UK COVID-19 Daily: Hospital Deaths Pass 20,000

Tim Locke

April 25, 2020

These are the UK coronavirus stories you need to know about today.

Hospital Deaths Pass 20,000

On March 17th we reported on Government Chief Scientific Adviser Sir Patrick Vallance telling the Commons Health Committee that deaths of 20,000 or fewer people linked to coronavirus would be a "good outcome". 

Prof Stephen Powis, national medical director of NHS England made similar comments on March 28th: "If we can keep deaths below 20,000 we will have done very well in this epidemic."

That milestone for hospital COVID-19 deaths alone was passed today with a further 813 deaths reported. The total is now 20,319.

It was "another tragic and terrible milestone," Home Secretary Priti Patel told the Downing Street briefing.

Prof Powis said: "It's a very sad day for the nation,  20,000 deaths is clearly 20,000 deaths too many."

He continued: "When Sir Patrick Vallance and I made that comment a number of weeks ago, what we were emphasising was that this is a new virus, a global pandemic, a once in a century global health crisis. And this was going to be a huge challenge, not just for the UK but for every country. I think unfortunately we have seen that challenge, not just here, but around the globe." 

He added: "As I've said before, this is not a sprint this will be a marathon in dealing with this virus."

Prof Powis said that overall "there is a trend towards a decline in death" and new cases confirmed by testing are "reasonably stable".

Of those admitted to hospital, "now we are getting a sustained reduction in people who are being treated in our hospitals", and in critical care wards:  "We are beginning to see a decline, although that decline will lag the overall number of admissions and our hospitals." 

Of the 711 deaths reported in English hospitals patients were aged between 34 and 100. Of these 87, aged between 34 and 90, had no known underlying health condition.  

Among recently announced NHS worker deaths were twin sisters who had both worked as nurses and who died within 3 days of each other.

The deaths of 37-year-old children’s nurse Katy Davis and her sister Emma, a former surgery nurse, have been called "devastating and tragic" by  University Hospital Southampton. Both had an underlying health condition.

In Memoriam: Healthcare Workers Who Have Died of COVID-19.

SAGE Secrecy

Membership of the Government's Scientific Advisory Group for Emergencies (SAGE) has come under the spotlight after it emerged the Prime Minister's Chief Adviser Dominic Cummings sat in on some meetings. Traditionally the names of members have been kept secret. Labour is now calling for transparency.

Prof Powis has been a SAGE member since February. He was asked if Mr Cummings made any contribution to meetings. He didn’t answer that directly, but said: "My experience of SAGE has absolutely been about scientists and experts, and there are scientific experts at SAGE from a variety of disciplines: epidemiologists, behavioural scientists, public health officials, immunologists, from the wide range of expertise that you would need to manage this crisis."

He continued: "What I've witnessed and experienced is a scientific discussion between scientific advisers, robust discussion at times, as we consider the evidence, conclude what the evidence is telling us, sometimes point to where the evidence is missing and where we need to generate further evidence, and then, as is in the name of the group, then to provide advice to government and government officials in terms of the scientific basis of the choices that government quite rightly has to make as elected representatives." 

Experts have commented via the Science Media Centre. 

Professor Sir Robert Lechler, president of the Academy of Medical Sciences, said: "My bias is always towards transparency, particularly when people start to smell conspiracies. The risk, of course, is that experts will complain that the wrong people are there, that their favourite discipline is not represented etc, but I think that is the lesser of two evils.

"As for Cummings listening in, that makes perfect sense to me. It should help him to communicate the balance of arguments to the political decision makers. Clearly, he shouldn't participate in the scientific discussions, but I see merit in him being ‘in attendance’."

Dr Jennifer Cole, biological anthropologist, Royal Holloway, University of London, said: "When people call for greater transparency of the SAGE system, they need to consider the potential negatives that could bring, as well as the positives. SAGE is not – as it is being portrayed in some quarters – a clandestine secret society. It is a confidential process that enables scientists from different disciplines to speak frankly, often in the face of great uncertainty, to discuss how findings from one field intersect with those from another, and how to work through compromises that may arise, and how best to communicate this to politicians who have to decide on what that evidence means for the decision they have to make." 

Prof David Porteous, Centre for Genomic and Experimental Medicine, University of Edinburgh, said: "Dominic Cummings is an unelected and unaccountable member of the PM’s team. The Government is disingenuous to claim that neither Cummings nor Warner, the key architects of Vote Leave and Brexit, are not ‘on’ SAGE (ironically, we have to take this ‘on trust’ from No 10 as the official list of the UK Government’s SAGE members is not publicly available). If Cummings and/or Warner were ‘in’ the room (or Zoom) and they are asking questions, then they are influencing SAGE. Their reported attendance and involvement in SAGE meetings would appear to be more than just ‘observer’ status." 

Waive Health Costs for Overseas NHS Workers?

Home Secretary Priti Patel was asked if she'd reconsider doctors and nurses who come to the UK to work in the healthcare sector having to pay a health surcharge. "We have a range of measures that are like most things in government under review, and we're looking at everything, including visas, surcharge, and that is something that obviously I'm working with my colleague Matt Hancock, in the Department of Health and Social Care because that's a joint policy with Matt's team, and we're looking at everything now in terms of what we can do to absolutely continue to support, everyone on the front line in the NHS.

"We are speaking about the health care professionals, the medics, the doctors, the nurses, the allied health care professionals, who come have come to the UK and are making an immense contribution." 

COVID-19 Crime

Lynne Owens, director general of the National Crime Agency (NCA) said police were cracking down on coronavirus-related crime, including unlawfully selling fake treatment kits, or PPE. "For example, a man from West Sussex was recently arrested by City of London police and charged after being caught making and selling COVID-19 treatment kits to people in the UK, the US, and France.

"Online in the last month, the National Cybersecurity centre, together with ourselves and the City of London police have taken down more than 2000 scams relating to coronavirus, including fake online shops, malware distribution sites and phishing sites, seeking personal information such as passwords or credit card details." 

More News in Brief

  • Approval has been given for a randomised clinical trial within the NHS treating COVID-19 patients with convalescent plasma donated by patients who have recovered from the virus. Up to 5000 patients a week could be treated as plasma collections are scaled to deliver 10,000 units a week. England's Deputy Chief Medical Officer Professor Jonathan Van Tam said: "The UK is leading the world’s largest trials to find a treatment for COVID-19, with over 7000 people so far involved testing a range of medicines; we hope to add convalescent plasma to this list shortly. Convalescent plasma has been used as an effective treatment for emerging infections in the past, and this step forward underpins our science-backed approach to fighting this virus."

  • The NHS has begun a publicity campaign to remind people it is still open for non-COVID-19 urgent care and treatment. A&E attendance in England is around 50% lower than usual. The British Heart Foundation reported a 50% fall in people attending with heart attacks. Professor Carrie MacEwen, chair of The Academy of Medical Royal Colleges, said: "We are very concerned that patients may not be accessing the NHS for care because they either don’t want to be a burden or because they are fearful about catching the virus." NHS Providers said that in the past 24 hours an ambulance trust has reported it has had 300 patients with severe illnesses refusing to be taken to hospital because of fears over coronavirus.

  • The BMA and other groups have written to England's Health Secretary Matt Hancock asking for greater flexibility on prescription dispensing during the pandemic. "It is absolutely crucial," BMA GP Committee Chair Dr Richard Vautrey said, "that the Government grants greater flexibilities to improve safeguarding and limit contact for dispensers and patients by removing the need for prescription signatures and prescription charges. Just as NHS staff working on the frontline expect to be adequately protected during the COVID-19 pandemic, it is only right too that dispensers should be afforded the same protection as the patient-facing nature of their role places them at considerable risk. Simply put, this is about protecting and saving lives."

  • Dyson says the ventilator it developed to help with a shortage of devices is no longer needed. Founder James Dyson said in a statement: "Mercifully they are not required, but we don’t regret our contribution to the national effort for one moment."

  • More records have been broken by 99-year-old NHS fundraiser Captain Tom Moore. He's the oldest person to get a record (he sings alongside Michael Ball) to number one. "We are NO.1? Really?" he tweeted. He's also broken the record for the most money raised ever by charity walk - at  £28m and still rising. He's 100 next Thursday.

See more global coronavirus updates in Medscape’s Coronavirus Resource Centre.

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