3% of all COVID-related deaths.
• There have also been 82 confirmed COVID cases in Australian government-subsidised home care. Victoria accounts for 63.4% of all Australian home care COVID-19 cases. Of the Australian cases, 7 people, 4 located in Victoria, have died.  There are currently 2 active COVID-19 cases, both in Victoria.
• As of 12 October, a total of 2,211 aged care workers in residential aged care facilities had been infected by COVID-19. Of these staff cases, 29 cases remain active with 2182 cases being resolved.
• The Australian government put in place a number of significant policy and funding measures to assist the aged care sector prepare for and manage COVID-19 infections. Australian government COVID-19 support to the aged care sector is now over $1.6 billion. This includes funding for a COVID-19 Support Payment provided to all residential aged care providers, and an aged care worker retention bonus designed to encourage direct care aged care workers to stay working in the sector.  Recent additional COVID-related funding to facilities provides for increased staffing costs, including for managing visitations and infection control training, and for enhanced advocacy and grief and trauma services for aged care recipients and families impacted by COVID-19 outbreaks.
• Aged care providers have also had priority access to the national stockpile of PPE, as well as healthcare rapid response teams and surge staffing support when an outbreak occurs in residential aged care. In home care, the government has provided additional funding to support meals on wheels, televisitor schemes and allowed for some flexibility in usage of funding.
• Direct support for aged care workers has included paid pandemic leave of up to 2 weeks for eligible aged care workers introduced by the Fair Work Commission in July 2020.  The Australian government has also instituted a pandemic leave disaster payment, a lump sum payment of $1,500 to help workers during the 14 days they may need to self-isolate, quarantine or care for someone. Victorian workers not entitled to paid pandemic leave or other leave may also apply for a $450 COVID-19 test isolation payment where they are awaiting test results.
• Despite government measures, on 2 October, the Royal Commission into Aged Care Quality & Safety found deficiencies in government planning around COVID-19 in residential aged care. The Commissioners found that infection control was inadequate, that PPE and testing was sometimes hard to access, and that surge staffing arrangements were not sufficient, resulting in poor care during COVID-19 outbreaks in Victoria. The Commissioners also found that the Australian government did not have a COVID-19 plan devoted solely to aged care. They recommended that the Australian government should publish a national aged care plan for COVID-19 and establish a national aged care advisory body. The Commissioners also recommended the Australian government should arrange the deployment of accredited infection prevention and control experts in residential aged care. 
• Nursing home visiting rules were first introduced by the Australian government on March 18, limiting visitors to two people a day, to be held in private rooms. However, many nursing homes introduced stricter rules, locking down facilities so that there have been no visitors except for under special circumstances. In Victoria there have also been strict rules mandated by the State government which, until recently, have restricted visits to one visitor per resident for one hour per day in special circumstances only.  Across Australia there is growing public concern about the ongoing impact of provider-and state-imposed nursing home lockdowns on the wellbeing of residents. The Royal Commission recommended that there should be funding for providers to ensure there are adequate staff to deal with external visitors to enable a greater number of ‘meaningful visits’ between residents and their loved ones.