Covid-19 and false narratives

Somehow, it doesn’t feel right to use space in this newsletter to talk about anything but COVID-19. The swiftness with which it has transformed UK society, the huge death toll which at the time of writing is still rising, the trauma and grief, the unprecedented impact it’s going to have on the UK economy. So much has been written already, meeting a seemingly unquenchable thirst for information.  And yet, at the moment, there seems to be a struggle going on to control, not just the virus, but the narratives about it, and the government’s response. An extreme manifestation of this are conspiracy theorists who believe that the virus was manufactured, and is somehow connected to the introduction of 5G networks – a justification for using this technology to undermine civil rights and impose mass surveillance. Got a hunch? Find some evidence to confirm it and post it online. Someone will believe it.

The construction of narratives, though, is not the exclusive prerogative of the lunatic fringe.  As we struggle to comprehend the enormity of the tragedy that’s unfolding, we also seek meaning: how has this happened? What will it mean for me and my family? How will it end? When will it end? We want to be reassured that our health and our livelihoods will be safe, that no-one we know will get sick or die. We want to know that our Government is in control, will look after us all, is straining every sinew, guided by the very best scientific evidence, that we will win the war against the virus, that our Prime Minister is a fighter

The Government knows this, of course, and it also knows that unless it is able to offer answers to these questions, it will lose control of this narrative. Losing this control should be every bit as scary to us all as the virus itself, and its impact on people’s ability to put food on the table.

This presents a real problem. Though we need to support a democratically elected government at an unprecedentedly difficult moment, how do we hold it to account?

Though we must support, we must also challenge to prevent inaccurate information or falsehoods being presented to the public. Nothing will undermine confidence in the Government’s narrative more quickly. It’s heartening to see even Michael Gove endorsing the role of experts; and the Government is surely lucky to have the current Chief Medical and Scientific Advisors. But their advice will only extend as far as evidence allows, and the government will also not be short of advice from others, less scrupulous about their sources.

What do we not know about Government approaches to dealing with COVID-19 at the moment?  There are, of course, many unanswered questions. Why was W.H.O. advice about mass testing not followed? Why are we still not testing 100,000 people a month as promised? Why isn’t an antibody test being used? Why did we not join an EU consortium to buy ventilators and other vital equipment? Why did it take so long for the Government to introduce ‘lock-down?’ What’s the strategy for lifting ‘lock-down’? Tempting as it may be, it’s vital at this time of national emergency that when the Government begins to answer these questions, spin does not supplant science.

There is, though, one question I do particularly want to ask.

This is why, 20 weeks after the virus first emerged in Wuhan at the time of writing, there are continuing shortages of personal protective equipment (PPE) for people who work in NHS and social care settings.  

I must declare a personal interest. My daughter is a doctor, currently working in an Intensive Care Unit, and, of course, treating COVID-19 patients. So far, she has received the equipment she has needed; but is aware that nationally, supplies are running very low, and in the care sector in particular, what’s available is grossly inadequate. As well as clapping and cheering for NHS and care staff every Thursday evening, the public need to ask why there are still shortages of PPE, and what the Government is doing about it. The Government needs to level with the public. So far, it has cycled from one explanation to another: (a) the public have bought up all the stocks (panic buying and selfish behaviour, not us guv); (b) unprecedented demand: who could have predicted (well, the DH did a few years ago – but it’s advice to stockpile appeared to have been overlooked); (c) distribution issues (I recall seeing Matt Hancock on telly a few weeks ago, sleeves rolled up, helping load protective clothing on an army lorry – that’s the spirit); (d) enough to go round if used wisely (surely this couldn’t have been an attempt to smear clinicians and care staff for profligate use, could it?); (e) changing clinical guidance about what clothing is suitable when treating COVID-19 patients; (f) last week’s stomach churning non-apology from Priti Patel.

Why does the Government feel it has provided enough PPE? In the absence of a clear explanation, here are some false narratives of my own. First, that they think PPE can be put on a 60c programme at the end of the shift. Second, that spraying a bit of Jeyes Fluid on PPE at the end of the day will do the trick.  Third, that NHS staff have a unique ability to work 12.5 hour shifts without stopping, even once, to eat, or go to the toilet, to use PPE wisely. Fourth, when stocks were ordered suppliers had run out of surgical gowns and masks and so ball gowns and Halloween masks instead. Perhaps readers could come up with some ideas of their own. But seriously, what we need is for the Government to have a coherent plan, competently executed, to get PPE where it’s needed – and fast. And while they’re doing that, maybe they could do with following W.H.O. advice on testing and contact tracing? [1]

[1] Pollock, A., Roderick, P., Cheng, K.K. & Pankhania, B., (2020) Covid-19: why is the UK government ignoring WHO’s advice?  BMJ 2010;368:m 1284 doi:10.1136/bmj.m.1284, (30 March 2020).

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