Concern testing asymptomatic hospital patients before discharge would provide ‘false reassurance’

There were concerns at the start of the coronavirus pandemic that testing asymptomatic hospital patients before discharge into care homes could provide “false reassurance” that they did not have the virus, MPs have heard.

Matt Hancock (pictured) said clinical advice was that testing someone without symptoms “could easily return a false negative and therefore give false assurance that that person did not have the disease”.

Clinicians were also concerned that due to the four-day turnaround for results, residents might go to a care home with a negative result but having caught the virus in the interim.

The Health Secretary told the Science and Health Committees at Westminster: “We set out a policy that people would be tested when tests were available. Then I set about building the testing capacity for us to be able to deliver on that.

“The challenge was not just that we didn’t have the testing capacity but also that the clinical advice was that a test on somebody who didn’t have any symptoms could easily return a false negative and therefore give false assurance that that person did not have the disease.

“At the same time, the clinicians were worried that because it took four days to turn a test around, that if they leave somebody in hospital for those four days they might catch Covid and therefore go back to a care home with a negative result but having caught it.”

Mr Hancock said the best estimate from Public Health England is that 1.6% of the transmission into care homes came from hospital discharges.

But Chairman of the Science and Technology Committee Greg Clark asked whether this was not a “stretch of the imagination” to believe, given that “we simply don’t have the data because people weren’t tested”.

Mr Hancock said he believes it is the “best assessment that can be made, given the facts on the ground in terms of what is and isn’t measurable”.

He said he understands why people feel strongly about residents going into homes untested from hospital, but in lieu of testing there were isolation rules in place for these patients.

He added that a “much, much higher” proportion of staff enter a care home each day than residents.

He said he could not recall correspondence from care providers offering the use of care facilities in which to isolate hospital patients being discharged to care homes.

And he denied that advice to test people on leaving hospital before returning to care homes was watered down at the request of the Department of Health and Social Care (DHSC).

Asked if discharge testing advice was softened at the instruction of his department, the Health Secretary said: “Not that I’m aware of.

“We followed the clinical advice throughout on this.”

He told MPs the Government had tried to throw a “protective ring” around care homes but that it had proved difficult.

“I think the most important words in the sentence are ‘we tried to’. It was very hard,” he said.

“Each and every death in a care home weighs heavily and always will. We knew from the start from very early in January that the impact of this disease was most significant on the oldest and therefore care homes were going to be a particular risk.

“We put in funding. We made sure PPE was as available as possible. We set guidance for care homes. Then later when we had the testing capacity – in July – we brought in weekly testing for staff.”

Mr Hancock said that at the beginning of the pandemic, his powers over social care were “extremely limited” and the DHSC did not even have a list of care homes in England.

Labour’s shadow social care minister Liz Kendall said Mr Hancock’s evidence to the MPs was “at best disingenuous”.

She added: “He selectively used briefings, evidence and clinical advice to defend his record instead of admitting his abject failure to protect care homes in the pandemic.

“Even Matt Hancock knows he now categorically failed to put a protective ring around care homes.

“He has now used multiple excuses for failing to test those discharged to care and family members who have lost loved ones will be frustrated and deeply upset that they still do not have the truth from the Secretary of State today.”

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