Our team raised the issue that we had shared an office with our now-sick colleague, but were told that since none of us had symptoms we should continue working as normal. We called down to the hospital housekeeping department to try and at least arrange a deep clean of our office, but were told that hospital housekeeping teams are not responsible for doctors’ offices, since they are “non-clinical areas”, and that if we wanted it cleaned we’d have to do it ourselves, on top of 13-hour days on Covid wards. And that was that. We had always joked that the office looked as if it hadn’t been cleaned in five years, but that turned out to have been an accurate observation.
Much of March 2020 was terrifying; some of it was exciting. One morning our seniors seemed to click just how bad the pandemic was going to be. We stormed around the ward, discharging every post-operative patient who wasn’t actively dying, much to the dismay of the physiotherapists who lamented that they hadn’t yet passed their stairs assessments.
We told them that their patients had a higher risk of catching Covid and dying in hospital than being discharged early and risking a fall at home. It felt like being in the beginning of a post- apocalyptic film, both incredibly real and surreal all at the same time. At this point there was no denying that we were in the middle of a catastrophe; we were part of history.
And we were completely unprepared for dealing with an infectious disease of this scale. Sure, at the hospital we were used to occasionally isolating one patient with TB in a side room, but not to questioning every patient who walked through the doors. It was all new to us. Doctors also aren’t involved in deciding where patients are moved — mysterious “bed managers” are in charge of that — and often arrive in the mornings to find that patient A6 has inexplicably switched with C4, and D3 has been moved to another ward entirely. This turned out to be rather a serious issue when C4’s test result returned positive, adding to the number of covid-exposed patients who would require isolation.
Initially, isolating potentially-infected bays was an endless cycle in which patients testing positive would be removed from the bay and the bay isolated. We would then immediately test other patients in the bay. This is what happened with our first Covid patient, the Italian tourist: we immediately tested everyone, and when those tests came back negative we then deisolated them, allowing the patients back. Several days later, one of those patients developed a fever. We isolated her and she, of course, tested positive for coronavirus. Whoever was making the isolation policy didn’t seem to understand that the incubation period was an average of five days, and a negative test immediately after exposure is next to useless.
I can make many excuses for our policies in the early days, but this one seemed idiotic — even at the time — for anyone with the most basic knowledge of virology.
I was soon placed on a ward for patients deemed “not for escalation”, which meant that if they required ventilation on the high dependency unit (HDU) or intensive care (ICU) they wouldn’t get it. These patients were generally 60 or over, but often otherwise fit and healthy until Covid struck. Occasionally we’d get called by the nurses to assess a patient when they deteriorated, and we’d ask if they were on maximum oxygen and then we’d leave again. What more could we do? There was no real treatment for the virus; it was a lottery and some got unlucky.
And soon it was my turn. My mother had developed a fever and a cough. I tried to instruct my father over the phone on how to assess her, so I could have a better idea of how unwell she was. I ordered them a pulse oximeter from Amazon — just before they sold out — and eventually, I became so concerned that I felt unable to avoid assessing her in person. There was no other way.
I had accepted at this point that I would inevitably catch the virus from her. I felt great guilt over that decision; I knew how much stress my colleagues were now under, and how my absence would impact on them if I became symptomatic. However, much as I cared about my patients and colleagues, I selfishly cared about my own mother more.
I arrived home after work that evening, and immediately made the decision to drive her the hour and a half journey to A&E. Understandably, the hospital didn’t allow me to stay with her — I was, after all, another source of infection to other patients and staff. So I sat and waited in the hospital car park for hours, until at 2am I decided to drive home. Two hours later the hospital phoned — my mother was ready for discharge and needed to be picked up now, even though she still had Covid. The nurse on the phone suggested that I should order her a taxi, since “taxi drivers don’t know if their passengers have coronavirus anyway”. I drove to the hospital and picked her up.
This was a common theme in the early days: Get The Patients Out Of Hospital At Any Cost. It was the same thinking that led to tens of thousands of preventable deaths in care homes via infected hospital patients. Some of the thinking seems justifiable, or at least logical: we didn’t know how full the hospital was going to end up, so how could we turn seriously unwell patients away at the door because we hadn’t been able to discharge Mrs Jones back to her care home with a mild case? Yet we did this for some time even after we knew what was happening as a result.
I emailed my consultant the next day, informing him that I had had close contact with a Covid positive patient and should self-isolate for 14 days. I was told that since I did not have any symptoms myself, I should continue to go to work. So I did. Five days later, I was eating lunch when I complained to my partner that they must have changed the recipe for the soup we were eating, because it tasted of absolutely nothing.
He looked confused. I went around sniffing at all the strongest-smelling things I could find — vinegar, mustard, garlic — but I couldn’t smell a single thing. I’d read online, and heard via friends, that Covid could cause anosmia and ageusia (loss of sense of smell and taste), but it was not yet a recognised symptom. I Googled and found some mentions of the Covid association in other countries, but it wasn’t in the UK guidance until 18 May, long after doctors knew about it.
Again, I emailed my consultant, asking if I should isolate, but was told that since I had none of the “three major” symptoms (at that time: cough, fever, shortness of breath) I should continue to work. So I did.
At the time, the situation was desperate and elective surgery was being cancelled, and medical staff brought in from doing academic work. During the worst days of April 2020 even our oxygen began to run out, and a doctor came round every ward asking us which patients were on oxygen and whether any of them could reduce their intake. So saturation levels for patients were turned down to 92% as oxygen was rationed.
Likewise with PPE, where we were totally ill-prepared for the coming onslaught. In the beginning, FFP3 masks were required for confirmed positive patients and no masks were needed for other patients. Later, surgical masks were required for even asymptomatic patients. However, supplies started to run low, and we often had to go to several different wards to find a box of masks in order to start work in the morning.
We were given stash of masks left over from the stockpiling for the 2009 swine flu epidemic, with stickers over the “use by” dates. We didn’t mind as long as we had something. But when even those stocks began to run low, the guidance on mask requirement changed — it’s funny how masks are suddenly “required” in fewer situations when supplies run low.
While this was an ongoing problem, we’d crowd round a phone — which seems strange in a time of Covid but in our tiny office we had no choice — to watch the now daily Covid briefings, with politicians claiming that there was no shortage of PPE.
TV cameras were always directed at ICU, where PPE was prioritised, and whose teams ended up with the lowest infection rates as a result. We on the regular Covid wards were never shown on the news with our flimsy plastic aprons and surgical masks.
There was a disconnect between what we knew on the front line — about how there was not enough PPE, about how poor patient and staff isolation was — and what we heard being said by politicians.
We had the feeling that both staff and patients were being viewed as expendables, and the most important thing was to avoid headlines about ICUs overloading. This is why we discharged Covid-positive patients to care homes, and why we also handed out huge numbers of Do Not Resuscitate orders for older-but-healthy people, who once might have been given a fighting chance but who now risked overwhelming the system.
Some mistakes are understandable; we were in a pandemic, with a system facing a new type of disease, but if we junior doctors were readily recognising these errors, and learning from them, then policy makers could have responded faster.
We learned from some errors; we got better. We learned to move patients to “Covid contact” wards, and only deisolate them if they tested negative on Day 5. Our ICU unit was the first to catch on to the fact that proning helped, even though the anecdotes had come from Italy before we even had our first patient — another thing we should have learned more quickly. We didn’t start proning patients on the ward routinely until well after the first wave. We stopped discharging infected patients to care homes — but it took thousands of deaths before this happened.
Some mistakes we still haven’t learned from. From the start, there was always a focus on touching contaminated surfaces, while countries like Japan emphasised the three Cs: closed spaces, crowded places, and close contact. We still focus on aprons and hand washing, even though we know of virtually zero confirmed cases of fomite transmission. So little is still done to ventilate rooms. Indeed in my wards, built in the post war era, we cannot even open our windows, where they exist at all.
We have learned many things since, but throughout last spring we continually under reacted and failed to update our policies rapidly enough. We under reacted when PPE was required, we under reacted with patient isolation, and with staff isolation. In every way we were underprepared and often underprotected, a group of young people some straight out of university sent out to fight the biggest threat facing Britain since the Second World War. Many of our older colleagues died doing so but for the junior doctors who lived through the epidemic, March 2020 was a month we can never forget.
But I wonder if we’ve learned enough over the past year to not make the same mistakes next time. Because of the nature and size of the NHS, it’s difficult to tell if the lessons we juniors learned so hard were also absorbed by our superiors. We’ve got to hope so.
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Subscribe“These patients were generally 60 or over, but often otherwise fit and healthy until Covid struck.”. What were they doing in hospital then?
This idea that people need to be in hospital because they have particular symptoms but are not ‘ill’ in general strikes me as symptomatic, if you’ll forgive the pun, of everything that has gone wrong in medicine and in the country in the last 50 years or so. And why many people are frightened. We used to have communities we were part of, now we are atomised individuals. We used to be people who required help from others in times of illness or trouble, now we are bodies with symptoms requiring pills.
My mother trained as a nurse during the war . From what she told me about her experience then I get the impression, that in those days patients were treated not as otherwise healthy individuals with specific symptoms, but as ill people, who needed looking after. Probably because of greater understanding and better medication this seems no longer to be the case. Hence the idiotic and cruel carry on you have just described.
Also hospitals used to be airy spaces with high ceilings. Now they are stuffy unventilated, overheated, and pre Covid, overcrowded. The TB sanatoriums used to wheel people out in the fresh air and sunshine every day. These things were understood as beneficial in times before doctors and nurses became the servants of pharmaceutical companies. And when the largely Christian members of those professions perhaps still believed in God and loved their neighbours as themselves – not as a set of isolated symptoms.
And suddenly viruses are living things who can stalk and hunt the healthy and strike them down all over so everyone has to face nappy up, pretend the world is ending, become hysterical, love being spied on and locked down like diseased things. I have never seen anything so medieval and deranged as this voodoo
Well said!
Voodoo is about it.
We are seeing tremendous push back in draconian measures in the US. Outside of poorly managed states like California and New York (still hurts to see my home state so impacted by such massive incompetence), life is moving back to normal. Many states never had mask mandates and didn’t do any worse than those that did. But even some states that did have them have dropped them. People are laughing at Anthony Fauci double masking after having the vaccine, he is no longer seen as the authority he once was. Other doctors are stepping forward to provide information the Fauci doesn’t like but he can’t point to any studies that show people who have had the vaccine or the virus should still be masking up. Restaurants are open and people are out and about.
And Joe is spending so much time wearing two masks, being oxygen deprived, no wonder he’s deteriorating so fast. He’s suffering brain damage from that, along with age-related cognitive decline.
Yes he appears to be compromised. But in fairness he did even before the election. Hence the effort to keep him isolated.
They were presumably in hospital to be treated for Covid.
Yes but the majority of the population have been denied any GP or dental care at all. Since there has been no referrals , tests etc surely this should have freed up the critical hospital side? If the government is going to have lockdown every time a virus emerges they are not sure about , how is this country going to manage? Plus the first lockdown still allowed millions of people to come in via airports , private yachts and planes-these people had to go somewhere-so everyone here being careful was a waste of time if unknown to us the government was throwing massive ‘measle’ parties into the system.
Perhaps I’ve been lucky, Kathleen, but my dentist has been operating more or less normally since last summer. I’ve also been able to consult my GP, both by telephone and physically, whenever necessary.
My GP daughter tells me that after difficulties in the first few weeks of the pandemic, 95% of her cancer referrals have been seen within the specified timescale and treated appropriately. Criticism of the NHS is justified but let’s keep it grounded in reality.
I am not blaming the NHS , they like everyone else were told to prepare for a major disaster. Usually if there is a large fire for example with expected great loss of life and injury -hospitals re-call staff and try to clear wards for the emergency. However once the incident is over things gradually return to normal-when is the government going to call off the state of emergency?
You have been lucky. Here in the UK midlands Dentists have been emergencies only – if you’re lucky. Our GP’s surgery locked up and GP’s available by Phone or E Consult only. Neither of which systems work very well and seem more to do reducing demand than anything else.
Guess it depends where you are. My annual dental check up was cancelled, with no offer of a later date. Emergency only….
The majority of people were denied access to any dental treatment for months, including my sister, whose root canal treatment was not completed for for months.
People were forced to remove their own teeth because they could stand the pain of an infected tooth, and couldn’t get access to any dentists. Hospitals didn’t want to know, and dentists were forced to close.
You forgot to mention that prior to this Scamdemic our vaunted NHS Facilities were awash with MRSA, C-difficile, and other unpleasant surprises.
Some of this was attributed to the conceit of Consultants failing to “scrub up”, nor change out of their ‘smart’ Saville Row suits, whilst flitting from facility to facility.
Perhaps in future we should take advice from Dante and place a very large notice above the entrance of every NHS Facility, reading “Despair of Hope all ye who enter here”.
Incidentally I have avoided using the word Hospital as its Latin origin means ‘guest’, which off course is completely inappropriate under present circumstances.
My mother died in hospital in 2007. She’d had a fall and broken her hip, but when I went to see her it was obvious she’d had a stroke (hence the fall). She was unable to speak and one side of her face was paralysed. She was on an orthopaedic ward, though when I spoke to the nurse in charge she conceded she’d ‘probably’ had a stroke. She was not being treated for that however. The ward was crowded with elderly patients and smelt of piss, like the worst-run care homes. I was shocked – I thought hospitals were clean hygienic places! A week later we were told she’d contracted C-difficile. That’s what she officially died of, two weeks after she entered the hospital. The staff seemed uncaring, but I think they were basically demoralised.
The NHS has been systematically run down and poorly managed for years before Covid arrived. I feel very sorry for this young nurse, and anyone working in a hospital who cares for patients as human beings.
At least we were able to visit my mother frequently in her final days, and she had a visit from a priest and the last sacraments, which perked her up no end and even restored her speech a little, two days before she died. Heaven help patients dying in hospital now, and their loved ones.
As you say this has been coming for years, despite Review after Review. Of the 1.5 million employed by the NHS only about 50% can be described as ‘clinical’ staff, the rest are that indefinable species known as ‘managers’, who would be better off managing a Mink Farm in Denmark.
As to the last moments you are only too correct, and as you say at least your late mother had a dignified death in 2007.
However now in 2021, “Heaven help patients dying in hospital now”.
Face down, throwing up the contents of their lungs into a plastic/vulcanised bucket, alone and terrified, it’s more like a scene from Dante’s Inferno.
What on Earth happened to Emergency Ward 10, Sir Lancelot Spratt and Matron Hattie Jacques?
1.3 million NHS Staff (1.2 mil full time equivalent) – 990,000 are clinical or scientific professional or support staff (inc 110,000 doctors, 300,000 nurses plus healthcare assistants, physio assistants, ambulance staff etc.) There are 40,470 managers. The rest are made up of central support staff, Estates, Cleaners etc. Data Source is the Kings Fund, October 2020.
I think it’s helpful to introduce some facts and data into these discussions, occasionally.
one manager for every 30 odd people. That’s a high number. Thank you for explaining.
If you think that’s a high number, you should try the major private sector company I used to work for. Reducing managers to 1-in-30 would have released a flood of people who could do something productive.
That is a pretty good ratio since matrix management became a thing I have seen instances where one ‘worker’ can have 4 managers all telling what to do
Thank you so much, but these figures don’t seem to add up.
110K Doctors plus 300K Nurses + do not make 990K, therefore is the residue of about 580K Support Staff? If so what are they exactly?
However ratio the of 1 Manager to 32 others seems reasonable.
The residue are Healthcare Assistants, Physio Assistants, Audiology Assistants, Anaesthetic Assistants etc. Basically clinical support staff who don’t hold professional medical or nursing qualifications.
Many thanks you have dispelled an ‘urban myth’.
I’d be surprised if there are many NHS staff who are cleaners. Most cleaning is done by contract companies. And it’s done extremely poorly in my opinion (hence all of the issues we have with MRSA, C-dificile etc.
My Grandfather died in the same way, aged 99 in 1999. He’d been to the library on the bus and collapsed on the pavement bringing home his supply of literature for the next fortnight.
Our population has grown by 9 million people since 2000. That’s equivalent to the whole population of London. Imagine the increased pressure in only 20 years. That is a 14% increase. Imagine having to increase the NHS budget in real terms by 14%. The 2020 spend on NHS is likely to have doubled as a share of GDP between 1950 and 2020 to around £158.4 billion (Source: Nuffield Trust).
Can that be considered as ‘run down’?
The big question is HOW did our population grow that much? The white British are not having enough babies for population replacement and the middle classes are especially slow at reproducing. Granted, some of us have been living a little longer, but that effect goes nowhere near explaining how the population has been growing in such a spectacular manner. The vast majority of the growth has been the massive influx of ll-qualified, thoroughly unsuitable third worlders, whose arrival has been unabated since New Labour came to power, while government after government have declared intentions to control and shrink the flow, to no avail.
Meanwhile, young people (amusingly the ones most in favour of facilitating migration) howl that they can not afford to buy houses or pay the rents required to secure a place to lay their head. I wonder why that is? Have they not heard of the effect on price of rising demand on a scarce and much desired commodity (housing)?
On the one hand we have the globalist nationless melting pot ideology saying let everyone come. At the other end there is the allure of an over supply of labour for those in a position to employ, especially when many are used to and happy to accept much lower wages and conditions. Thus we have the alliance of the liberal left with the neo liberal multinational corporates and employer middle class versus the conservative working classes, which would have sounded ridiculous a few decades ago and I suspect something to do with the focus shift to identity politics we now have. I daresay Hegel would have approved at least in part.
What most do not realise is the main reason the NHS was made into its modern format under Blair was to provide a platform to push Third World Immigration. That is why NHS worship was made to replace CofE, because it gave sainthood to the legions of third world health workers poached from their native lands by Gov Policy. UK Nursing and Doctors training was reduced till foreigners had to be brought in as their were not not enough created from natives. Then the NHS staff, and the millions of unskilled hone care, janitorial and so on workers pushed in on that model, and suddenly unskilled Third World workers were given the open border – on the basis of how they were the new health care workers, and UK could not exist without them. Check out ‘Chain Migration’ as another thing.
It is all Social engineering of the most worrisome kind. When I left the family home in London to move to USA, 1970s My old parts were still almost all British natives, now they are a minority. WHY? Did the voters demand this? London is well less than 49% native British, and falling fast as the oldies like my mother are forced to move out to because their great age.
Here we go again. I wondered how long it would take for this discussion to be taken over by those obsessed with immigration.Yawn.
Where else has the population increase come from? It’s not an obsession it is a rational point of discussion made more pertinent due to hospitals being rebuild with only 80% of beds compared to the ones demolished.
We see daily (not on the BBC of course – but on reputable sources nonetheless) examples of large numbers of mostly young men coming across the channel and being escorted to 4 star hotels for free board and lodging.
You may yawn – others more sensible – warn.
So you think we should be proud of taking medical and nursing staff from countries with a possibly greater need of them than ours?
Quite. We should be training up our own citizens as medical staff.
It’s a viscous circle . The white middle class abhor the generally appalling State Education on offer and therefore ‘ crucify themselves by paying for Private school fees (Eton currently £42K+.)
Thus they tend to have only two children if lucky, which is well below the rate needed.
I think the ‘bonk rate’ figures are : actual 1.8 Required : 2.8.
Most of the white middle class are happy with state education. Especially when they look at the arrogant third-rate conscienceless products of the private sector, whose failures and cronyism have given Britain the highest Covid death toll in Europe and the third highest rate of deaths per million population on the planet. Any Old Etonians spring to mind in that connection?
You prejudice betrays you.
I was educated at a dead-end comprehensive in the north-west. In my working career I have had to deal with a great many individuals from a public school background and overwhelmingly I found them to be far more educated, rounded, thoughtful, dutiful, competent and decent than those educated in the state sector.
I honestly believe that these people are essential to this country. My concern is that being taken from their families at a young age is a very high price that they have had to pay.
I couldn’t agree more with your comment. My daughter is 33 – and so few of her contemporaries (all working and most with degrees) have children yet. Very few of them have been able to afford to buy homes (in London/south east). And yet…..they’re all in favour of immigration. All violently opposed to the sensible discussions of Brexit, UK Migration Watch etc.
As for “The white British are not having enough babies for population replacement and the middle classes are especially slow at reproducing.” – they just can’t afford it. My daughter has just had her first baby – at 33. They wanted to own their own place before having a family – to have a secure financial footing. Both she and her husband are solicitors. They haven’t been having lavish holidays, luxury cars etc – they’ve been saving hard for a deposit.
Working families should be subsidised to have babies. The non-working should not (they currently are). We need to change the benefits system.
Your politicans hate you, that is why they decided to replace you as a people. The funny thing is they seem to hate the newcomers almost as much. Maybe Politicos really are sociopaths, like one always suspected.
The Ancient Greeks believed that anyone who actively sort Political Office was obviously suspect.
Therefore they introduced a system where appointments were made by lot.
We have the Roman system of ‘Partonage’, which only works in an authoritarian system, and is as corrupt a way of governing as has been invented, although it does work better than almost all other authoritarian systems as it is a pyramid structure with the sort of consent of those under it (although they may have no other choice) so rides on the success of those in the middle levels, the ones who actually do and produce stuff. I always found the Roman system of ‘Patronage’ to be the most fascinating thing about them, do a search on it if you do not know of it.
The main issue is that as the population has increased, the number of available hospital beds has decreased.
One might almost conclude the NHS is not the best way to do healthcare. Unsurprisingly, no European nation decided to emulate the ‘envy of the world’
“The staff seemed uncaring..”
Too many ward staff have seemed that for decades. Actual hands-on nursing appears to be beneath them. Much nicer to spend their time in the nurses office, looking at notes or a computer screen.
And having spent time on various wards in various hospitals, doctors are as rare as hen’s teeth, with a few exceptions, e.g. the doctor in Dorchester Hospital who was looking after my dad who’d been admitted for stage four bladder cancer.
Part of the problem with the NHS is the outsourcing of cleaning. Years ago hospitals were extremely clean, now they are cleaned by contracted private companies who recruit slovenly 3rd world cleaning staff who slop a dirty mop around when they can be bothered. The NHS needs to bring back the permanent staff cleaners who had a pride in the wards they cleaned and who were directly accountable to the Sister on the ward.
Norovirus is a particularly special gift that the NHS hands out to people each year, which you seem to have forgotten.
Are you pretending that there is no norovirus in countries which don’t have the NHS? Dream on.
I got norovirus at the NHS hospital my father was in! It was dreadful, we spent half the day every day sitting with him, and I got it and missed my flight home. They locked the ward after I caught it, my father did not get it though, but he was exceedingly tough. They did drop him wile moving him out of the bed, giving him vascular dementia from the resulting head injury. I ended up moving him to USA to live with me, and he did till his passing, and now my mother is living with me full time. NHS is a terrible thing for old people! They will force you to spend your inheritance in endless rules of ridiculous mandated home care, even if the family is doing the care! Their mission is to get all inheritance money spent, if you have any, and then care very badly for those who do not, using entirely third world and a few East Europeans in elder care, home care. – I spent 6 months there on and off dealing with him and all that till giving up and taking him home with me.
I do not like the NHS, you may have noticed.
You are an American. Your healthcare system consumes almost 20% of your GDP, compared to around 9.5% in the UK. Also your GDP is larger per person, so in absolute tems you spend around three times as much as us. Yet thousands die in the US, because they don’t have money, from conditions which would be treated by the NHS on the basis of need.
Agree?
And your point is? Of course something as critical as good healthcare (if it is important) would/should cost a lot?
By doing it on the cheap and not making people pay for their own you just got non-appreciative use, misuse and fraud.
Most of the great inventions/discoveries used in hospitals come from US medicine where they invest the money because it is worth it.
The US system is massively inefficient in its use of that money. Corporate profits and $2 million salaries for consultants mean the money leaks away in all directions. Americans know that. Even Republican voters want the system reformed. And the spending does not save Americans from death and disablement which would be prevented by the NHS. But since you didn’t respond to my comment on that, perhaps it’s not a concern to you?
BUT USA health workers are Americans! Visit the doctor, the hospital, the home health care, they are Americans! In UK they are foreigners to an insane degree!
So those $ are paying Americans, not cheaping out so you cannot afford to train your own workers – OR have lowered the pay so far that Natives will not do it!~ AND have removed the status from health work that natives will not do it as they see it as something third World people do.
NHS S*CK S. It is a Pathology in its self. It is a political and social engineering machine which does health care badly on the side!!!!!
This attitude that the goal of healthcare is to spend as little as possible is bizarre. It’s almost a point of pride with some, look how little we spend. As if healthcare wasn’t a huge quality of life issue.
Chris, You know nothing of USA health Care.
1) USA has universal health care: All gov workers at every level get it, even the guy who sweeps the park sidewalks. All Military get it, and their dependents, and after retirement at 40. All Corporate workers get it subsidized, All over 65 get it as Medicare, all poor people get it as Medicaid, all the rest get highly subsidized, OR FREE ‘Obamacare’. Hospitals may NOT turn away anyone in need.
UK care is very poor, BUT anyone who is anyone also has private health care insurance in UK, and also uses private Doctors and Dentists with cash. UK is 2 tiered.
I could go on for hours as I know Both, and I do not like the NHS as it is First a political organization, second a Health one.
It does seem particularly brutal to older people.
I can tell you stories! End of life care was a job I took when I first moved to USA, I worked in a Hell Hole home where the people without money and family were sent to die – I can tell stories of the USA back then that are horrific (1970s).
But things moved on, although end of life care (Hospice) is bad everywhere where the person does not have family in attendance. Without an advocate they get shoved aside as care time is rationed and the squeaky wheel gets the grease, also you need to visit to help feed and do light care as workers are just too busy everywhere.. If you can, care for your family members at end of life in your home, I did for my father, and will for my mother.
I have had a couple of experiences with hospice, one at home and a couple at a hospice facility. In all cases they were excellent and I do not know what the families would have done without them.
The home hospice care helped a very dear 50 year old friend die of brain cancer at home. They were excellent but unfortunately this woman’s three children, including a 13 year old, saw and heard some really horrendous things when my friend’s pain was no longer controllable without killing her with drugs. I would not have wanted my child to see or hear any of that at that age but the family really wanted her to be at home. In her case I do think care in a hospice would have saved her youngest child from a lot of pain.
I seem to remember something like 1,000 beds had to be shut down a couple of years ago due to norovirus outbreaks in NHS hospitals. Is it a cleanliness issue?
For several years now, Charles, all hospital patients are tested for MRSA on admission. The NHS has actually been very successful in reducing these infections. Credit where it’s due.
Nevertheless, hospital acquired infections have been a thing ever since there have been hospitals. Anyone without a fully functioning immune system, the elderly for example, should stay away from hospital if at all possible and, if that’s not possible, then get out asap.
The decision to discharge as many elderly patients as possible, as quickly as possible, at the start of the pandemic was clearly sensible – as this article demonstrates, they would have very likely contracted Covid otherwise – but obviously the manner of achieving this was (fatally) flawed.
Many thanks for that sound advice!
“Awash” is exaggeration, despite the harmful effect of privatising hospital cleaning. MRSA has been declining in recent years.
I agree that ventilation is key here (I recommend following Zeynep Tufekci’s work on this, she’s been consistently right and right before other people changed their minds). However, God isn’t real and we need to find a way to live ethically with that knowledge rather than complain about the number of people who’ve worked this out. I’m quite a fan of the modern Stoic revival myself.
Surely ZT is a Sociologist with zero medical training?
If her crusade on mask wearing had any validity surely the state would have equipped us all with ‘proper’ gas masks as they did in 1939?
Tried reading some of her stuff, right about ventilation as it’s basic stuff, she was hardly the 1st on that. Overall she seems very biased and usually wrong, she talks fondly about all the restrictions as if they’ve obviously been a success – and yet ignores the reality that multiple studies by far more honest people have found many of the restrictions to be unrequired, low value, useless or even counterproductive.
Almost all the anti-lockdown stuff I see is from the scamdemic fantasists (symptoms include going on about PCR, saying the virus hasn’t been isolated, talking about Resets and Agendas, along with the usual anti-vax/holistic woo crowd). If there are people saying “yes, the disease is real and the restrictions will work to reduce cases, but here’s a better way” and they have evidence/models rather than just “why don’t we just do X, it’s bound to work”, I’d like to see it.
Of course the disease is real, claiming ‘almost all’ the anti-lockdown stuff you see is from nutters is just confirmation bias. I’ve seen a lot of stuff from pro lockdowners that is equally nuts, full of hysteria, lies and assumptions and with plenty of politics thrown in.
See GBD and various other groups for alternative ways, and Sweden, Texas, Florida, South Dakota etc for far more limited restrictions and no worse outcomes than comparable regions with more restrictive polices. The GBD declaration was from several emininent scientists in the field and backed up by many others. Ironically it’s proposals were far more inline with established policy, but more humane.
Is there any clear unequivical evidence that our severe restrictions are worth it? You point to models, but these have consistently proven worthless. Restrictions are not the norm, they need evidence to back them, not counter them.
Strangely, the King of Sweden thinks you’re wrong about his country.
https://www.google.com/amp/s/www.bbc.co.uk/news/amp/world-europe-55347021
To quote: Sweden’s king has said his country “failed” to save lives with its relatively relaxed approach to the coronavirus pandemic.
Or the PM: “Of course the fact that so many have died can’t be considered as anything other than a failure,” Mr Lofven told reporters.
So the UK with all it’s restrictions, and far worse outcomes than Sweden, or almost any other country…. is that a success? You can compare Sweden to Scotland if you want to play the population density card. Both nations of course are actually highly urbanised with some massive empty wildernesses.
Ah we’ve made massive sacrifices and killed lots of other people with out sadistic lockdowns, and crippled others with fear, so it must be worth it.
It is clear that the king needs to do some reading about what is going on in the rest of the world.
A hardline Republican know-nothing Governor in South Dakota eased restrictions and the disease took off.
And that never happened in other countries when they did a lockdown?? You can only compare the average and the average non-lockdown US state had fewer deaths etc than the average lockdown.
That’s because predominantly rural states with Republican Governors are going to have very different tendencies towards person-to-person disease transfer than predominantly urban states with either Democrat Governors or the type of Republican who isn’t completely nuts.
Indeed, see Florida vs New York. And Florida has more people and an older population. But it shielded the elderly better. And didn’t toss its economy in the trash.
The GBD failed to explain how its aim of protecting the vulnerable could be achieved in a country like UK where the clinically vulnerable numbered 2.3 million – many of whom live in multigenerational households. Effectively the income of all those isolating would have to be met by the state plus the cost to employers of replacing those isolating with other staff. Add the cost of other support to isolating families such as the need for individual online teaching for children support with shopping and you get an idea of the impact of placing around 10% of the population under a sort of health based apartheid. Before you address the ethics of doing that and how you would end it.
As Adam Kucharski (an epidemiologist) says: “Anyone who says ‘countries can reach herd immunity through vaccination’ is using a model. Anyone who says ‘we can have big epidemic but keep it away from risk groups’ is using a model. Anyone who says ‘that model suggests X could happen but I think otherwise’ is using a model.”
If all models are worthless, the GBD authors’ model is worthless. If you don’t agree with this, you need to provide evidence that their model reflects what what plausibly happen if their recommendations were followed. Because (as far as I know) there is no published paper or code for this, we don’t have that evidence. (EDIT: Neil O’Brien MP ran some numbers on Twitter, not convinced the GBD plan works).
As I’ve said before, we didn’t need much of a model to work out the possible consequences of an unrestrained pandemic in the UK, just our (population specific) IFR and R values, and some multiplication. Anyone who thinks that (say) the Imperial model from March was the only way we reached that conclusion hasn’t been paying attention, Imperial’s contribution was to lay out “what if” scenarios for various approaches (which does need a more detailed model than “with this R, this many people will get it before it peaks, and with this IFR, this many of them will die”).
…yes and all those nutbags down at the IMF! Conspiracy theorists the whole lot of them!! With their ‘following evidence’, and ‘world economic initiatives’. 😛
The fantasists are those who’ve taken a bunch of sunlit uplands pieties about “stakeholder capitalism” and “sustainability” as evidence of a vast conspiracy to fake a pandemic.
I thought the conspiracy theories around Great Reset were that Covid was planned or made up to bring about a Great reset? Not that lots of people think capitalism needs an overhaul.
From a strictly positivist scientific standpoint the self isn’t real:no examination of the organism which incarnates you will yield the person you imagine yourself to be, the agency you imagine yourself to possess, which are wholly immaterial.
The Self is continuously developing and changing and needs looking after.
We need to continue to love our neighbours as ourselves. God is love and love is real, even to people who refuse to accept it as God.
“When the power of love overcomes the love of power the world will know peace.” – Jimi Hendrix
“All have sinned and fallen short of the glory of God.” – God.
Actually, that was St Paul in Romans. I’ve read the NT at least twice, so I should know.
Alison, I fear Paul might not believe in this “love” you speak of, at least not in the same way you and I might. I have a feeling he believes it to be, nothing more than chemical.
I don’t believe in God and I therefore don’t believe that love is God. However, I do think love is real and that you are absolutely correct, we do need to love our neighbours as ourselves.
Lol, not when you have a crazy, alcoholic, spiteful neighbour like mine!
Well, of course. When I say God isn’t real, I mean by God what Christians mean: the all powerful, all good, all knowing, creator of the universe. If you mean something else by the word, fair enough, but why confuse matters by calling that God?
God isn’t real to you. You have no special knowledge in this area.
However, I have seen in person the comfort that a belief in God, and the presence of a specialist in their faith can give to both patient and their lay friends and relatives. It is in my experience very discreetly offered.
Would you deny people that comfort ? I wouldn’t deny you your stoic philosophers.
I’m not sure what “not real to you” means. God is either real or not, there’s no “real to you”. I’m a former evangelical Christian, so I have some inside knowledge, although I’m far from being the only ex-Christian atheist, so not special in that respect.
In general, I think it’s better to believe true things than comforting falsehoods. Of course, I’m not able to deny people anything, they form their own beliefs.
The point is rather that atheism is as much a faith as Christianity. There is no more evidence for your assertion that God is not real than there is for the opposite view. As you say, “people… form their own beliefs.”
However, it should also be borne in mind that most of the great charitable hospitals which were absorbed into the NHS were founded by practising Christians. I’m sure they’d be appalled to see the preservation of life subjugated to the form filling, box ticking, and looking after the organisation we’ve seen described above, both in the article and in other BtL comments. Whether the Christian God is real or not, bureaucracy has proven no substitute for Christian teachings.
Specifically for Christian God (3 omnis, loving, created the universe), I find the best arguments against God’s existence are the Evidential Argument from Evil (from Rowe) and the Argument from Divine Hiddenness (from Schellenberg). As a former Christian, I find these good evidence that God does not exist.
It seems you have followed the atheist habit of mentioning your personal view that God is not real. Whatever you believe, that bald statement can neither be proved or disproved. Nevertheless, the belief has given a reason for a way of life to most of the world for most of the time Homo Sapiens has been here and possibly for previous variations of the species.
Newsflash! Gods aren’t real- sorry. If you estimate perhaps a 100 vastly different gods in the variety of cultures around the world, the only one could be real – it’s fatuous to believe that your own culture’s GOD is THE ONE! On the other hand there are strong psychological arguments for why the different religions have come about.
Now all you need to do is show the proof!!! I got my popcorn. For the record, I’m an agnostic.
Specifically for Christian God (3 omnis, loving, created the universe), I find the best arguments against God’s existence are the Evidential Argument from Evil (from Rowe) and the Argument from Divine Hiddenness (from Schellenberg).
I think you’ll find that the ultimate stoic was Jesus himself… anyway, who are you to declare that “God isn’t real”? He may not be real to you, but is real to millions of other living human beings. I grew up an atheist, but the more I learn about the teachings of Christ the better my life gets. Alison put it beautifully when she said “God is love and love is real”.
However, God’s Ancient Wisdom still exists, so Love other people as Yourself!
“These patients were generally 60 or over, but often otherwise fit and healthy until Covid struck.”. What were they doing in hospital then?”
They were there because they had Covid and needed some form of high pressure oxygen therapy (but not invasive ventilation …yet). Sounds from this para as though they were short of ventilators at that particular time and / or had realised that invasive ventilation was possibly not the best management option for these patients if it could be avoided.
The regularly updated ICNARC reports give a good picture of what has been going on : “ICNARC report on COVID-19 in critical care:England, Wales and Northern Ireland12 March 2021”
Patients with confirmed COVID-19 and basic respiratory support only – Admitted up to 31 Aug 16.1% had very severe comorbidities. Admitted from 1 Sep 9.9% had very severe comorbidities. These numbers are even lower when you look at those requiring advanced respiratory support. The age and social demographics of these cohorts are also worth a view in the adjacent tables – Mean age 60.2, Median age 62. 89% able to live without assistance in daily activities.
People do have accidents, break limbs and get sick from illnesses that strike whether one is basically healthy or not. Example: cancer.
Did you consider the UK population size in the 1940’s. In 1941 there were 48.2m souls It is now 67m, that is 19 million (+39%) more people, with sharpest growth between 2003/4 and present day. That’s similar in population to the whole of London and the South East. In 2000, it was still only 58.8m, 9 million less than today (London’s population now).
We have not been able to match resources to population growth.
Now it is well over 70,000,000, nearing eighty, if food sales by the grocers estimates are good guesses. The Gov gives its guess at population to achieve its agenda, not so you know how many people are in UK.
The decennial census, due this weekend by coincidence, tells us the population to within 1-2%. Don’t believe urban myths.
Labour didn’t spend less than needed. It increased NHS spending by putting 1% on National Insurance to fund the increase. But then the Tories got in, the PPE stockpile was run down from £840 million in 2014 to £510 million in 2019, and the NHS started missing targets on A+E waiting times and cancer treatment commencement waiting times in 2019 – before anyone had heard of Covid. You may think it significant that Tories are generally those who go private for non-emergency health issues, so have always left the NHS in a mess which Labour then has to clear up.
Explain how private patients leave the NHS in a mess. If I go private, less people use the NHS, and someone else gets my place in the treatment queue. Countries with more of a public private mix have better health outcomes, even France and Germany.
You are correct. The model used in the UK has not been replicated anywhere else… including the ex colonies like Australia and New Zealand. In Australia you are incourage by the tax system (only if you can afford it) to utilise private medecine The result as far as I can see , is that this reduces pressure on the public system and increases overall the money in rhe wider health infrastructure. When I moved to Australia I was astounded how much better the health care system is than the UKs. In the UK my personal experience had been that the NHS was very occasionally OK but mostly hopeless, bureaucratic and staffed by uncaring jobsworths.
From what I can see the UK NHS has become the new state religion ….. witness the laughable “north korea” style clapping in the street that occurred last year. (Created by a govt funded marketing company director claiming to be a ” London mum”)
If the NHS is ” the envy of the world” then its a very strange type of envy
According to world odometer, life expectancy in the UK is 81.77 years while in the US it is 79.11. In many other “first world” countries (Japan, Switzerland, Italy, Spain) it is closer to 84.
So neither the NHS nor the US system can really be described as “the envy of the world”.
Life expectancy is not based solely on a healthcare system. Americans drive many more miles than Brits do, for example. More miles driven, more auto accidents.
But if you do want to compare the US and U.K., compare cancer survival stats. That is a function of a healthcare system.
You’ve just made the basic argument for something Enoch Powell advocated: the abolition of National Insurance to combine it with general income (employee contribution) and business (employer contribution) taxes.
NI is there to provide for state pensions and unemployment benefits. That Labour decided to plunder it to fund the NHS tells us all we need to know.
It’s not just population, it’s medical care itself which is radically different today than what was available in 1941.
Because they won’t remain in power if they raise taxes enough to pay for the needed improvements. There’s a reason the worlds top tax havens are primarily British. No British government has ever spent the needed funds or raised the needed taxes. Under any government, the NHS has still failed on things like cancer survival. And it isn’t just wait times, it’s access to diagnostics and treatments available in other countries, yet denied the NHS patients.
Cancer wait time targets were being met under Labour. Under the Conservatives, they started to be missed (and that was pre-Covid).Happily, we have a Labour party which will fund the NHS properly once it gets into power and rebuilds the NHS, just as it did in 1997 after 18 years of Conservative rundown. And the NHS doesn’t have the massive profiteering and wastage, and callous disdain for those who can’t pay, which are seen in the heartless US system which you favour. Don’t pretend you care about those who are just above the threshold for Medicaid but can’t afford much or any private health insurance. What are THEIR wait times? They will never get their hips or knees fixed. In a previous posting, you stated that they “chose” how to spend their money. What a sick joke.
BTW, cancer survival statistics (lifespan after diagnosis) have a glitch – the earlier you detect the cancer, even if you do nothing to cure it, the more “years of life after diagnosis” are clocked up, and that’s the standard statistical measure on cancer. A vast number of men in their 80s have slow-growing prostate cancer which won’t kill them this side of 2070 and thus are rightly left alone. The same goes for a friend of mine in her 60s with “blood cancer” which is not being treated because it is not a threat (surprising, I know, but that’s what she says). If you spend money detecting those cancers, you can really improve your statistics in order to brag about them, but it doesn’t help anyone.
Spending on publicly funded NHS healthcare has doubled as a percentage of GDP from 3.5 to 7% since the 1950’s.
Countries with more private healthcare, particularly in diagnostics like Australia and Germany, have better health outcomes but also provide free healthcare.
Yes, I’m sure it has but that won’t keep up with population growth or with medical advances. 7% won’t pay for what’s available today compared with what was available in 1950.
I prefer a public/private system as well. I’ve never seen a system that provides free care. It’s all paid for. In Germany, Australia, everywhere.
Actually, the NHS is funded through taxes.
Endlessly creating money from thin air only goes so far for any country. Witness the debates of Yugoslavia, Zimbabwe and Argentine.
Eventually the currency becomes worthless. That holds true for every country except perhaps the USA. Money is just “trust that you will pay me what you owe me” so far the US hasn’t renaged on its debts..nor has the UK. Im not sure that will hold true forever, especially as the US and UK get poorer and weaker compared to China and China continue to hold so much US soveign debt.
It also explains why you fail to make the connection between taxes and the NHS.
Sorry to disappoint many, but money does not grow on trees, it has to earned. Value has to be created. If there was a magic money tree, there’d be no poverty in the world. Try doing absolutely nothing and see who pays you and how much they pay you.
The idea that government’s have money of their own without taking it from taxpayers is truly bizarre but unsurprising that some segment believes this today.
If it were true that the government could just print up all the money it needed then there would not be constant battles over funding the NHS. Everyone could simply have any operation they needed at any time, all drugs would be available, no problem. Bring all hospitals up to 2021 standards, and build a few hundred more so you don’t have bed shortages every year. You appear strangely unaware of how the NHS is funded. How can that be?
in fact, why should the government not simply hand out £1M to each and every Brit? Everyone could immediately become a millionaire! Think about it. No more funding issues for the military, whatever it wants, hey, here it is. Schools, public services, immediate raises for everyone. How does £1,000 an hour sound? Let’s get to printing!
My mother also trained as a nurse in the war, and worked through until the early 1980s. Yes – high ceilings, windows you could open, lots of fresh air. Each ward had its own cleaner who was part of the overall team, and answerable to the ward sister. Hospitals now have top-down management systems that make it impossible for the medical staff to have any input on these important details.
Hospital cleaning has been privatised. What’s received has to cost less than the taxpayer is paying, in order to leave a profit for the supplier. And its management team. And its shareholders. And the merchant bank and corporate lawyers which advise it. Yes, Right-wingers on Unherd, YOU are responsible for supporting this!
“These patients were generally 60 or over, but often otherwise fit and healthy until Covid struck.”
What were they doing in hospital, Alison? Perhaps they were in for elective surgery for bunions or kidney stones, or whatever? You know, all those little things that hospitals are there for. Perhaps they had broken an arm. None of those things preclude one from being otherwise fit and healthy in my book.
One of the most annoying features of the past year has been the tendency for people who like to downplay the seriousness of Covid to take the phrase “underlying conditions” as synonymous with “at death’s door”, i.e. not really a tragedy if they die. My 30-something daughter in law is CEV with severe asthma. Provided she doesn’t catch a serious respiratory disease, she has decades of happy, productive and fulfilling life ahead of her. Don’t write her off because of her underlying condition, please.
Sorry, anyone with severe asthma (and my young son is one of these people) is unlikely to be considered ‘healthy’ as defined and understood by the majority of people and definitely healthcare professionals. Nobody is “writing off” these people, but the maddening way in which most media reports have painted all of these supposed “healthy people” dying of Covid, is purposefully dishonest! The other f*****g day, I still saw a headline here in the US claiming that another ‘healthy 20 year old’ died ‘of Covid’. Then you read the actual body of the article, look at the picture, and you realize he’s about 60-80 lbs. ‘overweight’, does nothing outside of work and play video games (sitting for hours at a time), and diagnosed with ADHD. :-O
I suffer from a bit of hip arthritis, not bad at 72 and was persuaded by my very nice man consultant to pursue a yoga and exercise approach as opposed to surgery.
He told me of the NHS obsession with joint surgery and his anger at the number of people who historically had hip and knee surgery at great cost only to go home, sit in an armchair, stuff themselves full of tramadol, that famous brain neutraliser, watch TV all day and rely on as many disabled aids as possible.
That is not treatment that is a passport to a care home and tragic vunerability to hell’s little microbe’s.
In a pursuit for extended life, we created a hell with full board.
Beautifully put Allison.
Well said. Doctors in past times may not have had the whizz-bang techo toys and drugs but they did have common sense and they did know how to diagnose, using a combination of knowledge, instinct and intuition. They knew that a nutrient rich diet was important, as was fresh air and sunshine.
Today doctors are secretaries ordering tests and chemists prescribing drugs. It is little wonder they have gone along for the ride in the utterly irrational reaction to Covid-19.
There is no concept of health nor respect for the human organism, just a trainload of drugs to diminish or remove symptoms, which in itself must guarantee poor health because it is not cure.
Modern medicine if it cannot cut or drug something ‘out’ is largely helpless. Modern medicine is sourced in materialist reductionist mechanistic science, drowning in dogma, particularly the illogical but very convenient germ theory, producing generic treatments for generic humans who do not exist.
It is no wonder this form of medicine is now one of the top killers, most of it from prescribed medication, and a system which rarely cures. Medication for life and having body parts regularly removed is not cure.
We need doctors who can think for themselves, challenge the prevailing dogma and have respect for the innate brilliance of the human organism which can never be simply reduced to a machine or bag of chemicals.
What is illogical about the “germ theory” — assuming that by that you mean the rather well-supported notion that many human, other animal and plant diseases are the result of infection by parasites, fungi, bacteria, or viruses?
They might have been there for something else, and caught CV19 in hospital, along with 25-40% of the other CV19 cases.
This pandemic has generated much heated discussion about the advisability of lockdowns and other aspects of the response to the virus. No doubt we’ll be arguing over that stuff for years.
For me, though, there’s one clear conclusion. We owe a tremendous debt to the medical staff who were on the front lines of treating patients, especially in the first phase of the pandemic. Doctors, nurses, other hospital staff, ambulance personnel, all of them. They treated desperately sick and highly infectious patients as best they could with ridiculously inadequate PPE and with treatments that weren’t up to the job. And as the author said, some of those staff, especially older ones, lost their lives. Thank you to all of them.
..again we come back to my above post. Top senior scientists, doctors, immunologists, virologist, all knew that Ivermectyn, HCQ, Azithromycen, and zinc were already proven to eliminate the corona virus, as was proven by Fauci’s own 2011 study, and this was pulled down off the CDC’s website early on (not before I screen shotted it though), and as we saw, HCQ was banned, and vilified by the WHO, CDC, and the media, and all the medical professionals who were successfully using it, were struck off, banned, deplatformed, and silenced. Those doctors were issuing a 5 day course to patient upon first consultation, and completely iliminated the need for hospitalization. I also have a screen shot of the World Bank Trade Tariffs, which clearly show that “Covid-19 testing kits” were being sold to every country who had signed up for Event 201, and what is the date of that screen shot?…..2018. This was all pre-planned and pre-determined.
The myth that Covid19 was untreatable is one of the hardest things to explain, yet Ivermectin (by any measure a wonder drug) is still being ignored and Dr Tess Lawrie’s attempts to alert the Government are ignored as it would challenge the narrative they have chosen, “only a vaccine can help”. The continued misuse of PPE also makes little sense, pointless flimsy, plastic pinnies for example and ill fitting useless masks in the general population.
Are those screen shots available/visible online anywhere? Surely that World Bank one would be dynamite if it could be shown to be true. You can’t be the only person who’s happened to see it, if it is in fact real. And I say this as someone deeply sceptical of the official narrative. But if we’re going to oppose it we need verifiable evidence. Anyone can claim they’ve seen a screenshot.
I think we need to qualify your statement. HCQ is only effective in folks in severe distress – ICU, with ‘lung jelly’ like symptoms. In those cases, its a damn miracle drug.
HCQ has been trialled and found to be ineffective. The reasons claims for it still circulate on fringe websites is that Trump backed it, so it became a culture war issue.
HCQ was trialled and found to be ineffective.
Other drugs have been trialled and found to work (Dexamethasone was the first, there have been others since). They are now mainstays for Covid treatment across the world. For some reason, doctors tend to favour treatments which have been shown to be effective in trials rather than those which have been shown to be ineffective in trials, I can’t imagine why.
The fact that you push a discredited treatment, which has become a totem pole for fringe right-wingers because the great Donald Trump promoted it, shows the reliability of your other claims. It’s all rather reminiscent of 1940s Russia: “Comrade Stalin says that XYZ doubles wheat yields, and Comrade Stalin is never wrong!”
A very interesting, honest, and painful article, although none of it surprising. I warned my elderly parents a year ago not to go anywhere near an NHS hospital during the pandemic. It is indeed incredible that the loss of taste symptom wasn’t officially registered until 18 May. One or two friends of mine experienced this as early as March, and it was widely known among the population last large.
The role of the ‘bed managers’ as mentioned here is just another example of the waste and insanity of the NHS, caused partly by the fact that we have vastly fewer beds than we did 30 or 40 years ago, despite a massive increase in population. The money spent on the bed managers would surely be much better spent on more beds. For a start, beds don’t require pensions and holidays, although of course they do require more nurses etc. Even so, it surely better to spend the money on nurses, not bed managers.
Bed Managers are normally very experienced Senior Nurses who have responsibility for managing the distribution of patients within beds in hospitals. This includes facilitating the transfer of patients from ITU to less intensive beds and vice versa, patients from emergency wards to longer term care, identifying side rooms for infected patients, making judgement calls on which elective cases are cancelled to accommodate emergencies etc. It’s a highly clinical role. As the UK has historically operated at a much higher rate of bed occupancy than most comparable healthcare systems (95 to 100% compared to the more usual 80 to 85% or less) Bed Managers have a crucial (and actually extremely stressful) role in making decisions about which patient is placed where, why and what the risks associated with any decision are. Especially in crisis times.
In the account of events above the Bed Managers would have been working with limited information, as were the Junior Doctors. One difference would be that the Bed Managers had responsibility for the safety of all the patients in the Hospital, while the Doctors, rightly, were responsible for their patients.
I’m sure Jane Smith did not intend her article to be interpreted as a criticism of her clinical colleagues.
I was a doctor in the NHS before bed managers were invented. Much as I dislike my patients being moved by someone with a clipboard and a spreadsheet, it works better than it did. There used to be lacunae of quiet where few patients sat among empty beds tended by bored nurses. Hardly the best use of resources.
My daughter has been warning me never to go near a hospital unless unavoidable ever since she became a doctor, years ago, never mind at the start of the pandemic. Hospital acquired infections have been around for as long as there have been hospitals.
The reason we have fewer beds these days is because we’ve become much better at discharging patients earlier (I know it can be overdone) rather than keeping them in for prolonged convalescence during which time they are at risk of acquiring an infection.
Totally agree Dougie. Doctors and nurses (in my immediate family at least) will convince anyone they can to stay the hell out of hospitals, clinics, or the healthcare system completely, if at all possible. Simply because the risk is high that you will be worse off than when you started. Case in point, one of my favorite writers, John Prine. Went in because he broke a hip on tour, contracted Covid in the hospital and died of complications. My mom even sets bones herself around here. But then she’s one of these ‘nutters’ that others reference in the thread above, that practices “homeopathy”, or as we’ve always called it in my rural part of Eastern Europe – “medicine”.
I adored John Prine and I know his wife. He did not contract COVID in the hospital. He was admitted after he suddenly became very ill and at 73 with numerous health issues in addition to COVID, he sadly died. He was a really wonderful guy. This is not to say that you could not catch COVID in the hospital, my daughter did. But she is an ICU nurse.
Unprecedented literally means an event about which little is known beforehand. It will take many years of data to answer specific hypotheses about the potential impact of interventions, which were applied while the pandemic was unfolding (as it still is). The confounders are enormous, many yet unknown, and the baseline differences- in demographics, health care provision, a potential for implementing population level changes- so diverse that the chances of finding statistically meaningful patterns are near negligible. Meanwhile everyone can claim to be correct: lockdown versus no lockdown, school closure versus open, strategy a versus b etc.
I sympathise with the young medic. But while castigating policy makers for not knowing what they were doing, she was also googling symptoms, not being helped by years of her training.
we need to kind to each other. Everyone has suffered. There is no mummy or daddy we can run to and complain that life is unfair. I am not making this comment about this young person who has been candid and thoughtful about her experience, but about the nature of societal debate that relies on hindsight wisdom.
one illustration, according to the WHO two – thirds of all death globally were unrecorded before the pandemic. Some countries have only now instituted mandatory death recording forms. And yet we merrily produce tables of country performance on COVID by death rates. Even in countries with similar socioeconomic conditions, the way deaths are recorded varies so much that we should be wary of simple comparison.
time will tell. Meanwhile everyone assumes they are right.
> castigating policy makers for not knowing what they were doing, she was also googling symptoms, not being helped by years of her training.
This is not a fair or accurate interpretation of this comment.
There is a systematic problem with disconnection between the front line and policymakers across government. See Crewe and King’s book The Blunders of Our Governments from 2013. This results from the way UK government is structured.
Pointing this out is not to “castigate policy makers”.
So which country is best structured for health? Which government hasn’t made mistakes and in which era? What form of restructure of UK government would have led to better outcomes? and how can you prove that other than by hindsight wisdom.
Front line workers by definition see what is immediately in front. Policy makes have to make decisions on what is all around, including what is not visible to the front line worker.
The point I was trying to make was that Black Swan events can’t be prepared for. Technological or scientific advancements do not mean an end to uncertainty. Hindsight wisdom is unfalsifiable but that does not make it true.
Improvements result from frankly acknowledging failure not by ‘castigating’ the people who reveal them.
This isn’t a black swan event. It has been top of the UK risk register for years.
Its true that there is a lot of hindsight about, but the disconnect between front line and policy has long been identified as a systematic weakness in the UK. This couldn’t be further from hindsight.
Pandemics occur every flu season: WHO just changed definition. Average Covid fatality age exceeds average life expectancy. Statistically Covid prolongs life. Mortality figures have been higher in previous years and no one batted an eyelid. According to corporate fraud lawyer lawyer Reiner Fuellmich Covid is better understood as “organised crime”. He believes he can prove it and the technical basis of his case has already been proven in a court of law. Just because things aren’t reported in media doesn’t mean they’re not real. Quite the contrary. In the words of his friend Dr Wolfgang Wodarg who thwarted previous plandemic in 2009: ‘The emperor has no clothes’
Sweden. My Dad has been living between the UK and Sweden for years. The way things are set up over there are so much better for the residents. Less having to fill in the same form 100 times because different agencies won’t speak to each other, less covid crap… less mistakes made in hospitals early on in the pandemic. I have elderly relatives out there who caught covid and survived after hospital treatment. I doubt they would have been so lucky here in the UK. I’m not saying Sweden is perfect, but it’s most likely a whole lot better!
Not true. Swedes have major problems in access to healthcare. It is great if you can get to see a doctor or a specialist; not so good if you have to wait. The maximum waiting time for medical specialist assessment by law in Sweden is 90 days, but a third of people have to wait longer. Health outcomes very enormously by socioeconomic status. There is nurse shortage in three -quarters of health care services, despite the huge tax burden on citizens. New Karolinska hospital in Stockholm was the most expensive in the world when built, yet many departments got easily overcrowded and had to be transferred.
There is no perfect world.
The lack of good prophylactic advice has been and remains an astonishing dereliction. There’s still an emphasis on hand-washing. I am told that after a routine procedure next month I must take extra care to “clean and disinfect frequently-touched objects and surfaces” in my home. This would serve no useful purpose.
On the other hand, I have seen no mention of whether it would be a good idea to use an electric fan if one is indoors with others, to disperse the aerosols which are reportedly an important vector in enclosed spaces.
Providing sound, up-to-date and easy-to-follow advice would cost very little. It would help restrict the spread of infection by focusing efforts where they are effective. And it would give people a greater sense of control over their lives. Why is not being done?
Very good post. My answer to your concluding question is that ministers and their advisers took far too firm a view in the public health advice issued last March, so that it would be embarrassing if they had to change that advice and switch to something more evidence-based, like the three Cs mentioned in this article and in previous ones on this site going back to last autumn or earlier. I guess it will be hard for any inquiry to find a smoking gun on this, but there seems to have been a complete unwillingness on the part of the authorities to ask exactly how is the virus being transmitted. Hence the continuation of outdoor restrictions which are clearly not based on good evidence.
Probably the only laughable thing about this pandemic in the UK is the ridiculous worship of the NHS. Both it and the Department of Health have failed miserably in just about every way. The only reason we have managed to have a vaccine triumph, is that the Department of Health was prevented from running it and a special team was set up outside the normal health department umbrella. Clap for the NHS on Thursday evenings? Not likely.
The NHS has done its best despite a decade of Tory underfunding. NHS staff have worked at an intensity most of the rest of us couldn’t cope with. I applaud them.
But since you hate the NHS so much, what would you do about it? Do please be specific? How about a US style system, as favoured (generally covertly) by the American contributors?
It appears to me that the deification is because some people take accurate criticism of the NHS as a personal attack, as though they themselves were around in 1948 and have some personal responsibility for it.
Annette, as an American, why are you bothered by what health system we British choose? What business is it of yours?
Sorry, I’m forgetting, as a Trump supporter and someone who favours the US health system even though thousands die without treatment because they can’t afford it, you find the NHS an ideological offence. Treating people on the basis of need rather than wealth – what an appalling idea! And don’t pretend that Medicaid takes up the slack for those on low incomes, especially in Republican States where the income threshold for Medicaid eligibility is set lower than it is in Democrat States.
Vaccine procurement was handled by Vaccine Task Force. The Vaccine Delivery Programme is NHS. Test and Trace is Dept of Health (not NHS).
Interesting read, but the author is overly dramatic and a touch hysterical. I would suggest that the author read a very interesting short book by Dr. Sebastian Rushworth entitled “Covid: why most of what you know is wrong”. The contrast is remarkable. Dr. Rushworth is a first year Swedish junior doctor working in the ER of a large Swedish Hospital. i.e. at a similar career stage to the author. His take was entirely different from the author’s. Indeed in the middle of Stockholm, the ER departments were absolutely not overwhelmed, and he went from seeing 8 patients per shift to about 2-3 – while the majority were all COVID positive, the total number of patients decreased as people with cardiovascular events etc… didn’t go to the hospital. Further, as he rightly points out the mortality of COVID is a lot less than was first thought. And most importantly the average age of death from COID is higher than the average life expectancy: in Sweden 84 versus 82.
The book by Dr Rushworth is definitely worth a read.
Sweden. They knew from the get go that they were short of ICU beds and were concerned that Stockholm, in particular, was going to be another Bergamo so they triaged elderly patients up front – they were never taken to the hospitals – only 13% of the people who died in hospital in the first wave were > 70
From a pal of mine in Sweden in May :
I’m witnessing and living an humanitarian catastrophe. Hospitals are closed, they do not let people looking for help in. One needs to be previously allowed after a very hard screening by telephone. Only a tiny part of the covid19 symptomatic patients are allowed to go to the hospital to get treated. Sweden has officially 2653 deaths so far. There are doctors made calculation in internet based on official numbers of hospital utilization that conclude that only around 400 people died at the hospitals. More then 2200, more then 80% dies at home because they couldn’t get treatment. It’s too much scary because I don’t know whether my family will have treated if needed despite we are covered by the public health system, in theory. Information is slowly going out of the swedish state sponsored media bubble, but it’s taking too long.
On 10 Decmber, the Karolinska Institute had no spare capacity in its ICU (increased from 38 to 200 beds in the spring) and opened up an adjacent field hospital to free up beds in its main facility
Would you rather die in hospital or at home?
For myself, home, without any doubt whatsoever.
Covid means you can’t breathe. You need oxygen. Are you anticipating an oxygen system at home to mimic what hospitals provide?
I think this article unintentionally begins to circle in on the key issue.
If you have an out break of Virus which in the main only kills the elderly and co morbid (we did know this from Wuhan) and nearly a thousand unfortunate young medical people, who were overwhelmed by what is known as Viral Load (I will leave experts to judge in retrospect if that analysis stands up to cool deliberation) you need to rethink your entire admissions policy.
What this article proves is the NHS was not fit or ready for a Pandemic and therefore anyone with a fighting chance of survival or a highly likely hood of death should never have been taken anywhere near hospital. I remember very early on a medic turning to camera in Italy and said all these people in ICU will be dead at the end of the week maybe one will survive. So what on earth are we doing taking these people to hospital.
Why on earth did the NHS send out a non resuscitation order. If you think someone is to frail to be resuscitated why put them under at all, why not indicate that they are to call for palliative care and stay home with a family in a well aired room.
As for the returning people to spread in nursing homes this point is drastically over made 21,000 people died of Sars CoV2 in 2020 (ONS) in homes out of an overall total of 171,000 (ONS). News just in, people go to nursing homes to die with life expectancy of 2/3 years unless your demented.
Deal compassionately with people with a dreadful deadly virus in terms of pain relief but do not take them to hospital. Out of the 20,000 admissions in the 0-60 less than 500 died (ONS)who were fit and healthy thats a fantastic and worthwhile outcome and perfectly manageable.
The way this has been dealt with is to throw the 0-60 age group to the wolves either by destroying their lively hoods or expecting them to pay for this in the future. What should have happened is the 80 plus age group should have been given palliative care and a handful of fever hospitals created. Capacity issues should have been avoided by not taking these people to the hospital in the first instance.
The NHS barely manages in ordinary times with a high number of elderly and 30% obesity and 8% of the budget goes on type 2 diabetes, this article proves everything was done on a wing and a prayer to avoid criticisms of lack of compassion and if anybody thinks all those elderly lives saved (not the fit and robust many of whom got it and survived) are going to come out and enjoy the green uplands of post pandemia, they barely were able to before, now they will be terrified obsessed endlessly with health, thats what happens when you keep people alive with just one aim survival at any cost.
We need a great reset the acceptance that we die and do not live for ever and the future belongs to the young between 0-60 who have everything to offer and everything to lose.
Some months ago there was a very interesting comparison of Covid deaths in Lombardia and neighbouring Veneto. (Surprisingly for such an interesting article, it was in the New Statesman). Anyway, Veneto did much better because they did not rush every Covid case into hospital. And we all know that the last place for sick people is an NHS hospital.
The most dangerous place in England is an NHS Hospital.
The logic is irrefutable.
Drivel, on the same level as your ill-informed comments about the number of NHS managers which Mark Bridgeford had to painstaking deconstruct and put you right on. If your Covid gets bad and you are suffocating to death, you need oxygen and maybe a ventilator. That means a hospital.
If they are suffocating due to Covid and need oxygen, a hospital is exactly where they need to be. That’s why they go to hospitals all round the world, whether it’s an NHS hospital in the UK or a non-NHS hospital elsewhere.
Yes, it became obvious that not every COVID case requires hospitalization where you could infect other people. Many cases can and should be handled at home where people can better isolate and not infect others. NHS hospitals do seem to have issues with infectious disease spread even during non pandemic times.
Unlessof course they can infect others at home in crowded conditions.
Will hospitals now be designed with windows that open?
I totally agree. One the one hand we seem to be terrified of death and postpone at terrible cost of suffering and misery (anyone who has visited a dementia ward will know what I mean). ; on the other hand we refuse to condemn behaviour which will bring a premature decline in health .
As late as January 2021 Captain Tom Moore caught CV in hospital. I find that staggering.
The NHS is more dangerous than a Tiger Tank. If CV hadn’t got poor old Captain Tom, MRSA, C-difficile or something equally hideous would have done.
In fact he was probably safer storming the Normandy Beaches.
And I find it inevitable.
And died after having the vaccine, I understand.
It’s emergency conditions, with a highly infectious disease (the Kent variant being 50-70% more infectious than even the previous version). In a country where third-rate right-wing political leadership has ridden the golden conveyor belt to power, leading to an unnecessarily high rate of infections and consequently hospitals having to do the best they can with the facilities and staff available after ten years of Tory rundown, rather than having ideal conditions.
And the rest of Europe, where the situation is much the same, also the tories?
If you look at the ICNARC reports dating back to the spring you will see that the sort of triage you are talking about – not putting 80+ bods on ventilators (or any sort of respiratory support) was in operation from the start :
Age + demography of admissions for any sort of respiratory support : Mean age 60.2, Median age 62. 89% able to live without assistance in daily activities.
The morbidity associated with ventilator management of the frail and old has been known for years.
As for DNACPR, in a well managed health care system advanced care planning / advanced directives ought to be something your doctor discusses with you long before you become really ill.
It will be interesting to see what recommendations the CQC come up with after their invstigation of all this.
In the meantime everyone has the option to be very American about this and take personal responsibity fo organising enduring powers of attorney and personal preferences re : end of life care and laying in supplies for simple self deliverance as assisted dying is ostensibly still illegal in the UK.
The reason your initial tests were reading negative, is because you used a conventional testing method (which was correct), but the 48 hour test was a PCR test, and this was giving you up to a 90% false positive result, because a PCR test “CANNOT” identify, or isolate covid nineteen. (or any other virus for that matter) all it can do is pick up remnants of DNA strands, so the question needs to be asked. What person up the command chain knew that this was the wrong test, and why did they allow it to be used? Was it a lack of competence, or a deliberate ploy to “create” the illusion of a pandemic? Either way, there needs to be a serious scientific inquiry, and those found guilty of crimes against humanity need bringing to justice. We need to establish at what level were senior virologists, immunologists, and senior NHS managers were complicit in this deceit, and criminal negligence.
Yes, the PCR tests are one of the great rackets of our time, and indeed of all time. But a lot of people are making a lot of money from them, and that’s the main thing!
PCR tests are manufactured to contain specific primers – strings of amino acids that will bind to specific target regions of the Sars Cov 2 genome (or of any viral genome – you can manufacture a string of amino acids to match any bit of any viral genome). The test mechanism amplifies these bound sections of the viral genome and these are what is measured in a quantitative sense. The Lighthouse labs in the UK have primers that will bind to 3 different bits of Sars Cov 2 – N (nucleoprotein) ORF 1a/b (open reading frame 1a/b) and S (spike).
This article written in June describes the PCR test in a bit more detail and gives a history of the manufacture of the initial primers.
“Primer design for quantitative real-time PCR for the emerging Coronavirus SARS-CoV-2”
SARS-CoV-2 incidentally is an RNA virus.
We know what the operational false positive rate is with this test from the ONS random sampling in the summer when there were very few people carrying the virus – FPR about 0.08%.
For Test and Trace at the same time about 0.9% of tests were positive – you would expect a higher figure because T&T test more people with actual symptoms, they are not testing a random sample. You can’t have more false positives than the actual number of positive tests.
If PCR was hopeless overall (for whatever reason) it wouldn’t match & predict Covid hospitalisations and deaths as it does.
Does it pick up people who have had Covid and are no longer infectious ? absolutely which is why NO single test should be used as a single metric to determine an individual’s current situation – this applies to the rapid lateral flow tests as well. How do you get over this problem ? – by repeat testing, by using differnt types of test, by examining contact histories, by examining other signs and symptoms.
I certainly subscribe to the view that the Test & Trace system in the UK has been shambolic – this because of how it was set up and how it has been used rather than intrinsic problems with the tests themselves, limitations which are documented and well known and continuously scrutinised.
Very interesting and powerful piece. I think the other reason the response was originally so bad even in hospitals and even or especially with the senior staff (of the same age/generation as myself) is that there has been a generation or more without real experience of proper infectious diseases and how to handle it. What used to be common knowledge has been forgotten.
Infectious diseases you say?
I live very close to a famous large hospital in Aylesbury. Next door to the hospital is a small Asda. My ex-partner was an infection control nurse at said hospital and most of her job was spent trying to keep on top of the management of possible infection spread. For years, many staff of all descriptions and levels were told many times, some of them embarrassingly often, about getting changed before venturing out to meet the great British public. I.e. do a spot of shopping at Asda’s.
Every single time I go into Asda, there are NHS staff in full uniform wandering about the place buying things. It appears, even with all this COVID palaver, lessons still aren’t being learnt…
Interesting article. One thing that really stands out is that the hospitals and care systems (throughout the West) had very little planning/capacity in place for handling pandemics – in terms of infection control. Indeed it would suggest that in hospitals virus/infection control is worse at normal times – how many fragile patients with say a broken bone end up catching a killer bug whilst staying in hospital? How many carers wih no sick pay and under pressure to work (same for Nurses/Doctors) routinely soldier on when possibly infected – or how many wouldn’t even know they were ill? The general public shouldn’t be let off either, how many people visit patients in hospital when feeling unwell themselves?
There’s some low hanging fruit like more nurses, doctors, carers and sick pay and better PPE and testing for them – we need our own industrial capacity for this. Also whilst not cheap rebuilding more hosptials to have individual rooms per patient – and good ventilation would help with this and make life better for most patients. Previously I’ve viewed the horror of trying to ‘get better’ on an open ward with coughing patients as an annoyance, how would you sleep? Now we’d view the coughing itself is of more concern.
‘Indeed it would suggest that in hospitals virus/infection control is worse at normal times – how many fragile patients with say a broken bone end up catching a killer bug whilst staying in hospital?’
A lot. Certainly in the UK – and Scotland is three times worse than England.
“Scotland is three times worse than England.”
Situation normal then.
Yes, but it’s Westminster’s responsibility (just standing in for Ms. Sturgeon).
It’s always England’s fault, but we’ve got used to it.
or SNAFU, as it were.
Forming a consistent opinion about lockdown has been difficult with new information appearing and contradicting existing information. Perhaps the key question to answer is this: What proportion of those who died from Covid 19 contracted the disease either in hospital or in care homes?
https://www.physicaleconomics.org/copy-of-liberty-equity-wokestry
Probably no one, we now know the PCR’s are 1. not diagnostic, 2. were invented by Drosten without a drop of virus and approved by the FDA also without a drop of virus, 3. were all cycled at a ct value of 45 on the recommendation of the WHO, who only changed that in January this year. The whole thing is based on PCR’s and they are fake.
Almost the full house of nutter conspiracy theories, but you forgot to mention Bill Gates. Also needs more Great Reset. Please rectify this oversight immediately.
Whose this Bill Gates chap you keep banging on about?
Does he play for Aston Villa?
He is the guy watching you through your computer camera as you type. He is the reason most of us put a piece of black electrical tape over the camera hole.
Bill Gates is a fan of the big reset Paul (wonder why?):
https://news.bitcoin.com/the-great-financial-reset-imf-managing-director-calls-for-a-new-bretton-woods-moment/
Not sure why you keep bringing it up as if its some internet meme? This has been talked about by financial industry trend-setters for at least 2.5 years. Covid is just going to speed this up. Ultimately the aim is for governments’ central banks printing of money (digital of course) directly into cattle, i mean, citizens’ bank accounts. If you’re watching the industry at all, you know they’re clamoring for it, and have been for a while. Lots of fees to be made here. Lots and lots of untapped clients.
Some months ago, SAGE suggested that 22% of COVID transmission in the UK happened within hospitals. I’d suggest that pubs and other hospitality venues would be much safer places to be.
I suspect that’s an underestimation. But even if it’s correct, that’s the figure for ‘transmission’, not deaths. Those in hospital are elderly or already ill so the death rate will be considerably higher. How much higher really needs an investigation.
None of this surprises me and corroborates what my wife has told me. Shortage of office space meant she worked, ate and drank in various poorly ventilated offices often with 6 or more nurses and HPCs, without PPE except for face to face contact with patients. When she became ill early in the pandemic occupation health said because she only had a low grade fever and no continuous cough it didn’t tick the boxes for Covid so she should come back to work if she felt OK to work. She had a weekend plus 2 work days off. Fortunately most of her colleagues had mild symptoms or were asymptomatic although a few (mainly BAME) had a more serious illness although none were hospitalised. I upped my daily vitamin D dose and fortunately despite being in my early 60’s only had a mild illness (BMI<25 possibly helped).
Thank you for that poignant essay.
It sounds like Scutari all over again, except this time on a simply massive scale.
How was the worlds eight largest economy so ill prepared? It is a national disgrace, perhaps without equal in our history.
We were prepared. The pandemic plan was in place, and the intent was to deal with it via herd immunity. As we have done with all previous pandemics. Then SAGE weighed in, Johnson and co. panicked, and here we are a year later, with the economy destroyed, many SMEs destroyed, many people’s lives destroyed, and the wealthy rolling in the aisles laughing.
Yes agreed, even worse than the Charge of the Light Brigade!
More like ‘The Retreat of the Light Brigade’ where to save them from the danger of the charge they were ordered to rush to the rear, and thus, lemming like, off the cliff.
I appreciate the time and effort of the person writing this piece. However, 1. I would like to see on UnHerd essays, articles etc.. discussing the other side or the indeed many alternatives on the issue, instead of constantly promoting similar writings. And to my understanding aiming to keep up the fear the longer the possible.. 2. Who has decided that corona is the most important and the only issue in people’s life? Why are they keep pushing us to think on those terms every single day? 3. Why vaccination is the only choice, and not medicines and natural immunity? There are already medicines like invermectin. For me, the most serious, credible, and honest strategy is the Great Barrington Declaration. And I understand herd immunity is a natural process.. when the term is used along with vaccination is misleading and a kind of abuse and appropriation.. a kind of disrespect and distortion. We have already heard/read similar stories.. What about Ours stories? What about how corona IS a blatant Disrespect to everyone human? Is there a scientists/doctor/politicians who can explain why the so called cases go up.. whereas in lockdown? I do suspect that something else is going on.. perhaps it is a biological war, to keep us under control, they spread the virus here and there, to keep on with their agenda. I do not think that the virus is spread in those terms they describe .. Please see the video with Dr Daniella Anderson from Singapore says: it is not Airborne.. Why they keep telling us otherwise??.. I am a healthy person and good citizen, and I take democracy seriously, it is my duty to uphold and honor my right to decide everything about me. I take care of my health because I care of others. And by no means I was waiting for a virus to tell me what to do.. I do not insist and I do not give names to anyone who takes drugs, alcohol, smokes, feels safe with vaccines and if they wish they could inject themselves everyday.. enjoy! But.. they do expect that everyone in the world will comply to be forced into a global group of weak individuals unable to defend ourselves..! Are we babies here? Freedom, free will, tolerance, diversity and most of all Respect to each other are fundamental principles for adults’ health. Is corona a blatant Disrespect everyone human? Around the corner, there is only the Anti-anti-vaxxers propaganda.. https://www.youtube.com/watch?v=9g47wD55Nl8.
Bolsinaro is running a real time experiment in natural herd immunity in Brazil, right now, isn’t he ?
You can watch it unfold (from the perspective of the hospitals) in glorious technicolour here : COVID-19 Observatory points to the biggest health system collapse in the history of Brazil 17.03.21
Isn’t Belarus doing the same?
A chance for some interesting comparative analysis methinks.
And Florida. And in most ways, South Africa’s last wave. This list is long.
So Elaine G-L’s cynicism maybe misplaced.
South Dakota, the one State which just let it rip, and fared the best out of all of them, search for a speech by the excellent governor about it.
Others may disagree about “best out of all of them” – even given SD’s natural advantage of a predominantly rural and thus naturally socially distanced population.
From CDC (with all the attendant problems of how certain states are very slow about reporting deaths of any sort). A league table from a couple of weeks ago for all cause excess mortality compared with population adjusted average from the last 5 years :
1st Arizona +31%
5th N Dakota +25.3%
6th S Dakota +24.4%
21st California +19.9%
25th Florida +19.3%
62nd N Carolina -7.6%
Does anyone actually know what is going on in Florida ? (or anywhere else). Pals of mine who live there say that it varies from county to county – some didn’t open schools when De Santis ordered them to, some have bar and restaurant restrictions, different flavours of mask mandates etc. etc.
Yes, Florida public schools (some private schools never closed) were ordered open by the Governor and they had to open five days a week (or lose funding) although parents were allowed to choose to keep their kids homeschooling. The teachers union tried to block it and temporarily succeeded but de Santiago used an emergency executive order to get them open. Individual bars and restaurants can ask you to wear a mask as can grocery stores, although many people do not.
Florida focused on vaccinating the elderly first and it has a high percentage of elderly as it is a retirement state for many. It also never forced covid patients back into nursing homes.
Florida did better than many states (its death rate is 8% below the national level) that had lockdowns and now has the economy to show for it. It will take a long time for California and New York to come back even if they do impeach/recall their governors.
Yes, and didn’t destroy its own economy in the process.
Florida is vaccinating people in huge numbers. And with a larger population and an older population, it still has a lower death rate than states that did have lockdowns. Florida was not banking on natural immunity. But it also didn’t want to destroy its own economy..
I think we agree then in one point.. all in all corona is something else of what they say.. a political virus, a mind virus, an economy virus.. a culture and religion virus.. or perhaps what they really mean is that WE are the virus.. they want us to suppress and put under control… Most likely for me, it is a biological war.. they control it.. they spread it when and where ever they want.. If it appears that Herd immunity does not work .. of course!!.. it is because that is their Plan.. they will do all it takes to vaccinate with poison as many humans as they can.. Lies is their specialism..
How Dr Joseph Goebbels would have laughed!
Any sane organisation tries to ensure that it speaks with one voice, and that what it says is carefully considered rather than people who don’t have the full picture blowing off steam after a hard shift. The same is true of companies, like the one I worked for.
You yourself made spectacularly ill-informed claims about the number of NHS managers, a few screens above. Would you like to have found that a journalist put your views on the News, as a statement by the organisation you happened to be working for? Followed by Mark Bridgeford, who set you straight (a few screens above) by explaining that the facts utterly contradicted your prejudices, to the great embarrassment and public discredit of your employing organisation?
Think about it.
I agree with you, and how clever it has all been; the rhetoric has been masterful, faultless. If only all that skill had been put to better use.
Jane sounds like she works at Fawlty Towers. Her story and the blatant politicisation (read: trashing) of the AZ vaccine and its efficacy in Europe doesn’t serve to reinforce our trust in health care. The French have now done an about turn on AZ and, from today, will give it to anyone who can be persuaded to take it. The number will be fewer than before governments and the media got to work on it.
My gripe is a tangential one. I guessed that her by-line was a pseudonym which it turned out to be. We think we have free speech but it’s a delusion. No one uses their name if they could avoid it. Why should Jane fear repercussions if what she says is a fair account of her hospital experience?
The media have destroyed trust in them through their constant use of sources who insist on anonymity for reasons which are rarely good in terms of freedom of speech. Some fear they’ll be fired, others want to damage political opponents without taking responsibility.
We used to think an Englishman or saloon bar bore could speak his mind freely compared to the citizens of the dictatorships. Of course, he is comparatively freer but only within the limits of his fears.
‘We used to think an Englishman or saloon bar bore could speak his mind freely…’
Not now that they’ve closed the saloon bars! And most other places where a variety of people could gather and talk, exchanging ideas and experiences, and maybe even debate some form of action against grievances.
And the Government is cracking down on protest too, via the current crime Bill.
Labour is opposing that, so I trust they have your support?
I am so against this and yet those rioters make me want police. How to protest without tearing things down violently? Work stoppage.
Because she is reflecting on the actions and experiences of herself and colleagues that would be potentially worrying to future patients if they were able to identify the clinicians involved and would actually hinder open and honest, blame free, analysis of the experience she and her colleagues went through.
You are a little naive if you think whistle-blowers aren’t crucified. If her name got out, she would get struck off.
No reason for any staff to blame themselves but we must not learn the wrong lessons. There is little or no evidence that even surgical masks protect against or stop the spread of Covid, nor that locking down a whole society works either. The central contention here is that an asymptomatic patient infected others but the existence of asymptomatic spread is questionable-if the jab massively reduces symptoms and is the answer to getting out of lockdown, how can this be true because the virus is supposedly spread asymptomatically?
During the last couple of months of lockdown and increasing vaccination, the number of cases and the number of deaths have fallen massively.
Since Unherd is full of people claiming that lockdowns don’t work, and vaccines don’t work, I would love to hear how they explain what has actually happened. And why they have the cocksure attitude that they know better than doctors and scientists, when the evidence points to the success of the strategy designed by those doctors and scientists.
If lockdowns worked, Paris would not today be doing one again. If France could get a vaccination program going, people could stop dying.
I agree with you that there isn’t much evidence on masks either but with the vaccine rolling out now, in the U.K. and the US, cases are dropping (but even more relevant since cases are not particularly relevant), deaths are dropping. That is a function of vaccination of the elderly and the cessation of ridiculous practices of incompetent leaders, like sending covid patients back to nursing homes. Of course that won’t stop elites from wanting everyone to keep wearing masks. Good luck with that. As to lockdowns, not sure that the public would ever again sit still for the incredible damage done (at least in the US) by lockdowns driven by unaccountable people. With the two biggest US lockdown proponents who are accountable, well, they are both about to be recalled or impeached.
A very interesting and disturbing article. The total lack of preparedness is a serious indictment. OK, the exact nature of the disease could not have been predicted, but the UK authorities had identified a highly transmissible virus as one of the four main serious threats to the country. So one would think that the NHS might have had at least some plans in place, which could have been quickly fine-tuned to meet what was already known from China and Italy on things like the incubation period and key symptoms.
More generally, I guess this article has caused some confusion for regular posters on here who cannot decide whether to believe the article because it offers a stick to beat the NHS with, or rubbish it because it goes against the narrative that covid is not all that serious. I’d suggest sticking to the former.
We were prepared. The plan was as with previous pandemics to care for the vulnerable and let herd immunity be reached. This time, SAGE decided we needed to be terrified, Johnson and co. panicked, and here we are 12 months later, with the economy destroyed and the life of millions destroyed, for a disease whose mortality rate for the healthy has no statistical significance whatsoever. Quite why we are not hunting down Ferguson and co. and slaughtering them is beyond me.
Yes, the alarmist media and citizens put pressure on a Johnson to change the strategy.
And the scientific evidence put pressure on him, because like every Government in the world, Britain recognised that allowing the virus to rip would lead to hundreds of thousands of deaths.
We have seen that on a smaller scale when Boris refused to take SAGE advice in September and institute a two week circuit breaker lockdown, and the infection rate ran away, followed by hospitalisations and deaths.
Thus have we crucified the economy, inflicted ‘life changing events ‘ on millions, and made a mockery of our millennia and a half of civilisation and for what?
Circa 125,000 ‘body bags’ whose average is over 82! Greater even than normal life expectancy itself!
Is this lunacy gone mad or what?
On the plus side, I’ve had 367 days of wfh which has saved my sanity ( as 369 days ago I decided I couldn’t cope with the commute any more and would have to leave my job).
(though to be fair my sanity is not worth trashing the economy and destroying lives for).
People who could work from home carried on. Those who couldn’t lost their jobs. Creating yet more distance between the haves and have-nots. And young people damaged forever. Lockdowns killed. They also destroyed lives, some of which will never recover. Somehow sheltering the vulnerable while allowing the non vulnerable to carry on with life never occurred to the “experts”. Never again.
There would be a lot more than 125,000 if the virus had been allowed to rip.
And there would be a lot less if Boris had not baulked at decisions such as locking down earlier in March 2020 when 3000 Spanish fans attended a match in Liverpool and the Cheltenham Festival was allowed to go ahead, or locking down in September when SAGE recommended it but he delayed for 6 weeks until the virus was out of control at the end of October.
As so often, this is counting the deaths that actually happened on the wrong side of the balance sheet. The costs of the policies we did follow include the economic, social and cultural damage alluded to, plus the deaths and illnesses that actually happened. These are all on the same, negative, side. What goes on the other side are the deaths and damages that would have happened under whatever the proposed alternative is. Hard to assess, I know, but that’s what you need to do if you want to make a valid comparison.
How many people in the UK do you think were / remain “vulnerable” to catching and dying from Sars Cov 2 ?
A number please with accompanying details of the categories you have chosen for this model inside your head.
Totally agree. Anthony Fauci as well. That smug little incompetent gave constantly conflicting information, went political, was caught not following his own prescriptions and is today demanding that vaccinated people continue masking up. And seems to have no clue that that does not encourage vaccination. He is now as big a laughing stock as Joe Biden.
Indeed. We were perfectly well prepared until SAGE and Ferguson scared the crup out of Boris, who didn’t have the scientific skills or support to defend himself against them.
In January and February 2020 Boris Johnson missed five COBRA committees which were deciding Britain’s response. He took two fortnight-long holidays within two months, close to 50% absenteeism, in order to finesse his complicated personal relationships.
His first private comment on Covid was that we should ignore it.
His first public comment on it was that whatever lesser breeds in less exceptional countries than Britain might do, buccaneering Britain would not allow its post-Brexit advance to sunlit uplands to be derailed by what he called “excessive precautions”.
In March 2020, 3000 Real Madrid fans who were not allowed to attend football matches in Spain, because the virus was rampant there, flew into Liverpool to attend a match here.
And tens of thousands attended the Cheltenham Festival after the Government refused suggestions that it should be cancelled.
And in September, Boris refused to follow SAGE advice that there should be a two week circuit breaker lockdown to prevent the virus from getting out of control. He called that “ridiculous” when Keir Starmer pressed him to enact it. Six weeks later, guess what? – the virus was out of control. Boris had to crawl onto national television and announce a much longer lockdown.
Third-rate leadership from Boris Johnson and his cronies has been a big factor in Britain having the highest death toll in Europe, and the third-highest per million population globally.
Fascinating article – especially interesting from the perspective of understanding decision making under uncertainty. All the characters in the account made their decisions based on what they understood at the time and none were cavalier. The trade-offs between choices were often painful and only partially understood – but still decisions had to be made.
My two comments to offer on the level of uncertainty are these: first, the early data did give a pretty good idea of the risk profile in terms of both hospitalisation and death but this was exaggerated and continues to be exaggerated; second, where there is fear and impotence in the face of death, we need to remember our Creator and the one who offers genuine hope in the face of death. Both these observations are crucial if you want to navigate a good way through the fiasco.
First paragraph I agree with.
This is a good synopsis of why the NHS should by broken up. The questions I would also like answered, is how many staff were working at any given time. How many patients were in the wards at any given time. Why were doctors not informing their junior doctors of how the very many serious cases of other diseases they dealt with over the years.
I do not doubt for one moment that this junior doctor has been working hard and un difficult circumstances. At the end of the day every year flu hits the population. Every year many take to their beds, some get hospitalised and some tragically die.
All the funeral association figures show that deaths in 2020 were no different to other average years. Therefore, I suggest that a) the propaganda fed to our medical staff to create a real fear was indeed cruel and dangerous. B) the NHS has once again let down its frontline staff and its patients.
The solution is not more tests, injections or lockdowns. The solution is removal of this government, removal of Imperial College from any government advisory body, removal of all government health quangos and committees. Finally the removal of Government from any national health programme. Return health to the local doctors, cottage hospitals and private individuals who can make their own holistic decision for their health care programme. Give us back small government, low taxes and NO more bureaucratic behemoth that is unaccountable to the public.
Hmm. So when the SAIF submitted formal evidence to CMA in June 2020 stating
were they mistaken?
“All the funeral association figures show that deaths in 2020 were no different to other average years.”
Your reply: “So when the SAIF submitted formal evidence to CMA in June 2020 stating…”
My emphasis. June was immediately after the curve returned to normal so you had two months (mid March to mid May) where the majority of those excess deaths occurred.
You are both correct, not mistaken.
I disagree. Here we have the National Society of Allied and Independent Funeral Directors describing the first half of 2020 as having “over 42,000 excess deaths”. This is not consistent with the statement that “All the funeral association figures show that deaths in 2020 were no different to other average years.” To spell it out: there was a difference between 2020 and other years, that difference being that 2020 had 42,000 excess deaths in the first half, while the other years didn’t — and that figure of 42,000 comes from a funeral association. The original post is simply not correct. Of course, it’s part of a wider narrative trying to suggest that somehow the epidemic didn’t happen: I don’t know why people want to promulgate that suggestion, but it’s plainly incompatible with the truth.
In other words two bad days on the Somme?
More like a bad two weeks on the Somme: two bad weeks while certain people in Blighty are peddling a bizarre myth that there’s no war, no battles and no casualties.
So let’s look at 42,000 extra deaths (over half a year). That’s a couple of bad weeks during a World War. Or 20 years of motor accidents. Or 50 years of murders. Or an airliner crashing every day for six months. Or … well, you get the picture. Really rather noticeable.
The question is not whether 42,000 excess deaths is good or bad compared to some other disaster, it’s whether they happened at all. They did, and for some reason the original comment chose to state, falsely, that they did not.
95% of contributors to Unherd are fantasists or Russian Government wire-pullers, I’m afraid.
Unfortunately you are right, those that say the pandemic didn’t happen or there is no virus give ‘normal’ sceptics a bad name…
Only someone completely ignorant of history would suggest we go back to private medicine as it existed pre WW2. The gap in health between rich and poor would be much wider. Only today there is a report on how the NHS collapse of dental services has affected the poor much more heavily than the wealthy. Presumably you think you would be OK, so forget everyone else.
Ian, indeed. And one of the contributors here, American though doesn’t tend to advertise the fact, stated outright on a similar Unherd thread that the US system worked for her and that if others went without treatment because they couldn’t afford it, that was their “choice”. I’m afraid Unherd attracts such people.
The gap between rich and poor is already huge. You don’t believe the rich sit on NHS waiting lists, do you? Even middle class people with private insurance don’t. The rich don’t go without dental care because they can pay for it.
Medicine today is nothing at all like it was in 1948. And yet the NHS still operates like it’s 1948.
Deaths might be down because of fewer traffic deaths, Monday morning heart attacks, work accidents. Counter: more possibility for at home accidents, more suicides…
Tragic, but that’s real life for you. Decisions on never before encountered issues have to be made in split seconds; PPE ordered in never before bought quantities – while the whole world wants it and when most of it was made in China. There are never perfect emergency situations, never perfect strategies, never perfect solutions, never perfect people, never perfect premises. Healthcare delivery is tough enough in normal times. Most new enterprises fail. Nevertheless, we have achieved in months what normally takes years with testing, medicines, vaccinating and PPE manufacture here in Britain.
Will we be better prepared next time? It depends on how novel the situation is. We’ve been fed unrealistic expectations. That’s what needs to change.
But thank you Jane, both for doing the job and for bringing it to our attention.
‘Prevention is better than cure’ as we used to say in those far off halcyon days.
Yes – that horrible scenario has been repeated thousands of times this year – countless thousands of times, in fact. I saw some report a while ago which suggested that over twenty percent of the people who had died were infected while in hospital for one reason or another. This is of course nothing new; it is not very long ago that our wonderful NHS had more or less the worst infection rates for a host of dangerous infectious diseases in the developed world. MRSA, C-Difficile and others were everywhere and if you had an operation, or were treated for a wound after an accident, you were probably as likely to see horrible complications as a casualty at the Somme in 1916.
I heard it was 40%. Disease control in the NHS is truly appalling and it has been for years.
I would like to thank the author for a candid and perceptive account. No wonder you use a pseudonym. Keep safe.
Still, she couldn’t/wouldn’t whistle blow. We race bait, we keep our headlines and stats nice. We take care of our own.
This is a sobering account of the early days of the pandemic. Of course mistakes were made but what strikes me is that all of them (with the possible exception of PPE, for which I blame Hunt rather than Hancock) were made by senior clinicians, managers and the NHS leadership, rather than by ministers.
Perhaps this explains why Hancock wants to reduce the arm’s length status of NHS England.
What an embarassing piece of writing. We have not “learned” anything about Covid in the past 12 months that we didn’t know in early April. All the Italian data was public, the articles back then already showed loss of smell and blue toes as symptoms, difficulty breathing, we knew back then 90% of deaths over well past retirement age, we knew the comorbidities, we knew back then kids were less affected than for influenza.
These endless narratives of “we didn’t know”, “we are still learning”, are historical revisionist and really annoying.
It is what you get from the me, me, me generations.
And the cover your —— working culture of generations.
Tragic, but that’s real life for you. Decisions on never before encountered issues have to be made in split seconds; PPE ordered in never before encountered quantities – while the whole world wants it and when most of it was made in China. There are never perfect emergency situations, never perfect strategies, never perfect solutions, never perfect people, never perfect premises. Healthcare delivery is tough enough in normal times.
But thank you Jane, both for doing the job and for bringing it to our attention.
I replied to a comment on here and mentioned our species by name. **** Sapiens. Unfortunately the word was censored ! ;- )
Welcome to UnHerd!
I wonder what happens to commentators from Scunthorpe?
Or Penistone?
Fewer people would have died if they hadn’t indulged in unhealthy behaviours. But to try to protect these people (and the old) we had to lock everyone up and crucify the economy.
We should never forget how many of our experts were more worried about “racism” than the virus in February 2020. And not in jest either.
Boris Johnson was unbothered by it in February. We wasted time which could have been used to prepare, and learn from the experience of Italy. He played truant from COBRA meetings deciding the British response to the pandemic, and adopted a casual approach in which the nonsense in his head overruled professional advice.
“I asked the A&E consultant if he had screened the man for any Covid symptoms and he laughed, admonishing me — semi-jokingly — for my “racism” against Italians.”
What the actual f—?
This is the first thing the consultant thinks of, even if he was joking?
Asking if you should screen someone for an infectious respiratory virus, who has just arrived from a region of the world where it was at an epidemic level is basic epidemiological common sense.
It’s the same virtue signalling b.s. employed by Italian and New York officials encouraging their citizens to hug Chinese people to show how anti-racist and virtuous they were that helped spread CV19 in Italy and New York.
“I was soon placed on a ward for patients deemed “not for escalation”, which meant that if they required ventilation on the high dependency unit (HDU) or intensive care (ICU) they wouldn’t get it. These patients were generally 60 or over, but often otherwise fit and healthy until Covid struck.”
Weren’t these also the very patients most at risk, and who the NHS was supposed to be prioritizing, or have I missed something? So instead they were what? just left to die? And you prioritised the younger patients less at risk?
If this is what happened across other NHS hospitals, no wonder the UK has such a high death rate. What was wrong with departmental consultants, for example, talking to the admin staff responsible for bed management and working out a better policy other than playing musical beds with infectious patients.
Didn’t any of the more senior staff understand that any viral infection usually takes a few days to develop symptoms, so getting staff with coughs or other early symptoms to continue working might not be a good idea? Where were they trained? Disneyland?
So staff knew they were seeding CV19 infection in care homes and never spoke up to object, and work out a better plan. Frankly, I’m not the least bit surprised. We knew early on that this was happening, although nothing official was said back then, only much later when it no longer mattered. I am appalled. Usual left hand not knowing what the right hand was doing. The NHS needed its collective a*** kicked, not “saved” or praised.
This piece makes most medical doctors look like a bunch of kids: group think denies facts, then admits them, then panic, get excited, (!) panic again, overract, underract etc. Then write a public missive blaming all the other kids (with suitable disculpame caveats). Its a good job its not that way in gas power stations or aircraft maintenance hangars when there are adverse unexpected events – otherwise there’d be a lot of dead people. I would think very seriously before hiring anyone with a UK medical /surgical background for any sort of employment, and i’d probably reject them.
When the NHS messes up there are a lot of dead people too, the difference is it doesn’t much matter in the public sector because no one loses their job.
Incompetence is promoted up.
There are more logical thinkers in the trades, who often were mentored by family, life-long.
A brave and useful article – thank you.
this layman’s fears are that the NHS is a great. lumbering beast far too unwieldy and top-down, hierarchical, staffed in its upper echelons by jobsworthies and rule-givers, unable to be flexible or to allow doctors at the coal face any independence of action whatsoever. The NHS’s great and enduring error is in its poor treatment of covid patients, in its lack of early prophylactic treatment and its relatively poor outcomes compared to other countries, its insistence on waiting until patients are very ill before treating them.
A candid, but rather sprawling, narrative of a (very) junior doctor’s experience. One thing stood out about the author’s mother developing symptoms: there was clear guidance on what a person with symptoms should do, and this did not involve a personal review by a doctor relative (no matter how understandable). As a consequence of her actions she placed more people at risk, and put additional strain on her colleagues during her subsequent absence. It should also be pointed out that most hospitals require a rota manager (or equivalent) be consulted about possible staff covid-exposure, and if the author was indeed uneasy with their consultant’s response (I infer an orthopaedic surgeon) they should have sought such a second opinion before going into work. Worth pointing out given the author’s evident predilection for criticising colleagues. No doubt a trying time to be newly qualified, but comparison to war is overblown, and junior doctors of this grade would have had senior support making the more difficult decisions. I am a little surprised this piece was published on UnHerd in this form. No editors? No more seasoned (physician) contributors? A more concise and less localised piece, focussing on the beginning of the second spike, would prove more compelling and more revealing of NHS shortcomings (given the near universal uncertainty a year ago) in my opinion.
I would love to see a full investigation into this crisis. BUT the aim should focus on ‘how do we do better next time around?’ NOT ‘whose fault was it?. Already fingers are pointing. The lack of PPE seems to be ‘the Governments fault’. Genuine question: is it not the responsibility of the NHS to source whatever supplies they require, and the governement’s job to oversee and write the cheques? Let’s get some clarity into that sort of question. Also, can we refrain from starting with the assumption that anyone working for the NHS is a saint, but acknowledge that they did the best they could under the circumstances. Also leave aside the automatic assumption that the NHS is under-funded. Instead ask the question ‘given the funding available, was it used efficiently? Was the management of the NHS efficient? If not, how could it be improved?
It might also be interesting to know how much of the steadily rising NHS budget is disappearing into the final salary pension schemes of health trust managers.
The vast majority of NHS and public sector spending goes into the salaries and pensions of such people. It is entirely evil.
According to the King’s Fund,
It seems incorrect, then, that “the vast majority” of NHS spending goes into their salaries. Most public sector pensions, including NHS are not funded, so no current expenditure goes into them. They are obligations passed on to future generations.
Current net public sector pension spending, that is, pension obligations accrued in the past, is around £20billion a year. Even if that was all NHS pensions, which is far from true, that would still be quite a small proportion of the NHS budget.
Many, many thanks for these figures ! – have been looking for this sort of information for ever !
Ditto for your NHS daily death stats comment.
“although this figure does not include many clinical managers.”
This would seem to make the 43,000 figure somewhat unreliable. (The figures are actually quite old as well and they do not appear to be figures from the NHS itself) You’d need the total number of managers in order to say that Fraser’s statement seemed incorrect. And wouldn’t failing to include ALL the managers allow the NHS to appear to have fewer bureaucrats than it actually does? The NHS is one of the world’s largest employers and yet its staffing levels of doctors and nurses actually lags that of other western nations.
The King’s Fund is a well-respected independent think tank, and they, and I, linked to the NHS website that gives the figures.
Actually, a fair amount goes into buying goods (drugs, equipment…) and services from outside. But since public services are in many cases people-intensive, what would you suggest? That there are fewer doctors and nurses, or that they be paid less?
And how does that apply to another part of the public sector, the armed services?
Hysterical comments such as “it is entirely evil” are revealing, but not in the way you probably intend.
Everything is about massively expensive, often dangerous drugs instead of the simple realities for health, nutrient rich food, fresh air, sunshine and human contact.
Actually the NHS refuses to pay for some drugs (available in other countries), due to their cost.
It truly is amazing that we are still using cloth masks. I suppose people want comfort, but there has been so much time to make better quality and comfortable N95 masks.
Dear God! I know the NHS has had for a long time a very poor record of infection control but the cavalier attitude of senior clinicians here is truly frightening and easily explains why we have had such a high death rate compared to countries like Germany.
If the train of events listed here was duplicated throughout I’m not sure the NHS will survive the coming public enquiry.
Lots of things explain why we have such a high death rate compared to Germany:
The German mortality rate for wave two was the highest in Europe. The overall mortality rate now for Germany (75,196 deaths out of 2,658,851 cases – 2.8%) is comparable to the UK (126,122 out of 4,291,271 – 2.9%) both now higher than Belgium (previously highest in wave one) 22650 out of 827,941 (2.7%).
This can partly be explained because Covid hit German geriatric homes in wave 2 and not in wave 1. Luck also passes in waves.
Germany also has crowded housing and certain populations are exempt from following the rules.
They do have an easier health care system, with walk in appointments if you arrive before 8:30 a.m.
Saying but for Boris is stupid. Merkel is not shaping their health care policy. I also think Germany got lucky in part, whether due to blood type or who vacationed where. India also got lucky.
The U.K. does not have a high rate of COVID deaths compared to Germany. The NHS does have problems, long-standing ones, of infection control and cavalier staff attitudes. The bigger the bureaucracy of any kind, the more you find such attitudes.
Tks for giving your personal account, warts and all. Your lack of accusation is especially notable. The system of management appears primarily at fault..The account of soldiers in WW1, wondering about equipment, officers, orders to go over the top seem readily comparable. Change in existing systems or management is next to impossible unless forced by great defeats.
How to build flexibility into existing public management sytems, to deal with new and unforseen circumstances needs to be a prime requirement of future public management policy.Private industry deals with new disrupters all the time, faced with the brute truth of adept or die. Some are successful some not. So solutions are possible but will never be popular.
I wonder if the equivalent of the Territorial Army could be considered for the medical/nursing/caring professions, although where the money would come from I don’t know. But surely better and cheaper overall than the devastation that has been wrought over the past year and will continue to do so well into the future. Having on hand a body of people who are required to keep up to date with medical practices for when they might be needed at any given time might avoid some of the problems we have experienced with the pandemic and equip us for future problems and, dare I say it, pandemics.
With regard to Covid being likened to flu, I’m not aware of medics and nurses having to wear highly intrusive top-to-tail PPE and ventilating hoods – as they were in Wuhan and elsewhere – when caring for patients with flu.
With regard to politicians and the medical profession not knowing what they were dealing with, as has been stated in this article and elsewhere, I am dumbfounded by these assertions. What was happening in Wuhan from the start of Covid was plain to see night after night on our TV screens, and as it moved across Europe towards us.
Moreover, on 31 January 2020, members of the Wuhan medical profession published and globally distributed a rapid response article to alert the world’s governments and health services about what they should do in caring for Covid patients, based on their own first-hand experiences. The article was published on the BMJ website on 4 February 2020. I know; I read it. It was in the public domain. It made for harrowing reading. It not only described the symptoms of Covid in great detail, it gave salient information about the kinds of clinical practices the medical and caring professions should follow; it advocated the amount and type of PPE required; and detailed the extremely in-depth hygiene protocols and cleaning regimes to be put into place.
So to keep reading and hearing that government and the health service didn’t know what they were dealing with is incredulous. Some might say disingenuous.
Patients could have been given high doses of vitamin D and C instead of lethal intubation. We now know that Ivermectin is an effective early treatment which avoids the need for hospitalisation.
I am a doctor, working outside the UK. I don’t like anonymous articles. I particularly don’t like anonymous doctors. We are trained to face responsibility for our words and actions. Mistakes have been made by every health system with COVID and we have been learning as we go along. “Dr. Jane Smith” should put his/her name to what he/she writes. Otherwise the article should not have been published.
Dr. Orla Halpenny
Good advice but in an age of fascist medicine, people have to be prepared to lose their jobs if they challenge the running narrative.
We live in an age of bad science and dangerous medicine because the theological dogmas which now underpin modern science and its cult-like creation, Allopathic medicine, are considered sacred and beyond questions. The dogma-driven system is the very opposite of good science and good medicine.
It takes someone very brave and financially independent, or nearing retirement, to take such risks.
The story is certainly brutal but suggests that the doctors are powerless against the system that is so opaque that the doctors haven’t had their office cleaned in 5 years and didn’t know and some mysterious unacceptable entity moves patients around wards seemingly in the middle of the night. Had COVID not exposed the insanity of these ways if working they’d still be going on now.
the story also looks to roll this blame to government, despite us all knowing that anytime government wants to change anything the nhs go nuts.
the nhs needs serious reform.
most of those things recounted should never happen even in normal times. The fact they do is shocking and scary.
I know a hospital that wanted an untrained cleaner, who had just been hired, to clean an operating theater. They sub out to companies that just want staff so they get paid. Hygiene is not the priority.
Wasn’t there a very similar article by “Jane Smith” in the past?
Plagiarism?
This article has the usual slant: blame the Government when the NHS mucks up ( by sending patients back into care homes, e.g., a PHE decision) but worship the NHS when things work out well.
The DHSC which is the Government (not NHS) published the guidelines on discharging patients on March 19th 2020 which instructed the NHS to discharge patients within an hour of identifying that the patient was well enough to be discharged with no requirement (or indeed testing capacity at that stage) to test. On April 15th 2020 the DHSC instructed the NHS to test patients before discharge.
Public Health England, which wasn’t responsible for these decisions, is a Government body and not NHS.
I’m afraid your comment was factually wrong on those counts – but don’t let that get in the way of your ‘slant’.
Whatever…NHS, PHE, govt, DHSC (whatever that is)…all useless, all unaccountable, all feeding at the trough.
No, people doing the best they can.
Apart from Boris, who took two fortnight-long holidays within the crucial two months before the pandemic struck, and missed five COBRA meetings to decide Britain’s strategy. But we shouldn’t criticise, because he was dealing with two much more important issues: (a) how to handle the PR on announcing that his mistress was pregnant (b) how to do that while his former wife was recovering from cancer.
An unaccountable bureaucracy indeed. No wonder so many Brits carry private insurance.
Shocking! Why would you put a CoVid negative patient on a CoVid ward
The article omits to mention that NHS beds have more than halved in recent times. Of course the system would be overwhelmed.
It’s not all that recent. The NHS is overwhelmed every year during flu season, there are bed shortages.
Fascinating inside explanation of why the British covid pandemic was so bad. The health management could not change the decision-making process when the context changed with the emergence of a new highly contagious disease.
Jane, I completely agree and I’m delighted that your article featured prominently in the Times today. I also am a frontline hospital worker and the initial lack of PPE and failure to reduce hospital crowding was terrifying. Thank God this was not an even more serious disease – something similar to polio or smallpox which killed 30% of victims including the very young. I too hope lessons have been learned for the next time.
I hope the pseudonym covers a real doctor. Agree with every line.
Will NHS errors ever come out in the inquest ?
Lots made of intensive care beds to population ratio in UK.
Fear footage from Italy shows beds tight packed. What is the floorspace allowed to beds in NHS compared to , say Italy ?
Grim reading. Thank you for your service.
Outside of the official press conferences, in readers’ fora, I read of people who were staying at home, going out for their jabs, and coming down with CV a couple of days later. The readers would say that the person must have already had it, but what about getting infections on the day of the vaccine injection, with long lines, enclosed air space, and workers who do not change their protective clothing between seeing members of the public? Add from here, infected personnel.
Basically people are expendable. No one wants to be the whistle blower, because they are in service to someone who is in service to politicians and pay masters. We are living in such a corrupt system, that we are just halfa notch and slipping to living in the whole world as Third World. People on top are safe, so everyone climbs on everyone else to be safe. My job is fine. My kids are in private school. My safety is fine…
She couldn’t call out, and her superiors won’t learn…Yet they need to protest. Politicians and press sit pretty until we call them out and demand better. But we don’t, but look after our own parents…This is our future. Our elites will be okay, so we take comfort in that, I suppose.
There are 290,000 registered physicians in Britain. I followed the link. 30 died of COVID (I wonder how many had comorbidities or were elderly). That is ~1/10,000. I wonder how that compares to other causes of death for physicians, who have a higher average age than the general population.
The retirement age in the NHS is 65, so probably not many working doctors are in the age groups most at risk. A paper from the US suggests that the death rate from occupational causes among healthcare workers is in the range 17-57 per million per year. If that applies to the UK, one might expect 5-15 deaths from all occupational causes.
Such shocking, astonishing incompetence. No discipline, no lateral thinking, no intelligence. The NHS is truly unfit for anything.
Edited to clarify; the above comment applies to the institution and those running it. The writer appears to be better suited to being in a leadership position than any of those who she was reporting to.
Dear ‘Jane’
I signed-up to be able to thank you for this – if you read the comments. Please go-on. I do not mean to judge things that I know little about, for the drivers will be legion. However, regarding the NHS with blind faith, as some in politics would wish us to, is a mistake and whistle-blowing outside the ‘proper channels’, is essential and quite possibly life-saving.
Very interesting article. We can only hope that the experience of all front line staff will be taken into account when the inevitable inquiry into our covid response takes place. And by “all front line staff” I do mean all, not just doctors. My friend’s 29 year old daughter, an NHS receptionist, had no PPE provided even when medical staff were being kitted out. She died in April 2020 of covid. Non-medical staff are often forgotten about.
Why did this doctor think that she would inevitably get Covid if exposed to it? Was this a common theory at the time? And surely this is not a common theory now?
Heré’s the problem with all this. 1. the so called SarsCov2 virus has never been found, 2. the PCR tests do not diagnose anything, 3. as a junior doctor googling for symptoms you should know better, 4. even if the ”tests” were diagnostic they do not detect an infection and the UK and world were using them so badly they would have found covid on a rock.
These little drama pieces are nice, but they are not based on a single provable fact. And of course Panorama just exposed the terrible con of the PPE which is still in warehouses unused because in reality no pandemic arrived. And forgotten is the age of the ”deaths” in Italy, The mean age early was 80 and that quickly rose to 85.
No need to read beyond this statement, which is false.
But everything else she writes is true.
Really? So you would take the position that
As I said before: no need to read beyond this statement, which is false.
edited…
The UK mean age of death is still infuriatingly around 82.4!
“Death, where is thy sting?”
I know of two people who have died from it. One in his thirties, one in her fifties.
And that’s assuming that everyone counted as a Covid death actually died of Covid. We have had people in the US counted as Covid deaths when they died in car accidents. There’s money in Covid.
I think that’s a fair assumption. The ONS figures are derived from death certificates, each of which is filled out by a medical professional giving the cause of death. It’s a criminal offence to deliberately issue an incorrect death certificate.
It is also worth noting that the number of Covid-assigned deaths agrees broadly with the number of excess deaths: not exactly, but well enough to suggest that the figures are reasonably reliable.
That is nonsense, The virus has been found and its genome sequenced. You can look it up yourself. The article describes a hospital rammed with people in varying degrees of sickness with Covid. This is confirmed by talking to many ICU colleagues, the situation is unprecedented. Currently Paris has almost no spare ICU beds. If you deny this is the case, then essentially you are part of a religious cult, without any scientific basis for your opinions. Incidentally, for your information, doctors use Google all the time to check all sorts of information.
Well said.
Yes, well said. But I’m afraid most contributors to Unherd are members of religious cults, whether it’s claiming hydroxychloroquine is effective despite trials showing it isn’t (the divine Trump claimed it was, so the cultists can’t accept scientific evidence to the contrary), claiming that there is no disease, no-one dies of it, vaccines don’t work, all you need is vitamin C and zinc, etc. 2000 years ago they would have had temples at different corners of town.
I think ‘thou doth protest too much’. HCQ has proved very effective as early and prophylactic use…with scientific evidence to back it up. Most of the trials designed to intentionally shoot down any alternative to vaccination were done as treatment of already hospitalised patients. nobody (not even Dear Donald) claimed it was a wonder cure. Also the Vit. D and C and Zinc etc is also merely prophylactic in assisting the immune system. other suggested alternatives like Ivermectin also have an effect. logically, as there are many everyday consumable substances that can kill viruses.
Also being wary of novel not-thoroughly tested vaccines isn’t being ‘anti-vaxxer’ or saying all ‘vaccines don’t work’, although admitted there are a few of those people about.
What we are seeing now is in fact a live challenge trial stage, normally seen after the phase three (which are due to finish in 2022/3), something entirely unprecedented in that there are millions of willing volunteers.
Good post. Political rage seems to preempt clear thinking these days.
Bravissimo ! and right on the button.