a retiring ‘hand-hygiene’ doctor reflects…….
Forty years is a long time. Long enough to get to the Promised Land! Forty years I’ve been a doctor and academic in the sometime wilderness of a health service and I can tell you, “There’s no Promised Land!” By the time you read this I will have retired. Going a bit earlier than I wanted after some health problems. Going in very strange circumstances, working on a “non-COVID” ward, except that COVID-19 spreads, so that some days half the patients have it.
I could blog, like most doctors, about the shortages of alcohol hand-rub, masks and gowns, the sadness of families separated by isolation, and the fear that COVID-19 induces, especially at my age, with a one in 45 chance of dying from it. Not sure I’d cross a busy road at those odds! Talk about “teach us to measure our days” (Psalm 91)! But I have a different perspective, anticipating a post-COVID world, as I was for 20 years a ‘hand-hygiene doctor,’ and for many pre-COVID months, a ‘China Watcher’.
As ‘hand-hygiene doctors’, our group persuaded Government to put alcohol hand-rub at every bedside in the (successful) battle against hospital superbugs, when the UK was regarded as “the dirty man of Europe”. We trialled effective ways of improving hand-hygiene. We did infectious disease modelling. It’s ironic I depart when Britain appears to have Europe’s highest COVID-19 death rate, and the focus is again on hand-hygiene. When I find an empty hand-rub dispenser, I don’t know whether to be happy people are using it or cross that it has run out!
As a “China Watcher,” rallying Jews to help Uyghur Muslims facing the biggest Genocide since the Holocaust, I closely follow information from Chinese dissidents, researchers and NGOs.
On 11th February, 67 days after China’s first case, leaked intelligence suggested China had 2.8 million COVID-19 cases, not officialdom’s 44,000, with undertakers so overwhelmed they were burning bodies.
I emailed this to friends in public health. Suggested declaring a pandemic. Stopping flights. I got a “wait and see, it’s complex” response. I don’t blame them, given their constraints. Even I, when asked in shul in public, “Is a pandemic likely?”, said, “It’s possible but don’t quote me!” and I don’t have to answer to government! Took 29 more days to declare the pandemic. Turned out the ‘intelligence’ was right, for their figures predicted, pro-rata, the UK would have 136,000 cases, 67 days after our first case. It was actually 165,000. ‘Other countries did not ‘wait and see,’ saying ‘its complex’. They acted immediately, saying ‘this is dangerous’. And that is why I leave Medicine, ‘angry in the time of Corona,’ demanding some inquiries, reckonings, and settlements.
Britain needs an Independent Inquiry. Why did the infectious diseases models informing government actions not include the obvious infection control measure of testing and tracing? Was it because we had insufficient facilities? Did this have anything to do with the 2012-13 reorganisation of public health, which made it an arm of government, downsized its regional laboratory networks and pooled its funding with local government’s? Did the models include the hospital-care home interface? Our group warned in a 2001 BMJ editorial that we needed a national strategy for infection control in care homes, as the elderly had moved from the public to private sector without the accompanying infection control expertise. What did the 2016 pandemic simulation exercise show? What action was taken? Results are still classified! What did official advisers advise Government? There are no minutes. What were our intelligence services saying about China’s real COVID-19 figures? For the first time, I find myself in some sympathy with Julian Assange!
Other countries tested and traced straight away: Taiwan, South Korea, Israel. Israel’s death rate is 10% of ours, Taiwan’s and South Korea’s even lower. South Korea met early with industry and drove up essential supplies’ production. Why couldn’t we, governed by ‘the party of business,’ do the same? Their incompetence is shocking. Except we already know from many failed social reforms that this lot cannot organise anything. Couldn’t get shikkur in a Chabad House on Purim!
We need a reckoning with our Government for the decade of austerity which, to quote ex-Spurs manager, Harry Redknapp, describing a long injury list, “bit into the bone!” Call me ‘Cassandra,’ but before the 2010 election, I warned that a vote the wrong way would cause our social infrastructure’s gradual collapse. Our capacity even to cope with normal winter surges of activity, let alone a pandemic, has gone, as severe austerity saps efficiency. Our under-resourced Health and Social Care workers have stepped up to the plate, many paying with their lives.
I don’t want the public’s applause every Thursday night, I want them to demand a national settlement, a covenant between people and government, that the capacity of both health and social care is never allowed to wither like this again.
I’d like some accountability. If not “heads on spikes” or “their nobles in chains of iron” (Psalm 149.9) then perhaps ministers, who ignored pandemic simulation exercises or oversaw damaging reorganisations, banned from future office! There’s a worldwide crisis in confidence in government and leaders, seen as self-entitled elites, perhaps exemplified by our architect of ‘social distancing’ breaking regulations to tryst with his married lover! “Put not your trust in Princes” (Psalm 146.3).
Perhaps we get the leaders we deserve by not demanding AND paying for what we really need. After all this is, a covenant I am proposing! Time to take a serious look at the Nordic socio-economic model where both business and people pay but gain through robust health and social care. Ill health and disability are the ultimate democracies. We can all suffer these. We all have a duty to care. Six times a day we tell Hashem “You support the fallen, You heal the sick.” The truth is that it is we, created in Hashem’s image, that will support and heal. And how? The Shema answers: “with all your might”. What is “might”? “Money” (Talmud Babli, Berachoth 61b). Well, not all of it! But business and individuals will have to contribute more.
So, in the post-COVID world, if we really take stock, with our Inquiry, Reckoning and Settlement, then there might be a ‘Promised Land’ for my retirement after all!