Elderly coronavirus patients were denied intensive care by the NHS during the height of the Covid-19 pandemic.
People over 80 years of age and some in younger groups like those over 60 were not receiving potentially life-saving treatment as health chiefs feared the NHS was reportedly overflowing.
It is alleged that documents identified as a "triage tool" at the request of English chief physician Chris Whitty were used to prevent elderly Covid-19 patients from being ventilated in the intensive care unit.
In a research, the Sunday Times said the tool was used to create a "score" for patients based on their age, frailty and illness. Under the original system, people over 80 were automatically excluded from intensive care because of their age. Even those in the 60s and over who were viewed as frail and with pre-existing health conditions may have crossed the threshold of intensive care.
The tool was not officially released, nor was it an official NHS policy. However, in the paper, which includes claims by doctors that the tool was used in their hospitals, the documents were widely circulated among health professionals.
Drawing on the reports today, NHS bosses said that while early work was done on a national "triage tool" for critical care, it was "not finalized" and never released.
They also denied that the intensive care units were ever at full capacity, saying that even at the height of the pandemic, only 42 percent of the NHS ventilation beds were being used.
Meanwhile, an NHS spokesman added that more than 110,000 hospital patients have been treated with Covid-19 to date, two-thirds of whom were over 65 years old.
A graph showing the percentage of ICU hospital admissions versus the number of hospital deaths across different age categories
A graph shows the number of intensive care admissions for patients over 60 years of age. The graph shows that the percentage of elderly patients decreased while admissions increased
A graph from a report by the Cabinet Office Briefing Rooms (COBR) showing the percentage of critical care beds used by Covid-19 patients in the UK between March and April
At the height of the UK crisis, only a quarter of all beds were occupied by virus patients. As of April 7, 26.5 percent of the 67,206 people in England's hospitals were treated for coronavirus – the highest proportion ever recorded
Figures from the Office for National Statistics show that hundreds of fewer people in hospitals die from all causes
The allegations come from a three-month investigation by the Sunday Times that spoke to more than 50 witnesses, including doctors, survivors, nursing home workers, politicians and government advisors.
The investigation alleged that some general practitioners were asked to identify frail and elderly patients who would stay at home even if they needed hospital treatment due to complications from Covid-19.
It is also alleged that NHS England has issued guidelines on groups of patients who normally should not be admitted to hospital without the go-ahead from a senior doctor. These groups include all residents of nursing homes.
Meanwhile, paramedics have been told to be more selective about who to take to the hospital, the newspaper added.
The paper also claims that the controversial triage tool, first discussed by the UK's Moral and Ethical Advisory Group (MEAG) at the start of the pandemic in March, has been used in hospitals in Manchester, Liverpool, London, the Midlands and the South East .
The tool should be used to rate patients based on their age, frailty and pre-existing health conditions. This score would then be used to determine if a patient should be selected for intensive care if they needed it, with "eight" being the cutoff.
Under the tool, people over 80 would score nine points for their age alone, which means they would be automatically excluded, while those over 75 were initially marked as almost eight.
According to the Sunday Times, a second version was later produced which lowered the score for age. Nonetheless, people over 80 who were not in excellent physical shape should be denied treatment.
According to NHS chiefs, the service never adopted, published, or relied on such a tool, and its logo was not authorized for use with such a tool.
However, data shows that groups over 70 and 80 made up the lowest percentage of ICU patients, even though they had the most deaths.
Dr. Chaand Nagpaul, chairman of the British Medical Association, told the Sunday Times that "a large number of patients" have "not received the care they need" and that this is due to the health system "lacking the resources".
Meanwhile, Conservative MP David Davis said of the paper: “Politics seems to have paid the least amount of care to those who need it most.
"It is deeply wrong that the government failed to inform the public about this tragedy."
This graph shows the number of Covid-19 patients in intensive care units in UK hospitals when the coronavirus pandemic started between March and early April
This graph shows the number of UK hospital admissions in different parts of the UK when the coronavirus pandemic hit from March to early April
A graph from a report by the Cabinet Office Briefing Rooms (COBR) showing the percentage of intensive care beds used by Covid-19 patients in the UK between March and May
Conservative MP David Davis (left) told the Sunday Times: "Politics seem to have given the least care to those who need them most." Dr. Chaand Nagpaul (right), chairman of the British Medical Association, told the paper, “It is evident that a large number of patients have not received the care they need
What NHS bosses have to say about the Sunday Times article today
• NHS hospitals never ran out of ICU beds so there was never a need to refuse treatment due to NHS capacity.
• Doctors make decisions about the best course of treatment for their individual patient based on that person's specific needs and, wherever possible, with relatives, caregivers, or loved ones. That's what happened during this pandemic; There was categorically NO general national decision to refuse care to a group of people, not even because of their age.
• The optimal therapy for most Covid-19 patients in the hospital has been found to be oxygen therapy that can be performed in a general ward rather than sedating the patient on a mechanical ventilator in the intensive care unit. The latest data shows this in all Covid patients -19 patients who received some form of oxygen therapy were in fact 65 years of age or older.
• Elderly people were not refused admission to the intensive care unit during the first wave. In fact, they included the majority of patients admitted to intensive care with Covid-19. This applies regardless of the total number of patients of all ages in intensive care units in England being treated for Covid-19.
The decision to review a triage tool, however, was defended by health chiefs, who said the process was discussed at the start of the pandemic when it was estimated that Covid-19 could bring about two million people to the hospital.
An NHS spokesman said: “The NHS has not issued a national triage tool for critical care.
& # 39; Early work on a triage tool was commissioned when modeling suggested that two million people here might need hospital treatment and hospitals in northern Italy and Spain were overwhelmed.
"This was not finalized, let alone issued, as it became clear that thanks to the public's efforts to follow government orders, the number of patients would be kept within NHS capacity."
MEAG Co-Chair Professor Sir Jonathan Montgomery said, "We were asked to look into the subject of a Covid-19 triage tool, but it was not needed."
“Throughout the pandemic, doctors have focused on identifying the individual needs of their patients and then providing the care that will best benefit them.
"The rapid expansion of critical care capacity ensured that our initial concern that the NHS may not be able to meet all of its patients' needs was unfounded."
In the meantime, Dr. Alison Pittard, Dean of the Faculty of Intensive Care Medicine: "During the first wave of Covid-19, the NHS did not run out of the critical care capacity that was available to anyone who would benefit.
'As we learned more about Covid-19 treatment, that changed when it became clear that oxygen therapy, which can be done on general wards, is often more beneficial than a ventilator.
"It was consistently clear to the Faculty of Intensive Care Medicine that doctors should make decisions about how to treat patients as they normally would."
Last but not least! NHS workers are said to be "getting a vaccine in weeks" as the government accelerates the schedule for a mass induction before Christmas – while ministers introduce new laws to bypass EU approval for sting
By Michael Powell and Glen Owen for the mail on Sunday
Frontline NHS workers are slated to get a coronavirus vaccine within a few weeks as the government wants to speed up the schedule for a mass induction.
An email an NHS Trust chief sent to his staff that The Mail saw on Sunday shows the health service is preparing for a national immunization program before Christmas.
It can also be disclosed that the government has put in place new laws that would allow the UK to bypass the EU approval process if a safe and effective trick is in place before the end of the post-Brexit transition period on December 31st.
The move will bolster optimism that Boris Johnson will soon be able to ease the social constraints that have crippled the country since March through a “groundbreaking” vaccine.
In his memo to staff earlier this month, Glen Burley, General Manager of the NHS Trust at George Eliot Hospital in Warwickshire, wrote, “Our trust, along with NHS organizations at the national level, has been directed to be ready to run a vaccination program for Covid-19 workers to start in early December.
"The latest findings are that a coronavirus vaccine should be available this year, giving NHS staff priority before Christmas."
Frontline NHS workers are slated to get a coronavirus vaccine within a few weeks as the government wants to speed up the schedule for a mass induction. An email an NHS Trust chief sent to his staff that The Mail saw on Sunday shows the health service is preparing for a national immunization program before Christmas. (Above is the memo from Glen Burley, General Manager of the George Eliot Hospital NHS Trust in Warwickshire)
It can also be disclosed that the government has put in place new laws that would allow the UK to bypass the EU approval process if a safe and effective trick is in place before the end of the post-Brexit transition period on December 31st
Despite continued criticism, Mr Hancock has pushed through new legislation to remove the authority of the European Medicines Agency to approve the vaccine if it is ready before the end of December. Instead, British guard dogs can speed up their production. (File image of an experimental Covid drug that is being tested)
Mr Burley added that the vaccine "is expected to be given in two doses 28 days apart" and urged colleagues to get a flu shot by the end of November so they can qualify for a Covid-19 injection.
Diane Wake, executive director of the Dudley Group's NHS Trust, said at a recent hospital board meeting, “I hope that a Covid-19 vaccine will be available to healthcare providers by December. It has not been confirmed yet, but I hope to be able to offer our staff a Covid-19 vaccine. & # 39;
Despite continued criticism, Mr Hancock has pushed through new legislation to remove the authority of the European Medicines Agency to approve the vaccine if it is ready before the end of December. Instead, British guard dogs can speed up their production.
One health official said, "While we still believe the vaccine is expected to be ready early next year, Matt wants the freedom to operate if things move faster."
The official added that with the 2012 amendments to the Medicinal Products Regulation for Human Use that came into force on October 16, the UK "will no longer be subject to the EU process if a vaccine is developed before 2021 and that there is strong evidence that it is sure of high quality and is effective & # 39 ;.
The memo describes a vaccination program that frontline NHS staff like this surgeon will be the first to receive
They added, “Should a vaccine be available before the end of the year, we have taken solid steps to enable the Medicines and Healthcare Product Regulatory Authority to approve the vaccine for UK patients. This will only happen if there is a strong public health justification and the EU process takes too long. "
In any event, the regulator will have the autonomy to approve vaccines for the UK from 2021.
A senior government source said: "We have made sure that a vaccine that has been shown to be safe and effective is not prevented from using it by the need for approval from Brussels."
NHS workers will most likely receive the vaccine, which is being developed by Oxford University and pharmaceutical giant AstraZeneca and is in the final stages of studies.
The government has already bought 100 million doses of the drug, which is given in two doses. Under the government's plans, frontline NHS workers and nursing home workers will be vaccinated first, followed by those over the age of 80.
Human trials with the Oxford vaccine have been ongoing since April, involving around 20,000 volunteers around the world. Scientists have reported a "robust immune response" and no serious side effects.
Last night David Eltringham, executive director of the NHS Trust at George Eliot Hospital, said, "We don't have a specific date for the vaccine to be delivered, but we are preparing to start using the vaccine in early December."
Oxford's Covid Jab & # 39; only tested on 500 over 70s & # 39;
From STEPHEN ADAMS for the mail on Sunday
Britain's leading Covid vaccine has only been tested on around 500 elderly people in that country, raising questions about how effective it could be for a vital segment of the population.
There are high hopes for the Oxford University “ChAdOx” engraving, but only about 1,000 of the 10,000 people recruited into the UK arm of the Oxford process are 70 years or older. Half of them received the vaccine and the other half a placebo.
Last night, former Vaccination Czar David Salisbury said the relatively small numbers may not be enough to produce a meaningful result.
"If you just got 500 vaccinated and 500 got the placebo and you want to see a significant difference in protection between the two, you may not be getting much of the data," he said.
However, he added that early results seemed to show that older people given Covid vaccines developed good immune responses, so he hoped they would work well in the elderly.
The problem is critical as the virus is much more deadly in the elderly. An 80-year-old is about 1,000 times more likely to die of the virus than a 20-year-old, while five out of six Covid-related deaths have occurred in those over 70.
Earlier this month, Kate Bingham, head of the UK's Vaccine Taskforce, gave a clear signal that Covid vaccination should target the elderly, although vaccines are often less effective in this group as their immune systems tend to be less responsive.
For example, the flu vaccine given in 2016-17 was completely ineffective in those over 65, according to Public Health England. However, it has worked well for younger people.
Because Oxford's Covid vaccine works in a different way, there is no particular reason to believe it is a dud in the elderly, but all leading jab contenders are well aware of the problem.
Oxford has started parallel studies in Brazil, South Africa and the USA – but only the American “arm” registers over 65-year-olds. AstraZeneca, which handles the U.S. litigation requests, refused to say how many over 65s have been hired there to date.
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