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chaos in British hospitals, a predictable fiasco?

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The health situation is increasingly critical in the United Kingdom as the country suffers the full brunt of the effects of a variant of Covid-19 considered to be more contagious. While the government is singled out for its delays in decision-making, others believe that the crisis also stems from years of budget cuts.

The British healthcare system is “currently facing the most dangerous situation we can remember”. Chris Whitty, chief medical officer for England, did not mince words, Monday, January 11, to describe the health crisis that his country is currently going through in the face of Covid-19. According to him, the health services are preparing for their “worst weeks of the pandemic”.

The United Kingdom is the country in Europe most bereaved by the pandemic with nearly 82,000 dead. As the temporary morgue set up in the spring in Epsom, in the county of Surrey, a south-west suburb of London, fills up again, the Mayor of London Sadiq Khan has also sounded the alarm. He declared a state of “major incident” in the British capital on Friday, where the new coronavirus is “out of control”.

“The situation is critical with an extremely high daily number of contaminations and deaths”, summarizes Marisa Miraldo, professor of health economics at Imperial College London. “There are reports which show that patients wait for hours in ambulances at the entrance to hospitals,” she adds.

A government that is slow to react

The United Kingdom has been confronted since November with a new variant of the virus considered to be much more contagious. If it does not seem intrinsically more dangerous than the classic virus, it would be, according to studies, 50% to 75% more contagious, which increases the risk of saturation of hospitals by patients with Covid-19. For Marisa Miraldo, this variant reproduction rate makes it more difficult to control, but other reasons may also explain the resurgence of the pandemic. “Infection control largely depends on the rigor of health strategies and their implementation at the right time,” explains this health system specialist who has published reports on the subject with her colleagues Sabine van Elsland and Katharina Hauck.

British Prime Minister Boris Johnson has been under fire for several months for his management of the crisis. In the spring, he had been blamed for having triggered the first confinement late, introduced on March 23 in England. “When strong measures are taken earlier, studies show that the morbidity and mortality rates linked to Covid-19 are lower. According to recent research, if the first confinement had been decided a week earlier, the number of deaths would have fallen from 36,700 to 15,700 “, underlines Marisa Miraldo.

This fall, however, the lesson did not seem to have been learned. The head of government was once again slow to react. While scientists were already alerting in September to an upsurge in the epidemic, Boris Johnson did not decree the second confinement until October 31. At Christmas, it was also under duress that he finally decided to reconfigure part of his country when he had initially promised a relaxation of measures for the end of the year holidays.

According to a report by the Parliamentary Science and Technology Committee released on Friday, the government has also not been transparent enough about the scientific advice it has received and has failed to learn enough from it. the situation in other countries.

The NHS under high tension

Some observers also note that the United Kingdom is more affected because of the problems inherent in its public health system, the NHS (for National Health Service). After decades of budget cuts, caregivers are in dire straits. “We have just gone through more than a decade of financial austerity which has led to major cuts in our health system. This has weakened our ability to respond effectively to this pandemic,” said Sarah Hawkes, professor of global public health at University College London. “Hospitals now have to call in outside staff to help them cope with the influx of patients.”

In the midst of chaos, doctors and nurses from the NHS confide their dismay to the media every day. “The elastic will break soon and this is our great fear at the moment,” said Dr Alice Carter of University College Hospital in London to the BBC. “If we come to this, we will no longer be able to welcome anyone in intensive care, not just Covid patients, but also anyone who has suffered a road accident, heart attack or stroke.” “We are so stressed that we have to make choices between patients,” said nurse Ashleigh Shillingford. “It’s not the NHS I grew up with.”

For Professor Sarah Hawkes, this crisis is also a reflection of British society. “The United Kingdom has reached some of the highest levels of inequality in developed countries. Life expectancy is stagnating. The poorest have poor health and few opportunities for the future,” describes this specialist in public health. “The Covid-19 has added to this already fragile set. It is the most vulnerable members of our society who are most severely affected by the pandemic.”

Hopes for the vaccine

Despite everything, the government believes it has made progress since last spring. The United Kingdom conducts nearly 500,000 tests every day, while a national tracing system has been put in place to isolate infected people. The country is also basing its hopes on the mass vaccination program to get out of the pandemic by the spring. The first country to approve vaccines developed by Pfizer-BioNTech and AstraZeneca-Oxford, Great Britain has already vaccinated 2 million people. And she plans to open seven large-scale vaccination centers to meet the target of 15 million people vaccinated by mid-February.

“In the coming months, we will not see a noticeable effect of these vaccinations”, notes however Marisa Miraldo. “Around March, we will be able to alleviate certain constraints such as social distancing or wearing a mask, but we will not have a return to normal immediately.”

In the meantime, the British government on Tuesday urged the population to respect the confinement, otherwise at the risk of “costing lives”. Kit Malthouse, the Secretary of State for Public Safety, warned on Sky News that tightening restrictions were being considered if the situation did not improve on the pandemic front. “If one wants to […] to make this the last big lockdown in the country, it’s very important that we all follow the rules. “

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