The lives lost to hospital-acquired Covid
Thank you for your excellent article (Up to 8,700 patients died after catching Covid in English hospitals, 24 May). My wife was admitted to Basildon hospital in early September for a 10-hour heart bypass operation, and afterwards was in intensive care for three weeks before being transferred to general wards for recovery. The ward Pam went to had a Covid outbreak after a few days, and she contracted it. She was moved into a total of five wards – all had Covid at some stage – and she finally passed away on 18 November. Pam was a very nervous person and I dread to think what was going through her mind, as I was unable to have contact with her for her final seven weeks. I have yet to come to terms with her situation and passing.
Pam received marvellous treatment from the medical staff, even allowing me and family and friends to send emails, which a nurse read out to her. However, early in the pandemic a Nightingale hospital was built at the ExCeL centre to accommodate a significant number of patients; it has barely been used. I contend that if all the Covid patients within a 30-mile radius had been transferred there, it would have kept all the other hospitals in the catchment area free of the virus, and allowed them to operate normally, thus preventing a significant number of deaths. I am convinced that had such a policy been adopted, Pam would still be alive today.
Building the Nightingale hospital was a complete waste of money, as there were insufficient nurses to staff it. I know how hard the surgeons, medical and ancillary staff worked for a positive outcome, only to be let down by an incompetent government.David MarshChelmsford, Essex
• My husband was yet another statistic in the horrifying numbers of patients being killed by hospital-acquired Covid-19. Admitted for “a few days only” to have an MRI scan for unexplained drowsiness, a week later, on a routine test for Covid, he tested positive, was moved to a Covid ward, displayed no discernible Covid symptoms, but was put on “end-of-life” care a few days later.
He was a very disabled man, suffering from late-stage inclusion body myositis. NHS hospitals seem to have neither the experience nor the equipment to care properly for disabled people.
The palliative care he was offered was inadequate, and he was given a weapons-grade opioid. I was his 24/7 carer for 12 years, and fought the hospital tooth and nail to get him home, where he wanted to be. In the end, after three and a half hideous weeks, I prevailed and got him home, where he died 24 hours later. For the care and treatment of old people, frail people, and disabled people, the NHS is no longer fit for purpose.Jennifer BassettExminster, Devon
• Covid-19 deaths in hospital might have been reduced had hospitals vaccinated their elderly inpatients. My 89year-old mother fractured her hip on 21 December and was initially treated conservatively. We asked repeatedly about vaccination at the beginning of January and received this comment from the medical director: “The national position is that inpatients are not covered by the hospital vaccination programme and this is mirrored across Greater Manchester.” My mother contracted Covid-19 on 14 January, but luckily survived. Her hip was subsequently operated on, and on 14 April she was discharged to a care home, where she received her first vaccination.Prof David J LomasCambridge
• I read your article on hospital acquired Covid-19 deaths with sadness. The part hospitals play in spreading this virus has been neglected on many fronts. Absence of contact tracing for most hospital inpatients is another example of negligent infection control in the UK. We have published a small but disturbing study suggesting that twothirds of patients with Covid-19 in hospital are never engaged by NHS test and trace. Their close contacts are not properly advised and supported to selfisolate. Many thousands of preventable infections will have arisen. Up to 20% of cases in hospitals do not have a positive test and cannot be recognised by NHS test and trace. Failure to prevent the next tranche of patients mocks both poorly patients and hard-working NHS staff.
Our government divides, mismanages and misleads. This is disastrous for infection control, which requires locally managed, properly funded, locally coordinated public health services.Dr Bing JonesSheffield Community Contact • Your report on the dreadful toll of Covid-19 from hospital-acquired infections quotes Jeremy Hunt asking whether the right infection control policies were in place. Sheer intransigence over the airborne nature of Covid-19 transmission on the part of the UK infection control authorities has ensured that they were not. Despite overwhelming evidence of aerosol spread of the virus, joint guidance just released from the British Infection Association, the Healthcare Infection Society, the Infection Prevention Society and the Royal College of Pathologists remains wedded to the now thoroughly debunked theory that aerosol spread only occurs during “aerosol generating procedures” (AGPs), and refuses to recommend high-grade FFP 2/3 masks for all staff, and good ventilation everywhere in our hospitals.
The notion of AGPs itself has now been comprehensively discredited, with the Lancet recently calling for the term to be abandoned, “as it is neither accurate … implies aerosol emission is only from specific procedures … [and] potentially misidentifies the source of infection risk”. The BMJ reported over a year ago that healthcare worker infection rates on general wards were more than double those in intensive care units (ICUs), with non-clinical hospitality staff having the highest rates of all (34.5%); yet only ICU staff have FFP3 masks. The BMJ reported in January that there had been 850 healthcare worker (HCW) deaths between March and December last year, with 52,000 NHS staff off sick with Covid.
While it is not clear to what extent patients were infected by HCWs or by other patients carrying the virus, what is abundantly clear is that current infection control guidelines are failing to protect patients and staff, and are likely to have contributed to the thousands of patient and HCW deaths. How many more need to die before national guidelines are changed, and recommend proper protection against this airborne disease?Dr Jonathan FluxmanGP, London
• The number of patients who died from hospital-acquired Covid-19 infection reveals the huge amount of damage done by the government’s poor response in December 2019/January 2020 to the initial outbreak of Covid-19 in China, by:• Their unwillingness to learn from the experience gained from identification of Sars and Mers in east Asia and the Middle East.• An overreliance on the treatment of symptoms as well as inadequate capacity in every area, the early abandonment of contact tracing, and subsequently following only this medical model of health for the first six months of the pandemic.• A lack of recognition of public health expertise in prevention and protection of communicable diseases that resided in local authorities across the UK and was already operating well in areas far away from Whitehall and London.
Public health had been moved out of the NHS into local authorities by the Cameron-led coalition. From 2010, local authorities suffered savage cuts to staff and services as the austerity imposed by George Osborne increased year on year. Sadly, public health is still poorly understood by the government, as its latest attempts to reform Public Health England demonstrate.Dr Helen LewisRetired •