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.

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?

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.

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?

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.

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.

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.”

NHS COVID-19 ALERT. The latest news from the frontline. PPE is arriving, but without visors or gowns for aerosol generating procedures (AGP). Confusion over what is/is not an AGP. “Seeing COVID patients with no gown or goggles.” “Our Trust pretends there isn’t a problem and we are made to feel hysterical if we suggest it’s not safe.” “The contamination of arms, clothes, and other non-covered parts must be a key driver in UK hospitals. Pandemic will be driven by hospital infection.”

“There is a huge staffing crisis” with “no contingency plan.” There is no stand-down of elective procedure planning. Staff who have symptoms of COVID-19 are refused tests. At one teaching hospital: “We have been let down by a lack of testing and containment and naive behaviour.” Don’t forget dentistry. Dental health workers are fiercely critical of the Chief Dental Officer and General Dental Council for failing to give meaningful precautionary advice.

NHS COVID-19 ALERT UPDATE. Here is an example of PPE that has expired and with new expiry stickers covering old dates. The complete failure of NHS leadership to plan adequately for this outbreak during the past 8 weeks is a “scandal” of extraordinary proportions. It is “brutal on the ground.” I am being sent pictures of NHS workers wearing thin plastic aprons, surgical masks, and wrist length gloves. This is not PPE. Because of complete lack of leadership, health workers are trying to devise their own plans.

NHS COVID-19 UPDATE ALERT. There has now been “a marked change in urgency.” More staff are receiving training. But often without any PPE. There is still zero access to PPE for too many health workers, despite the words of Deputy CMO. She has been badly/wrongly briefed. Even worse, it is now clear that NHS PPE falls well below WHO/ECDC standards. No gown and inadequate masks and eye protection. Health workers need proper droplet and contact precautions. The PPE being provided won’t give sufficient protection. That means NHS staff are at risk.