Month: April 2020
The epidemic hit some local care homes badly after developing in East Devon in March – but the lockdown stopped a wider spread.
I am now in a position to report further on the Covid situation in care homes and the local community.
Outbreaks occurred in several care homes in Seaton and surrounding towns at the end of March/beginning of April, reflecting people having become infected earlier in March before the lockdown was imposed. A number of people are believed to have died. (The national graph above shows the drastic acceleration of deaths in care homes in the first two weeks of April; most ‘other excess deaths’ are probably Covid-related but not recorded as Covid.)
More critically ill in their 50s than 70s, according to hospital data. Overall Covid mortality TWICE the Public Health England figures, i.e. 30,000+.
The Government has belatedly changed its advice in its new TV ad, aired since Easter. it now says that Covid-19 is ‘life-threatening to people of all age groups’. Previously it had said that ‘the over-70s’ and people with serious conditions were ‘the vulnerable group‘.
No explanation has been given for this change, but the diagram above says it all. According to a report from the Intensive Care National Audit and Research Centre, up to 3rd April there were more people in their 50s critically ill with Covid-19 than in their 70s, and more in their 30s and 40s than 80s.
The figures will underestimate the number of 80+, because many are dying in care homes or at home without making it to hospital. However the message is still clear – and sobering.
Overall death toll now over 30,000, headed for 50,000
Indeed, the Cumulative Mortality Investigation (CMI) of the Institute and Faculty of Actuaries estimates (page 5) that overall there have been TWICE the number of deaths reported in the daily hospital counts. When Public Health England reported 15,400 deaths, the CMI estimates that had been 26,000-32,000 excess deaths.
Now that PHE are reporting 18,000 deaths, the likely real total would be in the range 29,000-35,000, and heading to over 50,000 for this wave.
The excess deaths include many people who have died of Covid but where Covid has not been put on the death certificate.
Our proposal for mass testing and tracing in the SW is gaining traction. Time for Devon MPs and councils to act.
- We are NOT pressing for a regional release of the lockdown at this stage.
- What we ARE arguing is for a large-scale return to testing, tracing and monitored quarantining of those who are infectious and their contacts, as advocated by Exeter University’s infectious disease expert Dr Bharat Pankhania.
- This would need not only a lot more tests but also rapid expansion of testing and tracing teams beyond the Public Health team, using district Environmental Health staff, and recruiting many others.
Beer-based Pecorama are making these ear guards, free of charge, to help carers wearing face masks for lengthy periods. They are being used and much appreciated in one local home where a resident has had the virus.
Email me firstname.lastname@example.org if you are a carer or care home manager and would like Peco to supply you with some.
They are based on a design produced by an enterprising school in Scotland and a video explaining them can be found at https://www.youtube.com/watch?v=QVpMvQpwgVM
Help build up a picture of the pandemic in Devon and nationally – report your health status through this app
Help slow the spread of #COVID19 and identify at risk cases sooner by self-reporting your symptoms daily, even if you feel well.
Download the app https://covid.joinzoe.com/
According to new information which I have been given, a much larger number of homes are now infected, roughly double the figures mentioned in my previous post. This confirms the desperate urgency of improving PPE for care home staff and ensuring that everyone transferred into a home from hospital is tested first, as the Government has very belatedly promised.
Statement by Devon county councillors calling for a regional public health approach to containing the epidemic in the South West
The RD&E – the death rate from Covid-19 is barely 10% of the rate in the worst affected trusts. We need extensive testing, tracing and quarantining of cases and contacts to control the virus
Statement by County Councillors Hilary Ackland (Exeter), Martin Shaw (Seaton and Colyton) and Claire Wright (Otter Valley):
The South West is experiencing the epidemic in a different way from other regions. We have the lowest levels of hospitalisation and death from Covid-19 in the country. South West councils, MPs and the police have had some success in preventing second-home owners and tourists further spreading the virus.
We therefore support the call by Dr Bharat Pankhania, Exeter University’s infectious disease and public health expert, to take advantage of the lockdown to introduce a regional approach to the epidemic in the South West, with intensive testing, tracing and quarantining to eliminate the virus.
We call on Directors of Public Health in the region to devote all available resources to this approach, and on Devon MPs to press the Government to give the necessary support for this.
While we do not believe the lockdown can be lifted imminently, effective control of the epidemic in the South West would be an important step forward towards a national solution and would enable local leaders to make the case for a regional approach to lifting the lockdown in due course.
Martin Shaw adds:
As of two days ago, 21 people had died of Covid in the RD&E trust, compared to almost 200 in many trusts in other regions. This shows that the epidemic is still very uneven – a patchwork of variable local epidemics, as Dr Pankhania has argued in the BMJ. We should press for an effective SW strategy.
I am hearing new stories of shortages of PPE for care home staff in the local area, along the lines of the story on BBC Spotlight last night. I gather that new national systems are being established for routine supply of PPE to the health and care sector, but these are still not up and running.
Recognising the difficulty, the Local Resilience Forum has had two emergency drops of PPE in the last week, which have been allocated to district councils and also to the CCG for primary care. It has flown out of the door but Devon does have limited supplies available from this resource for homes which have less than two days’ supply left.
In case of emergency, ie less than three days supply remaining, care homes are advised to go to the National Supply Disruption Resource (NSDR) which is managed nationally. However at least one care home were told that care homes would not be supplied through this route.
It seems we are still some weeks away from having a secure source of supply for the care sector. Meanwhile, the disease has been confirmed in 21 out of 400 or so care homes in Devon, which is probably an underestimate of the extent.
The only encouraging thing I have heard is that one patient from a local home was admitted to Intensive Care – contrary to national reports that care home patients are not being admitted – which seems to confirm the impression that the outbreak here is less severe and there is still capacity.