UK must prepare for second virus wave, health leaders warn

“To the relief of many in recent days we have witnessed the Prime Minister with jovial confidence and affability, announce that, ‘The long national hibernation is over’.  His hopefulness came however, with a note of due caution that this virus is still with us, is elusive and is still dangerous.  From one with lifelong experience at explaining a way out of tricky circumstances, this was indeed a joyous day for national celebration and not one for the doomsayers and pessimists.  Thanks to the staggeringly Herculean efforts of the government he said, only 65,000 people have died and it was now time for the survivors to get back to normal and start living again.  So solitary confinement is to be relaxed in England and we can be open for business again – but can we?

Not easily, says some expert opinion, expressed hot on the heels of the Prime Minister’s statement came dire warnings from the Royal Colleges of Surgeons, Physicians, GPs and Nursing.  The Presidents of these illustrious professional organisations and other NHS leaders responded with a cautionary open letter in the British Medical Journal to all the party leaders at Westminster warning quite simply that urgent action is needed to prevent a second wave of infection and further loss of life.

This body of opinion symbolises the views of those clinicians and managers staffing the so called ‘frontline’ and is thereby, not to be ignored.  These colleagues point to the almost predictable new outbreaks inflicting themselves on every country that has lifted restrictions stressing that while we deal with the end stages of the first pandemic, we need preparation for a possible second.  They acknowledge many positive protective mechanisms are beginning to be established.  Yet, these influential voices call for a rapid cross-party, four-nation review of preparedness not to dole out blame but to generate both scientific and public confidence in the measures to secure a safe ending of lockdown.  In March this year, we found ourselves indecisively vulnerable to this pandemic – as if tackling an avalanche with a bucket and spade – so this legitimate concern is that we do not find ourselves dithering back to square one.

This call on politicians to review national readiness is shrill and the authors call for an examination of governance and scrutiny at every level of government – national, regional and local – to improve transparency and public accountability.  Attention to procurement of vital equipment and services is needed they say along with a more robust communicable disease and public health infrastructure to test, trace and isolate.  They are rightly concerned that the disproportionate burden on black, Asian and minority individuals and communities be addressed and urge enhanced Pan-NHS resilience to shield other vulnerable people.  They also seek improved international collaboration to mitigate the hindrances to pandemic management caused by Brexit

So how significant are these warnings and what messages do they convey to the average person in the street?  Certainly, we are all fed up with lockdown, but the Prime Minister’s sanguinity at his joyful announcement was not nearly so readily endorsed by his Chief Scientist and Chief Medical Officer who looked and sounded guarded to say the least.  So, you may ask, how reliable is the science behind the key determinants for successfully easing lockdown?

Firstly, the reduction of restrictions is occurring at a time when the incidence of new cases is a concern, given that success is predicated largely on how effectively these can be identified and contained.  Fundamentally, how good is our track, trace and isolate system?  Well it isn’t very good because the R number is stubbornly at 0.8 and only one third of the 33,000 new cases this week are being successfully contained.  The Prime Minister had given assurance that this strategy would be ‘world class’ and will use an app to trace contacts in the way South Korea, Hong Kong and Germany have done so successfully.  Alas, this device will not be ready until winter and we are thus dependent on a system using an abacus, a slate and piece of chalk to manually trace contacts – and the all to important app has now been relegated by the Prime Minister to just ‘the icing on the cake’.

Secondly, social distancing advice is halved to one metre.  Not a problem if everyone knew what a metre is but to expect this to be maintained once town centre pubs open on a Saturday night is a tall order!

Thirdly, there is mask-wearing on which the advice is totally equivocal despite international evidence of their efficacy.  Taiwan issued every citizen with medical grade face masks at the inception of the epidemic, used an app for contact tracing, had a massive testing programme sustaining just seven deaths whereas we were told masks only work if you are a doctor or a nurse.

It is wonderful we are to urged by government to look on the bright side of life yet the effects of this tormentor are only half over so we might as well admit it.  The ‘numbers’ will thus be crucial as the restraints are lifted, but with the ending of daily briefings, repetitiously glib though they were, we still need the truth on what is happening, especially so because the risk analysis of the new measures is to flimsy?  Assuming we are not all mugs, it is surely time to now ask with the experts, whether those in government who seem not to know their ‘Rs’ from their ulna, will accept responsibility and act appropriately if everything does go belly up and rate of infections and deaths increase significantly?”