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‘Extraordinary omission’: key findings in scathing UK Covid report

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‘Extraordinary omission’: key findings in scathing UK Covid report

The joint report by the Commons health and science committees on lessons to be learned from the UK’s response to Covid spans 150 pages and is divided into six themes. Here are the main findings from each.

Planning for a pandemic

The section on preparedness draws on concerns highlighted as far back as May 2020 and finds that the UK was confident of the extent of its pandemic planning despite most of it being “too narrowly and inflexibly” based on the idea of a flu-type outbreak.

The planning did not properly consider asymptomatic transmission or take into account earlier outbreaks that failed to reach pandemic level, such as the Sars virus affecting east Asian countries in 2002-04, or the Mers virus first identified in the Middle East in 2012, the report found.

Detailing various government exercises about hypothetical pandemics, it said an “over-reliance on pandemic influenza as the most important infectious disease threat clearly had consequences – it meant that the emphasis of detailed preparations was for what turned out to be the wrong type of disease”.

Perhaps the most vivid piece of evidence in this section came from Dame Sally Davies, England’s former chief medical officer, who blamed what she called “groupthink”. The report quoted her as saying: “Our infectious disease experts really did not believe that Sars, or another Sars, would get from Asia to us. It is a form of British exceptionalism.”

Lockdowns and their timing

Among the most fractious debates in the response to coronavirus has been over the timing of England’s lockdowns, both when the first one was imposed in March 2020 and apparent delays in putting in place another in the autumn and winter of that year.

On the first lockdown, the report is clear and condemnatory: factors including a lack of testing capacity and doubts over whether British people would accept a lockdown prompted scientists and politicians to adopt a “policy approach of fatalism”, which would seek to manage but not suppress the extent of an outbreak. While this was not an active decision to seek so-called herd immunity, it amounted to this in effect, the report said.

Following what the committees called “simultaneous epiphanies” by ministers and advisers about the catastrophic effects of this approach, a UK-wide lockdown was finally announced on 23 March. The report said: “It is now clear that this was the wrong policy, and that it led to a higher initial death toll than would have resulted from a more emphatic early policy.”

It adds, more damningly still: “As a result, decisions on lockdowns and social distancing during the early weeks of the pandemic – and the advice that led to them – rank as one of the most important public health failures the United Kingdom has ever experienced.”

The report was, however, more equivocal on whether the ministers should have imposed a “circuit breaker” lockdown in England in late October 2020, saying the emergence of the more transmissible Alpha, or Kent, variant could have prevented this being effective anyway, and that a circuit breaker in Wales did not prevent a winter lockdown.

Test, trace and isolate

The report’s most consistent and vehement condemnation came in this section, beginning with what it described as a hugely serious failure to even try to copy the rapid rollout of mass testing in places like South Korea.

Public Health England claimed to have studied and then rejected the South Korean approach but could provide no evidence for this, the report said, adding: “We must conclude that no formal evaluation took place, which amounts to an extraordinary and negligent omission.”

This meant testing in everywhere but hospitals was halted, and so new cases or contacts could not be tracked. “As a result the UK squandered a leading position in diagnostics and converted it into one of permanent crisis … The consequences of this initial failure were profound … For a country with a world-class expertise in data analysis, to face the biggest health crisis in 100 years with virtually no data to analyse was an almost unimaginable setback.”

While testing capacity was later increased hugely, the report noted that government rhetoric was still often notably more impressive that the reality. “Ministers began by promising the test and trace system would be ‘world-beating’ in May 2020 when the truth was that it was that it was a laggard,” it said of the system, which had a budget of £37bn.

The report also castigated the low numbers of people who complied with self-isolation rules, citing a lack of financial support and the continued requirement to self-isolate for 10 days, long after tests were freely available to show they did not have the virus. As well as the impact this delay had on the economy and people’s lives, the report said, “by providing a powerful disincentive to take a Covid test and to disclose all contacts, it seems likely that it will have also caused more infections and cost lives”.

Social care

More than 39,000 care home residents died with coronavirus between 10 April 2020 and 31 March 2021, with the report finding that ministers and the NHS “both failed adequately to recognise the significant risks to the social care sector at the beginning of the pandemic”.

The committees concludes: “The UK was not alone in suffering significant loss of life in care homes, but the tragic scale of loss was among the worst in Europe and could have been mitigated.”

Some of these failures were specific to the pandemic, the report said, including the decision to focus on freeing up NHS capacity and thus release many patients into care homes without Covid tests, and problems with a lack of personal protective equipment. Others, such as a shortage of staff and funding difficulties, were “illustrative of a longstanding failure to afford social care the same attention as the NHS”.

Wider health inequalities

The report stressed that “the experience of the Covid pandemic underlines the need for an urgent and long-term strategy to tackle health inequalities”, a point highlighted by politicians and experts during the pandemic.

It noted the particularly high toll of Covid on people from minority ethnic backgrounds and on people with learning disabilities. It said: “It is telling that the first 10 NHS staff to die from Covid-19 were from black, Asian and minority ethnic (BAME) backgrounds, and evidence has since confirmed that the impact of Covid-19 on this section of the workforce has been significant.

“While the NHS has made progress in recent years, the experience of people from BAME groups during the pandemic has made it clear that inequalities persist.”

Vaccines

While the report gives recommendations on lessons to be learned from the development, procurement and distribution of vaccines, these were mainly based around other areas of government learning from it – particularly the flexibility and speed of the vaccines taskforce headed by Kate Bingham. The Covid vaccine programme overall, the report said, “has been one of the most successful and effective initiatives in the history of UK science and public administration”.

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Covid Vaccines Saved 20 Million Lives In First Year – Study

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Covid Vaccines Saved 20 Million Lives In First Year – Study

Covid vaccines prevented nearly 20 million deaths in the first year after they were introduced, according to the first large modelling study on the topic released Friday.

The study, published in The Lancet Infectious Diseases, is based on data from 185 countries and territories collected from December 8, 2020 to December 8, 2021.

It is the first attempt to estimate the number of deaths prevented directly and indirectly as a result of Covid-19 vaccinations.

It found that 19.8 million deaths were prevented out of a potential 31.4 million deaths that would have occurred if no vaccines were available.

It was a 63 percent reduction, the study found.

The study used official figures — or estimates when official data was not available — for deaths from Covid, as well as total excess deaths from each country.

Excess mortality is the difference between the total number of people who died from all causes and the number of deaths expected based on past data.

These analyses were compared with a hypothetical alternative scenario in which no vaccine was administered.

The model accounted for variation in vaccination rates across countries, as well as differences in vaccine effectiveness based on the types of vaccines known to have been primarily used in each country.

China was not included in the study because of its large population and strict containment measures, which would have skewed the results, it said.

The study found that high- and middle-income countries accounted for the largest number of deaths averted, 12.2 million out of 19.8 million, reflecting inequalities in access to vaccines worldwide.

Nearly 600,000 additional deaths could have been prevented if the World Health Organization’s (WHO) goal of vaccinating 40 percent of each country’s population by the end of 2021 had been met, it concluded.

“Millions of lives have probably been saved by making vaccines available to people around the world,” said lead study author Oliver Watson of Imperial College London.

“We could have done more,” he said.

Covid has officially killed more than 6.3 million people globally, according to the WHO.

But the organisation said last month the real number could be as high as 15 million when all direct and indirect causes are accounted for.

The figures are extremely sensitive due to how they reflect on the handling of the crisis by authorities around the world.

The virus is on the rise again in some places, including in Europe, which is seeing a warm-weather resurgence blamed in part on Omicron subvariants.

AFP

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WHO considers declaring monkeypox a global health emergency

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WHO considers declaring monkeypox a global health emergency

As the World Health Organization convenes its emergency committee Thursday to consider if the spiraling outbreak of monkeypox warrants being declared a global emergency, some experts say WHO’s decision to act only after the disease spilled into the West could entrench the grotesque inequities that arose between rich and poor countries during the coronavirus pandemic.

Declaring monkeypox to be a global emergency would mean the U.N. health agency considers the outbreak to be an “extraordinary event” and that the disease is at risk of spreading across even more borders. It would also give monkeypox the same distinction as the COVID-19 pandemic and the ongoing effort to eradicate polio.

Many scientists doubt any such declaration would help to curb the epidemic, since the developed countries recording the most recent cases are already moving quickly to shut it down.

Last week, WHO Director-General Tedros Adhanom Ghebreyesus described the recent monkeypox epidemic identified in more than 40 countries, mostly in Europe, as “unusual and concerning.” Monkeypox has sickened people for decades in central and west Africa, where one version of the disease kills up to 10% of people. In the epidemic beyond Africa so far, no deaths have been reported.

“If WHO was really worried about monkeypox spread, they could have convened their emergency committee years ago when it reemerged in Nigeria in 2017 and no one knew why we suddenly had hundreds of cases,” said Oyewale Tomori, a Nigerian virologist who sits on several WHO advisory groups. “It is a bit curious that WHO only called their experts when the disease showed up in white countries,” he said.

Until last month, monkeypox had not caused sizeable outbreaks beyond Africa. Scientists haven’t found any major genetic changes in the virus and a leading adviser to WHO said last month the surge of cases in Europe was likely tied to sexual activity among gay and bisexual men at two raves in Spain and Belgium.

To date, the U.S. Centers for Disease Control and Prevention has confirmed more than 3,300 cases of monkeypox in 42 countries where the virus hasn’t been typically seen. More than 80% of cases are in Europe. Meanwhile, Africa has already seen more than 1,400 cases this year, including 62 deaths.

David Fidler, a senior fellow in global health at the Council on Foreign Relations, said WHO’s newfound attention to monkeypox amid its spread beyond Africa could inadvertently worsen the divide between rich and poor countries seen during COVID-19.

“There may be legitimate reasons why WHO only raised the alarm when monkeypox spread to rich countries, but to poor countries, that looks like a double standard,” Fidler said. He said the global community was still struggling to ensure the world’s poor were vaccinated against the coronavirus and that it was unclear if Africans even wanted monkeypox vaccines, given competing priorities like malaria and HIV.

“Unless African governments specifically ask for vaccines, it might be a bit patronizing to send them because it’s in the West’s interest to stop monkeypox from being exported,” Fidler said.

WHO has also proposed creating a vaccine-sharing mechanism to help affected countries, which could see doses go to rich countries like Britain, which has the biggest monkeypox outbreak beyond Africa — and recently widened its use of vaccines.

To date, the vast majority of cases in Europe have been in men who are gay or bisexual, or other men who have sex with men, but scientists warn anyone in close contact with an infected person or their clothing or bedsheets is at risk of infection, regardless of their sexual orientation. People with monkeypox often experience symptoms like fever, body aches and a rash; most recover within weeks without needing medical care.

Even if WHO announces monkeypox is a global emergency, it’s unclear what impact that might have.

In January 2020, WHO declared that COVID-19 was an international emergency. But few countries took notice until March, when the organization described it as a pandemic, weeks after many other authorities did so. WHO was later slammed for its multiple missteps throughout the pandemic, which some experts said might be prompting a quicker monkeypox response.

“After COVID, WHO does not want to be the last to declare monkeypox an emergency,” said Amanda Glassman, executive vice president at the Center for Global Development. “This may not rise to the level of a COVID-like emergency, but it is still a public health emergency that needs to be addressed.”

Salim Abdool Karim, an epidemiologist and vice chancellor at the University of KwaZulu-Natal in South Africa, said WHO and others should be doing more to stop monkeypox in Africa and elsewhere, but wasn’t convinced that a global emergency declaration would help.

“There is this misplaced idea that Africa is this poor, helpless continent, when in fact, we do know how to deal with epidemics,” said Abdool Karim. He said that stopping the outbreak ultimately depends on things like surveillance, isolating patients and public education.

“Maybe they need vaccines in Europe to stop monkeypox, but here, we have been able to control it with very simple measures,” he said.

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NMA urges NCDC to step up fight against Monkeypox

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NMA urges NCDC to step up fight against Monkeypox

The Nigerian Medical Association (NMA) has urged the Nigeria Centre for Disease Control (NCDC) to step-up its efforts in educating and protecting Nigerians from the increasing cases of the ravaging Monkeypox disease.

It stressed that the Agency, which is saddled with the responsibility of disease prevention and control, must not lose sight of other infectious diseases like monkeypox, even as it focuses on COVID-19.

The doctors’ association, while urging Nigerians to adhere strictly to the preventive measures of personal hygiene, especially hand hygiene because like monkeypox, COVID-19 is still very much in the country, and the situation can become worse if not handled properly, implored religious institutions – churches and mosques – to take up the responsibility of sensitising their followers about the disease.

Recall that yesterday the NCDC announced that the country has recorded 21 confirmed cases of the Monkeypox disease in the last five (5) months, with one death. Also, in the month of May, a total six (6) new confirmed positive cases were reported from four (4) states – Bayelsa (2), Adamawa (2), Lagos (1), and Rivers (1).

Globally, according to reports from the World Health Organization (WHO), as of 26 May, there have been a cumulative total of 257 laboratory confirmed cases, with around 120 suspected cases reported, from 23 non-endemic countries. However, no deaths have been reported.

Speaking with The Nation, the newly elected President of the NMA, Dr Uche Ojinmah, said: “We have the Nigeria Centre for Disease Control (NCDC) that has the responsibility of not just monitoring and controlling COVID-19, but every infectious disease. Therefore, they should step up to the plate. It is the business of the NCDC; they can link up with the Ministry of Information and get people aware.

“They need to start giving us data on this Monkeypox as it happens across the country. With the current awareness coming from a reputable government institution like that, people will sit up. We need to start directing our calls to the appropriate institution, which is the NCDC. We don’t expect President Muhammadu Buhari to give us information on this. Let the NCDC step up to the plate and do their job.

“The Nigeria Centre for Disease Control needs to understand that it is not only COVID-19; it is important. It is however necessary to be combined in the sensitisation of the people. The media also have a role to play in sensitisation. The government needs to bring the will, but we all in our little ways can contribute.

“We have a bit of a problem in this country; we initiate measures, achieve a positive response, and we drop our guards. In 2015 when Ebola came, we took it on as a nation, and we got rid of it, and everybody went back to their normal lives. COVID-19 has come and with us, if you check even in flights now, you force people to wear their masks. Nigerians, therefore, need to be serious and the government needs to play a role.

“Monkeypox is here now and everybody pretends they don’t know – until it becomes a problem. I also expected that the government, civil society, and non- governmental organisations should have started spreading the message by now. Our churches and mosques should take up this course now that it has not become a disaster.

“Doctors should also start to educate patients they see that do not have it. We need to start now to prepare the minds of our people; it may not be as bad as Ebola or COVID-19, but it is still a problem. So, the earlier we start preventive measures, the better we will be.”

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