One great sadness of the pandemic is the loss of life of thousands of elderly people discharged from hospitals into care homes where they both died and spread the pandemic to others who died.
This was known to be happening at the time and was bravely publicised by the nascent Covid Actuarial Response Group, at that time – largely on these pages. In an article called “people don’t have a sell-by date“. I quoted Stuart McDonald, Ros Altmann and Deborah Price , all of whom could see what was going on at the time and were warning of the consequences.
This thread explains the situation as Stuart McDonald and his colleagues saw it then.
I am quoted in this WSJ article explaining on behalf of @COVID19actuary that many of those dying from COVID-19 had many years left to live. https://t.co/sPYDESJzO7
— stuart mcdonald (@ActuaryByDay) April 22, 2020
It was when I read this tweet and the articles behind it that I realised that what was going on was not something that could be justified on some abstract grounds such as “they were going to die anyway”.
Because being old and having multiple comorbidities (which most people over 65 have) do not mean that someone is about to die. New study out today saying the same thing – 10 years left to live on average.https://t.co/vmaIb5IRJo
— stuart mcdonald (@ActuaryByDay) April 23, 2020
Those who died during the first lockdown cannot be forgotten as “excess deaths”, they were for the most part, people who would be alive today but for Covid. Alive and loving, alive and loved.
How did this happen?
It was and is not because the public do not care, but that they do not care enough. Yesterday, the High Court ruled that Government policies on discharging untested patients from hospital to care homes in England at the start of the Covid pandemic were ruled unlawful .
This merited some public attention but not as much as Lewis Hamilton planting a tree. Absence does not necessarily make the heart grow fonder. The judgement was brought by Cathy Gardner and Fay Harris against the Health Secretary (the Matt Hancock) and Public Health England).
Lord Justice Bean and Mr Justice Garnham found the decisions of the then health secretary to make and maintain a series of policies contained in documents issued on 17 and 19 March and 2 April 2020 were unlawful.
They ruled this was on the grounds the drafters of those documents failed to take into account the risk to elderly and vulnerable residents from non-symptomatic transmission, which had been highlighted by Sir Patrick Vallance in a radio interview as early as 13 March.
Sir Patrick told the Today programme that “it’s quite likely that there is some degree of asymptomatic transmission”.
This happened because we did not care enough. It is no use denying it, there is a great deal of use owning up to it and asking some very real questions about how much we care for our elderly population today, not as an anonymous demographic , but as people alive and loving, alive and loved.
What will happen next?
Absence does not make the heart grow fonder, it distances us from those who are not here and allows the mistakes of the past to go unlearned from.
This mustn’t be allowed to happen. I hate the phrase “if we have learned one thing from the pandemic” as it assumes that there is not much to learn. There are many things to learn from the pandemic and one of those is that elderly lives matter as much an anyone else’s. Not more, not less. But the elderly were so much more vulnerable in the early stage of the pandemic because of their co-morbidities that we had an extra duty of care. But rather than being placed first in the priority orders, they were discharged from hospital to face very likely death in care homes that were not set up to deal with the pandemic as hospitals were.
There is no doubt that decisions early in the pandemic had to be made in the most difficult, rapidly changing circumstances. Policies and support for the care sector also improved as time went on.
But the hope will be that if or when there is a next time, there will be a much greater understanding of the importance of protecting the many older and disabled people living in care homes, as well as the NHS.
