Revealed: Elderly paid price of protecting NHS in Kent from Covid.

Elderly people were excluded from hospitals and intensive care during the height of the pandemic’s first wave as part of efforts  to stop the NHS in Kent being overrun a Shepway Vox Team  investigation can reveal.

The Chief Medical Officer of England & Wales, Chris Whitty  (pictured) devised guidelines called a “triage tool” that were later used to prevent  many elderly covid-19 patients in Kent, & elsewhere, from receiving ventilation in intensive care.

Intensive care doctors in Kent who the Shepway Vox Team have spoken to say the triage criteria set out in the documents – which gave a score for age, fraility and illness – was used in Kent NHS Trusts.

The Department of Health & Social Care have made it clear to the Shepway Vox Team the guidance produced by Whitty was never formally published. However more than a dozen sources say it was  certainly circulated in Kent NHS Trusts and used by hospitals and doctors.

These finding undermine what Matt Hancock , the health secretary said in the first wave of the virus

• “everybody who needed care  was able to get that care.“

Since the end of lockdown one we have spoken more than 30 witnesses, doctors, bereaved families, care home workers and Public Health England officials.

The Office of National Statistics figures for Kent show nine deaths in care homes at week 14, March 30 – April 5. By week 16 April 13 – April 19 they’d reached 69 covid-19 deaths making up 31% of all deaths in care homes in Kent. In week 17 the figure stayed the same but by week 18, 27 April – 3rd May this had risen to 37% or 62 covid-19 deaths in Kent Homes.

The graph makes it clear than non covid-19 deaths also rose at this time in Kent. This was due to the impact of the “triage tool” developed by Chris Whitty.

The available public evidence makes it very clear the young were certainly favoured over the old in Kent. This was due to the age based fraility score system commissioned by Chris Witty, the UK Chief Medical Officer.

Kent based intensive care doctors say the “triage tool” made it clear, that in the event of the NHS being overwhelmed patients over the age of 80 should be denied access to intensive care and in effect excluded many people over the age of 60 from live-saving treatment.

Kent based NHS doctors informed the Shepway Vox Team the “triage tool” was definitely used by medics in Kent hospitals to prevent elderly patients blocking up intensive care beds during the first wave of the pandemic.

NHS data shows that the proportion of over 60’s in Kent and elsewhere, with the coronavirus who received intensive care halved between the middle of March 2020 and the end of April as the pressure weighed heavily on Kent hospitals.

On the first day of lockdown 1, March 23rd, at a meeting of East Kent Hospital University Foundation Trust (EKHUFT) Board of Directors it was noted:

• Coronavirus screening of staff to reduce impact of self isolation has been suggested as a measure to mitigate impact but not feasible until testing capacity within trust available.

By the 16th April it is known that circa 90 EKHUFT clinical / medical staff recorded were off sick and 134 medical / clinical staff  were self isolating due to covid-19.

How many patients who entered EKHUFT hospitals might have caught covid-19 from EKHUFT staff from the 23rd March, until the trust did have the capacity to test within the trust?

According to BBC on August 27th,  The Care Quality Commission (CQC) has issued a section 31 under the Health & Social Care Act 2008 against EKHUFT after inspectors visited one of its sites on 12 August.

It is thought to be the first trust to face such action.

Inspectors visited its hospitals after NHS data showed that for the period 30 June to 26 July, the number of people testing positive for the virus 15 days after being admitted to hospital was twice as high in east Kent as at other acute trusts.

The number who tested positive eight days after admission was almost three times higher.

Official guidance states a positive test after 15 days in hospital is “definitely healthcare-associated” while a positive test after eight days is “probably healthcare-associated.”

It would appear then testing of EKHUFT staff may well have remained below capacity as evidence in the public domain shows patients were being infected, most likely from staff as these were internal transmissions within the built environment of EKHUFT hospitals.

Care Homes in Kent

In Kent & Medway there are 602 residential care homes.

458 residents died from Covid-19 between week 14 (30 March 2020 – 5th April) and week 45 (6th Nov).  The number of care home patients who died due to non-covid-19 causes is 3,435.  Those passing from covid-19 make up 12% of the care home population.

Many Kent based patients were discharged into care homes during the height of the pandemic which was a highly contentious and controversial move.  Indeed more than 45 patients we know of were sent to homes between April 1st and April 30th we have discovered, even though they had tested positive for covid-19.

This ill thought through policy played havoc, where staff had even less PPE than the hospitals and would often spread the virus as they worked shifts across different premises. One in four care homes in Kent declared a coronavirus outbreak during the peak of the infections between March & May.

In a report by Amensty International published on the 4th Oct, they too make it clear that official figures show admissions to hospital for care home residents decreased substantially during the pandemic (March – April) with fewer admissions than in previous years. In Kent, there was a lag as the virus took longer to take hold but follows the same pattern as set out in the Amnesty report. This meant in Kent trust beds didn’t become available until after week 18 (27th April – 3rd May), as is clear from the chart below and the graph above.

Hospital doctors & GPs have also described how the care home sector in Kent was left to fend for itself, as it was elsewhere around the country. A Kent based intensive care doctor who works for a local trust informed the Shepway Vox Team:

• “On my shifts during the height of the pandemic I don’t recall seeing any care home patient who had tested positive who were brought into our trust – not one.”

On the 6th May, the Prime Minister conceded “there is an epidemic going on in our care homes, which something I bitterly regret.“

However, there were still very sick people being not just being turned away from hospitals, but frightened to attend hospital because of the virus, especially the East Kent Hospital University Foundation Trust.