From the systemic failure of PPE over Covid-19, to bringing in the army, Freemasons, neolibralism and the government decisions that have undermined public health, where did February go? Health Matters editors are not sure, and apologise for the lack of NHS stories, but News from Nowhere’s moles have made good use of March’s imposed reflexion.
A hospital chief executive is reported by the HSJ as saying: “We are preserving ventilation capacity by ensuring that only those who may survive are considered”. It is good to know that interventions that are unlikely to help are not offered, and disconcerting to know that ventilation may be part of the flurry of pointless activities that so often make our deaths theatrical – ‘everything possible was done’. Advance care plans (remember them?) should contain the option for us to decline ventilation, say NfN moles, just as we may decline resuscitation.
Bringing in the Army
If, at the end of the Covid-19 pandemic’s first wave, there is a public inquiry into the handling of the coronavirus threat, the provision of personal protective equipment (PPE) to front-line staff is likely to be high on its agenda. The sight of the Health Secretary loading boxes into a van shows what a shambles NHS supply has become. The Health Care Supply Association has admitted to a “system” failure (without naming names or pointing fingers). According to the HSJ some trusts have turned to alternative suppliers to source protective kit, including DIY shops. Staff working in central purchasing teams report particular difficulties in getting hold of PPE, including a lack of UK-based manufacturers, other countries restricting exports in order to meet their local demand, poor quality products arriving as buyers work in a hurry, and some unjustified price rises introduced by suppliers. In some places protective kit is being delivered to the NHS by army lorries. Time for the NHS to grow its own PPE manufacturers, say NfN moles.
A welcome gesture
At the organisation’s dinners Freemasons traditionally toast ‘absent Brethren’ to remember those who are unable to attend their meetings in person. The 200,000 strong organisation adapted the usual toast, and invited everyone to toast ‘absent friends, and those working on the frontline in the NHS’, at 9pm on the 23rd of March.
News from Nowhere’s moles know little about Freemasonry, and nothing about its relationship to the NHS, but given their enforced staycation, they were able to do some research. Freemasonry in England and Wales contributed more than £48m to charity in 2019 and Freemasons annually give 18 million hours of their time towards unpaid voluntary work in their communities. They also own and operate the RMBI, (Royal Masonic Benevolent Institution) which has 33 nursing homes for both Freemasons and non-Freemasons. Freemasons also make donations across the country to local air ambulances, blood bikes and also provide a number of emergency response vehicles for the NHS. The Freemasons’ Fund for Surgical Research was created as a registered charity in 1967 and since then more than £5.4 million has been given in grants to the Surgeons’ College. The funds are sufficient to support four or five Fellows each year, who are members of the College, and publicly acknowledged as supported by the Fund. Now we know.
Coronavirus: mass testing part 1
A simple mechanism of testing for COVID-19, follow-up of contacts of those who test positive (‘contact tracing’), and testing them, has the potential to control the virus. So why did our government abandon testing and contact tracing, without an explanation? Could it be because the success of testing and contact tracing relies on the speed and efficacy with which suspect contacts can be identified and screened, and that is labour-intensive? Public Health has not only been transferred to local government, but has had substantial cuts in its budget over the last decade. We may be living through a period of reduced social and economic activity which will harm the least affluent, brought about by the use of a second-best option for mitigating (not controlling) the effects of COVID-19, in a country whose governments have undermined public health.
Sources: Keeling et al. The Efficacy of Contact Tracing for the Containment of the 2019 Novel Coronavirus (COVID-19) and Allyson Pollock, Socialist Health Association 23rd March 2020
Coronavirus: mass testing part 2
Sanjeev Silva, an ENT consultant & Nick Morris, a consultant obstetrician, have come up with a protocol for mass population testing to establish who is not infected (the ‘vulnerable’), who is infected (the contagious), and who is immune to any further infection.
In their view all NHS frontline staff (approximately 500,000) should be tested immediately with a quick screening test. Those staff who screen positive can then be tested with a more accurate but slower-to-analyse test, which can be used to categorise them as positive and therefore infectious, or negative and immune. Silva and Morris argue that this efficient and effective (but expensive) protocol will protect the NHS. It will allow staff to work and will prevent infected staff from remaining at work and infecting other staff and vulnerable patients.
Testing centres can be set up as drive-throughs and/or as a postal service, to avoid Covid-19 virus spread within groups. Several tests may need to be made on the same person over time – particularly those ‘not infected – to monitor for any changes in status and to react accordingly. NHS staff will need to be tested weekly until immune, so it will cost.
Source: available to Health Matters’ readers on request
‘We are seeing the materialisation of a new geography of risk which mirrors the dystopias portrayed in films like Blade Runner: Exclusion zones, evacuation zones, ‘red’ lock down zones, so many lines drawn in shifting sands. Public places are suddenly depopulated, ghost neighbourhoods and even whole cities are patrolled by zombies in space suits. The familiar rhythms of everyday life are disrupted or rendered strange. The urban uncanny rules OK.’
Read more News from Nowhere and articles on the NHS in ERA 3 at http://www.healthmatters.org.uk/