April 2020

2nd April

The NHS “clarified” rules on discharging patients from hospitals to care homes, stating that negative tests for COVID-19 were not required prior to such transfers and elderly patients who tested positive could be admitted to care homes if measures, such as wearing PPE and isolation, were implemented. (see entries for 15th and 28th April)

 

3rd April

Distribution started of a leaflet published by the Department for Health and Social Care for all households in the UK. The front page carried the message (all in capital letters): “Coronavirus – Stay at home – Protect the NHS – Save lives”. Included inside were six illustrations of how people should wash their hands. The top half of the back page of the eight-page A5 leaflet was headed “Going to work” and included a stand-alone line stating: “Certain jobs require people to travel to their place of work.” Who knew? The leaflet was withdrawn by the department on 14th May because it was “out of date”.

 

3rd April

The first of seven temporary critical care hospitals set up by NHS England to provide beds if normal NHS hospitals were unable to cope was opened in London. The NHS Nightingale Hospital London, set up in the ExCeL Centre in Docklands, had 500 beds and the potential for a further 3,500.

By 5th May six of the seven hospitals had opened, and by the following month all had been placed on standby. The National Exhibition Centre on the outskirts of Birmingham was partially converted to a hospital with a maximum capacity of 2,000 beds and Manchester’s Central Convention Complex for 1,000. The Birmingham hospital did not treat any patients before being scaled down to a standby unit for up to 400 patients which was to remain on standby until March 2021.

The Exhibition and Conference Centre at the  University of the West of England in Bristol had up to 1,000 beds; the Convention Centre in Harrogate 500; the Westpoint Centre near Exeter 116 (this was moved to a site at Sowton soon after being set up); the Centre of Excellence for Sustainable Advanced Manufacturing in Washington, Tyne and Wear, 460. The Harrogate and Exeter hospitals were repurposed as diagnostic clinics in June and July respectively.

Only two of the hospitals admitted patients: 54 in London and just over 100 in Manchester.

On 4th May it was announced that the London hospital would be shut but kept in hibernation in case “a second wave” of infections emerged. By mid-May the Manchester one was the only one treating patients.

The government is believed to have spent about £220 million setting up the seven temporary hospitals with running costs of around £15 million a month. Some admitted no patients at all. An NHS spokesperson said the hospitals had been built to provide back-up capacity to be used as needed, adding: “It is very good news for the health of our country that they have so far been needed much less than they might have been.”

• In Scotland, a 1,000-bed unit was set up in Glasgow's Scottish Events Campus; in Northern Ireland a 250-bed unit was opened at Belfast City Hospital’s tower block; and in Wales a field hospital was set up at the Principality Stadium in Cardiff – named the Dragon’s Heart Hospital – with leisure centres and a holiday park also being converted into places for coronavirus patients to be cared for.

 

4th April

A member of SAGE, Graham Medley, professor of infectious disease modelling at the London School of Hygiene & Tropical Medicine and director of the Centre for the Mathematical Modelling of Infectious Diseases, was reported to be pushing the concept of “herd immunity”, suggesting the country needed to prioritise the young over the old.

The government stepped back from the herd immunity concept, previously mentioned by Sir Patrick Vallance, the chief scientific adviser, after modelling data suggested such an approach would result in 250,000 deaths. [Appendix 7]

 

5th April

Boris Johnson was admitted to St Thomas’ Hospital in London after suffering with persistent symptoms, including a high fever, for 10 days, during which he self-isolated in Downing Street. Diagnosed with COVID-19, he was later moved to the intensive care unit after his condition worsened. He left hospital on 12th April for two weeks’ recuperation at Chequers, the PM’s country residence in Buckinghamshire, with his pregnant fiancée, who had also shown symptoms of the disease

• On 7th April Sarah Vine (wife of Michael Gove) wrote in her column in the Daily Mail, on no evidence whatsoever, that Boris Johnson’s illness had brought the nation together – and “taught us all what compassion really means”. “That the Prime Minister has been so badly affected by this disease is, in many ways, symbolic of the huge challenge we all face,” she said. Similar tosh appeared in other publications. For many it unified us in thinking “What a plonker” (or other even stronger words) for not sticking to the advice to maintain social distancing and avoid physical contact, thereby putting himself and quite a few others, including hospital staff and patients, at risk.

 

5th April

In an indication of the seriousness of the situation, the Queen made one of her rare addresses to the nation at a time other than Christmas. The 93-year-old head of state told us that we would succeed in the fight against the virus, and continued (in part): “I want to thank everyone on the NHS frontline, as well as care workers and those carrying out essential roles who selflessly continue their day-to-day duties outside the home in support of us all. I’m sure the nation will join me in assuring you that what you do is appreciated, and every hour of your hard work brings us closer to a return to more normal times. I also want to thank those of you who are staying at home, thereby helping to protect the vulnerable, and sparing many families the pain already felt by those who have lost loved ones.

“Together we are tackling this disease, and I want to reassure you that if we remain united and resolute, then we will overcome it. I hope in the years to come everyone will be able to take pride in how they responded to this challenge, and those who come after us will say the Britons of this generation were as strong as any, that the attributes of self-discipline, of quiet, good-humoured resolve, and of fellow feeling still characterise this country.”

One newspaper columnist told us that this speech had “moved the nation” and many tributes were paid by dignitaries, such as the Duchess of York and the Archbishop of Canterbury, and others both in the UK and overseas, including the US President. It was the most watched thing on telly in the UK for more than 10 years with some 24 million viewers.

 

15th April

The government said that all patients being discharged from hospitals would be tested for COVID-19. By this date well over 28,000 elderly patients had been moved from hospitals in England to care homes and more than 5,700 care home residents in England and Wales had died from the disease – either in the homes or in hospitals. It was reported that only 1,000 care home workers had been tested out of the estimated 500,000 staff. The government said that, as part of its social care action plan, all care home staff who needed a test would get one, especially if they were in a household that was self-isolating. In addition, care home residents with symptoms would be tested.

 

16th April

The government announced three further weeks of lockdown and said that five conditions had to be met before it could be eased. These were:

1. Protect the NHS’s ability to cope and be confident that the NHS is able to provide sufficient critical care across the UK.

2. A sustained and consistent fall in daily death rates to be confident the UK is beyond the peak.

3. Reliable data from government scientific advisers showing rate of infection is decreasing to manageable levels across the board.

4. Confidence that testing capacity and personal protective equipment are in hand with supply able to meet future demand.

5. Confidence that any adjustments to the current measures would not risk a second peak in infections.

 

17th April

A coronavirus vaccine task force was launched with the aim of supporting efforts to make a coronavirus vaccine available as quickly as possible. It comprised representatives from government, academia and industry and led by the chief scientific adviser Patrick Vallance and a deputy chief medical officer Professor Jonathan van Tam.

Members included the government’s “life sciences champion” Sir John Bell, as well as people from AstraZeneca, and the Wellcome Trust. Its remit was to make sure regulations and manufacturing capacity were such that the production of a vaccine could be quickly scaled up when one was successfully developed.

 

19th April

Dr Jenny Harries, a deputy chief medical officer for England, speaking at the Downing Street press conference, defended the government’s response to the coronavirus outbreak and its distribution of personal protective equipment to frontline workers and stated that the UK had from the start, and still had, a “very clear” plan for tackling the COVID-19 crisis. [Appendix 8]

 

22nd April

Sir Keir Starmer used his first “Prime Minister’s Questions” session as Labour leader to accuse the government of being slow in its response to the threat of COVID-19.

The First Minister/Foreign Secretary, Dominic Raab, deputising for the Prime Minister, gave a clever and well-considered reply: “I don’t accept his premise that we’ve been slow.” [Appendix 3]

• Dr Phil Whitaker, medical GP and author, wrote in the New Statesman that, “Modern medicine is good at keeping people alive but the crisis in care homes is a disgrace. The need to empty hospital beds ahead of the peak has meant that asymptomatic inpatients have been discharged to nursing homes without testing; many will have taken coronavirus with them. COVID-positive patients have also been sent to care homes, supposedly to be barrier-nursed in strict isolation, but the appalling failure to supply PPE to the care home sector has rendered this perilous proposition virtually impossible to achieve. Numerous institutions housing some of our most vulnerable people have been ravaged by coronavirus. In many cases, it will have been the panicked and ill-prepared system that sent the infection in.” [Appendix 5]

In the issue of 3rd July he wrote: “From the outset of the pandemic, most countries have employed time-honoured public health methods: quarantining; tracing and isolating contacts; imposing lockdowns; and controlling borders. But a few nations, the UK included, have taken strikingly divergent paths; none of them has emerged well.” His column in that issue was headed: “The government chose to follow the wrong science – with lethal social and economic consequences.” [Appendix 2]

 

28th April

The government announced that all care home staff and residents would be tested, whether or not they showed symptoms.

 

29th April

The Home Office said it had no idea how many people coming into the UK had COVID-19, or what proportion of people arriving in the country could have the virus. The Home Secretary, Priti Patel, said she did not have current numbers because the advice from the government’s scientific advisory group, SAGE, was that testing and quarantining arrivals would have a “negligible” impact.

“Their advice,” she said, “has been not to bring in any changes in terms of testing and things of that nature and we’re following that advice.” She was answering questions during a House of Commons home affairs committee meeting.

It was stated during the video hearing that 0.5% of the total cases of COVID-19 in the UK on 23rd March were from people who entered through ports but the government could not give current numbers. The Home Secretary said that quarantine and thermal screening had not been ruled out and could be implemented later, “based on the science”.

 

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