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The 31st October evidence session for Phase Two of the Covid-19 Inquiry was a Halloween nightmare for Boris Johnson and Dominic Cummings, casting some aides and advisors in a sinister light.
The public evidence exposed the infighting, indecision and chaos at the heart of Number 10 during the first pandemic wave in the early months of 2020, and revealed the Prime Minister’s complete unsuitability for leadership in a time of crisis.
Johnson’s Casual Disregard for the Lives of Older People
It highlighted the contemptuous, unrepentant attitude of Cummings, his willingness to blame everyone else in government apart from himself along with the confused, inconsistent lines of communication between scientific advisors, officials and ministers, resulting in what Cabinet Secretary Simon Case described as “Chaos”.
Most shocking of all was Johnson’s casual disregard for the lives of older citizens and his willingness to sacrifice them.
According to the diaries of then Chief Scientific Adviser, Sir Patrick Vallance, Johnson had agreed with Tory MPs that Covid-19 was “just nature’s way of dealing with old people”, that “the whole (Covid-19) thing is just pathetic”. Vallance also noted that Johnson was “obsessed with older people just accepting their fate and letting the young get on with life and the economy going”.
Ex communications director, Lee Cain, told the Inquiry that Johnson had been “concerned about the damage (from lockdown measures) on society as a whole and was trying to view things through that lens” when deciding the balance between locking down quickly to control the virus and potential harms to the economy.
Cabinet Secretary, Simon Case had said in a WhatsApp message that Boris had wanted to “let it (the virus) rip.”
Indeed, by October 2020, before the second Covid-19 wave, another Johnson WhatsApp had said that “The median age (for Covid-19 fatalities) was 82. That is above life expectancy. So get Covid-19 and live longer”. Johnson also wrote that: “I’m no longer buying the NHS overwhelmed stuff.”
It is hard to know where to begin with this. But I’ll try.
His Poor Grasp of the Mortality Data
First, life expectancy in the year you were born is not the same as life expectancy at the age you now are. A modelling study from Hanlon et al in Wellcome Open Research, using World Health Organisation (WHO) life tables, estimated that years’ life lost for people dying from Covid-19 averaged 14 for men and 12 for women.
Even adjusting for underlying long-term conditions, this was 11.6 and 9.4 respectively. Though the more underlying long-term conditions (at any age) the lower the number of years lost
The Health Foundation estimated that 1.5 million potential years of life were lost in the UK to Covid with an average of 10 years taken off each life.
According to analysis by the Office for National Statistics (ONS), between March 2020 and June 2022 there were 137,447 excess deaths in England and Wales. The highest numbers of excess deaths in that time were in April 2020 and January 2021, coinciding with the peak of the first and second waves.
So yes, the median age of those dying was 81 for men and 84 for women, higher than life expectancy when they were born, but many of these people would not otherwise have died but for Covid-19.
The Human Impact of Covid-19 on All Age Groups
Second – and I should not have to say this – these are human beings with families, life stories, years of contribution to society, roles as carers or grandparents, who have contributed tax and national insurance to the NHS over years. They are not “other”, not just expendable. They have human moral worth and people who care about them.
Given that most hospital admissions and bed days are already in people in late life, and that around one in three people in a general hospital bed is in their last year of living, should we write them off too – pandemic or not?
Nor is it just about death – but suffering.
As a doctor working on acute Covid-19 wards throughout the pandemic waves, I witnessed the grim sight, especially during wave one, before the development of effective treatments or vaccines, of how the virus hospitalised or killed so many people, and left others with long-term health damage. These were often unpleasant deaths from respiratory failure over days, with families prevented from visiting, and hospital staff working at serious personal risk. Many of those people would not have died unaided by Covid-19.
Third, it is not just older, frailer people who are clinically vulnerable to a pandemic respiratory virus. Those in younger age groups with disability, or with compromised immune systems, with diabetes, obesity, chronic respiratory or cardiac problems, or cancer were also at greater risk of serious infection, hospitalisation or death.
And “Long Covid” has harmed many people without underlying health conditions.
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Protecting the NHS Really Did Matter
Fourth, “protecting the NHS” was not just a slogan. England has the joint lowest number of hospital beds per 1000 people in the Organisation for Economic Co-operation and Development (OECD) with hospitals routinely rammed full and struggling to find capacity. There are only around 100,000 General and Acute beds for 62 million people. England also has among the lowest Intensive Care bed numbers per 100,000.
During the 2020 and 2021 pandemic peaks, around 1 in 4, then 1 in 3 beds were occupied by someone with Covid. Intensive care had to double in size to cope with the Covid-19 surge and put a huge strain on specialised and borrowed staff. Hospitals were close to running out of oxygen. Frontline healthcare workers were far more likely than the general public to contract severe Covid-19. Thousands were hospitalised or died. Many more were burnt out by the experience.
‘Let it Rip’ and ‘Herd Immunity’. Really?
Fifth, the notion of a focus on “protecting the vulnerable” and letting everyone else just get on with life is an impractical soundbite. There are around 8 million between 70 and 80 and 3 million over 80s in England. Add in those under 70 who are clinically extremely vulnerable, and that is a big chunk of the adult population. They often rely on care, support and interaction from younger people. Sequestering that many in prolonged isolation for their own good was never ever feasible.
Sixth, the notion that “Herd Immunity” aka “Population Immunity” from Covid-19 could ever be attainable before vaccines were available, just by “letting it rip” through the population and taking some collateral damage, despite natural variations of the virus, despite reinfection, was never remotely a viable one.
So some kind of health protection measures would always have been necessary during the 2020 and 2021 Covid-19 waves.
To pretend otherwise was a fantasy and was not a feature of the pandemic response in countries considered to have performed well.
Of course, we can argue about which set of measures that should have been, what constitutes “lockdown” per se – as the term is thrown about for things that never were – and about whether the main focus should have been more on testing, isolation of cases and contact tracing.
We can argue about whether the trade-off between the economy and health protection measures was a false dichotomy, or about the extent to which lockdown and other measures worked in various other nations.
Some of Boris Johnson’s remarks suggest he didn’t even want to protect older people, just expose them to a natural culling from the virus. But Johnson’s callous indifference to old and clinically vulnerable people, his inability to put their needs before his own popularity or party management, to listen to scientific advice or act with any consistency showed him, on Halloween, to be the self-serving ghoul that he is.
History will be “nature’s way” of dealing with this and his lucrative move to GB News won’t ever compensate for it.