A lack of protective equipment, inadequate testing, and discharging people from hospitals into care homes were the key mistakes made by the government in its approach to coronavirus in England, according to the first responses given to a major coronavirus inquiry seen exclusively by the Guardian.
Older people were “catastrophically let down” and many died before their time, according to a damning submission from the Age UK charity. It also described the initial policy of discharging the elderly from hospital into care settings without a Covid-19 test as a “terrible mistake”.
Public Health England issues guidance stating that it was “very unlikely” care homes would become infected. The guidance was not withdrawn until 12 March.
Despite a lack of official statistics about fatalities, care homes warn that they are at “breaking point” and MHA, the country’s biggest charitable provider, says it has suspected cases in more than half of its facilities.
The Department of Health and Social are guidelines on discharging hospital patients into care homes states: “Negative tests are not required prior to transfers/admissions into the care home.”
Chief medical adviser Chris Whitty says that more than one in ten care homes (13.5%) now has at least one case of Covid-19. Whitty says: “Care homes are one of the areas where there are large numbers of vulnerable people and that is an area of risk and therefore we would very much like to have much more extensive testing.”
Testing is expanded into care homes but only for people with symptoms.
Five of the largest care home providers say they have now recorded a total of at least 1,052 deaths
Care home deaths are included alongside deaths in hospitals after a sharp rise of more than 4,300 deaths over a fortnight in England and Wales. Testing is extended to staff and residents without symptoms.
Launch of a national delivery system for personal protective equipment to care homes is hit by a delay of up to three weeks
Academics report that more than 22,000 care home residents in England and Wales may have died as a direct or indirect result of Covid-19 – more than double the number stated in official figures.
An unpublished government study which used genome tracking to investigate outbreaks revealed that temporary care workers transmitted Covid-19 between care homes as cases surged. In evidence raising further questions about ministers’ claims to have “thrown a protective ring around care homes”, it emerged that agency workers – often employed on zero-hours contracts – unwittingly spread the infection as the pandemic grew, according to the study by Public Health England.
Care leaders, unions and MPs round on prime minister Boris Johnson after he accuses care homes of failing to follow proper procedures amid the coronavirus crisis, saying the prime minister appeared to be shifting the blame for the high death toll.
The British Medical Association (BMA) said the government’s testing and tracing capabilities at the start of the crisis fell “far short” of what was needed and left the infection to “spread unchecked”, while the Unite union doctors group said the government had been slow and had “squandered” weeks of valuable time.
Their perspectives on the government’s management of the crisis are among the first submissions to an inquiry run by the all-party parliamentary group on coronavirus, which has received 900 submissions from individuals, charities and public bodies in two weeks.
Public hearings will be held online every Wednesday with recommendations for the government due to be made by the end of summer, which MPs say is crucial in preparing officials for an expected second wave of the virus. Boris Johnson said this week he would look at the findings.
The groups to have given evidence include the Royal College of Obstetricians and Gynaecologists (RCOG), the Royal College of Physicians and the Royal College of Surgeons. The inquiry will also hear from bereaved families.
Layla Moran, the Liberal Democrat MP and chair of the cross-party inquiry, said: “This swift review will ensure that lessons are urgently learned ahead of a potential second spike.
“The stark warning that a second wave of coronavirus this winter could cause up to 120,000 deaths shows we have no time to waste.”
The BMA said it was giving its evidence to help the government prepare for a second wave and to improve care, which it felt could be managed through learning and planning.
However it was highly critical of the initial response, blaming the government for delays in reaching its 10,000 tests-a-day target. This level was achieved by the end of March.
“The initial government response in relation to the availability of testing and tracing fell far short of what was needed, which resulted in the infection spreading unchecked, as government did not initially have the capacity to test more widely, and its 10,000 tests-a -ay target was delayed.
“This situation continues, as ongoing delays to the NHS tracking app remain an area of serious concern, particularly as lockdown measures ease and we face the possibility of a second wave of the virus,” a BMA statement said.
The submission from Age UK said there was “no doubt” that a lack of access to PPE and inadequate testing regimes “played a role in the rapid spread of cases”.
It said discharging people into care homes without knowing if they had coronavirus was a “terrible mistake that was only rectified in mid-April”.
“Furthermore, while care homes were quick to reduce the number of visitors, many have been forced to rely on agency staff to sustain safe staffing levels. This certainly hasn’t helped, and, in some cases, it may well have facilitated the transmission of the virus between care settings,” Age UK’s statement said.
“The moral case, for government, on behalf of us all, to act to make good the deficits that have been laid bare, is even stronger than it was before.
“Older people in receipt of care, in care homes especially, have been catastrophically let down and many have died before their time as a result. The fact that similar tragedies have unfolded in other countries too is no consolation and no excuse.”
Evidence given by Doctors in Unite said: “Health and social care staff have embraced the challenges and worked flat out to care for the public. They have done this despite lack of adequate personal protective equipment [PPE], we will never know how many have lost their lives as a direct result of this.”
The Conservative MP and group vice-chair, Dan Poulter, said it was vital that lessons were learned before a difficult winter. Labour’s Clive Lewis, Plaid Cymru’s Liz Saville-Roberts and the Scottish National party’s Philippa Whitford are also on the committee, along with the Green party life peer Jenny Jones.
Other inquiries have taken place on specific elements of the coronavirus response since March. The House of Commons’ petitions committee launched its investigation into the government’s response to the coronavirus, which has so far reported back on its impact on parental leave and students. The health and social care committee also began an inquiry in March looking at the management of the coronavirus outbreak.
