Alison O’Connor: Hamstrung health system has battled admirably against Covid

US president Donald Trump, rather than protect his citizens, has been leading them towards a cliff edge and then over it, writes Alison O’Connor.
Alison O’Connor: Hamstrung health system has battled admirably against Covid
‘Washington Post’ catalogued, over the months, the errors, the denial, and the dysfunction and spoke of ‘31 times Trump downplayed the coronavirus’.

US president Donald Trump, rather than protect his citizens, has been leading them towards a cliff edge and then over it, writes Alison O’Connor.

The public health experts say the only way to truly know how you’ve performed in a health crisis, such as our current one, is after it is all over.

What we can say, at this point in time, is there is no doubt but that we are going in the right direction.

We need only observe the situations of our nearest neighbours in the UK, and the US, to give us the context in how really well we are doing.

Watching the US is like observing from afar some awful horror movie where people realise way too late the guy meant to protect them has actually been leading them towards the cliff edge and then over it.

It’s worse actually, in that a sizable number of the population, and senior politicians, could recognise exactly where things were going but were powerless to alter the course because the buck ultimately stops with the president.

There are daily reports on the extraordinary manner in which Donald Trump has mishandled this crisis.

One in particular, an investigation carried in The Washington Post last weekend, was truly breathtaking as it catalogued, over the months, the errors, the denial, and the dysfunction and spoke of “31 times Trump downplayed the coronavirus”.

In the UK, the phrase ‘herd immunity’ will live long in the national memory.

As the prime minster, Boris Johnson lies seriously ill in hospital, his ministers seem to spend as much time jockeying for position as handling the crisis.

Some of the briefing and back biting has been vicious. During the week, ministers were accused of self-preservation and focusing on their own careers by “shameful” bad mouthing of senior public officials on the unimpressive handling of the coronavirus in the UK.

In a hard-hitting article for the Guardian, Dave Penman, the general secretary of the FDA union, which represents the UK’s most senior public servants, said that some in government were ignoring the dedication of public servants and instead using them as scapegoats.

It was one of the biggest single shocks of all to hear that Johnson had been moved into an intensive care unit, and he will hopefully make a full recovery.

But how to forget some of his earlier utterances on the virus, not least this, on March 3: “I’m shaking hands continuously.

I was at a hospital the other night where I think there were actually a few coronavirus patients and I shook hands with everybody, you’ll be pleased to know. I continue to shake hands.”

But it actually does a disservice to our own health and political systems to only say they have performed well in comparison to the often shambolic experiences in the US and the UK.

As a standalone, both have performed exceptionally well in this crisis. This is especially true when you consider the state of our health system at the beginning of all of this, and the fact that we had a caretaker government in place.

Other countries that are mentioned which have responded well, such as South Korea, or Singapore, lived through the traumatic Sars epidemic and were far more virus-ready when the time came, able to act fast and with populations readily willing to co-operate.

Much criticism here has arisen from the failure to carry out 15,000 virus tests each day as promised by Health Minister Simon Harris on March 19.

He should never have given that pledge, but to be fair to the minister, who has mostly been exceptional during all of this, the World Health Organisation (WHO) was saying, “test, test, test” at that time, everyone was very panicked, and the definition for testing was far wider.

Even his critics in the health system would say he was trying to provide reassurance. But it was a pledge that has been used as a stick to beat everyone involved since.

At the start of this process the HSE began its effort to set up an integrated system to deal with Covid-19.

They were starting from zero. Essentially we had one laboratory — the National Virus Reference Lab (NVRL) — testing for the virus. We’ve now got 20. We’ve also got 50 testing centres around the country.

There are the procurement complications involving the ongoing global shortage and demand for reagent as well as swabs for testing, A broad case definition for testing was decided on (using the WHO and the European Centre for Disease Prevention and Control for guidance). This, as we all know, was subsequently significantly narrowed.

As things stand, even with the reduced testing numbers, the system is far from fully operational. The hope is that by the middle to end of next week it will be much improved.

Reagent is due to arrive from China. Once it is tested and approved by the NVRL, it can be used.

You might wonder why someone wasn’t sent to China to test it before it was sent, similarly with the personal protective equipment for healthcare workers, a significant amount of which was found to be unsuitable for use.

However, if we actually sent senior people to China to do thorough checks, they would have to isolate there for 14 days when they arrived and then isolate here when they got back. It simply isn’t practical.

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IRONICALLY, it is now believed that, given the new, redrawn definition for testing, there would not be enough suspected cases coming through the system to make anything near 10,000 people a day.

This does open up wider questions about whose testing definition we follow into the future, especially as we make decisions about how to open up the country again, a time when testing and tracing will be crucial to ensure the virus does not once again get a grip on the population.

So why hasn’t this very interesting fact about the probability of there not even being enough people in the testing system to make up that 10,000 figure been shared publicly?

Surely it might help people to understand and ease criticism? Well, those sort of decisions are taken by National Public Health Emergency Team.

Their logic on this is not currently known. Communication around all of this could have been much better, but to be absolutely fair the high degrees of suspicion that have been brought to the table in this instance are unfair within the broader context.

The media quite legitimately asks questions of the politicians and the senior health people. It is worth pointing out that they are given opportunities to do so on an almost daily basis.

Sure, there have been some unsatisfactory aspects but frankly there is little to complain about.

In the overall scheme of things, I’d be nominating most of the senior people involved here for a knighthood or a damehood if we had such an honours system.

Granting them, in the future, the freedom of where they are from is the least we can do on the evidence of the extraordinary work they have done for us so far.

Surely, for example, being allowed to graze sheep on St Stephen’s Green would be a fitting way to honour the supreme effort of the chief medical officer Tony Holohan, a native of Dublin, after he is granted the Freedom of the City.

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