'Reckless beyond belief.' We all knew it was an outrage at the time - in April 2020
As so much time has passed since all this craziness started some things are coming home to roost. I think there are only two or three things that really got me angry during this pandemic. Those of you that have read all of the diary will recall the scandal and I called it a scandal at the time, back in April 2020, involving releasing elderly patients back to care homes without being tested for COVID.
Of course they then returned to their respective care homes and half the patients there started dying. It was the panic to free up beds that was behind this, in my view.
I say, ‘my view,’ we learned on 27th April 2022 that it is also the High Court’s view. Indeed it is their view that it was not only ethically poor practice but actually illegal.
The case was brought by Dr Cathy Gardner and Fay Harris whose father’s Michael Gibson and Donald Harris died after testing positive for coronavirus while in a care home after patients had been released back to the establishment. Their legal team said that over 20,000 elderly or disabled care home residents had died from COVID just between March and June 2020.
Jason Coppel QC said,
‘The care home population was known to be uniquely vulnerable to being killed or seriously harmed by COVID-19. The government’s failure to protect it, and positive steps taken by the government which introduced COVID-19 into care homes, represent one of the most egregious and devastating policy failures in the modern era.’
Lord Justice Bean and Mr Justice Garnham found the decisions of the then health secretary (Matt Hancock) to make and maintain a series of policies contained in documents issued on 17 and 19 March and 2 April 2020 were unlawful because those drafting it failed to take into account the risk t elderly and vulnerable residents from non-symptomatic transmission highlighted by Professor Sir Patrick Valance in a radio interview as early as 13th March 2020.
The Prime Minister yesterday suggested that asymptomatic transmission was unclear at the time. The court clearly felt otherwise.
I remember being so angry about this process at the time. On 13th April 2020 I wrote in this very diary –
‘Other reports suggest that patients are being discharged from hospital to care homes but are not re-tested to see if they are clear or still shedding the coronavirus. Authors note. This is surely a catastrophic mistake – a scandal!’
(P127 of PART 1 of the diary).
I then continue with author’s commentary for two pages on why this is a terrible decision. You can see how angry I was.
‘It is madness, an outrage, and reckless beyond belief. Our senior citizens deserve much better protection than this. It is the single most aggravating action the government and hospitals have been party to, in my view. We saw today that there were thirteen deaths in one single care home and nine in another.’
If I could see the madness of such a policy at the time, why couldn’t the government?
Below is the entry for the 13th April 2020 in PART 1 of the diaries - I start my rant on the section headed 'The plight of care homes through to 'family life'.'
MONDAY 13TH APRIL 2020. EASTER MONDAY
Facts and figures.
717 deaths in the UK in 24 hours.
9 in Scotland.
15 in Wales.
6 in N.Ireland.
667 in England.
Total deaths in the UK is now 11,321.
290,720 people have been tested so far.
88,621 tested positive in total.
New cases: 3,543 + 799 (NHS staff). Total new cases: 4,342 today.
Author’s note. The data relating to those in hospital beds is flattening and should decrease in the coming days.
Spain has begun to loosen its lockdown measures. They had 517 deaths in their 24-hour period, and 619 on Sunday. Their total death rate so far is 17,489. Non-essential factories have opened up. It is interesting to see police at transport hubs handing out face masks to members of the public.
President Macron in France has extended his country’s lockdown until 11th May. He has stated that by then France would be able to test every citizen. This claim may be misplaced confidence; tests at the moment are unreliable and inaccurate. I hope he is right. He has said that restaurants and festivals will remain closed until at least July and beyond.
Our lockdown period is being reviewed, and by law, it must be decided by this coming Thursday. I feel that our death rate will increase over the next couple of days ahead of this. We will see. It is expected that the lockdown will be extended by at least another three weeks. It is much too early to release it in my view.
The lockdown releases are a challenging time. Will there be a second wave? A few days after China released its lockdown slightly, they had 118 new cases.
In South Korea, it was reported on Friday that 91 recovered coronavirus patients in the city of Daegu, the worst-hit area, have tested positive for the disease yet again. This is worrying as there was the hope, nay expectation, that having COVID-19 would give the recipient immunity from the coronavirus.
It is possible that the virus may have remained active in the person for a more extended period after the illness than first thought. There are various potential scenarios, including that the virus had been ‘re-activated’ rather than the host being re-infected. Hopefully, there is an innocent explanation to it all. It does illustrate the lack of knowledge we have of this killer virus.
As for the UK, I hope that the lockdown will be extended, and we will, at least, have the advantage then of monitoring how the lockdown releases are working in the different countries, and observe the different strategies used and the impact.
Two hundred members of the armed forces are being used to assist ambulance personnel around seven NHS Trusts, and they will drive ambulances and work at call centres.
NARPO (National Association Retired Police Officers) have moved from informing members of funeral dates of officers who have passed away, to having an online condolence book for them to sign, as funerals are now limited to a handful of close relatives. It is a nice touch and may offer comfort for the family when they read reminiscences and stories from former serving colleagues.
Tomorrow the World Health Organisation is giving guidance for countries considering releasing their lockdowns. There are six qualifying points:
1) The transition is controlled.
2) Healthcare systems can test, trace, and control.
3) The outbreak is controlled in places like hospitals and care homes.
4) Preventative measures are in place for essential places like schools.
5) Importation risks are managed.
6) Communities are educated, engaged, and empowered to adapt to the new norm.
Author’s note. I spoke yesterday about the trauma of people dying alone in the hospital because of the risk of spreading the disease. There is a potential glimmer of hope. When I have looked into this, there is a chance for some families. However, in the heat of battle, it may not be practicable, but that is a separate point to the legitimacy of having a visitor to see a dying patient.
NHS England advises that hospital visiting is ‘suspended with immediate effect and until further notice.’ However, it does list some exceptions to this rule. In certain circumstances, one visitor, who must be an immediate family member or carer, is allowed to visit a hospital patient. The exceptions allowing such a visitor are as follows:
1) If the patient is receiving end-of-life care.
2) If the visitor is the birthing partner of a woman in labour.
3) If the visitor is a parent or ‘appropriate adult’ visiting a child patient.
4) If the visitor is supporting someone with a mental health condition such as dementia, a learning disability or autism, or where not being present would cause excessive distress.
The guidance applies to all in-patient, diagnostic, and out-patient areas.
5 pm Press Briefing. Dominic Raab. Secretary of State for the Foreign and Commonwealth Office.
Deaths continue to increase in line with Italy’s rate. (Italy is two to three weeks ahead of us in their outbreak).
The masks' policy remains the same in that it is felt it protects others rather than stopping the wearer from getting the disease.
Author’s note. So, why not endorse it?
As previously mentioned, one of the key indicators, among others, in assessing the suppression of the virus is the ‘r’ factor. In the scientific modelling of data, the ‘r’ factor is the number calculated for how many people with COVID-19 infect others. If that figure is less than 1 (person), it indicates that the virus is on the decline. No lockdown release can be sustained if that figure rises above 1 because that means that the virus will grow exponentially.
The plight of care homes.
The plight of Care Homes is rising very much to the surface at this juncture. Many Care Homes report that they feel that they have been left out of the protective measures afforded to front line workers in the NHS. Other reports suggest that patients are being discharged from hospital to care homes but are not re-tested to see if they are clear or still shedding the coronavirus.
Author’s note. This is surely a catastrophic mistake – a scandal!
Professor Chris Whitty states that 13.5% of care homes have been affected by cases of COVID-19. This equates to circa 2,200 establishments. Ninety-two care homes have reported cases in the last 24 hours. One care home – Stanley Park care home at County Durham has so far had thirteen COVID-19 deaths, and Wren Hall in my home county of Nottinghamshire has had nine deaths.
There needs to be some cut-off as to who qualifies for government support, and most of the care homes are privately run enterprises. Stepping back from that, however, the reality is that the residents are incredibly vulnerable, and once the virus gets its claws into a care home, it can spread wildly. It is the perfect environment for it to thrive and grow.
At the moment, there is limited or next to no PPE being supplied to Care Homes. There is no removal of VAT (Value Added Tax 22%) on the purchase of PPE as there is with the NHS. Some doctors won’t go into the care homes, and many staff are off sick, or too frightened to work.
The London School of Economics has done a study on care home deaths. In Spain, it was 57% of deaths, Ireland 54%, Belgium 42%, France 45%, and Italian extrapolation of data showed 53%.
This could make our figure circa 22,000, not 11,000 deaths. Numbers are flexible are they not?
Author’s note. I want to address the current furore that exists around care homes. It is on a couple of levels.
One is the lack of inclusion of deaths in care homes in the figures being released each day. Some other countries, such as France, include these deaths in their data, yet we do not.
The second point which may be ‘cause and effect’ is the apparent blind-spot of care homes in this country during the crisis so far. Care homes house the most vulnerable, elderly people in our society, yet the staff have been pretty much on the back burner for PPE, testing, and consideration.
Patients recovering from COVID-19 have been discharged from hospitals to care homes without knowing whether they are still shedding the virus. Nor if they have caught the illness in hospital (if there was another reason than Covid for admission to hospital).
They have received no testing prior to allocation or return to care homes.
It is madness, an outrage, and reckless beyond belief. Our senior citizens deserve much better protection than this. It is the single most aggravating action the government and hospitals have been party to, in my view. We saw today that there were thirteen deaths in one single care home and nine deaths in another.
I will report the different commentary and confusion around these deaths so that the reader can decide for themselves whether the government is being sneaky with the figures they are providing.
The current official death toll is 12,107. The ONS - Office of National Statistics state that leading up to 3rd April, an additional 1,492 people, did not die in hospital.
So the real total number would be 13,599 deaths. The ONS claim that half of that figure of 1,492 are deaths in care homes. Making circa 750 deaths. This should make the official government figure 750 higher at 12,857.
When the Chancellor and experts were challenged to include this number in official statistics, it was claimed that it is logistically challenging. Hospitals are fewer, and there are many thousands more care homes. Hospitals have an infrastructure conducive to reporting, and it is known in a hospital when they die of COVID-19, whereas out in the community, it is a doctors judgment on a death certificate.
It does beg a couple of questions: How do other countries manage it when we are seemingly incapable? Are death certifications worthless? If there is some doubt about GP’s writing death certificates accurately, why wasn't this doubt expressed before the pandemic? It seems to suffice for Coroners.
The Scottish Government has announced that a quarter of all deaths in the country are in care homes.
Some journalists have printed stories that they believe there have so far been 4,000 deaths in care homes, which, if added to our official figure, would make the death toll 16,000 rather than 12,000. If this increases exponentially, it can be seen why politicians might fight to keep the number to one side.
Further to this, the ONS ascertained that in the week 28th March to 3rd April 2020, there were 16,387 excess deaths. This excess death figure is actually circa 6,000 over what it usually is over the past 5 years.
Apparently, 3,475 of this additional 6,000 have been linked to COVID-19. What about the other 2,625 cases? Is it fair to attribute all, or the bulk of these deaths, to an ongoing global pandemic? Is it a coincidence?
As for the PPE question around protecting staff in care homes, the protests are growing. It also begs the question of whether the government should be using your tax pound to supply millions of items of equipment to private care homes when they charge thousands of pounds a month for residents to stay there? Do they not have a duty of care to their staff? What have the care home businesses done about it? What about the duty of care to the residents? Should the government belatedly address this problem? The answer is yes, along with a retrospective invoice to the millionaire owners.
‘Great British spirit.’
The letter that Prime Minister Boris Johnson sent to all households in the UK never arrived at our house, by the way. Looking online, I can see that the letter, somewhat predictably talks about the need to stay home to protect the NHS. There was an accompanying leaflet explaining where further assistance can be obtained. It talks about things getting worse before they get better. He thanks those working hard to get through the crisis and volunteers, and the ‘great British spirit’ will beat the virus.
Quote of the day:
‘From caring comes courage.’ – Lao Tzu.
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