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  • Writer's pictureMike Parker

We failed to safeguard the elderly in the pandemic and must never do so again.

A pandemic has been looming for decades and we failed to prepare for it. I remember several years ago, after a long trip, remarking that I heard the same cough at airports across the world. We are so connected now it was inevitable that at some point, something nasty would go global. Hollywood has made dozens of films about it (Vulture). You may remember Outbreak (Trailer 1995) when Morgan Freeman and others saved us all from an infected monkey with flower petals. Or more recently Contagion (Trailer 2011) when Laurence Fishburne and others saved the World from a Chinese Virus with a novel vaccine. Who would have thought life would imitate art so precisely?

Despite several Prime Ministers, 649 other MPs, and 783 Lords all sitting down of an evening watching these films with their families, like the rest of us, they put relatively little effort into answering the question "What on earth would we do in this situation?". We know that they asked the question, as they staged a pandemic rehearsal in 2016 called the Cygnus exercise, the findings of which were only recently released. Yet they still weren't prepared when it happened, and we made and are still making some really stupid mistakes, which have cost the elderly dearly, with the over-sixties representing 96% of Coronavirus deaths in 2020.

In researching this article, I have discovered that we knew everything we needed to in order to foresee that the elderly would be at significant risk during a Pandemic. Yet when I look back at the Government response in the run up to lockdown, I find it woefully lacking in measures to protect the elderly from a disease which the Government knew they were 800 times more likely to die from. I look at the failure to prepare people for infection and the failure to care for them once they were infected by leaving those testing positive without treatment, as we decided to put all of our eggs in the vaccine basket. I look at the reduction in hospital beds over recent decades, and how this has made the NHS dependant on Care Homes looking after elderly residents sick with Winter-Flu and now with Covid. Finally I look at the number of deaths. I conclude the article with a set of recommendations to help us do better, not if, but when this happens again, and I hope that this article finds its way to someone who can make that difference.

Before the pandemic, we knew that an elderly person in is 100 times more likely to die than a young person.

Life becomes increasingly fragile as you age. Understanding exactly how fragile is important when making public policy. As such the Office of National Statistics (ONS) is commissioned by the Government to produce "National Life Tables". These tables, which I have reproduced graphically below, show that mortality rate increases exponentially as you age, being a minimum from the ages of 5 to 15, and slightly elevated during infancy.

Source: Data from the Office of National Statistics (ONS)

Below the age of about 65, the mortality rate is less than 1%, increasing to about 35% at age 100. The figures in these tables can be used to assess the relative risk of death between two people in the UK. Calculating the ratio of the mortality rates for an elderly person, and a young person will tell us exactly how much more at risk the elderly are. Comparing the average figures for men, an 80 year old is 106 times more likely to die than a 20 year old.

Before the pandemic, we knew that the elderly make up 85% of deaths from mild Winter Flu viruses.

Every year it is primarily the elderly who die from winter flu. Again the Government commissions the collection and analysis of this data. Surveillance of influenza and other respiratory viruses is undertaken throughout the year by the Influenza Surveillance Team at Public Health England’s National Infection Service (PHE NIS), in collaboration with similar teams in Scotland, Wales and Northern Ireland. The team generates weekly outputs during winter flu season, and an annual report every May. The report from May 2019, included a table with the age breakdown of deaths associated with Influenza.

Source: Deaths in England associated with Influenza, Surveillance of influenza and other respiratory viruses during Winter 2018 (Public Health England)

Even with widespread vaccination of the elderly since 2000, the majority of deaths are still amongst those aged 65 and over, being 89% in Winter 2014, 80% in 2015, 84% in 2016 and 84% in 2017. Counterintuitively this is no better that the percentage before vaccination began, for instance being 89% in 1967 (Miller & Lee 1969), but of course these days people are living longer and so a greater proportion of the population are in the vulnerable age group over 65.

In January 2020, we knew that the Wuhan virus was a severe respiratory virus related to SARS.

The very first news story in the UK about a mystery virus causing severe pneumonia in Wuhan, published on the 3rd of January, reported that we were dealing with a respiratory virus, rumoured to be related to the SARs virus.

The World Health Organisation (WHO) were informed about the virus by China on the 31st of December 2019. Over the next few days they assembled a task force, informed outbreak reporting networks, and publishing their first news article on the 5th of January (WHO), in which they described the symptoms of the virus:

"The symptoms reported among the patients are common to several respiratory diseases, and pneumonia is common in the winter season; however, the occurrence of 44 cases of pneumonia requiring hospitalization clustered in space and time should be handled prudently." Source: "Pneumonia of unknown cause – China" (WHO)

On the 11th of January the WHO tweeted (Twitter) that it had received the genetic sequence for the "novel coronavirus" from China (WHO). Academics around the world analysed the sequences provided by China. Responses started coming in the same day on Twitter (CIDRAP). Vineet Menachery, University of Texas, tweeted that nCoV appears to be a group 2B coronavirus. Andrew Rambaut at the University of Edinburgh, tweeted that nCoV is 89% similar to SARS (Twitter). The name SARS-CoV-2 wasn't used until February (Virological). Nonetheless we knew by the middle of January that the Wuhan Coronavirus was a severe acute respiratory virus related to SARS.

In January 2020, we knew everything necessary to foresee that the elderly would have a significantly higher risk of death from Coronavirus.

Some 41 days before the first case of Coronavirus in the UK, we knew everything we needed to know in order to foresee that the elderly would be at risk from this severe and novel virus.

To recap, we knew that:

A. The elderly have a mortality rate 100 times higher than young people.

B. The elderly make up more than 80% of deaths from mild respiratory viruses.

C. The Wuhan Coronavirus is a severe respiratory virus.

Knowing A or B alone, the Government could have anticipated from their own data that the elderly would be extremely vulnerable during a pandemic of a novel respiratory virus. Knowing A and B together, leaves little room for doubt of this outcome. The logical interpretation is that the elderly are likely to have a mortality rate more than 100 times that of the young, and to account for more than 80% of deaths from the virus. Once combined with C, the likelihood of this outcome becomes more of a certainty. The logical interpretation is that the elderly will almost certainly have a significantly elevated risk of death from the Wuhan Coronavirus, with a mortality rate well in excess of 100 times that of young people and with them making up well in excess of 80% of deaths from the virus.

In March 2020, we knew that the elderly were 800 times more likely to die from Coronavirus!

At the beginning of March, a statement was released by the Scientific Pandemic Influenza Group on Modelling, Operational sub-group (SPI-M-O), which gave the infection fatality ratio for the virus:

"The Infection Fatality Ratio (IFR) is the proportion of people infected by COVID-19 who die... Our best estimate of the infection fatality rate is in the range of 0.5% to 1%, ranging from 0.01% in the under 20s to 8% in the over 80s." Source: "SPI-M-O: Consensus Statement on 2019 Novel Coronavirus (COVID-19)", 2nd March 2020 (UK Gov).

Previously we calculated from the National Life Tables that in a typical year an 80 year old is 106 times more likely to die than a 20 year old, considering all causes. Performing the same calculation using these figures, we find that an 80 year old is 800 times more likely to die from Coronavirus than a 20 year old.

Yet the Government's Coronavirus response did little to safeguard the elderly.

Despite all this knowledge and the logical predictions possible, despite having a Parliament with 650 MPs and 783 Lords, and despite having god knows how many Civil servants... the Government response had no specific provisions for the elderly, to keep this extremely vulnerable group safe.

The Government's first Coronavirus press conference

3rd of March 2020 - The Government held it's first press conference on Coronavirus to announce and discuss its newly released Coronavirus: action plan. Present were the Prime Minister, Chief Medical Officer, and Chief Scientific Adviser. The three described the Government's plan and responded to questions from the press.

The Government understood that Coronavirus posed an elevated risk to the elderly, but they offered no specific actions or recommendations to protect them.

“Let me be absolutely clear that for the overwhelming majority of people who contract the virus this will be a mild disease from which they will steadily and fully recover as we’ve already seen.” Boris Johnson, Prime Minister. “Central to all of this is making sure that we protect the vulnerable, and the highest risk groups are the elderly and those with preexisting illness and those are the ones we’ve got to make most care to protect during this.” Sir Patrick Vallance, Chief Scientific Officer. “Overall probably around 1% of people who get this virus might end up dying based on the Chinese expereince. To be clear what that therefore means is that 99% of people will not, and if, as I think is entirely possible, a higher proportion than we are currently aware of get the infection without any symptoms, in fact that mortality rate will go down. But lets take 1% overall as the current reasonable figure. It goes up a bit in people who are older or more vulnerable as Sir Patrick said. It will be much lower than that in younger people who have no other health problems.” Chris Witty, Chief Medical Officer.

So two months after the Wuhan virus was first reported by the BBC, with all the knowledge, opportunity for reasoning, and even data showing that the elderly were 800 times more at risk of death from the virus than young people, the Government's only advice to the public was for everyone to wash their hands whilst singing happy birthday!

Subsequent press conferences in March

12th of March (watch on YouTube) - The Prime Minister, Chief Scientific Adviser and Chief Medical Officer give an update on Coronavirus and advised everyone with symptoms to stay at home for 7 days. The elderly were advised against going on Cruises. The Prime Minister addressed the elderly specifically.

"I also want at this stage to speak directly to older people because this disease is particularly dangerous for you, for older people. Even though the vast majority of older people will experience a mild to moderate illness I know that many people will be very worried and I think we should all me thinking about our elderly relatives, the more vulnerable members of our family, our neighbours, and everything we can do to protect them over the next few months. We’re going to need to mobilise millions of people to help and support each other, and I just want you to know that the Government will do all we can to help you and your family during this period. We’re not just going to be, as you saw yesterday, supporting the economy during this period, we will be providing money and many other forms of support and helping communities to support each other." Boris Johnson, Prime Minister, 12th of March 2020.

Doing "all we can to help you" sounded promising, but the feedback I've had from the elderly people I know is that this support never materialised, and the only support they were offered was from pockets of courageous volunteers.

16th of March (watch on YouTube) - The Prime Minister, Chief Scientific Adviser and Chief Medical Officer introduced new voluntary measures including: home working; household isolation for 14 days; increased social distancing; avoiding gathering; to reduce social contacts. Identified vulnerable groups as over 70s, any adults who would be advised to have flu vaccine, and women who are pregnant and emphasised that these groups should take greater care. Discourage visits to care homes. Care homes highlighted as challenging.

17th to 22nd of March - Press conferences on Coronavirus were held daily from the 16th of March until the lockdown was announced on the 23rd of March. At the time of writing these are all available on YouTube.

17th of March (watch on YouTube).

18th of March (watch on YouTube).

19th of March (watch on YouTube).

20th of March (watch on YouTube).

21st of March (watch on YouTube).

22nd of March (watch on YouTube).

The Government announces a national lockdown.

23rd of March - Immediately Parliament had passed the legislation to do so, the Government released an emergency broadcast in which everyone was told to stay at home, protect the NHS and save lives. Exceptions were made for key workers and those who could not work at home, but the majority of the country stayed home. People were allowed out to shop for food and to exercise outdoors. The roads were empty. There were no specific instructions in this broadcast to safeguard the elderly.

We should have been shielding the elderly, but instead we forced them out to the shops.

As part of the lockdown announcement, Prime Minister Boris Johnson advised everyone to buy their groceries online. However, there was no emphasis on reserving these services for the elderly and most vulnerable.

"Use food delivery services where you can" Boris Johnson, 23rd of March 2020

The unprecedented and serious nature of the lockdown scared people. Young and healthy people, were made to contemplate their own mortality for the first time, so when the time came to do their shopping, many amongst this technically savvy generation chose to order their groceries online rather than risk catching the virus in the supermarket. They didn't stop to think that this would force the elderly out to the shops, but that is what happened.

This was the experience of a friend of mine:

"At the start of lockdown we tried to order our shopping from Sainsbury's in Braintree, but all the delivery slots were taken." Alan Stannard, Great Leighs, Essex. Aged 75 during the first wave of Coronavirus.

There should have been a national effort to shield everyone with a high risk of dying from the virus, including the elderly, who as we have said were known at that time to be around 800 times more likely to die from COVID-19 than young people. Every effort should have been made to provide them with everything they needed so they could stay safely isolated at home for long enough to build up herd immunity amongst the young, fit and healthy, who could and should have been serving their communities by participating in a scheme to distribute food and medicines to those isolating, at near zero risk to themselves. The Government's own data from March 2020 showed that the Infection Fatality Rate (IFR) was only 0.01% for those under 20 years of age. This age group make up 25% of the population (UK Gov), or approximately 17 million people. If all of them were exposed to the virus, the most deaths we could have expected was 1,700, and even less if we also shielded the vulnerable members of this age group with pre-existing conditions.

Indiscriminate lockdowns are a bad strategy to minimise deaths during a pandemic. Sure they help "flatten the curve", but all this means is moving hospitalisations and deaths to the right. It may protect the NHS, but it does little to save lives. There are much better strategies. A lockdown which discriminates based on your IFR, shielding all the vulnerable whilst cautiously exposing and building immunity amongst the least vulnerable must logically lead to less deaths overall.

We are still failing to encourage people to optimise their health and fitness and to take supplements to boost their immune system.

It is the unhealthy that get sick. Where was the advice to loose weight, eat well and exercise to get your blood pumping and metabolism up. Where was the advice to get plenty of vitamins and minerals in your diet, most notably Vitamin D which has been known for a long time to boost the immune system and is recommended by the NHS.

"During the autumn and winter, you need to get vitamin D from your diet because the sun is not strong enough for the body to make vitamin D. But since it's difficult for people to get enough vitamin D from food alone, everyone should consider taking a daily supplement containing 10 micrograms of vitamin D during the autumn and winter... Do not take more than 100 micrograms (4,000 IU) of vitamin D a day as it could be harmful." Vitamin D, NHS.

We have known it helps your body fight off infections for years, so why should we expect Coronavirus be any different? It isn't. The data has been published showing that blood levels of Vitamin D correlate with large reductions in mortality from Covid-19.

Source: Borsche et al, MDPI Journal.

I think most people are deficient in Vitamin D. When I had mine tested in the summer, when it should be fine, mine was only 15 ng/ml. But we can see from this graph that people with blood levels over 40 ng/ml have a much lower near zero mortality coefficient. Now you can argue that correlation is not causation for this particular virus if you like, or you can realise that this is the expected behaviour based on prior knowledge about Vitamin D boosting the immune response, increase your Vitamin D intake and reduce your mortality. I know what I will be doing, and I can tell you that all of my elderly friends and relatives are taking large doses of Vitamin D ahead of the Omicron wave this winter. Yet the Government remain silent on this issue.

We are still failing to provide treatment, even though early treatment has been claimed to achieve an 85% reduction in mortality!

The most unforgivable failure during this pandemic has been leaving those who contracted the virus without treatment. The chances of a successful outcome are always higher if you treat the patient early, whether you're treating a cold or cancer!

When I caught Coronavirus, all I got was an email from the NHS telling me to stay at home and call for help once I'm dying, and a phone call from Big Brother about contact tracing. There was absolutely no mention of treatment, just a link to the Coronavirus website, which STILL HAS NOTHING ABOUT TREATMENT on the home page.

Incase you've never had one, this is the "phone us when your lips are blue" email:

It would take an entire article to review all the different treatments, antiviral drugs, herbs and home remedies which, if administered early enough could plausibly improve the outcome for patients infected with coronavirus. The better Doctors around the world were working like mad to find drug combinations to try and save their patients. Dr Peter McCollough testified to the Texas state senate that their early treatment protocol achieves an 85% reduction in deaths in patients over the age of 50 with preexisting medical conditions.

The Government had no interest in pursuing early treatment and people were left helpless. It was shameful. We were given no advice about treatment. We couldn't see a Doctor to get a prescription, and even if we could have, Doctor's were being intimidated out of using their initiative and experience to prescribe things that they thought might help. Neither could we get what we wanted because of the gatekeepers at Pharmacies. The only thing left was basic over the counter medicine and home remedies, and the later were mocked and derided by the media, despite the fact that there are literally dozens of natural substances with antiviral properties. This is not Health Care, its Don't Care! I've removed what I wrote after this, but the first word is "It's", the second is a synonym for procreation, and the third word rhymes with grit.

The irony, I realised at the time, was that living in the once freedom loving mother of modern democracy, the State had control over my health, whereas if I was living in the formerly Communist Russian Federation I would have had control over my health, because I could ask someone to go to the Pharmacy and buy me anything I wanted.

We placed far too much reliance on novel vaccines, which arrived too late for the first and second waves of the virus, and came at the expense of everything else.

The Government put all of our eggs in the vaccine basket, even though fundamentally the purpose of vaccines is to prevent a future pandemic, not to end one you're already in!

The second wave of Coronavirus was over by the beginning of March 2021, by which point 124 thousand people, mostly elderly people, had died.

Source: Deaths in the United Kingdom (UK Gov)

By that time less than 20 million people had the "partial protection" offered by the first dose of the vaccine. So the vaccines did almost nothing to reduce deaths during the first and second waves.

Source: Vaccinations in the United Kingdom (UK Gov)

The vaccines arrived too late, which was always going to happen. Developing these vaccines on such a short timescale was a great, but terrifying achievement. I have major ethical concerns about the principle of rushing the development of any chemical or substance being administered to the entire human race. It was reckless and to push them through any faster would be even more reckless.

That aside, the principle of vaccination is sound, and so far, the vaccines appear to have been successful at reducing deaths in the third wave. I reserve judgement because the large second wave was a different variant to the first, but the third wave has so far been the same variant as the second, so you're not comparing eggs with eggs as they say. The second wave was dominated by Delta, whereas the first wave was presumably Alpha. So far the small third wave has been a ripple of Delta, so we cannot confidently attribute this reduction to the vaccines; although don't expect that to stop the Government claiming as much. The new Omicron variant will likely cause a significant surge in cases, as we saw last year when the dominant variant changed mid December. Hopefully if the experience so far in South Africa is repeated here, we will not see the deaths to go with it. I recommend following the updates from Dr John Campbell to get a balanced and scientific view on what is happening.

We failed, despite lots of warnings, to ensure the NHS had the capacity to handle a pandemic, with only 50% of the beds we had in the 1980s.

Almost every year there are reports about the NHS struggling to cope with winter flu or some other virus. These are some of the articles published since 2000:

"Flu epidemic exposes NHS crisis", The Guardian, 9th Jan 2000.

"Flu outbreak may 'overwhelm' NHS", BBC, 23rd Sept 2005.

"Overstretched hospitals face winter flu crisis...", The Guardian, 24th Sept 2017.

This is unsurprising when the number of hospital beds has fallen so significantly in recent decades, despite the population increasing significantly, leaving us unable to cope with peak capacity during a flu epidemic or during the peaks of the present Coronavirus pandemic. According to Statista the number of hospital beds has fallen from around 240 thousand in the year 2000 to around 160 thousand today. A paper by Hensher and Edwards published in the British Medical Journal, puts the number of hospital beds in 1982 at 348 thousand (BMJ).

Source: Statista

Is it any wonder that we need to put so much emphasis on "protecting the NHS" when we have half the number of beds we did 40 years ago, despite a larger and older population?

We failed the elderly by making the NHS dependant on Care Homes looking after elderly people with Winter Flu and now with COVID-19.

To overcome the problem with Hospitals, or to hide it, the Government has become reliant on Hospitals discharging elderly patients into Care Homes as quickly as possible, despite the obvious lack of medical expertise, provisions and equipment.

In March 2020, right at the start of the pandemic, care homes were being put under pressure by the Department of Health to take in patients being discharged from Hospital, despite concerns that these patients could have Coronavirus.

“On 12 March, there was a meeting of a number of large care-home providers with the department to talk about the pressure that the NHS could come under, and whether or not we could facilitate and support the NHS by taking patients who we could care for. We were very, very clear right from the get-go, even before we knew the worst ravages of Covid, that we couldn’t take people unless they were tested. On 2 April, rules on discharge to care homes from hospitals clarified that negative tests were not required before discharge. By then, a significant number of people had already caught Covid and we were starting to have concerns about asymptomatic presentation, yet rules on discharge from hospital issued out to care homes were that we couldn’t expect to have a test.” Source: Sam Monaghan, CEO of MHA (The Guardian).

In May 2021, The Guardian reported that 25,000 people had been discharged into care homes between 17 March and 15 April of 2000, and that there is widespread belief among social care workers and leaders that this allowed the virus to get into the homes. Health Secretary Matt Hancock defended the lack of testing based on the availability of testing at that time. The Government had to prioritise how the testing capacity they had was used, and care homes were not on their list of priorities.

The Government updated its policy on the 15th of April 2020 in their Covid-19 action plan for adult social care (UK Gov), introducing the requirement for the NHS to test patients prior to discharging them into care homes. Whilst an improvement, this did not prohibit the discharging of patients with COVID-19 into care homes, it legitimised it. The Government was relying on Care homes continuing to take in patients with COVID-19. Care homes were essentially asked "Can you handle it?" and if not, the local authority could apply for Government funding to put them up elsewhere.

This was the Government's plan headed into Winter 2020 (UK Gov). Some 136 care homes participated in the scheme (Carehome). These “hot homes” were mostly wings of care homes that used separate staff and separate entrances to prevent the virus from spreading (The Guardian). Considering staff shortages, and with minimal training, personal protective equipment (PPE), or modifications to their facilities (for instance to prevent the virus spreading through the air conditioning), the likelihood of viral transmission being prevented under such circumstances is obviously very low.

It was a failure and tens of thousands of elderly care home residents died before their time. The data on deaths in Care Homes has been published by the ONS. Since the beginning of the pandemic, there were 173,974 deaths of care home residents, of which 42,341 were recorded as involving COVID-19.

Source: "Deaths involving COVID-19 in the care sector...", 11th May 2021 (ONS)

With all these failings, in 2020, there were 78 thousand deaths involving COVID-19 of which 96% were people aged 60 and over.

The fact that Coronavirus was disproportionately affecting the elderly became widely known in October 2020 when The Daily Mail published an article stating that the average age at death for patients with Covid-19 was 82 (Daily Mail).

I examined the Office of National Statistics dataset myself in January 2021 and produced the following graph to illustrate the age distribution of all deaths involving Covid-19 in 2020. Out of the 77,686 deaths recorded, some 72,894 or 96% were people aged 60 and over.

This ONS dataset, including data specific to Covid-19, was available from the 7th of April 2020 (see revision history). The percentages were similar even then. Every month from April onwards that the ONS published its statistics, was another month the Government failed to react logically to the data by implementing specific measures to safeguard the elderly.

The final death toll?

At the time of writing the UK Government is giving the following figures for the UK:

146,627 - Deaths within 28 days of positive test

170,911 - Deaths with COVID-19 on the death certificate

We don't know what the final death death toll will be. Perhaps 200,000 if Omicron is the third and final wave. If we're "lucky", which seems like a terrible adjective in this context, the Omicron variant will be low in virulence and high in transmissibility, it will infect everyone, give them full immunity and the Pandemic will end. Again I recommend the reader to watch the videos by Dr John Campbell.

For context I should say that these are deaths "associated with" COVID-19. We will never know exactly how many people died "of" Covid-19. However, the average number of deaths per year for the five years from 2015-2019 was 605 thousand. Adding the 78 thousand deaths within 28 days of a positive Covid test in 2020, we should expect around 683 thousand deaths if this an accurate record of excess deaths due to COVID-19. There were 690 thousand deaths in 2020, so it it does seem at a very simple level that the "Deaths within 28 days of positive test" dataset is an accurate record of excess deaths due to COVID-19.

Lessons we must learn from this

I could spend this conclusion bashing the Conservative Government for their failings, and they surely deserve it, but in truth this has been a long time coming and a lot of the problems are systemic. Could the other lot have done any better? I doubt that. It is a shame "Red or Blue" is all the democracy we have left and it is miserable that Parliament lacked the intellectual capacity to foresee and plan for this, which is surely not unrelated to making both houses Party Political and filling the Commons with halfwits who will do whatever they are told... but that is not the subject of this article.

As angry as all these failures make me, it is not constructive to criticise without offering a solution. So I'm going to end, stoically, by trying to make something positive from this very negative experience. The Coronavirus pandemic happened and we reacted the way we did, and cannot change that. Now we must take the opportunity to look back and ask what we could have done better, and make changes to ensure we do better next time.

We need a Pandemic Preparedness Act

The main thing this Pandemic should have taught us is that we need to be prepared. Some of the measures necessary with the worst viruses are extreme violations of our rights (many of which are traditional, not statutory, but that is a whole other issue), so they should not be introduced by a Government under Royal Prerogative, but through an Act of Parliament thoroughly debated and developed transparently with the full scrutiny of Parliament and in full view of the Public. This will allow the people to decide what measures we will accept under what conditions, and what we will not. Government by consent, not tyranny.

Infrastructure and capacity

The NHS must have capacity to accommodate everyone seriously ill. Expansion capacity in the form of Nightingale Hospitals was and is a great idea but needs staffing, with a small number of medics leading a trained reserve of volunteers. Only recovering patients with low to zero viral load should ever be admitted to Care Homes, which requires infrastructure changes, staff training and equipment to prevent the virus from spreading across the home.

Proportionate measures

Measures should be introduced dependent on the threat level, but the number of threat levels must be increased and the system must take account of the Infection Fatality Ratio to ensure that measures are proportionate to the threat. We can't be maxing out the threat level and locking down the entire country, and lumbering the next generation with a debt approximating slavery, for viruses only slightly more virulent than influenza, when the reality for most healthy people is the worst symptom they they'll get is a bit of a temperature and a cough that lasts a week a so. If the measures are proportionate, people will follow them.

Shield all vulnerable people.

In the absence of data, assume that the weakest and most vulnerable members of society will be at highest risk from the virus, including the elderly, the sick, newborns and pregnant women. The groups at lowest risk from the virus, generally the young, fit and healthy, should be involved in a war-like effort to shield the vulnerable by getting them supplies while they are isolating. Put the systems in place to make it happen, encourage people, and watch the Country rise to the challenge.

Prepare for infection.

Develop an online guide and pamphlet with relevant experts to inform people how to get their body, overall health and immune system in peak condition to fight off infection. Including for instance nutrition, exercise, weight-loss, supplements (Vitamin D!!!), and any over the counter medicines and home remedies that will help. Link to further resources.

Encourage home remedies, don't deride them.

Before modern medicine we survived. There are herbs and roots etc, backed by peer review, to reduce inflammation, ease pain and strengthen immunity; quinine, garlic, turmeric, aloe vera all have antiviral action. Increase the range of over the counter drugs! There are also techniques like steam inhalation, nasal ablutions, gargling, hot/cold baths to regulate body temperature, salt to boost blood electrolytes and more. A good strategy can slow infection, aid the immune response and buy the patient time to get treatment.

Never ever ever leave people without treatment again!

We must find a way to get patients early treatment at home or we have failed as a society. If we can do Just Eat, then we can do Just Treat! Our medical records are online, a Doctor can review, phone, write a prescription and a volunteer can pick it up from the Pharmacy and deliver it in a matter of hours. Enable Doctors nationwide to share and rate treatment protocols they have used with their patients to quickly determine good treatments.

Encourage Doctors to enrol patients into studies to discover new treatments.

A novel virus has no known treatments, but that does not mean there are no treatments. Physicians must be empowered and entrusted to do their job to discover new treatment protocols without interference. Scientists are not Physicians! The perception that we need a double blind randomised controlled trial to determine acceptable treatments for a condition is a fallacy which does more harm than good. There are over 1600 drugs listed in the British National Formulary (BNF), all with recommended dosage and safety data. Let Doctors, not Scientists, decide how to treat their patients.

Final words

Thanks for reading this article. If you agree with what I've said, share it on Social Media, send it to your MP or a member of the House of Lords, and let's try and learn something from this so we're better prepared next time. But please, if you are elderly don't live in fear. Life is for living, and too many people have died during this pandemic having barely seen their loved ones. Even as an 80 year old the Infection Fatality Ratio is still only 8%. It's not as apocalyptic as the media makes it sound, and there are a lot of things you can do to reduce that. Get as fit and healthy as you can. Eat as well as you can, with lots of greens. Drink lots of fruit juice. Lose a bit of weight. Take plenty of vitamins, and large doses of vitamin D during the winter. Exercise to get the blood flowing. Learn what home remedies you can use to fight infections in your nose and throat. Get the vaccine. Whilst I'm not a fan of younger people getting it (and definitely not children), as an older person, unless you have a good reason to avoid it, the risk/benefit analysis says you're better off getting the vaccine, especially if you ask the nurse to aspirate the needle. But live your life! We only get one.

Cover image:

Source: Produced using images from Imperial College and Emerald Publishing.




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