The UK is now in its third week of a three-week lockdown. But as we see the mounting number of people diagnosed with the severe acute respiratory syndrome coronavirus two, and with that the growing number succumbing to coronavirus disease, I think most of us know that this will not be the last week that we need to stay at home.
While we’re in the throes of this pandemic, we need to focus on three things: reducing the spread of the virus; protecting people who are at most risk of contracting the virus; and ensuring that those who do contract it have the treatment and care that they need.
Overall, most people are being sensible and following the requirement to stay at home. When we’re not at home, we’ve all been told how important it is to maintain at least two metres between us to prevent the virus spreading. But the focus on enforcing this has been on individuals, whether in parks, at work or on beaches.
Why are we still allowing businesses undertaking non-essential work, where social distancing of at least two metres is almost impossible to observe, to stay open – potentially spreading the virus between workers and their families? Italy stopped non-essential production on March 23rd. Why haven’t we? Serving a constituency where warehousing and distribution are key industries, this is one of the biggest concerns of my constituents who work in this sector.
Personal protective equipment (PPE) is essential in stopping the spread of the virus. But as I said when I wrote to Matt Hancock three weeks ago, thanking him for his efforts, the lack of PPE for our health workers could mean that not only do they contract the virus themselves, they also transmit Covid-19 to their family, colleagues and vulnerable patients.
Over the last three weeks, I have had doctors and nurses contacting me about the inadequate PPE supply from masks to gloves and gowns. One A&E doctor told me that whenever he carried out an aerosol-generating procedure, which he does routinely every shift, he risked contracting the virus as he doesn’t have the recommended FFP3 respiratory mask.
A nurse reported that she was caring for a patient dying from Covid-19 with a mask that just wasn’t fit for purpose and no gown at all, just a flimsy apron. We’re now seeing our doctors, nurses and frontline carers dying as a result of the inadequate protection they’ve been issued with, when this was entirely preventable.
We need to be asking why we didn’t start to stockpile PPE in January when we saw how infectious this virus was, why it took so long to join the joint EU procurement programme to access PPE and other medical equipment more promptly, and how we’re going to ensure adequate PPE supplies get through to health and care workers at the frontline from the regional pandemic supply hubs that have now been set up.
Another tool in public health’s armoury is contact tracing. This involves tracing and contacting whoever an infected person has had interactions with in the previous ten days or so, and then getting them to self-isolate and prevent the further spread of the virus.
With under 300 people in Public Health England to do this, contact tracing was scaled back in the middle of March as soon as it was clear that coronavirus was spreading within the community. In other countries, notably Germany, Ireland, Singapore and South Korea, it was a cornerstone of their work to prevent Covid-19 from spreading. I’ve been told the Republic of Ireland are recruiting thousands of people for this task. Together with testing, it enables us to understand the dynamics of the virus, preventing it from reemerging in the future.
On testing, we know that the World Health Organisation (WHO) has said all countries should “test, test, test”. Not just to diagnose who with symptoms has the virus and needs to self-isolate, but also to understand its prevalence in asymptomatic people. The WHO even provided guidance of how to develop tests and testing regimes at the beginning of March. Once again, we have been behind the curve.
Contact tracing could have prevented the virus’ spread back in February, but as soon as it was being transmitted within communities, the demand for diagnosis was always going to outstrip supply. Now we need to prioritise the testing of vulnerable people presenting for hospitalisation and our NHS and care workers.
But even then our testing facilities to diagnose Covid-19 positive people are struggling, and we really need to be taking up all available offers from labs such as the Crick Institute. Separate to this, the developments for antibody tests to tell if we’ve had the virus and are now afforded some immunity, needs to be escalated, without compromising reliability. We don’t want a test which has more than 2% of false positives, potentially allowing the virus to re-emerge.
This emergency has shown us a lot about our society. We’ve seen the best of people: our selfless NHS and care workers, those who have volunteered or are looking after neighbours. But we’ve also seen the worst: deceiving and stealing from isolated vulnerable people, shops profiteering, individuals stockpiling goods leaving the health workers who we rely on with nothing.
This is being replicated at a global level with some countries gazumping other countries’ medical supplies that they’ve bought and paid for. I heard about one country – I won’t name them – that literally hijacked much-needed PPE and ventilators on a runway!
More than ever, we need strong, principled leadership – leadership that recognises that we can only beat this virus, and others like it, through international co-operation and collaboration, by sharing data and expertise, even resources. We are an interconnected world, and viruses don’t recognise borders.
This health emergency, which we have yet to see peak in the UK, will be followed by an economic and potentially a social one lasting most of this decade. And we need to be planning for this, too. Globally, it is estimated that the Covid-19 pandemic could cost as much as $10tn and for each percentage point lost in the economy typically ten million more people fall into poverty.
To quote The Lancet: “As the global economy plunges deeper into an economic crisis and government bailout programmes continue to prioritise industry, scarce resources and funding allocation decisions must aim to reduce inequities rather than exacerbate them.”
We must make sure that the poor, who are predicted to suffer disproportionately in this crisis, don’t also suffer in its aftermath through widening socioeconomic inequalities, as well as the inequalities in life expectancy and healthy life expectancy. Out of this emergency, and the tragedy and heartbreak that so many will endure, we must take the opportunity to reflect on the kind of society we want, what this means for our economic response and for our welfare state.