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Throughout the day, Prime Minister Boris Johnson has ignored growing calls from politicians and academics to close more than 30,000 schools in the country. He has repeatedly rejected such calls, arguing categorically that such restrictions are not necessary, according to the advice of academics, which he allegedly listens to.
But the shocking figures presented to those gathered in the gray government building on Victoria Street in London clearly showed that policy must change, and fast.
For two hours over a cup of coffee, members of the scientists’ advisory group discussed facts that show that the spread of the virus among children, parents and teachers is much greater than expected. Furthermore, it was clear that radical measures of social exclusion (quarantine was already in force in much of Europe at the time) would have to be announced in the near future.
However, in that tense meeting, the main concern was political dialogue. Among those present were Chris Whitty, England’s chief medical officer, and Pattrick Vallance, the government’s chief scientific adviser. After attending live press conferences with Johnson, they became the public face of the British war with Covid-19. They agreed that the time had come to make a fundamental decision to close the schools, although they were concerned about the loss of confidence.
Not long ago, during the peak of the outbreak, the United Kingdom (United Kingdom) had the highest weekly death rate in twenty years. According to statistics published last Wednesday, more than 26 thousand. deaths According to some models by university experts, the UK can outperform all other European countries in terms of total hospital deaths. Now only lags behind Italy.
Lacking essential medical supplies, the government even sent a military plane to Turkey to transport protective clothing for health system workers from there. B Johnson himself had already recovered from COVID-19, which had even placed him in the intensive care unit and forced him to fight for life.
The initial decision not to close schools is only one side in the story of the British response to the pandemic, which Johnson’s critics consider too slow. The government waited longer than other countries before deciding to close restaurants, bars, and shops and tell people to stay home. At a time when other countries were tracking nearly all cases of infection, the Johnson administration had difficulty testing the population and tracking the spread of the virus.
It is too early to finally evaluate the efforts to overcome a pandemic, achievements or defeats. The National Health Service (NHS) still registers an increase in cases. According to a government spokesperson, the government is taking all appropriate measures when necessary and following the advice of scientists.
However, one thing is clear: Britain had time. He wasted it, according to Johnson experts, academics and political opponents. According to them, the opportunity to store vital equipment was lost in February, when international competition was not so fierce. And later, during the critical period in March, the virus broke out along with people fleeing the country.
Although they realized that the infection was spreading out of control in society, it took the government more than a week to close bars and schools, and eleven days for a more extensive quarantine to be introduced.
“We close too late, that’s mathematically obvious,” said Martin McKee, a European professor of public health at the London School of Hygiene and Tropical Medicine (LSHTM) who advised the World Health Organization (WHO) on the pandemic. “English distinctiveness is really harmful.”
Based on the minutes of parliamentary committee meetings, interviews with senior ministers and government officials, comparisons of data with other countries, and discussions with virus and medical experts, this article outlines a number of missed opportunities to prepare for the worst case and prevent the spread of the disease.
Earlier this year, an official message came from the Johnson government: There is no reason to worry that a new disease will take hold in China. The focus of all politicians was on the final, extremely tortuous withdrawal from the European Union after more than three years of controversy.
“The whole of the UK is always well prepared for such outbreaks,” the country’s health secretary, Matt Hancock, told the House of Commons on January 23 when China decided to quarantine its most affected region. Government officials have just increased the risk to the population from “very low” to “low.”
The UK, unlike other European countries, has been trying to maintain a normal lifestyle for weeks. After February 21. The teleconference in Italy, when Italy reported her first death from coronavirus, raised the risk to ‘medium’ by the British government agency Public Health England. Not everyone was so calm. John Edmund, professor of epidemiology at the London School of Hygiene and Tropical Medicine, then wrote an email to the group warning that the level of risk should be raised to “high.”
An emergency doctor at Hillingdon Hospital (West London), Meng Aw-Yong, said he already had infected patients at the time. Later, after taking a closer look at one of the patient’s x-rays, he realized it was a coronavirus.
“I unknowingly treated Covid patients,” said Aw-Yong, who has 28 years of experience and is also chief medical officer for the London Police. – If I treated a Covid patient without protection and that patient easily spread the virus, we missed the opportunity. He put me in danger. Also to your friends, family. At some point, we missed the opportunity to stop the spread at an early stage. “
However, the Cheltenham Festival, an annual celebration of horse racing lovers, brought together 250,000 participants from March 10-13, immediately after Italy introduced national quarantine. The Champions League soccer match between Liverpool and Atlético de Madrid was watched by 50,000 fans on March 11, the day the WHO declared a Covid-19 pandemic.
The government has opined that people will catch the virus faster by watching games indoors, such as in a beer bar, than in an open stadium. The national quarantine was not introduced until March 23.
“Even when that happened in China, it was necessary to realize that we must act quickly,” said David King, who served as the government’s chief scientific adviser between 2000 and 2007. “The following steps should have been taken: provision of lung ventilators, equipment of protection for medical personnel, as well as continuous tests. “
Johnson has streamlined the British approach to “stay calm and live” to the point of “washing your hands” as long as “Happy Birthday” is sung twice. In early March, the 55-year-old prime minister, after visiting the hospital, was proud to “shake hands with all the patients there, possibly the coronavirus.”
Most importantly, he said, wash your hands. On April 6, Johnson was admitted to the intensive care unit as his condition worsened.
Since March 12, Johnson’s tone has changed dramatically. He turned sadly from Downing Street to the nation, saying it was too late to prevent Covid-19 from taking hold and that the only hope was to slow its spread and avoid catastrophe, a hospital overload.
That day marks a turning point, as the government refuses to try to curb the coronavirus and chooses to move to its response plan, in the words of officials, in a “postponement” phase. The government has also given up efforts to assess the population on a larger scale.
In response to B. Johnson, Ch. Whitty said that community testing is no longer a priority and that efforts will focus more on confirming hospital infections for patients.
The next day, Mr. Vallance caused outrage, speaking of the desire to establish “some kind of collective or collective resistance” as soon as possible. According to P.Vallance, about 60 percent. The UK population is around 40 million. People: They must be infected with coronavirus to prevent it from spreading. The government now claims that “collective immunity” was never an official policy, but the same day that Vallance issued his controversial statement, Hancock’s actions spoke of something completely different.
The Secretary of Health contacted the G7 countries by teleconference to try to coordinate their responses and share experiences. Hancock asked the Italian representative if Italy was also working on a “collective immunity” plan. The Italian spokesman did not wrap his words in cotton: allowing the virus to spread freely would kill thousands more, and there is still great uncertainty about the nature of the virus, so there is no guarantee that such a risky idea will work. Hancock was surprised. The damage is already done. Medical experts accused Johnson of not acting fast enough.
Refusal to evaluate the population was largely contrary to WHO recommendations and the practice of other countries. In South Korea, where contact tracing exists, the government has managed to curb the coronavirus outbreak at much lower levels than in many other European countries. By stopping monitoring of the UK population that had been in contact with patients infected with the virus, those without symptoms were able to continue to spread the virus.
Three days after Mr. Hancock’s conversation with the G7, the most famous alarm bell rang. On March 16, a team of scientists from Imperial College London, led by Neil Ferguson, warned that if the UK did not take more aggressive steps to control the virus, 250,000 people could die and the health system could be overwhelmed.
That day, an official government advisory group, the Scientific Advisory Group on Emergencies (SAGE), whose members and minutes are not made public, met in London to decide on the closure of schools and broader quarantine measures.
Johnson announced the first phase of social isolation, telling the public where it is possible to work from home and not meet friends in bars and restaurants. The virus spread much faster than expected. The UK did not have as much time as it thought it had.
It is already clear that the decision to abandon large-scale testing posed a major problem for the UK.
“It seems to me that we need to significantly increase the scope of the evidence, and I will insist on that very strongly,” Vallance told a parliamentary committee on March 17. Johnson himself landed on the matter two days later, promising that up to 250,000 tests would be conducted per day, although he did not specify a planned date.
Why did the UK refuse to test the public, taking another step contrary to key international recommendations? Vallance informed the committee that “clearly there is not enough testing capacity, 4,000 tests a day, to move forward.” Efforts are said to have focused on the most difficult patients treated in the hospital.
Researchers have already realized that there are thousands of unknown cases of infections, and they find contact tracing useless.
“This is an unprecedented global pandemic, and we have taken the right steps in fighting it at the right time, listening to the advice of the best scientists at all times,” said a government spokesman. “Since mid-January, government advisory teams have taken steps to prevent the threat.”
On March 27, the virus hit the main links of the British government. B. Johnson and M. Hancock declared themselves infected with the virus and immediately isolated. Ch. Whitty reported that she also had symptoms and was quarantined, although she did not perform the test.
Mr. Johnson’s case was serious. A week later, he was hospitalized and then transferred to the intensive care unit, and underwent oxygen therapy to help him breathe. He later said, thanking the doctors who saved his life, that his fight against the coronavirus “could have ended in two ways.”
After returning to government work on April 2 for self-isolation, Hancock found confusion. In addition to the leaders, the cabinet found it difficult to control the situation, and the politically toxic issue of testing problems gained even more acute momentum.
According to a source, well versed in the situation, Hancock has matured a plan to head back. He promised to do 100,000 tests a day in late April. Such an objective caused another controversy.
Johnson’s team was not happy, the source said. He warned Hancock’s allies against setting such a high target, fearing that the government would receive harsh criticism if it did not implement such a plan. Hancock did not give up. Another source questioned such a version of events, accusing the Johnson administration itself of setting a goal that seemed unattainable at the time.
UK, April 23 tested, 425,821 people were tested, of which 138,078 tested positive. The total number of tests carried out in this country is slightly higher than the weekly figures in Germany. On April 22, 23,560 tests were conducted in the UK. The total number of deaths was 18,738, excluding those who died in nursing homes.
Last Thursday Hancock said test capacity should hit 100,000 by the end of next week.
The main challenge in the country is to increase laboratory capacity, in contrast to Germany, which has been collaborating with the established diagnostic industry for decades, say two government officials. “It is logistics at incredible speeds,” said an official.
Private labs offered help but received no response, said McKee of the London School of Hygiene and Tropical Medicine.
“One of the problems with the test is that the government agency Public Health England has insisted that it be allowed to address the problem itself,” he said. “Many veterinary and university laboratories and other private sector companies have offered their services, but no one has contacted them.”
Of course, the UK is competing with the rest of the world for the necessary resources and explains that the slow increase in testing capacity is due to a shortage of chemical reagents. In April, the government involved laboratories, universities, and industry to increase test volumes, at least in part.
A government minister who participated in the pandemic response campaign acknowledged that mistakes had been made, and stressed that there were decisions that had to be made instantly without enough information or time to consider other possible options. “You just have to decide based on your instincts,” said the minister.
But as the pandemic spread, even more deficiencies appeared, and the government had to go after other countries with all its might. Professionals in the medical sector have warned that the crisis has revealed a clear shortage of intensive care nurses. The ministers praised the retired former doctors and nurses in a hurry for help.
In late January and February, the government made efforts to order more medical supplies, although many doctors rushing to the front lines still don’t have the necessary equipment. The government reports that it has already provided doctors with more than $ 1 billion. Personal protective clothing, including face masks and bathrobes, but acknowledges that it still faces a logistical challenge in distributing facilities on a broader scale, outside of hospitals.
Austerity, inspired by the financial crisis, also had consequences. After a good decade, when spending on the health system increased 1.3 percent. per year, the country is below the European average in terms of doctors, nurses, beds and scanning equipment.
According to Mr Hancock, the UK currently has 12,000 lung ventilators to aid more severe breathing, compared to 6,660 before the pandemic. Data from the ministries of health show that other countries were better prepared.
Germany had some 28,000 lung ventilator resuscitation beds before the coronavirus crisis, and that number has now increased to 30,000. Italy, the first European country to resist a pandemic coup, had a total of approximately 18,300 lung ventilators in public and private hospitals before the crisis. .
The British government initially estimated that it needed 30,000 lung ventilators to overcome the peak of the pandemic, and Johnson, who contacted the producers by conference call on March 16, asked them to produce thousands a month. Manufacturers such as Airbus, Siemens, Nissan, Dyson, Babcock and others responded to requests.
A month later, a modified device made by Penlon Ltd., who had already worked in the field, was approved under an expedited procedure, but the amount they delivered did not meet government plans.
The good news is that while the UK is projected to have the highest number of deaths in Europe, growth in the case is slowing and projections are expected to be revised. The demand for pulmonary ventilators does not exceed capacity.
However, by March 23, when Johnson announced world quarantine, there had been 335 deaths in the UK, less than in Italy (463) when he introduced his own quarantine, but three times the number of deaths in France (91 ) and Germany (94). ) when these countries instructed residents to stay home.
Delays in introducing social distance measures have hurt the UK, as has the fact that London is a bustling international metropolis, said Ali Mokdad, a professor at the University of Washington Institute for Health Assessment and Metrics.
“In hindsight, procrastination was a mistake,” said Mokdad. – It is like a deck of cards, and you have to play with the cards you have. Yes, England is at a disadvantage as a hub and hub for people around the world, but then more aggressive restrictions must be applied. “
The government quickly received praise for its financial countermeasures to help struggling businesses and households as the economy crashed. A survey by market research firm YouGov Plc., Published last week, found that 68 percent of Britons believe that the country’s authorities are handling the coronavirus crisis properly.
However, while Johnson was still recovering at his country residence near London, the government left without a guide that extended the quarantine, the end of which remains to be seen. This does not prevent ministers from conflicting with the best tactics available. Some fear that the economic damage outweighs the public health benefits that have been achieved by extending the restrictions.
Furthermore, scientists are aware that their opinions and evaluations are observed under a microscope. Johnson and his team are urging the government to follow all scientific advice, but in recent days, experts themselves have struggled to emphasize that politicians are responsible for all final decisions.
A minister, who was reluctant to publish his name when discussing internal policy issues about the impact of quarantine on the state of the economy, emphasized: “The problem is that the rules have been followed very carefully,” he said. – We didn’t say, ‘Don’t work.’ We said, “Stay home, but work from home.”
Johnson himself, who has received fierce criticism for the delayed response, is now reluctant to relax measures of social distance, fearing that a premature withdrawal from quarantine could lead to a powerful second wave that would devastate the British health system ( NHS). In both cases, whether scientific advice is followed or not, the political risk of such a second spike can be too painful.
According to Aw-Jong, an ambulance doctor in London, the blackest phase of the outbreak was reminiscent of a true “war zone.” During his shift, he faced five or six Covid-19 deaths per day: “They couldn’t see their relatives. I couldn’t speak to anyone. It is probably horrible to die like this.”
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