Over 400 daily care home deaths at peak of coronavirus outbreak, says analysis

At the height of the coronavirus outbreak, more than 400 deaths related to Covid-19 occurred in UK nursing homes every day, new analysis shows.

According to the first UK assessment of daily deaths by the PA news agency, there were more than 3,000 deaths in nursing homes related to coronavirus in a week in mid-April.

The number of deaths increased fivefold between the start of the month and the nursing home peak on April 17, when nearly 500 residents died.

At this time, testing for all staff and residents – regardless of symptoms – was not available in England, Scotland, Wales and Northern Ireland, while providers had not yet been advised to limit staff movement between houses.

Carl Heneghan, a professor of evidence-based medicine at the University of Oxford, believes that workforce movement was of “immense” importance in helping to spread infections in the absence of effective tests.

Thousands of hospital patients were discharged from care homes from mid-March and there was difficulty accessing personal protective equipment (PPE).

PA analyzed data from the UK statistical offices to reveal the daily death toll through the end of July.

It comes before Sunday – six months since the death of the first nursing home resident related to Covid-19 – and also found:

  • More than 400 deaths involving Covid-19 occurred in UK nursing homes on 11 days in April.
  • The number of deaths has more than quintupled in just over two weeks, from 93 on April 1 to 490 on April 17 – the highest daily total.
  • On April 26, when the UK’s first nation announced that caregivers should limit staff movement, the UK had seen 9,074 deaths in nursing homes – 51% of the total up to 31 July.
  • On April 28, when the UK’s first nation announced testing for all nursing home staff regardless of symptoms, there were 9,776 nursing home deaths in the UK – 55% of the total up to 31 July.

Chris Whitty, England’s Chief Medical Officer, said in July that “ major risks ” were not taken into account early on in social care settings, including staff working in multiple homes and those on no paid sick leave.

Asymptomatic testing was first announced in England on April 28, despite Public Health England (PHE) saying it was worrying from the end of March.

The first country to advise healthcare providers to limit staff movements between homes was Northern Ireland on April 26.

There was a gap of about two months between guidance from PHE advising care homes to share the workforce in mid-March, to new advice to limit the movement of staff announced on May 13, in addition to funding to prevent the spread of infections in care homes. in England.

Prof Heneghan said this was due to a lack of clinical experience in the government advisory team and a lack of leadership.

Recognizing that care homes were dealing with a large number of sick or self-isolating workers, he told PA: “The government should have advised that temporary workers, if used, should be employed in one care home and not travel between multiple care homes. advice should have been given in mid-March. “

This should have been accompanied by funding to increase the workforce, he added.

He believes this should be applied in winter, but has seen no sense of urgency in protecting care homes.

Professor Martin Green, Care England chief executive, said guidance has been “slow to come” and it is urgent to address it, especially with regard to visits.

He said, “Many care homes were closed before the national guidelines came into effect.

“Unfortunately, patients were discharged from the hospital without testing and this, compressed with insufficient personal protective equipment, posed enormous challenges for nursing homes.

“Routine testing is absolutely essential to gain confidence in the system for residents, staff, family members and beyond.”

The potential risks of personnel relocation were first discussed at a meeting of the Scientific Advisory Group on Emergencies (SAGE) on April 21.

Dr. Ian Hall co-authored the discussed article, which was not made public until June 19.

The University of Manchester academic said the PA’s concerns about the relocation of staff should have been made public as soon as possible and that, given capacity issues, he believes staff should have been given priority in testing the symptomatic residents.

But he said, “ What we didn’t know at the time in April and May was the complexity of the workforce situation, and so one of the concerns, I know, was’ when we get too hard on the potential for workforce Because it’s a means of transportation there can be a lot of staff absent and this can have consequences for the care needs of the otherwise healthy but vulnerable residents’.

“So it is a very delicate balancing act between trying to limit the introduction of infections and ensuring that care is still provided.”
MHA, a UK healthcare provider, said mistakes should not be repeated and called for more funding, regular testing and “no mistakes or delays”.

Chief executive Sam Monaghan said, “What this analysis does is confirm that during the peak of the virus, despite following all the best infection control measures, the industry was not supported with what turned out to be the additional critical tools we needed. to manage. the spread of the virus. “

Gavin Edwards, Unison’s senior national officer, said social care should be treated as an “essential public service” with pay and benefits priority to avoid a repeat of the first wave.

He said: “Social workers often receive a poverty wage, work with zero-hour contracts and are not paid when sick. In addition, many have faced a massive fall in income as they follow counseling and isolate themselves. This clearly helped boost infection rates in the industry. “

A spokesperson for the Department for Health and Social Care said: “We have made every effort to ensure that residents and staff of care homes are protected, including testing all residents and staff, who have provided 200 million pieces of PPE, for which £ 600 million has been earmarked for infections in nursing homes and a further £ 3.7 billion has been made available to municipalities to deal with the pressure from the pandemic – including in adult social care.

“As a result of the measures taken, nearly 60% of nursing homes in England have not had an outbreak at all and the rate of coronavirus deaths in nursing homes in England is lower than in many other European countries.”

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