When cancer patient Pamela Clifford underwent surgery at the height of the pandemic her family’s worst fears were realised when she contracted Covid-19 while receiving treatment.
Ms Clifford, 72, never made it home and her story is now mirrored in the thousands of vulnerable people who caught the virus after being admitted to hospital during the pandemic.
One in seven patients, more than 40,600 people, admitted to hospital in England during the pandemic are believed to have contracted Covid-19 while there, and at least 8,000 of them died from the virus.
Former health secretary Jeremy Hunt, who is now chairman of the UK's Health and Social Care Select Committee, called the scandal the “biggest undiscussed problem” of the pandemic and believes England’s first wave could have been shortened had different guidance been followed.
Covid victims’ bereaved relatives demand answers
Ms Clifford’s family have lodged a formal complaint with the Royal Stoke and County Hospital, Stafford, and her daughter Susan Colborne is demanding answers.
"My mum was placed on a Covid ward, even though she tested negative, instead of being treated as a cancer patient," healthcare worker Mrs Colborne told The National.
“She was then moved to intensive care and again placed next to Covid patients and she messaged me to say how worried she was. I called them and said 'my mum is really vulnerable and you have put a Covid patient next to her' but they refused to move her. Then she tested positive and we lost her. I wish my mum had put the surgery off for six months because she might still be here.
“I have heard so many similar stories. The hospitals have made a lot of mistakes, you do not put positive and negative patients together.
"Everyone wants to blame the government but the hospitals should share the blame. What happened to our families is being brushed over.
"We will keep on fighting. If the roles were reversed and it was me who had died my mum would be at 10 Downing Street knocking on the door demanding answers until they admit mistakes were made. It’s my job to keep fighting for her.”
In Scotland, terminal cancer patient Stephen Levin, 56, a former university lecturer, had a similar experience.
He was recovering from an operation when his ward at Glasgow Royal Infirmary was placed into quarantine after a patient tested positive, and within days he and the rest of the ward had contracted Covid-19.
He described the level of care and infection control as “terrible”.
“Staff will not enforce people to wear masks, it’s truly horrendous,” he said. “If I knew what I know now, I would not have come into hospital.”
Thousands seek public inquiry over Covid deaths
More than 3,000 grieving relatives have launched legal action against the government and wrote to Prime Minister Boris Johnson calling for a public inquiry.
Matt Fowler, co-founder of Covid-19 Bereaved Families for Justice, told The National the group wants the government to admit its mistakes and stop "insulting" the memory of those who have died.
"We firmly believe that had the government approached the pandemic differently, truly followed the science and taken the right actions at the right times, that many of our loved ones would still be here today," he told The National.
“As time goes on, more evidence emerges about government failings in relation to the timing of lockdown, provision of PPE and testing in health and care settings, isolation of cases within care homes and hospitals and much more.
“As a group, we aim to not only seek accountability for the mistakes that have been made, but perhaps even more importantly, to stop those same mistakes being made again, causing more families to needlessly suffer the overwhelming grief that we are experiencing. We are seeking a public inquiry, starting immediately to look at key elements of the government’s approach and inform it going forward.”
On Wednesday, Mr Johnson announced a full public inquiry into Covid will start in Spring 2022.
It is expected to be the biggest probe since the Iraq war and will be a judge-led investigation.
Opposition leader Sir Keir Starmer has criticised him for it not starting earlier.
One in seven patients caught Covid-19 in hospital
NHS England figures reveal massive regional differences in the risks of catching Covid-19 as an inpatient, or nosocomial infection.
Patients at North Devon district hospital in Barnstaple, in the south of England, had the highest risk with 31 per cent of the hospital's coronavirus patients catching it while receiving treatment for another illness in the hospital. Some 500 kilometres away in the northern city of Hull 28 per cent of Covid inpatients were infected.
Layla Moran MP, chairwoman of the all-party parliamentary group on coronavirus, said patients and NHS staff have been “abysmally let down”.
"Our cross-party inquiry has received harrowing evidence from families who lost loved ones to Covid caught on wards and from NHS staff who were left without adequate PPE," she told The National.
“Doctors have warned how they struggled to separate Covid and non-Covid patients when the pandemic was at its peak.
“This shows why the government must continue to focus on suppressing the virus to ensure these tragic consequences for patients and staff never happen again.”
NHS England said the high infection rates recorded were as a direct result of increased cases in the community.
“Since asymptomatic tests kits were made available for the first time by the government’s test-and-trace programme in November, millions of staff have been tested helping to keep infections as low as possible, and all staff have been asked to rigorously follow PHE’s infection control guidance with hospital infection rates currently standing at around 4.5 per cent,” it said.
A report by the Hull University Teaching Hospitals NHS Trust’s associate chief medical officer Dr Dan Carradice revealed 78 people died after contracting Covid-19 at Hull Royal Infirmary.
He said the issue was "one of the greatest current threats to patient safety" and called for rapid progress to address it and asymptomatic testing of all staff working in clinical areas.
"It is critically important that progress is made rapidly so that future outcomes are better, especially as newer strains of the virus have greater transmissibility,” he said.
Mr Hunt said up to a quarter of Covid-19 infections in patients were “hospital acquired”.
“Upper estimates of this data suggest that around 36,000 cases in the first wave were caught this way which could mean 8,000 deaths related to hospital acquired Covid occurred in that wave,” he said.
MP Craig Mackinlay said he was “very concerned” about the infection rates and demanded action.
“I find it hard to believe that this – the so-called nosocomial infection rate – cannot be solved,” he told the UK parliament. “A chap called Paul Tucker, aged 57, went into hospital with a serious condition that was nothing to do with Covid and he died because he was in a mixed ward with Covid-positive patients.
“I beg you to get infection under control in our hospitals.”
Half of all hospitals inspected broke Covid rules
In October, the Healthcare Safety Investigation Branch reported on the factors behind hospital-acquired Covid-19 infections in England.
It revealed the root causes laid in the building design, ventilation, overcrowded wards, staff shortages and a lack of testing and protective equipment around the onset of the pandemic.
In December, a study by doctors in north-west England revealed “major deficiencies” in compliance with Public Health England’s guidance on good practice in preventing nosocomial Covid-19 transmission.
Failings included patients being allocated beds before negative tests were confirmed, lack of regular testing for clinical staff and not using protective screens between patients.
Consultant David Oliver said the high infection rates were “alarming”.
“With so much pandemic pressure on acute beds, right now is not the time. But when we’re through the worst of the current crisis, we need to think about how we could improve prevention of nosocomial viral transmission for all infections, to stand us in better stead next time,” he said.
Last week, it was revealed that almost half of UK hospitals inspected by the Health and Safety Executive in Covid-19 spot checks were found in breach of health and safety laws.
The HSE ordered eight hospitals to take "remedial action to remedy contraventions of health and safety law" and gave advice to a further four of the 17 inspected, the Health Care Journal said.
It looked at issues including social distancing, hygiene, personal protective equipment and ventilation.
“The NHS trusts and boards involved had all invested significant time and effort to implement a variety of Covid control measures in the hospitals inspected,” the HSE said.
“Health and social care professionals continue to work tirelessly, and we thank them for their commitment and dedication.”
Calls for upgrade of hospital ventilation systems
Mr Hunt suggested a detailed analysis of airborne infections and a raft of other measures.
“We should definitely have had earlier advice to adhere to social distancing in the non-Covid areas of hospitals. Speed of testing in hospitals is also a vital tool we should have used earlier: why did it take until November to introduce weekly testing of NHS staff?
“But the biggest unknown was the extent of airborne rather than surface infections. Future guidelines need more focus on ventilation than hands and surfaces. Upgrading ventilation systems – especially in old hospitals – is expensive, but clearly worth doing to prepare for future pandemics.”
This month, the World Health Organisation recognised that Covid can be caught by airborne transmission.
Environmental engineering professor Dr Shelly Miller was one of 246 scientists who signed an open letter appealing for governments and medics to recognise the risk of airborne transmission last July.
“A group of international scientists co-ordinated a meeting with the WHO to explain that this pandemic is airborne,” she said.
“We were flabbergasted that they shunned us – the rest is a tragedy.”
Prof Cath Noakes, of the University of Leeds, highlighted the need for “investment, training and policy changes”.
“We have been saying the air matters for more than 12 months but there is minimal on-the-ground action to improve ventilation or recognise airborne transmission fully in IPC guidelines,” she said
“Respiratory infections are airborne. We need to invest in ventilation. You might even stop more than one pandemic from happening.”
This month, she published a paper on the issue which recommended the "need for more detailed sampling studies”.
“Hospital‐acquired infections are a globally significant problem and their treatment can be costly,” she wrote.
“In the UK, HAIs are estimated to cost up to £1 billion ($1.41bn) per year as of 2017 and the hospital environment is thought to play a role in approximately 20 per cent of all HAIs by influencing the survival and spread of pathogens in the environment.
“There are a very small number of studies that carry out sufficient quantitative measurement to reliably assess relationships between airborne microorganisms and environmental parameters.”
Dr Christine Peters, a consultant, was another to back further research into ventilation.
“It should not be surprising that risks to patient facing staff are higher than non-facing staff,” she said. “What is unbelievable is that we are over a year into a pandemic and we let that risk continue with no changes to guidelines.”
President of the Hospital Consultants and Specialists Association (HCSA), Dr Claudia Paoloni, told The National the design of hospitals "fatally undermined" infection control.
"We went into the pandemic with pitiful PPE stocks against a backdrop of understaffing and where in some cases the cramped physical design of hospitals driven by pressure to save costs fatally undermined infection control," she said.
“Although our understanding and protection improved slowly from the tragic, desperate days of March 2020, the continued absence of testing and government foot-dragging over better PPE in hospitals left staff with a near impossible task when it came to nosocomial infection. In the face of demands to increase non-covid work, they simply were not given the tools to do the job safely.
“The reluctance to roll out the highest level of protection continued well into the appalling wave this winter, a crisis which was far deadlier than it needed to be as a result of the government’s reticence to order a rapid decisive lockdown in the face of rampant community infection. "HCSA and others continue to sound the alarm on the risks of aerosol transmission and are urging greater deployment of higher level FFP3 masks now and in future pandemics. This fear has increasingly been borne out by research, yet cost is cited in opposing better front-line infection control.
“The lessons of this pandemic must be learned. We need a national conversation about the levels of staffing, beds and resources needed to ensure pandemic readiness in future. Our fear is that, once covid has receded, pressure for cost-cutting will come back with a vengeance. If the lives lost needlessly in the past year are to mean anything at all, we simply must not allow this to happen.”
Dr Ben Carter, a senior lecturer in biostatistics at King’s College London, led a study into the number of hospital-acquired covid cases and said the true picture will never be known.
“It’s impossible to have no transmission,” he said. “When you’ve got something that’s very contagious and very rife within the population, it’s just hard to know.”
For grieving families, the fight to change the way hospitals deal with Covid-19 will continue.
"If we have another wave, I believe the government will do things differently because there are more than 40,000 voices who will not let them forget this," Mrs Colborne, 52, told The National.
“I will keep fighting until they admit they made mistakes. The families will be the voices of all those no longer here who have needlessly died after catching this in hospital, in the hope we can stop other families going through what we have.”