Wednesday, April 8 saw the highest death toll from the first wave of Covid-19 in the UK. Six months on, Christina Lamb talks to the families and frontline workers who will never forget that dreadful time.
The predawn hours of Wednesday, April 8 saw the rising of a supermoon — the biggest full moon of the year. It was reaching its fullest just before 4am when Kenneth Sazuze was woken by a phone call from Good Hope Hospital in Birmingham. His beloved wife, Elsie, was there, stricken with Covid-19.
"You need to come quickly," he was told. "It's bad news."
He woke their two children and rushed to the car. Twenty minutes later they arrived at the intensive care unit and put on protective gowns, gloves and masks. His daughter Anna, just 16, was not allowed in, but Kenneth, 45, and his son Andrew, 22, were taken to the bedside. Elsie, 44, was unconscious and hooked up to an alarming array of tubes — as she had been since going on a ventilator six days earlier, after falling ill at the care home where she worked near Wolverhampton.
"We prayed and spoke to her," Kenneth says, sitting in the living room of their crowded home in Erdington, surrounded by photos of Elsie graduating as a nurse, smiling her big smile. Her presence is everywhere. Wedding photos back when she was 22. The giant television on which she and Anna used to giggle at The Real Housewives of Atlanta. The music system she played to dance to Whitney Houston. The kitchen where she loved cooking Malawi rice and fish, now piled up with dirty plates. Outside in the garden there is a freshly dug fish pond, where Kenneth intends to build a fountain in her memory.
"It's a house, not a home, since she left," he says. "We're trying to keep up the standards, but it's not easy.
"We were soulmates" is how he describes their relationship. "We met at primary school in Malawi, then came to the UK after our first-born so we could give our children a better education." He spent ten years in the army, including a stint at the post office in Helmand, Afghanistan. Once the children were older, Elsie had trained as a nurse and worked at a hospital. Last year she switched to agency care work to have more flexibility to help their daughter through her GCSEs. "She was our backbone," he says.
Kenneth spends some of his time as a DJ, but is also studying to be a nurse and had been working on hospital wards during the Covid-19 pandemic. With Elsie at the care home, either could have brought home the infection, though he says Elsie and her colleagues had been particularly concerned at their lack of PPE.
Worried about infecting their children, they would strip off in the garden before entering the house. Both fell sick the same day and took to their bed, but four days later she woke at 2am, telling him "I can't breathe". He called an ambulance. "I filmed her as she was taken away," he says, showing a video on his phone. "It's as if I knew she wasn't coming back."
In hospital Elsie's condition worsened and she was placed on a ventilator on April 2. He shows me her last message, sent just before she went on the ventilator, on his phone — where she is listed as Elsie Wife Honey. "Love you," he had texted. "Love you more," she had replied. After going on the ventilator she never recovered consciousness and died on April 8. "Losing her was the worst day of my life," he says.
Such scenes were happening all over the country that day, as Covid-19 reached a peak and exacted a tragic toll. Six months on we have become inured, to a degree, to the upheaval of coronavirus, though the personal losses remain just as painful. Even as cases rise again, it is hard to recall the sense of shock that gripped the government and country in the spring.
More than three million people tuned into the daily Downing Street coronavirus briefing on April 8. It was given by Rishi Sunak, the whippet-thin young chancellor who, only a few months earlier, was an unknown junior minister in the unglamorous department of local government. Not yet 40, he was giving a remarkably assured performance inside the wood-panelled No 10 reception room as he stood at the centre of three socially distanced podiums carrying the warning message "Stay home. Protect the NHS. Save lives". "Let me start by reminding everyone of our step-by-step action plan to defeat coronavirus," he said. "At every stage we have followed the latest scientific advice."
He then quickly skimmed over the figures: 19,438 more hospital admissions and 938 more deaths related to Covid. It was a record. In fact, as it later emerged, there were 1,445 Covid-related deaths that day in the UK — the most on any single day. True, many were elderly and had pre-existing health problems; but to put the scale in context, those 1,445 deaths were 20 times the toll of the Grenfell Tower tragedy and 25 times that of the July 7 bombings in 2005, Britain's deadliest terrorist attack of recent years.
Behind Sunak's suave manner and the accompanying slides of global death comparisons showing the UK behind Spain, France and Italy, all hell was breaking loose.
The prime minister, Boris Johnson, was in intensive care. At the same time his top adviser, Dominic Cummings, the health secretary, Matt Hancock, the chief medical officer, Chris Whitty, and the head of the civil service, Mark Sedwill, had all come down with the virus. Cummings, as would later emerge, was in Co Durham, having broken lockdown rules he helped devise and driven 424km north with his wife and child. The prime minister deteriorated so much that, although No 10 officials were briefing journalists that he was "in good spirits", he was fighting for his life and too weak to communicate with aides.
No other country had seen so much of its leadership infected. Even the heir to the throne, the Prince of Wales, had recently had to self-isolate after displaying mild Covid-19 symptoms. Meanwhile, people were still arriving unchecked into the UK by plane. From the start of lockdown on March 23 to April 8, 1,937 passenger flights had flown into Heathrow, according to the travel analysis firm Cirium. Many were arriving from coronavirus hotspots such as Italy and Spain.
One of the world's leading disease data analysis units had just issued projections that the UK would become the worst-hit country in Europe: the Seattle-based Institute for Health Metrics and Evaluation predicted 66,000 Covid-19 deaths in the UK by August.
The nightmare scenario, seen in northern Italy a few weeks earlier, of hospitals running out of beds and ventilators, and doctors having to play God to decide who to save, was looking increasingly likely. Hospitals in the UK had already turned corridors, orthopaedic centres and operating theatres into intensive care units and halted other operations and cancer treatments. Later it would emerge that, to make room in hospitals, thousands of elderly patients were being discharged into care homes without being tested for the disease.
On the previous evening, April 7, the first patients had been transferred into the 4,000-bed Nightingale Hospital constructed in ExCel, the east London convention centre, in only nine days.
"Rule No 1: keep calm and don't panic" reads the message in big red letters across the staff noticeboard of ward 28 at Heartlands Hospital in Birmingham. By April 8 that rule was being tested to the limit as wave after wave of coronavirus cases flooded in.
Heartlands is one of four hospitals in the University Hospitals Birmingham NHS Foundation Trust, which had by far the highest number of admissions and deaths in the country. The trust has reported 976 Covid deaths so far, with 35 fatalities on April 8 alone. Built in the late 19th century to treat fevers, Heartlands retains an infectious diseases unit, ward 28, which became the main Covid zone. Within days of receiving its first patient in March, the 48-bed unit filled with coronavirus cases — all on supplemental oxygen, including many who would normally be in intensive care —then overflowed to the neighbouring ward.
"It was horrendous," says Leanne Poole, the matron. "We'd watched what was happening in Italy and thought that was awful, then it was, like, boom — it's here and it's real and you're in the midst of it. It was like a tsunami. Looking back, I don't know how we got through."
By April 8, Poole was working 14-hour days, arriving at 7am and often not leaving till 9pm, all the while dressed in sweltering PPE. "We're all infectious diseases nurses so it's our speciality, but nothing prepared us for what was actually coming," she says.
"The hardest thing was that patients came in relatively well, they seemed like you and me, then deteriorated very quickly. You could be talking to someone one minute and within half an hour they were going to the ICU [intensive care unit] and being ventilated."
Heartlands is in Bordesley Green, one of the city's most deprived areas, where more than half the children are born in poverty, according to a 2018 study by Loughborough University. More than two thirds of its population are from ethnic minorities, mostly Pakistani but also Romanians, living in multigenerational homes.
Yet Poole says: "The ward was full of patients of all ages and ethnicities. Nobody was safe. It didn't matter if you had a big house and lots of money in your account — if you were going to be a victim, you were."
She shows me what she called the Rainbow Room, a cupboard-like space decorated with pictures from the local community and stocked with chocolates and tissues. "I didn't want to call it the Wobble Room," she says, "but that's what it was —to come in for a bit of a wobble, cry, scream and take ten minutes. It was really helpful."
There was something else. About 11 per cent of infections originated in hospitals, according to the government advisory committee Sage — and staff were scared, particularly about taking the disease home to their own families. "I didn't feel I could reassure them as it was all a bit unknown," Poole says. "You were torn between going and doing your job, but also the risk you were putting your family under."
She has two sons, aged 13 and 15. "I kept reassuring them — my husband and Mum and Dad — it's fine, we're using PPE. Then of course I got it." Many of the hospital staff fell ill and several died. They had started testing in late March, but had only limited numbers of tests. One of the ward sisters, Juliet Hibbert, 41, even recorded a video on her phone for her son in the event she died.
"I knew I was at high risk being BAME [black, Asian and minority ethnic]. I wanted my family to know this is why I became a nurse in case anything happened," she says. "It was like a war zone and I was on the front line." Hibbert too ended up with the disease, and to her horror passed it to her son, who is asthmatic. "I was riddled with guilt," she says.
It was the sense of hopelessness that got to Poole most: "Sometimes driving home I would stop the car and sob. I'd ring my mum and say, 'I don't think I can do this any more.' But then you have a shower and a sleep and you do. I think the public got us through it — the clapping, the gifts, feeling the nation coming together and rooting for us."
The sickest patients on ward 28 were transferred upstairs to the ICU, where Anna Dennis, 44, is a critical-care consultant and part of the trust's preparation team. They turned five operating theatres into wards, each with six beds.
"By April 8 we'd had three weeks of patients coming in every day," Dennis says. "I've done critical care for 20 years and never seen anything like it. So many people, some on ventilators, so sick all the time. Usually on ICU we have one or two really unwell, but here we had as many as 35, so we couldn't give the same attention. It was a disease we had never seen before and affected people so differently that it felt a bit like Russian roulette. "
One thing, though, was striking: how many of the victims were obese. "Not everyone, but lots of them were obese," Dennis says. She and her fellow doctors were noticing something else too: "Our community is mostly BAME and they seemed particularly vulnerable." Data from the Office for National Statistics later showed that people of black ethnicity were two to three times more likely to be diagnosed with Covid-19 than whites, and mortality rates were also higher among blacks and Asians — though the findings may be skewed since the NHS has many BAME staff.
"Our mortality rate in ICU was 40 per cent and it was 50 nationally, so I think we did OK," Dennis says. "But that's still very big. Usual critical-care mortality is 15 per cent."
While most days that spring tended to blur into each other as they were so busy, April 8 is one she won't forget. It was the worst day in ICU: although five patients were discharged, three more were admitted and five people died, including one in their twenties.
Among them was their youngest patient, Fozia Hanif, 29, who had given birth six days earlier after losing a baby the previous year. She had been rushed into hospital when she could not breathe, and her son, Ayaan, was delivered by caesarean section at 31 weeks. Fozia saw his photos but died without ever being able to hold him.
About eight hours after Kenneth Sazuze answered his call from the hospital in Birmingham, the family of Dr Abdul Mabud Chowdhury received a similar summons from Queen's Hospital in Romford, Essex. Chowdhury had been ill with Covid-19 since March.
"Remember his name," says his son Intisar, 18, in the garden of their house in Hornchurch, east London. It seems a world away from the height of the crisis: all around are the suburban sounds of lawnmowers and BBC Radio 4.
Chowdhury, 53, was a urology consultant at Homerton University Hospital in London, popular among his colleagues and a beloved father and husband who loved helping people, playing tabla drums and throwing surprise parties.
Born in a village near Sylhet in Bangladesh, Chowdhury and his wife, Rehana, had both studied medicine before coming to the UK with little money. They lived in a tiny flat above a shop as he did further studies at University College London and Rehana at King's College London.
"They wanted to give their children a better life, like so many immigrants," Intisar says. "He was inspirational." He was also a romantic. Last July he threw a surprise 25th wedding anniversary party for Rehana at a banquet hall in Ilford, a kind of re-creation of their wedding. He got family friends to send a fake invitation to a party so she would get dressed up, and when she walked in her favourite Bengali song was playing and she started crying.
"He was the most compassionate and bravest person you ever met. He'd help everyone and anyone, never, ever said no and was the best father me and my sister could ask for," Intisar says.
But in mid-March Chowdhury fell ill. It started with a fever and cough and he self-isolated in the living room, watching Bangladeshi television shows. "It's the first time I remember him relaxing," Intisar says. "He never took a day off."
In the middle of the night one Sunday he couldn't breathe. Rehana drove him to Queen's Hospital and the next day he was given an oxygen mask, then five days later taken to intensive care and intubated. He seemed to be improving, but suddenly went into septic shock and deteriorated very quickly. At midday on April 8 the family were called to the hospital to say goodbye.
"He was unconscious, but hearing is the last to go and even if he couldn't hear us, we could say what we wanted," Intisar says. "They didn't let my sister Wareesha in as she is only 11, which was heartbreaking — she was Daddy's little girl."
He died around 10.30pm. Only afterwards did Intisar discover that, a few days before being admitted to hospital, his father had written a letter to the prime minister on Facebook warning about the shortage of PPE. Two days after Chowdhury's death the health secretary, Matt Hancock, announced the government would ensure daily deliveries of PPE to frontline workers after what he described as a "Herculean logistical effort". For Intisar it was too little, too late.
"Although Dad wasn't dealing directly with Covid patients, he was working in a hospital where there was Covid and other staff were working with it. I'm 99 per cent sure he got it there. I feel if he had been protected his death would have been prevented."
With the focus on hospitals and protecting the NHS, what no one really knew at that time in early April was that a crisis was unfolding in care homes.
Amanda Henry, 38, thought her 78-year-old dad, Robert, was safe at Aspen Court, a care home in Poplar, east London, where he had lived since February last year after his dementia worsened. Aspen Court is part of Britain's largest care home operator, HC-One, which runs more than 300 homes and whose parent company is based in the tax haven of the Cayman Islands.
Amanda knew none of that. A busy sales and property administrator and mother of three, she just knew it was around the corner from her home and that her father needed somewhere with full-time nursing after his dementia became more severe.
Robert had not wanted to go into a home and did not settle easily. He referred to other residents as "the elderly" and told them he had worked for the Queen — in fact, he had driven a truck during reconstruction work at Windsor Castle following a fire in 1992.
His health had deteriorated after a bad fall in August 2019. He had been admitted to hospital in October that year with pneumonia and then again in February, but he had recovered. The last time she visited was March 14, the day before the home locked down.
"He was so well, sitting up watching TV, asking about my two daughters," she says. "I told him, 'I'm not allowed to come and see you because there's this horrible virus and it's not safe, so I'll come back in a few weeks.' He said, 'All right, doll.' "
On her son's birthday, April 3, she got a letter saying there were ten suspected Covid-19 cases at the home and the staff were doing all they could to deal with it. "I called and said I was concerned, but they said don't worry."
On April 6 they called again to say her father had a high temperature and they were giving him paracetamol. By then Amanda was growing increasingly disturbed and said: "You told me he has a cough, now a fever — this is not rocket science."
The next day she got a call from the home's GP, Dr Osman Ali. "He said he had seen Dad and was really sorry but he'd contracted the virus. He told me there were no more tests available, but said he was 99 per cent sure Dad had Covid and I could come to see him, although I would need to wear full PPE."
At the care home they gave her a pair of gloves, a medical mask and a flimsy apron. "I saw my dad and he recognised me and held my hand, but couldn't speak."
She was surprised at the lack of protection worn by care workers. "Staff were coming in and out of the room. One had no gloves or apron and the mask was only half on, and they were not changing before going into another room."
The following day, April 8, Aspen Court told her that her father had deteriorated. "I rushed there. My partner is a builder so gave me his mask and goggles. The staff at the home were all asking where I'd got it."
She found her dad slumped and unresponsive. "He was dribbling and struggling to breathe. I asked staff if they could take him to hospital but they said no, they thought it had been explained there would be no hospital admittance. They said, 'We don't know he has it and if we send him he will probably catch it.' It felt like they thought he wasn't worth NHS resources."
Amanda went home to give her children their tea. She was in bed at 10.30pm when her phone rang. It was the care home. "They said, 'You need to come now.' I rushed there and as I was going up, a nurse said, 'Oh, I'm sorry, your dad just passed.' I went to his room and it was really distressing. I cried out. He was laid on the bed and was yellow, his eyes slightly open, his mouth wide open and he was cold. I shut his eyes and mouth."
To add insult to injury, when she got a sympathy card from the care home it was addressed to her late father.
A few days after Robert died, David Behan, executive chairman of HC-One, told the BBC that Covid-19 was present in two thirds of the group's homes and represented a third of deaths over the previous few weeks. Aspen Court had been one of the hardest hit.
Between the end of March and early May, 33 of its 68 residents died, 21 of the deaths recorded as related to coronavirus. The company said the home had been provided with only four tests by Tower Hamlets, three of which were positive. Two residents had been transferred back from hospital to the home at the start of the pandemic, but had tested negative.
Robert Henry's funeral was streamed to the family as only ten were allowed to attend. To Amanda, the last indignity was that he was buried in the clothes he died in — "a dirty T-shirt" — and that her son and partner were not allowed to carry the coffin owing to potential infection. I'm Forever Blowing Bubbles played as it was wheeled out. The ashes sit on her coffee table, in a small box with a plaque engraved with the phrase "If I don't see you thru week, I'll see you thru window", which, before his dementia got too bad, they used to say to each other on the phone in a northern accent instead of goodbye. Above is the date — April 8, 2020.
One day in April
The other Covid events making headlines on April 8.
Get well, Boris; good luck, Carrie
The Queen sent a message to the family of the prime minister, Boris Johnson, and to his pregnant partner, Carrie Symonds, wishing him a "speedy recovery" from Covid-19.
Step down, back pain and television up as UK is trapped at home
One third of people said they were eating less healthily after the mass shift to working from home - and alcohol consumption was soaring.
Second-home owners accused of fleeing under cover of darkness
City dwellers were said to be sneaking off to their rutual retreats, often in tourist resorts, despite lockdown restrictions.
Cries of "Wohoo!" in Wuhan
Residents of the city where Covid-19 emerged were allowed to travel to other areas for the first time since millions were isolated there on January 23.
Across the channel: Curbs on daily outdoor exercise in France
Paris banned "panting, sweating" daytime joggers from 10am to 7pm after large groups ignored social distancing rules.
Written by: Christina Lamb
© The Times of London
