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MENDIP TIMES
Care home conundrum
COULD we have done better to protect the residents of care homes during the pandemic? They were always likely to be most susceptible to the new coronavirus, and By Dr PHIL HAMMOND despite government promises to put a protective ring around care homes, there were 30,000 excess deaths – mostly from Covid – in England in the first 23 weeks of the pandemic. Other European countries also suffered high care home deaths. The question is, will we do better next time? – as there surely will be a next time. One bit of the jigsaw showing where we went wrong was revealed in the High Court last month, which ruled that the government’s policy of discharging untested patients from hospital to care homes in England in March and April 2020 was unlawful. It was also extremely risky, and very poor infection control, because we knew that the virus could spread both without any symptoms and before symptoms occurred. And yet care homes were not even advised that untested, asymptomatic patients should be isolated for 14 days after discharge from hospital. Even if they had been told to do this, many overcrowded and understaffed homes just wouldn’t have had the capacity to do this. So why did we send infected patients back to the places where they were most likely to spread the virus to those who were most likely to die from it? We got ourselves in a terrible mess for two reasons. The first was that the experts advising the government concluded that a respiratory virus that spread rapidly in the air and often without symptoms would be impossible to stop, and it would be a waste of time and effort to try. So we didn’t even try border controls, face masks and a test-trace-isolate programme in the beginning and didn’t change course when East Asian countries were getting success in suppressing the virus with these methods.
It’s doubtful that the bumbling inefficiency and bolshy individualism of the British could have matched the urgent action and conformism of, say, South Korea or Taiwan, but perhaps we could have reduced the height of the first wave by acting sooner. As it was, we imported the virus in large numbers from all over the place and let it spread freely in our communities. We didn’t have enough PPE and barely any tests. When faced with a massive wave, we had only two choices. Take it on the chin or lockdown (or, as it turned out, both). We don’t have many spare beds in our hospitals at the best of times and we were desperate to avoid the awful pictures of an overloaded health service seen in northern Italy. So the government made a very tough choice. It discharged as many elderly patients as possible from hospitals, most without testing them, to clear space for younger Covid patients who might survive aggressive treatment and ventilation. This was a rationing decision and always going to be at the cost of increased spread and deaths in care homes. However, some care homes kept residents safe by refusing admissions that had not been negatively tested, although many were pressured into accepting them. Others asked staff to live onsite or nearby in isolation to prevent transmission. The government could have trebled the meagre pay of care home workers, put them up in, say, caravan parks or hotels and kept mixing to a minimum. We could have used empty hotels or unused Nightingale hospitals as a step between hospital and care home to quarantine infected residents, or give them decent end of life care, but that would have required more staff. As it was, thousands of elderly residents were isolated in care homes, still caught Covid and died alone. Widespread testing and better PPE belatedly improved safety, and it also allowed relatives to visit. Next time, we need to get up to speed quicker and better protect those most likely to die whilst allowing named relatives to visit and be there at the end of life.
Dr Hammond’s Covid Casebook, a Sunday Times bestseller, is out now
PAGE 68 • MENDIP TIMES • JUNE 2022
Plop the Raindrop
I LIKE the spring, when all the blossom comes out. I usually try to hitch a ride with a friendly bee to see what’s about, starting with snowdrops early on. That’s if any lazy bees can bother to come out of their holes or hives on the odd sunny day in February. There’s more room on a bumble bee than a honey bee. Bumble bees look like a flying brick. I like to find a comfy spot on their head so I can hop off if I want to stay in a particular flower. We water droplets are small enough to do that. It also avoids the bees’ wings which could throw me a mile if they hit me. After daffodils, things start to get really busy, so I have a huge choice of what to try. I’m quite partial to rosemary, which has beautiful blue flowers. I’ve developed quite a friendship with some of the bees who are happy to tell me what new flowers are out. Sometimes it means flying quite a long way. One bee was particularly partial to primroses. I hopped off her after we had visited the 14th flower and asked another bee if she could find some wallflowers. But there was more to come. Dandelions, bluebells and wild garlic tasting of – well garlic. Then all the trees start to have blossom. I probably don’t need to tell you what cherries, apples and pears taste like. There will be poppies, orchids and hawthorn blossom next! I sometimes feel really guilty, just going for a ride, when the bees are working so hard. But you can help. If there’s space, think about planting wild flowers in your garden. It will encourage more insects, which will help the birds. And it might give me even more to eat! MENDIP GRANDAD
