A leaked letter sent by a GP surgery reveals a grim future for thousands of people who will not be given hospital treatment for Covid-19.
The letter says they would need certain patients to complete Do Not Attempt Cardio Pulmonary Resuscitation (DNACPR) forms.
Llynfi Surgery, in Maesteg, South Wales, sent the letter to patients with serious health conditions such as incurable cancer, motor neurone disease, and untreatable heart and lung conditions, on Friday, March 27.
Senior NHS chiefs have apologised for any distress the letter may have caused but have not denied the accuracy of the plans outlined.
It said that people with certain serious conditions are "unlikely to be offered hospital admission" if they become unwell with coronavirus and "certainly will not be offered a ventilator bed".
The letter has been revealed by a patient who wished to remain anonymous.
He said: "It not only greatly upset me but my family and close friends.
"It was like having my death warrant sent by the grim reaper. It made me feel worthless.
"I've lived with cancer for eight years and I want to live another couple of years. I'm not digging my grave yet."
The letter continued: "We would therefore like to complete a DNACPR form for you which we can share with the OOH [out of hours] GP services and which will mean that in the event of a sudden deterioration in your condition because of a Covid-19 infection or disease progression the emergency services will not be called and resuscitation attempts to restart your heart or breathing will not be attempted."
Although people with underlying health conditions are more likely to die as a result of Covid-19 infection, victims of the disease range in age and levels of health and fitness.
In Wales, 69 people have now died after testing positive for coronavirus.
The surgery goes on to suggest that the "best option" for patients is to stay at home to be cared for by their family with "ongoing support from ourselves and community nursing services".
People considered at highest risk from coronavirus, including those with serious respiratory illnesses and cancer patients, have been told to self-isolate for 12 weeks to "shield" them from coming into contact with the virus.
A number of "benefits" to signing the DNACPR form are also listed in the letter:
- "Your GP and more importantly your friends and family will know not to call 999
- "Scarce ambulance resources can be targeted to the young and fit who have chance of surviving the infection"
- "The risk of transmitting virus to friends, family and emergency responders from CPR (even chest compression alone) is very high. By having a DNACPR form in place you protect your family and emergency responders from this additional risk."
The letter ends with "in an ideal situation" the conversation would be had in person but this could not be done because of the risk of GPs catching the virus from "asymptomatic carriers".
Patients will instead be contacted by phone this week, it says.
The final line reads: "We will not abandon you but we need to be frank and realistic about what the next few months holds for all of us."
A spokesman for Cwm Taf Morgannwg University Health Board said: "A letter was recently sent out from Llynfi Surgery to a small number of patients.
"We have been made aware that the letter has caused upset to some of the patients who received it.
"This was not the intent and the surgery apologise for any distress caused.
"Staff at the surgery are speaking to those patients who received the letter to apologise directly and answer any concerns they may have."
