The forecasts that spooked Boris Johnson into slowing exit from lockdown

“I won’t be buccaneering with people’s lives” Boris Johnson, Monday

Haroon Siddique www.theguardian.com 

On Monday, Boris Johnson announced his roadmap for lifting all Covid restrictions by 21 June but faced criticism from some Conservative MPs for not providing for a speedier return to normal life. Here is some of the evidence the government and its scientific advisers have been considering, outlining the risks of lifting restrictions too early.

Deaths

Based on modelling by Warwick University and Imperial College London, the Scientific Pandemic Influenza Group on Modelling (SPI-M), a subgroup of the Scientific Advisory Group on Emergencies (Sage), warned that “rapid relaxation [of restrictions] results in a very large wave of hospitalisations and deaths”.

It said that if all restrictions were lifted by 26 April (scenario one), even under the most optimistic of assumptions, including 4m doses of vaccine a week from 22 March, there would be “another wave comparable in size to January 2021, resulting in a further 62,000 to 107,000 deaths in England”. More pessimistic vaccine efficacy led to a prediction of 102,000 to 176,000 further deaths.

Explaining the likely resurgence were restrictions lifted earlier, SPI-M says: “There are still many people in vulnerable groups who do not have protection; neither directly (either because they have not been vaccinated or because their vaccination has not prevented them from becoming infected then ill) nor indirectly from wider population immunity (because many younger age groups have not yet been vaccinated or infected).”

Hospital admissions

With warnings that the NHS is “on its knees” after three waves of the pandemic, ensuring it is not overwhelmed by a fourth wave is one of the key factors in the decision about whether to lift restrictions.

For its paper, discussed by Sage on 4 February, SPI-M asked University of Warwick and Imperial College to model four scenarios, with scenario one envisioning the earliest return to minimal measures (26 April) and scenario four the latest (2 August). SPI-M said: “All four scenarios modelled lead to a substantial resurgence in hospital admissions and deaths.” It found the models from the two universities to be in “remarkable quantitative agreement about hospital admissions”.

Daily admissions for Covid peaked at 4,134 on 12 January, but on Monday stood at 904. The most optimistic interpretation of scenario one in Warwick’s modelling suggested a resurgence in admissions later this year, peaking at between 4,000 and 6,500 admissions a day.

Hospital occupancy

In the same document, SPI-M said: “Unless vaccine efficacy is significantly better than assumed here, it is highly likely that hospital occupancy would be higher than that seen in January 2021, if all restrictions are lifted by the start of May, even under the optimistic vaccine rollout scenario modelled here of 4m doses per week from the end of March.”

The number of beds in England occupied by Covid patients peaked on 18 January, at 34,336. This has since fallen (the figure was 14,137 on Monday) but the modelling warned of a reverse if restrictions were lifted too early. Under the most optimistic interpretation of scenario one, Warwick’s modelling suggested occupancy of approximately 20,000 to 50,000 beds.

SPI-M wrote: “Relaxation of current restrictions would be safer the lower the prevalence and hospital occupancy reached before any relaxations commence. This would give a longer time window to respond if it becomes apparent that the relaxation of measures is leading to an unsustainable rise in hospital admissions. Lower prevalence of infection will also reduce the risk of the evolution of new variants.

“Hospital occupancy is still very high and will remain so for a significant length of time. SPI-M-O’s [the operational subgroup’s] medium-term projection of hospital occupancy in England on 8th March is between 5,600 and 12,1001.”

Avoiding another lockdown

It is universally agreed on all sides of the argument that avoiding another lockdown is vital, whether to preserve people’s mental health or to prevent businesses being forced into closure or to lay off employees. SPI-M makes clear that lifting restrictions in haste would risk a fourth national lockdown based on the modelling.

It states: “As restrictions are relaxed virus transmission will increase. The more slowly restrictions are relaxed, the greater the number of hospitalisations and deaths prevented by vaccination and hence it would be less likely that restrictions would need to be reimposed later to avoid hospitals being put under extreme pressure. Rapid relaxation results in a very large wave of hospitalisations and deaths.”

Johnson has left a minimum of five weeks between each stage of restrictions being lifted and this, again, is supported by the evidence presented by SPI-M. It says: “It is much less likely that restrictions would need to be reimposed if an approach were taken in which each step was followed by a careful evaluation of data before any further unlocking was allowed. Several weeks between steps are required to determine if that change has significantly increased transmission.”

Restoring wetland drained over 150 years ago for farmland – Ozzie style

Bringing an Australian wetland back to life

www.bbc.co.uk

In the shadow of Australia’s Grampians National Park lies Walker Swamp, a once-thriving wetland that was artificially drained and farmed for over a century.

But it is now welcoming new life once more, after a huge restoration project.

Its revival is one “message of hope” amid so much grim environmental news, ecologists tell the BBC.

Video by Isabelle Rodd

How the NHS can meet the demands of an ageing society

Letters www.theguardian.com 

Bruce Keogh (The NHS rose to the challenge of Covid, but its next test may be even harder, 18 February) makes salient points about the post-pandemic NHS, with emphasis on older people. The six tests are useful, but his focus on digital technology does not reflect the needs of older people, many of whom do not use it. In fact at times, it seems an administrative deterrent to manage demand rather than to enable patients to access services. Will the NHS fund digital training for older people?

His comments about keeping older people out of hospital are doomed unless four critical issues are dealt with: reform of the funding system for social care; doing away with the iniquitous system of “continuing healthcare”, classing those with dementia as not ill and robbing many older people of their life savings; raising the “carer’s allowance”, recognising that this care saves the NHS large sums every year; and moving healthcare staff from hospitals to the community, enabling GPs to provide a more comprehensive service.

Without these actions, the NHS will continue to be hamstrung in its efforts to reduce unnecessary admissions and long stays in hospital.

Ron Walton

Penarth, South Glamorgan

• There is a danger of missing the crucial issue of how integrated health and social care will be delivered at a local level. During the pandemic, the NHS introduced a system called “discharge to assess” (D2A). The immediate pressure was to get patients out of hospitals as soon as possible, but D2A is part of a continuing “home first” approach. D2A assumes that the majority of patients can be discharged straight home from hospital. It does provide for patients who may need more support before returning to home-based independence, but the numbers are assumed to be small and they are supported only on a limited basis.

Because of the closures of community hospitals and a lack of resources, too many people fall through the gaps between hospital and home, NHS and local authority, and are sent home without adequate support, or placed in care homes miles from where they live.

The promised reform needs to guarantee that integrated health and social care is properly provided after people are discharged from hospital, across the country, at a local level.

John Forsyth

Penzance, Cornwall

Most pheasants sold for food ‘contain lead shot’

Almost all pheasants sold for food in the UK contain toxic lead shot, scientists have found.

Despite voluntary ban declared a year ago.

There is also concern that the large and increasing release of gamebirds and associated shooting practices may be having negative impacts on the UK’s native wildlife.

By Victoria Gill  Science correspondent, BBC News www.bbc.co.uk 

The discovery comes one year into a five-year transition to non-toxic shotgun ammunition – a move backed by nine UK shooting organisations.

Of 180 birds examined by the scientists, 179 were shot with lead.

One shooting group said finding humane and effective alternatives to lead would take time.

‘No detectable impact’

The team, consisting of scientists and conservationists based across England and Scotland, bought wild-shot common pheasants that were sold by game dealers, butchers and supermarkets around the UK.

With labs closed in lockdown, the scientists carried out the pheasant dissections in their own kitchens.

“We took out the shot and sent it off for analysis and 99% of the ammunition we extracted was lead,” said Prof Debbie Pain, from Cambridge University.

“So really that hasn’t declined at all since the shooting organisations signed up to the voluntary ban.”

That voluntary ban was a declaration in February 2020 by shooting and countryside organisations, which all committed to phasing out lead shot and transitioning “completely” to non-toxic alternatives. Those alternatives are already widely available and include steel, bismuth and tungsten.

That commitment, the scientists conclude, has not yet had any detectable impact.

Lead is toxic even at very low concentrations, as Prof Rhys Green from Cambridge University explained.

“Over time, it has been banned from a progressively lengthening list of products, including plumbing, paints on things like children’s toys and as an additive to petrol. And the maximum allowable concentration of lead in many foods has also been limited by an EU directive, which still applies in the UK,” he said.

“But game meat products are not included on that list of foods, for reasons that are unclear. Currently, the amount of lead in game meat sold for human consumption is not regulated by law.”

Lead shot also builds up in the environment.

“When lead is shot into wildlife, it can be eaten by predators like scavenging birds,” Prof Pain explained. “And a lot of lead gunshot falls into the environment and it can then be eaten by wildfowl and terrestrial birds and cause poisoning.”

media captionDanish hunter Niels Kanstrup explains why he believes lead shot is a “poison for hunting”

The evidence about lead in the environment has led to an EU-wide ban on the use of lead shot over wetlands. But, because that restriction did not enter into force before the end of the Brexit transition period, it will not apply in the UK.

The British Association for Shooting and Conservation (Basc), which previously argued against any change in the rules on lead ammunition, now supports the voluntary transition, but told the BBC that “change is difficult” and would take time.

“Lead shot is the traditional ammunition for live quarry shooting – it has been for generations,” said Steve Bloomfield from Basc. “[Our members] have to take time to try the alternatives – and those alternatives have to be effective and humane.”

In Denmark, hunters have had to use those alternatives since 1996, when lead shot was banned for all hunting.

Prof Green said he hoped these findings would speed up the move away from lead shot.

“I hope, within a few years, lead shotgun ammunition is not being used at all for game shooting in the UK,” he told BBC News.

“I have an open mind on whether this can be achieved through voluntary change or requires a government ban, but the evidence so far indicates that the voluntary approach needs to step up its effectiveness dramatically if it is to remain credible.”

Hancock under fire for claiming there was ‘never a PPE shortage’

Matt Hancock has faced outrage after claiming there was ‘never’ a national personal protective equipment (PPE) shortage during the pandemic.

Elisa Menendez metro.co.uk

The health secretary’s remarks were described by Labour as an ‘insult’ to frontline health and care workers who were forced to use ‘inadequate’ PPE, with some fashioning gowns out of bin bags.

His comments came amid questioning over a High Court ruling last week found he had broken the law over Covid-related contracts.

Mr Hancock told Sky News: ‘If I had my time again, absolutely I’d do exactly the same thing again. Exactly the same thing.

‘What I care about is making sure people have the protection they need. I care deeply about the staff of the NHS and the staff who work in social care and I care deeply that they have everything they need.

‘It was really tough but there wasn’t a national shortage at any point. There were difficulties in individual areas but there was never a national shortage.’

Hancock says he’d do ‘exactly the same thing again’ with PPE contracts

In further interviews today, he reiterated that ‘we were very close’ to a national shortage and it was difficult to deliver PPE ‘in the teeth of a national pandemic’.

However, he insisted it never got to that point as his team distributed supplies successfully – despite health and social care workers complaining of desperate shortages across the country which put their lives at risk.

Palliative care doctor, Rachel Clarke, called Mr Hancock’s remarks ‘categorically not true’.

Dr Clarke wrote on Twitter: ‘I say this as someone who *begged* local veterinary practices and schools for masks and visors.

‘Whose hospice nearly closed down through lack of PPE. This was happening up and down the country. It was horrendous.

‘The failures to provide PPE at the time were bad enough – but to lie about it now? Well that’s inexcusable.’

John Peek responded: ‘I’m a dentist and early in the pandemic, I gave visors and goggles to doctors who were working in A&E with totally inadequate PPE.’

Doctor Dominic Pimenta, chairman of charity the Healthcare Workers’ Foundation, said in a thread that the NHS ‘ran out of the correct PPE nearly instantly in many areas’.

He wrote: ‘Covid is airborne. Nearly 1000 U.K. healthcare workers have died as a consequence of inadequate PPE, one of the worst rates in the entire world.’

Rosena Allin-Khan MP, Labour’s shadow minister for mental health, said: ‘It is an insult to claim there was no shortage of PPE.

‘Many frontline workers had to ration protective equipment, putting themselves at risk.

‘Lots of it was inadequate and poorly fitting, and some NHS staff had to make gowns themselves from bin bags.

‘The fact is, it was a smash-and-grab for Tory donors and friends. And protecting workers who were putting themselves in harm’s way to look after people seems to have been an afterthought.’

Meanwhile, around 12 million masks being used in the NHS currently may not meet safety standards and have been withdrawn, reported the BBC.

Shadow Health Secretary Jonathan Ashworth said: ‘This is yet another example of ministers buying duff PPE that is inadequate for protecting our hardworking NHS staff. Ministers should apologise and ensure every penny for every piece of unusable PPE is recovered.’

The health secretary’s comments came amid questioning over last week’s High Court ruling over his department’s failure to publish details of coronavirus-related contracts on time.

He insisted the case, brought forward by the Good Law Project, was not over the ‘substance’ of the contracts but because they were published ‘on average around a couple of weeks late’.

Mr Hancock insisted legal cases about transparency returns were ‘completely second order’ to saving lives and that his officials had been working long hours to procure PPE instead.

As part of the Government’s transparency policy, No 10 is required to publish the procurement of any contracts for public goods or services worth more than £120,000 within 30 days.

The judge said there was ‘no dispute’ that in a ‘substantial number of cases’ Mr Hancock had ‘breached his legal obligation to publish contract award notices within 30 days’.

The billions spent by the UK government on fighting Covid need proper scrutiny

The point of Brexit, according to its champions, was to liberate Britain from intolerable EU rules. One of these was that government contracts should always go out to transparent competitive tender. This was supposed to aid efficiency and avert the endemic corruption of certain European states. One such state now appears to be Britain.

Simon Jenkins www.theguardian.com 

Last November the National Audit Office estimated that since the coronavirus pandemic began, Whitehall had given out £18bn in procurement contracts, largely for PPE supplies and test-and-trace services, including to firms with little or no record of such work. It turned out that the government also secretly set up a fast conduit – a so-called VIP lane – for contracts to people personally known to ministers, peers and MPs.

Unsurprisingly, this became a crony bonanza. Of the £18bn spent, the NAO has traced £10.5bn awarded directly without competition. About one in 10 bids to supply through the fast-track system were awarded contracts, against one in 100 from open tender bidders. Meanwhile, the procurement consultancy Tussell found that of £15bn in health department contracts to buy PPE by October, only £2.68bn of the contracts had been published.

The sums are staggering, as is the potential for waste. In August it was reported that 50m face masks unsuitable for the NHS cost the Treasury £155m: they came from a contract worth £252m with Ayanda Capital, a firm with a senior adviser who was also an adviser to the UK Board of Trade at the Department for International Trade. The NAO found multiple shortcomings with deals signed with Ayanda and Public First.

Last week we saw court documents showing Dominic Cummings’ central role in awarding a contract for Covid focus groups to Public First, “a research company owned and run by two of his longstanding associates”. The contract is the subject of a judicial review, in a case taken by the public interest group the Good Law Project.

On Friday, a high court judge ruled that Matt Hancock, the health secretary, acted unlawfully by not publishing details of multibillion-pound government Covid contracts. The case was also taken by the Good Law Project, which highlighted three PPE contracts: “A £252m contract for the supply of face masks with a finance company, Ayanda Capital; a £108m contract with Clandeboye Agencies, which had previously supplied only confectionery products, and PPE contracts worth £345m with a company trading as Pestfix.” It claims that the government has failed to publish such contracts in a timely manner, hampering scrutiny and transparency.

In his ruling, Mr Justice Chamberlain said: “The secretary of state spent vast quantities of public money on pandemic-related procurements during 2020. The public were entitled to see who this money was going to, what it was being spent on and how the relevant contracts were awarded.” He also criticised the minister for not simply admitting the breaches of the rules instead of spending £207,000 of public money defending them.

A familiar feature of emergencies is that governments feel entitled to take powers that would not be merited in normal times. Hancock certainly deserves sympathy for what has for him been a nightmare year. But we are seeing a web of connections involving others in the Tory establishment in the awarding of contracts: the much discussed “chumocracy”. Hancock’s attempts to excuse his lack of transparency as being “second order to saving lives” ring hollow.

Public sympathy relies on such emergency powers not being abused – as clearly is happening in these cases. At a time when billions in taxpayers’ money is being spent fighting disease and relieving hardship, breaking rules designed to avoid corruption can only diminish public sentiment and sympathy.

The government clearly hopes that its success with the Covid vaccination will wipe out memories of its failures in the early days of the pandemic. Yet it may be the case that its slapdash approach to PPE contracts has contributed to the raw fact that Britain has one of the highest Covid death rates in the world. When this emergency is over, the most searching of all inquiries will be needed: only this will ensure that a government all too happy to avail of emergency powers will actually bring them to an end.

Cost cap granted: “We will keep fighting” – Good Law Project

We are pleased to be able to tell you that the Court has granted a cost-capping order in our judicial review over the award of huge PPE contracts, without advertisement or competition, to Pestfix (a pest control company), Ayanda (an opaque private fund owned through a tax haven), and Clandeboye (a confectionery wholesaler).

goodlawproject.org 

After Government said it would cost an unbelievable £1million pounds to defend the case, we asked the Court to cap our exposure to Government’s legal costs at £100k. We are a small not-for-profit that relies on crowdfunding. After reviewing our fundraising efforts for the case so far and looking at what we have saved for a rainy day, this is the figure we could afford. 

Instead, the Court has granted a cost-capping order of £250k. It means that if we lose the case, we are liable to pay a quarter of a million pounds to Government, as well as needing to cover our own legal costs. Despite huge support from members of the public, generous individuals and organisations, we are still short.  

But we will not be bullied out by costs. This case, which we are bringing alongside EveryDoctor, is simply too important.

In awarding the cost-capping order, the Judge seemed to agree:

“All citizens are likely to have an interest in whether or not the procurement on the part of the government is done using good governance procedures and integrity. And therefore there is a real wider public interest that has been represented by the claimant group, which is a not-for-profit group, in bringing this challenge”

We will fight this case to its conclusion. The case will be heard in Court in May. If you are in a position to donate to the legal challenge, you can do so here:

https://www.crowdjustice.com/case/108million/