26 October 2017, Thursday

Our dining room is back to normal again; the lockdown is over.

We had been in lockdown for over a month due to a norovirus epidemic in the nursing home.  Lockdown means locking the home up against cross infection: forbidding visitors in, movement of residents around the home and strict (supposedly) quarantine of sick residents.  This was in line with the federal government guidelines on gastro outbreaks.

In practice, it was a little different.  Yes there was quarantine - against the rest of the world, but not against the infection inside the home.  On being identified as sick, a resident was confined to their room up to three days after the last symptoms appeared.  Some residents suffered relapses.  Other residents could not be confined to their rooms because they were confused.  There was some cross infection because of that.  But the main source of infection, I believe, was from the carers themselves.  Quite a few of the residents are bedbound, and do not leave their rooms, nor do they have visits from other residents.  This theoretically means they are safe from infection however it made no difference; all of the bedbound residents became sick. The only way they could catch the norovirus was from the carers, apart from the occasional wandering of a confused resident.  This happened in the lower corridors, but not on the first floor.  It became obvious that the carers were a source of infection and some steps were taken to halt this source of infection but it was not very effective: the carers were not trained in infection control procedures.  

Apart from the attempt at quarantine to prevent cross infection, visitors were forbidden and at times, there was an attempt to prevent residents from leaving the building.  That didn’t work - for a start the smarter residents just got up and went.  I couldn’t find any mention of restriction of uninfected residents in the government guidelines and I believe there is no legal ability to detain a resident without arresting them.  I am not sure how that would go down at my home but it was not tested - on being told I should not go out (after going out several days in a row) I merely said that I had tested negative for the virus.  The nurse laughed, commented that I must be a lawyer, and let me go.  I had been ready to argue the point but it was not necessary.  

Lockdown was taken seriously internally.  All the fire doors were closed and to get to my dining room I had to go through all the fire doors - 9 sets of them, in a wheelchair.  This was supposed to prevent residents, confused in particular, from moving about and cross infecting others.  It didn’t work.  Residents who had rooms in the far end of the home and usually ate in the main dining room in the other end were ‘trapped’, and were accommodated in our small dining room.  This was only possible because some of the residents who usually ate in our small dining room were sick or kept to their rooms for the duration of the infection.  

There was a feeling of siege about the place - the closed fire doors, the tables in the corridors piled high with nursing equipment, the need to wear a mask on moving about the home, the number of doors with an infection sign on them, the strange residents in our dining room and familiar residents missing.  

The lack of visitors was distressing to some.  D was beautific in his happiness yesterday when he received a visit from his wife.  He thought his wife had left him and he had become very depressed and aggressive.  He did not understand what was happening.  I know others felt unhappy about it as well.  

I was lucky, I went out as usual. I did get sick, for about 18 hours, so I spent three days in my room.  I tested negative to the norovirus and I am not sure I had a gastro bug at all.  I had been having loose motions for a week or so prior to the bad night, and this continued for several days after the episode.  I think I had an attack of lupus - it does occasionally manifest as a bowel disturbance.  I had nausea, and a small amount of vomiting.  This was stopped by an injection and following that I had a bad night with very bad pain in the whole body.  No cramping in the bowel or any other symptom of gastro bug, so I can only assume some other cause.  Or perhaps my ileostomy protected me?