Infectious disease experts and health unions have slammed the federal government's relaxation of aged care rules that have allowed private sector staff to resume working across multiple facilities during the COVID-19 pandemic with one describing it as "disastrous" and a "political decision based on cost".
Aged care centres in Melbourne are again on high alert for COVID-19 and health authorities are again reviewing a decision to make vaccination mandatory for aged care workers in the midst of Victoria's debilitating statewide seven-day lockdown.
It has been revealed the federal government's 'single site funding support' arrangement was reinstated on Friday when Victoria's lockdown began and Melbourne was declared as a Covid-19 hotspot. Not a ban, rather an incentive to stay in one workplace, the emergency arrangement was created in the wake of Victoria's last outbreak which lead to the deaths of 655 aged care residents.
University of NSW epidemiologist Mary-Louise McLaws, has joined other experts and unions including the Australian Nursing and Midwifery Federation in criticising the rule relaxation as unsafe.
"This beggars belief," Professor McLaws told The Canberra Times.
"It could only be a political decision based on cost. It is a critically poor decision. Disastrous."
It comes as the end of Victoria's debilitating lockdown this Friday appears unlikely, with 11 new cases in the state in the past 24 hours and the number of exposure sites swelling to 270.
Victoria's Chief Health Officer Brett Sutton says the outbreak is being assessed day-by-day; "these are concerning numbers, these are concerning settings."
"It's been a rapidly moving virus and the transmission that's occurred in those high-risk settings has been very substantial so we have to take it as a day-by-day prospect," Professor Sutton said.
"We're neck and neck with this virus and it's an absolute beast."
There are three clusters in this outbreak, but the aged care one is causing significant concern for its high risk setting, the incomplete vaccine take up in the sector and an apparent relaxation of rules.
Four of the 54 active COVID-19 cases in the current Victorian outbreak are related to aged care facilities, including a staff member who worked at two centres; Arcare Maidstone and BlueCross Western Gardens. Another worker in her 50s at Arcare is classed as a "mystery case" as her connection to other Covid-19 clusters is not known.
There is also the son of the mystery case testing positive, as well as a 99-year-old asymptomatic resident who has been transferred to hospital as a precaution.
Another resident who tested negative is being re-tested. Staff members at two other Royal Freemason aged care homes in Melbourne and Footscray also worked at the Maidstone home, but they have so far tested negative.
Professor Sutton says public sector aged care workers are "effectively prohibited" from working across multiple aged care sites, but it is different for private facilities, regulated and funded by the federal government, with effectively a commonwealth workforce.
"It is massively risky to move across different settings," he said on Monday.
"It's a risk, wherever it occurs doesn't matter public or private. But the question of how it's effectively enforced supported financially or otherwise, in terms of policy is a question for the Commonwealth."
The acting Victorian Premier James Merlino is also referring to the federal government, but the federal Health Minister, Greg Hunt, is casting it back to the states and a need for flexibility.
"It is very much something that could be done under public-health orders at the state level," Mr Hunt said.
"It is critical that we can have testing staff move between sites, vaccinated staff move between sites, clinical first responders exactly as we are now, the need to cover those that are ill and the need for search workforce.
"All of those things show the need for flexibility."
But Mr Hunt said the difference with this outbreak is "100 per cent of facilities in Victoria" have had their first vaccine dose. That's a reference to residents. It is getting close to completion but not all aged care residents in Victoria have been vaccinated and not all workers have been vaccinated as it is not mandatory for workers.
The minister says the medical expert panel of state chief health officers and Commonwealth officials has been asked to review whether aged care vaccinations should be mandatory.
"That has been referred to requests of the Prime Minister and myself," he said. "It had previously been discussed, but for medical reasons and the view of that group had not advised in favour of it."
Any change could be considered by national cabinet as early as this week.
Victoria's testing numbers remain high, with 43,874 test results received over the last 24 hour period, while 16,752 vaccine doses were administered.
The outbreak has three current clusters; one in the city of Whittlesea, one in Port Melbourne and the other surrounding the aged care facilities.
"The next couple of days are going to be so critical. I want to say to people it may get worse before it gets better," the acting Premier said.
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