The first Lancet COVID-19 Commission Statement is 👉bit.ly/345MP7T Here are our 10 priority actions:
1. Track down the origins of the virus in an open, scientific, and unbiased way not influenced by geopolitical rivalries.
2. Continue to suppress the epidemic through a proven package of non-pharmaceutical interventions—and learn from countries in Asia-Pacific.
3. Base policies on scientific evidence and stop politicians from subverting that evidence.
4. Collect and publish timely and internationally consistent data on the state of the pandemic, including on the humanitarian and economic consequences.
5. Ensure universal access to tools to fight COVID-19—testing, medicines, and future vaccines.
6. Secure access to emergency financing from the IMF/WB for low and middle income countries.
7. Urgently put in place protections for vulnerable groups.
8. Prepare for a deep restructuring of global finances, including debt relief and new forms of international financing.
9. Economic recovery will be based on public investment in green, digital, and inclusive technologies.
10. We must support and strengthen multilateralism—UN institutions and the UN Charter—resisting any attempts at a new Cold War.
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Ten questions we need to answer now. 1. Despite having some of the most scientifically advanced societies in the world, why have most countries so abjectly failed to protect their peoples from the worst consequences of this pandemic?
2. How do international institutions hold national leaders accountable for their mostly failed responses to COVID-19?
3. What should countries do to prioritise the protection of vulnerable key populations from COVID-19—BAME, the poor, the excluded, the marginalised, those with chronic illness, and frontline workers, including in health?
My interpretation of Boris Johnson this evening: the pandemic of COVID-19 in the UK is much more serious than we have been led to believe. Johnson was unusually serious, fists clenched, no jokes about squashing sombreros.
The switch to “stay alert” is an act of appeasement to those in his party who don’t understand how serious this disease is (remember, Boris Johnson does). Be clear about what he said: we are Level 4 in his new alert system, and that’s after 7 weeks of lockdown. Not good at all.
He was clear that we are only just R<1. That gives us no headroom for error. The epidemic in care homes is definitely not under control and we are nowhere near ready for test, trace, isolate.
Contrary to those who believe “the time isn’t right”, it’s important to document the fatal mishandling of the SARS-CoV-2 pandemic by government. There is prima facie evidence of government misconduct. Look at the evidence.
On Jan 30, WHO declared a Public Health Emergency of International Concern, its highest level of alert. This should have been a wake-up call to every government in the world. What did Boris Johnson do?
The next day, Jan 31, Boris Johnson gave a speech announcing that the UK has now left the European Union. He spoke about “national renewal and change.” He did not mention WHO’s global warning of impending danger.
Today the UK Prime Minister returns to work. His first task is not to decide when to end the lockdown. Instead, it must be to manage public expectations about the length of lockdown. He needs to speak to the British people today.
Evidence from Wuhan showed that a 10-week lockdown worked to cut community transmission. That suggests the UK lockdown should last until June 1. This would give us time to ramp up testing, recruit the workforce to contact trace, and to produce real-time Ro (Rt) to guide lifting.
Also, look at Italy. Their lockdown began March 8-10. They are making minor adjustments on May 4 (8 weeks; take-outs from bars/restaurants). Museums/libraries open after 10 weeks. Dining in restaurants June 1 (12 weeks). Italy is following the Wuhan timeline.
Just for the record: the UK government is deliberately rewriting history in its ongoing COVID-19 disinformation campaign. My Jan 24 tweet called for caution in UK media reporting. It was followed by a series of tweets drawing attention to the dangers of this new disease.
On the same day, I tweeted a series on Lancet publications that emphasised the severity of COVID-19: human-to-human transmission, a critical illness requiring ICU admission, and a virus with “pandemic potential.” Read the article. What is happening now is all there.
On Jan 25, the next day, I drew attention to the issue of ICU capacity and asked why there was no discussion of this urgent clinical challenge.
NHS COVID-19 ALERT. It’s important to balance concern/alarm at government strategy/implementation with stories of success. I’d like to call out the “joint-operational protocols and management restructuring” at one north London hospital. Protecting staff/testing are priorities.
But the overall picture remains dismal. “Things on the front line are getting worse not better”, writes one consultant surgeon. “There is a huge mismatch about how the situation is presented publicly and the reality.”
Many examples exist of lack of full-face visors, goggles, FFP3 masks, and gowns. Coughing on an open ward is an AGP, yet no protection is offered. One nurse writes: “the situation is not good.” Staff are overstretched. They feel they are not working in a safe environment.