The institutional nature of COVID-19

It was clear early on from Italian data that COVID-19 was largely a disease of institutions. Hospital infections were the major driver of transmission rates as was the case with SARS1 and MERS.

Care home residents comprised around half of all deaths, despite making up less than 1% of the population. Despite this, no early targeted measures were taken to protect vulnerable people and patients were discharged without testing into care homes. Access was restricted for residents’ families removing oversight of treatment and safeguards. Support services such as physiotherapy and in house GP visits were removed. Staffing levels were reduced due to isolation policies.

Following an investigation, the Care Quality Commission (CQC) found that potentially unlawful do-not-resuscitate orders (DNR notices) were allocated to some care home residents during the pandemic without the patients or family’s knowledge or consent. In addition, prescriptions increased for the sedative, Midazolam. An article from The Pharmaceutical Journal, dated 19th May 2020, suggests that Accord healthcare sold its entire 2-year stock of Midazolam to ‘wholesalers’ at the request of the NHS in March 2020.

It is a well-known fact that Midazolam is a respiratory depressing drug that creates the respiratory symptoms of COVID-19. Publicly available data shows that the ‘first wave’ of COVID-19 and excess deaths, only occurred once the pandemic was announced and lockdown commenced, not before, despite plausible evidence from sewage samples (tested using PCR we might add) suggesting COVID may have been in circulation as early as March 2019.

This raises the question of how many excess deaths seen in the first wave were caused by the implementation of restrictions and the physical and psychological effects of these, alongside increased use of DNR notices and the drug Midazolam.