Here’s an early take on our two bumper select committee grillings over the last two weeks - Dominic Cummings and Matt Hancock. A thread...
There was more melodrama than normal but it is not possible to stack up the most sensational revelations without evidence. Today's new @Dominic2306 tweets show the PM's total frustration ('f***ing useless' etc.) but do not prove anyone 'lied.'
Personal accusations are of course the most media-friendly but should not expose the much more serious failures in the functioning of the state in a national emergency, including key revelations about both scientific advice/herd immunity and test and trace.
It’s clear ministers were only offered two extreme options - suppression (lockdowns) or mitigation (let the virus spread but protect the vulnerable). The East Asian middle way (close borders, hi tech test &trace) wasn’t modeled by SAGE until April when we were well into lockdown
Given that most East Asian countries had fewer lockdowns (in Korea's case no lockdowns) this was a serious failing in our structures, perhaps caused by a 'pandemic flu' mindset although to the credit of our scientists this did not extend to vaccine R & D.
This delay meant infections were > 2000 cases/day by the time T&T got going, much higher than in Asia which set it up to fail alongside other issues such as central rather than local contact tracing (which has now been sensibly reversed) & no blanket salary replacement guarantee.
I also think (I was part of this groupthink) we were over-focused on testing targets (100k, then 500k, then 1m/day) so didn't focus on the only metric that matters in a pandemic: proportion of potentially infectious isolating. At times 20-40% of those needed to isolate weren't…
Set against this must be our national vaccine triumph: not just in securing 400m doses before we knew they’d work, but a flawless NHS roll out. The paradox is that the biggest failures in the performance of the state will have to be balanced against its most stunning achievements
Our joint report will set out key lessons to be learned and I won't pre-empt. But for me two early lessons stand out: being as nimble, searching and pragmatic in our pandemic response as we were in our vaccine response is one...
It’s clear ministers were offered two extreme options - suppression (lockdowns) or mitigation (let the virus spread but protect the vulnerable). The East Asian way (close borders, hi tech test & trace) was not modeled by SAGE until April when we were well into lockdown.
Given that most East Asian countries had fewer lockdowns (in Korea's case no lockdowns) this was a serious failing in our structures, perhaps caused by a 'pandemic flu' mindset although to the credit of our scientists this did not extend to vaccine R & D.
This delay meant infections were > 2000 cases/day by the time T&T got going, much higher than in Asia, which set it up to fail, alongside central rather than local contact tracing (which has now been sensibly reversed) and not offering a blanket salary replacement guarantee.
I also think (I was part of this groupthink) that we were over-focused on testing targets (100k, then 500k, then 1m/day) so didn't focus on the one metric that matters in a pandemic: proportion of potentially infectious isolating. At times 20-40% of those meant to isolate weren't
Set against this must be our national vaccine triumph: not just securing 400m doses before we knew they’d work, but a flawless NHS roll. So the paradox is that the biggest failures in the performance of the state have to be balanced against some of its most stunning achievements.
Our joint report will set out key lessons to be learned and I won't pre-empt. But for me two early lessons stand out: being as nimble, searching and pragmatic in our pandemic response as we were in our vaccine response is one...
...and much earlier transparency on the scientific advice being given to ministers is the other, so we allow more peer-review and quicker course correction.
The public inquiry will have the last word, but realistically it will take at least two years to report. I hope our joint recommendations will give the govt some ideas to implement much earlier than that. Watch this space….
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Big news for the NHS that Sir Simon Stevens is stepping down. A thread...
When we recruited for a successor to Sir David Nicholson in 2013, there was a good deal of trepidation about the role following controversy over the 2012 Act. Simon, however, was the standout candidate and hiring him remains one of the best decisions I have ever taken.
Despite his time as a special adviser in No 10 and in the private sector in the US, SImon has always been NHS to his core. But neither he nor I knew just how bumpy things would become with immense operational and financial pressures across the NHS and social care system.
Hospital acquired COVID-19 remains a major problem as it STILL accounts for 15% of COVID hospital patients: assets.publishing.service.gov.uk/government/upl… It remains the biggest undiscussed problem in the pandemic to date: a thread.
It was even worse: a paper by PHE and LSHTM for SAGE in January stated that 20-25% of infections in hospital patients in the first wave were hospital acquired: assets.publishing.service.gov.uk/government/upl…
Upper estimates of this data suggest that around 36,000 cases in the first wave were caught this way which could mean 8,000 deaths related to hospital acquired COVID occurred in that wave: dailymail.co.uk/news/article-9…
Deeply disappointed to hear UK govt is halving aid to Yemen. Timing is inexplicable with the UN warning only last week that Yemen faces the worst famine the world has seen for decades. In their words it is ‘falling off a cliff’. Thread...
In their appeal for MORE funding, the UN cited aid cuts from other countries last year which cut 4 million people off from food aid, who are now ‘in the long, slow, brutal, painful, agonizing process of starving to death’. washingtonpost.com/world/middle_e…
UNICEF say 2 million children are acutely malnourished and over 368,000 children under 5 are suffering from severe acute malnutrition. 1.7million children are internally displaced. Only 1 in 3 people have access to running water. unicef.org.uk/donate/yemen/
Why lockdown isn’t working fast enough and what we should do next: a thread..... Not just borders and monitoring new strains, but time to fix the biggest flaw in our current strategy, namely that three quarters of those with symptoms do not self-isolate.
6.3 million have had their first jab, infections are down 22% (7 day avg) & hospital patients 4% below Jan 18 peak. So why should we be cautious? hsj.co.uk/coronavirus/25…
The answer is uncertainty over new strains: whilst vaccine seems to work as well against UK/Kent strain, this may not be the case with the S African strain (already here) and the Brazilian strains (one of which is already here but not yet the Manaus one): reuters.com/article/uk-hea…
Time to act: thread on why we need to close schools, borders, and ban all household mixing RIGHT AWAY.
To those arguing winter is always like this in the NHS: you are wrong. I faced four serious winter crises as Health Sec and the situation now is off-the-scale worse than any of those.
It’s true that we often had to cancel elective care in Jan to protect emergency care but that too is under severe pressure with record trolley waits for the very sickest patients
As soon as the government officially moves us to the ‘delay’ stage, it is effectively confirming that an epidemic IS coming. So on the basis of the information we currently have, what's the outlook?
Yesterday was the first day confirmed new cases in the UK exceeded those in China (67 in the UK vs 40 in China). Last week Chris Whitty told the select committee he saw ‘no reason in theory why the UK would go higher than China.’ So how bad did it get in China?
Chris Whitty used a figure of 20% of population in Wuhan province when he came in front of the select committee, but says those with symptoms are likely to be 5% or less. WHO figures are lower - only 0.1% of population - but there is likely to be significant under-reporting.