X Close

How Britain betrayed the elderly Each and every lockdown made their lives harder

Who is really afraid? The very old? Or those seeking to control them?Credit: Carlos Costa/AFP via Getty

Who is really afraid? The very old? Or those seeking to control them?Credit: Carlos Costa/AFP via Getty


November 1, 2021   7 mins

“I just want to take a pill and make everything stop. I know I mustn’t, but I want to.” Daphne has had a tough time recently. She fell last June and broke her hip. A stint in hospital followed and then a care home, with no visitors allowed. This was no ordinary year. Within a few months Daphne was back at home, that’s when she tested positive for Covid-19. “I had a chest infection but the doctor wouldn’t come out unless I took a test.” The NHS frontline stayed as far away from Daphne as it could, and aged 98 she struggled.

“I don’t want you to come,” she told me on the telephone.

“But I’ve had coronavirus recently Daphne. I can help you.”

“Yes, but I don’t want you to see me like this. I want you to come when I’m back to normal. I’ve not told you what happened after I left 16th Searchlight Company.”

I am an oral historian. I turn old women’s stories into books and in the process sometimes I cross the professional line. It is hard not to during a pandemic working with 17 isolated veterans all of whom served in the female army (Auxiliary Territorial Service – ATS) during World War II. The youngest is 96. Our conversations are often the only meaningful communication they have from one day to the next. After pleasantries and a quick health check, I ask these women to channel their younger selves.

Returning to her restorative tonic — the war — puts the mettle back in Daphne’s voice. She is quick to remind me that she only accepts guests when her hair is fresh set and coloured (soft chestnut). “In the army they encouraged us to take care of ourselves, that was very important.”

But taking care of herself in this new ‘war’ has proved almost impossible: cut off, alone and now suffering with Long Covid, Daphne is miserable. “I’m doing my best to stay alive for you. I want to make it to the book launch, but sometimes I wish I wasn’t here.”

Daphne in the ATS, aged 18.

Army Girls is my third project involving the extreme elderly and the first written during a pandemic. My newest friends are society’s exceptional outliers, with all the research suggesting that reaching a great age takes much more than good genes. Longevity requires optimism, ambition, and multi-generational friendships. Try retaining just one of those criteria with no technology (is your great-granny on Zoom?) and no visitors, while facing down what might well be your last year on earth.

Between the first waves of Covid-19 I visited my oldest friend, Ann. She is 107, lives in a care home and is (more or less) ‘compos mentis.’ By her own admission things have slipped a bit recently. Being alone hasn’t helped. Ann was born before the start of World War I; she can still recall Union Jacks spread out in her Buckinghamshire garden on Armistice Day, 1918, flirting with communism in the Thirties and counting bacon in World War II, but she has never experienced anything like this pandemic. “I just have to accept it, what choice do I have?”

During last year’s visit, our conversation was monitored (a carer kept guard in the corner) and timed. Ann struggled to hear what I was saying, (masks are deafening when you’re old). She stared blankly at my obligatory disposable apron and muttered “it’s time they uninvented plastic.” Post-vaccine, the process of visiting remains cumbersome. For some it is a deterrent. I am shooed out of communal areas despite swathes of impersonal PPE and a negative test. Ann shrugs, “I am currently working hard on forgetting the last 18 months.” Dig deep and Ann is still there but Covid has diminished her. She’s become the personification of our reduced humanity. She can’t wait to get to the end.

Ann with the author last month, age 107 years old.

Marino Plata, Ann’s care worker who is full of love and song, shakes his head. “It was too sudden; the lockdowns were too much with too little explanation.” Marino is one of the thousands of experienced health care workers who have noticed an accelerated decline in their elderly residents during successive lockdowns and restrictions. “Ann at least understood what was happening, others didn’t. They were confused and desperately missed their visitors and activities. They died sad.”

Adam Gordon is a Professor of the Care of Older People and President Elect of the British Geriatrics Society. He saw Covid-19 wreak its worst. “At the beginning of the pandemic even for an experienced practitioner like me, I was affected; early on we weren’t sure how to treat patients with the virus. I still have flash backs, I’ll spare you the gruesome details.”

Adam reminds me that when coronavirus first came knocking, Britain was shamefully unprepared. Between 20,000 and 30,000 of our vulnerable elderly died unnecessarily and horribly. This nightmare scenario led to hastily revised practice: better PPE, strict lockdowns, no visitors. Britain could not keep climbing up the Covid-19 league of shame. And sure enough, fewer very old people have subsequently died. But has their last year of life been worth living?

Do not go gentle into that good night. The prophetic words of Dylan Thomas have proved almost impossible to live up in Covid times. Old age should burn and rave at close of day. Not a chance if you’ve been locked up in your care home (or your own home), with no visitors and, crucially, no voice on the public stage.

“There’s the tension” admits Professor Gordon, “the competition between protecting people from the virus and their other needs was underestimated. It is nuanced.” And modern debate doesn’t like nuance. I was blocked and shouted down on Twitter by several influencers for querying their calls to extend the lockdown last summer. Too many only see one side of the ‘tension’ the professor talks about. After a terrible start, the restrictions Britain’s elderly had to endure were dehumanising to the point that many no longer wanted to live. ‘Deconditioning’ is the word he uses to describe their accelerated cognitive and physical degeneration.

“It’s dreadful to be alone and old,” explained another Anne. She was 96 years old and a former WWII junior commander in the ATS. Like 107-year-old Ann, she too had lived through an era when duty was the nation’s watchword; the press was censored, the people were conscripted, and hundreds of thousands of her generation died. It is that generation who have once more been in the firing line, but this time their duty was to be solitary and still. Pride is harder to wear in private. For the first time Anne watched Remembrance Day in November 2020 on television, rather than celebrating it with friends in her local church. It was a disappointing replacement. She sighed, “I wish someone would rub me out, I wish I could disappear.”

Anne was a Norfolk County Vice President of the Guide Association and mid-pandemic she reckoned that “the reason why Guiding has been so successful is that we were all involved together in our activities. Humans are built to be together.” Anne died in July 2021, most of her last year lived alone.

Professor Gordon admits that data has not been collected to track the unprecedented deconditioning that’s taken place over the last 18 months. Daily we are assailed with graphics charting Covid-19 cases and death rates, but there is no equivalent measure for the impact of loneliness, suicidal thought, feelings of abandonment and physical deterioration that the restrictions have induced in the extreme elderly. As 107-year-old Ann pointed out “I have terrible forgettery, this won’t be remembered.” Perhaps society is banking on that. When judgement day comes it will ask whether our very oldest, most precious citizens were ‘protected’ from Coronavirus. But who will ask if their last year (or two?) was worth being saved for?

Public health concerns over the spread of the virus have seen the human right to safety bulldoze other basic needs. Rectifying this imbalance is crucial as a second Covid-19 winter looms with large sections of the public already demanding increased restrictions. What will they mean for the extreme elderly? The average care home inhabitant is over 85, with a life expectancy of just two-and-a-half years, many won’t live to see the end of the winter. Has anybody asked them what they want? Do we really want to condemn yet more to a lonely death?

When I met her in the summer of 2020 Beryl may well have been the last ATS WWII Physical Training instructor alive and aged 99, with swollen legs in a heat wave and a pandemic, life was hard work. She worried about the modern world — “I think there’s more wrong today. It’s harder for you lot.” Things were certainly harder for Beryl who was struck by the contradictory game of national statistics: “In the Second World War in order to win they didn’t talk about death tolls, but in this current battle it is all we focus on.”

Beryl, aged 99, being interviewed last year.

She wasn’t killed by Covid-19, but in February this year Beryl died, and her close friend sent me a message: “She rarely complained and she didn’t give up, but sadly, her last year was more like imprisonment since she was unable to see her friends thanks to coronavirus.” Like so many others, Beryl’s last months were collateral damage in Britain’s war against the pandemic.

As an NHS practitioner, Professor Adam Gordon has lived both sides of the problem. Given all he’s been through I’m embarrassed by my visible emotion during our conversation. In less than 12 months five women I work with have died. I managed to say goodbye to one and I’ve been to just one non-virtual funeral. The Professor confirms that Britain is sitting on a pandemic of grief; hundreds of thousands of people could not see those they loved most before they died and then were unable to give them an affirming send off among friends and family.

It is not just old people who have experienced depression; minus our elders, Britain has struggled with feelings of guilt and loss.

Yesterday Daphne, one of the 17 women featured in Army Girls who we met at the beginning of this article, left me a message. “I can’t get an appointment with my GP. I can’t work the new system.” But she has not given up. “When I get through, I am going to ask them to give me a pain shot so I can come to the book launch.” Many of her contemporaries haven’t been able to ‘rage rage against the dying of the light’ and aged 98, a Covid-19 survivor who is fully vaccinated, Daphne is determined to be the exception.

Unless, that is, a fresh wave of winter restrictions pin her and us down. Then we will need to push back and ask: who is really afraid? The very old? Or those seeking to control them?

An Evening with the Army Girls is at 6.30pm, 10th November, National Army Museum, London. Tickets are £10. 

Army Girls: The secrets and stories of military service from the final few women who fought in World War II by Dr. Tessa Dunlop is available to pre-order here. 


Dr Tessa Dunlop is an author, broadcaster and historian. Her book Elizabeth And Philip: The story of young love, marriage and monarchy (Headline, £20) is published on 10 November.

Tessadunlop

Join the discussion


Join like minded readers that support our journalism by becoming a paid subscriber


To join the discussion in the comments, become a paid subscriber.

Join like minded readers that support our journalism, read unlimited articles and enjoy other subscriber-only benefits.

Subscribe
Subscribe
Notify of
guest

66 Comments
Most Voted
Newest Oldest
Inline Feedbacks
View all comments
Lesley van Reenen
Lesley van Reenen
2 years ago

This brought tears to my eyes. It is an observation and question that is so obvious – no one questioned the quality of life of the elderly or considered what they wanted (or what other groupings wanted, it must be said). The elderly paid the price and the lockdown enthusiasts put moral pressure on politicians to protect the elderly at all costs, thereby condemning them to live their last months in unhappiness and solitude.
My mother was murdered in a care home during lockdown. She wasn’t afraid of Covid and was not afraid of dying. She was afraid of lockdown and her last months were spent alone, terribly unhappy and as it turns out, an easy isolated target for a malign individual. So few people stop their continual virtue signalling to consider the individual human cost of lockdowns.
Thank you Tessa for the work that you are doing.

Last edited 2 years ago by Lesley van Reenen
Chris Wheatley
Chris Wheatley
2 years ago

Last week I seem to remember a comment about the ‘rhythm of life’, a rhythm which changes, the nearer you get to the music.

As Billy Bob says, somebody had to make a choice between risking more deaths and keeping old people isolated. Whatever you believe about ‘freedom’, that was a decision which couldn’t be taken case by case.

A similar thing happened to me when a close relative died in a home thinking that everybody had deserted him at the end of life. Yes, it was terrible but I had a responsibility to everyone in the home to prevent me from storming in and risking the infection of all of the inmates. This is what you are missing in your discussion – a responsibility to everyone who was in the home.

ralph bell
ralph bell
2 years ago
Reply to  Chris Wheatley

They are residents not ‘inmates’, however, no doubt that’s what they became.
I think decisions were not made for the wellbeing of the residents but for covering the risk averse backs of managers, council officials and health professionals.

Judy Johnson
Judy Johnson
2 years ago
Reply to  ralph bell

An interesting observation,
How do you think decisions would have been made differently had they not been made to cover backs? Would more or fewer residents have died?

Lesley van Reenen
Lesley van Reenen
2 years ago
Reply to  Judy Johnson

It is the obsession with the death count in care homes that is the problem. That should not be the measure. The measure should be the quality of their last few months. These people are mostly aged and have little life left. In their last months left they have been isolated from everyone, often having little access to the outside world via digital media, been separated from loved ones, often unable to make phone calls because they are deaf – on it goes. It is a disgrace. The West should hang their heads in shame.

Billy Bob
Billy Bob
2 years ago

Who gets to decide what’s best for the elderly though? They’re not a homogeneous bloc, some will have wanted to see guests and would have been happy with the increase risk that entailed, others would have wanted to play it safe until higher numbers of the population were vaccinated

Lesley van Reenen
Lesley van Reenen
2 years ago
Reply to  Billy Bob

Those that are not happy with guests, don’t have guests. Problem solved.
I’m willing to bet that most of the elderly after a short time would want to see their friends and family – even a smiling face. It is inhumane to isolate them.
Is this the beginning of a trend? Every time an infectious disease breaks out we immediately lock up and isolate the elderly? Isn’t it time Western society developed a more healthy attitude towards people leaving us – especially the aged?

Jean Nutley
Jean Nutley
2 years ago

Arguably inhumane to lock anyone up in a care home, many could be cared for at home.
care of the elderly desperately needs an overhaul.

Billy Bob
Billy Bob
2 years ago

So those that didn’t want guests would have to have been confined to their room, unable to go about their daily business. Isn’t that simply swapping one form of lockdown for another for certain groups of people?
Surely a better option would have been to lock down care homes to protect the vulnerable residents, and any that don’t want to live under those conditions could have gone to live with family members?

Lesley van Reenen
Lesley van Reenen
2 years ago
Reply to  Billy Bob

Many homes did not allow mixing of residents during lockdown.

Billy Bob
Billy Bob
2 years ago

That never happened

Lesley van Reenen
Lesley van Reenen
2 years ago
Reply to  Billy Bob

You really are something, aren’t you. My mother was confined to her quarters along with the rest of her care home.

Jane McCarthy
Jane McCarthy
2 years ago

So was mine. I’m with you Lesley.

Felice Camino
Felice Camino
2 years ago
Reply to  Billy Bob

My mother was confined to her room the entire time until her death in July 2020. She hated every minute of it and never had been so angry in all her life. And no, she could not go and live with family members, her needs were too great.

Jean Nutley
Jean Nutley
2 years ago
Reply to  Billy Bob

You make very good points, my mother would have elected to see her family, if asked. However not all of the family were able to visit, because they themselves were vulnerable.

Lesley van Reenen
Lesley van Reenen
2 years ago
Reply to  ralph bell

Yes, the use of the word ‘inmates’ was a giveaway as to the innate opinion. These people are numbers, not individuals.

Lesley van Reenen
Lesley van Reenen
2 years ago
Reply to  Chris Wheatley

The rhythm of life includes death, but should not include forced isolation and cruelty. You completely miss the point.

andrew harman
andrew harman
2 years ago

He always completely misses the point!

Chris Wheatley
Chris Wheatley
2 years ago
Reply to  andrew harman

Takes a bow! Obviously, only you understand what’s really happening out there. I should have realised. No room for other opinions here.

andrew harman
andrew harman
2 years ago
Reply to  Chris Wheatley

Sanctimonious and patronising! Your virtue signalling posts are always a highlight for me and for the record I welcome all opinions. you construct a straw man argument.

Lesley van Reenen
Lesley van Reenen
2 years ago
Reply to  andrew harman

This was one of the reasons I’ve moved away from the left. There is too much anger, hypocrisy and pure theatre and too little real caring and pragmatism.

andrew harman
andrew harman
2 years ago

Yes, I have come to dislike the left more and more although I absolutely defend their right to express and opinion. It is just that they seem not to like others to be accorded the same courtesy. It was instructive that the doctor cited in the article spoke of the reaction to his expressing a view that dared to challenge theirs. I have friends from all parts of the spectrum and there is no doubt that it is the ones tending left who are most intolerant of dissent. With a number I avoid political or controversial discussion now. Not all are like that though. I suspect you and I disagree on a number of issues Lesley, indeed this has been apparent a few times but I absolutely welcome the spirit of open debate we see on here. I reject the conspiracy theorising scapegoating often prevalent on the right but they need to be heard. I refer again to Hannah Arendt’s marketplace of ideas: these things are better out in the open. Free speech is the foundation of everything.

Chris Wheatley
Chris Wheatley
2 years ago

How naive – that everyone who doesn’t exactly agree with you has to have a label – The Left. Talk about empty-minded!

Billy Bob
Billy Bob
2 years ago
Reply to  Chris Wheatley

The left have a major problem, in that they’ve allowed the noisy militant minority to the far to come to represent them. You only ever here from idiots such as Momentum on the news and social media rather than the more normal centre left.
It’s not a problem faced by the opposition, the centre right majority are firmly in control, having completely disowned the far right such as the National Front.
Until the left do the same with their more militant side then unfortunately they’ll continue to be associated with them, and it’ll be those that form people’s opinions

Lesley van Reenen
Lesley van Reenen
2 years ago
Reply to  Chris Wheatley

Chris, actually it is instructive that your impulse on reading that my mother had been murdered, was to immediately try and point score against me on the basis of a recent post. Well my position has not changed in a year or a weak – death is a part of life.

Laura Creighton
Laura Creighton
2 years ago

I am shocked to hear about your mother. Deepest condolences.

Lesley van Reenen
Lesley van Reenen
2 years ago

Thanks you Laura

Galeti Tavas
Galeti Tavas
2 years ago

Lockdown was a crime against Rule of Law, Freedom, Children and the Young, and every citizen of the Western World, and most of the economies, and most of the Developing World and all of the Third World..

There has never been such a great injustice imposed by a nation on its own people since the Communist horrors against their own people. This is Covid Response was/is crime against the citizens by their OWN Governments! It ‘The Crime of the Century’ and I wish vast numbers of studies on every single aspects of the main harms produced by Lockdowns are quantified, and blame assigned.

I could list so very many collateral damages, as I have so many times here, and they are an astoundingly great a list of destruction, magnitudes beyond what I would guess taking a Swedish route and letting everyone manage themselves. I fear the entire global economy may be driven into a Great Depression of a scale never seen before by the Gov Debt based spending, Gov QE, wile at the same time reducing production of goods and services to this Vast Degree – wile paying people to not work, and business to remain shuttered.

That is a double hit to the economy. The insanely large loss of productivity, coupled with borrowed money to pay for all those non-created products and services. The people were given the money to consume from debt – and the production of goods and services hugely reduced! This is an impossibility, and it will be paid for. You see tail effects in the Harbours backed up with ships, and gaps on the shelves, and energy costs rocketing, and inflation not seen since the 1970s (which they fought by raising interest to a peak of 20% – if they raise them 2% the economy will collapse)

So our nations are severely harmed – the loss of education alone, irreplaceable. But the most terrible of all is we lost our Rights and Freedom! We became a ‘Subject People’. We are now the property of our Governments, we can be locked up without a trial, we become dependent on Government handouts, our savings and pensions to be destroyed by the inflation and coming stock market crash. We are like children now, to hostile and unjust authority. The Vax Mandates are a crime against citizen’s rights. People who have Natural Immunity being Fired! Locked out of society.

In USA the National Security Services now turned the ‘War Against Terror’, Vast Powers from the ‘Patriot Act’ giving them near carte blanche of power and money and millions of agents – against its own citizens! In some ‘Free countries’ the Military patrolled the streets.

“White supremacist terrorism is the deadliest threat to the United States, President Joe Biden told lawmakers Wednesday night as he aimed to pivot from the country’s post-9/11 foreign fights to one at home.”

WTF??? I live in the South USA, I do not know One White Supremacist, and I work in the construction trades, so should know if such a thing exists. NO this is the might of the Secret Police loosened onto the citizens. Political Crimes, and eventually Gulags like the Chinese have for the Uyghurs, for the wrong thinkers I suppose. This is to keep fear of speaking out at a maximum. To scare the wrong thinkers, and ultimately to punish them.

Covid Lockdown, one night in March 2020 we went to bed in the wealthy Free West, and woke up in a bankrupt Police State. The Women above have seen freedom, risk, danger, courage, resolution, unity, fighting spirit; and they saw none of it these last years. Just a cowed and frightened, subject, people.

Roger le Clercq
Roger le Clercq
2 years ago
Reply to  Galeti Tavas

I think you are largely correct but urge you to get the jab.

Billy Bob
Billy Bob
2 years ago

They’ll be on the horse dewormer would be my guess

Alex Stonor
Alex Stonor
2 years ago
Reply to  Billy Bob

What does it matter to you what people choose for themselves?Your disparaging remarks are the biggest part of the problem: people playing god, judging others especially when the evidence of lies, falsification and suppression of facts are appearing on the media stage daily. This article details one of the crimes against one sector of humanity; children & the young have also suffered and it appears that we’ll never have the data on this.

jim peden
jim peden
2 years ago

We had to rescue my own mother-in-law (now 97) who was living in her own home independently up until March last year. She lost her social contacts due to the lockdowns – nieces and neighbours were afraid to go near her. She has become senile in the past year – a less generic description than deconditioned. I suspect this would have happened at some point without the restrictions and hysterical behaviour but there’s no doubt it has hastened her demise. My wife is now her full-time carer and we too are now unable to resume our former lives. She was a proud woman who made munitions in WW2 and was young for her age but this has finished her. I imagine that this kind of story is repeated in thousands of homes across the UK. Needless to say I have become very sceptical of the competence and motives of the powers that be and their acolytes.

Mary McFarlane
Mary McFarlane
2 years ago
Reply to  jim peden

So sorry to hear of your mother in law’s decline. It has been a nightmare for families with elderly relatives such as yours. We had a similar experience with my poor mother who lived to 97, but happily for her is now released from this world.

Galeti Tavas
Galeti Tavas
2 years ago
Reply to  jim peden

I brought my old mother back from London in December last year to live with me here in USA, she is 95. Here we have no lockdown, it is a lovely climate and she sits on the porch of her cottage, or on my porches (my guest cottage by my house, very tall built on pilings, she walks up the 20 ft of stairs still) which has forest on one side, and water on the other, for hours a day, out in the warm air, watching the environment, fish splashing, birds always flying about, dazzling sunsets and always weather and clouds and sunlight changing. She goes to Church, to various events, shopping, to my beach cottage, the whole world is normal here.

Her 2020 in London was terrible, my sister had to move in with her, and both locked down together….. My sister now also lives with us here, she misses London a bit, but would never wish to do more than visit again.

I wonder if I will be allowed back to London as I refuse the vax.

Billy Bob
Billy Bob
2 years ago
Reply to  Galeti Tavas

Did you get banned Sanford, had to come back on a new name?

Brendan O'Leary
Brendan O'Leary
2 years ago

According to various UK studies, average length of stay in a UK care home is just under 30 months, invariably ending in death.
Narrowing it down to those in nursing beds, it’s about half that.
This inevitably means that during pandemic restrictions, many, probably most, of those who entered a nursing home before 2019 will have died alone without even close family visits.
I’m baffled by the poster below who simultaneously claims the visiting bans were necessary to prevent more deaths and that he feels more sorry for the young.
The young have their lives ahead of them and plenty to look forward to. Care home residents had only one thing to look forward to besides death – family visits, which were denied them by authorities claiming to act on their behalf.

Last edited 2 years ago by Brendan O'Leary
Galeti Tavas
Galeti Tavas
2 years ago

In a sane society the whole system functions to promote the wellbeing of the young. First because they are young so have a life ahead, and are mostly innocents and unworldly. Next because they will do all the work to keep society working as their time comes, and have the families to keep the world functioning, and to give point to our existence.

The old are the ones who have had their time, and are last on the scale of those who should protected. All the people younger have some dependent on them, and they are thus very important and needed by others, The old are dependent, so their loss does not have a circle of dependents left without their means of support.

Brendan O'Leary
Brendan O'Leary
2 years ago
Reply to  Galeti Tavas

The young also want to see their old and dying relatives. Much more than you seen to think. And they see, in the way their dying family members are treated, what lies in the future for them.

Tim Bartlett
Tim Bartlett
2 years ago

A truely dispiriting read. The states dishonesty is matched only by its incompetence. No good raging at them though, its our long term voting habits that have led us here. It seems, as always, if you want to make a better world you have to build the foundations yourself.

Marcus Scott
Marcus Scott
2 years ago

This from the Amnesty International Report:

In March, I tried to get [a resident] into hospital—the ambulance had employed a doctor to do triage but they said, “Well he’s end of life anyway so we’re not going to send an ambulance” … Under normal circumstances he would have gone to hospital … I think he was entitled to be admitted to hospital. These are individuals who have contributed to society all their lives and were denied the respect and dignity that you would give to a 42-year-old; they were [considered] expendable.

Who made these decision within the healthcare system?

Doctors have an obligation to assess the needs of each patient and act accordingly. They are not to follow the order of a politician or a bureucrat if it not in the interest of the patient. I am not aware of a single NHS doctor who spoke up about the mistreatment of the elderly during the early phase of the lockdown when the care homes were all but cut off from medical assistance. I suspect many NHS doctors need to go and reacquaint themselves with their ethical codes, including these two clauses from the Declaration of Geneva:

THE HEALTH AND WELL-BEING OF MY PATIENT will be my first consideration; and

I WILL NOT USE my medical knowledge to violate human rights and civil liberties, even under threat;

Elaine Giedrys-Leeper
Elaine Giedrys-Leeper
2 years ago
Reply to  Marcus Scott

It has been known for years that patients 80 + years (or even younger) with co-morbidities do not do well when admitted to hospital and this was reinforced very early on in the pandemic in relation to critical care and Covid. – you take a 75 + year old and subject them to very unpleasant continuous positive air pressure >> biphasic positive air pressure management or perish the thought, mechanical ventilation (and everything else that goes with treating SARDS in terms of fluid management, renal management, cardiac management etc.) … then they die. This is why when you look at the ICNARC report for critical care April 2020 the mean age of patients in critical care was 60 (SD 12.7) and the median 61 (IQR 52,69).
So, this anecdote that you quote is right on the button – triage for end of life care early in 2020, was carried out either at the care homes by the supervising doctors – the doctors who knew the most about these patients or by doctors who were associated with the ambulance service (not ideal). All these doctors would have known the bald statistics of how poorly elderly patients do in hospitals + in March / April 2020 and in January 2021 they would have been expected to do much worse because of the shortage of trained staff in critical care.
Other piece of information for you – there are NO government guidelines in the UK for a situation where a critical care doctor has only 1 available bed and has to make a choice between 2 + patients as to who gets the care.
In Lombardy in March 2020 they chose simply according to age. Critical care staff in the UK came very close to having to do something like this in early 2020 and January 2021.
Some discussion documents on this thorny issue have been produced by RCPhys, NICE, BMA and the Intensive Care Society but no national conscensus has appeared. A group of hospital doctors in Bath produced a discussion paper to operationalise these decisions in early 2021 and set out principles that could be used practically. They felt that these sorts of decisions were too important for doctors to make on their own.
My guess is that with a waning pandemic and currently no huge strain on critical care that this sort of work is way down Sajid Javid’s “to do” list.
Moral to ths tale ? – make damn sure (no matter your age) that you have a living will in place and that you have discussed it at length with your nearest and dearest and that everyone can access it – makes end of life decisions much easier for the family and health care professionals who will be caring for you.

Marcus Scott
Marcus Scott
2 years ago

The Amnesty Report is not about end of life decisions. It makes the claim that care home residents were “abandoned” because the residents were seen as expendable, blanket DNRs were put in place and the sick refused admission to hospital despite there being the possibility that individuals might have been kept alive. 

For example:

Throughout the pandemic, repeated concerns about the inappropriate use of Do Not Attempt Resuscitation forms have been raised. Care home managers reported to Amnesty cases of local GP surgeries or Clinical Commissioning Groups requesting that they should insert DNAR forms into the files of residents as a blanket approach.

Amnesty’s research exposed how a group of six Sussex CCGs issued DNAR guidance on 23 March 2020 to 35 GP surgeries and 98 care homes. The document instructed all practices to: “Search your clinical system for any care home patients who do not have a resuscitation order recorded (either ‘not for’ or ‘for’ resuscitation) and put appropriate orders in place”.

and:

“From day one, the care home was categoric it was probably COVID and he would die of it and he would not be taken to hospital. He only had a cough at that stage. He was only 76 and was in great shape physically. He loved to go out and it would not have been a problem for him to go to hospital. The care home called me and said he had symptoms, a bit of a cough and that doctor had assessed him over mobile phone and he would not be taken to hospital. Then I spoke to the GP later that day and said he would not be taken to hospital but would be given morphine if in pain… He died a week later.”

Who bears responsibility for this, assuming the claims are accurate?

Elaine Giedrys-Leeper
Elaine Giedrys-Leeper
2 years ago
Reply to  Marcus Scott

In the context of the pandemic in the spring of 2020 when appropriately staffed critical care beds were at a premium one can understand why the alleged “blanket” DNAR guidance (not mandated) was issued.
Overall survival rate for adults following out-patient CPR is about 6% and maybe 10-20% in a hospital setting – these figures decrease with increasing age and only refer up to the time of hospital discharge, not afterwards.
Nationwide CPR registries from Denmark and Sweden report a 30-day survival of out-patient CPR among patients 80 years or older between 2.0% and 4.1%, again, decreasing with increasing age.
As to triage at the care home level for admission to hospital in March / April 2020 and January 2021 that would have been as ever a multifactorial decision – local hospital capacity / patient preference, if known / expected quality of life for patient on dischage (if they survived) / patient’s competence to make a decision / patient’s current medical status etc. etc.
The second anecdote you quote is undated. The “it would not have been a problem for him to go to hospital” would only be a valid statement if the reporter was this 76 year old’s doctor which was clearly not the case. The management failure here was apparently that the patient’s doctor did not have a useful discussion with the friend / relative about the pros and cons of hospital admission for this particular 76 year old with Covid at that time in that particular part of the country (Covid load in the local hospital at that time ?). The fact that morphine was mentioned as part of the end of life management plan would indicate that this doctor knew exactly what they were doing and was suitably compassionate.
In an ideal world everyone would have a written “what to do if I arrive at death’s door” plan covering a series of different scenarios and discussed at length with family / friends / family doctor and updated as ones health and priorities in life, change.
The Care Quality Commission’s 2021 report Protect, respect, connect – decisions about living and dying well during COVID-19 highlighted that sufficient information to complete DNACPR forms was available in only 42% of cases, while an assessment of the patient’s best interests was recorded in only 32%. So, there are a lot of conversations that need to be had in the UK right now between individuals, families and their doctors about death and dying because this happens to EVERYONE sooner or later.
There have been big discussions about how these problems can be managed better at the recent RCPhys Med+ conference and detailed in a recent Medscape briefing which you can Google using “Practical Approach to End of Life Decision Making Needed”

Last edited 2 years ago by Elaine Giedrys-Leeper
Jonathan Ellman
Jonathan Ellman
2 years ago

“… when coronavirus first came knocking, Britain was shamefully unprepared. Between 20,000 and 30,000 of our vulnerable elderly died unnecessarily and horribly.” – Not only when it first came knocking but seemingly as late as February 2021 when Captain Sir Tom Moore contracted covid in hospital. It’s not certain that’s true and the figures for those who contracted covid either in hospital or in care homes are not clear either. But of those that died ‘of’ covid rather than ‘with covid, it could be as high as 50 percent. Furthermore, had the focus of our efforts been on protecting the vulnerable, nosocomial infections may well have been far lower. And if those that died ‘with’ covid are discounted, then the death toll is closer to a quarter of the official estimate than to half.
None of this is clear and given the uncertainty and fear around the disease, heads do not necessarily need to roll. But, as with the effect of lockdowns on the very young populations of Africa and the rest of the developing world and as with the origins of the disease, this needs a more thorough and open investigation.

Chris Wheatley
Chris Wheatley
2 years ago

Depending on your definition of the word ‘elderly’, about 20% of the population of the UK is elderly. It must be a truism to say that Britain neglects them.
Britain follows the USA in sending the elderly to care/rest homes when in other parts of the world the elderly are respected and stay as part of the family. It could be argued that this imprisonment is for the health of the prisoners; it could also be argued that their children are just too busy to look after them. Let’s say a bit of both. This is the first step in the master plan. It has been said that the reason COVID attacks ethnic minorities badly is that the elderly in these communities stay as part of the family unit.
So, on the one hand we throw out our old ones and then complain that the government is maltreating them in a pandemic or, on the other hand, we keep them with us and they could suffer at home. Hm! Who can we blame if we don’t agree on a personal level? Why can’t we have the best of both worlds?
Another point. If we value and respect the elderly so much, why isn’t it a hate crime to call someone an ‘old bas**rd’ or ‘an ‘awkward old sod’? Why are there almost no articles about the elderly on UnHerd? Why are the opinions of the elderly ignored?
It is said that more than 50% of the readers of The Daily Mail are over 65. Shouldn’t we be looking at the letters pages of the DM for the real opinions of the elderly? If the elderly are at risk of dying of COVID, shouldn’t lockdown vs no lockdown or masks vs no masks be decided by a referendum of the elderly? Shouldn’t calling someone a Boomer be a hate crime? Could each nursing home have a vote?
My point here is that people are claiming to speak for the elderly without asking their opinions on things. That is a lack of respect.

Last edited 2 years ago by Chris Wheatley
Galeti Tavas
Galeti Tavas
2 years ago
Reply to  Chris Wheatley

“Shouldn’t calling someone a Boomer be a hate crime?”

I always run for my safe space if anyone uses the word ‘Boomer’. Please give a trigger warning before using that hate term next time.

Francis MacGabhann
Francis MacGabhann
2 years ago

My heart breaks for these old people, especially as I know it’s all so unnecessary. It’s about narcissistic people polishing their halos, and the don’t give a damn the pain they cause others.

Jeffrey Chongsathien
Jeffrey Chongsathien
2 years ago

Politicians, police, doctors, voters… whoever supported all this sadistic crap over the last 2 years should be hung for crimes against humanity. Death penalty now.

Last edited 2 years ago by Jeffrey Chongsathien
Galeti Tavas
Galeti Tavas
2 years ago

calm down, there is little likelihood that the mess of blame will ever be unraveled. The security systems who are tasked with uncovering conspiracies and all captured by those who need investigation. The foxes now run the hen house.

Michael Kellett
Michael Kellett
2 years ago

Thank you for this article. Like others who have commented here, it brought tears to my eyes. What we have done to these gallant ladies – and to all the thousands of others who are and have been in the same situation – is a national shame and disgrace. Johnson, Hancock, Whitty, Ferguson et al, who are the ones ultimately responsible, should all be made to read this. I hope and expect that history will not be kind to them.

Billy Bob
Billy Bob
2 years ago

What would you rather those politicians have done?

Edward De Beukelaer
Edward De Beukelaer
2 years ago

What should really worry us is that the ‘medical profession’ asks for more restrictions etc. Makes you wonder what their ethics are or is heir perspective so narrow they do not have the vision to care for people’. Public health is far far far more than coronavirus. And, note, it is not coronavirus that has caused many of the problems, it is the decisions made by narrow focussed experts and scared politicians, cornered by the press, that have caused all these issues.
The pandemic is the consequence of pollution, bad food (bad health) and a type of medicine that is not adapted to reality (= a medicine based on an industry of illness: for them coronavirus was ‘God-sent’).

T Doyle
T Doyle
2 years ago

Very good article.

Liz Walsh
Liz Walsh
2 years ago

God bless those valiant women. Like the common for Holy Matrons, fortem virile pectore. It is unkind to isolate elders, to preserve their health…most of us humans would much rather live every day of our lives — till the last moment, be it soon or late. It is, of course, a projection of the fearful souls who populate the administrative state. Until they get over fear, those folks are going to have all bad days. Thank you for your service, and KBO, ladies!

D Glover
D Glover
2 years ago

 it will ask whether our very oldest, most precious citizens were ‘protected’ from Coronavirus

That’s a bit manipulative. You could make a case for the young being ‘precious’ in the sense that they have lives to live.
You could make a case that the young are giving up more than the old. Education, earnings, partying, concerts have all been foregone. Friends haven’t been met, jobs haven’t been started.
We shut down society to protect the elderly, because they are the main group who die of covid. We didn’t lock up the old to protect anybody young.

Billy Bob
Billy Bob
2 years ago

Unfortunately if the government hadn’t enforced restrictions on rest homes realistically tens of thousands more would have died.
There’s an argument to be had about which is worse, living in enforced isolation or a much higher fatality rate, a decision I’m glad I’ve not had to make quite frankly, however I feel the government was in a no win situation with that one, especially after the criticism they received at the start of the pandemic for sending Covid patients back into the care homes to free up hospital beds.
All generations have suffered due to lockdowns, personally I think the young have been affected much worse than the elderly

Lesley van Reenen
Lesley van Reenen
2 years ago
Reply to  Billy Bob

Wheeee…. And there goes the whole point of the article over Billy Bob’s head.

Billy Bob
Billy Bob
2 years ago

What is the point of the article then Les? The way I read it was that the elderly suffered due to the loneliness caused by lockdown.
If that’s incorrect what are you suggesting the author was trying to say in their piece?

Lesley van Reenen
Lesley van Reenen
2 years ago
Reply to  Billy Bob

That things should change the next time an infectious disease hoves into view. This happens every year btw.

Martin Brumby
Martin Brumby
2 years ago

Lesley, you are quite right. And reference to previous Pandemics (not least Asian Flu 1957 & Hong Kong Flu 1968) shows that all this tyranny and cruelty can’t be justified.
There is no doubt in my mind that, even in the few years left to me, it will be recognised that the lockdowns have destroyed more lives than those they allegedly saved.
And I don’t believe that this was just the usual Government incompetence.

Galeti Tavas
Galeti Tavas
2 years ago
Reply to  Martin Brumby

It was part of a dark plan. Locking down the world for a virus which 99+% survive was not sane.

The repercussions of this breaking of the global economic system will cause huge problems, a vast number will never recover economically from this, maybe billions will have their life earnings reduced so severely they will have poverty as their lot.

Billy Bob
Billy Bob
2 years ago

So what should change?
Realistically I can see two options regarding the care homes, which is to allow visitors which will increase the number of fatalities amongst care home residents as we saw at the beginning of the pandemic, or essentially quarantine them to stop them being killed but lessening their quality of life so.
I doubt you’d find a consensus even amongst the residents, a 95 year old on their last legs would no doubt have a different attitude to a more sprightly 70 year old for instance, so expecting society at large to rally around a single plan simply would never happen

Iris C
Iris C
2 years ago
Reply to  Billy Bob

“If the government hadn’t enforced restriction on rest homes, realistically tens of thousands more would have died,” you say.. Really! How can you justify that figure. You can’t! You are just maintaining the stance you have taken and massaging your self-righteousness.

Billy Bob
Billy Bob
2 years ago
Reply to  Iris C

Because we know the virus is much more deadly for the elderly, therefore it stands to reason that letting it work its way through rest homes early in the pandemic would have likely resulted in thousands of more deaths. Look how many died in the initial stages when patients were sent back to rest homes to get a picture of just how many would have been infected.
This isn’t to say what was the correct approach, as I honestly don’t know, but after the criticism the government received for not protecting the elderly at the start you can’t really then blame them for isolating the care homes afterwards

Iris C
Iris C
2 years ago
Reply to  Billy Bob

But wouldn’t they be the same deaths but only occurring later?

Ian Stewart
Ian Stewart
2 years ago

It’s laudable that this writer is seeking to document the experiences and insights of the old, which are invaluable.
However she then launches into a long condemnation of our treatment of the elderly during Covid, using ‘shame’ and ‘league of shame’ language. I get thoroughly sick of smart ass journalists who can see and solve all the worlds problems condemning everything society attempts to do, and these old people won’t have tolerated such attitudes in their prime, constantly applying blame and victim allocation.

Last edited 2 years ago by Ian Stewart