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2,000 elderly residents died in care homes in a single week, largely unnoticed, because they weren't included in the daily press briefing numbers. As the grim statistics finally start to catch up with the peak of the outbreak, here's what went wrong... https://twitter.com/ONS/status/1255068610034360320?s=19
March 19: government secretly tells hospitals to send hundreds of elderly coronavirus patients to care homes to recover, while potentially still infectious. This clears hospital beds, but has devastating results in the fragmented care home sector. https://www.telegraph.co.uk/news/2020/04/24/care-homes-ordered-take-patients-suspected-coronavirus-nhs-hospitals/
March 27: care homes raise the alarm about issues with staffing shortages due to illness and self isolating, and a lack of PPE and testing. https://www.bbc.co.uk/news/uk-england-52066318
April 2: government updates guidance to reinforce that care homes should take in elderly people from hospitals and homes without waiting for them to test negative for coronavirus. One care home owner describes this as "importing death into care homes". https://news.sky.com/story/coronavirus-sacrificing-the-elderly-care-homes-asked-to-take-covid-19-patients-11969661
April 3: meanwhile reports emerge that the NHS is telling GPs that hospitals won't take in sick care home residents, and that they should just be left in their homes to die untreated, uncounted, and potentially infecting other residents and staff. 
https://www.bbc.co.uk/news/uk-politics-52155359
https://www.bbc.co.uk/news/uk-politics-52155359
April 4: a care home in Sheffield is criticised for taking in recovering hospital patients. We now know they were following govt guidance. https://www.bbc.co.uk/news/uk-england-south-yorkshire-52164672
Within a few weeks almost 1 in 10 of that care home's residents are dead, 30% have been sick, and half the staff have been off work. This is the cost of the government's hospital bed clearing operation. https://www.ft.com/content/86d9807e-2a47-47b2-8dff-8ab50b16e036
April 8: the Chief Medical Officer advises people not to visit care homes. Sensible, but a bit pointless if you're still telling care homes to take in elderly people recovering from coronavirus who may still be infectious, without even testing them. 
https://www.express.co.uk/news/uk/1266385/Coronavirus-care-homes-latest-Chris-Whitty-news-UK-covid-19-death-toll
https://www.express.co.uk/news/uk/1266385/Coronavirus-care-homes-latest-Chris-Whitty-news-UK-covid-19-death-toll
April 10: the @DHSCgovuk and CQC realise their numbers are hopelessly wrong and make it easier for care homes to report deaths. As almost nobody is being tested, they start counting suspected covid-19 deaths too. https://www.independent.co.uk/news/health/coronavirus-care-home-deaths-england-easter-bank-holiday-latest-a9477826.html
April 13: reports emerge that care home deaths caused by covid-19 are being massively under reported. In one week deaths in care homes were 1,280 higher than average, but only 175 of the death certificates mentioned coronavirus.
Thread here - https://twitter.com/C4Ciaran/status/1251445665084903427?s=19
Thread here - https://twitter.com/C4Ciaran/status/1251445665084903427?s=19
April 13: data shows that in other European countries up to half of all covid-19 deaths took place in care homes. Our government claims the number here is about 10%.
They're clearly wrong. https://www.theguardian.com/world/2020/apr/13/half-of-coronavirus-deaths-happen-in-care-homes-data-from-eu-suggests
They're clearly wrong. https://www.theguardian.com/world/2020/apr/13/half-of-coronavirus-deaths-happen-in-care-homes-data-from-eu-suggests
April 13: even the government's figures now show that 1 in 7 care homes have reported cases of coronavirus, including 92 outbreaks in the last 24 hours. https://www.mirror.co.uk/news/politics/breaking-care-homes-face-coronavirus-21860324
April 14: only 500 care home workers have been tested so far. More than a million people work in social care, many of whom are off sick or self isolating as a precaution. https://www.independent.co.uk/news/uk/politics/coronavirus-care-home-cases-testing-nhs-workers-easter-latest-a9464771.html
April 14: @MattHancock pledges that sick care home staff and residents will now all be tested, starting "immediately".
Spoiler: this isn't true. https://www.itv.com/news/2020-04-15/coronavirus-matt-hancock-peston-testing-care-homes/
Spoiler: this isn't true. https://www.itv.com/news/2020-04-15/coronavirus-matt-hancock-peston-testing-care-homes/
April 16: @MattHancock claims that only 15% of care homes have reported cases of coronavirus. Given the lack of testing and delays in reporting, this is likely to be severely underestimating the scale of the problem. https://www.dailymail.co.uk/news/article-8224439/Governments-handling-care-homes-lockdown-shambolic.html
April 17: survey reports 42% of care home workers now dealing with suspected cases of covid-19 in their homes. Most say there has been no testing of staff or residents yet. The virus is out of control and we have no idea how many cases there really are. https://www.itv.com/news/2020-04-17/exclusive-poll-shows-true-extent-of-coronavirus-crisis-in-care-homes/
April 19: the National Care Forum estimates 4,000 residents have died in care homes, unnoticed, because the daily briefing only reports deaths in hospitals. That's more than the 3,300 care home residents who died in a hospital, and therefore were counted. https://www.theguardian.com/society/2020/apr/19/care-homes-body-says-4000-residents-may-died-have-from-coronavirus
April 21: official figures report 1,000 covid-19 deaths in care homes in the week to April 10th, up from 217 the previous week. They expect another 1,000 died over the Easter weekend. This is awful, but still underestimating the true scale of the crisis. https://www.theguardian.com/world/2020/apr/21/coronavirus-deaths-in-care-homes-in-england-and-wales-more-than-quadruple-in-a-week
April 22: a GP reports 125 of 1,000 care home residents registered at her practice have died in the last month. Normally it'd be about 28. She lists a catalogue of failings, from a lack of testing and PPE to sick patients being discharged into care homes. https://www.theguardian.com/world/2020/apr/22/without-a-plan-its-not-going-to-stop-care-homes-fear-worst-yet-to-come-covid-19
April 22: the Chief Medical Officer seems to say deaths in care homes are largely unavoidable and that we'll just have to count the dead when this is all over.
Many of these deaths were completely avoidable if basic precautions had been taken. https://www.bbc.co.uk/news/uk-politics-52386808
Many of these deaths were completely avoidable if basic precautions had been taken. https://www.bbc.co.uk/news/uk-politics-52386808
April 23: @MattHancock claims that "anybody in a care home who has symptoms now gets tested".
Spoiler: he's wrong.
Spoiler: he's wrong.
April 23: @BrandonLewis goes off script and admits sick care home workers still aren't being tested and this is "dreadful". The govt is struggling to meet its testing target, and half the capacity available isn't used because it's hard to access. https://www.theneweuropean.co.uk/top-stories/cabinet-minister-brandon-lewis-admits-dreadful-more-care-workers-not-tested-for-coronavirus-gmb-piers-morgan-northern-ireland-secretary-1-6620233
April 24: @MattHancock denies that care home residents still can't get tests "because we have changed the rules".
He's still wrong. https://twitter.com/GMB/status/1253574704033599489?s=19
He's still wrong. https://twitter.com/GMB/status/1253574704033599489?s=19
April 24: leaked email says "processes to [test sick care home residents] have still not been established" as of the 22nd. Also staff must travel (sometimes hours) to drive through test sites. The rules might have changed but staff still can't get tested. https://www.theguardian.com/world/2020/apr/24/sick-care-home-residents-not-tested-despite-uk-government-pledge
April 26: @DominicRaab throws his colleague @MattHancock under the bus AND lies, claiming patients "have to be tested" before being discharged to care homes. Govt guidance still says "negative tests are not required prior to transfers into the care home" https://twitter.com/BBCPolitics/status/1254374349638942721?s=19
April 27: while elderly patients were being refused treatment or sent back to care homes while still infectious, the much vaunted temporary hospital at the Excel in London has been sitting empty, with only 51 patients in 3 weeks. https://www.bbc.co.uk/news/uk-england-london-52448982
When this is over we must overhaul our fragmented social care system to make sure it can never happen again. There are 400,000 residents in tens of thousands of care homes run by thousands of companies and charities, often on a shoestring budget.
https://www.ageuk.org.uk/discover/2020/04/government-care-homes-coronavirus/
https://www.ageuk.org.uk/discover/2020/04/government-care-homes-coronavirus/
Many big chains are run by hedge funds and vulture equity groups that send any profits to tax havens while saddling their homes with massive debts, paying staff peanuts, and cutting costs to the bare bones. https://www.ft.com/content/952317a6-36c1-11ea-a6d3-9a26f8c3cba4
Combined with the govt's decision to discharge sick patients to care homes and hospitals then refusing to take new cases back from homes, and failure to provide PPE or testing to care homes, the result has been devastating.
Worryingly, excess deaths in care homes that week were double the number mentioning covid-19 on the death certificate. Either lots of coronavirus deaths STILL aren't being counted, or lots more people are dying from other things as care homes struggle. https://twitter.com/BBCNews/status/1255108467309846529
April 29: Govt adds non-hospital deaths to its numbers. But it still only counts people who tested +ve. Given almost nobody was tested in care homes, this handily sweeps 1000s of deaths under the carpet, and will continue underestimating daily deaths. https://twitter.com/DHSCgovuk/status/1255544386940739584
https://twitter.com/DHSCgovuk/status/1255544386940739584
Very detailed report from Reuters covering the disastrous decisions and lack of testing and equipment that have created the crisis in our care homes. https://www.reuters.com/investigates/special-report/health-coronavirus-britain-elderly/
@MattHancock again claimed today that people are now tested before being discharged into care homes. Government guidance has not changed since April 20, and still says negative test not required.
https://news.sky.com/story/coronavirus-health-secretary-matt-hancock-answers-your-covid-19-questions-11983853
https://www.gov.uk/government/publications/coronavirus-covid-19-admission-and-care-of-people-in-care-homes#history
https://news.sky.com/story/coronavirus-health-secretary-matt-hancock-answers-your-covid-19-questions-11983853
https://www.gov.uk/government/publications/coronavirus-covid-19-admission-and-care-of-people-in-care-homes#history
@ONS figures now say over 8,000 residents died in care homes in England alone up to May 8th who had covid-19 mentioned on their death certificates. 1,500 in the last week. Due to reporting issues early on, this is sadly likely to be an underestimate. https://twitter.com/ONS/status/1260128147829383169
Meanwhile there's continuing confusion over testing of care home workers. The latest govt guidance clearly says @CareQualityComm are responsible, but they say this changed 10 days later. Nobody seems to have updated the online guidance if that is true. 
https://twitter.com/guardian/status/1260292902632251401
https://twitter.com/guardian/status/1260292902632251401
The relevant guidance is here, dated April 15th, and says "CQC is leading coordination of testing" (2.9). https://www.gov.uk/government/publications/coronavirus-covid-19-adult-social-care-action-plan/covid-19-our-action-plan-for-adult-social-care#supporting-the-workforce
Then on April 20 the CQC issued this press release, saying they have "been contacting adult social care providers to book appointments for their staff to be tested". But it talks specifically about testing staff who are already self isolating.
https://www.cqc.org.uk/news/releases/cqc-books-testing-appointments-nearly-12500-care-staff-rolls-out-support-measures
https://www.cqc.org.uk/news/releases/cqc-books-testing-appointments-nearly-12500-care-staff-rolls-out-support-measures
Also at the end it says all the CQC do is send "an invitation email with a link to an online booking form and information on who can be tested", which is hardly coordinating anything. Actual testing is "coordinated by PHE and DHSC". So it's easy to see where confusion arose.
