21 April 2020 — Dr Malcolm Kendrick
Unfortunately, it seems that COVID-19 has infected everyone involved in healthcare management and turned their brains into useless mush.
Lockdown has two main purposes. One, to limit the spread of the virus. Two, and most important, to protect the elderly and infirm from infection – as these are the people most likely to become very ill, end up in hospital, and often die. [In my view, if we had any sense, we would lockdown/protect the elderly, and let everyone else get on with their lives].
However, the hospitals themselves have another policy. Which is to discharge the elderly unwell patients with COVID directly back into the community, and care homes. Where they can spread the virus widely amongst the most vulnerable.
This, believe it or not, is NHS policy. Still.
Yes, you did just read that. COVID-19 patients, even those with symptoms, are still to be discharged back home, or into care homes – unless unwell enough to require hospital care e.g. oxygen, fluids and suchlike. If this is not national policy, then the managers are telling me lies.
In fact, it does seem to be policy, although the guidance from the UK Government is virtually incomprehensible1. I have read it a few times and I fail to fully understand it – or partially understand it. I tried reading it upside down, and it made just about as much sense.
I wrote about this situation in my last blog, as the impact of COVID of care homes was becoming apparent – even to politicians. I thought that someone, somewhere, might have realised the policy of flinging COVID positive patients – or patients who may have COVID – out of hospital, and into care homes, might prove a complete and utter disaster.
I now call care homes COVID incubators. Places where the disease can grow and multiply, happily finding new host after new host. Not so happily for the residents.
Equally, sending people home is further complete madness. Sending them home to somewhere that, very often, contains another elderly and frail person. Normally a husband or a wife. Did anyone think through the consequences of this? Clearly not. Do you think the other person in the house may be at risk? Really, you think. Surely not, knock me down with a feather…
If there is not another elderly partner in the house, there will usually be carers who come in to look after the freshly discharged COVID positive patients. These carers will have almost no protective equipment. Even if they do, they will be lifting and moving the patient around, washing them, taking them to the toilet… in very close proximity. The chances of getting infected are very, very, high.
These carers will then go and visit other elderly, vulnerable patients scattered around the community. They become the perfect vectors to spread the virus far and wide, amongst the exact group of people that we are trying to protect.
I have been doing a lot of jumping up and down about this over the last few days. The hospital trusts appear incapable of understanding the argument. ‘Clear the hospital, clear the hospital’… are the only words they seem capable of uttering.
The hospitals, I point out repeatedly, have been cleared. Wards are standing empty, corridors echoing. The first peak has also been passed – even if no-one dares admit it. So why are we continuing to fling COVID positive patients out into the community? Why? Why? Why?
‘Because it is national policy’. Squawk. ‘Because it is national policy’. Squawk. ‘Pieces of eight, pieces of eight.’
The entire nation has been locked down. Do not travel, stay two meters apart, do not go outside blah, blah. Meanwhile we have the perfect anti-lockdown policy in place for the very people we are mostly supposed to be protecting. There are two parallel universes here.
If you wanted to create a system most perfectly designed to spread COVID amongst the vulnerable elderly population, you may well have come up with the current one. Infect people with COVID in hospital, and then scatter them into care homes and the rest of the community. Making sure that you infect all the carers on the way.
As Albert Einstein said. ‘Two things are infinite, the universe and human stupidity… and I’m not so sure about the universe.’
Thud… the noise of my head hitting the desk in utter frustration.