Another pandemic as big as the Covid crisis which killed 7 million people worldwide is “a certainty”, Prof Sir Chris Whitty warned, as he said the UK’s lack of intensive care capacity for the sickest patients was a “political choice”.
The NHS faced an ‘absolutely catastrophic situation’ when the virus first struck in 2020, but it could have been ‘significantly worse’ had the UK not gone into lockdown, England’s medical chief officer said.
“We have to accept that a future pandemic on this scale will happen,” he told the public inquiry into Covid-19 on Thursday. “It’s a certainty.”
It would also be “foolish” not to assume that asymptomatic transmission of a deadly virus would happen again, he added.
The warning from Whitty came to a doctor repeatedly burst into tears at the inquiry as they described how the Covid crisis for NHS staff was like responding to a “terrorist attack” every day, with infected patients “raining from the sky”.
Prof Kevin Fong – a former clinical advisor in emergency preparedness, resilience and response at NHS England who was on shift during the 7/7 London bombings – said the scale of deaths in hospitals at the height of the pandemic was “truly astonishing”.
Some intensive care units in England were so overwhelmed that staff had to put bodies in clear plastic garbage bags after they ran out of body bags, and then immediately put another Covid patient in that person’s bed, Fong said.
Giving evidence after Fong, Whitty said expanding the capacity of the NHS could help it better cope with an increase in sick patients in the future. “Take ICU [intensive care units] in particular, the UK has very low ICU capacity compared to most of our peer countries in high-income countries,” he said. “Now, it’s a choice, it’s a political choice.
“It’s a system configuration choice, but it’s a choice. That’s why you have less reserve when a major emergency happens, even if it’s short of something on the scale of Covid.”
Whitty said that solving the NHS workforce crisis was also essential. Healthcare systems cannot be ‘scaled up’ in a future pandemic without ‘trained people’, he added.
“You can buy beds, you can buy space, you can even put in oxygen and things… But fundamentally, the limitation on that system, like any system, is trained people, and there’s no way you can train someone in six weeks to have the experience of an experienced ICU nurse or an experienced ICU physician. It is simply not possible.
“So if you don’t have it in the emergency—if it’s an emergency of this speed of onset—don’t have any illusions that you’re going to have it while you’re peaking.”
Among his other recommendations, Whitty said being able to conduct lightning-fast scientific research and reduce health disparities deserves the most focus. “If we’re not serious about trying to tackle health disparities between pandemics, there’s no way you’re going to be able to do that when the pandemics occur,” he said.
“The biggest one that I think deserves slightly more emphasis is having the mechanism to be able to do research very, very quickly.”
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Referring to the development of vaccines and treatments, he added: “I think people always underestimate, at the beginning of pandemics, that it’s actually the science that’s going to get them out of the hole, not all the other stuff. The other things hold the line until science does the job.”
Whitty said that as well as direct damage due to Covid, such as deaths and prolonged Covid, there was indirect damage “stemming from the system being overwhelmed or at least unable to cope … all diseases, not just Covid, with higher death rates than they would have had”.
He admitted that the messaging about which masks NHS staff should wear to protect themselves from Covid was “quite mixed up” early in the pandemic. He also said officials “didn’t get it across well enough” that the public should continue to go to hospital for serious illnesses other than Covid. There would never be “perfect balance” when it came to stay-at-home messages, he said.
“We tried… we tweeted, we talked about the podium and so on. Whether we pushed the risks of Covid too strongly on the messages, I think that’s actually a much more difficult one. “
Whitty said that today he is still concerned about whether the government “got the level of concern right” about the dangers of Covid in 2020. was low, or did we not pick it up enough and therefore people did not realize the risk they were running into?
“I think that balance is really difficult, and some people would probably say that — if anything — we overdid it, rather than under, in the beginning.”
In a statement, Covid-19 Bereaved Families for Justice UK, which represents thousands of people, said the scenes described in intensive care units “were not inevitable, can never be considered acceptable, and must never be repeated”.
