‘Devon is closed’: Council calls for tougher penalties for lockdown flouters

At last we hear from Leader of DCC, John Hart – Owl (and Owl makes no apology for pointing out that the speed of Covid-19 transmission exposes those who make the wrong call and even those who make a late call in a matter of days, it doesn’t wait until you have moved on. These are not normal times, Covid-19 is unforgiving).

Leader John Hart said he was planning to meet the bosses and chief executives of all Devon’s district councils to discuss co-ordinated enforcement action against holiday providers who continue to take bookings.

The authority this afternoon (Wednesday) issued an all-party message for visitors to ‘stay away from the South West’ ahead of the Easter weekend.

East Devon Reporter  eastdevonnews.co.uk

County council bosses want tougher penalties for people flouting coronavirus lockdown rules – after telling holidaymakers and second home owners: “Devon is closed.” 

The authority this afternoon (Wednesday) issued an all-party message for visitors to ‘stay away from the South West’ ahead of the Easter weekend.

Leader John Hart said he was planning to meet the bosses and chief executives of all Devon’s district councils to discuss co-ordinated enforcement action against holiday providers who continue to take bookings.

“As we head to Easter, we want to send a very clear message to holidaymakers and second home owners,” said Mr Hart.

“Devon and the South West are closed. We will welcome you with open arms when this is all over, but right now please stay away.

“We currently have low coronavirus infection rates in the South West, but, if you come here, you stand a chance of bringing it with you and we do not want it under any circumstances.

“We want the message to go out loud and clear and we want our MPs to stop those organisations which are still advertising holidays here.”

Labour leader Rob Hannaford added: “It’s highly damaging and irresponsible for people to be coming to the South West to holiday accommodation or second homes and we want more police spot checks on our borders.

“We have a lot of elderly people here who are most susceptible. We are at the bottom of the regional tables for coronavirus infection and we want it to stay that way.”

Liberal Democrat leader Alan Connett said: “We want people to come here when this is all over but for now the message is clear: stay home and stay safe.”

Independent group leader Frank Biederman added: “We need the Government to introduce huge fines for people who flout the regulations and we really need to emphasise that we are closed. The NHS can’t care for visitors as well as our own residents.

“The vast majority of our tourism businesses are closed and are taking a big financial hit for the benefit of the community but we need to crack down on those who refuse to do so.”

Arrests made after M5 caravan convoy crash

Three people have been arrested following a crash involving a convoy of caravans on the M5 into Devon and Cornwall this afternoon.

Howard Lloyd  www.devonlive.com

The incident, near Tiverton, sparked two miles of queuing traffic at around 1.30pm – mainly HGVs delivering goods in the South West.

Two lanes were blocked and a dog was loose.

An eyewitness described the moment a caravan lost control and crashed into a lorry before a dog inside escaped into oncoming traffic.

Paul Martin, a builder from Taunton, was just outside Tiverton in his van following what he described as a ‘convoy of caravans’ which he believed to be travellers heading towards Exeter.

He claims one of the caravans collided with a lorry before hitting the central reservation – an accident which saw two of the lanes closed off.

“They were very lucky to escape with their lives,” Paul said. “It could have been so much worse.

“I was following one of the caravans – I think they were travellers heading towards Exeter – and one of them was behind a Toolstation lorry.

“It pulled out to overtake but hit the side of the lorry.

“When that happened, it split the caravan open and a dog bounded out. I managed to catch the dog and put him back in the car.

“The dog then managed to escape again and ran onto the other carriageway into oncoming traffic but I managed to catch it again.

“It could have been a lot worse. If they had gone over the central reservation when they crashed or someone had swerved to avoid the dog on the other carriageway, it could have been really nasty.”

Devon and Cornwall Police have since confirmed that three people have been arrested and are in custody.

“We attended a RTC on the M5 Southbound at 13:37. 3 people have been arrested for various offences and are being held in Exeter custody.

“Two stolen vehicles also seized,” the force said.

Paul spent about 25 minutes at the scene blocking off two of the lanes with his van to ensure no traffic hit the damaged vehicles.

He said there was not much traffic on the motorway due to the ongoing travel restrictions caused by the coronavirus pandemic.

The incident sparked a furious reaction, with people angry that caravans were being allowed to travel on the motorway without being stopped.

 

Cliff fall blocks beach between Branscombe and Sidmouth

A massive cliff fall has blocked the beach between Branscombe and Weston Mouth, east of Sidmouth. 

Before you rush off to look at it, Owl should remind everyone how Devon and Cornwall Police expect people to behave during lockdown regarding travel and exercise.

The latest statement from the force said: “In light of recent guidance issued by the National Police Chiefs Council (NPCC) and College of Policing, Devon & Cornwall Police is not changing advice on travelling.

Cornwall Live reported yesterday how the NPCC issued new guidance saying that people can drive a reasonable distance for exercise during the coronavirus lockdown period.

However, Devon and Cornwall Police has released a statement stating that it will not be changing advice on travelling despite what the NPCC and College of Policing said.

It also stated that travelling to a beauty spot [for example] to surf is “not within the spirit of what we are trying to achieve”.

“Government advice remains the same, and it is expressly to prevent the spread of coronavirus, to save lives, and to protect the NHS. It includes the following:

  • Only go outside for essential food, health reasons or work (but only if you cannot work from home)
  • If you go out, stay 2 metres (6ft) away from other people at all times
  • Do not meet others, even friends or family. You can spread the virus even if you don’t have symptoms.

“There has been much discussion around what the legislation does and doesn’t specifically prohibit. The legal aspects of the legislation are based upon whether a person’s actions are reasonable or not. Officers will continue to make individual judgements based on the specific circumstances presented to them.

Chris Carson  www.midweekherald.co.uk

Beer Coastguard rescue unit is warning people that there are ‘huge rocks’ on the slope that could fall ‘at any time’.

Their advice to coastal walkers is not to go near the landslide.

A spokesman for the team said: “Please keep away from this area – both the clifftop and the beach.”

A spokesman for East Devon District Council said the area was not under its control but was owned by the National Trust.

No one from the National Trust was currently available to comment

 

Breaking News, Coronavirus: East Devon MP hears concerns over PPE for medical centre staff

The MP for East Devon, Simon Jupp, is to look into shortages of personal protective equipment (PPE) at local doctors’ surgeries during the coronavirus crisis.

Philippa Davies www.sidmouthherald.co.uk

Concerns were raised at Sidmouth Chamber of Commerce’s monthly breakfast meeting on Wednesday, April 8, which was held online with Mr Jupp as a guest.

A member of the chamber said she had spoken to a nurse at a local medical centre, who thought their PPE would run out next week.

Mr Jupp said: “I will raise it specifically with the county council and East Devon District Council, and raise it with the NHS locally as well, to see what can be done.

“This has been raised with me about other doctors’ surgeries, and unless people tell me I don’t know, so I will raise that specific case as I have with other doctors’ surgeries locally.”

He was also asked whether a temporary Nightingale hospital is being set up at Westpoint, near Exeter, to treat Covid-19 patients.

He said: “It’s something being looked at as cases progress.

“I know at the moment our hospitals across the county, including the RD&E, are coping relatively well with the Covid-19 patients.

“I can report that the levels of PPE available in our hospitals for the frontline NHS staff in our part of the county is pretty good, with another supply due today according to the sources I’ve had, and I do speak to the NHS on a regular basis on that.

“I know there are plans in progress for (a Nightingale hospital) if we get to that stage where it’s obvious that our hospitals, and that includes our community hospitals too, can’t cope with the level of cases.

“This is something we are keeping a watching brief on, and this is something that is being led by the CCG and Devon County Council and the local resilience forum.”

He said everything possible is being done to make sure frontline NHS staff have the equipment they need, to the extent of getting the army involved.

“I was told, as an MP, to warn constituents that if you see a tank going down the road don’t be too concerned, it could be delivering PPE.

“Genuinely, every single Government department is doing its utmost to get supplies to the right places at the right time.”

 

Why the coronavirus tests you’ve never heard of hold the key to exit from lockdown

“At the Centre for Applied Microbiology and Research, housed within the high security Defence Science and Technology Laboratory at Porton Down near Salisbury, scientists are pouring over 800 blood samples taken from a representative sample of the English population.”

“They are conducting tests today which, more than any others you may have read about, will decide the shape and timing of Britain’s coronavirus exit strategy. Perhaps, just perhaps, they will provide the key to the door that is lockdown.”

By Paul Nuki, Global Health Security Editor and Sarah Newey, Global Health Security Reoirter www.telegraph.co.uk

If the tests work, and virologists are confident they will, they will provide Britain with the answers to the most important unknowns about Covid-19: How many of us have already had the virus? How common are asymptomatic carriers? And how much immunity, if any, do we acquire after surviving an infection?

The answers to these questions are what virtually every government the world over is rushing to unearth. They are the gold dust of the pandemic. They will inform not just exit through a much more precise modelling of the pandemic’s trajectory, but the best approach to treatments and vaccines.

Little wonder then that this – the “fourth pillar” of the government’s testing strategy – is being conducted behind the high security fences of Porton Down.

“This sort of study is absolutely vital because we are so uncertain about the level of infection in the population”, said Mark Woolhouse Professor of Infectious Disease Epidemiology at the University of Edinburgh. “As things stand we could be out by a factor or 10 or even 100. If work like this gives us even a rough pointer initially it would be hugely valuable”.

While some elements of the British response have been slow, the work at Porton Down is understood to have been underway since January. Moreover, it plays to our skill set as a nation, based as it is on high-end science rather than the more mundane – but crucially important business – of high volume throughput or production.

Experts say the first two months were spent validating high tech “assays” for reliably identifying coronavirus antibodies and designing a robust longitudinal blood sampling study. The first 800 blood samples were delivered to the laboritary in late February.

“We are expanding this programme during April so that we have the potential to test around 5,000 samples per week”, said the Department of Health and Social Care. “We will also roll out a national mass population sample over the coming months… the aim is to enrol 16,000 to 20,000 people who will undergo repeat testing”.

Attention has been focused on swab tests for the virus and cheap home antibody tests to tell people if they have already been infected. While the swab tests are reasonably precise, the home antibody testing kits are currently woefully inaccurate.

In contrast, the antibody tests or “assays” being run at Porton Down are said to be excellent. “The tools are there. The expertise is there. You can be quite confident PHE at Porton Down has access to sensitive assays that can accurately determine antibody levels in patients’ blood,” said Zania Stamataki, a senior lecturer in viral immunology at the University of Birmingham. 

Dr Stamataki added that it was these Porton Down assays that the commercial antibody tests which the government has taken options on are being validated against.

The initial aim of the work at Porton Down is to establish how widely the virus has spread. Current models assume the spread to date is fairly modest, at around three to four per cent of the population. If the modelers had a more precise grip on this crucial variable they would be able to predict the course of the epidemic with much greater certainty.

“Data in the coming weeks will enable estimation… with greater precision,” the team at Imperial College London, whose work underpins the UK’s lockdown strategy, admit in a report dated March 30. 

Prof David Heymann, infectious diseases expert at the London School of Hygiene and Tropical Medicine, added: “Community surveys will provide us with idea of the level of people infected and that is very important to inform the modelling. Modelers use best possible data at the time they do the modelling, but this changes rapidly.” 

Just as a political pollster can take a small but representative sample of the population to establish voting intentions with some accuracy, the scientists at Porton Down hope to pin down a figure for the spread of the virus from the initial 800 blood samples they are currently studying. This will be improved on as they test more blood samples over time.

The study will also provide data on the vexed question of how many people with Covid-19 experience no symptoms or symptoms so mild they carry on as normal and (perhaps) unwittingly spread the disease to others. This again is vital information for those devising Britain’s exit strategy. Current estimates for non-symptomatic carriers vary hugely.

“Blood antibody tests themselves will not tell you about symptoms but if you have gathered detailed clinical information from those you are taking blood from it should do”, said Prof Woolhouse.

Karol Sikora, professor of medicine at the University of Buckingham and former director of the WHO, added: “In studies on cruise ships and small countries, where they’ve tested just about everyone, some 50 per cent of people infected have no symptoms whatsoever, not even a sore throat or cough. 

“That number could mean 20 to 30 per cent of the population have been infected in the UK, which would have huge implications for our strategy – especially around herd immunity and NHS capacity. That information really is vital.”

Last, and perhaps most important, the work at Porton Down will – over the course of six months to a year – show whether or not the antibodies produced as a result of contracting Covid-19 give protection against the virus, and how long that protection lasts. Currently, science is completely in the dark about this, the single most important question of all.

“The hypothesis is that the existence of antibodies means you will have some protection but this is not necessarily the case,” said Dr Stamataki. “We do know that antibodies from some existing coronavirus can last for a year or more. But this is a novel virus and it is possible both that its antibodies are not protective or that they don’t last.”

The Porton Down research will establish this by means of a longitudinal study whereby the participants would have their blood checked for antibodies regularly over time to see how long they last. Animal studies will be run consecutively to test their protective potency.  

“One can’t overstate the importance of establishing the strength of any immunity”, said Dr Stamataki. “Even if it lasts for just a year it would give many of us the chance to return to normality.”

The work at Porton Down puts into perspective the trouble governments around the world are having with home antibody tests. Even if these tests prove accurate they are next to useless unless it is known that the antibodies they test for provide protection.

The work at Porton Down should, within months, start to answer that vital question.   

 

Coronavirus is creating a hole at the heart of government 

“Not Boris Johnson, surely. Not that most bouncy and irrepressible of men, who always seemed the definition of a lucky general. While we know this virus does not discriminate, there is still something faintly surreal about the idea of the prime minister lying in intensive care, his own body now a battlefield for the virus that has come to define his fledgling premiership.”

Gaby Hinsliff  www.theguardian.com

Once in a generation – and only then if it’s unlucky – a nation finds itself living through events so dramatic they almost defy belief.

Not Boris Johnson, surely. Not that most bouncy and irrepressible of men, who always seemed the definition of a lucky general. While we know this virus does not discriminate, there is still something faintly surreal about the idea of the prime minister lying in intensive care, his own body now a battlefield for the virus that has come to define his fledgling premiership.

Don’t underestimate how many ordinary people will be shaken by the sight of a 55-year-old laid low like this, despite the best care the NHS has to offer. So many lives have already been touched by this virus in ways we could never have imagined three months ago and now, by a terrible irony, the man responsible for leading us through it is one of them.

Whose heart does not go out out to a heavily pregnant Carrie Symonds, weeks away from giving birth to their baby? The wider Johnson family, too, deserve to feel supported in their distress, like any other family waiting for news from hospital. Yet beyond this private and very understandable distress lies a grave new political reality. Just as the epidemic nears its dangerous peak, a hole is emerging at the heart of government.

It no longer feels like a coincidence that the Queen was finally deployed on Sunday night, just as Johnson was heading for hospital. Her address to the nation was a gentle reminder that in Britain power does not rest solely in one place, yet in practice there is only so much she can do to steady a ship now heading for constitutionally uncharted waters.

Dominic Raab, the foreign secretary, has been asked to deputise for Johnson, yet that official language conceals a very grey area. Unlike America, Britain has no designated survivor to step up in an emergency. Constitutionally speaking, there is no such thing as an acting prime minister either; there are only prime ministers, who serve until they lose an election, resign or die, and in their absence power devolves to the cabinet as a whole.

Raab’s new status is essentially a means of preventing the chain of command from becoming confused or mired in internecine cabinet rivalries, although it remains to be seen whether he really has the authority to knock his colleagues’ heads together. (Those who wonder why it’s him in charge rather than the Cabinet Office minister, Michael Gove, now self-isolating after a family member showed coronavirus symptoms, perhaps miss the point that Johnson was nominating not a successor but a caretaker.)

For now, the opposition seems willing to give all this the benefit of the doubt. Illness transforms the prime minister in the public mind, to the extent that it would seem grotesque for Labour to use this moment for political advantage. Nor can Keir Starmer do anything that might be interpreted as pressuring a sick man back to work; we’ll never know whether Johnson would have got this ill if he’d rested the minute he was diagnosed, but a culture in which politicians don’t feel able to take sick leave even on their hospital beds is in no sense a healthy one.

Yet it remains the opposition’s job to hold government accountable for management of this epidemic, and if Johnson’s absence turns out to be prolonged, questions will eventually have to be asked about the democratic basis on which his chosen substitutes continue to govern.

The cruelty of this situation is that it pits the human imperative to be kind, to make allowances for awful circumstances, against the remorseless political imperatives of a crisis in which many more lives are at stake.

For there are life-changing judgment calls to be made over the coming weeks, as Downing Street grapples not only with clinical questions about when and how to lift the lockdown, but with an economic crisis unfolding alongside it at pace. It no longer seems credible that we will simply pick up where we left off pre-virus, and huge decisions loom about how to restart a hollowed-out economy and how the bills now being racked up will be repaid. With all due respect to Raab, there is only so far a stand-in can go in taking decisions which will determine what kind of society emerges from this.

What exacerbates the problem is that the country didn’t just vote for a Conservative government last December, or even for a slate of policies. It voted, perhaps more than usual, given the degree of switching across party lines, for one man and one idea. Johnson embodies not so much an ideology as a mood, a feeling, a sense of what Britain could be that was inextricably bound up with (but not wholly limited to) Brexit.

Whether his brand of breezy confidence suits the management of an epidemic is not, perhaps, a question to be asked over his hospital bed. But it’s hard to see anyone else in government occupying quite the place he did in the public imagination, should his absence extend for more than a few weeks.

Clearly it’s to be hoped the prime minister makes a swift and full recovery. But nobody bounces straight back from intensive care into 18-hour days at the office, which suggests at best he will need time to convalesce. Downing Street may need to start preparing the public soon for the possibility of a long, slow road back to normality.

Power instinctively fears a vacuum, because of the risk that it will fill with panic. The suspicion at Westminster for days now has been that No 10 was playing down the seriousness of the prime minister’s illness in order to keep the nation calm, a suspicion only reinforced by a curiously strained Monday night press conference in which Raab insisted the boss was still overseeing things from his hospital bed while admitting that he hadn’t actually spoken to him since Saturday.

Within hours, it emerged that the prime minister was in fact heading to intensive care. Sudden deterioration is an emerging hallmark of coronavirus cases, so it is not impossible that his office was as taken aback as anyone else by this decline. But from here on in, candour is essential.

These are extraordinary times, which means voters may well accept extraordinary solutions for a while to allow the prime minister a chance to heal. But we cannot live for ever in a state of democratic ambiguity, and if the road to recovery proves longer or harder than expected, there may come a time when Johnson faces a very personal choice between the job he has craved all his life and the national interest. Downing Street cannot be alone in hoping it doesn’t come to that.

Plight of care homes must not be forgotten

“These are frightening times to be in a care home. It’s incredibly hard not only for the elderly residents, deemed to be at high risk and fearful for their lives, but for their carers too, struggling away while the focus has been on the hospitals.”

Followers of East Devon Watch will be too well aware of how a frightening situation has been turned into unimaginable horror for the residents, and their relatives, of Budleigh Shandford Care Home being closed by Abbeyfield. Under lockdown there can be no contact with loved ones.

Alice Thomson www.thetimes.co.uk

These are frightening times to be in a care home. It’s incredibly hard not only for the elderly residents, deemed to be at high risk and fearful for their lives, but for their carers too, struggling away while the focus has been on the hospitals. Of all the key workers battling through this pandemic, residential carers are in a particularly vulnerable position. Low-paid, often young and inexperienced, or immigrants far from loved ones, they are expected to fight on the forgotten front line with little help or medical equipment and to act as angels when they could become harbingers of death.

There are more than 400,000 elderly in residential homes across the country. Everyone applauds the doctors, nurses, emergency staff, teachers and shelf-stackers but the care workers are too easily shunted to the side and neglected.

Many work long hours on zero-hours contracts as “unskilled” workers, helping the elderly to eat, go to the toilet, bath, brush their hair, cut their toenails, or in the case of those with dementia or Alzheimer’s, encouraging them to connect in small ways with life. The workload is exhausting, turnover is rapid and vacancies were already running at 20 per cent. The pay differential between care workers with less than one year’s experience and those with more than 20 is 15p an hour so they aren’t rewarded for acquired skills. In fact, they are often castigated for being uncaring when the majority are empathetic and selfless.

Both my parents are in care homes where the carers have made huge efforts to make the residents feel as comfortable as possible, reassuring them as they nervously self-isolate in their rooms, feeding them as nutritiously as they can from limited supplies and singing with them. For my father, who has dementia, it’s a struggle not to be able to roam the corridors or countryside.

Carers always worry about the welfare of their beloved residents: now, last in the line for testing, they know they could bring devastation to their workplace if they pick up the virus. Or they could catch it while holding the hand of a dying patient, who may be desolate without their family, or in the case of those with dementia, horribly disorientated.

Sixteen residents at a care home in Glasgow died in just over a week after a suspected outbreak of coronavirus. The patients at the Burlington Court care home were not tested for Covid-19 because they were not admitted to hospital; two staff members are also undergoing treatment. It must be horrific to attempt to provide some dignity to the final moments of so many at once, acting as surrogate family to the dying, while also worrying whether you might bring the virus back to your partner or children.

Sam Monaghan, chief executive of MHA, the UK’s largest charity provider of care for older people, said: “NHS staff are used to dealing with a high volume of end-of-life care; social care staff who develop close personal relationships with residents over months and years are not.”

Care staff have often been the last to receive personal protective equipment (PPE) despite dealing with serious cases. Meanwhile managers are worried that residents and families are being nudged to sign Do Not Resuscitate order forms. Many have been told informally not to call an ambulance for those over 75 or expect them to be admitted to hospital, although NHS England says there is no national guidance.

Rachel Beckett, chairwoman of Wellburn, which has 14 homes across the northeast, says: “With no guidance, financial or moral support, we know for now we’re in this on our own. Our carers, who are overworked, stressed and being pushed to the limit, both physically and mentally, aren’t part of the wider story.” Agency workers have been called in but they could become super-spreaders as they move between homes. So managers are appealing for volunteers to sign up to a national care force while staff self-isolate or recuperate from symptoms.

In Europe, the devastation wrought by the virus has caused a care scandal. France’s retirement homes, shuttered from the world, have reported multiple cases of double-digit death tolls. In Spain, military units had to be dispatched to disinfect care homes after staff fled. Twenty-three people were found dead in a Madrid residence.

There are ways to ameliorate care homes’ plight. In Belgium, families of elderly coronavirus patients have started legal action to ensure their relatives get places for intensive care treatment but the majority of frail octogenarians in Britain would probably be horrified to take the place of a young person on a ventilator. As the 86-year-old Joan Bakewell says in an interview in The Times today: “If I was the oldest by far and a younger person needed a ventilator, I wouldn’t be fighting for my life over theirs.”

However, dying residents could perhaps say goodbye to families if there was more protective equipment and staff must be provided with PPE, and be fast-tracked for testing. Volunteers should sign up to help at nationalcareforce.co.uk and grandchildren can write letters and paint pictures. Arts charities are already performing outside windows.

Above all, when this is over, the government must recognise that it is futile to separate social care from the NHS — they operate in conjunction. Care staff need to be better paid and residential homes should never again be seen as an afterthought. We seem to think of ourselves as a nation that doesn’t care about the old but the coronavirus has shown us how much we do.

 

Thousands more vulnerable Britons to be told to shield themselves for 12 weeks

Thousands of vulnerable Britons at high risk from coronavirus have not yet been told they should be staying indoors for 12 weeks, it has emerged.

With the peak of the virus thought to be several days away, officials have admitted that there have been “mixed messages” about which people should be “shielding”.

Shaun Lintern Health Correspondent www.independent.co.uk 

Vulnerable people may have been inadvertently putting themselves at higher risk because they are unaware that they should be staying home.

Last month the government announced that it would contact 1.5 million people to tell them that they should be shielding. GPs were then asked to find out more information on other patients they were aware of who needed to follow similar advice.

But in some cases, GPs have been unable to add people to the existing list of those who are entitled to receive food deliveries and urgent supplies during their 12-week isolation.

A letter from deputy chief medical officer Dr Jenny Harries – who has been alongside ministers in daily press conferences from Downing Street – and Dr Nikki Kanani, NHS England’s primary care director, admitted there had been “mixed messages”, telling doctors to “disregard” previous advice as fresh attempts were to be made to identify those at risk.

Alison Thomas, whose 95-year-old mother Else Catchpole is blind, deaf, takes medication for heart failure and suffers bouts of breathlessness, criticised the delays and said people were being left at risk.

Ms Catchpole, who lives in Cambridge, relies on her daughter for care eight hours a day and is unable to leave the house or even prepare her own food and drink.

“I went on the government website and it said she does not fit the criteria. I went to her GP and asked him to add her. He called me and said he totally agreed with me and said he had a long list of people but they had been told they weren’t allowed to add anyone and to wait,” said Ms Thomas.

She worries she could bring the virus into her mother’s house and fears what could happen if she becomes sick herself. She said: “I am angry and frustrated. It seems completely chaotic. I think there could be millions who have been missed.”

A GP in the northwest told The Independent: “We are being told to wait until the centralised lists have been done then we will be told when we can do our searches and add people. Apparently there has been some problems with the coding used for searches and also the wording in the letter sent out.

“We’re getting lots of patients asking why they haven’t received their shielding letter yet. And some asking why they have received one.”

The government introduced the shielding policy on 21 March for 1.5m people thought to be “extremely clinically vulnerable” to the virus.

Asked about the issue at the daily No 10 press conference, chief medical officer Chris Whitty said there were around 16 million people who were aged over 70 and have pre-existing health conditions who he said should be following government advice on isolation.

He added: “There is this particularly vulnerable group, around 1.5 million … who we are very keen to have the absolute minimum contact possible for quite a long period of time.”

He said most had been contacted or would be as a second wave of letters was sent out this week.

“There will be people who go in to the shielding programme who were not initially identified,” he said.

In their letter to GPs sent on Friday last week, Dr Harries and Dr Kanani said: “We know that there have been mixed messages about this patient group.”

They said most patients at highest risk had been identified and written to, but added: “This week we expect more people to be identified as we are validating the centrally held list against general practice data. People identified through this process will be sent a letter in the post and these will also be flagged in your GP system.”

GPs were asked to identify patients they believed should be included, but the letter said: “We are aware that there have been other sources of guidance asking you to identify and contact large numbers of extra patients. We ask you to disregard this.”

The letter said details of patients who had self-identified as vulnerable would be sent to GPs this week, adding: “We ask that you review this list and consider if any of them should be included in the highest clinical risk group. Please send a letter to any you consider to be at highest clinical risk and add a flag to their record.”

Hospital specialists are also working to identify patients they consider to be at risk.

Professor Martin Marshall, chair of the Royal College of GPs, said: “A priority for GPs is to ensure our most vulnerable patients are kept as safe as possible during the pandemic and official advice is that ‘shielding’ is the best way to do this.

“If a patient thinks they meet the criteria to be in the highest risk group and should be shielding but hasn’t received notification, or adversely, if someone has been told they should ‘shield’ but don’t think they meet the criteria, they should contact their GP or hospital specialist.”

 

Next fortnight is crucial to Boris Johnson’s chances of survival

“Most will get a mild form of the disease” was the mantra trotted out during the early daily briefings from Downing Street as we were pursuing the “acquiring herd immunity” strategy. Whilst this is true, Covid-19 is distinguished by causing severe symptoms in a minority. 

We all wish the Prime Minister a full and speedy recovery. 

This article presents the brutal facts as they relate to what we know to date in this epidemic of what it can do to a minority. We must all hope that medical science can find effective therapies to alleviate symptoms whilst the world waits for a vaccine.

Tom Whipple  www.thetimes.co.uk 

It was not, we can be fairly certain, the hospital handshakes that did it.

At the beginning of March — a month ago and a world away — Boris Johnson was criticised after saying that he had been going around hospitals greeting patients and, in defiance of the coronavirus, shaking them by the hand.

Today Mr Johnson is back in hospital for very different reasons, and there is neither defiance nor glad-handing.

As foolish as the handshakes may have been, it seems far more likely that his infection can be traced to a fortnight later and what could be called the “Cobra cluster”. On the day when Britain went into lockdown Neil Ferguson, the government’s leading adviser on disease modelling, was in Downing Street.

It turned out that he was also providing a less than theoretical lesson in disease spread — the next day he would announce that he had coronavirus. We will never know for certain if he was “patient zero” for the cabinet. We do know that in the days that followed Matt Hancock, the health secretary, Chris Whitty, the chief medical officer, and Dominic Cummings, Mr Johnson’s chief adviser, all went down with symptoms. And so, on March 26, did Mr Johnson.

We understand enough about the virus’s trajectory to know that most people who get over it easily do so in the first week in which their symptoms appear. As Mr Johnson compared notes with Mr Hancock, who was diagnosed on the same day, they would have not, initially, felt that dissimilar. Inside their bodies — most likely confined largely to their noses and throats — the coronavirus was reproducing, multiplying, and recreating the symptoms of a bad cold.

While Mr Hancock’s immune system was already containing and controlling the coronavirus, in Mr Johnson, for whatever reason, the infection was probably spreading to his lungs. And, about ten days after his symptoms began, the infection had worsened to such an extent that he had to go to hospital.

From the intensive care unit there are two routes out: death or discharge. According to very early data, both are equally likely. That bald statistic ignores both Mr Johnson’s circumstances, however — he is five years younger than the average British coronavirus patient in ICU — and the fact that the present statistics are based on only a fraction of cases. Most Britons who have gone into ICU with this virus are still there.

What we do know from experiences abroad is that the next fortnight is crucial. As more of Mr Johnson’s cells die they will be sloughed into his lungs, clogging them with fluid and debris. At the same time, doctors now believe, he will be in danger of a “cytokine storm”, in which the immune system overreacts, rushing in defensive cells and opening up blood vessels — causing damage and leading to yet more fluid on the lungs.

If he can battle that and come out the other side then, on average, we would expect to see Mr Johnson give a wave — albeit a feeble one — from the steps of St Thomas’ about 18 days after symptoms began, the weekend after next.

Patients who do not survive leave, on average, four days after that.

 

Dominic Raab chosen as first secretary of state because he was rock solid on Brexit

Owl finds interesting local connections to Dominic Raab, First Secretary of State, now deputising for Boris Johnson.

One of the prominent backers for his leadership bid for the Conservative Party was Sir Hugo Swire MP. And Swire’s replacement as Conservative candidate for the Devon East constituency, Simon Jupp, joined the Foreign and Commonwealth Office in 2019 as a Special Advisor to Dominic Raab when he was the First Secretary of State and Foreign Secretary.

Connections, connections,

Steven Swinford, Lucy Fisher, Oliver Wright  www.thetimes.co.uk 

Dominic Raab was made first secretary of state by Boris Johnson because he offered his “unconditional” support during the Tory leadership contest and was considered “rock solid” on Brexit.

Mr Raab was Mr Johnson’s main Eurosceptic rival during the contest in June last year but was eliminated in the second round of voting. On the evening of his elimination he told Mr Johnson that he had his full support and made clear that he was not asking for any cabinet job in exchange for his backing.

Mr Johnson also believed that Mr Raab was “rock solid” on Brexit and would take Britain out of the EU if he became incapacitated.

By contrast, Michael Gove, who was knocked out in the penultimate round of voting, did not directly endorse Mr Johnson. He said instead that both Mr Johnson and Jeremy Hunt, the final two candidates, would make “great prime ministers”.

“Boris liked the way he just came right out and backed him,” an ally of Mr Johnson said of the foreign secretary. “Dom is also popular with the Vote Leave crew who are in Downing Street.

“There’s also another reason: Dom is rock solid on Brexit. The thinking was that if someone had to take on the prime minister’s role they had to be clear on Brexit.”

Mr Johnson also distrusted Mr Gove after he sabotaged his campaign for the Conservative leadership in 2016. “Boris never fully forgave Michael Gove for betraying him in 2016. The question was more how Michael ended up with such a senior cabinet position. It is a credit to him that he got so much, given what had happened before.”

Mr Raab’s role deputising for Mr Johnson caps a remarkable ascent. The father of two, 46, who is married to a Brazilian marketing executive called Erika, has just one year of cabinet experience behind him.

A former lawyer, he was an adviser to David Davis while the Conservatives were in opposition before becoming an MP himself in 2010. He holds a black belt in karate and is a former member of the British squad for the martial art.

Mr Raab has said that karate helped him cope with the premature death of his father, Peter, who fled to Britain from Czechoslovakia at the age of six to escape the Nazis. Mr Raab was only 12 when his father died of cancer.

“Sport helped restore my confidence, and that hugely benefited my attitude to school and life,” he said last year. “There were strong role models, camaraderie and an ethos of respect. I take the discipline and focus I learnt from sport into my professional life.”

One political aide who has worked with him said that his background had shaped his politics. “On the one hand he is a typical bright suburban grammar school kid. But he doesn’t come from a background of loads of money, and graft means a lot to him.”

Within Westminster, however, Mr Raab has developed a reputation for being cold or even abrupt. Unlike Mr Johnson and Mr Gove, he is not particularly “clubbable” and is seen as a hard taskmaster.

A former diary secretary was secretly recorded by a newspaper in 2018 saying that Mr Raab was “difficult” to work for, “dismissive of women” and demanded exactly the same lunch every day from Pret a Manger.

“He needs loosening up. He’s very uptight,” she told the Mirror. “He has the same baguette with the same smoothie with a pot of fruit everyday. It’s the Dom Raab Special.”

Another former staff member said that the characterisation was unfair. “I’ve never thought of him as cold and in private away from the office he is a totally different person,” they said. “If he is going to a meeting he expects everyone to . . . know what they are talking about. If it’s clear that they don’t he’s not afraid to cancel the meeting and say let’s do this again when we know what’s going on. Some people take that as cold, but it’s not.”

His new position is likely to lead to tensions with other senior ministers, and Mr Gove in particular.

Early in his career Mr Raab was seen as politically close to Mr Gove, now the minister for the Cabinet Office, for whom he worked as a junior minister in the justice department during David Cameron’s premiership.

They were on the same side in the Vote Leave referendum, and in its aftermath Mr Raab switched his support in the 2016 Tory leadership race to Mr Gove after Mr Johnson dropped out.

But relations between the two were damaged in the campaign last year to replace Theresa May when Mr Gove suspected that one of Mr Raab’s aides had leaked details of his cocaine “confession”, which derailed his campaign.

“It would be fair to say that they are no longer the best of friends,” said one senior Tory who knows them both. “But I think they both know they need to work together.”