John Lister
The seemingly daily interview sessions in which a minister stands in front of microphones and cameras to waffle, evade and lie their way through a succession of awkward questions, without giving a clear or concrete answer to any of them, have continued as the epidemic has gathered pace.
However the attempts to palm off journalists and the public with superficial claims and statements have proved increasingly ineffective, while the frustrations of the NHS staff whose own lives are potentially being put at risk have been voiced more loudly and effectively.
Time and again Matt Hancock, whose department assured us in February that the NHS was “extremely well prepared for coronavirus,” has been seen to have lied and dissembled when asked about the extension of testing, supplies of personal protective equipment (PPE) for hospital staff, and delivery of ventilators to supplement the inadequate stocks.
Hancock’s claim – made on BBC Question TIme, that he was working with supermarkets to secure deliveries of food to vulnerable patients was denied by retail insiders and described as “totally made up”. Even the Daily Mail cast doubt on the assertion that new ventilators could be in hospitals ‘within days’ when manufacturers were warning that it would take a month to start large scale production.
On March 15, Hancock publicly denied that government policy included the development of “herd immunity” which would involve the infection of up to 60% of the population with the virus, insisting “Herd immunity is not our goal or policy,” just days after the government’s scientific advisor Sir Patrick Vallance had outlined exactly that policy alongside Boris Johnson, and explained it at length in a Sky TV interview.
Testing
Hancock has also given repeated false assurances that the programme of testing for the virus, central to the WHO proposals for containing the spread of disease, was being “ramped up,” in the face of evidence that levels of testing have barely increased in weeks.
A recent Financial Times free to read report shows how the UK became one of the first countries to develop an accurate test after the virus details were published by the Chinese in January, but then charts how limited has been the British roll-out of testing. While South Korea showed how testing and a huge effort to track the virus and trace contacts of those affected had managed to ‘flatten the curve,’ in Britain no such effort has been made.
The government announced on March 11 it was aiming to increase testing to 10,000 per day; on March 17 the government claimed it was working ‘very fast’ to roll out COVID-19 testing for frontline NHS staff, after doctors warned a failure to provide quick tests could deepen workforce shortages; on March 25 Boris Johnson promised to increase testing to 250,000 a day: but according to the Financial Times officials say it won’t reach 25,000 until the middle of April, and the latest picture shows only 6,500 tests per day.
NHS staff are now promised testing from the last week of March – but only after some NHS trusts have had up to 50% of staff off work and self-isolating, unaware if they have the virus or just symptoms. A new “game changing” test for antibodies to show if people have had the virus is also promised: but as the FT points out it’s still unclear when this will be widely available.
Ventilators
Ministers and their spokespeople have also clearly been lying over their long delays and failure to secure adequate additional supplies of ventilators, to ensure the NHS receives them in time.
The dithering and delays go back to the early days of the outbreak in January, but also much more recent decisions that have denied the NHS a share of a bulk procurement of ventilators and protective gear:
Two weeks ago Britain decided not to join in joint efforts by the EU which combined an export authorisation scheme to prevent vital medical equipment leaving the bloc’s single market and an accelerated procurement process to help member states secure ventilators and testing kits. No 10 initially said it did not join these efforts because the UK was no longer a member state:
“We are no longer members of the EU,” the prime minister’s official spokesperson told reporters early on Thursday.
“We are doing our own work on ventilators and we have had a very strong response from business. We have sourced ventilators from the private sector and international manufacturers.”
However after mounting criticism that the government was putting “Brexit over breathing”, the spokesperson later changed the story completely, arguing that the UK had missed the procurement deadline due to a “communication problem” which meant the country was not invited to apply in time.
At least one of these versions must have been a lie.
A spokesperson for the European Commission has since dismissed the claim of any communication problems, and confirmed Britain is able to participate in “any joint procurement” during the 11-month Brexit transition period.
MSN reports that “The procurement programme, initiated by the commission, uses the bulk buying power of the single market to get priority for ventilators and protective equipment – which doctors have warned are in short supply in the UK.”
The first tranche of orders, which will go to 25 of the 27 member states, covers “masks type 2 and 3, gloves, goggles, face shields, surgical masks and overalls” – just what NHS staff are crying out for.
But this failure to grab an opportunity to ensure bulk provision of vital equipment is no stray story – it is part of an ongoing pattern of failure to make serious provision to fill identified gaps in NHS stockpiles that can make the difference between life and death.
The Financial Times reports that
“A proposal that could have supplied the NHS with as many as 25,000 ventilators from China … went unanswered until it was too late, according to two companies behind it.
“Direct Access said it first contacted officials on 16 March with a plan to obtain manufacturing slots of 5,000 machines per week, which it conceived with Dubai-based Topland General Trading, as first reported by the Nantwich News.
“Had quicker action been taken when we first contacted the client, we would now have supplied up to 15,000 ventilators with a further delivery of 10,000 within the next two weeks,” said Andy Faulkner, owner of Topland. “And yet now, there are currently none on order with lead times two to three months away.”
The Financial Times also reports another company, which asked not to be named, who said they had written to the business department at the start of last week offering to provide hundreds of ventilators for $15,000 each, but had received no reply. “My concern is that the government actions don’t match their words,” said one executive there.
World class systems
There has been a similar story of cynicism and deception over the distribution of protective equipment. Health Minister Nicola Blackwood told Pharmafield magazine on February 12:
“We have world-class systems in place to prevent supply problems and we are working closely with industry and partners to prevent shortages and ensure the risks to patients are minimised.” England’s Deputy Chief Medical Officer, Jenny Harries, told a press conference on March 20, 2020: “The country has a perfectly adequate supply of PPE.”
More than six weeks after Ms Blackwood’s claim, and almost a week after the army was called in to help get the failed NHS distribution system functioning and forestall a threatened revolt by frustrated front line staff, we know that these assurances, too, were untrue.
Instead, front line staff in hospitals and GPs are still desperately trying to access the stocks of PPE they require, with some hospital departments sending out to DIY stores or begging donations of masks from school laboratories, and others improvising their own makeshift protective gear from whatever materials they can lay hands on as they wait in vain for deliveries from a chaotically privatised NHS Supply Chain.
Cost-saving versus safety
Worse still it’s been revealed that in 2017, after an expert review recommended providing visors or safety glasses to all hospital, ambulance and social care staff, officials at the Department of Health, then headed by Health Secretary Jeremy Hunt, rejected the advice on grounds of cost, and refused to stockpile the quality of kit required to keep staff safe during the current crisis.
Worse still, documents uncovered by TruePublica reveal that a 3-day exercise in 2016 to test the readiness of the NHS to cope with a pandemic of flu was the latest to show that the plans were inadequate, not least because of a lack of availability of sufficient ventilators: yet nothing was done to revise the plans, or fill the gaps that were exposed in provision of equipment.
TruePublica has also highlighted the decision on March 21 by the Johnson government to downgrade the classification of Covid-19, and – despite the fact that it has caused more disruption and more deaths already in Britain than any High Consequence Infectious Disease since World War Two – cease to regard it as a ‘High Consequence Infectious Disease’.
As a result: “the British government has reclassified Covid-19 as less of a consequence than SARS (total global deaths recorded 774), MERS (total global deaths recorded 600), – along with Avian Influenza H7N9, H5N1, H5N6, and H7N7. Listed as High Consequence Infectious Disease (HCID) is even the Andes Virus Infection (possible one global death) which infected just four people in the UK with no known deaths.”
Noting that “the updated document ends with – “This guidance includes instructions about different personal protective equipment (PPE) ensembles that are appropriate for different clinical scenarios,” TruePublica tries to guess the reason for this apparently irrational change:
“Has the government covered its back to stop legal cases against it for not supplying the correct safety equipment to frontline medics who die, given that many doctors are complaining of lack of PPE?”
Serial failures
Lancet editor Richard Horton has been consistently criticising the government’s serial failures to heed international expert advice and early warnings, resulting in weeks of delay in taking basic steps. He argues:
“The NHS has been wholly unprepared for this pandemic. It’s impossible to understand why.
“Based on their modelling of the Wuhan outbreak of COVID-19, Joseph Wu and his colleagues wrote in The Lancet on Jan 31, 2020:
“On the present trajectory, 2019-nCoV could be about to become a global epidemic…for health protection within China and internationally… preparedness plans should be readied for deployment at short notice, including securing supply chains of pharmaceuticals, personal protective equipment, hospital supplies, and the necessary human resources to deal with the consequences of a global outbreak of this magnitude.”
As a result, argues Horton, “Patients will die unnecessarily. NHS staff will die unnecessarily. It is, indeed, as one health worker wrote last week, “a national scandal”. The gravity of that scandal has yet to be understood.”
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