The discharge of elderly people from NHS hospitals into care homes without having been tested at the beginning of the pandemic—while understandable as the NHS prepared to accept a surge of covid patients—had the unintended consequence of contributing to the spread of infection in care homes. The seeding of infections also happened as a result of staff entering care homes, and the failure to recognise this risk early is a symptom of the inadequate initial focus on social care. The lack of available testing at the time meant that the extent of spread by each route of transmission cannot be fully known and has not been conclusively determined by the report commissioned from PHE by the Government.