Coronavirus set to re-emerge in society through care homes, warns NHS chief

Exclusive: ‘I think there is a mood of optimism around, which I think we need to be quite cautious about,’ warns NHS England director

Shaun Lintern
Health Correspondent
Friday 01 May 2020 09:30
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Coronavirus in numbers

Care homes will be the route through which Covid-19 spreads back into the community, a senior NHS England director has warned.

In a private online briefing for hundreds of NHS chiefs on Thursday, Professor Keith Willett, NHS England’s senior incident director for coronavirus, said there had been a “shift in the recognition” of the extent of coronavirus now spreading between patients and staff in care homes.

He said the proportion of care-home residents dying had increased from a quarter to 30 per cent, adding: “The expectation is that for the next few weeks … those care homes will be the epicentres of transmission back into society and feeding the endemic problem that we will have going forward.”

His comments come amid growing criticism that the NHS may have introduced the virus into care homes earlier in the epidemic when homes were told they had to take Covid-19 patients from hospitals to help free up beds on wards.

Public Health England has said there have been more than 4,500 care homes affected with a coronavirus outbreak, around a third of all homes.

Prof Willett told NHS bosses that the health service was still in a “precarious” situation and could go back to the heights of the coronavirus surge within weeks or even days.

He cautioned NHS chiefs against assuming the health service was now out of danger, adding that while it had come through the peak, in some places such as London, hospitals had come close to being overwhelmed.

“We did ride that first wave with some spare capacity, but boy was it tight in some parts of the country, and you know that. London got very close to not having sufficient capacity. And I think we need to be very careful that we aren’t making an assumption that somehow we’re on a downward trajectory that’s not going to change.”

He said he was regularly talking to the government’s Scientific Advisory Group for Emergencies (Sage), adding: “I would summarise our position currently as saying: we are a very long way from where we were when we went into lockdown. And we can rapidly climb back to where we were in a matter of weeks, possibly in a matter of days.

“There’s a keen discussion going on in the media, and among senior leaders and I’m sure in your organisations and in your minds, about the lockdown finishing, and somehow getting back to normal. We are absolutely nowhere near the level of activity that we were when we went into lockdown. We are probably 10 times more busy with Covid-19 than we were then.”

Boris Johnson, the prime minister, today said the UK had passed through the peak of the epidemic but he warned against coming out of the lockdown quickly.

The government is expecting to publish a plan setting out how it will relax restrictions next week.

Prof Willett told NHS chiefs during the online briefing: “The situation clearly is somewhat easier than it was a few weeks ago, but it doesn’t mean that we are in any way over this pandemic. And the position is really still quite critical.”

He said between 400 and 700 people were still dying every day, adding: “We need to be very cautious about thinking that we are done with this. We certainly are not.”

Prof Willett, a former consultant surgeon for the NHS, said the ability to be able to fully test and contact trace individuals would be vital for the UK to exit the lockdown, but he said there was still need for improvement with testing centres not being conveniently placed for people.

“We need to be getting into a position where we can really do that test and trace and track people, so that we ensure that we can get ourselves out of this pandemic in a very structured way. And that will be dependent on just how many cases there are in society.

“You can imagine there could be 20,000 people a day at the moment becoming infected, that’s not an unreasonable estimate arguably. If that is the case, then doing the testing, tracking and tracing of all of those contacts would be exceptionally difficult. So we do need to be further down that slope of recovery before we are in a good place.”

He concluded: “Perhaps I have been a bit pessimistic and bleak, but that was intentional in part because I think there is a mood of optimism around, which I think we need to be quite cautious about and [make sure it] is not disproportionate to the position we find ourselves in.”

NHS England was approached for comment.

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