The Times - UK (2020-10-20)

the times | Tuesday October 20 2020 1GM 11

News

Estimated chance of

dying if infected

less than half the level at the

start of the pandemic

Fatality rate

0.5%

*Participating

hospitals, data

does not include

Scotland

Sources: CEBM,

Public Health

England, NHS

England, ONS, MRC

Biostatistics Unit

Cases per

100,

Under 10

11-

21-

31-

41-

51-

Over 200

101-

101-

Jul
6-

Jul 27-

Aug 2

Aug

17-

Sept

7-

cally, the rise in cases gives us hope this

might improve further. As more

patients end up in hospital, we have

more people to test new drugs on.

By Christmas it is very likely the

world’s doctors will be given another

proven drug, to complement dexam-

ethasone. Even so, there is no disguis-

ing that winter looks likely to be long,

depressing and, for many, lonely.

We will not be buoyed by the weather

of April. Nor — perhaps — will we be

carried along by the cohesion of a coun-

try that met its neighbours every

Thursday to clap the NHS. But, with a

grim determination and a lot of hard-

won knowledge, the statistics show that

we can still keep our heads above water

as the second wave passes.

There’s no hiding from facemask

refuseniks, Hugo Rifkind, page 29

Frank advice for the young

from lockdown pensioners

Greg Wilford

When a care home resident in Devon

was asked to share her life lessons with

the world, she gave an unexpectedly

blunt answer.

“Keep your legs together” was the sage

piece of advice from Bett, a pensioner in

Yelverton Residential Home in Devon.

Her tip for younger generations was

widely shared online after she was

photographed with the message on a

whiteboard.

Residents from the home, who are

aged from 75 to 104, also gave advice

such as “spend all your money, enjoy

yourself while you’re young, have some

cheek and don’t be pushed around”.

Another wrote: “Think before you

ink, never go to bed without apologising

for an argument, turn your back on an

argument rather than a thump.”

Peter Gaffney, the home’s manager,

said that the activity was part of a

programme to show that spirits were

high despite the anxieties over the pan-

demic. Other activities have included

celebrating World Gurning Day with

their own competition, indoor boules

and tennis, cake-making and fair-

ground games.

Mr Gaffney said: “This latest activity

has gone a bit crazy and we were not

expecting it at all. We have got a couple

of activities co-ordinators here and

through the lockdown with restricted

visitors we have been using our Face-

book page a lot more to show families

what is going on in the home.

“We were not expecting it to go off

like it has... But our residents have

made a few wise comments that have

made people laugh. It just shows all staff

and residents are in good spirits.

“We know the residents very well so

some of the comments didn’t surprise

us. Margs is quite a character and Bett’s

comment... has come across well. A lot

of people have liked that one as they

say that is what their mums used to say

to them.”

The number of people dying in private

homes has jumped by nearly a third in

less than a year, with a significant in-

crease in deaths of dementia sufferers.

There were 25,472 excess deaths in

private homes in England and 1,644 in

Wales between December 28 and Sep-

tember 11, according to the Office for

National Statistics. The ONS measures

excess deaths as the increase on the

average number of deaths for the same

period over the previous five years.

Of the total number of excess deaths

in England and Wales, 24,387 and 1,

respectively were during the pandemic.

The figures show that the leading cause

of death in private homes was ischae-

mic heart disease, and that deaths from

prostate cancer doubled.

Deaths from dementia and Alzheim-

er’s disease in England have risen 79 per

cent during the pandemic, with 2,

excess deaths from these diseases at

home between March 14 and Septem-

ber 11. In Wales there was a 94 per cent

rise, with 133 excess deaths involving

dementia and Alzheimer’s disease.

The majority of excess deaths in pri-

vate homes in England were among

men and women aged 70 to 89. Men ac-

counted for 53.8 per cent of the deaths.

The leading cause of death for men was

heart disease, accounting for 19 per cent

of all male deaths in private homes.

Deaths of men at home from heart

disease rose 26 per cent in England

compared with the five-year-average

(1,705 additional deaths), with fewer

dying in hospital.

Deaths from prostate cancer rose by

53 per cent — the biggest percentage

rise compared with the five-year aver-

age with 801 additional deaths. Deaths

from bowel cancer rose by 46 per cent.

For women the leading cause of

death was heart disease, accounting for

10.5 per cent of all deaths in private

homes.

Deaths from dementia and Alzheim-

er’s disease of women in private homes

increased by 75 per cent in England

compared with the five-year average

(1,335 additional deaths). Deaths of

women in hospital suffering dementia

and Alzheimer’s disease fell by 40.6 per

cent in England and 25.5 per cent in

Wales.

Sarah Caul, head of mortality at

ONS, said: “While deaths in hospitals

and care homes have dropped below

the five-year average since the initial

peak of the coronavirus pandemic,

we’ve consistently seen deaths in pri-

vate homes remain well above the five-

year average. We have seen an overall

increase of deaths as well as a redistri-

bution of various causes of death. For

instance, while deaths of heart disease

are below average in hospital, it has

been above average at home.

“It’s a similar picture when looking at

prostate cancer for males and dementia

and Alzheimer’s disease for females.

Unlike the high numbers of deaths in-

volving Covid-19 in hospitals and care

homes, the majority of deaths in private

homes are unrelated to Covid-19.”

News

Deaths at home are

up by nearly a third

during pandemic

Katie Gibbons Leading causes of death

in the home in 2020

Ischaemic heart diseases

Cancerous tumour of

trachea, bronchus and lung

Cancerous tumour

of prostate

Men

Ischaemic heart diseases

Dementia and Alzheimer’s

Cancerous tumour

of trachea,

bronchus and lung

Women

*March 14, 2020 to September 11, 2020. Source: ONS

3,

2,

3,

3,

2,

8,

In the middle of August, somewhere

near Cardiff, someone breathed in par-

ticles of coronavirus. This should not, in

itself, have been remarkable.

Except, we now know, this particular

strain had never been seen before in

Wales. Neither had the strain breathed

in two weeks later in Betsi Cadwaladr,

or the one that, about the same time,

was infecting its first Welshman in

Cwm Taf Morgannwg.

Thomas Connor, from Cardiff Uni-

versity’s biosciences team, does not

know exactly what happened after he

sent a report outlining these findings to

the Welsh government. But very short-

ly after being presented with firm evi-

dence that the virus was being import-

ed into Wales, Mark Drakeford, the first

minister, started talking about border

restrictions. On Wednesday he said

Genomics maps ‘family tree’ of virus

Tom Whipple Science Editor that such measures would stop outsid-

ers “bringing the virus with them”.

Professor Connor is part of what is

the world’s largest and most impressive

coronavirus genomics project. In

March, genomics scientists from across

the UK met at the Wellcome Trust in

London to discuss what they could do

to help with the pandemic response.

That day they resolved to sequence

the genomes of the viruses in as many

infections as was feasible. “The govern-

ment said they would probably back it,”

Professor Connor said. “Within a

matter of days with a lot of promises to

universities that they’d be reimbursed,

we got it up and running.”

As a result about half the coronavirus

genomes sequenced in the world have

been done in Britain, among them 40

per cent of cases in Wales. If used cor-

rectly it is an unparalleled tool for un-

derstanding and tracking outbreaks.

“We’ve clearly got an uptick in cases

now,” Professor Connor said. “One of

the first questions is, is that coronavirus

circulating in the community? Is it just

the coronavirus there left over from the

first wave? Or is it something new?”

Because they had the viral genomes

they knew it was the latter. Coronavi-

rus, like all viruses, is constantly mutat-

ing. Most mutations make no differ-

ence to how it spreads, but like a family

tree, they show where it came from.

A Cambridge University team has

used the technology to decipher out-

breaks in care homes and at Adden-

brooke’s Hospital. In one case the

genetic fingerprint of the virus, re-

vealed by sequencing, showed that six

hospital patients had been infected by

virtually identical sub-strains. A team

of epidemiologists quickly discovered

that all six patients had attended the

same outpatient kidney dialysis clinic.

Bett’s words of wisdom from Devon

were widely shared on social media