Coronavirus: Tier 4 brings no hugs in care homes as new COVID-19 mutation hits England

A mutant strain of coronavirus spreading across London and the South East which is more infectious than others, has prompted Prime Minister Boris Johnson to ban households from meeting indoors at Christmas and stop hugs and other physical contact at care homes in tier 4 areas.

The Prime Minister announced new stricter tier 4 restrictions for London, the South East and Essex from Sunday 20 December. New guidance issued on Saturday night (19 December) by the Department of Health and Social Care states that care home visits in tier 4 areas can only happen behind substantial screens, in visiting pods or through windows.

Only care homes in tiers 1, 2 and 3 can allow residents to have physical contact using lateral flow tests and PPE where the visitor has been tested and received a negative result. Using testing, two visitors are allowed twice a week for residents.

Health secretary Matt Hancock and care minister Helen Whately had previously promised earlier in December to make hand-holding and hugs possible between families in care homes in time for Christmas, with the roll out rapid lateral flow testing to visitors.

'Last minute changes' causes 'significant challenge' to care providers

Vic Rayner, executive director of the National Care Forum, which represents care providers, said: "Visits can and should continue in tier 4. However the change in government policy to refuse the use of on site testing in tier 4 will cause enormous distress to residents and loved ones.

"It will also be a huge blow to providers who have spent the last week preparing and training staff to use LFD's [Lateral Flow Device test kits] and communicating and planning with relatives to enable meaningful visits by Christmas.

"The last minute changes to Christmas plans will also cause a significant challenge to all care providers - residential and homecare.

"Staff rotas have been planned to ensure everyone got a chance to spend time with families over the five day Xmas period This will of course all have to change as everyone assimilates the impact of this snap change of direction.

"Care workers have always been the occupational group with the highest number of people working on Christmas Day. This means it is once again the lowest paid group of staff who are being asked to make some of the biggest sacrifices."

The new, more infectious strain of COVID-19 has exacerbated concerns over lateral flow tests and the safety of close-contact visits outside tier 4.

Rapid testing rolled out by the government in care homes cannot detect all positive cases, leading to care homes finding that a negative result can often be a false negative.

Research released by the government’s Scientific Advisory Group for Emergencies (Sage) has shown that the tests (produced by US company Innova) are capable of detecting only 48.9 per cent of active infections.

Over a million lateral flow tests have been sent to England’s 385 biggest care homes.

Evidence about the new mutant strain led to Boris Johnson's announcement at the weekend canceling Christmas for almost 18 million people in London, south-eastern and eastern England as the region went into tier 4.

Announcing the tier 4 restrictions last Saturday, the Prime Minister said: “There is no evidence the variant causes more severe illness or higher mortality, but it does appear to be passed on significantly more easily”.

Boris Johnson said the variant strain may be up to 70 more transmissible and was first detected in September.

All care homes, regardless of tier (and except in the event of an active outbreak) can have outdoor visiting and screened visits. Visits in exceptional circumstances including end of life ‘should always be enabled, in all tiers’, the guidance states.

Government guidance also states indoor visiting without testing may only go ahead in tier 1 areas where visitor testing is not yet available in the particular care home and this must be limited to two people (one preferably), ‘with social distancing, no physical contact, PPE use and good hand hygiene observed at all times’.

Mutant strain detected 'in every region'

Scientists on the government’s New and Emerging Respiratory Virus Threats Advisory Group (Nervtag) have said the VUI 202012/01 mutant strain, which was identified by Public Health England laboratories at Porton Down, is spreading more quickly.

Speaking about the new strain, Dr Susan Hopkins, of Public Health England, said many regions had cases of the new strain, they were in smaller numbers than in London, Kent and parts of Essex.

Dr Hopkins told Sky’s Sophy Ridge On Sunday: “It has been detected in many other parts of the country.

“Every region has cases but with very small numbers. It has also been detected in Wales, in Scotland, we have not had any detected in Northern Ireland."