A combination of the UK variant becoming dominant and a new “double-mutant” variant emerging has overwhelmed India.
This week I counselled a patient who lost a family member to COVID-19 during the first wave of the pandemic. My patient has been suffering from clinical depression ever since.
It is easy to get caught up in the positivity surrounding the successful rollout of the coronavirus vaccines here in the United Kingdom, but the dark days that led to almost 130,000 COVID-related deaths are still etched in many NHS workers’ minds.
Each one of these 130,000 people were human beings with hopes and aspirations; each one had someone who loved them and who will miss them now they are gone.
The Covid-19 Bereaved Families for Justice UK has called for a public inquiry into the government’s handling of the pandemic, and has been backed by prominent figures including the Archbishop of Canterbury. But the government has refused, stating: “An inquiry now is not appropriate, and the very people who need to give evidence to an inquiry are working round the clock.”
This has not only angered families of those who have died but also front-line healthcare workers who have watched their colleagues die after catching the coronavirus while at work.
To say that those who are in charge of the handling of the pandemic are too busy to give evidence feels like a smack in the face for many like myself who have been managing patients with COVID-19, balancing the needs of those with other illnesses and running COVID-19 vaccination hubs. We are the ones who are really “working round the clock”.
Last week, Dominic Cummings, the man who was chief adviser to the Prime Minister during two waves of the pandemic, revealed just how poorly the government has handled the pandemic. He lambasted Boris Johnson, Health Secretary Matt Hancock and other senior members of the government as well as himself in a seven-hour session with MPs of the Commons’ Science and Technology Committee.
The man who famously drove to tourist hotspot Barnard Castle in April 2020 when the rest of the country was in a nationwide lockdown to “test his eyesight” apologised for his own shortcomings over the handling of the pandemic before describing a government that allegedly lacked leadership especially in the early stages of the crisis. He claimed Boris Johnson failed to grasp the gravity of the situation and delayed lockdown measures meaning “tens of thousands of people died who didn’t need to die”. He went on to say he didn’t think Johnson was “fit to be prime minister after presiding over a chaotic and incompetent pandemic”. The government, of course, disputes these claims and Cummings has yet to provide evidence to back them up.
However, he took particular aim at Hancock, stating that he had lied repeatedly in government meetings about the testing of care home residents who were in hospital before being discharged home. Cummings told the committee: “The government rhetoric was that we put a shield around care homes … it was complete nonsense. The opposite of putting a shield around them, we sent people with COVID back to care homes.”
Whatever the truth is here, I can speak from experience when I say that people were being sent back to care homes from hospital in March and April 2020 without being tested for COVID-19, potentially leading to the virus being seeded in care homes full of the most vulnerable people in our society.
As a community doctor, I went out to see these patients as they deteriorated. I had to assess them and make a diagnosis of COVID-19 on symptoms alone – tests were not available to us. I felt completely helpless.
Treatment options were limited and sending them back to hospital was futile as treatment options were limited then and many of them were not candidates for intensive care treatment and ventilators due to being so frail.
The lack of personal protective equipment (PPE) for healthcare workers during the first wave of the pandemic remains a contentious issue. Many hospital workers took to social media at the time with pictures of poorly fitting PPE and some even having to make PPE for themselves out of bin bags.
There were also concerns over who was being awarded contracts for making and delivering PPE. Companies such as Clandeboye Agencies were awarded contracts worth hundreds of millions of pounds to deliver PPE, but its main business was confectionery.
In February 2021, the High Court ruled that the health secretary had acted unlawfully by failing to publish details of these multimillion-pound contracts within the 30-day period required by law. Government regulations require details of all contracts worth more than £10,000 ($14,290) to be published within this time frame. At the High Court ruling, Hancock said that while “there were individual challenges accessing PPE, there had never been a national shortage, because of my team”. Healthcare workers who had lost colleagues and put their own lives at risk due to difficulties accessing PPE were deeply offended by this. Dame Donna Kinnair, the chief executive of the Royal College of Nursing, said: “Nursing staff who were put in harm’s way because they could not access proper protective equipment will find this claim deeply insulting.”
More recently, as the UK battles with rising numbers of cases of the variant first detected in India, which has been discovered in some communities, people are asking why the borders were not closed down early enough to keep it out.
As UK citizens were told that they should only travel and leave the country for essential reasons, thousands of planes were allowed in from other countries, potentially bringing in a steady flow of new COVID cases. While people were told to self-isolate after entering the UK, it became clear many were not doing so, leading to the community spread of the virus.
Eventually, a “traffic light” system was introduced for foreign travel, with a ban on travel to countries on a “red” list, though those returning from red list countries were still allowed in but had to self isolate in hotels for 10 days and produce two negative COVID tests. Pakistan and Bangladesh were added to this red list on April 9, 2021, but despite India having much higher rates of infection and seeing a deadly wave of the disease sweep through its major cities, it was not added until April 23, when the country’s disastrous second wave had already been under way for some time.
Many in the UK believe that this delay was due to Johnson’s desire to fly to India to discuss a trade deal with Indian Prime Minister Narendra Modi. The trip was eventually cancelled, but not soon enough to prevent the variant first identified in India and causing chaos in that country from reaching the UK.
In the delay to place India on the red list, thousands of people were allowed to fly in from India and some of them were carrying the highly transmissible variant with them. This has led to outbreaks of the new variant in places like Bolton and Bedford in the UK, and local health authorities have struggled to contain its spread.
Furthermore, there are questions about how transparent the government has been about the spread of this new variant in schools. Data from Public Health England (PHE) originally contained a page that suggested 7.8 percent of cases of the variant first found in India in the UK were linked to transmission within schools, but when the document was published on May 13, this page had been taken out. Scientists are concerned that this variant can spread more readily in children and this data must be considered before any easing of restrictions that are set for June 21 in the UK.
There is no doubt that the vaccine rollout has been a huge success in the UK, but I want to make one thing clear: the success of the vaccine rollout is due to the dedication of my colleagues in the NHS who have worked tirelessly over the last six months to ensure as many people get the vaccine as possible. I, like many other doctors and nurses, have committed many of my days off to working in our local vaccine centre. To claim the success of the vaccination programme is down to the government alone without the huge contribution of the NHS, particularly those in primary care, would be untrue and insulting.
Despite all this, the government is still insistent it will not start a public inquiry until April 2022. As someone who has worked on the front line throughout this pandemic, who has seen patients die from the disease, I would like to see this inquiry brought forward and I am sure doctors in other countries feel the same.
There are many questions to be answered and lessons to be learned and we need to learn them while we are still fighting the pandemic – not afterwards. Without an independent, public inquiry right now, that will not be possible.
Progress report: Pfizer vaccine approved for children aged 12 to 15
On May 28, the European Medicines Agency (EMA) announced that it had authorised the use of the Pfizer-BioNTech COVID-19 vaccine for children aged between 12 and 15. This means EU countries can start vaccinating school-age children.
The EMA reviewed the results of a study involving more than 2,000 children aged 12 to 15 which found the vaccine to have a 100 percent efficacy rate in preventing COVID-19, though they admit the sample size was small and the rate is more likely to be somewhere above 75 percent. Side effects experienced were similar to the ones experienced by adults and include a sore arm, tiredness, headache, chills and fever. These side effects are short lived. The authorities in the United States have already approved the use of this vaccine in adolescents aged 12 to 15. Other countries (including Qatar and the UAE) are also already rolling the vaccine out to children in this age group.
Personal account: Why I am so angry with Indian yoga guru Baba Ramdev
I, like many healthcare professionals around the world, was left feeling furious last week after yoga guru Baba Ramdev mocked sick people in India for trying to source oxygen cylinders.
Baba Ramdev shot to fame because of his televised yoga classes in India and has millions of followers online. He also has a successful business empire. A video of the guru went viral showing him saying “God has given us free oxygen, why don’t we breathe that? How can there be a shortage of oxygen when God has filled the atmosphere with oxygen? Fools are looking for oxygen cylinders. Just breathe the free oxygen. Why are you complaining about a shortage of oxygen and beds and crematoriums?”
The video had drawn much criticism from healthcare professionals in India and around the world, who have put their lives on the line caring for those with COVID-19. Baba Ramdev eventually withdrew his statement but, later, another video emerged of him blaming doctors for COVID-19 deaths.
To mock people who are sick and vulnerable shows a complete lack of empathy. To mock doctors who are on the front line shows a lack of compassion and insight. As a doctor, I support those who have been working throughout the huge wave of COVID infections and deaths that India has seen. We only ever practise evidence-based medicine and want what is best for our patients.
And now, some good news: COVID antibodies may last years if you have had the virus
A study published in the science research magazine, Nature, shows that people who have had a previous COVID-19 infection are likely to produce antibodies against the virus for most of their lives.
Researchers behind the study found that, after a COVID-19 infection, cells in the bone marrow that are triggered as part of your immune response may retain the memory of the virus and produce long-lasting antibodies as a defence against future infections with the same virus.
The study examined 77 people and, after 11 months, antibody levels could still be detected, albeit at lower levels, in the blood.
The author of the study has urged people who have had an acute infection to still come forward and get the vaccine, however, as this will help protect them against emerging variants.
Reader’s question: Is it safe to go on foreign holidays?
For many of us, it has been more than a year since we were able to travel abroad safely. Many countries have travel restrictions in place to discourage citizens from taking foreign holidays during the pandemic.
As time goes on, the lure of warm weather and pristine beaches becomes harder to resist, but it is important to remember the pandemic is far from over.
While we know the vaccines protect us from serious illness from the virus, we still do not know just how much vaccines reduce transmission of the virus to others.
The added concern about foreign holidays is the risk of encountering new variants of the coronavirus. People tend to mix in close proximity when they are on holiday – be it in hotel restaurants or shops and cafes. This increases the risk of spreading variants and the chances of a person bringing one home.
There is good evidence so far that two doses of the vaccine offer good protection against the variant first identified in India, but we still don’t know how effective vaccines are against those variants first found in South Africa and Brazil. We also have no idea where the next worrying variant is likely to arise.
If a new variant brought in by foreign travel takes hold in a community, it may be difficult to contain and will subsequently spread outwards to other parts of the country, leading to longer and harder restrictions for everyone.
So, my advice is to hold off on foreign holidays this summer – it is safer and arguably just as enjoyable to explore beauty spots in your home country. Let this summer be the summer of the “staycation” and we can look forward to foreign travel again in the future when it is safer for everyone.