The Care Home Tragedy
It is always easier to criticise with hindsight but we are nowhere near the end of the present Covid-19 pandemic to analyse properly with full facts and objectivity. But, even allowing that all governments were faced with novel and unprecedented and harsh decision to be made, the UK Government already earned opprobrium for making two flawed and reprehensible decisions, viz:
- neglecting care homes and;
- lying about it.
Whether the mantra that drove their strategy—”stay home/protect the NHS/save lives”—was correct is not the issue. There are around418,000 people in care homes, almost all elderly, many with a wide variety of ailments and all to be considered ‘vulnerable/ Once it became clear in early February that the virus would strike Britain, the support for and advice to vulnerable people outside the NHS was, at best, misguided and made worse both by their policies mandated to the general public and the manner in which they published statistics on the pandemic..
Until March 13th, government advice to care homes was clear and comforting:
- there is no need for care homes to change procedures
- care homes residents were isolated from the general population
- residents in care homes were therefore not under threat
Such glib presumptions were not withdrawn until April 5th after outbreaks in care homes were logged, many staff were self-isolating at home and others declining to come to work because of fear of infection. It would seem that homes were infected by patients being forcibly discharged from hospitals by NHS administrators to clear beds. This was made such high prioroty that discharges were made without testing for virus infection. Even where tests were made, test results were often not known before the patient entered the care home.
Staff and visitors bringing in contagion from outside were a minor cause. Attempts by care homes to secure tests or protective equipment (PPE) were generally unsuccessful, made worse by suppliers responding that they were instructed to supply only to the NHS.
The first positive response to address this was elicited by a Sky News reporter rom Health Minister Matt Hancock at the daily press briefing when he assured the country that both testing and PPE would be made available to care homes as a priority. This was during the month-long effort to ramp testing up to 100,000 a day. As testing was available only at a limited number of sites, some of them drive-through, the many care home staff living far from the sites or without cars were not able to be tested. By May 5th, thrree weeks after the promise was made, many care homes were without PPE and had received only partial testing.
While tests were not happening care homes were not appearing in the daily avalanche of precise statistics and colourful charts that appeared at each daily government press briefing. It particular, the exact numbers of Covod-19 related deaths were only for deaths in hospitals. Only in late April did Office of National Statistics (ONS) data for other deaths, particularly in care homes, become available—and then only weekly. and delayed by two week.
Even then, it was a gross underestimate, placing the estimate at under 15%.of all related deaths. As a result, care homes continued to struggle for equal priority with the NHS for tests and PPE, suffering acute staff shortages and having to deal with the trauma of resident dying without any family in attendance, due to lockdown.
It was only when the new Labour leader Kier Stalmer started to ask pointed questions about the true figures that reality finally emerged.
ONS statistics for the month of April showed 18,000 more deaths than would normally be expected for that month and allocated 8,152 to the virus n care homes. Bad though this was, the other 10,000 remained unexplained, until it was realised that a further 2,500 were actually care home residents who had been hospitalised and died there. Revision of the numbers showed that some 40% of the 34,366 virus-related deaths were from care homes.
That’s about 13,700 people out of 418,000 care home residents, or a death rate per million of 33,000. Given that the current UK death rate (already one of the worst in the world) has just passed 500 per million, this factor of 66 for mortality among the vulnerable elderly in our care homes is both scandalous and reprehensible.
Some Must Get Their Jotters
The middle of the pandemic may be no time for the brutal recriminations necessary. But the glib assertions made at daily press that all is well needs to stop immediately and someone’s political career needs to end in contrition, apology and resignation,
Investigation of the degree to which clinical advice in hospitals was overridden by NJS administrators to ‘save the SNS’ by clearing beds under government instruction also needs to be made.