The pressures of coronavirus are intense, and agonising in many different ways.
While the political focus has largely been about what is going on in hospitals, there is growing concern about some of the most vulnerable in our society, who live in nursing and residential homes.
The BBC has been passed a document sent to GP practices by the Brighton and Hove Clinical Commissioning Group – that’s the local NHS management in that part of Sussex – setting out guidance on how to cope with Covid-19 in care homes.
There are 35 GP practices and 98 residential or nursing homes in that area.
The document spells out that many vulnerable people may not be admitted to hospital for treatment if they contract the virus, and directs all homes to "check they have resuscitation orders on every patient". Hancock: ‘Huge work’ to achieve virus test goal
First coronavirus field hospital opens in London
It is not unusual for ‘Respect Forms’ or Do Not Resuscitate orders to be discussed and signed by elderly and vulnerable people as part of careful preparation for the end of life.But one care manager was deeply concerned that residents and families are being pushed to sign the forms.The CCG guidance even provides a suggested script for GPs to use in conversations with residents and families – part of which says "frail elderly people do not respond to the sort of intensive treatment required for the lung complications of coronavirus and indeed the risk of hospital admission may be to exacerbate pain and suffering".It goes on: "We may therefore recommend that in the event of coronavirus infection, hospital admission […]