Amnesty International condemns Johnson government for thousands of UK care home deaths

Amnesty International has catalogued how the actions of Boris Johnson’s Conservative government led to the deaths of thousands of elderly people in care homes during the first stage of the coronavirus pandemic.

Amnesty’s report was largely ignored by the media or relegated to inside pages. Yet it presents evidence that the government’s policy of herd immunity was responsible for mass murder. The government was entirely aware of the probable outcome of their policy and went ahead regardless of the risk to thousands of lives.

The report, “As if expendable: The UK government’s failure to protect older people in care homes during the Covid-19 pandemic”, details how, between March 2 and June 12, 18,562 residents of care homes in England died with COVID-19. The vast majority (18,168) were aged 65 and over, representing almost 40 percent of all deaths involving the virus in England during this time frame. Of these, 76 percent (13,844 deaths) occurred within care homes for the elderly.

During this brief period, 28,186 “excess deaths” were recorded in English care homes, a 46 percent increase in comparison with the same period over previous years.

Amnesty conclude that the Tory government together with its agencies at national and local level have “taken decisions and adopted policies during the Covid-19 pandemic that have directly violated the human rights of older residents of care homes in England—notably their right to life, their right to health, and their right to non-discrimination”.

The report argues that the decisions and policies of the Tory government “impacted the rights of care home residents to private and family life, and may have violated their right not to be subjected to inhuman or degrading treatment.”

Amnesty documents how the government was fully aware that COVID-19 represented a disproportionate risk of serious illness and death to older people, especially those suffering underlying health conditions. The government’s “Risk of death estimates”, compiled in early March, showed COVID-19 infection fatality rates ranging from 0.01 percent for people under 20, rising steeply to 8 percent for people aged 80 years and over.

The government therefore knew that the approximately 400,000 residents of care homes, many of whom live with multiple health conditions, physical dependency, dementia, and frailty, were at an exceptional risk. But at the height of the pandemic, the government failed to take any measures to protect care homes.

Contrary to the claims made by Matt Hancock, the Secretary of State for Health and Social Care, that a “protective ring” was encircling care homes “right from the start,” Amnesty highlights decisions and policies adopted by the authorities at the national and local level in England which served to increase care home residents’ risk of exposure to the virus. These include:

● The mass decanting from hospital into care homes of patients infected or possibly infected with COVID-19 and advice that “[n]egative tests are not required prior to transfers/admissions into the care home”.

● Advice to care homes that “no personal protective equipment (PPE) is required if the worker and the resident are not symptomatic,” and a failure to ensure adequate provisions of PPE to care homes.

● A failure to assess care homes’ capability to cope with and isolate infected or possibly infected patients discharged from hospitals, and failure to put in place adequate emergency mechanisms to help care homes respond to additional needs and diminished resources.

● A failure to ensure regular testing of care home workers and residents.

● Imposition of blanket Do Not Attempt Resuscitation (DNAR) orders on residents of many care homes around the country and restrictions on residents’ access to hospital.

● Suspension of regular oversight procedures for care homes by the statutory regulating body, the Care Quality Commission, and the Local Government and Social Care Ombudsman.

Amnesty states, “Some of the UK government’s decisions with regard to care homes seem heedless at best”. Until March 13, two days after the World Health Organization declared COVID-19 a global pandemic, and despite having received information warning of asymptomatic coronavirus cases from its own advisers, the government advised care homes against the use of PPE. Official guidance for care homes stated, “If neither the care worker nor the individual receiving care and support is symptomatic then no personal protective equipment is required above and beyond normal good hygiene practices.”

Amnesty suggests, “Other government decisions appear inexplicable.” But its actions were not merely heedless, or reckless, but actively murderous.

Amnesty concludes, “Via its Department of Health and Social Care (DHSC), the government in mid-March adopted a policy, executed by NHS England and NHS Improvement, that led to 25,000 patients, including those infected or possibly infected with Covid-19 who had not been tested, being discharged from hospital into care homes between 17 March and 15 April—exponentially increasing the risk of transmission to the very population most at risk of severe illness and death from the disease. With no access to testing, severe shortages of PPE, insufficient staff, and limited guidance, care homes were overwhelmed. Although care home deaths were not even being counted in daily official figures of Covid-19 deaths until 29 April, some 4,300 care home deaths were reported in a single fortnight during this period.”

The report notes how the level of virus transmission decreased dramatically over the summer—after thousands had died—allowing visits by friends and relatives to those who survived and still resided within care homes to recommence, making the impact of the pandemic on the health and wellbeing of older people much more visible. While the full extent of COVID-19’s impact on the body is not fully known, the consequences for older people have been, in the words of Amnesty, “tragic”. Among some older people there is “reduced movement and cognitive functions, loss of appetite, depression, and a general loss of the will and desire to live.”

Amnesty’s report calls for regular testing for care home residents, staff and visiting families, and for the government to review all “Do Not Attempt CPR” orders on care home residents that have been added without proper process. It cites the Joint Committee on Human Rights, a body appointed by the House of Lords and the House of Commons to consider matters relating to human rights in the UK, which wrote in a September report, “The blanket imposition of DNACPR [Do not attempt cardiopulmonary resuscitation] notices without proper patient involvement is unlawful. The evidence suggests that the use of them in the context of the Covid-19 pandemic has been widespread.”

The report also calls for an adequate and ongoing supply of PPE for care homes, to enable them to comply with national guidance, and to ensure all staff have received workplace training on its purpose and proper usage.

Amnesty raise the demand for an independent public inquiry into the government’s handling of the pandemic that should make “key recommendations on an urgent and expedited basis by the end of November 2020.”

Their report states, “The pandemic is not over… Lessons must be learned; remedial action must be taken without delay to ensure that mistakes are not repeated."

This will fall on deaf ears. Due to the government’s reckless reopening of the economy, schools, colleges and universities in the last three months, the virus is already out of control. For Johnson and the corporate oligarchs, what counts is profits not human lives.

At the end of February, Johnson’s chief advisor Dominic Cummings explained the crux of the Tory’s coronavirus response in a behind closed doors discussion. According to the Times, those present summarised his position as “herd immunity, protect the economy, and if that means some pensioners die, too bad.” A senior Conservative source described his view as “let old people die.”

Outside of a mobilisation of the working class—to protect lives and take the response to the pandemic out of the hands of the ruling elite—the policy that led to horrific death toll detailed in the report can only lead to many thousands more fatalities.