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Opinion

Like Scrooge, Boris Johnson needs to change his ways before it’s too late

Thousands more deaths could be prevented should the government embrace science, trust the public, give out consistent public health messages and lead by example, writes Dr John Puntis, co-chair of Keep Our NHS Public.

In Charles Dickens’s novel A Christmas Carol, it is the hideously shrouded ghost of Christmas yet to come that points out what the future has in store for Scrooge unless he seriously mends his ways.

As a result, Ebenezer is gloriously transformed, with benefit not just to himself, but to wider society. If any such visitor appeared to prime minister Johnson (cast in the role of Scrooge by his right wing critics for belated imposition of much needed Covid restrictions last Christmas) it would appear that he failed to heed the warnings.

As it now turns out, this may even have been because he was partying too hard.

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At that time, Covid related deaths had risen to 72,000 giving us one of the highest fatality rates in relation to population anywhere in the world.

Almost one year later we have reached the horrifying total of 170,000 deaths for which Covid-19 is given as a cause.

This is both remarkable and lamentable for a rich country with a proud history of public health. There are (despite those who claim Covid is all over) currently 7,500 patients in hospital and around 1,000 deaths each week.

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The spread like wildfire of the new variant Omicron is threatening not only to ruin Christmas for families, but to overwhelm an exhausted and depleted NHS and knock the economy off course once again.

Even Conservative Party ex-health minister Jeremy Hunt conceded after a review by parliamentary committees that the government record amounts to one of the most important public health failures in UK history.

It certainly did not have to be like this. Public health experts and scientists including some members of the government Scientific Advisory Group for Emergencies (SAGE) and the Independent-SAGE have been arguing consistently for a raft of interventions to tackle spread of infection (social distancing, face masks, ‘test, trace isolate, support’, working from home, greatly improved indoor ventilation) rather than promoting vaccination alone as a magic bullet.

Families of the bereaved have been pressing for a judicial inquiry since the summer of last year, precisely in order to learn lessons and do better. The government’s claim it was too busy saving lives is belied by the appallingly high death toll, the reorganisation of Public Health England in the midst of the crisis, and its reactionary legislative programme.

The prime minister took nearly 400 days to meet relatives face to face, and the chair of the inquiry (Baroness Hallett) has only just been announced. It is unlikely that any recommendations from an inquiry will be formulated and published for several years, when any practical relevance will be uncertain.

Anticipating this would be the case, a ‘People’s Covid Inquiry’ was held by the campaign group Keep Our NHS Public, with nine online sessions from February to June this year.

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This was a ‘citizens tribunal’ – part legal proceedings, part theatre, part publicly speaking ‘truth to power’ – aimed at raising issues to more visible levels than government or the media were prepared to do on their own. The panel was chaired by the renowned human rights barrister Michael Mansfield, ably assisted by barrister Lorna Hackett together with a panel of three medical experts. Evidence was taken from a range of international and national authorities, frontline and key workers, and the bereaved.

The final report of the Inquiry was published on its website and released to the press on December 1 this year. Key emergent themes included the devastating effect of austerity on the NHS and social care pre-pandemic, leaving both in a severely weakened state when challenged by coronavirus.

Instead of wrongly claiming that tried and tested World Health Organization public health strategies for containing infection did not apply to advanced countries like Britain, these should have been embraced from the start.

This would have included widespread testing, border controls and a ‘test, trace, isolate, support’ system grounded in local public health teams with the necessary pre-existing skills and knowledge. Lessons in putting prevention of community viral transmission at the centre of the response could have been learned from countries such as New Zealand and Viet Nam where successful interventions resulted in far fewer deaths and a reduced economic impact.

These issues are once again brought into sharp focus by the spread of Omicron – according to Jenny Harries, head of the UK Health Security Agency, the biggest threat of the Covid pandemic so far.

Dr John Puntis.

Booster vaccination is essential but takes time to implement and then translate into immunity, as well as potentially displacing important routine health care resulting in deferred consequences.

Further restrictions on people mixing are now essential but must be matched by government support for infected individuals allowing them to isolate (e.g. sick pay increased to the average European level), and to businesses facing potential collapse.

Crony contracting should be ended and proper investment made in NHS facilities and staff, and in social care. Vaccine roll out to less wealthy countries must be a priority in order to protect against future variants, and the UK government should stop blocking the waiver of intellectual property rights related to vaccine production technology.

The deep health inequalities heightened during Covid-19 must be addressed with focus on investment in health and social care and on the social determinants of health (housing, jobs, environment, poverty, etc).

The prime minister is in thrall to the hard right in his party who are happy to legislate to curtail the rights of migrants and citizens but find mask wearing aimed at limiting their freedom to infect others a step too far.

Rather than wasting time on the current Health and Care Bill that does nothing to address any of the pressing problems facing the NHS, the government needs to focus on one of its primary responsibilities – protecting the public.

It is too late for the many who have died, but thousands more deaths could be prevented if government were to embrace the science, trust the public and work in partnership, give out consistent, clear and honest public health messages and, most importantly, lead by example.

It may have lost the trust of the public, with some ministers currently open to criminal charges of misconduct in public office, but as Scrooge learned, it is never too late to admit your faults and change your ways. There is much still at stake.

John Puntis is co-chair Keep Our NHS Public

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