Victims of the Covid dementia disaster: How 50,000 cases were missed in lockdown

Up to 50,000 dementia cases were missed during lockdown, it emerged last night.

Around one in ten new sufferers went undiagnosed because referrals to memory clinics all but stopped at the start of the Covid pandemic.

Experts warned the backlog could put further pressure on overstretched hospitals if they – rather than specialist units – have to deal with patients not known to have dementia.

It is feared even more cases will be missed if virus restrictions return in autumn or winter.

James White of the Alzheimer’s Society said: ‘Thousands of people with dementia have remained in the dark about their condition, unable to get help that is most effective the earlier you get it.’

He said the backlog came on top of the difficulty of helping sufferers whose routines and activities had been devastated by lockdown.

In other developments:

  • A Mail audit found the first year of the pandemic saw hospital appointments for the six major non-Covid illnesses plummet by around 330,000;
  • Hopes rose that the third wave of Covid might be ebbing after cases in England dropped to below 30,000 yesterday, a fall of nearly 20,000 in a week;
  • Haulage bosses said the self-isolation ‘pingdemic’ could wreck the supermarket supply chain in two to three weeks;
  • Train drivers and binmen are set to be given an exemption from quarantine;
  • Health Secretary Sajid Javid was forced to apologise for a tweet saying the nation should not ‘cower’ from Covid.

Around one in ten new dementia sufferers went undiagnosed because referrals to memory clinics all but stopped at the start of the Covid pandemic (stock image)

The figures on missed cases were revealed by Alistair Burns, national clinical director for dementia and older people’s mental health at NHS England and NHS Improvement. Around 475,000 people in England are normally officially registered with their GP as having dementia – around two thirds of all those with the condition – but since the pandemic struck that number has fallen as low as 427,000. 

Professor Burns said GPs ‘did as they were told’ and stopped referring patients for dementia assessments at the start of lockdown in March 2020. Referrals resumed slowly again last summer but declined again during the second lockdown.

The University of Manchester professor added: ‘There was an effect of 40,000 to 50,000 people who should have been on the dementia register but who were not. That’s the kind of figure we are talking about.

‘We do hear a lot about the effect of lockdown on cancer and stroke [diagnosis rates], and that’s absolutely right, but there is an effect on dementia as well.’

He also said dementia sufferers had ‘disproportionately lost out during the pandemic’ by being isolated from family, friends and their communities. The professor was addressing the Dementias 2021 conference in London in a personal capacity.

Dr Hilda Hayo of Dementia UK said the charity had been inundated with calls about delays in accessing a diagnosis. She added: ‘A diagnosis of dementia can give families clarity, help them plan for future, and provide access to support services in the community. With significant delays in this process, then families with dementia will be further left behind.’

Dr Liam Fox, who worked as a GP before being elected as a Tory MP, last night advised ministers to ‘think carefully’ about how any new lockdown would impact the treatment of conditions such as dementia.

He added: ‘Having done so well so far we must not squander the vaccine dividend by being too cautious and put the economy at unnecessary risk, especially the small businesses that we require for our recovery.

‘We also need to think carefully about the impact on other health conditions that such measures could have.’

NHS figures show the dementia diagnosis rate in England declined steadily from March 2020 to this March, before gradually beginning to rise this spring.

Dr Liam Fox, who worked as a GP before being elected as a Tory MP, last night advised ministers to 'think carefully'

The NHS dementia chief, Professor Alistair Burns (pictured), said up to 50,000 new dementia cases may have been missed

Dr Liam Fox (left), who worked as a GP before being elected as a Tory MP, last night advised ministers to ‘think carefully’. The NHS dementia chief, Professor Alistair Burns (right), said up to 50,000 new dementia cases may have been missed

But rates remain below normal levels, with the number assessed in the first few months of 2021 significantly lower than before the pandemic. GPs made 50 per cent fewer dementia assessments and 33 per cent fewer referrals to memory clinics in the six months to April 2021, compared with the six months to March 2019.

In response to Professor Burns’s comments, NHS England said: ‘It is understandable that during the pandemic, some older people felt they were unable to seek help for symptoms that may be suggestive of dementia, such as memory loss, but the number of referrals is now increasing and the NHS is offering support to patients and their families while they are waiting for a diagnosis.’

Some scientists have begun to talk of a return to restrictions as early as September, despite England opening up again only a week ago.

Chief medical officer Chris Whitty told an online event hosted by the Science Museum earlier this month: ‘I don’t think we should underestimate the fact that we could get into trouble again, surprisingly fast.

‘And I think, saying the numbers in hospitals are low now, that does not mean the numbers will be low in hospital in five, six, seven, eight weeks time – they could actually be really quite serious.

‘At that point, it looks as if things are not topping out, we do have to look again, and see where we think things are going.’

At a press conference in May, Sir Patrick Vallance, the chief scientific adviser, said that if cases go up again in winter face coverings on public transport might be necessary. He added that ‘working from home if it’s appropriate to do so’ could continue in the longer term.

The Government has said it will hold a review in September to decide whether tougher coronavirus restrictions need to be imposed ahead of the winter. 

Too afraid to go to hospital despite heart attack 

Lifesaver: Kelvine Tomlinson and his wife Jill, who finally called for an ambulance

Lifesaver: Kelvine Tomlinson and his wife Jill, who finally called for an ambulance

After suffering a severe heart attack, Kelvine Tomlinson delayed calling 999 for fear of catching Covid in hospital.

His wife Jill, 50, took the decision out of his hands after an hour of seeing him grow increasingly ill and called for an ambulance – which Mr Tomlinson, 53, says saved his life.

But he believes that the delay during lockdown this time last year led to moderate damage to his heart, which could have been avoided if he had made the call earlier.

Mr Tomlinson, who lives near Preston, said he wanted others to weigh the chance of catching Covid against the major health risks of not going to hospital. After a heart attack four years earlier he recognised the signs but did not want to be taken into hospital unless he was certain it was necessary.

Mr Tomlinson said: ‘Like everyone else, I thought, “Do I really want to be going to hospital at this time?”

‘There may be a risk of catching Covid but it is still minimal, while the risk of having a major impact on your health if you do not go into hospital is significantly higher.’

Devastating health cost of lockdown laid bare: Mail audit reveals 330,000 fewer hospital admissions for cancer, heart attacks, stroke, diabetes, dementia and mental illness since March 2020

The devastating health costs of lockdown are today laid bare by figures showing a huge drop in hospital treatment for the most serious non-Covid conditions.

In the 12 months since March 2020, there were 330,000 fewer hospital admissions for cancer, heart attacks, stroke, diabetes, dementia and mental health conditions compared with the previous year.

This is a fall of 15 per cent – but prior to March last year, admissions for those six disease types had been broadly rising due to the ageing population and obesity.

Health policy experts warned that the ‘missed’ admissions had led to avoidable deaths and harm. They said many patients waiting for care were in pain and ‘seriously in need of treatment’.

The biggest drop was for cancer, with 285,413 fewer hospital admissions between April 2020 and March 2021 compared with the previous year, NHS Digital data shows.

Across the 12 months, cancer admissions fell by an average of 17 per cent.

They dropped by a third in April and May 2020 and then again by 22 per cent in January 2021, when the restrictions were at their most severe.

These admissions include surgery, chemotherapy and radiotherapy as well as scans and consultations to diagnose tumours. Admissions may also cover A&E visits, and can mean multiple visits by one patient.

The Mail’s analysis shows the extent to which the restrictions have affected non-virus illnesses, with potentially life-threatening consequences.

Siva Anandaciva, chief analyst at the King’s Fund think-tank, said: ‘Any delays in people seeking or receiving treatment are concerning, but even more important is the real impact these delays have on people’s lives.

‘Understandably, there is now growing concern of increasing numbers of avoidable strokes, heart attacks and deaths from cancer in the coming years if these missed or delayed treatments are not made up for.’

John Appleby, director of research at the Nuffield Trust think-tank, said: ‘The NHS tried hard to keep the most urgent operations for conditions like cancer going and often succeeded, but at the worst of the pandemic even these services were swamped in some places – and many less urgent operations that were delayed still had a serious impact on quality of life.’

He said a ‘shadow waiting list’ now exists, comprising patients who have not yet been referred by their GP or have not yet seen a professional at all, adding: ‘Many will be in pain and seriously need treatment.’

Michelle Mitchell, head of Cancer Research UK, said: ‘We’re starting to see signs of recovery in cancer services, with more people now being referred for cancer tests than before the pandemic.

‘But with tens of thousands of people left undiagnosed or waiting for tests and treatment, a huge effort is still needed to clear the backlog as swiftly as possible. Without this, the UK faces the prospect of cancer survival going backwards for the first time in decades.’

Dr Sonya Babu-Narayan, of the British Heart Foundation, said: ‘The risk of dying from an untreated heart attack is far higher than the risk of complications or death from developing the virus in hospital.’

Rachel Power, head of the Patients Association, noted how many patients found it difficult to get a referral when they wanted one. She said: ‘Undoubtedly some patients have delayed seeking treatment during the pandemic, either for fear of burdening the NHS or out of nervousness about catching Covid-19. 

Tragic dad begged for a bowel cancer scan 

Pushed aside: Ben Bradbeer and wife Emma

Pushed aside: Ben Bradbeer and wife Emma

A devoted father-of-three died  from bowel cancer after he was forced to wait nearly four months for a scan during lockdown.

Ben Bradbeer, 39, from Poole, Dorset, visited his GP last February but was sent away with antibiotics.

The builder called his doctor weekly to plead for a scan but was told he could not be referred to a hospital specialist due to concerns over coronavirus.

In June, Mr Bradbeer was finally diagnosed with terminal bowel cancer that had spread to his liver and lungs. He died on February 2.

Wife Emma, 38, said: ‘The system has failed people like him. People with cancer were pushed aside and sent to their deathbeds.’

‘But our research shows that it has been more common for patients to seek care but struggle to get it… patients have struggled to access GP services in particular.’

In total, the NHS Digital data shows there were 329,224 fewer hospital admissions across the six illnesses between April 2020 and March 2021 compared with the previous year.

Experts believe the drop in admissions was partly caused by patients being too scared to see their GP or believing their surgery was closed to all but the most urgent cases. 

Patients were also reluctant to go to A&E or dial 999 –and all of these factors led to fewer hospital admissions.

At the same time, hospitals scaled back operations, consultant clinics and treatments even for life-threatening conditions such as cancer, heart attacks and strokes.

Across the board, admissions had not returned to pre-pandemic levels by March 2021, the latest month for which figures are available.

Dementia admissions were particularly badly affected last year, falling by 46 per cent in April.

The NHS dementia chief, Professor Alistair Burns, said up to 50,000 new dementia cases may have been missed.

Stroke admissions, meanwhile, dropped by 16 per cent in April 2020 and then again by 11 per cent in February.

And for diabetes patients, admissions fell by 36 per cent in April last year and by a further 15 per cent in January.

The hospital admissions data mostly includes planned care such as surgery, scans or consultations but it may also cover A&E visits. 

Admissions can count as the same patient going to hospital on more than one occasion.

The drop in treatments means the NHS is now facing an enormous backlog.

Figures show there are a record 5.1million on the waiting list, including 2,700 who have been waiting for at least two years. 

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