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Sat 28 March 2020
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Former consultant to the Department of Health and Social Care Stephen Colegrave explains how premature deaths are under-recorded and demands full transparency over the Government’s scientific advice.

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It is fairly obvious by the way he is tackling the Coronavirus outbreak that the US President, Donald Trump, cares more about the health of the stock market than the nation. He is doing everything he can to inhibit mass testing and concentrating on flashy initiatives such as banning European travel in the hope of turning markets around – even if it is having the opposite effect.

This could be explained as typical of a populist leader’s approach of covering up inactivity and the avoidance of doing hard stuff – such as really improving public health and resilience. But, it seems increasingly clear that Trump still believes his re-election chances are tied to the stock market and that, as long as the Dow Jones is healthy in six months time, voters will forgive him for his ineffectual handling of the Coronavirus pandemic, which wasn’t his fault in the first place.

As Andy Slavitt – the former Medicare, Medicaid & ACA head for the then President Barack Obama – explained today, experts are expecting US deaths to reach up to a million mainly because of inaction and a lack of preparation, particularly when it comes to testing.

The real concern in Britain is that we will also be kept in the dark about the COVID-19 pandemic because premature deaths for people in their 70s – and especially in their 80s – will hardly be noticed or attributed to the Coronavirus.

Over the past few days, the Government has been floating the idea of “herd immunity” as the best approach to tackle the pandemic. Since this would require immunity through infection of a majority of the population in the absence of a vaccine, Prime Minister Boris Johnson and his chief advisor Dominic Cummings could be suggesting this as the best course of action in order to avoid a financial recession and follow the Trumpian plan.

They could be calculating that many Coronavirus deaths will go unattributed and unrecorded. They have already admitted that, although nearly 800 people have so far tested positive for the virus, the real figure is likely to be 10 times greater. In effect,  90-95% of Coronavirus cases will never be known.

The UK has form on this. In many deprived parts of the country, premature death is already prevalent. As I have written previously in these pages, the recently published Health Equity in England – The Marmot Review 10 Years On report highlighted that health inequalities in the UK that have led to premature death in large sections of the poorest parts of our society. A premature death is defined as the death of a person aged under 75 – many of the poorest areas of the UK fall well below this.

“Living in a deprived area of the north-east is worse for your health than living in a similarly deprived area in London,” Dr Jennifer Dixon, chief executive of the Health Foundation, which commissioned the report, said. “To the extent that life expectancy is nearly five years less.”

The Government knows that the public is largely ignorant with regards to premature deaths.

In 2017, the Royal Society of Medicine stated that austerity measures were likely to have been responsible for 30,000 deaths in England and Wales in just one year, 2015. That same year, researchers at UCL estimated that there had been 150,000 premature deaths due to austerity between 2015 and 2020.

The Government has a strong majority, but the one thing that could scupper any re-election chances is a major recession and prolonged economic shock. This would be much worse for a Conservative Government since the party seems to do well off the back of its perceived financial competence.

This might seem fanciful given the current Coronavirus crisis but a heath event can arguably be blamed on something else, its effects are unlikely to impact many people under 70 and the true numbers are likely to be hidden.

Conservative MP Jeremy Hunt, the former Health and Social Care Secretary, has been critical of the Government’s approach on the Coronavirus and is worried that the lack of action is speeding up the infection and death rates. 

We are told that that the Prime Minister has chosen this path based on scientific advice, but as someone who has worked closely with the Department of Health and Social Care in the past, I know it will have received different options. Typically, three of these are provided in a submission by civil servants and one option encompasses “doing nothing”. I strongly suspect that one of the options would have been closer to what Hunt would have wanted – an approach much more closely aligned to Italy and France, with widespread social isolation recommended and the banning of large public events.

We will never know unless the scientific advice is made public and we will never know how political considerations altered that advice unless it is published.

If the Government wants our trust, it should be transparent about this. We should all demand that it immediately releases all of the options presented by the Civil Service and given an explanation as to why the UK’s outlier approach has been chosen. Otherwise, we may be left drawing the terrifying conclusion that this Government cares more about markets than it does about deaths.


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