UK COVID-19 Daily: Was Science Advice Wrong on Care Homes?

Tim Locke

May 19, 2020

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

Was Science Advice Wrong on Care Homes?

Work and Pensions Secretary Therese Coffey has said some of the scientific advice ministers received over care homes was "wrong".

"You can only make judgements and decisions based on the information and advice that you have at the time," she told Sky News, adding: "If the science was wrong, the advice at the time was wrong, I'm not surprised if people then think we made a wrong decision."

Yesterday, physicist Professor Brian Cox criticised ministers for being too quick to say they were 'following the science'.

"I've seen it in several interviews with several different politicians, when asked a difficult question," said Prof Cox. "It's very easy to say, 'well, we were following the science'.

"That's not an appropriate defence."

Today the Office for National Statistics released its weekly update on COVID-19 mortality data for England and Wales. These included:

  • 37,375 deaths involving COVID-19 were registered in England and Wales between 28th December 2019 and 8th May 2020

  • The number of deaths involving COVID-19 in care homes registered by 8th May was 9495 in England and 480 in Wales

  • Care home deaths involving COVID-19 in week 19 as a percentage of all deaths in care homes continued to rise, to 39.2% compared with 37.8% in week 18

  • Hospital deaths in week 19 were 114 lower than the 5-year average for the same week

  • Death registrations were lower due to the VE Day bank holiday

Dr Jennifer Dixon, Chief Executive at the Health Foundation, commented in a statement: "Today’s figures show that the number of COVID-19 related deaths in care homes in England and Wales are now falling. However, the number of weekly deaths in care homes from any cause remain significantly above the 5-year average, with 2247 excess deaths in the week ending 8th May.

"The government 'action plan' for social care was published nearly a month after the lockdown was introduced on 23rd March. The mortality data suggest that the action has come too late to stem the avoidable loss of life for care home residents, and social care staff - mostly women - who are about twice as likely to die from COVID-19 as other adults. The Government’s approach to social care stands in contrast to the NHS which saw a much fuller and swifter response to the pandemic."

The Guardian said a leaked Public Health England report found coronavirus was passed between care homes by temporary care workers.

The paper said the report was based on data from the Easter weekend and warned: "Infection is spreading from care home to care home, linked to changed patterns of staffing, working across and moving between homes."

It added that workers were often asymptomatic so "by the time local health protection teams are informed of an outbreak substantial transmission may already have occurred".

At the Downing Street briefing Environment Secretary George Eustace defended the handling of care homes: "We don't accept the, the caricature that that we took an approach that was wrong. Very early on in this epidemic we had protocols in place for care homes. There was guidance as to how they should approach things. As the situation developed, then more stringent policies were introduced by way of policy around discharge.

"We got to the point that everybody was tested before discharge. But in those early weeks, there will have been some instances where people may have been discharged who were asymptomatic. And there may have been some small number of instances where they may have been showing symptoms but would have been isolated, and that was the guidance at the time that was in place."

England's Health Secretary Matt Hancock told the Commons today: "This morning's statistics confirm that 27% of coronavirus deaths in England have taken place in care homes, which compares to a European average of around half. But whatever the figures say, we will not rest from doing whatever is humanly possible to protect our care homes from this appalling virus to make sure residents and care colleagues have the safety and security they deserve."

Back to School in England?

Teaching unions have continued their opposition to a partial reopening of schools in England next month, including issuing a checklist saying marking books would not be safe.

At the Downing Street briefing Professor Dame Angela McLean, Deputy Chief Scientific Adviser, was asked if the delayed track and trace programme needed to be in place first. "Scientists have been very clear in our advice that changes to lockdown as we model them need a highly effective track, trace, and isolate system to be in place," she said. 

Environment Secretary George Eustice was asked if the plan for schools was political not scientific. "I don't accept that it's putting the science to one side, but it is absolutely the case that all of us are going to have to live alongside this virus for some time to come. And we do need to try to live our lives and identify ways of returning to work as far as possible, and to put in place those social distancing measures, and that's what's happening," he said.

Daily Deaths and Data

Another 545 UK COVID-19 deaths were announced today taking the total to 35,341. 

Of the 174 deaths in English hospitals, patients were aged between seven and 102. Six of them aged between 45 and 90 had no known underlying health condition.  

There were 89,784 tests yesterday. This figure includes home tests that have been sent out but not yet processed.

Another 2412 positive cases were reported, and 10,025 people are currently in the hospital with coronavirus down 17% from this time last week. 

There were 639 COVID-19 hospital admissions in England yesterday, and 15% of UK critical care beds are being used by COVID-19 patients.

More News in Brief

  • A Medscape UK reader poll has highlighted issues doctors have been experiencing in getting the right PPE for COVID-19 patient care. Sixty-four percent of respondents had been involved in frontline COVID-19 care and 31% experienced COVID-19 patient contact without adequate PPE.

  • Adults with chronic conditions, such as obesity, hypertension and lung disease, disproportionately reduced physical activity levels during the first weeks of the lockdown, according to a UK preprint study on medRxiv . Senior author Dr Chrissy Roberts, Associate Professor at LSHTM, said: "We believe that the trade-off between being protected from COVID-19 and the health detriments of reduced physical activity could place already vulnerable populations in a potential 'no-win' situation."

  • Coronavirus infections may cause psychiatric problems in some patients, including delirium and PTSD in hospital and potentially after recovery, according to a review of evidence by UCL Institute of Mental Health and King’s College London published in the Lancet . Senior author, Professor Anthony David from UCL, said in a news release: "To avoid a large-scale mental health crisis, we hope that people who have been hospitalised with COVID-19 will be offered support, and monitored after they recover to ensure they do not develop mental illnesses, and are able to access treatment if needed."

  • Medical groups have criticised the Government's refusal to waive the immigration health surcharge for NHS and care staff. Doctors’ Association UK, the British Association of Physicians of Indian Origin, and the Association of Pakistani Physicians of Northern Europe, have written to Home Secretary Priti Patel to say: "At a time when we are mourning colleagues your steadfast refusal to reconsider the deeply unfair Immigration Health Surcharge is a gross insult to all who are serving this country at its time of greatest need." Dame Donna Kinnair, Chief Executive and General Secretary of the RCN, has also written to Ms Patel. She said: "We have already received devastating accounts from members who are struggling to pay the charge, and the impact that it is having on their families’ lives."

  • The English Premier League says six unnamed staff and players from three clubs have tested positive for COVID-19. They'll now self-isolate for 7 days. The League carried out 748 tests on Sunday and Monday ahead of socially-distanced training starting today.

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

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