God's Waiting Room

"Never has the term 'God's waiting room' been so poignant."​ 

One in ten residents of UK care-homes has died either directly or because of conditions created by the Covid-19 response. That's 16,000 people, mainly old folks. And that's a national disgrace. 

This unseen catastrophe is now emerging into the public domain. Instead of fixating on the antics of Dominic Cummings and his ill-advised road trip, would it not serve the public interest more if journalists had focused their attention on care-homes? Cummings consumed much of the media oxygen in recent weeks, while the old suffered. Was that the aim? Has Cummings proved a useful distraction that the journalists fell for? 

Back in March, estimates of the extra Covid-19 deaths likely to hit the UK ranged from 50,000 to 500,000 in a year. The herd immunity approach envisaged a death toll near the upper figure of 500,000 with 7.9 million people needing hospitalisation. Then Boris Johnson's government panicked. In a flash, the herd immunity policy is gone, and a lock-down came in. In preparation for an expected surge of Covid-19 admissions, the NHS emptied its wards of sick older people, sending them to care-homes.

At that time, even before the lock-down started, 801 care-homes already had Covid-19 cases. Then in the first two weeks of the lock-down, a further 1,800 care homes in England alone reported outbreaks. 

Without PPE for staff or residents, and many homes running with only 60% manning, a disaster was looming. Yet nothing was done. Even before the Covid-19 outbreak, we knew that a good many care-homes operated below par. Under-funded, under-staffed and inadequate to meet the needs of chronic patients, the risks were evident. 

It's now known that many residents died of dehydration. These vulnerable people, with memory loss, unsupervised and unvisited by relatives, forgot to drink. With existing medical conditions and isolated from families, they soon lapsed. Never has the term 'God's waiting room' been so poignant. 

By contrast, Hong Kong care-homes keep three months supply of PPE on site. Family visits continued, with masks worn and temperatures checked. You have to recognise that having family come in helps relieve the staff and ensures residents are not neglected. Hong Kong had no care-home Covid-19 outbreaks.

Meanwhile, the NHS beds were empty. The NHS Nightingale hospital, built at high speed and with much buzz, was soon mothballed. When the future inquiry sits to consider the UK government's response, the treatment of people in care-homes will make for uncomfortable deliberations. 

Likewise, the decision to go for a full lock-down needs re-examining. If, as Boris claims, the UK has been 'following the science every step of the way' - what was Hong Kong, South Korea and other places doing? What science did they have at hand? Many jurisdictions opted for either no lock-down or a partial lock-down, and they attained better outcomes. We must ask that question.

Estimates suggest the lock-down caused 150,000 deaths, including 60,000 missed cancer diagnoses because the NHS shut down everything to focus on Covid-19. When my Mum turned up at her local outpatients for an emergency test, she found the staff unoccupied and idling. The place was empty. 

With 298,315 Covid-19 cases as of 16th June and 41,821 deaths, the UK is sitting at the lower end of predicted fatalities. Thus the predicted half-million deaths now appears unlikely. However, had care-homes taken adequate precautions that figure would be substantially lower. 

Experts are now forecasting awful consequences across a range of ailments because tests, treatments and operations faced suspension. We know that pandemic planning is a numbers game — a cruel numbers game at that. Yet the people lost to the virus must be balanced against the impact of a cure across the wider population. 

Thus, while I'm critical of Boris and his team, I must reserve some sympathy because I wouldn't want to be in the decision-making chair. And for that reason, any inquiry must focus on learning lessons, instead of splattering everyone with blame. After all, the public can decide at the ballot box whether they wish to punish Boris.

On the bright side, the daily number of cases and deaths is easing, although the potential for a second wave is there. Some economies will recovery faster than others. Also, evolution is acting to make the virus less virulent. Viruses struggle to survive, like all living things, and if it kills the hosts, the chances of passing on the virus get reduced. That's why Ebola never manages to spread far.  It kills off people; thus, a simple containment strategy and isolation defeats it. 

Over time, Covid-19 strains that are less virulent will emerge as triumphant to loiter in the human population. On a more troubling note, you could argue that the lock-down prevents evolution from acting to our benefit. By confining people to locations that allow rapid transmission — such as care-homes — the virus can thrive and move on. That's something for the scientists to ponder once all the data is in. 

In the meantime, wash your hands, practice social distancing and wear a mask — yes, I was wrong about masks—Mea culpa.