Covid: What happened to care homes early in the pandemic?

The work of leaked WhatsApp messages sent and received by erstwhile wellness caput Matt Hancock has highlighted the contented of authorities argumentation connected attraction homes during the archetypal question of coronavirus.

The Telegraph claims Mr Hancock ignored proposal - successful April 2020 - to trial everybody going into attraction homes.

His spokesperson disputes this and says helium had besides been advised that determination was not capable capableness to bash so.

On 14 March 2020, the authorities began prioritising the astir susceptible individuals for testing, including those successful hospitals and attraction homes.

If an outbreak was suspected, a fistful of residents astatine a location could beryllium tested.

Reality Check understands that immoderate attraction providers recovered entree to investigating to beryllium precise constricted astatine this time.

On 14 April, according to messages seen by The Telegraph, which we cannot independently verify, determination was treatment of proposal from Chief Medical Officer Sir Chris Whitty to Mr Hancock that determination should beryllium investigating for everyone going into attraction homes.

It is reported that Mr Hancock initially accepted that proposal but aboriginal that time changed his caput and said the authorities should conscionable perpetrate to investigating radical being moved to attraction homes from hospitals.

Mr Hancock's spokesperson said this followed an operational gathering astatine which helium had been advised that it was not imaginable to trial everyone going into attraction homes.

This included a pledge to trial each attraction unit who needed one, for illustration if they were successful a household that was self-isolating.

At that point, conscionable 1,000 attraction unit had been tested retired of an estimated fractional a cardinal who enactment successful attraction homes.

The authorities said it would "move... to a argumentation of investigating each residents anterior to admittance to attraction homes", starting with radical being moved determination from hospitals.

All attraction location residents with coronavirus symptoms would besides beryllium tested.

On 28 April, this was extended to each attraction unit and residents, careless of whether they had symptoms.

It's important to retrieve that aboriginal successful the pandemic it wasn't wide understood that radical who didn't person symptoms could walk connected coronavirus.

On 19 March 2020, NHS guidance said that "unless required to beryllium successful hospital, patients indispensable not stay successful an NHS bed".

This argumentation was implemented to escaped up beds successful beforehand of an expected surge successful coronavirus patients.

On 2 April, the rules connected discharging patients to attraction homes were clarified, saying "negative [coronavirus] tests are not required anterior to transfers/admissions into the attraction home".

Even aged patients who tested affirmative could beryllium admitted to attraction homes, if measures - specified arsenic wearing idiosyncratic protective instrumentality (PPE) and isolation - were used.

By this time, an estimated 25,000 patients had been discharged to attraction homes. In July, Panorama gathered data from 39 infirmary trusts, which showed three-quarters of radical discharged were untested.

Up to this constituent much than 5,700 attraction location residents had died successful England and Wales (either successful homes oregon successful hospital).

Public Health England has published research into the interaction of infirmary transfers. It recovered that 1.6% of the lab-confirmed outbreaks successful attraction homes that they knew astir by mid-October 2020, had travel from radical discharged from hospitals.

But it is not wide what percent of outbreaks up to 15 April (when the investigating argumentation changed) were the effect of patients being moved to homes.

And it is important to enactment that, astatine this time, determination was a deficiency of investigating truthful not each outbreak whitethorn person been recorded. Also, the figures bash not number radical who were not antecedently attraction location residents who were transferred into them from hospitals.

The authorities has repeatedly said that decisions to discharge patients from hospitals during this clip were made by aesculapian professionals connected a case-by-case basis.

The authorities launched the National Supply Disruption Response connected 13 March, a centralised enactment for attraction and wellness providers to rise concerns.

This was followed connected 19 March by a committedness to present 300 masks to each attraction provider.

Concerns implicit PPE peaked astatine the extremity of March and aboriginal April, arsenic bodies specified arsenic Unison, the Royal College of Nursing and care homes themselves highlighted shortages.

Because attraction homes are mostly privately-run, they are liable for purchasing their ain PPE. Many recovered their section suppliers were moving debased and that they were competing with better-funded hospitals.

A letter from the government connected 2 April recognised "the challenges providers whitethorn person experienced successful obtaining PPE supplies implicit caller weeks," and promised that the proviso concatenation would beryllium bolstered, with enactment from the equipped forces.

On 10 April the authorities announced a PPE enactment plan, which included freeing up 34 cardinal pieces of instrumentality to "local resilience forums" who would past administer it to attraction homes done section authorities.

By this point, 3,100 attraction location residents had died successful England and Wales.

General guidance produced connected 25 February 2020 included proposal for carers connected what to bash if they came into interaction with idiosyncratic with Covid-19 - but determination was thing advising against visits to attraction homes.

In 1 conception it said: "It remains precise improbable that radical receiving attraction successful a attraction location oregon the assemblage volition go infected."

Another conception said: "Currently determination is nary grounds of transmission of Covid-19 successful the United Kingdom. There is nary request to bash thing otherwise successful immoderate attraction mounting astatine present."

However, the government's ain Scientific Advisory Group for Emergencies (SAGE) had advised connected 10 February that "it is simply a realistic probability that determination is already sustained transmission successful the UK, oregon that it volition go established successful the coming weeks."

On 3 March, the authorities released its coronavirus enactment plan - the papers did not notation restricting visits to attraction homes.

By 5 March, England had had 273 cases of radical with the virus.

That time Prof Chris Whitty told a committee of MPs that arsenic determination were cases that could not beryllium traced backmost to radical who had travel from abroad, it was "highly apt truthful that determination is immoderate level of assemblage transmission successful this microorganism successful the UK now".

Italy suspended visits to attraction homes astatine this point, 5 weeks aft signaling its archetypal case. A time later, Nursing Homes Ireland, which represents hundreds of attraction homes successful Ireland, banned non-essential visits, conscionable six days aft the archetypal confirmed lawsuit successful the country.

On 10 March, Prof Martin Green, caput of Care England, which represents autarkic attraction providers, directed disapproval successful an Independent article astatine the authorities for its response.

"There is nary grounds of a plan. I'm not adjacent definite they person these plans and aren't conscionable making them up arsenic they spell along," helium said.

Some homes were already deciding to adjacent their doors to visitors, with attraction groups Barchester and HC-One stopping non-essential visits connected 10 March and 12 March.

On 13 March, the government's guidance from 25 February was updated to accidental that "care location providers are advised to reappraisal their visiting policy, by asking no-one to sojourn who has suspected Covid-19 oregon is mostly unwell, and by emphasising bully manus hygiene for visitors".

On the aforesaid day, Bupa and Four Seasons attraction homes stopped non-essential visits.

It wasn't until 16 March that it was announced that societal distancing should beryllium carried retired by everyone, successful peculiar those aged implicit 70 and susceptible people.

That day, the premier curate was asked astir attraction homes and said: "We don't privation to spot radical unnecessarily visiting attraction homes."

In the play betwixt 25 February and 16 March, 14 deaths of attraction location residents were reported on with 30 outbreaks successful England's 15,000 attraction homes.

On 21 March, guidance was introduced to promote medically susceptible radical to stay indoors arsenic overmuch arsenic imaginable until the extremity of June - a process known arsenic shielding.

Finally, connected 2 April a papers from the Department of Health and Social Care said that "family and friends should beryllium advised not to sojourn attraction homes, but adjacent of kin successful exceptional situations specified arsenic extremity of life".

This portion was primitively published successful July 2020.