“Outbreaks are inevitable, but pandemics are optional”

The Tory government has increasingly come under fire from the public and healthcare workers for its handling of the Covid-19 crisis. Images on social media of health workers crafting makeshift personal protective equipment (PPE) from bin bags, school goggles and snorkels have sparked disgust.  

How lives are being put at risk by profit

By Seán Burns

The Tory government has increasingly come under fire from the public and healthcare workers for its handling of the Covid-19 crisis. Images on social media of health workers crafting makeshift personal protective equipment (PPE) from bin bags, school goggles and snorkels have sparked disgust.  

A spokesperson for the Royal College of Nursing (RCN) reflected the feeling of staff on the frontline: “Nursing staff should never be forced to choose between their safety and their livelihood – this equipment must desperately reach the frontline.” Forty-six healthcare workers in the UK have already died as a result of contracting the Covid-19 virus, and the RCN has warned that more will come. The safety of health workers’ families is also jeopardised. Many staff may have immunocompromised family members, or family with an underlying health condition that puts them at particular risk of serious complications.

Medical experts planning for an influenza pandemic advised the government three years ago to stockpile equipment such as eye protection. But the recommendations were toned down after the government’s economic assessment questioned the “cost-effectiveness” of such purchases. In reality, the time and space to prepare for this pandemic was there. 

Tories forced to act

At every stage, the Tories hesitated to hurt business interests in the course of this crisis. Their “herd-immunity” strategy was nothing more than a justification for continuing business as usual. Non-essential workplaces were kept open as long as possible so as not to impede upon profits. Packed tube networks, where workers were crammed in like sardines in order to get to work, put the health of workers at risk. Likewise, the focus of the bailouts announced has been on safeguarding bosses and shareholders, not workers.

Stomont has not performed much better either, taking their lead from Westminster and putting the interests of big business ahead of public health. They were slow to shut down schools and other public institutions. While threatening ordinary people with fines if they leave their homes unnecessarily, they have allowed many non-essential workplaces to remain open and are refusing to enforce sanitation and social distancing measures at work, with the Health & Safety carrying out no physical inspections, despite reports that these are being widely flouted.

The Imperial College suggested the Tories’ ‘herd immunity’ strategy could lead to 250,000 deaths. Only when the scale of the potential catastrophe, and the political impact it would inevitably have, dawned on the Tories did the government belatedly move into action.

New guidelines

With threats of staff quitting over health concerns and growing public outrage at the failed herd  immunity strategy, the government was forced to introduce new guidelines and ramp up the distribution of PPE to hospitals across the UK. The previous guidance recommended no PPE, except during high-risk procedures when healthcare workers were within one metre of a patient with suspected or confirmed Covid-19. The new guidelines are consistent with the two-metre social distancing rule.

This change has been welcomed by NHS staff as bringing the guidance more in line with World Health Organisation recommendations. There is still, however, a reality of shortages throughout the health service. Professor Derek Alderson from the Royal College of Surgeons urged their members not to risk their health. He said the new guidance was an improvement, but so long as shortages remained, “my warning still holds true”. With some reports indicating that 50% of NHS staff still don’t have adequate PPE, shortages are a reality despite government assurances.

Research from the Massachusetts Institute of Technology suggests that Covid-19 may last in the air and on surfaces for longer than initially thought, reflecting the fact that this is a new contagion and what information we have available to us is limited. In these circumstances, the maximum protective measures should be introduced to ensure the health and safety of staff.

The slow response has caused severe problems in securing and distributing PPE. According to the British Medical Association, PPE in London and Yorkshire are at “dangerously low levels”. Likewise in Belfast, GPs have stated they may be forced to withdraw services over lack of PPE. This is in spite of Health Minister Robin Swann’s assurances that “we have sufficient PPE supply for current demand”.

Inadequate supply of PPE

Just to care for the 11,000 coronavirus patients who were in English hospitals on 1st April, the NHS would require up to 7.9 million sets of PPE every month. This does not take account of the potential for rising numbers, or the needs of care homes, doctors’ surgeries or other exposed staff working in the wider health service. 

Robin Swann’s assurances ring hollow when confronted with facts on the ground. The lack of PPE in the domiciliary care sector has led to staff shortages and the spread of Covid-19. More than a week after his statement, many care homes and community care providers still hadn’t received their starter pack of Covid-19 PPE supplies, some only getting them after residents have already begun to show symptoms. Infection clusters are beginning to develop amongst care homes.

Conor Murphy, the Stormont Finance Minister, admitted the failings in Stormont’s approach in terms of their inadequacies in securing PPE when he said, “The truth is we needed to be in the market a couple of weeks earlier.” What Conor Murphy is accepting is that market forces must play a role in provision in our health service, despite greatly impeding the process of securing PPE.

Matt Hancock claims,  “We need everyone to treat PPE like the precious resource that it is”. He is attempting to shift blame for the government’s unpreparedness and disastrous handling of this crisis onto the shoulders of supposedly wasteful healthcare workers. The capacity to produce enough PPE is there, the issue is that it rests in private hands and production is being driven by profit, not need.

Manufacturers have complained of a lack of government specification for PPE and, as a result, they won’t ramp up production for fear of being left with additional costs if specifications change. Some companies have engaged in vicious ‘price-gouging’, with reports indicating a 1,000% price increase. This exposes the absurdity of private production being utilised for this vital equipment. Companies are putting their profit margins before the production of PPE to protect frontline staff and this is costing lives. 

“Trace, test and treat” 

The “laissez-faire” approach of the UK Government has been epitomised in the approach to testing for the Covid-19 virus. They have been slow to move towards mass testing, which the World Health Organisation has stressed as key to getting ahead of the spread of the virus. Healthcare workers are reportedly queuing for hours at local Ikeas and other venues to get tested, only to be turned away because they have reached capacity. 

The “trace, test and treat” strategy implemented by South Korea has relied on active, free and massive screening and has been successful in containing the spread of the virus, without resorting to draconian lockdown measures, such as the quarantines introduced in China. The measures in the UK lag far behind other countries. 

In the week ending 4th April, 132 laboratories across Germany carried out an average of 116,655 swab tests per day. The total number of swab tests done by 4th April in Germany was well over 1.3 million. Their target is to increase capacity to 200,000 a day by the end of April. The UK, by contrast, is hoping to reach 100,000 tests a day by the end of the month. As of the 10th April, the cumulative UK total stood at 316,836 tests.. 

Public health, not private profit

This level of testing falls far short of what is necessary to combat the spread of Covid-19. Health Secretary Matt Hancock, when explaining this difference between the UK and Germany, said, “My German counterpart, for instance, could call upon 100 testing labs ready and waiting when the crisis struck, thanks in large part to Roche, one of the biggest diagnostic companies in the world.”

Hancock is attempting to paint a picture of a strong private sector being the reason for Germany’s success in testing. In reality, it is the level of public funding into healthcare and access to resources which have made the crucial difference. The real weakness in the National Health Service is not the lack of private enterprises to fall back on, but decades of cutbacks and underfunding. David King, the former Chief Scientific Adviser, confirmed as much in an interview he gave recently: “It goes right back to 2010, when the government came in with a very clear policy to reduce public spending across the board, including the National Health Service.” 

Germany spent €4,271 (£3,744) per person on healthcare (11.1% of GDP), compared to €3,566 per person on healthcare (9.7% of GDP) in the UK in 2016. Germany also has more critical care units and ventilators than any other European country. Across the German state there are 25,000 ventilators, compared to 8,000 for the UK which is an improvement on the 5,000 which were in possession previously. That is not to suggest that there are no problems with the handling of the crisis in Germany, but it’s clear the response had been considerably more effective.

Kick out the profiteers!

Bharat Pankhania, senior clinical lecturer at the University of Exeter medical school, responded to Hancock by stating: “This is nothing to do with capacity… capacity can be expanded very quickly, and there are plenty of labs.” The issue here is that many of the labs have been partly or fully privatised. Financial pressures due to cutbacks have caused more and more laboratories to merge, and it is now the case that many individual Health Trusts no longer directly own their pathology services.

The price of this privatisation is now biting, with private interests acting as a hinderince on the ramping up of testing. Rather than having at its disposal the full weight of the country’s healthcare facilities, private labs are pursuing their own bottom lines. Diagnostic kits are on sale for up to £375. Private labs are continuing to offer tests to those who can pay for them, leading to the situation where those with an “underlying wealth condition” can get easy access to testing, while the rest of us must forego. We have to ask the question: why can private companies charge such extortionate prices and use their labs to maximise their profits rather than protect public health? 

This is not an issue solely for Westminster. Locally, Randox is one of at least two companies with labs in Northern Ireland producing tests for Covid-19. The company is on record saying they were selling the tests for an extortionate price of £120 each. This is despite having received £23 million in public funds through Invest NI in 2018, and benefited through research partnerships with Queen’s University and the University of Ulster. Public pressure has forced Randox to stop privately selling tests in the UK and to distribute them directly through the NHS, but they will still do so while making a profit.

The acceptance of private profit in healthcare has and continues to act as an impediment on the ability to tackle this virus. What we need is a planned, coordinated approach that utilizes the full weight of the resources at our disposal, not the anarchy of the profit-driven market. Private medical facilities and producers should be requisitioned and their resources used for the public good. Rather than the anarchy of the profit-driven market, we need public ownership and democratic planning so this pandemic can be tackled as efficiently and effectively as possible.

Public ownership of all health facilities and manufacturers needed

The trade union movement should utilise its authority and weight in society to exert pressure over the Tories and Stormont to take decisive action to protect public health. The massive anger at the respective governments could be utilised to demand the nationalisation of private labs and manufacturers. We got a glimpse last year of the power of health workers to enact change. Their strike action over pay forced concessions from Stormont. What is needed now is a collective approach from workers across the board to fight for public health. 

Private companies should not be able to engage in rampant profiteering off the back of this crisis. Profit should not be in consideration when dealing with the possibility of lives being lost. The trade union movement should demand that medical manufacturers, as well as any other private enterprise that has the potential to produce what we desperately need, must be brought into public ownership and production ramped up to meet the needs of society, not the bottom line of shareholders. 

For planning, not profiteering!

“Outbreaks are inevitable, but pandemics are optional” – those are the words of Dr Larry Brilliant, one the people responsible for eradicating smallpox. The capitalist system we live under, which puts profit above all else, has helped make this pandemic a reality. It is evident that the desire to protect profit, and leaving production in private hands, has led to a chaotic and mismanaged handling of this crisis. Through sweeping nationalisation, the implementation of an emergency plan of production could be enacted to meet urgent needs. Such an approach necessitates the involvement of health workers at every level of the decision-making process, as they know best the intricacies of what is required in terms of testing and supply of medical necessities at this stage.

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