News Corona guidelines RIVM led to insecurity in elderly care

Corona guidelines RIVM led to insecurity in elderly care

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Employees and administrators in the nursing home and home care sector believe that they have been put in unsafe situations during the corona crisis. The main reason for this was the RIVM guidelines. They prescribed that wearing protective clothing such as mouth masks was “unnecessary” in all kinds of cases.

Healthcare workers say that this has infected the elderly who died later. In addition, many employees have fallen ill themselves and are now struggling with health problems.

This is evident from research by News hour to the corona crisis in elderly care. Before that, documents were inspected and the creation of various guidelines was investigated. Talks were also held with dozens of people directly involved in the sector.

Regret

Two care organizations, the Association of Nurses and Carers and the ZorgthuisNL sector association now say that they regret following the RIVM guidelines.

They raised the situation several times with the Ministry of Health in recent months, but RIVM hardly changed the guidelines. The two umbrella organizations now want to draw up their own guidelines and no longer automatically follow RIVM. In a response, the ministry emphasizes that the guidelines were written in consultation with the umbrella organizations for elderly care.

Ministry: employers responsible

Healthcare workers are now working on the question of where the responsibility lies. Some have become seriously ill. The ministry says that if there have been really unsafe situations, the employers are ultimately responsible. But the ministry had to follow the employers’ RIVM guidelines.

The Inspectorate SZW (the former Labor Inspectorate) states that it has not investigated whether the RIVM guidelines actually correspond to the working conditions legislation. Moreover, the inspectorate says that it was instructed by the cabinet to temporarily use the RIVM guidelines as a starting point for supervision during the corona crisis.

RIVM said in March that you were not contagious without complaints and always advised against the preventive use of mouth masks in elderly care. It was “not necessary” and because of the scarcity “not desirable”, according to the Outbreak Management Team (OMT). This meant that employees in nursing homes only wore mouth masks in departments where corona had been diagnosed. Personnel worked without protection in so-called ‘clean’ departments.

Even when reports of the increasing number of infections in the nursing home sector reached OMT, the guidelines remained the same.

At the height of the crisis, Nieuwsuur got a glimpse of a care home hit by corona in Boxtel. An employee filmed the disaster that occurred there:

According to the Ministry of Health, the RIVM guidelines were not based on scarcity, but were based on the safest possible situation for the patient and employee. However, RIVM cannot substantiate why it would be safe to provide a corona patient unprotected within 1.5 meters, and only refers to “general principles from infection prevention”.

However, this principle does not appear in earlier Dutch guidelines on infection prevention in elderly care. The former chair of the working group that wrote those earlier guidelines, Christina Vandenbroucke, does not recognize this rule either.

The cabinet publicly called on staff in nursing and home care to follow the RIVM guidelines. RIVM now says that these were only guidelines and that health care workers should have deviated from them. But that turned out not to be easy in practice. Healthcare institutions that wanted to use more oral masks than was required according to guidelines could not turn to the national distribution body of the government. That divided the protective equipment on the basis of the RIVM guidelines.

In other countries, however, mouth masks

It is striking that stricter rules often applied in other countries. According to the guideline in Germany, for example, all healthcare workers who came into contact with the elderly wore preventive masks. According to the German RIVM, health care workers were able to carry the virus with them and transmit it to the elderly without complaints.

In Germany it was also mandatory that every employee in elderly care wore an FFP mask when entering the room of a (suspected) corona patient. In the Netherlands, FFP masks were only prescribed for “high-risk procedures”, which mainly take place in the hospital.

The RIVM guidelines also prescribed that oral masks were not always necessary when caring for (suspected) corona patients. For example, if a health care professional could keep a distance of one and a half meters from the patient, or if it was only “fleeting contact” of “less than 5 minutes”, then protection “was not necessary”.

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