Omicron Webinar FAQs

Hertfordshire Care Providers Omicron Update Webinar FAQS 21/12/2021
Category Variants and Transmission
Q1: Can a person contract Delta and Omicron at the same time?
Answer: Delta and Omicron are variants of COVID so you cannot contract both at the same time.
Q2: What does 2.9 times more transmissible mean in real terms?
Answer: If you had thirty people in a room, and Delta enabled you to infect five of them, Omicron would infect up to 15 of those thirty
Q3: If transmission risk is much higher than before what are the initial thoughts on zero staff being available at any given moment i.e. is it now possible for all staff in any one location to be isolating at the same time?
Answer: This is possible so we would encourage all to continue to follow social distancing and good IPC measures. It may also be worth reviewing your business continuity plan
Q4: Is omicron easier to catch or is it that is replicated quicker once in you?
Answer: Yes - It is easier to catch
Q5: What would your advice be for us to give to our Care Staff to keep them as safe as possible? Not just vaccination but practical advice?
Answer:
1. Reduce social interaction
2. Face Masks
3. Get vaccinated
4. Test before social interaction
5. Hygiene
Q6: Am I right in thinking if the symptoms show much quicker in Omicron then you will be infectious for a shorter time?
Answer: That varies. Some people continue to be infectious after symptoms. Some reduce their infectiousness as soon as symptoms develop. Biology work is currently underway to determine this in much more detail.
Q7: What is your suggestion on those who work in the office for a homecare company (care coordinators, recruitment etc...) should do at present?
Answer: Work on a hybrid policy. Come in if you have to, work from home when you can. In the office ensure it is ventilated and people wear face coverings and test before coming in.
Q8: I understood the exact timeline to be circa. 28 days. Surely some numbers cannot be correct?
Answer: Once a person has caught any of the virus variations how many days will pass before they can infect others people can you share those involved as; A) Being on the front line we have not heard or seen this plan B) share info with the sector so we can share or get involved in promoting service 2.5.1 of the management of staff / exposed patients in health and social care settings (GOV website) states fully vaccinated staff members do not need to isolate if a contact if a) fully vaccinated and b) no symptoms and test negative LFT.
Q9: The 9% reinfection rate of Omicron - is that dependent upon whether fully vaccinated or not?
Answer: It is possible that the protection against reinfection by Omicron afforded by past infection may be as low as 19% as reported in this study https://www.imperial.ac.uk/news/232698/modelling-suggests-rapid-spread-omicron-england/ The study found ‘’a significantly increased risk of developing a symptomatic Omicron case compared to Delta for those who were two or more weeks past their second vaccine dose, and two or more weeks past their booster dose (for AstraZeneca and Pfizer vaccines). Depending on the estimates used for vaccine effectiveness against symptomatic infection from the Delta variant, this translates into vaccine effectiveness estimates against symptomatic Omicron infection of between 0% and 20% after two doses, and between 55% and 80% after a booster dose.’
Category Testing
Q1: How is Omicron detected via PCR tests? I believed additional testing would be needed to identify the Omicron variant, is this the case? If so how long does the additional testing of the positive PCR test to take to identify Omicron?
Answer: The PCR tests for S Gene Target Failure and currently that is a proxy for Omicron, then it goes for full sequencing to detect the exact variant because we now have the full Omicron Genome. We can now do this more rapidly before https://www.bbc.co.uk/news/health-59460252#:~:text=In%20standard%20PCR%20tests%2C%20Omicron,is%20needed%20to%20be%20sure But full sequencing could take several days. Target failure comes back at same time as positive result
Q2: At the moment we don't test for 90 days after a positive test. If someone contracts a different variant to the one that caused the initial positive test how are we going to know?
Answer: You need to follow the current requirements for 90 day testing. If someone has symptoms with 90 days of being positive they need to speak to a health professionals, such as there GP. Unfortunately taking tests will likely lead to a positive result even when not positive and lead to staff and individuals having to isolate.
Q3: If an LFT can go from neg. to pos. in 8 hours, explain rationale in only doing 1 every 48 hours?
Answer: Once every 48 hours is thought to be the best compromise taking into account practical issues of having to repeat the tests more often
Q4: Could teams in social care just register LFD kits when they are positive, like the NHS teams? not three times a week negatives.
Answer: This process is led by Department of Health and Social Care, we can share this feedback with them to see if the process is being reviewed
Q5: Testing the Staff for PCR , how will we know if it is Omicron ?
Answer: Within the next two weeks it is likely that UKHSA will assume all infections in Herts are Omicron but the variant will be sequenced . Some of this has been mentioned earlier.
Q6: What would you advise if an employee has previously tested positive for covid-19 tests positive on a lateral flow test within the 90 days? Do we advise they self-isolate again?
Answer: Awating answer
Q7: Where can we access LFTs - we cannot get them online or at local pharmacies. How can we test without tests?
Answer: We understand that there is more supply available online or at pharmacists so please continue to try, alternatively call 119, who should be able to help. We are talking to DHSC around making lateral flow tests available to order at the same time as PCR testing for those organisations using a UON to order kits
Q8: Can you remind me clearly of the testing requirements for a staff member who has previously tested PCR positive. What happens if they are a contact of positive case - testing wise? Also how are we defining symptoms in this case (omicron might not show the same symptoms - JM stated evidence of cold - like symptoms)
Answer: Awaiting answer
Q9: What happens if we struggle to get LF test kits?
Answer: Orders are now going through on the portal. If you have any issues please contact 119 and inform your monitoring officer. For ongoing issues please contact the provider hub.
Q10: If someone tests positive to Delta they don't then re-test for 90 days. How do I know if they contract Omicron in that period?
Answer: If someone develops symptoms in the 90 days then they need to have a clinical assessment to agree whether a test is required.
Q11: With the increase in requirements for LFD for staff and residents when will there be in increase in the numbers of LFD allocations to meet the additional needs of these testing kits?
Answer: This process is led by DHSC, so we are assuming they will increase the number of kits
Q12: Dept of Health and Social care have written to us and stated that testing needs to be 3 LFT per week (and one PCR), I have communicated this to the team and now I am confused that the info here is that this guidance has not changed....
Answer: We suggest that you follow the process they have written to you to undertake. We will escalate to DHSC that the guidance has not changed
Q13: Why can't we in home care be prioritised like care homes to get LFT tests? Surely, we are more vulnerable going into more homes?
Answer: We are talking to DHSC around making lateral flow tests available to order at the same time as PCR testing for those organisations using a UON to order kits
Category Vaccines and Boosters
Q1: Some of the clients in which we support are struggling to get their boosters. They cannot access the community. Is there anyone we can contact so that they get boostered please?
Answer: Please contact your local clinical lead to check if a visit can be scheduled to your location. If you still have issues accessing the vaccines or require further information please email the HCPA Provider Hub at assistance@hcpa.org.uk
Q2: If you had first two doses Jan and March 2021 and booster 6 month later in October how does that affect the figure 7 vaccine effectiveness - which are about 3 month booster. Are the figures the same?
Answer: The key thing here is the booster, so even if it is six months after the first two doses, the booster still boosts immunity
Q3: How long do they think booster is effective for?
Answer: Currently not sure. At least ten weeks is the data we have but as work continues we will know more
Q4: Some people have had AstraZeneca for 1st and 2nd and Mordena as booster. does this mean that Mordena is more effective than Pfizer?
Answer: Either Moderna or Pfizer is good as a booster. I had Moderna as booster and Astrazeneca as initial two. Results suggest pretty similar levels of boost to immunity.
Q5: How long will boosters last to provide high protection?
Answer: So far at least ten weeks high protection against Omicron. That's the current data we have and so it may be longer but we don't know yet
Q6: Has Herts any plans to tackle those unvaccinated, as this is increasing the risk to others as they are out in the community
Answer: Yes we have a vaccine take up plan which includes personal invitations,local community leaders, volunteers from communities. There is a team of people working on this
Q7: Is there going to be full vaccination for children under 16?
Answer: For children 12-15 who are otherwise healthy, the second dose has been approved by government. For children under 16 who have underlying health conditions, they are already eligible for full vaccination. No decision yet on vaccination for healthy 8-11 year olds.
Q8: Some of the clients in which we support are struggling to get their boosters. They cannot access the community. Is there anyone we can contact so that they get boostered please?
Answer: Please contact your local clinical lead to check if a visit can be scheduled to your location. If you still have issues accessing the vaccines or require further information please email the HCPA Provider Hub at assistance@hcpa.org.uk
Q9: If someone has been vaccinated but has only had one dose and then now wishes to have their second, but this is done much later than recommended, will this affect the effectiveness of the vaccination protection for that individual?
Answer: Awaiting Answer
Q10: Where can we get Social Care ID Letters from?
Answer: Please contact the HCPA Provider hub- assistance@hcpa.co.uk
Q11: When is it advisable to get a booster after you have had a Covid infection if you have been doubly vaccinated? is it 90 days so as not to overload the immune system too early? What about if they are showing positive symptom again within 90 days?
Answer: You will have to wait 90 days after a negative PCR result, Vaccination of individuals who may be infected or asymptomatic or incubating COVID-19 infection is unlikely to have a detrimental effect on the illness. Source: UKHSA COVID Vaccination Programme
Q12: Our chef is waiting for his second vaccination, currently off work waiting for 2nd jab .he works in the kitchen. Could you confirm weather he can still work in the kitchen or does he have to have his second vaccination done?
Answer: Unless he has an exemption he cannot reyurn to work in a Care home without beign vaccinatd due to the new legislation.
Q13: Care givers that are not double vaccinated, what advice can you give?
Answer: We would strongly urge everyone is fully protected (all three vaccines) to ensure persons cared for and other colleagues’ safety. If you require further support i.e. Public Health nurse support please contact assistance@hcpa.org.uk
Category Visiting in and Out
Q1: Can a resident have pod/garden/screened visits as well as 3 nominated visits and 1 essential care giver? some residents have big families.
Answer: Yes they can as long as the home has risk assessed this and can follow IPC measures
Q2: The guidance for visitors in Care homes has changed but what about Supported Living?
Answer: No update currently from Government on this being update, please continue to use current guidance.
Q3: With regard to named visitors. Can they bring along someone from their household - such as husband and wife?
Answer: Each resident can have three named visitors for indoor contact visits, if they bring someone they need to be one of the named visitors.
Q4: What about Residents going out to Relative’s home during outbreak? In particular we have a few requests for Xmas day and are in lockdown until 27/12/21
Answer: Residents can go out of the home in an outbreak, as long as you have undertaken a risk assessment which includes the reviewing the residents vaccination status, history of contact with covid cases in the home (they will need to have a negative PCR and to be tested daily during their contact period) and also having a LFT done on the day of the visit out. If the resident has had 2 doses then the person will not need to self isolate as long as they can follow the enhanced testing. Residents who have not received at least 2 doses of the vaccine, and are not exempt from vaccination, should isolate for 14 days following a visit out They also need to make sure that the family members taking the person out of the home, is aware of the outbreak and the potential risks associated with this
Q5: What happens if a resident changes their mind and wants to change the 3 visitors they have told us about?
Answer: This will need to be considered in the risk assessment by the home and be clear in the visitor policy
Q6: What is the guidance for residents testing after an outing?
Answer: If the resident has had 2 doses then the person will not need to self isolate as long as they can follow the enhanced testing. Residents who have not received at least 2 doses of the vaccine, and are not exempt from vaccination, should isolate for 14 days following a visit out
Q7: What is the advice for service users for overnight stays over Christmas for supported living services
Answer: People living in supported living should be supported to leave the supported living site. We would advise that on their return, they complete LFD’s for 10 days if possible
Q8: When the guidance says residents should be tested on 'visits out of the home' does that include even if they go to the shop? i think the guidance misses our type of services and it is more aimed at elderly services where the service users don’t get out as much. This makes it quite unclear to me
Answer: Awaiting Answer
Q9: If a service user spends days out with family, we do an LFD test on return. Do we need to do more, if they were identified as close contact how do we test them?
Answer: This is based on a risk assessed approach but we would recommend they do complete a LFD on return. If they are a contact and they are fully vaccinated, then they need to have a PCR and isolate until this has returned negative. They also need to LFD’s during their contact period
Outbreaks
Q1: Will 1 positive person in the care home be classed as an outbreak based on the infection rate.
Answer: No, an outbreak is defined as 2 or more positive or symptomatic staff or residents linked cases. However, please still report a single case to HPT (telephone 0300 303 8537) so support and advice can be provided.
Q2: What about service who resident find it difficult to isolate during outbreak and their bedroom is not ensuite due to their mental state?
Answer: You will need to do a risk assessment which is documented and shared with staff. Options to implement are having a commode in the resident’s room (as long as there is also a hand wash basin available) or identifying a toilet/shower for their use only and ensuring it is cleaned after each use and ventilated. You can let your monitoring officer know if you are having difficulties or challenges as support and advice can be provided from specialists. Strategies could include planning 1 to 1 activities in the person’s room or if safe to do so identifying a space for their use only and if the resident can tolerate wearing a facemask. All plans will need to be risk assessed and mitigations put in place so that risk of transmission to anyone else is reduced.
Contact Tracing and IPC
Q1: Whilst strictly adhering to IPC as a toolkit, is it considered safe to continue with day clubs for the elderly and vulnerable, with Risk assessments in place or should we suspend these for now?
Answer: If IPC practices including social distancing and good ventilation included in the risk assessments, there is no requirement to suspend the services. If you identify confirmed Covid 19 cases in either staff or people you support then you should let the commissioners know as you may have an outbreak.
Q2: Do you class close contact as staff to staff (wearing PPE) or person we support (LD not care home) to staff (wearing PPE) and person we suppoprt to staff (wearing PPE) . i would class close contact as someone you live with not the above
Answer: Staff who correctly wear a facemask (TIIR) covering their nose and mouth and additional PPE (gloves/aprons/eye protection), correctly cleaning hands when supporting people are not close contacts. You can have close contacts between staff such as car sharing or sharing accommodation or going out socially. Therefore, contact tracing of both staff and residents is important.
Q3: Is vaccine tracing open to staff as well as people we support?
Answer: I assume you mean contact tracing? The manager of the service should undertake contact tracing of staff as well as those you support, checking if PPE was worn correctly and IPC practices followed. This should also include if any staff have travelled together or live/socialise together. This is because the manager will need to check any staff who are close contacts (as per definitions) and if exempt from self-isolation have taken the correct tests (and they are negative), are fully vaccinated, don’t have symptoms before they return to work.
Q4: Is there still a 10 day isolation period for contacts of an individual who has been infected with Omicron?
Answer: On 15th December, Self-isolation requirements were removed for contacts of a case infected with the Omicron variant of SARS-CoV-2. Please ensure the requirements listed in the guidance are met if staff are to be exempt from self-isolation i.e., they are fully vaccinated, do not have symptoms, have had a negative PCR test before returning to work and undertake daily LFTs for 10 days after the last contact.COVID-19: management of staff and exposed patients or residents in health and social care settings - GOV.UK (www.gov.uk)
Q5: Is it still 48 hours that you go back for contact tracing?
Answer: Correct. People with Covid 19 are infectious 2 days before they show symptoms (or, if they did not have any symptoms, from 2 days before the date their positive test was taken) and up to 10 days after.