As a doctor, I have always known that a time like this might come. That there might be a national public health emergency of some kind, and that my colleagues and I would be deployed to the front line. We were aware of this risk when we signed up to the profession. We know that we have a moral duty to serve the public and to save the lives of others, even if it comes at great risk to our own.
But what is about to happen is beyond what any of us have imagined. Not because of the scale of the crisis that lies ahead, but because we have been abandoned by our government.
The government’s approach to COVID-19 has diverged dramatically from World Health Organization (WHO) guidelines, which call for widespread testing, contact tracing, quarantine, and stringent social distancing policies. We have seen these strategies work elsewhere in the world – in China, South Korea, Taiwan, Japan, Hong Kong and Singapore. As someone who has trained in public health myself, I know that this is the bread and butter of epidemiological intervention. So I am in shock that our government’s “herd immunity” strategy meant that in the crucial first weeks of this crisis it decided to do, effectively, nothing.
The Director General of the WHO said that to shift from containment to mitigation was “wrong and dangerous.” Richard Horton, the Editor-in-Chief of the Lancet, likened the government’s policy to “playing roulette with the public.” Anthony Costello, an ex-director at the WHO and Professor of Global Health at University College London, called it “reckless.”
Perhaps most shocking of all, the government decided to stop widespread testing. This doesn’t make any sense. How are we supposed to know what’s coming down the pipeline if we don’t have the faintest clue of how quickly this virus is spreading? How are we supposed to know when and where to tighten our interventions? We are completely in the dark.
Meanwhile, NHS wards are quickly filling up with COVID-19 patients. Frontline staff do not have adequate protective gear. Some of them are beginning to show symptoms themselves, and yet they are not being tested and therefore cannot know if they are spreading the disease. They fear for their families.
We know that the infection rate for doctors working in this pandemic is high; in Lombardy it is 20%. We will be exposed to an extraordinary viral load. How is it that healthcare workers in China and the rest of East Asia are equipped with hazmat suits and respirators, while the government of one of the richest countries in the world cannot even issue us basic masks? We are not being treated with the dignity and care due to frontline workers. Instead, it feels like we are being treated as cannon fodder.
The scary thing is that all of this comes after a decade of brutal austerity. Following cuts to the health service, the UK has been left with one of the lowest intensive care capacities in all of Europe, and among the fewest hospital beds per capita. The NHS will be overwhelmed in short order. We are being set up for failure. Like my colleagues in Italy, we will be forced to make decisions about who to treat and who to let die.
If I were confident that my government was doing its utmost to protect people, I would join the fight wholeheartedly. But I see no signs of such good faith. I feel that my colleagues and I are being deserted to a disastrous fate. We are being made to take the fall for a decade of austerity, and for negligence and dithering at the top. Who will take responsibility for the lives that will be lost as a result of these decisions? Who will be held accountable?
In paediatrics, we don’t take chances with people’s lives. If a baby comes in and there’s a threat of infection, we treat swiftly because the risk of delay is so high. We can’t afford to lose a single moment. Similarly, given how dangerous this virus is, it is imperative that we act now, on the evidence of what works.
We need rapid rollout of widespread testing, contact tracing and quarantine. We need to shut down major cities to bare bones. We need to protect frontline staff with the highest quality equipment. We need to requisition factories to produce ventilators. We need to expand ICU capacity and commandeer more space for hospital beds. With any luck, we can hold this virus off long enough to develop an effective treatment, or even a vaccine.
The government needs to release funding for all of this, as quickly as possible. And the private sector needs to step up too – it’s in the national interest.
We dare not passively consent to this government’s inaction. Not when the chorus of expert dissent grows louder every day. To Boris Johnson and the Chief Medical Officer, I say: please, turn this ship around while you still can.Print