Having experienced both the highest death toll and the worst economic hit in Europe, a public inquiry into the U.K. government’s handling of the pandemic is inevitable. The calling of an inquiry by a minister is, at the very least, a tacit admission of responsibility for a disastrous event that happened ‘on your watch’. As such, the government’s strategy will be to apportion blame on itself for the more forgivable errors they made and deflect blame from the less forgivable ones.
It was very telling therefore, of the government’s wider strategy of blame avoidance, when last week Boris Johnson stated that ‘too many care homes didn’t really follow the procedures’. The government, by now, will have realised that their policy towards care homes was not only avoidable but also possibly the worst mistake they made during the pandemic. This would explain their need to divert blame onto care homes themselves. This would also explain why when care home workers were rightly outraged by these remarks, No.10 refused to apologise. In fact, their response was either to say that these comments had been misinterpreted or, as Matt Hancock did, to spin them so vaguely that they lost their original meaning entirely: ‘asymptomatic transmission was not known about, the correct procedures were therefore not known’.
To be clear, this is another way of saying: ‘this problem may not have been your fault but it certainly wasn’t ours’. This only goes pre-emptively to sow more doubt as to where the culpability lies surrounding the disaster in care homes. This cannot be allowed to happen.
Between March 17th and April 16th, the government’s policy was to discharge elderly hospital patients without Covid-19 tests back into care homes to free up hospital space – often against the will of the staff who worked in them. As a Covid Cardiologist in a top London hospital tragically put, ‘we discharged known, suspected, and unknown cases into care homes…[with] no PPE to prevent transmission’.
To understand the sheer lunacy of this policy, Sage already knew by early March that the virus was incredibly lethal to the average age of a care home resident but comparatively mild or asymptomatic in others. Claiming that ‘asymptomatic transmission was not known about’ is a lame excuse. Discharging untested patients into care homes always posed the serious risk of patients subsequently developing symptoms. This would allow for the spread of an incredibly contagious and deadly disease in an environment where infection controls were almost non-existent.
As the Nightingale Hospitals remained almost empty and the NHS never came close to exceeding their ICU capacity, the virus ravaged care homes. The U.K. has recorded an excess of 30 000 care home deaths, two-thirds of which are directly attributable to Covid – about half the overall U.K. Covid-19 death toll. Carl Heneghan and Tom Jefferson – from the Centre of Evidence-Based medicine – suggest that the third of deaths not directly attributed to Covid-19 may have other horrific causes. Years of underfunding combined with staff absences from infections may have led to thousands of patients not receiving the adequate care they needed. For instance, it is common to lose your sense of thirst in old age. It was found in the southern Île-de-France region that residents were dying of fluid loss and starvation. Thus, it is not a stretch to suggest that such findings may explain some of the excess care home deaths in the U.K.
Furthermore, there seems to be a very strong correlation between areas that suffered from extremely high death rates and those where care homes were affected particularly badly by Covid. Despite New York’s especially tight lockdown, 4 500 virus patients were sent into nursing homes leading it to have one of the highest death rates in the world. Similarly, in Europe, two-thirds of Spain’s deaths and half of Sweden’s occurred in care homes whilst Italy saw a spike of 19 000 excess deaths. Conversely, countries such as South Korea and Hong Kong who had already experienced SARS, reacted not with nationwide lockdowns, but with targeted approaches such as limiting visits to care homes early, ensuring they had 3 months adequate PPE supply and effectively isolating infected residents.
It is important therefore that leading up to the inquiry politicians, the media and especially the public do not allow the government to play the game of blame avoidance. Firstly, because failing to be held to account for its most catastrophic policies during the pandemic may mean they will be doomed to repeat them if a second wave were to hit. Secondly, on a principled level, it has always been wrong to try and hold people responsible for events over which they have no control.
Image Credit: Graham Higgins (via Flickr)