A total of 1,789 patients have died in hospital after testing positive for coronavirus in the UK, as of 5pm on Monday. This represents a 27% day-on-day increase – by far the biggest so far.
Covid-19 was mentioned on 210 death certificates in England and Wales by 20 March, according to new stats released this morning by the ONS. This was the first time non-hospital deaths (in the community and in care homes) were included in the death figures.
Thousands of new ventilators are to be delivered to the NHS next week, Michael Gove told the daily news conference. He said that as well as buying more from abroad, the UK was developing new sources of supply at home, which would roll off the production line this weekend to NHS hospitals.
There are some signs that physical distancing measures are working to flatten the spread of infection, but this is no time to become complacent, said Stephen Powis, the medical director of NHS England. He said while there was a “bit of a plateau” in the number of new cases testing positive, “we must not take our foot off the pedal”. Gove added that “this is absolutely not the time” to be relaxing physical distancing measures: “People’s sacrifices are worth it, they are making a difference, but we must not let up.”
Nearly 3,000 migrant doctors, nurses and paramedics plus their family members are to have their visas extended for a year to assist the fight against coronavirus, the Home Office announced. The extension, which is free of charge, will apply to about 2,800 NHS workers whose visas are due to expire before 1 October.
Thousands of workers including refuse collectors, cleaners and maintenance staff are to receive full pay if they go off sick because of coronavirus, after their employer Amey admitted it was wrong to only offer £94.25 per week.
The outsourcing giant sparked anger among workers when a senior manager told them last week they would only get the statutory minimum because he believed Covid-19 was “less severe than flu”.
Less than 24 hours after the Guardian first reported the firm’s controversial position and with the death toll from the virus rising, Amey has announced that any employee who is affected by Covid-19 because they are sick or are self-isolating will receive full pay rather than statutory sick pay with immediate effect.
Amanda Fisher, the chief executive of the services company with prison, defence and council contracts and a £2.3bn-a-year turnover, also issued a public apology. The new terms are likely to benefit up to 3,000 of the firm’s 17,000 employees who were facing the lowest rates of sick pay.
The attempt to downplay the severity of the illness which has claimed at least 33,000 lives globally, was described as “shocking” by the GMB union. It also appeared to be factually wrong. Flu has been calculated to be fatal in 0.1-0.2% of cases. Chris Whitty, England’s chief medical officer, has predicted that coronavirus would kill around 1% of the people who contracted it, and there are fears that figure could be higher.
Announcing its U-turn, Fisher said:
We take pride in our employees being the driving force behind our business and we realise that on this occasion we got it wrong, for which we apologise. We have conducted an immediate review of our policy and can announce that any employee who is affected by Covid-19 – because they are sick or are self-isolating – will not be penalised for the effects of coronavirus.
This decision has been made to help protect our employees in the midst of the current coronavirus pandemic, and ensure we are following government guidelines for keeping employees safe from the unnecessary spread of infection.
The mayor of London, Sadiq Khan, has written to every Premier League and Championship football club in the capital asking they provide assistance to the NHS in “unprecedented times” amid the fight against coronavirus.
In a letter sent this week, Khan asked the ten clubs to provide help in three key areas: access to medical staff, access to stadium facilities and accommodation for NHS workers living away from their families, as well as for health and care workers who need easy access to field hospitals.
Mental health experts have challenged plans to allow Scottish councils to move mentally-incapacitated patients from hospital beds into care homes without consent.
The Mental Welfare Commission for Scotland, a statutory body, said it had significant concerns about emergency coronavirus powers set out in a new Scottish government bill which is expected to be debated and then passed in a single day at Holyrood tomorrow.
The commission, which monitors and advises on mental health legislation in Scotland, said it was particularly worried about the government’s decision to scrap the normal procedures used when a council or hospital wants to move a patient with dementia or other mental illnesses out of a hospital bed into a care facility.
Until now, a patient’s opinions or previous views on where they wanted to be treated would be taken into account, or their guardian or family member with power of attorney would be consulted; any disagreements could end up in a sheriff court hearing.
The commission said those were now being temporarily removed, without any process for those decisions to be overseen or monitored. That meant a mentally-ill patient could end up in a care home without their or their guardian’s consent, to free up hospital beds for other patients.
In a policy memorandum published alongside the bill, the Scottish government said it was justified because elderly patients were the most vulnerable to the coronavirus, while the crisis meant extra beds were desperately needed.
The government said:
Hospitals are looking to increase dramatically the number of beds available to deal with the expected large influx of patients affected by coronavirus and requiring hospital treatment. Adults lacking capacity are often elderly patients with dementia who are at high risk from coronavirus and it is a high priority to move them to somewhere safer and more suitable for their care and treatment.
Dr Arun Chopra, the commission’s medical director, said it was very concerned about the rights of those patients.
We understand the need for this emergency legislation to become available during these exceptional times, but we would want to see the reduction in safeguards to only be used if absolutely necessary, and for as short a time as is possible.
We believe it is vital that effective mechanisms are in place to scrutinise how and when these powers are used.
The commission said it would adapt its monitoring systems to cope with the emergency powers published in the new coronavirus (Scotland) bill, and the impact the pandemic had on services. But it said ministers needed to amend the bill to require councils to notify a statutory body every time these orders were used.
The Swedish furniture giant Ikea has today reopened the doors of its Croydon store – but only for vulnerable customers and key workers who can shop for essentials at its Swedish food market.
The rest of the store will remain closed but the Swedish food market is opening to key workers at different times, including NHS workers and police, the elderly, most vulnerable and their carers and Ikea co-workers.
Its normal range has been bolstered with staple items including bread, milk, butter and canned tomatoes. Other members of the public will not be admitted.
The decision to prioritise this location is due to the store’s proximity to Croydon University hospital – just one mile away and one of the worst-hit by coronavirus in London.
The store will initially open to key workers Monday-Friday between 8am-12pm and 2pm-4pm, while elderly and vulnerable customers and carers can visit between 12pm-2pm. Customers will be asked to show ID to gain entrance.
In order to ensure customers and co-workers’ safety, Ikea is implementing measures to enforce 2 metres distance between shoppers and staff, with payment by card only.
Gary Pearce, store manager at Ikea Croydon, says:
Now more than ever we need to come together as a community. We want to do everything we can to support those most in need, including NHS workers at our local hospitals. By offering some essential food items alongside our Swedish food range, we hope that we can help to make their everyday lives just a little bit easier during these tough times.
Jason Groves, political editor of the Daily Mail asked about testing and “why we are doing so badly” compared to Germany.
Gove said the increase in the number of deaths was “shocking and disturbing” and it is right to increase the testing.
Dr Harries said “we want to be testing where it is useful” and testing for clinical care is a priority, then getting front line workers back into safe work. She said:
We have started a number of tests at the PHE facility and other scientists working in testing cohorts of groups of people, which are age specified if you like so that we can start to get a good idea of how many people in the population have had it and then extrapolate that number out so we get a picture for the whole country. That is more of a clue in many ways in managing the end of the outbreak and when we can take the locks off.
She said a postal test which the government is trying to roll out would be “extremely useful”.
The BBC News At Six presenter, George Alagiah, who is being treated for cancer, has said that he had tested positive for coronavirus. His wife, Fran, has also experienced symptoms.
Alagiah had decided earlier this month that he was going to stop appearing on air from the studio amid the virus outbreak following advice from doctors and colleagues.
He told BBC News At Six’s Sophie Raworth:
In some ways, I think that we, those of us living with cancer, are stronger because we kind of know what it is like to go into something where the outcomes are uncertain.
I certainly feel that having had that experience, in my case six years as a cancer patient, I went into this feeling actually quite strong, if I can live with cancer, I can certainly live with Covid-19.
George Alagiah who’s being treated for cancer reveals he has had coronavirus. @BBCAlagiah talks to me on @BBCNews at six #bbcnewssix
Gove said the sharp rise in UK deaths from coronavirus was “deeply shocking” but he could not say exactly when the peak would come:
There’s not a fixed date like Easter when you know that the peak will come, it depends on the actions of all of us. We can delay that peak, we can flatten the curve through our own particular actions.
Powis said the sequence of progress would involve a reduction in the number of infections, followed by a reduction in the number of hospitalisations a week or two later, and then finally a reduction in the number of deaths:
I expect that we will still see unfortunately a rise in deaths because that is the measure that unfortunately we will turn around last.
On PPE, Harries said she had optimistically said 10 days ago they had “solved the PPE position”, but admitted that 48 hours later the distribution problems had started again in getting the equipment to the right places.
She said they then started to take a UK wide approach to logistics and deliver the products went to where the risk was. They are setting up a new electronic system to request PPE which might be useful for care homes:
The distribution element has been a little bit tricky at times and we have now taken a whole strand of the logistics, including with the army’s support actually, out so that we are developing a UK position on that stock and distribution flow.
And the underlying critical point about this is that the PPE should go to match where the critical, clinical risk is.
I would expect end of life care to be just as good as it is in normal times and I know that’s something that our clinicians and hospitals and other health care facilities are thinking about very carefully.
Clearly with the additional impact of this particular virus we do need to think carefully about when people are discharged from hospital if they have had the Covid, and so we have issued specific guidance to assist in that discharge, for instance, if discharging into care homes.
So we have taken account of the fact that over and above our normal procedures we need to take account that we have a new infectious disease.
New services involving the RAF have been unveiled to help coronavirus patients by speeding up medical transport.
Michael Gove said three RAF Puma helicopters are stationed at Kinloss barracks in Moray, Scotland, and will work with Chinook helicopters based at RAF Leeming in North Yorkshire to respond to requests for assistance from NHS trusts across Scotland and the north of England.
A second helicopter facility for the south is based at RAF Benson, South Oxfordshire. An RAF transport aircraft has already been used in an evacuation of a critically ill patient to Aberdeen for treatment.
'People's sacrifices are worth it, they are making a difference, we must not let up' – Gove
Gove said there are some signs, as Powis has said, that people are observing physical distancing and that we may be able to flatten the spread of infection. But he added firmly:
Now is absolutely not the time for people to imagine that there can be any relaxation or slackening. It is a hopeful sign but we must be wary of over-interpreting any individual day’s data. We must maintain this united national effort in order to keep people safe. People’s sacrifices are worth it, they are making a difference, but we must not let up.
Some signs we are flattening spread of infection, but we must not be complacent
Stephen Powis, medical director of NHS England, said the NHS needs everyone in the country to play their part in reducing transmission of the virus, which will take pressure off the health system and prevent more deaths.
Social contact has been reducing over the last few weeks, Powis said, proving the public was heeding the advice. For example, transport use has decreased dramatically.
Less social contact means a lower chance the virus can pass from one person to another. Over time that will mean a lower number of people testing positive. That will also translate into a lower number of hospital admissions, which typically takes place two weeks after transmission.
The rate of hospitalisation is currently increasing, which is expected at this stage. But if social contact continues to decline, the number of hospitalisations will also.
China over time has flattened the curve and the number of deaths has reduced.
Powis said there was a “bit of a plateau” in the number of new cases of people testing positive for Covid-19 in the UK, however:
We have had a rise in the number of UK cases but recently there’s a little bit of a plateau. I think it’s really important not to read too much into this because it’s early days.
We’re not out of the woods; we’re very much in the wood. But as you can see the number of infections is not rising as rapidly as it was.
So green shoots but only green shoots and we must not be complacent and we must not take our foot off the pedal.
Thousands of new ventilators to be delivered to NHS next week – Gove
A critical constraint on the ability to rapidly increase testing capacity is the availability of the chemical reagents that are necessary in the testing, Gove said. The health secretary and the prime minister are working with companies worldwide to ensure we get the material we need to increase tests of all kinds.
Gove said we have just over 8,000 ventilators deployed in NHS hospitals now, but we need more. We are buying more from abroad, including from EU nations, and developing new sources of supply at home.
This weekend the first thousands of new ventilator devices will roll off the production line and be delivered to the NHS next week. From there they will be distributed to the frontline.
Also, the government is increasing capacity to provide oxygen to patients at earlier stages of the disease, hoping to prevent deterioration.
Gove said they are also conducting rapid clinical trials on those drugs, including antimalarials, which may be able to reduce the impact of Covid-19 to those affected.
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