More than 43,000 people died in UK care homes with Covid listed on their records between March 2020 and July 2022. The official inquiry now says the care sector was treated as an afterthought while hospitals were protected. Families and some observers ask a harder question: were the deaths only from the virus, or did treatment rules and drug use play a larger part? Here is what the inquiry found, what the numbers show, and where the claims differ.
What the Inquiry Actually Found
On 20 October 2026, Baroness Heather Hallett published the sixth report of the UK Covid-19 Inquiry. It covers adult social care. The report states there were more than 43,000 recorded deaths involving Covid-19 in care homes in that period. Covid-19 was the second leading cause of death in care homes in all four UK nations in 2020.
Hallett wrote that the adult social care sector “appeared to be something of an afterthought.” The mantra of “protecting the NHS” sometimes came at the expense of care home residents and staff. Claims by then-Health Secretary Matt Hancock that a “protective ring” had been put around care homes from the start were called unfounded. The opposite was true in the early weeks.
Key failures listed include:
- Hospital patients were discharged into care homes in March and early April 2020 without testing capacity to know their Covid status. Isolation of those patients was not initially advised in England, Wales and Northern Ireland. The inquiry called this a significant omission.
- Severe shortages of personal protective equipment left staff using bin bags, festival ponchos and painters’ overalls. Hallett called this wholly unacceptable.
- Visiting restrictions caused profound isolation. Some people died without family present. The inquiry noted immense emotional harm.
- There was evidence of inappropriate Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions in some places, though no national policy for blanket use. Orders rose sharply in the first nine months.
The inquiry concluded that these failures created an environment in which the virus could spread like wildfire. Action to protect the sector came too late. It made eight recommendations, including better pandemic planning for social care, clearer rules on hospital discharges and isolation, financial support for staff to stay home if ill, and mandatory end-of-life care training.
Official sources: UK Covid-19 Inquiry statement and BBC coverage.
The Alternative View: Treatment Protocols and Drugs
Some families, former MPs and alternative reports argue that the deaths were not only from the virus. They point to NICE guideline NG163, published in early April 2020. Its full title was “COVID-19 rapid guideline: managing symptoms (including at the end of life) in the community.”
NG163 advised doctors on treating breathlessness, anxiety and agitation in people with Covid who were not going to hospital. For end-of-life cases with moderate to severe breathlessness and distress, it recommended opioids such as morphine together with a benzodiazepine such as midazolam. It stated that sedation and opioid use should not be withheld because of fear of causing respiratory depression. Anticipatory (“just-in-case”) medicines were to be prescribed in advance.
Critics say this guidance, combined with Do Not Resuscitate decisions, limited GP visits, no ambulance call-outs in some cases, and bans on family visits, created conditions where strong sedatives were used more freely. Midazolam and morphine together suppress breathing. In someone already struggling with a respiratory illness, the effect can be rapid. Some call this a death pathway rather than ordinary care. They note that the old Liverpool Care Pathway had been withdrawn years earlier amid concerns, and they see NG163 as a revived version under a new name.
Scottish data is often cited. Excess deaths in care homes spiked sharply in spring 2020, during the first lockdown. At the same time, midazolam use rose. National Records of Scotland figures and prescribing data show the two lines moving together. In England, midazolam prescriptions for sedative or analgesic use roughly doubled in April 2020 compared with the 2019 monthly average (from around 17,500 to over 38,000).
One recent related report on Planet Today examines broader Covid hospital and care protocols: The COVID Reckoning That Never Came. An earlier piece discusses claims about midazolam orders: Government told doctors to KILL patients.
What the Numbers and Experts Actually Show
Fact-checking organisations such as Full Fact have looked at the midazolam claims repeatedly. They found no evidence that the drug was used with the intention of ending lives on a large scale, or that it formed a formal euthanasia policy. Euthanasia remains illegal in the UK. Midazolam is a standard palliative drug used to ease distress at the end of life for cancer patients and others. When large numbers of people are dying of a respiratory disease, prescriptions of such drugs are expected to rise. The Care Quality Commission noted the increase and linked it to community treatment of Covid patients at the end of life.
A 2020 letter in the BMJ from experienced palliative medicine consultants welcomed the rapid guidance but raised concerns. They said some recommended doses of morphine and midazolam were higher than usual non-specialist guidelines, that focusing on morphine might increase sedative use, and that the advice risked unintended harm if applied without careful judgement. They called for review. NICE later updated and eventually replaced NG163.
The official inquiry report does not discuss NG163 or midazolam as a cause of the deaths. It attributes the high toll to the virus spreading because of the listed failures in protection, testing, PPE and isolation. Studies examined by the inquiry found that hospital discharges were one route of infection into care homes but were unlikely to have been the dominant driver of the first wave.
Primary sources for the guideline: archived NICE pages for NG163 (published 3 April 2020, last updated 13 October 2020) and the BMJ summary. Full Fact analyses: No evidence midazolam used to kill thousands.
Why the Timing Still Raises Questions
Critics point to the pattern of excess deaths. In the weeks before the first lockdown, some UK excess death figures were low or negative. Once lockdown began and care homes closed their doors, deaths in those homes rose sharply and stayed high for weeks. After the first lockdown eased, the excess fell. They ask why a virus would produce its main effect only while isolation, restricted medical access and the new symptom-management guideline were in force.
Supporters of the official account reply that the virus was new, testing was scarce, and care homes house the most frail people. Once it entered, it spread fast. High death numbers then drove higher use of end-of-life medicines. Correlation is not the same as causation. Blanket claims of deliberate murder lack direct evidence from death certificates, medical records or official investigations.
Both sides can cite real facts. The inquiry documents clear policy failures that left vulnerable people exposed. Prescription data and Scottish excess-death charts show the midazolam rise happened at the same time as the death spike. Independent palliative specialists raised dose concerns in real time. No public inquiry or major fact-checker has concluded that the government ordered mass killing via these drugs.
What Remains Unresolved
Families who lost relatives still want clearer answers on individual cases. Some Scottish and English inquests have examined midazolam and morphine use. Blanket DNACPR decisions and the absence of family visits removed ordinary checks. Stockpiling of midazolam was official policy because demand for intensive-care and palliative drugs was expected to rise.
The inquiry’s recommendations focus on future planning, isolation rules, staff support and training. They do not reopen the question of whether the symptom-management guideline itself contributed to avoidable deaths. That gap is what keeps the alternative accounts circulating.
Readers can examine the primary documents: the full Module 6 report on the inquiry website, the archived NG163 text, National Records of Scotland prescribing and death data, and the Full Fact and BMJ sources above. The official record attributes the 43,000 deaths to Covid spreading amid policy failures. Alternative accounts attribute a large share to the combination of isolation, limited care and the use of respiratory-suppressing drugs under NG163. The evidence for each view is public. The conclusions differ.
Original source material draws from the UK Covid-19 Inquiry Module 6 report (published 20 October 2026) and contemporaneous reporting. Related analysis appears on Planet Today at the links given above.
Disclaimer: This article presents findings from the official UK Covid-19 Inquiry alongside publicly available prescribing data, guideline text and alternative interpretations. It does not claim that deliberate murder has been proven. Readers should consult primary documents and form their own view. Fact-checkers have found no evidence of a national euthanasia policy using midazolam.