Coronavirus: 'til death do us park

10/04/2020

As the official daily figures for Covid-19 deaths were yesterday reported as 881, bringing the cumulative total to 7,978, the Guardian makes it very clear that which we already knew – that many such deaths are not being recorded in the daily figures.

This is because only hospital deaths are included in the official figures which, as the Guardian notes, means that "hundreds" of UK care home deaths don't make it into the statistics. Care England, the industry body representing private care homes, estimates that the death toll is likely to be close to 1,000.

Industry leaders and the Alzheimer's Society say they believe the coronavirus is now active in around half of care settings, which look after about 400,000 people in the UK. This, we are told, is far higher than the estimate given by the CMO who on Tuesday said that just over nine percent of care homes had cases of Covid-19.

Martin Green, chief executive of Care UK, asserts that, "We are seeing underreporting of the number of deaths", adding that "Deaths might not be in the thousands yet, but it is coming up to that level". In his view, "We need a proper analysis of death rates occurring across care homes, and the government should be collecting this (sic) data".

In terms of detail, we learn that around 70 percent of residents in one Yorkshire care home are suspected of being infected. Thirteen people have died in another Yorkshire home and 11 have died in a home in Northamptonshire. The provider there also believes half of its care homes have cases of infection.

A separate care home in Luton reports that 15 people had died during the crisis, including five who tested positive for Covid-19. Three care homes in Scotland announced 30 deaths between them earlier this week and press reports in the last week have catalogued at least 36 other care home deaths.

Clearly, in terms of data collection, this is a major lacuna, and it must also distort perception of how the epidemic is progressing. Recently, we have seen an active policy of excluding care home residents from hospital treatment, which must have had an impact not only on cumulative totals but also the rate of increase.

As medical staff also learn more about the treatment of the disease, and the survival rates, the indications are that they are being more selective about who is admitted for treatment, which means that there may be a significant rise in the numbers given palliative care in a home environment.

Peter Kyle, MP for Hove, is critical of the government approach to this matter. "By only counting deaths in hospitals", he says. "[ministers] are sweeping the deaths of older people in care homes under the carpet". He argues that, "If social care was a priority that matched other sectors, government would be counting and acting".

But if this goes to confirm that the Covid-19 death rate is being deliberately underplayed, it seems there are no official illusions about the real magnitude of the problem. While ministers have been quick to parade the creation of the so-called "Nightingale Hospitals", with no fanfare at all an emergency programme has been running in parallel to build a national network of temporary mortuaries.

Although we are aware of the new facility in East London as well as Birmingham Airport, what has not been announced centrally is the sheer scale of this new programme, even though it is being planned and coordinated by the Cabinet Office alongside local authorities.

The first clue came from my own local paper, the Bradford Telegraph & Argus which yesterday devoted its front page to a plan to turn the "iconic" Richard Dunn sports complex into a mortuary.

A spokesman for Bradford Council is cited as saying: "All Local Authorities across the country are having to make arrangements for temporary mortuaries as a precaution, to cover all eventualities in the current medical emergency".

And indeed, that is the case. In Leeds, the neighbouring local authority, a temporary facility is to be set up at the Waterside Industrial Park in Stourton, on the southern edges of the city, at a cost of £800,000. A company has already been appointed to provide and install essential equipment.

Further east, Hull City Council is using an old aerosol factory, on Stockholm Road, Sutton Fields Industrial Estate, as a mortuary, at a cost of £300,000. Coffins and refrigerators have already been ordered for the site, the former having risen in price due to "rising demand".

Calderdale District Council, Bradford's western neighbour, is planning to set up a mortuary in Halifax's Shay football and rugby stadium. Further west in the land of Lancashire, another mortuary is to be set up at Warton Airfield, home of BAE Systems. Once work begins, it is expected to be completed in the space of just eight days and it can be operational before the end of the month.

Up in the North East, the Ministry of Defence has been charged with setting up short-term "rest areas" for bodies. Key sites have been identified at Queen Elizabeth Hospital in Gateshead, South Tyneside District Hospital, Sunderland Royal Hospital, Northumbria Specialist Emergency Care Hospital in Cramlington and Albemarle Barracks in Northumberland.

A joint media statement on behalf of Sunderland City Council and South Tyneside and Sunderland NHS Foundation Trust said: "As part of the response to the Covid-19 pandemic, plans across all partner agencies are now very well advanced and contingency arrangements are being put in place as we prepare for a peak in cases".

Further north, RAF Kinloss is to become an emergency coronavirus mortuary, with a disused hangar pressed into service by Moray Council. On the Scottish borders, we have the local authority using the Border Ice Rink at Kelso, although the project is currently only in the planning stage. An ice rink is also under consideration in Cheshire, where Halton Borough Council has hired the Planet Ice Rink in Widnes.

In Staffordshire, the 60-acre showground is to be the site of a temporary mortuary, with a "reserve site" at Alrewas Hayes Grain Store, near Burton. Further south, in Oxfordshire, we learn that another airfield - this one the former USAF airbase of Upper Heyford – is also to be the site of a mortuary. A source tells the paper: "Work has been going on around the clock to get things ready", with converted hangars providing a total capacity for 1,480 bodies.

In mid-Powys, in Wales, the County Council and the Powys Teaching Health Board have confirmed that they are setting up a temporary mortuary at the Wayside Enterprise Park. Yet another facility is being set up by Herefordshire Council at its Three Elms site. It will provide services for Wye Valley NHS Trust at Hereford County hospital.  Swindon is to have a 500 body mortuary operational from next week, constructed on a staff car park of the town's Great Western Hospital. The project is led by Wiltshire Council.

Across the other side of the country, in the East Midlands, a temporary mortuary has been set up in an industrial unit in Nottinghamshire's Forest Town. An eyewitness reported HGV refrigeration trucks being parked up at the site. In Norfolk, the Norfolk Resilience Forum, the partnership of organisations responsible for co-ordinating the county's response to the pandemic, are looking at how and where they might need to construct a temporary facility in the county.

Temporary mortuary plans are advanced in Cambridge, as the County Council has announced that work is to begin on converting a Marshall Aerospace and Defence hangar. In the northern home counties, however, we have the second Planet Ice Rink at Milton Keynes, where work has already been completed to turn the building into a temporary mortuary, capable of holding hundreds of bodies.

Not so very far away, in Essex, Essex County Council (ECC) has contracted Kenyon International Emergency Services Ltd to provide a service "to manage excess deaths" at the Chelmer Park and Ride facility in Chelmsford. The site is expected to be required for about six months. Central Bedfordshire Council is earmarking RAF Henlow as a site, with plans to prepare one of the buildings as a temporary mortuary.

London, which already has one temporary mortuary in preparation, and additional capacity at the Excel Centre, is to get even further capacity at West Middlesex University Hospital, with the installation of refrigeration units in an external area of the hospital's campus away from the sight of visitors.

Yet another site is being prepared at Leyton by Waltham Forest Council, at a site formerly used to store refuse trucks. Workers have set up three large tents to house bodies, which already began arriving last Sunday. Another site is to be located in South Essex in the car park in Corbets Tey, and yet another mortuary is being set up next to Breakspear Crematorium in Ruislip, west London.

Guildford, at the University of Surrey is being earmarked for another site, based at the University's Vet School, less than a mile away from Royal Surrey County Hospital. Surrey County Council has also announced a temporary mortuary at the Surrey Fire & Rescue Service's headquarters in Reigate.

Kent County Council is planning additional capacity for up to 3,000 bodies, at several locations in the county. Work has already started on a site in Beddow Way, Aylesford, due for completion by 20 April. A marquee with a floor space of 1,000 square metres is due to be installed in one part of the site.

And, to make sure it is not left out, a temporary mortuary for 240 bodies will be created at Sandy Park, Bristol, with works expected to be completed today, when six chilled containers covered by a large gazebo will be installed in an existing city council vehicle depot.

That, to my rough count, makes for well over 30 temporary mortuaries, in the planning stage or close to completion – doubtless with more to come. And the pressure is clearly on. Mortuaries in the East Midlands have already reached capacity, forcing the authorities to use the new facility at Birmingham Airport, even though it hasn't been finished.

This epidemic, it seems, has a long way to go.