Breaking News: Government coronavirus adviser quits after breaking lockdown rules

Professor Neil Ferguson, an epidemiologist whose modelling convinced Boris Johnson to press ahead with a UK-wide lockdown, stood down from the scientific advisory group for emergencies (Sage) after allegations emerged in the Daily Telegraph on Tuesday evening.

Ashley Cowburn Political Correspondent www.independent.co.uk

A key scientist advising the government on coronavirus has resigned after reportedly flouting social distancing restrictions, admitting he made an “error of judgement”.

Professor Neil Ferguson, an epidemiologist whose modelling convinced Boris Johnson to press ahead with a UK-wide lockdown, stood down from the scientific advisory group for emergencies (Sage) after allegations emerged in the Daily Telegraph on Tuesday evening.

It was claimed professor Ferguson had allowed a woman to visit him at home in London at least two occasions during the lockdown.

In a statement, the professor of mathematical biology at Imperial College London, said: “I accept I made an error of judgement and took the wrong course of action.“

He continued: “I have therefore stepped back from my involvement in Sage. I acted in the belief that I was immune, having tested positive for coronavirus, and completely isolated myself for almost two weeks after developing symptoms.

”I deeply regret any undermining of the clear messages around the continued need for social distancing to control this devastating epidemic. The Government guidance is unequivocal, and is there to protect all of us.“

A government spokesman confirmed Prof Ferguson’s resignation when approached by The Independent.

His is not the first high-profile resignation of the pandemic, with Dr Catherine Calderwood having quit as Scotland’s chief medical officer after making two trips to her second home.

Sir Iain Duncan Smith, the former Tory leader, told The Telegraph: “Scientists like him have told us we should not be doing it, so surely in his case it is a case of we have been doing as he says and he has been doing as he wants to.

”He has peculiarly breached his own guidelines and for an intelligent man I find that very hard to believe. It risks undermining the government’s lockdown message.“

Prof Ferguson’s research with Imperial College London colleagues warned that 250,000 people could die in the UK without drastic action shortly before the prime minister imposed the restrictions.

 

UK government ‘using pandemic to transfer NHS duties to private sector’

“Now, the Guardian has seen a letter from the Department of Health to NHS trusts instructing them to stop buying any of their own PPE and ventilators.

From Monday, procurement of a list of 16 items must be handled centrally. Many of the items on the list, such as PPE, are in high demand during the pandemic, while others including CT scanners, mobile X-ray machines and ultrasounds are high-value machines that are used more widely in hospitals.

Centralising purchasing is likely to hand more responsibility to Deloitte…… “

Rupert Neate www.theguardian.com

The government is using the coronavirus pandemic to transfer key public health duties from the NHS and other state bodies to the private sector without proper scrutiny, critics have warned.

Doctors, campaign groups, academics and MPs raised the concerns about a “power grab” after it emerged on Monday that Serco was in pole position to win a deal to supply 15,000 call-handlers for the government’s tracking and tracing operation.

They said the health secretary, Matt Hancock, had “accelerated” the dismantling of state healthcare and that the duty to keep the public safe was being “outsourced” to the private sector.

In recent weeks, ministers have used special powers to bypass normal tendering and award a string of contracts to private companies and management consultants without open competition.

Deloitte, KPMG, Serco, Sodexo, Mitie, Boots and the US data mining group Palantir have secured taxpayer-funded commissions to manage Covid-19 drive-in testing centres, the purchasing of personal protective equipment (PPE) and the building of Nightingale hospitals.

Now, the Guardian has seen a letter from the Department of Health to NHS trusts instructing them to stop buying any of their own PPE and ventilators.

From Monday, procurement of a list of 16 items must be handled centrally. Many of the items on the list, such as PPE, are in high demand during the pandemic, while others including CT scanners, mobile X-ray machines and ultrasounds are high-value machines that are used more widely in hospitals.

Centralising purchasing is likely to hand more responsibility to Deloitte. As well as co-ordinating Covid-19 test centres and logistics at three new “lighthouse” laboratories created to process samples, the accounting and management consultancy giant secured a contract several weeks ago to advise central government on PPE purchases.

The firm said it was providing operational support for the procurement process of PPE from existing and new manufacturers, but declined to comment further.

“The government must not allow the current crisis to be used as cover to extend the creeping privatisation of the NHS,” said Rachel Reeves, the shadow chancellor of the Duchy of Lancaster.

“The process for the management and purchase of medical supplies must be open, transparent and subject to full scrutiny. Deloitte’s track record of delivering PPE to the frontline since this virus began is not one of success and taking more decision-making authority from NHS managers and local authorities shifts power further from the frontline.”

Tony O’Sullivan, a retired paediatrician who co-chairs the campaign group Keep Our NHS Public, said this was a “dangerous time” for the NHS, and that the “error-ridden response” from government had exposed a decade of underfunding.

“Now, rather than learning from those errors they are compounding them by centralising decision-making but outsourcing huge responsibility for the safety of the population to private companies,” said O’Sullivan.

Allyson Pollock, the director of the Newcastle University Centre for Excellence in Regulatory Science, said tasks including testing, contact tracing and purchasing should be handled through regional authorities rather than central government.

“We are beginning to see the construction of parallel structures, having eviscerated the old ones,” she said. “I don’t think this is anything new, it just seems to be accelerated under Matt Hancock. These structures are completely divorced from local residents, local health services and local communities.”

Friday’s letter, signed by two officials from the Department of Health and Social Care, says that from Monday key equipment will be purchased through a procurement team comprising hundreds of staff from the government’s commercial function and other departments.

Global demand for equipment has been “unprecedented”, according to the letter, and it is therefore “vital that the UK government procures items nationally, rather than individual NHS organisations compete with each other for the same supplies”.

Trusts are told to flag any purchases already in progress so that these can be taken over by the central team and put into a central pot. “The national team can help you to conclude the deal, reimburse you, and manage the products through the national stocks.”

In a separate email, sent from NHS England on Saturday, trusts have been instructed to carry out a daily stock check from the beginning of this week. They must report down to the nearest 100 their stores of 13 types of protective equipment, including gloves, aprons, masks, gowns and eye protection. The information is being gathered by Palantir, a data processing company co-founded by the Silicon Valley billionaire Peter Thiel.

The information will be used to distribute equipment to those trusts most in need, and in some cases move stock from one hospital to another.

A purchasing manager, speaking anonymously, said hospitals were concerned they might be forced to hand over stock and then run out before it could be replaced. “The lead time on some of these orders is 90 days,” said the manager. “Centrally, there is nobody who is able to deliver things more quickly. What this is going to do is force people to hide what they’ve got.”

“This coronavirus pandemic is being used to privatise yet more of our NHS against the wishes of the public, and without transparency and accountability,” said Cat Hobbs, director of campaign group We Own It. “This work should be done within the NHS. It shouldn’t be outsourced.”

“This is not the time for a power grab,” said the Labour MP Rosie Cooper, who sits on the health and social care committee, which is conducting an inquiry into the management of the outbreak. “Whatever contracts are awarded they have got to have a sunset clause. Three months, six months, it has got to be shown to be cost effective for it to continue after a certain date,” she said.

The Department of Health was contacted for comment.

Outsourcing

Testing centres

Contracts to operate drive-through coronavirus testing centres were awarded under special pandemic rules through a fast-track process without open competition. The contracts, the value of which has not been disclosed, were granted to accountants Deloitte, which is managing logistics at a national level. Deloitte then appointed outsourcing specialists Serco, Mitie, G4S and Sodexo, and the pharmacy chain Boots, to manage the centres.

Lab tests

A coalition of private companies and public bodies have come together to form Lighthouse Labs, to test samples in three centres in Milton Keynes, Cheshire and Glasgow. Deloitte is handling payroll, rotas and other logistics, working alongside pharmaceutical giants GlaxoSmithKline and AstraZeneca, as well as the army and private companies Amazon and Boots.

Nightingale hospitals

Dozens of private companies have won contracts to build, run and support the Nightingale hospitals. Consultancy firm KPMG coordinated the setting up of the first Nightingale at the ExCel centre in east London alongside military planners. Infrastructure consultants including Mott MacDonald and Archus also had roles in the project.

Outsourcing firm Interserve worked on the construction of the Birmingham Nightingale hospital at the NEC, and was awarded a contract to hire about 1,500 staff to run the Manchester Nightingale. G4S secured the contract to supply security guards for all the Nightingale hospitals.

Recruiting extra NHS and hospital staff

Capita, another outsourcing firm, was awarded a contract to help the NHS “vet and onboard thousands of returning nurses and doctors”.

PPE

The government appointed Deloitte to help it ramp up British production of protective equipment and source stocks from the UK and abroad. Some figures in the UK manufacturing industry have described the project as a “disaster” and accused Deloitte of pursuing factories in China – where prices have leapt and supply is tight due to huge global demand – rather than focusing on retooling UK factories to make more kit.

Clipper Logistics, a Yorkshire-based logistics and supply chain firm founded by the Conservative donor Steve Parkin, was awarded government contract to supply and deliver protective equipment to NHS trusts, care homes other healthcare workers.

 

The inside story of the UK’s NHS coronavirus ventilator challenge

“The inside story of what happened in this period is one of early panic and confusion, of companies with expertise clashing with those seizing the limelight with ambitions to innovate, of questionable designs, and the desperation of a government setting targets and then deciding it didn’t need to meet them after all.

The judgment as to whether ministers have made the right call will be made in the months to come. Either way, the clinicians and medical device experts who spoke to the Guardian say lessons have to be learned.”

Rob Davies  www.theguardian.com 

As realisation dawned that a full-blown coronavirus outbreak was inevitable, the government set British industry a seemingly impossible task.

The NHS had about 8,000 ventilators available but the latest modelling, based on evidence from China, suggested that up to 30,000 would be needed, within a matter of weeks.

During a conference call on Monday 16 March, dozens of manufacturers and medical device specialists were told the grim news and asked to launch a wartime-style effort – dubbed the ventilator challenge – to bridge the gap.

Nearly seven weeks later, things look very different. The NHS has neither needed 30,000 ventilators, nor has it come close to calling on the 18,000 that health secretary Matt Hancock set as a revised target in early April.

The inside story of what happened in this period is one of early panic and confusion, of companies with expertise clashing with those seizing the limelight with ambitions to innovate, of questionable designs, and the desperation of a government setting targets and then deciding it didn’t need to meet them after all.

The judgment as to whether ministers have made the right call will be made in the months to come. Either way, the clinicians and medical device experts who spoke to the Guardian say lessons have to be learned.

The ventilator challenge began on Saturday 14 March, led by chief commercial officer, Gareth Rhys Williams, the civil servant who oversees state procurement.

“I got an email at midnight asking if I could call him [Rhys-Williams],” said Nick Grey, a designer and inventor behind Worcestershire-based technology firm Gtech. “He said the PM had given him a special job: ‘we’re going to need up to 30,000 ventilators in two weeks, is that something you can help with?’”

Building a modern high-quality machine from a standing start would, he believed, have been impossible. But like many other designers and engineers who responded to the rallying cry, Grey believed he could knock up something serviceable.

“I said, ‘If you’re really stuck and people can’t breathe I can produce something that can keep them going.’ It would have had to have been really bad to do that.”

Grey wasn’t the only who was sceptical about producing something more sophisticated. Asking manufacturers to switch from cars or jet engines to specialist medical devices was unrealistic according to Craig Thompson, head of products at Oxfordshire firm Penlon, one of the few specialist ventilator firms in the country.

But at this stage, according to Whitehall sources, ministers were desperate; they believed tens of thousands of people might require ventilation. Basic devices, however undesirable, might have to do.

“We were of the view that we had to back every horse,” said an adviser to a cabinet minister involved in the plans.

The strategy was threefold; buy proven devices from the few small firms that made them, import some from overseas and, most importantly, look to the the ventilator challenge to deliver thousands more machines.

Already though, some experts were concerned at how much credence was being given to the notion that non-specialist companies could build their own simple devices.

“They [the government] were initially talking about a Manley-Blease-style ventilator,” said a source at one specialist ventilator company. “They sent links to it.”

He was referring to a 1960s design by Roger Manley and the Blease Medical company, a major advance at the time but crude by modern standards.

In a document sent to manufacturers, the government said the new devices should ideally be able to support a patient for a number of days, but left open the option to build devices capable of providing support for a few hours to a day.

“These companies were all focused on the big prize of coming up with their own ventilator,” said the source. “I saw videos of some of them … the jerky motion suggested something that hadn’t been fully thought through. They didn’t exactly impress me as far as working concepts go.”

Dr Alison Pittard, dean of the Faculty of Intensive Care Medicine, has said that simple devices of this nature would have been “of no use”.

Yet firms with no prior experience were increasingly bullish that they could design and build a prototype within weeks.

One of these was Dyson, the engineering group whose success was built off the back of the bagless vacuum cleaner invented by its founder, Sir James Dyson. On the evening of 25 March, the billionaire Brexit-backer indicated in an email to staff that the prime minister, Boris Johnson, had personally asked him for help.

The company had been working with Cambridge-based The Technology Partnership on the CoVent, a breathing device that it believed would help meet the nation’s needs. The government, he said, had ordered 10,000.

Within an hour of the memo to staff, Dyson was sending out mocked-up images of the CoVent. The move angered some of those involved in parallel projects, who felt the buccaneering tone masked the enormity of the challenge.

“Dyson jumping the gun wasn’t helpful to anyone,” said one source. “We were looking at them aghast. Nobody said you had to start from scratch.”

According to one source, the firms that opted to design and build new machines had to lean heavily on support from the medical device regulator, the Medicines and Healthcare products Regulatory Agency (MHRA).

“Without the independent regulatory teams, most of these projects would have gone nowhere,” the source said. “It’s easy to say you can just design a ventilator but the safety isn’t just in the design, it’s about how you make them, the quality management, servicing them. It’s not an innovation programme, it was there to meet a clinical need. And that need was always most likely to be met by scaling up manufacture of existing devices.”

Only one group had taken this latter approach and it was quietly making more progress than any other.

The Ventilator Challenge UK consortium, involving more than 20 firms, counted the likes of Rolls-Royce, Airbus, Ford and McLaren among its number. It is on track to deliver thousands of ventilators to the NHS. Rather than reinvent the wheel, the consortium focused on existing designs.

“It was our choice that it was the quickest route,” said Dick Elsy, the consortium’s chairman. “Others pursued the start-from-scratch approach and some [of those projects] have been turned off.”

By early April, Ventilator Challenge UK was inching towards production and imports were starting to trickle through, albeit not in the volume the government had hoped for.

Meanwhile Dyson, defence group Babcock and a group of Cambridge scientists called Sagentia were continuing to work on their new prototypes.

Still though, the numbers were far lower than hoped. The NHS now had close to 9,000 devices but none had yet come from the ventilator challenge.

“The fact is that the industry has answered the call but the government wasn’t shouting early enough,” confided a frustrated source involved in one of the projects in early April.

Despite commissioning multiple new devices with no measurable chance of success, the government hadn’t, in fact, backed every horse.

The UK failed to join an EU procurement scheme that promise to source proven designs, a revelation that led to the prime minister being accused of putting “Brexit over breathing”. The row descended into farce as the government changed its story, first indicating the snub was deliberate before blaming a “communication problem”.

By 5 April though, the health secretary, Matt Hancock, had reduced the target to 18,000 ventilators, a more manageable if still rather distant prospect.

Three days later, based on clinical advice, the government upgraded its requirements.

Doctors treating Covid-19 patients had learned that they typically suffered rapid fluid build-up in the lungs, requiring frequent drainage. The initial specifications had not envisaged this and some of the more basic models were not equipped to handle it.

One anaesthetist, who asked not to be named, said the Department of Health and Social Care should have been aware of this issue far earlier.

“We had done strategies for changing over ventilators as people built up fluid. We knew that was going to be the case.”

Other clinicians say doctors’ understanding was constantly changing.

“What I would say is that this is genuinely a new disease,” said Dr Daniele Bryden, vice-dean of the Faculty of Intensive Care Medicine and an intensive care practitioner who has treated coronavirus patients. “It takes time to understand long-term impacts for the individual.”

Some projects fell by the wayside. Even the high-spec Penlon Prima EOS2, manufactured by Ventilator Challenge UK and now being used in hospitals, had to be sent back to the factory to be refined.

With cancellations and delays like these affecting the race, time appeared to be running out – 10 days after Hancock revised down the ventilator target to 18,000, the NHS still had only 10,000.

Luckily for Covid-19 patients – not to mention the ministers overseeing the ventilator challenge – external factors came to the rescue.

Only about half of Covid-19 patients admitted to intensive care with breathing difficulties were being put on mechanical ventilators.

Martin Allen, a consultant respiratory physician and board member of the British Thoracic Society, explained why.

“In Wuhan, when they tried other ventilation strategies they failed. Everyone needed to go on to invasive ventilation, so there was a concern that spread throughout the rest of the world,” he said.

In Italy though, a lack of the devices forced doctors to try other strategies, such as increased use of Cpap machines, which deliver oxygen via a mask rather than requiring intubation – where oxygen is delivered by the ventilator through a tube inserted into the airway.

Of the experts who spoke to the Guardian, many felt that the ventilator strategy would not have withstood a sterner test.

“The country has been fortunate that we’ve not see the levels we frankly should have expected” said one ventilator expert. “It could have been far worse.”

The government said that it was, at all times, guided by expert scientific advice.

Yet manufacturers felt the plan began too late, while imports that were supposed to number around 8,000 have only just passed 800. Last week it emerged that 250 from China were ditched because doctors feared they might harm or even kill patients.

Of the “new” ventilator projects, none have reached the final stages of testing and the majority – including those made by Sagentia and Dyson – have proved surplus to requirements.

Dr Bryden questioned whether the intense focus on ventilators was ever the most sophisticated approach.

“You cannot save somebody’s life with a piece of equipment alone. You also need someone who knows how to look after the patients.”

Prof Carl Heneghan, director of the centre for evidence-based medicine at Oxford University, believes that a strategy that relied on firms cobbling together life-saving devices in a matter of weeks should teach us more enduring lessons.

“When we look back there will be serious questions to answer about all of the decisions made. What’s been very noticeable is that we always seem to be one step behind on the policy.

“If it’s not ventilators it’s tests, if it’s not tests, it’s PPE. It’s an important lesson that we have to invest, to create overcapacity for these moments.”

“We’ve really cut to the bone in this country far too much.”

 

A view from “down under”: ‘Biggest failure in a generation’: Where did Britain go wrong?

Owl has an international following – following a tip off – here is an Aussie view from the Sydney Morning Herald dated 3 May. It’s a devastating examination of our Governments handling of the pandemic.

Bevan Shields www.smh.com.au 

Health Secretary Matt Hancock was midway through a radio interview when the phone call came through live to air. On the line was Intisar Chowdhury, whose father Abdul had made a prescient public plea to Boris Johnson in late March.

Through a Facebook post, the 53-year-old consultant urologist for a London hospital had urged the Prime Minister to make sure every health worker in Britain would be given protective equipment during the coronavirus pandemic. Abdul Mabud Chowdhury died just three weeks later, after contracting the disease.

In his phone call, the doctor’s grieving son asked for answers and an apology: “The public is not expecting the government to handle this perfectly,” he told Hancock. “We just want you to openly acknowledge that there have been mistakes in handling the virus, especially to me and to so many families that have really lost loved ones as a result of this virus and probably as a result of the government not handling it seriously enough.”

Chowdhury seemingly spoke on behalf of a growing chorus of health experts, MPs and members of the public who think Britain’s response to the crisis has suffered from a series of deadly mistakes and miscalculations.

The charges focus on four areas: that healthcare workers struggled to access personal protective equipment, that Britain was too slow to implement a lockdown, that it bungled testing, and that vulnerable care home residents were not properly protected.

Downing Street and key ministers such as Hancock have been reluctant to concede many errors, although their tone has shifted over recent days as the official death toll hit 28,446, one of the highest in the world and well above the 20,000 figure Chief Scientific Adviser Patrick Vallance once said the government hoped to not exceed.

Says Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine and an adviser to the World Health Organisation: “The countries that moved fast have curtailed the epidemic. The countries that delayed have not. It’s as simple as that.”

Dr Richard Horton, editor in chief of The Lancet medical journal, is even more damning: “The handling of the COVID-19 crisis in the UK is the most serious science policy failure in a generation.”

Hancock and Johnson had their first discussion together about the virus on January 7. The government’s crisis committee, COBRA, would meet several times over the following weeks and the Scientific Advisory Group for Emergencies started crunching the numbers. The government knew a threat existed but did it fully understand just how bad it could get?

By March 12 a full-scale outbreak had taken hold in Italy and the illness was spreading across Europe. More than 1000 Italians had already died and thousands more were gravely ill in packed hospitals in the country’s hard-hit north. The deadly potential of an invisible killer was becoming more obvious by the hour.

That day, Johnson announced Britain would move from the “contain” phase of the emergency to the “delay” phase. This decision would prove a pivotal moment. The shift meant contact tracing would be abandoned, and testing would be restricted to those only in hospital with symptoms. The move was at odds with the WHO, which urged countries to “test, test, test”, as well as Germany’s much-lauded program of mass testing.

The Prime Minister warned at the March 12 press conference that the “worst public health crisis for a generation” was about to hit the country and that “many more families are going to lose loved ones before their time”.

What he did not announce was a lockdown. Or anything close to it. Tougher measures would come but not yet, Johnson said, citing the need to introduce measures when they would have the most impact. But his chief scientific adviser also cast serious doubt on whether closing schools, banning mass gatherings or stopping international flights would ever be effective levers to pull.

Instead, Brits were encouraged to wash their hands and stay home for seven days if they had symptoms. Schools remained open, restaurants and bars traded as usual, and visitors were still allowed into care homes. Flights were arriving from mainland China, even though Australia had banned them six weeks earlier. Heaving public events were still allowed. A Champions League match in Liverpool drew a crowd of 52,000, about 3000 of whom came from Madrid, where a partial lockdown was already in force. More than 250,000 tickets were sold for the Cheltenham horse racing festival. Both events are now being investigated by health officials who suspect they may have contributed to the rapid spread of the disease in the areas surrounding the venues.

By March 16, the government’s advice abruptly strengthened. People were told to stay away from pubs, theatres and clubs, to avoid non-essential travel and to work from home if possible, although the orders were not yet mandatory.

Why the sudden change? The government had just been handed a bombshell piece of research by scientists from Imperial College London warning that taking a light-touch approach to the virus would cause 250,000 deaths in Britain and overwhelm the National Health Service (NHS). Any hope of defeating the virus by building “herd immunity” in the community was smashed. The only way to prevent 250,000 deaths was through draconian measures, the researchers concluded.

Even then, Johnson would not put Britain into lockdown until one week later on March 23. By that point, many other European countries with a much smaller death toll had already been locked down.

Says David Hunter, an Australian-educated professor of epidemiology and medicine at the University of Oxford: “It’s very easy in hindsight to state the obvious, which is that the lockdown came too late.

“The British response so far is not a model to follow. It has one of the worst epidemics in Europe and the world. That may have happened anyway. There’s no way to know for sure, but some aspects of the response have almost certainly contributed to the high mortality.”

A former Australian high commissioner to Britain, Mike Rann, says crucial mistakes were made right when they had the most damaging impact: “The earliest stages were handled negligently,” Rann says. “A shambles of mixed messaging, poor organisation and a complacent attitude that what was happening in Italy wouldn’t happen here.”

Hunter says border closures in Australia and New Zealand stood in stark contrast to Britain, which only briefly imposed restrictions on people flying in from Wuhan. Even today, the few passengers still arriving in Britain are under no obligation to self-isolate.

“Good public health practice would be to, if not close the borders, then at least have some sort of mandatory self-isolation for people coming in during the very early stages of the pandemic,” Hunter says.

“The reasons why the UK did not do it are unclear. Australia, albeit at a different stage of the epidemic, has been highly successful in closing its border, as has New Zealand, and that has almost certainly played a role in the much much lower number of cases.”

Arrivals at Heathrow Airport were half what they normally were in March but still, 3.1 million landed there over the month. Nearly half a million came from the Asia-Pacific; 875,000 were from the European Union, and 711,000 came from North America.

Home Secretary Priti Patel supported a ban on travellers who had been in hotspots but was slapped down by Downing Street, which cited scientific advice that doing so would have little impact on the spread of the infection. When this spat was under way, Australia’s borders had already been closed for a week to all foreign travellers. Australia banned flights from China as early as February 1.

The decision on March 12 to abandon mass testing meant the government could only guess who was infected with the virus and how it was behaving. Government experts at one point estimated as many as 55,000 people had contracted coronavirus, even though there were just 2000 confirmed cases. The extent of its spread would not become obvious until hospitals started to fill with seriously ill patients.

Of the few tests that were available, the results were initially processed by a small number of government-run laboratories. Private sector labs and universities offered to help but now say they were given the cold shoulder before the government eventually embraced them as the answer to ramping up testing.

Nobel prize-winning geneticist Sir Paul Nurse told the BBC’s Question Time program that testing was “absolutely critical and hasn’t been handled properly”.

“We know that with this particular disease, you can be infected and have no symptoms. Now, this makes absolutely no sense. We were allowing, potentially, for front-line workers to be on the wards, potentially infecting people, because we weren’t testing.”

Nurse, who is the director of Britain’s largest biomedical research lab, the Francis Crick Institute, likens the addition of private facilities to the flotilla of small boats that rescued British soldiers from the beaches of Dunkirk and says their call-up was long overdue.

One of the strongest critics of the testing system has been Jeremy Hunt, the health secretary under former prime ministers David Cameron and Theresa May. Piers Morgan, a polarising morning television presenter and former tabloid newspaper editor, repeatedly mauled government ministers on his Good Morning Britain program about the deficiencies.

Under pressure, Hancock announced a plan to lift the number of tests conducted each day to 100,000 by the end of April. He achieved it − sort of. The government reported 122,000 tests on April 30. The devil is always in the detail, though: about 40,000 were tests mailed to people but not yet returned to labs for results. Regardless, Hancock’s ambitious goal has transformed Britain’s approach to testing and, if sustained, it will make it one of the world’s most prolific testers. The government is also hiring 18,000 “contact tracers” by the middle of May.

Despite the recent surge, those early delays mean Britain has conducted just 10.13 tests per 1000 people, the lowest rate in western Europe. Italy’s rate is 32.73, Ireland’s is 31 and Germany’s is 30.4.

Australia’s testing effort has been double the relative size of Britain’s, despite having a far less serious outbreak. And for all the criticism of the US response to the crisis, the rate of testing there never fell below the rate in Britain in April.

In his first address from Downing Street after his own battle with the virus, Johnson said the government was determined to fix the “challenges” that “have been so knotty and infuriating”.

“I’m not going to minimise the logistical problems we have faced in getting the right protective gear to the right people at the right time, both in the NHS and in care homes. Or the frustrations that we have experienced in expanding the numbers of tests.”

The additional testing capacity has allowed the government to get a better grip on the unfolding toll in Britain’s care homes. It was previously flying blind. Only three weeks ago, even symptomatic care home residents and staff did not qualify for a test. For many weeks, patients were discharged from hospitals and into care homes without being tested to check whether they would be taking a deadly virus to a place where it could unleash havoc.

The Office for National Statistics, which compiles death data based on whether COVID-19 was mentioned on death certificates − believes 4343 care home residents died in England alone in the fortnight ending April 24. In the week ending April 17, 7316 people died in care homes from all causes. This was 2389 more deaths than the week before and almost double the week before that.

Care home deaths were not added to Britain’s official death toll until late last week, and the true extent of the loss is still unclear. In early March, Johnson and his team spoke of “shielding” care home residents during the worst of the epidemic. They have since failed, but are not alone: all badly affected countries in Europe have experienced a wae of death in care homes.

While the Prime Minister has enjoyed a sharp rise in his personal approval ratings since the outbreak began, polling firm Ipsos MORI has recorded a “significant rise” in the number of people that think the government acted too late. Two weeks ago, 57 per cent felt that way but that figure now stands at 66 per cent.

Johnson and Hancock have been keen to stress that Britain has passed through the peak of the virus without the NHS being overwhelmed, pointing to a massive and rapid expansion in capacity and the early purchase of thousands of ventilators.

Chief Medical Officer Chris Whitty says the only way to truly compare Britain’s response will be once the pandemic has run its course not just in Britain but in other countries that may yet experience serious outbreaks.

“We are nowhere near the end of this epidemic. There is a very long way to run for every country in the world on this and I think let’s not go charging in to who’s won and who’s lost.”

 

UK trade minister Conor Burns resigns over loan threats

When “three houses” Robert Jenrick was not required to resign over travelling to his second home, Owl thought this Government was without shame.

A close ally of Boris Johnson has resigned as a minister after being found to have used his position to try to intimidate a member of the public.

Rajeev Syal www.theguardian.com

The international trade minister, Conor Burns, was found by the standards committee to have made a series of veiled threats while attempting to intervene in his father’s dispute over a loan.

The committee recommended a suspension from parliament over multiple breaches of the MPs’ code before No 10 announced his resignation. A Downing Street spokesman said Burns had resigned after the committee’s report.

The commissioner for standards received a complaint from a member of the public connected to a firm with which Burns’s father was in dispute over the repayment of a loan. The complaint centred on a letter sent by Burns, which claimed his father had made extensive attempts over a period of years to reach a settlement on repayment of that loan.

In the letter, written in February 2019 on House of Commons notepaper, Burns stated he was writing on his father’s behalf enclosing an earlier letter sent by his father to the company to which, he stated, no response had been received.

“I am acutely aware that my role in the public eye could well attract interest especially if I were to use parliamentary privilege to raise the case (on which I have taken advice from the house authorities),” Burns wrote.

The MP suggested the complainant, a former senior civil servant whose name was redacted from House of Commons documents, could avoid having him raise the case in the Commons by securing the payment of the loan to his father.

Burns noted the complainant’s “high-profile role” outside the company “could well add to that attention”. By raising the case during parliamentary proceedings, Burns’s words would have been protected from a legal challenge by parliamentary privilege.

When confronted by Kathryn Stone, the commissioner for standards, Burns said he had not sought formal advice. Stone said his behaviour “gives fuel to the belief that members are able and willing to use the privileges accorded them by their membership of the house to benefit their own personal interests”.

“The content of the letter suggests the use of the principal emblem of the house was more deliberate than accidental. And, as I explained in my letter to Mr Burns of 11 June 2019, his reference to having sought advice about privilege from the house authorities was misleading,” Stone wrote.

The report released by the standards committee found that he had also misused parliamentary-headed notepaper. It accused Burns of behaving “disrespectfully” during the investigation and of claiming he had not received a memo from Stone over several months.

The cross-party committee recommended he should apologise in writing to the Commons and to the individual concerned – a recommendation that will need to be signed off by the Commons.

“The right of members of parliament to speak in the chamber without fear or favour is essential to parliament’s ability to scrutinise the executive and to tackle social abuses, particularly if the latter are committed by the rich and powerful who might use the threat of defamation proceedings to deter legitimate criticism.

“Precisely because parliamentary privilege is so important, it is essential to maintaining public respect for parliament that the protection afforded by privilege should not be abused by a member in the pursuit of their purely private and personal interests,” the report said.

Burns, 47, was made a trade minister in July when Johnson became Conservative leader and was a key member of his campaign team. He was elected to represent Bournemouth West in 2010 and defended his seat in 2015, 2017 and 2019.

He served as parliamentary private secretary to Johnson when he was foreign secretary but resigned from the post in July 2018.

Burns expressed his regret in a tweet on Monday. “With deep regret I have decided to resign as Minister of State for International Trade. @BorisJohnson will continue to have my wholehearted support from the backbenches,” he said.

In a separate development, another minister at the Department for International Trade, Greg Hands, was ordered on Monday to apologise for misusing parliamentary stationery to send a letter to thousands of constituents.

In October 2019, the Chelsea and Fulham MP had told the commissioner he was willing to publicly acknowledge he had breached the rules, apologise and reimburse the £4,865 costs. But with the election looming, Hands changed his mind.

The committee said: “It is hard to avoid the conclusion that Mr Hands may well have been motivated by a desire to avoid the embarrassment of having to make a public apology for breaking parliamentary rules during a general election campaign.”

 

Rival Sage group says Covid-19 policy must be clarified

Yesterday the “alternative Sage” said the Government needs to clarify whether its objective was to suppress or manage infections of Covid-19. Owl is concerned about one, little mentioned, aspect of the long term consequence of  “managing within the capacity of our NHS” .

Owl hears a lot about NHS capacity being measured in terms of the supply of PPE, number of beds and ventilators etc, not much about the limits of human endurance. In a couple of articles Owl has posted recently, Max Hastings has drawn comparisons between this emergency and the way resources are, or have been, mobilised in war. One wartime experience is a recognition of “battle fatigue” and the need  to manage this through “troop rotation” (either as individuals or as units) to maintain full efficiency. (Owl uses the recognised military terms to facilitate research searches.)

Frontline NHS staff have been working at full stretch in extremely stressful conditions. It is unlikely that this peak work rate could , or should, be sustained indefinitely.

Before coming to the article, Owl reports that there is now a substantial “fringe” scientific effort: 

DELVE: Data Evaluation and Learning for Viral Epidemics is a multi-disciplinary group, convened by the Royal Society, to support a data-driven approach to learning from the different approaches countries are taking to managing the pandemic. 

RAMP: The Royal Society is also convening the Rapid Assistance in Modelling the Pandemic (RAMP) initiative to support efforts to model the Coronavirus (COVID-19) pandemic. RAMP is bringing modelling expertise from areas other than pandemic modelling to support the pandemic modelling community already working on Coronavirus (COVID-19). 

Nicola Davis  www.theguardian.com 

The government has fundamental questions to answer about its approach to tackling Covid-19, an independent body of experts have said.

The Independent Sage committee – a body of 12 scientists and experts set up in parallel to the government’s Scientific Advisory Group for Emergencies (Sage) – is chaired by the former UK government chief scientific adviser Sir David King, who has criticised the official body’s previous lack of transparency.

Its members said on Monday that the government needed to make clear whether its objective was to suppress or manage infections of Covid-19, saying the two required very different processes and it was unclear which the government is pursuing.

The team have also recommended that new health policies for ports are developed to prevent cases of Covid-19 being imported, particularly as and when restrictions are lifted, while they have stressed the need for better financial support for marginalised groups and the BAME community.

Among other recommendations, they also advise that the government needs to move towards a local approach to testing and tracing.

The group was set up by King and Professor Anthony Costello after concerns about the lack of transparency around the government’s current Sage participants, and the revelation that 16 of the 23 known members are employed by the government. While the official Sage group is known to include behavioural scientists, pandemic modelling experts and infectious disease specialists, Dominic Cummings, Boris Johnson’s chief political adviser, is also known to have attended meetings.

Holding their first meeting on Monday, the Independent Sage group discussed a number of points, including the need to avoid stoking social divisions as lockdown is eased.

“People were very surprised at how adherent the population has been and a lot of that is down to collective solidarity as people have been rising to the challenge,” said Prof Susan Michie, a behavioural psychologist at UCL. “Going forwards, in terms of lifting lockdown, it’s going to to be a very different situation. A lot of thought has to be given to how this will be managed. If it’s not handled well, it risks potential divisions between groups.”

Other topics included the potential benefits to harnessing the island status of the UK and Ireland, as countries such as New Zealand have done, and developing new port health policies.

Prof Gabriel Scally, president of the epidemiology and public health section of the Royal Society of Medicine, noted that unlike many countries, Britain and Ireland have maintained open borders in the face of Covid-19.

“That seems to me, as we go into a situation where we are thinking of lifting restrictions, places us in sudden jeopardy,” he said, adding that a key issue at present in countries including China is cases of coronavirus imported into the country, including from citizens who had returned from travelling abroad.

At a press conference, chaired by the MP David Davis, after the first meeting of the new group, King added that the government needs to manage the pandemic without banking on a vaccine, noting that it remains unclear at present how well the newly developed vaccines will work, while Prof Karl Friston, of University College London, cautioned against placing too great an emphasis on the “effective reproduction number”, or R, which is the average number of people that one infected individual will pass the virus on to and has been a recurring figure in the government’s daily press conferences.

“R in an of itself is not a cause of pathology, death, suffering or any other measurements of those things,” Friston said. Indeed R is not fixed, and is affected by a number of factors, including by policies such as social distancing.

Friston added that the current prevalence of the virus in the population is a more useful figure when it comes to making important policy decisions.

“R is post-hoc reflection, it is a nice statistic, it is easy to model,” he said. “However, it is not really the thing you should be aiming at.”

 

Hundreds of fish killed in major pollution incident in East Devon

Hundreds of fish have died after a major pollution incident on an East Devon river at the weekend.

Ten kilometres of river were affected after 100,000 litres of slurry poured into Southleigh Stream near Colyton.

Keith Rossiter  www.devonlive.com

The stream is a tributary of the River Coly, which in turn feeds into the River Axe southeast of the town.

The Environment Agency said it stepped in to investigate after a local farmer reported the loss of 100,000 litres of slurry from a storage tank. The agency said a number of fish had died, and officers were carrying out a fish kill assessment on the River Coly.

An East Devon news website said the farmer dug a ditch to reduce the flow to the stream after he was made aware of the incident, which is understood to have happened on Friday.

Most of the slurry reached the watercourse which was heavily discoloured when officers arrived on site on Sunday, making it difficult to assess the impact of the pollution, the Midweek Herald said.

“The Umborne Brook joins the River Coly at Colyton which will help dilute any pollution,” the Environment Agency told the news site.

“Officers have returned today to carry out a fish kill assessment and consider any further remedial measures.”

The Environment Agency said that it is investigating how slurry entered Southleigh Stream from a large store in the area.

“Our officers have recovered more than 400 dead fish, including brown trout, salmon fry, bullheads, stone loach, minnows and lamprey, and are now looking at the impact on the watercourse’s invertebrates.

“Any future action will be informed by the outcome of our investigation.

East Devon councillor Paul Arnott, who represents Coly Valley, told the Western Morning News yesterday that he understood hundreds of fish had died.

“The ecological impact on the River Coly is a disaster. It’s not just fish but birds and all sorts of other flora and fauna.

“I walk the river with my wife and daughters and appreciate what a beautiful thing it is and how crystal clear the water is.

“But if you go there now, you can’t see the river bed. The water is brown. It’s a tragedy.

“We will be looking for good, strong action from the Environment Agency.”

Ed Parr Ferris, Devon Wildlife Trust conservation manager, said:

“This incident has occurred on a section of river, the River Coly, already classed as in poor condition by the Environment Agency due primarily to agricultural pollution.

“The EA has been focusing attention on agricultural pollution on the River Axe, of which the River Coly is a tributary, due to the failing status of this important river. The Axe is recognised internationally as a Special Area of Conservation for its plants, invertebrates and populations of important fish – Atlantic salmon, bullhead, brook lamprey and sea lamprey.

“The estuary is also a Marine Conservation Zone.

“This is especially concerning as it’s the second major pollution incident on the river in two years which emphasises the need for stronger regulation, alongside advisory support for farming businesses to manage and protect our amazing river wildlife.

“Devon Wildlife Trust is working closely with the Environment Agency and other organisations to better protect and enhance the wildlife and environment in the Axe catchment.”