My experiences of nursing home outbreaks-why do they get so bad?

Firstly increases in community transmission lead to staff or visitors getting infected. Who then bring it to work.

Covid-19 is super infectious so it will test the limit of every bit of your practices around infection prevention and control.

Staff continue to get sick and are excluded from work.

Residents get sick too and their care needs rise quickly.
At a time when staffing is tight, and probably not enough to cover the residents.
It's really hard to find staff to work in nursing homes currently.

When there is a shortage of staffing then infection prevention and control practices like PPE etc get harder to implement consistently enough.
Things spiral quickly and basic care of the residents is under threat.

This is why letting Covid go through the community and "shielding the vulnerable" doesn't work either.
Because those nursing home staff who live in the community will be infected. No one left to provide care for our precious elderly.