Heartbreaking testimonies from workers on the frontline paint a horrifying picture of life and death during the coronavirus outbreak in some of Greater Manchester's care homes.

There were more than 4,000 coronavirus-related deaths in care homes up to April 24, according to the Care Quality Commission.

But it is the stories from care home workers on the frontline that reveal the awful truth behind the numbers.

Staff tell of feeling powerless as they lose resident after resident to this cruel disease. They say they have seen patients test positive for Covid-19 in hospital before being moved to a care home without disclosure of their condition - risking the lives of staff and the elderly.

They recall nursing patients with chest infections being refused antibiotics under the assumption they have COVID-19.

And they live daily with the problem that's plagued key workers from the start - a dangerous shortage of testing and PPE.

On Tuesday - and confronted by up-to-date numbers on the death toll by the Care Quality Commission - Health Secretary Matt Hancock said they would finally expand testing to all care home residents and staff in England whether or not they showed symptoms.

He also said care home deaths would be included in daily figures from now on.

But the lack of urgency up to now has already taken its toll on workers, who speak with flat resignation of this perfect storm; years of austerity and neglect by central government, compounded by weeks of inaction.

The M.E.N spoke to a senior nurse with nearly 20 years' experience who works in a Greater Manchester care home.

She says there have been 17 deaths from confirmed or suspected COVID-19.

Four of those deaths - at the beginning of the crisis - were patients who had come to them from hospital having tested positive for COVID-19.

Crucially, she claims, the home was not told of their status and it was only when they noticed the symptoms and spoke to a GP that the positive result was found in their medical notes.

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She said: "We hadn't been told - probably because they thought the home wouldn't take them.

"I think those patients brought the infection into the home.

"All those patients have died now."

The Department for Health and Social Care says a new 'action plan' means all patients will be tested before they are discharged from hospital to care homes.

In homes with a coronavirus outbreak, workers can't clock off at the end of their shifts, go home to their families and forget about their day. Their days - and the pain that defines them - follow them home.

She added: "For those with COVID-19 it's a horrible, slow painful death. We have to lie to families and tell them they were settled, comfortable and peaceful. We can't tell the truth because it will break their hearts even more.

"They are short of breath, their lungs fill up and they are basically drowning. Some of them need suctioning to clear the phlegm and secretions.

"They have temperatures which create hallucinations, they are extremely agitated. They see people, animals, they try to grab out.

"They have abdominal pain. We try to settle them and comfort them and we just can't."

She added: "I feel we've lost people who weren't ready to go.

"They had underlying health conditions but they were well in themselves. Then they got COVID-19 and deteriorated rapidly and passed away in a horrible death.

"I'm absolutely certain these people weren't ready to die. They had years left in them."

This week, Health Secretary Matt Hancock said they would expand testing to all care home residents and staff, regardless of symptoms. But Public Health England today told the M.E.N they are currently only testing where residents are symptomatic.

The nurse's home has been sent just four swabs by Public health England over the course of the crisis. All four were used on residents who tested positive and have now sadly died and although they have been promised a 'weekly' delivery of swabs, none have arrived.

She also claims doctors are withholding medication from residents she believes are not suffering from COVID-19.

"We ring GPs when residents clearly just have the chest infections they get all the time. They get several a year and need antibiotics.

"But because the symptoms are similar to COVID-19 doctors are refusing to treat them with anything other than end of life drugs.

"They say 'if they deteriorate, they deteriorate'.

"When it's somebody's mother or grandmother and they are left in a bed to die with no treatment it's horrible.

"I just think this is a forgotten generation.

"The attitude is 'they're in a care home, it's God's waiting room. I think this is the view of the Government.

"It's just really really sad. I don't feel valued by society either. Not at all.

"And I'm doubtful society will learn from this, although I hope they will.

"Only time will tell."

The M.E.N also spoke to a care assistant who works at a home where there have been four COVID-19 deaths.

One of those had been transferred from another home at the end of March with symptoms but was only tested days before she passed away. She was the home's first case.

She feels bosses at the home have tried to hide the truth from them.

"Managers are having meetings and not informing staff about what's going on. They don't want us to phone in sick.

"We only knew about the first case because there was a sign on the door saying not to go in without a mask on."

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But those masks are hard to come by. The carer said she arrived on shift to be told there were two masks between six of them.

"Four of us were told we'd have to use towels.

"Through no fault of their own dementia patients spit at us. We need to be protected, we need eyewear."

Sadly, the scale of the crisis in care homes doesn't surprise her.

"I said to my family when this first started. You wait, this will be in the news and care homes will be at the forefront of the deaths and the conversation.

"We are classed as the lowest of the low. Nobody sees the other side, the pressure we are under.

"Each day I go to work thinking 'what's today going to bring?'

"It's deaths that could have been avoided, that's the sad thing about it. I feel dumbstruck. We are trying to protect people but there's no proper leadership.

"It doesn't matter how old you are, you've got a right to be treated like everybody else.

"Once it's over I think it will go back to normal, the lowest paid job ever with no support at all.

"I've known a lot of really good carers who have put their heart and soul into it, but they have left the care industry and are in packing jobs now, it's more money and care was just so disheartening.

"I work with so many good carers but we just don't know what to do. We don't have the right protection, that's why it's spreading."

The question of why COVID-19 is spreading so rapidly in care homes is being considered by Dr Thomas House, a mathematical epidemiologist.

He works at the University of Manchester and is a member of a national mathematical modelling committee advising the government.

He says general policy around care homes needs looking at, adding: "This highlights the broader picture of how we are looking after people at the end of their lives."

But they are also looking at how COVID-19 enters care homes - and what happens when it does.

He said: "We are trying to work out whether older people are more susceptible, as well as getting more ill."

He said the way in which care homes are exposed to the general community is also key, adding: "We know coronavirus spreads well in these close contact environments. You can't lock them down. It's bigger than a usual household, staff don't live there, people are coming and going. There's a vulnerability in how they are set up."

This could be why some smaller care homes have so far managed to side-step the pandemic.

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Yvonne Timms, a nurse at Faversham Nursing Home in Urmston, says they have had no reported cases of COVID-19.

She said: "I've touched wood so many times.

"We're a small family run business without lots of staff. We've had people come in from hospital but we made sure they were tested to make sure they were clear first.

"We were running drastically low on PPE but we've had some donations from different companies in the area and from the Red Cross.

"We've been one of the lucky ones. Being small has definitely helped and we've no agency staff coming in and out so we've not got people bringing the infection in from different areas.

"It's just the same staff every day and we are strict with infection control."

Rachel, Hind, company director for Hind Care Ltd which runs Faverhsam and Brookfield Nursing Home in Urmston, added: "We haven't got cases, but we're expecting it, we're preparing for it. We feel sadly it's only a matter of time.

"We've done everything we can but if it does come in it will be shopping supplies. We have no visitors, all staff literally go home and come to work, they don't mix socially, they don't go shopping, they are shielding.

"Even if lockdown eases we will be very very cautious about letting families in. I think that we are smaller has kept it at bay."

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A Public Health England spokesman said care homes where there are suspected cases of COVID-19 are asked to notify them and they will arrange for 'rapid' testing for all symptomatic residents and will advise on what action to take.

They said they give tailored infection control advice so staff can protect themselves and residents.

What the Department for Health and Social Care say:

"Social care is on the frontline of our fight against coronavirus and the safety of staff and residents is our top priority.

"We are working around the clock to ensure PPE is delivered as quickly as possible to those on the frontline during this global pandemic for as long as it is required and have so far delivered over 1 billion items.

"We are using our increased testing capacity to test all symptomatic care home residents, care staff, and their families."

They said there is an action plan to support social care, including ramping up testing, overhauling how PPE is delivered to care homes and minimising the spread of the virus.

On PPE , they said there is a 24-hour NHS-run helpline where workers can report shortages, there is a PPE sourcing unit for teh Government to secure new supply lines from across the world and they are piloting a new online portal for health and social care workers to order PPE.

Supply of PPE ris prioritised based on clinical need and include highly vulnerable groups and takes account of those who are 70 or over.

On testing , they said the Care Quality Commission uis leading the coordination of regional testing and all registered care providers have been contacted. They have launched an online portal for essential workers to book tests.

In guidance they added: "Our social care action plan will ensure all patients discharged from hospital are tested before going into care homes."

On residents discharged from hospital, they said all care home residents will be tested before being admitted into their care home.

They said they would ensure residents arriving from hospital would not put those already in the home at risk.

Some coronavirus-positive residents would still be moved to care homes but they would only be housed on sites with effective isolation strategies.

The government has made £1.3bn available to support this.

They said they have enhanced guidance so even asymptomatic residents moving to a care home must be isolated for 14 days.

There is £1.6bn to help local authorities deal with COVID-19, including for adult social care services, as well a further £1.6bn for councils delivering 'front line services'.

They said their action plan would 'support the care workforce, unpaid carers, local authorities and the NHS for their ongoing hard work to maintain services and continue to provide high quality and safe social care to people throughout the pandemic'.