Could exit plan start in ten days? Hopes rise for an end to the lockdown

Ministers could be given the green light to start planning an exit from the lockdown within ten days, the Chief Medical Officer suggested last night. 

Chris Whitty said Government experts hoped to have enough evidence about the transmission of the coronavirus by that point to ‘judge how we can go into the next phase’. 

The lockdown is set to be extended today for at least three weeks, despite fresh warnings about the long-term impact on the economy. 

Ministers could be given the green light to start planning an exit from the lockdown within ten days. Pictured: Queen’s inspirational message plays to the capital’s empty Piccadilly Circus

Ministers could be given the green light to start planning an exit from the lockdown within ten days. Pictured: Queen’s inspirational message plays to the capital’s empty Piccadilly Circus

Ministers could be given the green light to start planning an exit from the lockdown within ten days. Pictured: Queen’s inspirational message plays to the capital’s empty Piccadilly Circus

The Cabinet is expected to rubberstamp the extension in a conference call this morning ahead of a formal decision this afternoon by the Government’s emergency committee Cobra, which will be attended by Nicola Sturgeon and political leaders in Wales and Northern Ireland. 

Multiple Government sources said there would be ‘no surprises’, with restrictions rolled over for another three weeks and the next review unlikely before May 7.  

Health Secretary Matt Hancock said the continuing high death toll, which rose by 761 to 12,868 yesterday and is expected to spike again today, showed ‘why we cannot let up’. 

He added: ‘We will not lift these measures until it is safe to do so.’ 

But at the daily Downing Street press conference, Professor Whitty said the epidemic was ‘probably reaching the peak overall’.

He added: ‘The more understanding we have of where that is, which will happen over the next ten days, the more easy it is to judge how we can go into the next phase in a way that is properly evidence-based.’

It comes as a report compiled by Tory peer Lord Gadhia and GlaxoSmithKline chairman Sir Jonathan Symonds calls for the reopening of the High Street, as reported by The Sun.

The missive, seen by ministers, says that coffee shops, estate agents, and restaurants should be the first to reopen. 

The report adds that post-lockdown premises would have to continue to enforce social distancing measures and that the country must ‘learn to live with Covid.’ 

Last night ministers were under mounting pressure to at least explain how and when the lockdown restrictions will be eased. 

Labour leader Sir Keir Starmer called on ministers to publish an ‘exit strategy’ from the lockdown, which has been in place since March 23. 

There is also growing unease in Tory circles about the economic damage being caused. 

Former Chancellor Sajid Javid said it was vital to ‘phase out this lockdown as soon as we possibly can based on scientific advice’.  

A new report from the Resolution Foundation think-tank suggests that the economy could return to near-normal levels relatively quickly if the lockdown lasts three months, with GDP perhaps just 3 per cent lower in the medium-term. 

But a six-month lockdown could result in unemployment hitting five million.  

Chris Whitty said Government experts hoped to have enough evidence about the transmission of the coronavirus by that point to 'judge how we can go into the next phase'. Pictured: No sign of sunbathers or families on Bournemouth beach

Chris Whitty said Government experts hoped to have enough evidence about the transmission of the coronavirus by that point to 'judge how we can go into the next phase'. Pictured: No sign of sunbathers or families on Bournemouth beach

Chris Whitty said Government experts hoped to have enough evidence about the transmission of the coronavirus by that point to ‘judge how we can go into the next phase’. Pictured: No sign of sunbathers or families on Bournemouth beach

Experts have compiled a list of 275 ideas to reduce the spread of coronavirus after the lockdown has been lifted.

The suggestions, made by Cambridge University, include banning cats from going outdoors and making people walk clockwise in outdoor spaces such as parks, as reported by The Telegraph.

Professor William Sutherland, at the University of Cambridge’s Zoology department said: ‘There’s increasing pressure to reopen the economy and get people back to work and out of isolation.

‘But if we return to operating as we did before the pandemic, there will be a second wave of the virus.

‘All activities will need to be considered individually, and phased back in carefully.’

Other suggestions include patients with doctors waiting out in their car before being called in for surgery and cafe owners only opening the outdoor areas of their business first.

Another idea is for people to have permits to leave the house, such as in France where they implemented a 6pm curfew.

Pressure intensified last night after Angela Merkel released the first details of plans to allow Germany to emerge from lockdown. 

But former health secretary Lord Fowler, who led the Thatcher government’s response to the Aids crisis in the 1980s, cautioned against lifting the lockdown ‘prematurely’. 

The Tory peer, now Speaker of the Lords, told the BBC: ‘We will certainly get into the most enormous difficulty and trouble if we go too prematurely and then a few months later we go back into crisis again. That needs to be avoided.’

One care home. 18 residents. Six dead, 8 infected. Family’s verdict? It’s CRIMINAL… as 24 die in another tragic home

by Andrew Levy for the Daily Mail

A third of the residents at a virus-hit care home have died in just ten days.

In a stark example of the crisis in the sector, six passed away as staff struggled to contain an outbreak.

Last night the daughter of one of the dead said the state care homes had been left in was ‘wicked’. 

Rhona White, 64 – whose mother Peggy Grainger, 86, had a moving final letter from her family read to her because they were unable to visit – said: ‘The whole situation is just criminal. People are being allowed to die in these homes and nobody seems to really care about it.’

Ian Charles Leverington was the first resident to die  on April 3

Ian Charles Leverington was the first resident to die  on April 3

Gillian Howard, 77, who was  described by the care home as 'an extravagant person', died on April 8

Gillian Howard, 77, who was  described by the care home as 'an extravagant person', died on April 8

Ian Charles Leverington (left), 70, a retired engineer, was the first resident to die on April 3 while Gillian Howard (right), 77, who was described by the care home as ‘an extravagant person’ who ‘enjoyed telling stories of her past and her connections with the Royal Family, died on April 8

Some 85 per cent of carers at Philia Care Home in Peterborough have either fallen sick or had to self-isolate after coming into contact with carriers. 

The home had 18 residents at the start of the month. Six died in a ten-day period from April 3.

Eight of the remaining 12 are believed to have been infected, although three of these have recovered. Staff try to stay healthy, but many struggle to get hold of personal protective equipment (PPE). 

At one point, they even resorted to making home-made visors from plastic file wallets held over their faces with Alice bands.

Bosses yesterday warned inadequate financial support and the dramatic loss of residents was creating a funding crisis that could result in closure – and would be repeated in homes up and down the UK.

George Smith died last Friday at the age of 88

George Smith died last Friday at the age of 88

Peggy Grainger was described as a 'gentle loving person who always put her family first'

Peggy Grainger was described as a 'gentle loving person who always put her family first'

George Smith (left), 88, who was described as ‘a caring man who has spent his whole life caring for his own loved ones’ died last Friday while Peggy Grainger (right), who was described as a ‘gentle, loving person who always put her family first’ died on Monday

Managing director Carol Smit said: ‘We will not be able to sustain this indefinitely.’

Manager Heidi Seldon, who has moved into the home and sleeps in her office, said: ‘What I wasn’t prepared for was how hard it was going to be, emotionally, watching so many of my residents suffering from coronavirus.

‘We’re just trying to hold ourselves together and hope that there will be some light at the end of the tunnel.’

Deputy manager Zdenka Dunczikiva has returned to work after falling ill. The 29-year-old, who is staying at the home round-the-clock and has left her five-year-old son with her parents, said: ‘Sadly six people have passed away and it looks like more will go. The next few days are going to be really, really hard.’

The first resident to die, on April 3, was retired engineer Ian Leverington, 70. His only child, Haley Leverington, 38, said: ‘My dad would still be alive today if it wasn’t for the virus.

Laura Dunn-Green, a worker at the care home, read out a final family letter to Peggy Grainger before her death

Laura Dunn-Green, a worker at the care home, read out a final family letter to Peggy Grainger before her death

Laura Dunn-Green, a worker at the care home, read out a final family letter to Peggy Grainger before her death

‘It’s a hidden scandal because the death toll could be twice as bad if they took notice of the care homes.

‘But they’re only looking at NHS hospitals and the general public. Just because they’re elderly doesn’t mean they don’t have a right to be recognised.’

Other victims included Gillian Howard, 77, who died on April 8 and was described by the care home as ‘an extravagant person’ who ‘enjoyed telling stories of her past and her connections with the Royal Family’.

George Smith, who died last Friday aged 88, was ‘a caring man who has spent his whole life caring for his own loved ones’ while Mrs Grainger, who died on Monday, was described as a gentle, loving person who always put her family first’.

The home, which was rated good by the Care Quality Commission last year, is one of six operated by Trust Care Management Group. None of the others has so far been hit by Covid-19. 

Some 85 per cent of the carers at the virus-hit care home in Peterborough (pictured) have either fallen sick or are having to self-isolate after coming into contact with carriers

Some 85 per cent of the carers at the virus-hit care home in Peterborough (pictured) have either fallen sick or are having to self-isolate after coming into contact with carriers

Some 85 per cent of the carers at the virus-hit care home in Peterborough (pictured) have either fallen sick or are having to self-isolate after coming into contact with carriers

The local care commissioning group (CCG) recently increased its budget by just 4 per cent – less than the shortfall caused by rises in the national living wage, inflation and soaring PPE costs.

A quarter of its annual PPE budget has been spent in just three weeks on goggles, gowns, visors and gloves. Senior staff also claimed the CCG made a verbal agreement to block purchase all the beds for six months but withdrew it because of the virus outbreak.

Mrs Smit last night called on the Government to end the two-tier system under which the NHS pays no VAT on PPE but care homes pay full price. She said an ’emergency measure’ to remove VAT during the crisis should be introduced, adding: ‘At least that would give us some kind of funding relief.’

There are also concerns about who will administer end-of-life medication including pain relief.

GPs stopped visiting the home at the start of the pandemic and community nurses have warned that they may not be able to attend in future due to staffing problems.

Chris Graham, the group’s national operations manager, said: ‘They [staff] have been offered training by Zoom or Skype. 

But the home will need to be insured and indemnified. There has to be training and competency.’ 

Trust Care Management Group is owned by Mrs Smit and her business partner, and run by two families. 

It started with two care homes in 2010. Philia Lodge was the fourth. The home normally has a budget of £46 a week for PPE. In the last three weeks it has spent £1,236.

Public Health England delivered 300 face masks to every care facility at the beginning of the crisis, but ‘with no guidance’.

Mr Graham said: ‘We didn’t use it at the time because we didn’t have a positive case. But people [at other homes] were using them because they thought they had been delivered to use [as a preventive measure].’

Peterborough City Council also provided four days’ worth of gloves and aprons after it set up a Covid-19 response team. But there were no goggles or face masks as they were no longer in stock – they had already been sent to NHS hospitals.

Mrs Smit said: ‘The Government should have had a contingency plan.’ No sick residents were turned away from hospital – but the home was usually told to keep them in their care. Those who were ill were assessed by a GP [remotely], or by paramedics or call handlers on the 111 service.

Mr Graham said: ‘We were told they had to stay at the home because they were reaching the end of their life.’

…and 24 dead in another tragic home

Twenty-four residents have died at a care home in around three weeks.

A third of victims at Bradwell Hall Nursing Home had tested positive for Covid-19, with others dying after suffering ‘pneumonia-like symptoms’ having not been tested.

The first positive test at the home in Staffordshire came on March 23, the day Boris Johnson ordered Britain into lockdown.

Days later, it issued a public appeal for donations of face masks. The purpose-built facility is the largest care home in the county, with 163 single rooms and 12 shared rooms. Around 140 residents live there.

Fury over elderly who are doomed to die: Controversial guidance given to care homes says coronavirus sufferers should only be treated at hospital ‘if appropriate’…and ambulances may refuse to take them

by Sophie Borland, Health Editor of the Daily Mail

Fears have been raised that care home residents who are seriously ill with coronavirus are being kept away from hospital after national guidelines suggested they should only be admitted if ‘appropriate’. 

The advice, in two separate sets of guidance, says care home managers should consider whether being sent to hospital is ‘the best course of action’ for a resident and warns that ambulances may not be sent if ‘conservative care’ at the home is deemed preferable. 

Recommendations from the British Geriatrics Society, a professional body representing 3,900 doctors and specialists in healthcare for the elderly, say care home managers should discuss possible admissions with paramedics, doctors and other healthcare staff. 

The advice adds: ‘They should be aware that transfer to hospital may not be offered if it is not likely to benefit the resident and if palliative or conservative care within the home is deemed more appropriate. 

Rainbow posters, used as a symbol of hope during the coronavirus pandemic, are seen in the window at Oakland House care home in Manchester, northwest England

Rainbow posters, used as a symbol of hope during the coronavirus pandemic, are seen in the window at Oakland House care home in Manchester, northwest England

Rainbow posters, used as a symbol of hope during the coronavirus pandemic, are seen in the window at Oakland House care home in Manchester, northwest England

‘Care homes should work with healthcare providers to support families and residents through this.’ 

Separate guidance from the Department of Health, Public Health England and the NHS instructs care home managers to ‘assess the appropriateness of hospitalisation’ if residents become seriously ill with the virus. It adds that they should hold discussions with a resident and their family to ‘determine if hospitalisation is the best course of action for the resident’. 

Why can’t they all be treated here?

NHS Nightingale hospitals remain largely empty with just a few dozen patients being treated at the three biggest sites. 

It led to calls last night for the temporary hospitals to be adapted to cater for care home residents who had tested positive for coronavirus amid fears that homes are struggling to cope. 

Temporary hospitals have recently opened in London, Manchester and Birmingham, which combined have the capacity for as many as 10,000 patients. 

Others are being set up in Bristol, Harrogate, Exeter and Sunderland. 

But only 19 patients needed to be treated at the ExCel centre hospital in east London over the Easter weekend, leaving hundreds of beds with ventilators spare, the Health Service Journal reported. 

The temporary hospital has 500 beds with ventilators and room for 3,500 more patients. 

The Prime Minister’s spokesman said NHS Nightingale in Birmingham was ready to take patients and NHS Nightingale in Manchester had already received patients. 

But it is understood that the three sites have only received a few dozen patients because normal hospitals have had spare capacity. 

Liz Kendall, Labour’s social care spokesman, said: ‘If there is any spare capacity in NHS Nightingale hospitals we need to make sure they are used for those who need it most, including elderly people with coronavirus who would otherwise have to go into care homes with all the risks that brings.’ 

 

Charities fear that the policies will result in patients not being taken to hospital even when it is in their best interests.

The Alzheimer’s Society warned that the guidance would be ‘misinterpreted’ by staff and ‘inadvertently prevent access to critical care to people who need it’.

Age UK stressed that decisions on whether to take a patient to hospital must always be based on ‘individual circumstances’ rather than a blanket policy,

 Earlier this month care homes in Brighton were told that residents would not be admitted to hospital  because it might increase their suffering.

One care home manager said they felt ‘shocked and numb’ at the advice issued by Brighton and Hove Clinical Commissioning Group (CCG), adding that a GP had even told them ‘none of your residents aged over 75 will be admitted to hospital’. 

Another said: ‘We have been told flatly that it would be highly unlikely that they would be accepted into hospital.’ Similar guidelines were sent out to family doctors in north-west London, who were told that they would face ‘difficult decisions’ about whether to admit care home residents to hospital.

The documents, obtained by Pulse magazine from the region’s eight CCGs, stated that frail, older patients ‘do not benefit from aggressive hospital treatment’. 

Care home residents are far less likely to survive if they are given intensive oxygen therapy or put on a ventilator compared with otherwise healthy patients. #

That said, they will still benefit from the close monitoring of doctors and less invasive oxygen treatments that will be offered in hospital. 

Sally Copley, director of policy and campaigns at Alzheimer’s Society, said: ‘People with dementia who have Covid-19 and need to go to hospital should be able to, just like anybody else. 

‘These guidelines should always be applied on a case-by-case basis, and take into account the person’s needs. Our worry would be if stretched and exhausted health and care workers misinterpret these guidelines, and inadvertently prevent access to critical care to people who need it.’ 

Caroline Abrahams, charity director at Age UK said: ‘Decisions about transferring care home residents to hospital must be made by doctors, together with the older people themselves wherever possible, and with their families too.

‘They need to take into account any wishes older people have already expressed about treatment and going into hospital and recognise that unfortunately, any admission at present runs the risk of exposing residents to the virus.

 ‘Above all, these decisions must always be based on individual circumstances, not a blanket policy.’ 

Professor Martin Marshall, chair of the Royal College of GPs, said: ‘Whether during a pandemic or not, decisions about a patient’s care must be made based on their individual medical needs, as well as their individual wishes.

‘Some patients will not want to die in hospital, so if it sadly gets to this stage, whether related to Covid-19 or not, admittance to hospital would not be appropriate.’

The recommendations from the British Geriatrics Society, published at the end of last month, explain: ‘Care homes should be aware that escalation decisions to hospital will be taken in discussion with paramedics, general practitioners and other healthcare support staff.’ 

The Department of Health’s guidance, produced with PHE, the NHS and the Care Quality Commission at the beginning of the month, states that if a resident might need to go to hospital with coronavirus symptoms, staff should ‘consult the resident’s advance care plan or treatment escalation plan and discuss with the resident and/or their family’. 

A quarter of coronavirus deaths in Scotland have been in care homes, the country’s National Records office revealed yesterday – 237 of the 962 suspected victims north of the border. 

First Minister Nicola Sturgeon said all residents showing symptoms of the disease will now be tested

 

 

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