We started the week with the notification that Boris Johnson failed to hand over his mobile Covid WhatsApp messages before the 4pm Monday inquiry deadline. We’ve had Brexit and poor lines of communication, but now we have a new excuse to add to the list – Boris can’t switch on his old phone.
First up on Monday was Dr. Class Kirchelle, who was “instructed by the Inquiry to address the following matters: the history of public health bodies in England, Wales, Scotland and Northern Ireland”.
Yet again, the problem with the inquiry is the lack of focus. Instead of asking what public health interventions are evidence-based and not implemented, the inquiry discusses irrelevant topics, such as the increase in laboratories in 1965.
Medicine has moved on significantly, and the focus on public health misses out that the detection and mangement of respiratory agents is the bread and butter of primary care. Interpretation, therefore, requires an understanding of how the health system works, how medicine has evolved and the nature of respiratory illnesses. Oh, and also maybe some evidence. If you also want to know about public health, we also think you should have gone to the horse’s mouth and called up those public health officials who have some skin in the game and could have given a real-world experience of the changes and how these changed the situation on the ground.
Professor Sir Michael McBride, Northern Ireland’s Chief Medical Officer, also provided more ammo for the B-word excuse:
I think — well, it’s absolutely correct to say that that work wasn’t finished, for the reasons that you’ve outlined, both at a U.K. and at a Northern Ireland level because resources were diverted to EU exit planning.
Even Lady Hallett is now in agreement with the Brexit effect.
LADY HALLETT: “Were pressures on the PHA exacerbated by uncertainty about regulatory arrangements pending the exit from the European Union?”
Sir Michael’s Answer. “No immediate examples come to mind. There is no doubt, however, that their capacity was deflected, as everybody’s was, in terms of trying to plan and prepare for EU exit; but I can’t think of specific examples in response to that.”
LADY HALLETT: Well, I think everybody’s agreed there was an impact.
The argument is that everyone was distracted, it was Brexit that did it, and because of austerity everyone was underfunded, particularly public health. However, the question in the room should be if you weren’t distracted, had sufficient funds and had a phone that worked, what would you have done differently to be prepared?
Up Tuesday was Baroness Arlene Foster, the ex-First Minister of Northern Ireland. We couldn’t help but notice that a new excuse reared its head – the acronyms did it.
Question. “There is also quite a diffuse structure and a split between planning bodies, such as the elements of the Executive Office, the Department of Health and so on, and pandemic preparedness groups, and what are known as EPGs and SPGs, the response groups, the emergency preparedness groups and strategic co-ordination groups. To what extent were you aware of the quite broad and diffuse nature of this structure when you were First Minister, or of the fact that there were these structural divides between the various entities in the Northern Irish Government?”
Answer. “I would have been aware, my Lady, of the different structures and responsibilities between the Public Health Agency and the Department. However, I would not have been aware of the very many different groupings that there were to advise the Minister in relation to all of the different threats that may come towards Northern Ireland. I found it difficult actually sometimes to follow all the acronyms that were in the papers that were furnished to me, so I wasn’t aware of all of those, no.”
OMG, if the first minister didn’t understand the acronyms being used, then – IMO – why didn’t she ask for them to be removed? Stop LOL!
We sympathise, however, as we’re still trying to decipher the wiring diagram presented by Counsel in week two: so far, we have enlisted graphologists, Egyptologists, escapists, modellers, diviners and codebreakers from GCHQ, to no avail.
Arlene was also aware that, at times, her officials only had observer status in some critical decision-making venues. However, nothing was done about this at the time.
Question. “Just lastly, on this topic, did you know that the Senior Medical Officer for Northern Ireland only had observer status, with no speaking rights at the Joint Committee on Vaccination and Immunisation, and that Northern Ireland only had observer status at the Advisory Committee on Dangerous Pathogens meetings, the ACDP?”
Answer. “I think I became aware of that on reading the evidence before I came to this hearing.”
So if the SMO was an observer in a crisis, what exactly do they do if they have a point to make? Throw paper aeroplanes?
On Thursday, Johnson’s excuse became more farcical as he proclaimed he couldn’t remember his passcode. The need to have a record of who said what and when is central to the functioning of Government.
It was also the turn of Dr. Richard Horton, editor of the Lancet, who shed more crocodile tears.
It documents our astonishment about the changed pathogenicity of coronaviruses, so that they’re now targeting humans, and it warns the world community that it needs to understand these, this category of viruses, develop better diagnostics, better treatments, vaccines, and really put coronaviruses on the map as a serious human threat.
Now, that was in 2004. We have MERS in 2012 and ongoing, and, with hindsight, we clearly did not elevate the threat – despite being warned clearly about the threat, did not elevate that threat into our National Risk Register.
Sorry, mate, it won’t wash, see here and watch the date stamp.
It is a remarkable statement – that the Government was “warned clearly about the threat” – from someone who published some of the worst industry-sponsored influenza vaccine and antiviral trials (we’re still waiting for the protocol).
The Lancet was one of the main vehicles of the propagation of box thinking, with influenza as the only kid on the block.
In 2005, Horton wrote in the Lancet:
It is almost universally acknowledged that another influenza pandemic is inevitable. Intervals between pandemics have varied from 11 to 42 years with no clear pattern, but since the most recent pandemic was 37 years ago in 1968, the upper limit of past experience is being fast approached.
Not a jot about coronavirus or any of the other hundreds of respiratory viral agents or their subtypes. So we are now heading towards another enlarged set of box thinking: influenza and coronaviridae.
The Lancet held a conference in Singapore in 2006 of the world’s experts in influenza “to allow them to prepare for the next influenza pandemic, and to identify gaps in pandemic preparations.”
The retrospectoscope is a powerful instrument. The re-writing of history is only possible because so few are prepared to study the past. It might help if the Editor in Chief – on occasion – read his own journal.
In 2009, when Tom wrote ‘Mistaken identity: seasonal influenza versus influenza-like illness’ for the now defunct Clinical Evidence, he was not invited to contribute further because of the fixed narrative of the time. In this, he made the same points as in the relevant TTE posts, but some people’s arrogance is only surpassed by their ignorance.
Finally, Mr. Gove, in his evidence, contradicted the previous witness statements that identified Brexit as the cause of the disastrous decisions made by the Government during the Covid pandemic. Gove tells us it’s the opposite – Brexit was a lifesaver.
We came extremely close, within hours, of running out of medicines for intensive care during the pandemic, it wasn’t widely reported at the time, and I think the only reason that we didn’t run out is because of the work that Steve Oldfield and his team did, which they did during 2019, in preparation for a no-deal Brexit, but became extremely useful in saving lives during the pandemic.
Will we ever be able to get a straight story? We doubt it. Dr. Horton remarked on the “changed pathogenicity” of coronavirus:
This is a global report, but commissioned by the U.S. Institute of Medicine. It documents our astonishment about the changed pathogenicity of coronaviruses, so that they’re now targeting humans, and it warns the world community that it needs to understand these, this category of viruses, develop better diagnostics, better treatments, vaccines, and really put coronaviruses on the map as a serious human threat.
But we have documented the absence of a universal and credible definition of a Covid case, the use of 14 different definitions of deaths and that up to 40% of hospital admissions for Covid were, in fact, in people admitted for other reasons who tested positive eight or more days after going into hospital. So what is Horton talking about?
There’s an odd list of invitees for module one: a mix of politicians, advisers and the odd journal editor. There’s a week to go, and we’re none the wiser as we continue to rely on folks’ opinions, crocodile tears and furious backpedalling. Can anyone yet point to what we should have done to better prepare?
Dr. Carl Heneghan is the Oxford Professor of Evidence Based Medicine and Dr. Tom Jefferson is an epidemiologist based in Rome who works with Professor Heneghan on the Cochrane Collaboration. This article was first published on their Substack, Trust The Evidence, which you can subscribe to here.
Stop Press: Kevin Bardosh in UnHerd says that as the first module of the Hallett Inquiry – on resilience and preparedness – comes to an end, we’re still no closer to understanding whether the lockdown policy was sensible or not.