Covid danger warnings ‘inexplicably removed from Welsh Government advice note’

Martin Shipton

Warnings that failing to test care home residents who showed no symptoms of Covid-19 was dangerous were “inexplicably” removed from a Welsh Government advice note, the UK Covid Inquiry has been told.

Evidence given to the latest module of the Inquiry proved that the Welsh Government had recklessly caused the deaths of care home residents, according to the solicitor representing Covid Bereaved Families for Justice Cymru.

Brian Stanton gave a closing statement to Module 6 of the Inquiry on behalf of the group that accused the government of “hiding behind the science” rather than admitting its errors.

‘Damning’

He said: “The findings of the Vivaldi Study [into Covid-19 infections in care homes] are a damning indictment of the failure to protect the most vulnerable within our society, and raise serious questions about the extent to which the right to life was protected.

“The study found that 33% of surviving care home residents were infected with Covid-19 during the first wave, and that once infected, there was a 36% chance they would die. To show how wholly disproportionate these risks were, the ONS [Office for National Statistics] estimates that as of August 19 2020, just 1.8% of those living in private households in Wales had been infected and the death rate in the general population was around 1%.”

Mr Stanton listed specific areas of failure, all of which, he said, contributed to the appalling outcomes in care homes in Wales.

‘Dysfunctional’

On testing failures, he said: “Testing decisions and policy in Wales were so slow, dysfunctional and reactionary that it’s hard to know where to begin. Emails from Care Inspectorate Wales following a meeting with the Welsh Government on April 22 2020 record that testing arrangements are fragmented and differ across Wales, there is no central lead for testing, and no one could answer the question who or what organisation is in charge.

“The Welsh Government’s position on testing has two key features. First, that the risk of discharging untested patients into care homes did not come to the fore until April 15. Second, that it was not until May 12 that the balance tipped in favour of a programme of testing asymptomatic care home residents and staff.

“The Cymru Group submits that both these submissions are false. In both cases, testing was required because of the risk of asymptomatic transmission. You heard in Module 7 from professors Fraser, Nurse and Harris that the evidence of asymptomatic transmission emerged quite clearly throughout February and March 2020 through studies from China, Hong Kong, Italy, and the cruise ship Diamond Princess.

“This evidence was not hidden from Wales; it was publicly available and until understood. And just yesterday you heard from the RCN, the largest group of frontline professionals, that asymptomatic transmission was very clearly apparent from the evidence prior to March.

“Given the extreme vulnerability of care home residents to care home infection, proper precautionary approach demanded asymptomatic testing both on discharge from hospital and routinely within care homes at the earliest opportunity. The Welsh Government decided against this precautionary approach, and chose to prioritise testing elsewhere, but rather than own and explain this decision at the Inquiry, they have hidden behind the science.”

Meeting note

Mr Stanton went on to set out how Public Health Wales met with Public Health England on April 18 2020 to discuss the results of a study. Directly following this meeting, Public Health Wales produced a meeting note that included the following statements: “Covid-19 has proved highly infectious in closed settings. Once three or more cases are reported, there is around 50% prevalence in both staff and residents, despite apparent use of PPE. Most care homes will become affected over the next six weeks. There is also evidence of underreporting in deaths and of a rise in deaths in the care home setting. Possible measures to consider include prevention of entry into the home and more testing of staff, including asymptomatic.”

Mr Stanton said this report was shared with the Welsh Government immediately on April 18, such was its significance, and prompted the drafting of ministerial advice the same day.

He added: “This advice was not finalised until April 30, an inordinate delay given the serious risk to life, and when finally produced it advised against routine testing based on a lack of evidence in favour of asymptomatic testing and a lack of testing capacity.

“However, an earlier version of this advice, which was commenced on April 18, states something very different about the evidence in favour of asymptomatic testing. It states: ‘Our current policy in Wales is to test all symptomatic residents and staff. Evidence suggests that this approach results in asymptomatic Covid-19 individuals, many of whom will go on to develop disablements, not being identified and a source of ongoing risk to residents and staff international evidence suggests that increasing testing in care homes for asymptomatic staff will provide added protection against the virus.’

“Inexplicably, these warnings that accurately reflected the scientific position at the time were removed from the final advice.

“The Welsh Bereaved are outraged to learn from Inquiry disclosure that the Welsh Government clearly knew from at least April 18 of the need for asymptomatic testing, yet continued to publicly deny its clinical efficacy until May 12, after the damage of wave one had already been done.

“This tactic of using claimed scientific advice to stifle debate and challenge sat uneasily with some of their scientists. For example, the message of the Welsh Chief Scientific Adviser for Health, Rob Orford on March 27 2021, asking ironically: ‘Do we need some emergency science this weekend?’

“The group submits that this cynical approach is now clearly exposed at the Inquiry.”

After outlining further failings in the way care home residents were treated, Mr Stanton concluded: “The Welsh Government needs to step up and take responsibility for what went wrong so that there can be learning and improvement and so that families can begin to move on. And if the evidence heard in this module does not convince them to do so, nothing will.”