Nope, I’m going to wait for an Independent Inquiry (if there will ever be one) before spending time reading this kind of thing!
Instead, I’m going to produce my own report. Clearly, I’m going to be completely balanced and unbiased (errrrrrrrr!), or at least I’ll base my observations on my own honest experience of the pandemic. Your own experience may be different to mine, but that’s okay, I’m writing the blog so it’s my opinion that matters (other than ECIC’s opinion, obviously!)
I’m going to split my report into 3 sections, the Good, the Bad and the Ugly (or what went well, what didn’t go so well, and what was downright dreadful!).
So, let’s start on a positive note:
The Good
- Initial listening to infection control teams – as panic gripped the country and hospitals, one group of staff kept their heads and started to give the common-sense advice they are well known for… the infection control teams. Even though Covid-19 was a new disease, infection control teams around the country started to apply respiratory precautions, recommend personal protective equipment and patient isolation practices to limit the spread within hospitals of SARS CoV2 (or 2019-nCoV as it was first described back in February 2020). Rather than throw their hands in the air and say “I don’t know” they started to tackle the problem head on and that was great; unsung heroes just getting the job done!
- Rapid roll out of testing for SARS CoV2 – locally the response to the Covid-19 pandemic involved a lot of people coming together to work out how to deliver a PCR test for SARS CoV2 within 24 hours of admission to hospital. Okay, I know there were problems along the way and things didn’t always go smoothly, but locally laboratory staff bent over backwards, worked loads of additional hours, and pushed out all the stops in order to get a decent hospital service up and running. Being able to test quickly meant we could rapidly move patients within the hospital to the correct area and reduce the spread of SARS CoV2 to other patients. It was a herculean effort and a job well done!
- Vaccination program – okay, this is actually in the Parliamentary report, but the speed and efficiency with which the various Covid-19 vaccines were moved from pharmaceutical companies into people’s arms was nothing short of breath-taking. The local vaccination centres were brilliant from what I could see. Having been down to Aldershot to have mine, I couldn’t help but be impressed. I turned up in a grump (unusual for me, I know…) expecting to have to stand in line whilst people ran about like headless chickens… I couldn’t have been more wrong. I was straight in, checked and jabbed before I could even say “Covid-19”. I then spent longer sitting in my car having been told to wait 15 minutes until I could leave! A really great service and a credit to themselves… well done! (ECIC says Crookham Memorial Hall in Fleet, were just as efficient and really cheery in the process)
Okay, so that’s my three good highlights. Now onto the not so good:
The Bad
- Building Nightingale hospitals – this might be a bit controversial but was spending £530 million on these units really good value for money? The simple answer is no, but let me explain. In order to have a 4,000 bed Nightingale hospital you would need at least 16,000 staff members… but where were they going to find 16,000 members of staff who weren’t already working in acute Trusts? The NHS went into the pandemic with 100,000 vacancies for goodness sake! The problem was not bed capacity, it never is; it is a lack of staff! Not only did building these units pull expertise out of the acute Trusts trying to deal with sick patients but they were never going to be able to function because there were no people to look after the patients. In the end only 51 patients were treated at the London Nightingale Hospital… what a colossal waste of time, money and resource… but it made politicians look good when they walked around it saying, “if China can do it so can we!”
- Overuse of antibacterials – I wouldn’t be a Microbiologist if I didn’t get this in somewhere. Less than 1% of patients with Covid-19 admitted to hospital have a secondary bacterial pneumonia. Despite this, across the UK 60-70% of Covid-19 patients received an antibacterial drug… why?! I think in the early days this was mainly to help the doctors feel like they were doing something, because before we had the evidence to support the use of steroids, we had nothing! When the dust settles from Covid-19 I do wonder what the global antibiotic resistance rates are going to be. How much worse are we going to have made the problem with all of the unnecessary antibacterials that have been thrown at this virus?
- Poor use of quarantine – I have used the term quarantine rather than saying we should have closed international borders and severely limited domestic and international travel because I don’t mean this in a Nationalistic way. Stopping people moving within and between countries would have dramatically reduced the spread of SARS CoV2 globally. Countries like the UK wouldn’t have imported lots of cases and then spread them around within our own borders, and we wouldn’t have then exported new variants to other countries to cause chaos around the globe. To me this was irresponsible… I appreciate there might have been economic reasons for keeping borders open but I’m a Doctor and for me keeping people (both in the UK and overseas) safe and healthy is the priority.
And finally, the things that personally really irritated me. I can accept that mistakes and bad decisions were made but these things were completely unnecessary:
The Ugly
- Science by press release and pre-peer review publication – I’ve put these two together because they essentially did the same thing. Press releases, media sound bites and poor-quality publications lead to many false leads in the control of Covid-19 and sometimes actually caused harm. From Donald Trump spouting rubbish about hydroxychloroquine, to pangolins or research labs in China being the source of Covid-19, to the results of clinical trials being released without proper scientific scrutiny. All of these have damaged the confidence of people in the proper scientific studies and even lead to deaths as people self-treat with random chemicals. In 2020 there were an estimated 100-200,000 pre-peer review papers about Covid-19 released onto the Internet, of which only a quarter have apparently been published (many after corrections)… there is an awful lot “stuff” out there and much has even been cited in National policies without ever going through a peer review process! Let’s hope this trend is reversed after Covid-19 settles down and we can start to trust the literature a bit more again.
- Panic buying – Okay, this one annoyed me because of its inherent selfishness. (ECIC you are included… buying frozen turkey in October!!! …I guess she only ordered one!) How many toilet rolls do people really need?! We have seen this madness again last week with people panic buying petrol because of fears of shortages. I suspect this was one of the most depressing things for staff in the NHS to see going on, whilst we were trying to look after sick people. I can still remember the videos of NHS staff crying because they had not been able to get any shopping after working double shifts because people who should have been staying at home had been out and ransacked the supermarket shelves.
- Failing to understand the basics of infection control that could help protect the most vulnerable – again this is a possibly controversial one, but I found it really frustrating to see a minority of people on the news complaining that no one was telling them what to do to prevent the spread of SARS CoV2 to vulnerable people. Since being a small child, I have been taught about the basics of hygiene; wash your hands, blow your nose into a tissue, stay at home when you’re sick and don’t kiss Grandma when you are ill. I know this might sound a bit facetious but ultimately THIS IS the basis of good infection control; lockdowns, PPE and vaccines all help BUT only if underpinned with good basic infection control, and that message never seemed to get broadcast LOUD AND CLEAR!
So, there you have it. My own report into the good, bad and ugly of the response to Covid-19. There is no science to back it up, no peer-review (except all of you good folks) and no Jeremy Hunt (thankfully!).
But what do you think? In particular what have been your good experiences of the pandemic? After all it’s been bad enough so perhaps it is now time to concentrate on the good bits…