Offline: it’s time to ask questions and learn lessons
One year after the WHO assessment, on March 11, 2020, that its Public Health Emergency of International Concern (PHEIC) had evolved into a full-fledged coronavirus pandemic, what can we conclude? Many governments have decided not to conclude anything. They argue that it is still too early to learn any lessons. With more than 2.5 million deaths worldwide and 1 million more expected by June 1, this political hijacking is no longer sustainable. Indeed, it is unacceptable. As governments resist accountability, countries are seeing unofficial investigations spring up to fill the void. In the UK, Keep Our NHS Public held the first session on evidence from its People’s Covid investigation last week. Chaired by human rights lawyer Michael Mansfield, five witnesses testified. Jo Goodman’s father died on April 2, 2020. He received a letter from the government advising him to protect himself 9 days after his death. His daughter believes he was probably infected while sitting in a crowded hospital waiting room. The staff did not have personal protective equipment (PPE). Her experience led her to join others who had lost loved ones to create Covid-19 Bereaved Families for Justice UK, which called for an independent statutory public inquiry led by a judge. They have repeatedly requested to meet Prime Minister Boris Johnson. He repeatedly refused their requests.
The lessons of the pandemic are not difficult to discern, although they are politically impractical for governments concerned with keeping control of political discourse. Johnson hopes to regain some integrity through a demonstrably successful national immunization program. But, as Professor Sir Michael Marmot at Mansfield said, the UK’s poor performance had several possible explanations that warranted further investigation. First, there was a political class distracted by Brexit who refused to put welfare and fairness at the heart of their policies. Second, worsening socio-economic inequalities have made some groups particularly vulnerable to infection. Third, the long-standing disinvestment in the public sector has put the health system at risk, and in particular the public health system and social services. Finally, the poor health of the population meant that many communities were poorly protected against a dangerous new virus. Holly Turner, a nurse with learning disabilities, described how the care sector had been fatally weakened after years of neglect. Professor Gabriel Scally explained how the public health system had been “decimated” by a decade of austerity. And John Lister described how these policies put intolerable pressure on the National Health Service (NHS). The People’s Covid survey aims to learn lessons to rebuild the NHS. He will collect evidence until June.
The COVID-19 Genomics UK consortium has done more than any other organization to anatomize the severity of these first months of the pandemic. More than 1,000 separate import events have spread the virus across the country, first from China, then from Spain, France and Italy. More than 80% of virus imports took place between February 27 and March 30, 2020. The consortium concluded that to get ahead of the virus, “rapid or preventive interventions” were needed. The UK government had 4 crucial weeks after the WHO declaration of a USPPI to prepare – building testing capacity, securing national borders, providing PPE to frontline services, NHS preparedness, protection of nursing homes and knowledge sharing with other countries to ensure a coordinated comprehensive response. But the Johnson administration didn’t do much during those crucial few weeks. The paralysis of his government has allowed the country to be overwhelmed by the coronavirus. The COVID-19 Genomics UK Consortium found that the largest viral lineages were already in the country at the time of the first lockdown on March 23. Instead of acting decisively, the government erred with a heartwarming set of myths – that herd immunity would save us, that the flattening of the epidemic curve (“crush the sombrero” in Johnson’s words) would suffice, and that there had to be a trade-off between health and economics. Western governments, like Johnson’s, were too slow and too indecisive. They didn’t follow the science. They have shown erratic leadership. They were still reluctant to do what was necessary to drive the virus out of the communities. And they lost the trust of their audience. Saying forgiveness is necessary, but it is not enough. If democracy means anything, the ministers who have presided over this human catastrophe must be prepared to submit to independent scrutiny. And, if necessary, make way for more capable political leaders.
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