Care Homes and Coronavirus

Care Homes and Coronavirus

The total number of elderly and vulnerable patients in UK Nursing and Care Homes is estimated around 13.5 of the population of 65.64 million.

                                                        

Coronavirus does not discriminate when it comes to choosing its victims. But Care Homes in UK and across Europe are battling to stop the spread among the elderly.

Why?

1.    The news is particularly worrying because medical advice suggests that people over 70 years and with certain existing health conditions are particularly vulnerable to developing serious COVID-19 symptoms.

2.    Deaths in UK Care Homes linked to Coronavirus has shot up by 2,375 to 4,333 in just one week – the week to April 24,2020.

3.    Many have complained that the most vulnerable people in society may have been abandoned and left to die, where everyone’s mind was on the care in NHS hospitals, up and down the country to contain the spread.

4.    The Personal Protective Equipment (PPE) needed for those working in Care Homes had been singled out as of the lowest priority. The Labour Party Opposition has claimed this is the primary cause of deaths in these homes.

5.    The Guardian newspaper report has claimed that Care Home deaths are counted separately and never make it to the daily Department of Health & Social Care statistics. One Care Home has told the paper that a third of its residents

had died of this pandemic.

Deaths reported as Coronavirus statistics

Deaths which happen outside of hospitals such as in Care Homes and at homes,have not been included the daily statistics given by the DHS.

                                                 

Asked of the Chief Medical Officer UK, Chris Whitty, if deaths were recorded properly in such settings, he said: “Everybody who sadly dies in Care Homes, the Doctor will make an assessment based on their view about what is the cause of death, that’s what

the death certificate says in all cases.”

Besides, deaths in Care Homes or at home can take longer to trace because of important steps such as post-mortems, funerals and paperwork to pass through Coroners’ offices. Thus, there is no way of knowing for certain the numbers in Care Home deaths, as there is only a weekly figure published by ONS (Office of National Statistics).

New data collated by Care England, the country’s largest representative body for Care Homes, suggests the number of deaths from COVID-19 is far higher that the figure published by ONS.

It is not only in Nursing & Care Homes, but also the poorer parts of England have seen 55.1 deaths per 100,000 population, compared with 25.3 deaths per 100,000 in the wealthiest parts of UK.

The data also showed more people died of the virus in London than in any other areas per 100,000 population. 
                                          

What exactly is the true picture of deaths due to Coronavirus?

With Parliament in lockdown until recently, the Labour Opposition has not been able to call the Government to account. There has also been a media clamour and public concern for the correct total of deaths due to COVID-19.

This week the Opposition Leader, Sir Keir Starmer has called for daily figures from the Government to be published of people dying in Care Homes, so that the true scale of the problem is public knowledge.

Government response  

In a bid to give hope to worried Brits, Prime Minister, Boris Johnson has this morning (1 May 2020) said: “I can confirm that we are past the peak of this disease, we are on the downward slope.” He also promised to set out a comprehensive plan next week to kickstart the economy, get schools open, and find a way to make workplaces safer, by perhaps, “Brits to wear face masks in public”. But he also inferred the lockdown could last for months until the minimum number of new cases falls below 1000 a day.

What is the R” rate?

While details of an exit strategy are to be reviewed as planned by 7 May,2020, the Government has said it needs to be satisfied of five (5) key Tests before considering it safe to moderate the current lockdown measures. One of them is the “R rate.”

The “R rate” refers in simple language to the " effective reproduction number" and is a way of measuring how a disease spreads  through a population. Mathematicians call this phenomenon exponential growth,and it explains why coronavirus infected so many people all over the world so quickly.

As this pandemic, according to science, has an estimated reproduction number, meaning an infected person will likely pass the virus to at least three (3) other people. A reproduction number that is higher than 1 poses a significant risk, making it harder to contain the spread and for NHS to cope with it. However, if this number is lower than 1, it is the science that the virus will eventually die out in time.

But the opposite is true,if R is below one,then an epidemic will eventually fizzle out altogether. If R was 0.7 then 100 infected people would go on to infect 70 people,who would go on to infect 49 people,then 34 and so on. That's why anything over 1 is bad news.

The “R rate” today according to ONS is between 0.5 and 1.Keeping the R number low will be critically important if the UK is going to prevent a second wave of coronavirus infections.

How do we measure it?

There are lots of different ways of calculating R. Scientists have been looking at the genome of the virus to see how it changes as it infects new people. They can also look to death and  hospitalisation figures to get a sense of how many people have contracted the disease.The problem is that most of these methods involve looking into the past to some degree. To get a more up-to-date sense of the coronavirus R number, the UK is starting to test samples of the population to see how many of them have the disease. this should help the Government track the changes in R over time and see if the infection rate is rising or falling. Also critical is that the UK does not exceed its critical care bed capacity,and that the NHS has enough space capacity to resume normal treatments.

What are the five tests before lockdown is slowly released?

1.    Protect NHS ability to cope and provide sufficient critical care across UK.

2.    A sustained and consistent fall in the daily death rate.

3.    “R rate” -the infection rate is in decline.

4.    Confidence that Test capacity and PPE are in hand and to meet future demand.

5.    Confidence that any adjustments to the current measures would not risk a second peak.

All the above tests are a balancing act to provide and protect the public, the health of the people and the economic health of the nation, so that confidence is restored. But nothing is certain in love and war and now in Coronavirus.

Victor Cherubim