Is truth the first casualty of pandemics? Of all the deplorable claims made about Covid, for me the most brazen was one of the earliest, in April 2020, by Boris Johnson. He said we “succeeded in the first and most important task”, because “at no stage has our NHS been overwhelmed. No patient went without a ventilator. No patient was deprived of intensive care … We avoided an uncontrollable and catastrophic epidemic.”
When the prime minister uttered those extraordinary words, immediately after his own hospitalisation with Covid, I nearly choked in disbelief. Our death toll that day had reached 26,771. It was a dizzying number, too vast to comprehend. You grope for analogies to anchor such losses in your mind. This was like 60 jumbo jets full of human beings, each packed to capacity, falling from the sky. The insensitivity of attempting to spin as “success” such manifest horror took my breath away.
The truth is, Covid caused a collapse of healthcare as we know it – in both the first and subsequent waves. The NHS was overwhelmed. Two years on, so much rewriting of history has happened, it is easy to forget just how anarchic and desperate conditions were inside our hospitals in early 2020. NHS staff threw everything they had at increasing ICU capacity, but England’s starting point was only 4,000 critical care beds – one of the lowest numbers per head of any country in Europe. Horrified by the images from China and Italy, frontline staff like me implored the government to lock down. Yet hospitals were literally beginning to run out of oxygen before Johnson finally decided to act.
The service did not cope so much as shut down. In the frantic scramble to claw together as many ventilated beds as possible, surgical procedures in their thousands were cancelled. Cancers were left undiagnosed. Vulnerable patients dug in at home, too fearful or obedient to present to hospital. Staff couldn’t get tested for Covid. The PPE shortages were real and deadly. As for that “protective ring” Matt Hancock would later try to claim he threw around care homes, it was pure fiction. We all know what really happened to care home residents. Ignored and overlooked, they died in their thousands, not so much “cocooned” – as the government claimed – but incarcerated with Covid.
It serves many people politically to try to rewrite the grim realities of the pandemic as they actually unfolded inside the NHS. If anything, the attempts to spin, erase and deny the lived experience of health and care workers are more concerted now than ever. The mythologising of NHS “heroes” has been replaced by a pernicious new narrative, seductive to those of a libertarian bent, that lockdowns were draconian blunders – a panicky overreaction that must never be repeated. Last month, for example, the Telegraph published a piece by Fraser Nelson dramatically entitled: “Our liberty rests on whether Sage will admit to its horrendous lockdown mistakes.”
This could not be more wrong. Certainly lockdowns were a last resort, to be avoided if at all possible. But had we not locked down two years ago today, and again in January 2021, we would have seen corpses in hospital car parks, much like those harrowing images of Covid tents springing up outside hospitals in New York. Even as it was, there were too few ambulances, ventilators and critical care beds to go round. Patients died in corridors, they died in waiting rooms, they even died in hospital toilets. They died at home, alone, waiting for overwhelmed paramedics who couldn’t get there in time.
I write these facts not to shock but to urge reflection. It may be politically convenient for the government to embrace the “end” of the pandemic, for example – ending free testing, tracing and the requirement to self-isolate – but 11,000 hospital beds in England remain occupied by patients with Covid. Staff morale, meanwhile, has never been lower. A record number of more than 400 employees in NHS England are quitting their jobs every week.
One NHS intensive care consultant recently tweeted: “We started the pandemic with 17 ICU consultants. Over the last 24 months, two have retired, one has resigned, one is on long-term sabbatical, three have been off for long periods with stress – all needed psych support.” Clearly there isn’t a hope of reducing the 6.2 million-strong waiting list in England with staff attrition like that.
The bottom line is that the NHS is not coping much better now than it was at Covid’s peaks. We are drowning – in Covid patients, cancer patients, the patients on the waiting list backlogs, and the patients whose conditions have become infinitely more complex and harmful because they’ve been waiting so long. There are so few staff – and those left are so burned out and traumatised – that patients are inevitably being neglected. Oddly, NHS England seems to be following Sajid Javid’s lead in remaining silent about this. So much for NHS candour.
If patients matter, then being candid about Covid matters. The government must first be honest about the crisis conditions inside the NHS, and then commit to resourcing an urgent and long-term expansion of frontline staff, future-proofing the NHS against new waves of Covid. False narratives about the NHS “coping” are unhelpful and damaging. Is it any wonder our morale is at rock bottom when our lived experience – the world we inhabit daily – is sanitised, airbrushed and erased, and our political leaders – and much of the media – seem determined to ignore it and “move on”?
Rachel Clarke is a palliative care doctor and the author of Breathtaking