Coronavirus crisis causes spike in the number of Britons dying at home
Coronavirus crisis has caused a spike in the number of Britons dying from cardiac arrests at home because people are ‘too scared to call 999 in case they catch the disease in hospital’
- Dozens more people than usual are dying at home from cardiac arrests every day
- Doctors say seriously ill people are taking longer than normal to phone 999
- Patients worried about catching virus or don’t want to be a burden on the NHS
- Learn more about how to help people impacted by COVID
The coronavirus crisis has led to a spike in the number of Britons dying from cardiac arrests at home, medics have warned.
More than 80 extra deaths are occurring every day in London alone before paramedics reach the victims, leaked A&E figures show.
Doctors fear seriously ill people are reluctant to phone an ambulance because they are worried about catching the coronavirus or don’t want to be a burden on the NHS.
Many of the excess deaths are thought to be caused by the virus, raising fears the true death toll is far higher than the official 12,000.
Dozens more people than usual are dying at home from cardiac arrests every day before paramedics reach them, leaked A&E figures show. Pictured: Paramedics wearing face masks as they take a patient in to to St Thomas’ Hospital in London
Official data showed the week ending April 3 was the deadliest since records began in 2005, with 16,387 fatalities recorded (navy line). There were 6,082 deaths over the five-year average (orange line). The graph shows how the week compares to others since the start of 2020
Minutes of a meeting held by London A&E bosses last week, obtained by The Guardian, said there were almost three times the number of 999 calls for cardiac arrests on the weekend of April 4 and 5.
The ambulance service was called out 140 times a day compared to its average 55. Most of the people concerned were dead by the time paramedics arrived.
The minutes of the online meeting, held on Monday 6 April, said: ‘People don’t want to go near hospital, as a result salvageable conditions are not being treated.
Robert Dingwall, a professor of social sciences at Nottingham Trent University told MailOnline a ‘deterioration’ in health is expected in the next couple of years due to the damage of the coronavirus pandemic.
He said: ‘High levels of unemployment are strongly associated with poor health outcomes at a population level.’
The impact on physical health may become apparent at a slower rate than mental health.
It will ‘be expressed in a continuing rise in obesity resulting from inactivity, limited diet and, in some cases, excess alcohol’, Professor Dingwall said.
‘Obesity is associated with a range of other conditions like Type 2 diabetes, cardiac, circulatory and respiratory problems.
‘There are also worrying indications of people delaying presentation at hospitals for conditions like stroke, where immediate medical treatment can have a big impact on the outcome.’
The Institute for Fiscal Studies (IFS) warn of the coronavirus pandemic putting ‘the NHS under unprecedented strain and leading to cancelled operations and disruptions to non-coronavirus emergency care’.
This will disproportionately affect older individuals, and those from less affluent backgrounds, both in the short and the medium term, the think-tank warned.
Emergency hospital admissions per head are ten times higher among those in their 90s than among those in their 30s, and 1.7 times higher among those from the most deprived areas than among those from the least deprived.
The NHS has already postponed all non-urgent elective operations for at least the next three months.
George Stoye, an associate director at IFS, said: ‘This will cause immediate distress to those affected and knock on effects on waiting times that could take years to unwind.’
‘Patients with conditions that are time critical re not presenting and concerns rising as to how we manage these patients, eg, no longer able to perform an open appendectomy [for an inflamed appendix].’
Medics believe that many of the excess deaths are caused by coronavirus.
The disease makes it harder to breathe and get oxygen into the lungs, forcing the heart to work harder.
‘Of these 85 extra cardiac arrest deaths a day in London, they must be mainly COVID-19,’ said the head of one A&E department.
It comes after an extra 2,600 non-coronavirus deaths were recorded in a single week.
England and Wales suffered a total of 16,387 deaths in the week up until April 3, the most since 2005 and more than 6,000 above average.
Of the excess deaths, COVID-19 was not reported on at least 2,600 certificates, meaning they were from other causes.
Tom Dening, professor of dementia research at the University of Nottingham, said there were many reasons for the spike, ‘including people not feeling able to attend their GP surgeries, call an ambulance or attend A&E.
He added: ‘Therefore, some serious conditions may present too late for effective treatment.
‘Another possibility is that some people with serious conditions, like cancer or chronic kidney disease, are either unable or unwilling to attend hospital on the usual regular basis, so their treatment regimes may lapse.
‘Some people confined to their homes are likely to be drinking and smoking more, or eating less healthily, and this may also contribute to health problems, including accidents, around the home.’
People with diabetes or high blood pressure may struggle to manage their condition if GP surgeries are closed, he added.
Appointments have moved to over the phone or video call, but managing unstable conditions is much harder remotely than with face to face attention.
Robert Dingwall, a professor of social sciences at Nottingham Trent University, said the strain of the outbreak on the NHS may be resulting in heart attacks or stroke patients not being treated quickly enough.
He added: ‘There is some fears that parents aren’t taking children sick to hospital. They fear if they take their children to A&E they may be infected with COVID-19.
‘A child with chronic asthma for example, it’s a perpetual worry for parents. Maybe, parents are hanging on a bit longer [to go to hospital] and the interventions are less effective.’
Professor Dingwall said some deaths may reflect an increase in suicides or stress-related physical disorders as a result of lockdown and unemployment.
But he said it was too early to say this was the case for sure due to how those deaths are investigated.
There are also concerns the disruption to daily life will drive people to drink more alcohol, smoke or eat unhealthily.
Professor David Spiegelhalter, of the University of Cambridge, said he was disturbed by the rise in deaths, The Times reports.
‘I don’t think I’ve been as shocked when I looked at something. I knew there was going to be a jump in Covid-registered deaths. I hadn’t expected such a huge number of deaths which didn’t mention it on the death certificate.’
An NHS spokesperson said: ‘Anybody who needs urgent help – people experiencing heart failure, or expectant mums worried about their baby – should absolutely come forward and seek help from their local NHS.
‘There is no doubt that, as the chief medical officer said, coronavirus is putting more pressure on NHS services, but NHS staff are freeing up thousands more beds for critical care whilst also keeping other essential services running, so parents, relatives and anyone worried about their health should continue to use their NHS.’
WHAT DO WE KNOW ABOUT THE CORONAVIRUS?
What is the coronavirus?
A coronavirus is a type of virus which can cause illness in animals and people. Viruses break into cells inside their host and use them to reproduce itself and disrupt the body’s normal functions. Coronaviruses are named after the Latin word ‘corona’, which means crown, because they are encased by a spiked shell which resembles a royal crown.
The coronavirus from Wuhan is one which has never been seen before this outbreak. It has been named SARS-CoV-2 by the International Committee on Taxonomy of Viruses. The name stands for Severe Acute Respiratory Syndrome coronavirus 2.
Experts say the bug, which has killed around one in 50 patients since the outbreak began in December, is a ‘sister’ of the SARS illness which hit China in 2002, so has been named after it.
The disease that the virus causes has been named COVID-19, which stands for coronavirus disease 2019.
Dr Helena Maier, from the Pirbright Institute, said: ‘Coronaviruses are a family of viruses that infect a wide range of different species including humans, cattle, pigs, chickens, dogs, cats and wild animals.
‘Until this new coronavirus was identified, there were only six different coronaviruses known to infect humans. Four of these cause a mild common cold-type illness, but since 2002 there has been the emergence of two new coronaviruses that can infect humans and result in more severe disease (Severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) coronaviruses).
‘Coronaviruses are known to be able to occasionally jump from one species to another and that is what happened in the case of SARS, MERS and the new coronavirus. The animal origin of the new coronavirus is not yet known.’
The first human cases were publicly reported from the Chinese city of Wuhan, where approximately 11million people live, after medics first started publicly reporting infections on December 31.
By January 8, 59 suspected cases had been reported and seven people were in critical condition. Tests were developed for the new virus and recorded cases started to surge.
The first person died that week and, by January 16, two were dead and 41 cases were confirmed. The next day, scientists predicted that 1,700 people had become infected, possibly up to 7,000.
Where does the virus come from?
According to scientists, the virus almost certainly came from bats. Coronaviruses in general tend to originate in animals – the similar SARS and MERS viruses are believed to have originated in civet cats and camels, respectively.
The first cases of COVID-19 came from people visiting or working in a live animal market in Wuhan, which has since been closed down for investigation.
Although the market is officially a seafood market, other dead and living animals were being sold there, including wolf cubs, salamanders, snakes, peacocks, porcupines and camel meat.
A study by the Wuhan Institute of Virology, published in February 2020 in the scientific journal Nature, found that the genetic make-up virus samples found in patients in China is 96 per cent identical to a coronavirus they found in bats.
However, there were not many bats at the market so scientists say it was likely there was an animal which acted as a middle-man, contracting it from a bat before then transmitting it to a human. It has not yet been confirmed what type of animal this was.
Dr Michael Skinner, a virologist at Imperial College London, was not involved with the research but said: ‘The discovery definitely places the origin of nCoV in bats in China.
‘We still do not know whether another species served as an intermediate host to amplify the virus, and possibly even to bring it to the market, nor what species that host might have been.’
So far the fatalities are quite low. Why are health experts so worried about it?
Experts say the international community is concerned about the virus because so little is known about it and it appears to be spreading quickly.
It is similar to SARS, which infected 8,000 people and killed nearly 800 in an outbreak in Asia in 2003, in that it is a type of coronavirus which infects humans’ lungs. It is less deadly than SARS, however, which killed around one in 10 people, compared to approximately one in 50 for COVID-19.
Another reason for concern is that nobody has any immunity to the virus because they’ve never encountered it before. This means it may be able to cause more damage than viruses we come across often, like the flu or common cold.
Speaking at a briefing in January, Oxford University professor, Dr Peter Horby, said: ‘Novel viruses can spread much faster through the population than viruses which circulate all the time because we have no immunity to them.
‘Most seasonal flu viruses have a case fatality rate of less than one in 1,000 people. Here we’re talking about a virus where we don’t understand fully the severity spectrum but it’s possible the case fatality rate could be as high as two per cent.’
If the death rate is truly two per cent, that means two out of every 100 patients who get it will die.
‘My feeling is it’s lower,’ Dr Horby added. ‘We’re probably missing this iceberg of milder cases. But that’s the current circumstance we’re in.
‘Two per cent case fatality rate is comparable to the Spanish Flu pandemic in 1918 so it is a significant concern globally.’
How does the virus spread?
The illness can spread between people just through coughs and sneezes, making it an extremely contagious infection. And it may also spread even before someone has symptoms.
It is believed to travel in the saliva and even through water in the eyes, therefore close contact, kissing, and sharing cutlery or utensils are all risky. It can also live on surfaces, such as plastic and steel, for up to 72 hours, meaning people can catch it by touching contaminated surfaces.
Originally, people were thought to be catching it from a live animal market in Wuhan city. But cases soon began to emerge in people who had never been there, which forced medics to realise it was spreading from person to person.
What does the virus do to you? What are the symptoms?
Once someone has caught the COVID-19 virus it may take between two and 14 days, or even longer, for them to show any symptoms – but they may still be contagious during this time.
If and when they do become ill, typical signs include a runny nose, a cough, sore throat and a fever (high temperature). The vast majority of patients will recover from these without any issues, and many will need no medical help at all.
In a small group of patients, who seem mainly to be the elderly or those with long-term illnesses, it can lead to pneumonia. Pneumonia is an infection in which the insides of the lungs swell up and fill with fluid. It makes it increasingly difficult to breathe and, if left untreated, can be fatal and suffocate people.
Figures are showing that young children do not seem to be particularly badly affected by the virus, which they say is peculiar considering their susceptibility to flu, but it is not clear why.
What have genetic tests revealed about the virus?
Scientists in China have recorded the genetic sequences of around 19 strains of the virus and released them to experts working around the world.
This allows others to study them, develop tests and potentially look into treating the illness they cause.
Examinations have revealed the coronavirus did not change much – changing is known as mutating – much during the early stages of its spread.
However, the director-general of China’s Center for Disease Control and Prevention, Gao Fu, said the virus was mutating and adapting as it spread through people.
This means efforts to study the virus and to potentially control it may be made extra difficult because the virus might look different every time scientists analyse it.
More study may be able to reveal whether the virus first infected a small number of people then change and spread from them, or whether there were various versions of the virus coming from animals which have developed separately.
How dangerous is the virus?
The virus has a death rate of around two per cent. This is a similar death rate to the Spanish Flu outbreak which, in 1918, went on to kill around 50million people.
Experts have been conflicted since the beginning of the outbreak about whether the true number of people who are infected is significantly higher than the official numbers of recorded cases. Some people are expected to have such mild symptoms that they never even realise they are ill unless they’re tested, so only the more serious cases get discovered, making the death toll seem higher than it really is.
However, an investigation into government surveillance in China said it had found no reason to believe this was true.
Dr Bruce Aylward, a World Health Organization official who went on a mission to China, said there was no evidence that figures were only showing the tip of the iceberg, and said recording appeared to be accurate, Stat News reported.
Can the virus be cured?
The COVID-19 virus cannot be cured and it is proving difficult to contain.
Antibiotics do not work against viruses, so they are out of the question. Antiviral drugs can work, but the process of understanding a virus then developing and producing drugs to treat it would take years and huge amounts of money.
No vaccine exists for the coronavirus yet and it’s not likely one will be developed in time to be of any use in this outbreak, for similar reasons to the above.
The National Institutes of Health in the US, and Baylor University in Waco, Texas, say they are working on a vaccine based on what they know about coronaviruses in general, using information from the SARS outbreak. But this may take a year or more to develop, according to Pharmaceutical Technology.
Currently, governments and health authorities are working to contain the virus and to care for patients who are sick and stop them infecting other people.
People who catch the illness are being quarantined in hospitals, where their symptoms can be treated and they will be away from the uninfected public.
And airports around the world are putting in place screening measures such as having doctors on-site, taking people’s temperatures to check for fevers and using thermal screening to spot those who might be ill (infection causes a raised temperature).
However, it can take weeks for symptoms to appear, so there is only a small likelihood that patients will be spotted up in an airport.
Is this outbreak an epidemic or a pandemic?
The outbreak was declared a pandemic on March 11. A pandemic is defined by the World Health Organization as the ‘worldwide spread of a new disease’.
Previously, the UN agency said most cases outside of Hubei had been ‘spillover’ from the epicentre, so the disease wasn’t actually spreading actively around the world.
Source: Read Full Article