The UK has been in lockdown since March 23rd 2020 in an attempt to slow down the spread of the Covid 19 virus. Six weeks on the number of new cases per day has begun to decrease and government and business are clamouring to restart the UK economy. We believe that people’s health should come before profit and that there should be no return to work until it is safe to do so.

The UK has the highest death toll from Covid 19 in Europe and the data does not to support that it is yet safe to relax physical distancing.

https://www.theguardian.com/world/2020/may/05/uk-coronavirus-death-toll-rises-above-32000-to-highest-in-europe

https://www.theguardian.com/world/2020/may/02/coronavirus-uk-how-many-confirmed-cases-are-there-in-my-area

We may have reached the peak but there were still nearly five thousand new cases diagnosed on 3rd May 2020 and because access to testing has been so poor it is impossible to know how many other people in the community are infectious.

We cannot undertake any meaningful planning for an exit strategy from the current lockdown without an understanding of COVID-19’s prevalence and our current levels of immunity.

On April 2nd Health Secretary Matt Hancock promised to test 100,000 people daily by the end of the month. The government claim to have reached their target though there are allegations that the tally was artificially boosted.

https://www.theguardian.com/world/2020/may/01/ministers-accused-of-changing-covid-19-test-tally-to-hit-100000-goal

Testing must be safe, freely available and reliable and must be accompanied by rigorous contact tracing.

https://www.theguardian.com/world/2020/apr/29/uk-turned-down-offer-of-10000-coronavirus-tests-a-day-four-weeks-ago

True prevalence is proving hard to predict. Where one study suggests 75% of people infected may be asymptomatic, another reports a very low rate of current infection – less than 1% of the tested population.

The only way out of this is to gather data and learn the truth.

Epidemiological studies of appropriately sized, randomised cohorts repeated every few weeks would chart the progress of the disease.

Cuts to Public Health have made it virtually impossible to mount coordinated local responses to Covid 19 with testing, isolating and contact tracing. Restoring and updating local communicable disease control is an integral part of properly funded, publicly provided health and social care.

https://www.theguardian.com/world/2020/apr/26/to-tackle-this-virus-local-public-health-teams-need-to-take-back-control

The lack of appropriate PPE is an ongoing problem in public facing jobs and this will only be exacerbated as more people return to work. Industry must be immediately repurposed to produce appropriate PPE in sufficient quantities.

If people are to return to work it must be safe for them to do so, including their commute.

Each workplace should undergo appropriate risk assessment to prevent unnecessary transmission of the virus. We do not believe that the Government can be trusted to do this. Trade Unions must have oversight. For example it should be up to the education trade unions to determine whether it is safe to open schools and the criteria that will need to be met. Schools must not be seen by Government and business as convenient childcare to enable kickstarting the economy. We support the NEU’s demands that schools should only be opened when it is safe to do so.

https://actionnetwork.org/forms/open-schools-when-it-is-safe/

Covid 19 has highlighted the importance of a nationally coordinated, publicly provided health and social care service. The NHS has excelled itself in coping with the crisis whereas the largely privatised, for profit, care home sector, which has no central coordination, has been tragically unable to prevent Covid 19 from taking a huge toll on it’s residents.

https://www.bmj.com/content/bmj/369/bmj.m1465.full.pdf

It is well known that there is a spike in morbidity and mortality from all causes when a pandemic hits and services focus on the crisis in hand.

https://www.bmj.com/content/bmj/369/bmj.m1607.full.pdf

The private health sector must not be allowed to profit from this. The private sector should be requisitioned if they are needed to help to clear the backlog. Matt Hancock, Secretary of State for Health and Social Care promised “We’ll give the NHS whatever it needs and we’ll do whatever it takes.”

https://www.parliament.uk/business/news/2020/march/covid-19-statement/

The NHS needs investment to deal in house with the waiting lists inevitably generated by the crisis, and investment must be ongoing to preserve NHS resilience. One of the lessons from Covid 19, and most winter flu epidemics, is that the NHS cannot be run flat out all year round without headroom and spare capacity to cope with peaks in demand.

New infrastructure, such as software for arranging work rotas, is increasingly outsourced to the private sector. This is unnecessary and could easily be managed within the NHS.

Neither must health care be rationed to cope with the back log. We reject the blanket use of the term Procedures of Limited Clinical Value (POLCV). Patients care must be decided individually on clinical need and not restricted due to financial pressures.

Deprived populations have very high death rates and the effects of societies’ response to Covid 19 disproportionately affects those from BAME communities, the poor and vulnerable.

https://www.theguardian.com/uk-news/2020/may/01/covid-19-coronavirus-newham-london-uk-worst-affected-area

The UK is one of the most unequal societies in the world, while the more affluent are able to isolate in comfortable homes with plenty of outside space the poorest often have to share beds and go without food, for them physical distancing is impossible. Many epidemiologists, including Sir Michael Marmot, have demonstrated that the more unequal a society is the less healthy it is for everyone, including the richest. The Health Foundation Report published only two months ago “ The Marmot review ten years on” is a damning indictment of Government policy.

https://www.health.org.uk/publications/reports/the-marmot-review-10-years-on

Many other commentators suggest ways to redress the imbalance, they have largely been ignored by the Tory Governments. We contend that if these measures had been introduced it would have been much easier to contain Covid 19. We demand that Marmot’s original recommendations to be fully implemented.

http://www.instituteofhealthequity.org/resources-reports/fair-society-healthy-lives-the-marmot-review

In conclusion we believe that people’s health must not be sacrificed in the interests of profits. There should be no return to work until it is safe to do so and ordinary people must not be made to pay for the crisis, there must be no return to austerity. The UK is a rich country and there is plenty of money in society to ensure that everyone’s needs are met. If the banks could be bailed out in 2008 the people can be supported properly now. A Green New Deal would help to provide a more sustainable economy and a Universal Basic Income would help orientate us towards a fairer society based on need not profit.

In summary before lock down ends there must be:

  • Testing which is freely available with contact tracing which is rigorously followed up and restoration and updating of local communicable disease control as an integral part of properly funded, publicly provided health and social care.
  • Frequent epidemiological studies of appropriately sized, randomised community cohorts to determine the prevalence of Covid 19.
  • Appropriate PPE for all public facing workers.
  • Repurposing of industry to produce sufficient supply of appropriate PPE.
  • Universal Basic Income and a Green New Deal with an economy based on need not profit.
  • Trade Union oversight on the safety of return to a particular workplace and trade union control of the safety aspects such as physical distancing
  • No exploitation of the backlog in care by the private sector to boost their profits.
  • A comprehensive National Health and Social Care Service, publicly funded, publicly provided and free at the point of delivery for all in the UK with adequate investment and an end to outsourcing, privatisation and fragmentation.

Posted by Jean Smith on behalf of Doctors in Unite 5.5.20

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2 Comments

  1. JohnB says:

    Is there an explanation as to why deaths from Covid 19 are only classified as such, for daily counting and reporting purposes, if and only if the deceased has been previously tested positive for C19? I understand that deaths recorded as from C19 on death certificates are NOT included even though the certificate specifically states the cause of detah as C19 if there has not been a test.

    1. Brian Joseph Gibbons says:

      A death certificate does not require that the person has been tested positive for Covid-19 for that diagnosis to be listed as a cause or contributory factor in the person’s death.

      https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/articles/coronaviruscovid19roundup/2020-03-26

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