As the Guardian reports concerns about a sharp rise in the number of deaths at home during the pandemic, a paramedic with the West Midlands Ambulance Service describes the changes he has seen on his shifts.
“Lots more people are dying at home and being discovered dead at home. Some of them are people who tested positive for Covid-19 and were sent home as there was no clinical benefit in helping them; they are more elderly people. People are being sent home, essentially, to die there.
“We are going to people in their late 60s and have been told before we get there that they have tested positive for Covid and have a DNR, do not resuscitate[order], that’s been put in place by a doctor, so they are not for resuscitation. We arrive and they have oxygen levels of 85% or below and they are not going to recover.
“There has been a significant increase in people dying at home. It’s rare now for me to do a shift and not to use a procedure called ROLE – which stands for recognition of life extinct – with someone, but it used to be maybe once a week.
“It’s happening a lot in care homes and that is heartbreaking. Big care homes will have 70 to 80 residents and carers will wander from one room to the next without changing personal protective equipment as they don’t have any. A colleague was saying to me last Friday that it’s very likely coronavirus will decimate entire care homes, and everyone in them is so vulnerable and the policy is so lax.
“A number of other patients are also dying at home from cardiac arrest. Now in our area the ROLE procedure has changed because of the volume of patients who are dying. We have always had ROLE but what is new is that, because of the volume of [such cases], they are changing the way we do it. You would normally need a GP to confirm that someone has died and why, but due to the sheer volume at the moment that is not practical.
“In the job last week we did three ROLEs in one nursing home in one night. That is almost unheard of.
“This is really significant. Are these deaths at home being recorded in the daily statistics of deaths? No, they’re not at the moment. Is that a way of the numbers [of overall Covid-related deaths] being fudged?
“I don’t know what the policy is elsewhere, but here in the West Midlands ambulance personnel have been told to continue trying to resuscitate people who do not have a DNR in place, including those who have suffered a cardiac arrest, even though hospital doctors in the region have been told not to undertake an active attempt to resuscitate someone. The resuscitate procedure is important because it puts clinicians at risk of catching the coronavirus.
“A nurse I know was left heartbroken by the new policy. She said that she saw a 25-year-old die and there was no attempt to resuscitate. You have got nurses breaking down in corridors saying they became a nurse to help, not watch people die.
“Before, when we brought patients in, they would be taken to resuscitate. But now a doctor jumps in the back of the ambulance and calls it. The doctor will say ‘stop all active attempts to resuscitate life’ and they are probably correct in doing that. But the difficult question is that it is putting stress on paramedics. Why are we being hung out to do all we can and then a doctor just jumps on and says ‘stop’?”
