In shielding its hospitals from COVID-19, Britain left many of the weakest exposed

I just published this report with Reuters. Read the full version here: https://www.reuters.com/investigates/special-report/health-coronavirus-britain-elderly/

A REUTERS SPECIAL REPORT

Even as the UK government was promising to protect the elderly and vulnerable from the coronavirus, its policies were putting them and their carers at risk. A Reuters investigation has found that care homes were neglected – with deadly consequences.

 Filed 

On a doorstep in the suburbs of north London, three-year-old Ayse picked up a tissue to wipe away her grandmother’s tears – tears for one more victim of the virus.

The little girl was waiting for her mum, Sonya Kaygan. Her grandmother hadn’t broken the news that Kaygan, 26, who worked at a nearby care home, was dead, one of over 100 frontline health workers killed by the coronavirus in Great Britain.

The grandmother, also called Ayse, spoke through sobs. “Why? Why?” she repeated. Why couldn’t she visit the hospital to say her goodbyes? Why did so many die in her daughter’s workplace? At least 25 residents since the start of March, of whom at least 17 were linked to the coronavirus. It was one of the highest death tolls disclosed so far in a care home in England. And why did Kaygan and her colleagues resort to buying face masks on Amazon a month ago, protection that arrived only after she was in hospital?

A Reuters investigation into Kaygan’s case, the care home where she worked, and the wider community in which she lived provides an intimate view of the frontline of Britain’s war on the coronavirus. It exposes, too, a dangerous lag between promises made by Prime Minister Boris Johnson’s government and the reality on the ground.

Even as the government was promising to protect the elderly and vulnerable from the deadly virus, local councils say they didn’t have the tools to carry out the plan, and were often given just hours to implement new government instructions.

Policies designed to prevent hospitals from being overwhelmed pushed a greater burden onto care homes. With hospitals given priority by the government, care homes struggled to get access to tests and protective equipment. The elderly were also put at potentially greater risk by measures to admit only the sickest for hospital treatment and to clear out as many non-acute patients as possible from wards. These findings are based on documents from government agencies seen by Reuters, interviews with five leaders of local authorities and eight care home managers.

It is too early to reach final conclusions about the wisdom of these policies. Still, staff and managers of many care homes say they believe the British government made a crucial early mistake: It focused too much attention on protecting the country’s National Health Service at the expense of the most vulnerable in society, among them the estimated 400,000 mostly elderly or infirm people who live in care homes across Britain.

The government summed up that policy in the slogan “Protect the NHS.” The approach gave the country’s publicly-funded hospitals priority over its care homes. A UK government spokesman defended the strategy. “This is an unprecedented global pandemic and we have taken the right steps at the right time to combat it, guided by the best scientific advice.”

The effects of this approach have been felt desperately in Elizabeth Lodge, in Enfield, north London, where Kaygan worked.

The first coronavirus test of a resident of the Lodge only took place on April 29. That was 34 days after the first suspected case at the home, said Andrew Knight, chief executive of residential services at CareUK, a private company which operates the home. It was also 14 days after Matt Hancock, the UK health secretary, pledged tests would be available to “everyone who needs one” in a care home.

“The government’s response on testing has come way too late to have any meaningful effect on keeping the virus out of our homes,” said Knight, the CareUK executive, in a statement to Reuters.

So far, at least 32,300 people have died in Britain from the coronavirus, the highest toll in Europe, according to official UK data processed by 2 May. Out of those deaths, more than 5,890 were registered as occurring in care homes in England and Wales by April 24, the latest date available. These figures don’t include care home residents who were taken to hospital and died there.

Many care home providers believe the figures understate the number of deaths among care home residents because, in the absence of testing, not all are being captured. During the 10 weeks prior to the outbreak, including the height of the flu season, an average of 2,635 people died each week in care homes in England and Wales. By April 24, that weekly death toll had risen to 7,911. According to Reuters calculations, the pandemic has resulted in at least 12,700 excess deaths in care homes.

 “I think the focus early on was very much on the acute sector,” or urgent hospital treatment, “and ensuring hospitals were able to respond in an effective way,” said Graeme Betts, acting chief executive of Birmingham City Council, which oversees the UK’s second-biggest city. “And I think early on care homes didn’t get the recognition that perhaps they should have.”

Helen Wildbore, director of the relatives and residents association, a national charity supporting families of people in residential care, said while it was right for the initial focus to be on protecting the NHS, “I think it has taken too long for the government to turn its attention” to vulnerable people outside hospital. “I think it’s fair to say that the sector has felt like an afterthought for quite a long time.”

Jeremy Hunt, a former Conservative Party health secretary and now chairman of the House of Commons health select committee, advocated banning visits to care homes by friends and family from early March, advice that wasn’t followed. Speaking to Reuters, he drew a parallel between the UK’s response to the coronavirus and the way it deals with peak winter demand for hospital services.

“What happens with any NHS winter crisis is the focus of attention immediately switches to the hospitals and dominates the system’s thinking,” he said. “Many people in the social care sector told me exactly the same thing happened with COVID-19.”

The government spokesman said protecting the elderly and most vulnerable members of society had always been a priority, “and we have been working day and night to battle coronavirus by delivering a strategy designed to protect our NHS and save lives.”

Full report: https://www.reuters.com/investigates/special-report/health-coronavirus-britain-elderly/

Special Report: Johnson listened to his scientists about coronavirus – but they were slow to sound the alarm

LONDON (Reuters) – It was early spring when British scientists laid out the bald truth to their government. It was “highly likely,” they said, that there was now “sustained transmission” of COVID-19 in the United Kingdom.

If unconstrained and if the virus behaved as in China, up to four-fifths of Britons could be infected and one in a hundred might die, wrote the scientists, members of an official committee set up to model the spread of pandemic flu, on March 2. Their assessment didn’t spell it out, but that was a prediction of over 500,000 deaths in this nation of nearly 70 million.

Yet the next day, March 3, Prime Minister Boris Johnson was his cheery self. He joked that he was still shaking hands with everyone, including at a hospital treating coronavirus patients.

“Our country remains extremely well prepared,” Johnson said as Italy reached 79 deaths. “We already have a fantastic NHS,” the national public health service, “fantastic testing systems and fantastic surveillance of the spread of disease.”

Alongside him at the Downing Street press conference was Chris Whitty, the government’s chief medical adviser and himself an epidemiologist. Whitty passed on the modelling committee’s broad conclusions, including the prediction of a possible 80% infection rate and the consequent deaths. But he played them down, saying the number of people who would be infected was probably “a lot lower” and coming up with a total was “largely speculative.”

The upbeat tone of that briefing stood in sharp contrast with the growing unease of many of the government’s scientific advisers behind the scenes. They were already convinced that Britain was on the brink of a disastrous outbreak, a Reuters investigation has found.

Interviews with more than 20 British scientists, key officials and senior sources in Johnson’s Conservative Party, and a study of minutes of advisory committee meetings and public testimony and documents, show how these scientific advisers concluded early the virus could be devastating.

But the interviews and documents also reveal that for more than two months, the scientists whose advice guided Downing Street did not clearly signal their worsening fears to the public or the government. Until March 12, the risk level, set by the government’s top medical advisers on the recommendation of the scientists, remained at “moderate,” suggesting only the possibility of a wider outbreak.

“You know, there’s a small little cadre of people in the middle, who absolutely did realise what was going on, and likely to happen,” said John Edmunds, a professor of infectious disease modelling and a key adviser to the government, known for his work on tracking Ebola. Edmunds was among those who did call on the government to elevate the warning level earlier.

From the outset, said Edmunds, work by scientists had shown that, with only limited interventions, the virus would trigger an “overwhelming epidemic” in which Britain’s health service was not going “to get anywhere near being able to cope with it. That was clear from the beginning.”

But he said: “I do think there’s a bit of a worry in terms you don’t want to unnecessarily panic people.”

Johnson, who himself has sickened with the virus, moved more slowly than the leaders of many other prosperous countries to adopt a lockdown. He has been criticised for not moving more swiftly to organise mass tests and mobilise supplies of life-saving equipment and beds. Johnson was hospitalized on April 5 and moved to intensive care the next day.

It is too soon to judge the ultimate soundness of the UK’s early response. If history concludes that it was lacking, then the criticism levelled at the prime minister may be that, rather than ignoring the advice of his scientific advisers, he failed to question their assumptions.

Interviews and records published so far suggest that the scientific committees that advised Johnson didn’t study, until mid-March, the option of the kind of stringent lockdown adopted early on in China, where the disease arose in December, and then followed by much of Europe and finally by Britain itself. The scientists’ reasoning: Britons, many of them assumed, simply wouldn’t accept such restrictions.

The UK scientists were also mostly convinced – and many still are – that, once the new virus escaped China, quarantine measures would likely not succeed. Minutes of technical committees reviewed by Reuters indicate that almost no attention was paid to preparing a programme of mass testing. Other minutes and interviews show Britain was following closely a well-laid plan to fight a flu pandemic – not this deadlier disease. The scientists involved, however, deny that the flu focus ultimately made much difference.

Now, as countries debate how to combat the virus, some experts here say, the lesson from the British experience may be that governments and scientists worldwide must increase the transparency of their planning so that their thinking and assumptions are open to challenge.

John Ashton, a clinician and former regional director of Public Health England, the government agency overseeing healthcare, said the government’s advisers took too narrow a view and hewed to limited assumptions. They were too “narrowly drawn as scientists from a few institutions,” he said. Their handling of COVID-19, Ashton said, shows the need for a broader approach. “In the future we need a much wider group of independent advisers.”

Michael Cates, who succeeded Stephen Hawking as Lucasian Professor of Mathematics at Cambridge University, is leading an initiative by the Royal Society, the UK’s leading scientific body, to bring modellers in from other scientific disciplines to help understand the epidemic.

“Without faulting anyone so far, it’s vital, where there is such a lot at stake, to throw the maximum possible light on the methods, assumptions and data built into our understanding of how this epidemic will develop,” he told Reuters.

In a statement to Reuters, a spokesperson for the Department of Health and Social Care said the government was delivering “a science-led action plan” to contain the outbreak. “As the public would expect, we regularly test our pandemic plans and what we learned from previous exercises has helped us to rapidly respond to COVID-19.”

A LOW RISK TO THE PUBLIC

When news came from China in January of a new infectious disease, Johnson had reason to believe his country was well prepared. It had some of the world’s best scientists and a well-drilled plan to deal with potentially lethal pandemics. Perhaps, some scientists say in hindsight, the plan made them slow to adapt.

For many years, the Cabinet Office – a collection of officials who act as the prime minister’s direct arm to run the government – took the threat of pandemics seriously. Presciently, it rated pandemics as the Number 1 threat to the country, ahead of terrorism and financial crashes.

At the centre of planning was a small group of scientists, among them Edmunds. His research group at the London School of Hygiene and Tropical Medicine runs one of the two computer modelling centres for epidemics that have mostly driven government policy. The other is at nearby Imperial College. Edmunds remembers that early in the outbreak, the data from China were sketchy, in the period “where the Chinese were trying to pretend that this wasn’t transmissible between humans.”

Edmunds and his colleague at Imperial, Neil Ferguson, were part of an alphabet soup of committees that fed advice into the Cabinet Office machinery around the prime minister. Both were founders of the flu pandemic modelling committee, known as SPI-M, that produced the March 2 report warning of more than 500,000 deaths. This committee had met together for nearly 15 years.

Ferguson did not respond to a request to be interviewed for this article.

Edmunds and Ferguson were also part of NERVTAG, the New and Emerging Respiratory Virus Threats Advisory Group. Both too were members of the Scientific Advisory Group for Emergencies, known as SAGE, that advises the government in times of crisis. SAGE reports directly to Johnson and the government’s main emergency committee, COBRA.

At first, when NERVTAG met on January 13, it studied information from China that there was “no evidence of significant human to human transmission” of the new virus, according to minutes of the meeting. The scientists agreed the risk to the UK population was “very low.”

The evidence soon changed, but this wasn’t reflected in the official threat level. By the end of January, scientists in China began releasing clinical data. Case studies published in the British medical journal, The Lancet, showed 17% of the first 99 coronavirus cases needed critical care. Eleven patients died. Another Chinese study, in the same magazine, warned starkly of a global spread and urged: “Preparedness plans and mitigation interventions should be readied for quick deployment globally.”

Edmunds recalled that “from about mid January onwards, it was absolutely obvious that this was serious, very serious.” Graham Medley, a professor of infectious diseases modelling at the London School and chairman of SPI-M, agreed. He said that the committee was “clear that this was going to be big from the first meeting.” At the end of January, his committee moved into “wartime” mode, he said, reporting directly into SAGE.

Dr Jon Read, a senior lecturer in biostatistics at the University of Lancaster, also a member of SPI-M, said by the end of January it was apparent the virus had “pandemic potential” and that death rates for the elderly were brutal. “From my perspective within the sort of modelling community, everybody’s aware of this, and we’re saying that this is probably going to be pretty bad,” he said.

But the scientists did not articulate their fears forcefully to the government, minutes of committee meetings reveal.

On January 21, scientists on NERVTAG endorsed the elevation of the UK risk warning from COVID-19 from “very low” to “low.” SAGE met formally for the first time the following day about the coronavirus threat. So did COBRA, which was chaired by Matt Hancock, the health secretary, who would contract the virus himself in late March. He told reporters after the meeting: “The clinical advice is that the risk to the public remains low.”

In response to questions from Reuters, the government’s Department of Health declined to clarify how the risk levels are defined or what action, if any, they trigger. In a statement, a spokesperson said: “Increasing the risk level in the UK is a belt and braces measure which allows the government to plan for all future eventualities.”

Two days later, China put the city of Wuhan, where the outbreak began, into a complete lockdown. Hubei, the surrounding province, would follow. But already, 17 passenger flights had flown directly from Wuhan to Britain since the start of 2020, and 614 flights from the whole of China, according to FlightRadar24, a flight-tracking service. That meant thousands of Chinese, some of them potential carriers, had come to Britain. On April 5, scientific adviser Ferguson said he estimated only one-third of infected people reaching Britain had been detected.

As they watched China impose its lockdown, the British scientists assumed that such drastic actions would never be acceptable in a democracy like the UK. Among those modelling the outbreak, such stringent counter-measures were not, at first, examined.

“We had milder interventions in place,” said Edmunds, because no one thought it would be acceptable politically “to shut the country down.” He added: “We didn’t model it because it didn’t seem to be on the agenda. And Imperial (College) didn’t look at it either.” The NERVTAG committee agreed, noting in its minutes that tough measures in the short term would be pointless, as they “would only delay the UK outbreak, not prevent it.”

That limited approach mirrored the UK’s longstanding pandemic flu strategy. The Department of Health declined a request from Reuters for a copy of its updated pandemic plan, without providing a reason. But a copy of the 2011 “UK Influenza Pandemic Preparedness Strategy 2011,” which a spokesman said was still relevant, stated the “working presumption will be that Government will not impose any such restrictions. The emphasis will instead be on encouraging all those who have symptoms to follow the advice to stay at home and avoid spreading their illness.”

According to one senior Conservative Party politician, who was officially briefed as the crisis unfolded, the close involvement in the response to the coronavirus of the same scientific advisers and civil servants who drew up the flu plan may have created a “cognitive bias.”

“We had in our minds that COVID-19 was a nasty flu and needed to be treated as such,” he said. “The implication was it was a disease that could not be stopped and that it was ultimately not that deadly.”

While the UK was prepared to fight the flu, Asian states like China, Hong Kong, Singapore and South Korea had built their pandemic plans with lessons learned from fighting the more lethal SARS outbreak that began in 2002, he said. SARS had a fatality rate of up to 14%. As a result, these countries, he said, were more ready to resort to widespread testing, lockdowns and other draconian measures to keep their citizens from spreading the virus.

Scientists involved in the UK response disagree that following the government’s flu plan clouded their thinking or influenced the outbreak’s course. The plan had a “reasonable worst case” scenario as devastating as the worst predictions for COVID-19, they note.

Mark Woolhouse, a professor of infectious diseases epidemiology at the University of Edinburgh, and a member of the SPI-M committee, said COVID-19 did behave differently than an expected pandemic flu – for example school closures proved to be far less effective in slowing the spread of the coronavirus. But, broadly, “the government has been consistently responsive to changing facts.”

By the end of January, the government’s chief medical adviser, Whitty, was explaining to politicians in private, according to at least two people who spoke to him, that if the virus escaped China, it would in time infect the great majority of people in Britain. It could only be slowed down, not stopped. On Jan 30, the government raised the threat level to “moderate” from “low.”

The country’s medical officers “consider it prudent for our governments to escalate planning and preparation in case of a more widespread outbreak,” a statement said at the time. Whitty did not respond to questions from Reuters for this article.

A TIME TO PREPARE

On the evening of January 31, Boris Johnson sat before a fireplace in 10 Downing Street and told the nation, in a televised address: “This is the moment when the dawn breaks and the curtain goes up on a new act in our great national drama.”

He was talking of finally delivering Brexit, or what he called “this recaptured sovereignty.” Until that moment, Johnson’s premiership had been utterly absorbed by delivering on that challenge.

With Brexit done, Johnson had the chance to focus on other matters the following month, among them the emerging virus threat. But leaving the European Union had a consequence.

Between February 13 and March 30, Britain missed a total of eight conference calls or meetings about the coronavirus between EU heads of state or health ministers – meetings that Britain was still entitled to join. Although Britain did later make an arrangement to attend lower-level meetings of officials, it had missed a deadline to participate in a common purchase scheme for ventilators, to which it was invited. Ventilators, vitally important to treating the direst cases of COVID-19, have fallen into short supply globally. Johnson’s spokesman blamed an administrative error.

A Downing Street aide told Reuters that from around the end of January, Johnson concentrated his attention increasingly on the coronavirus threat, receiving “very frequent” updates at least once per day from mid February, either in person or via a daily dashboard of cases.

In the medical and scientific world, there was growing concern about the threat of the virus to the UK. A report from Exeter University, published on February 12, warned a UK outbreak could peak within four months and, without mitigation, infect 45 million people.

That worried Rahuldeb Sarkar, a consultant physician in respiratory medicine and critical care in the county of Kent, who foresaw that intensive care beds could be swamped. Even if disease transmission was reduced by half, he wrote in a report aimed at clinicians and actuaries in mid-February, a coronavirus outbreak in the UK would “have a chance of overwhelming the system.”

With Whitty stating in a BBC interview on February 13 that a UK outbreak was still an “if, not a when,” Richard Horton, a medical doctor and editor of the Lancet, said the government and public health service wasted an opportunity that month to prepare quarantine restriction measures and a programme of mass tests, and procure resources like ventilators and personal protective equipment for expanded intensive care.

Calling the lost chance a “national scandal” in a later editorial, he would testify to parliament about a mismatch between “the urgent warning that was coming from the frontline in China” and the “somewhat pedestrian evaluation” of the threat from the scientific advice to the government.

After developing a test for the new virus by January 10, health officials adopted a centralised approach to its deployment, initially assigning a single public laboratory in north London to perform the tests. But, according to later government statements, there was no wider plan envisaged to make use of hundreds of laboratories across the country, both public and private, that could have been recruited.

According to emails and more than a dozen scientists interviewed by Reuters, the government issued no requests to labs for assistance with staff or testing equipment until the middle of March, when many abruptly received requests to hand over nucleic acid extraction instruments, used in testing. An executive at the Weatherall Institute of Molecular Medicine at the University of Oxford said he could have carried out up to 1,000 tests per day from February. But the call never came.

“You would have thought that they would be bashing down the door,” said the executive, who spoke on condition of anonymity. By April 5, Britain had carried out 195,524 tests, in contrast to at least 918,000 completed a week earlier in Germany.

Nor was there an effective effort to expand the supply of ventilators. The Department of Health told Reuters in a statement that the government started talking to manufacturers of ventilators about procuring extra supplies in February. But it was not until March 16, after it was clear supplies could run out, that Johnson launched an appeal to industry to help ramp up production.

Charles Bellm, managing director of Intersurgical, a global supplier of medical ventilation products based outside London, said he has been contacted by more than a dozen governments around the world, including France, New Zealand and Indonesia. But there had been no contact from the British government. “I find it somewhat surprising, I have spoken to a lot of other governments,” he said.

Countering such criticism, Hancock, the health minister, said the government is on track to deliver about 10,000 more ventilators in the coming weeks. One reason Britain was behind some countries on testing, he said, was the absence of a large diagnostics industry at the outbreak of the epidemic. “We didn’t have the scale.”

GAME OVER

It was during the school half-term holidays in February that frontline doctor Nicky Longley began to realise that early efforts to contain the disease were likely doomed.

For weeks now, doctors and public health workers had been watching out for people with flu-like symptoms coming in from China. Longley, an infectious diseases consultant at London’s Hospital for Tropical Diseases, was part of a team that staffed a public health service helpline for those with symptoms. The plan, she said, had been to make all effort to catch every case and their contacts. And “to start with, it looked like it was working.”

But then, bad news. First, on Wednesday the 19th of February, came the shock news from Iran of two deaths. Then, on Friday the 21st, came a death in Italy and a bloom of cases in Lombardy and Veneto regions. Britain has close links to both countries. Thousands of Britons were holidaying in Italy that week.

“I don’t think anybody really foresaw what was happening in Italy,” Longley said. “And I think, the minute everybody saw that, we thought: ‘This is game over now.’”

Until then, Longley said, everyone felt “there was a chance to stamp it out” even though most were sceptical it could be done long-term. But after Iran and Italy, it was obvious containment would not work. The contact tracing continued for a while. But as the cases in London built up, and the volume of calls to the helpline mushroomed, the priority began to shift to clinical care of the serious cases. “At a certain point you have to make a decision about where you put your efforts as a workforce.”

Slideshow (23 Images)

Edmunds noted that Iran and Italy had hardly reported a case until that point. “And then, all of sudden you had deaths recorded.” There was a rule of thumb that, in an outbreak’s early stages, for each death there were probably 1,000 cases in a community. “And so it was quite clear that there were at least thousands of cases in Italy, possibly tens of thousands of cases in Italy right then.”

Amid the dreadful news from Italy, the scientists at NERVTAG convened by phone that Friday, 21st February. But they decided to recommend keeping the threat level at “moderate,” where it had sat since January 30th. The minutes don’t give a detailed explanation of the decision. Edmunds, who had technical difficulties and couldn’t be heard on the call, emailed afterwards to ask the warning to be elevated to “high,” the minutes revealed. But the warning level remained lower. It’s unclear why.

“I just thought, are we still, we still thinking that it’s mild or something? It definitely isn’t, you know,” said Edmunds.

A spokesman for the government’s chief scientific adviser, Sir Patrick Vallance, didn’t directly respond to Reuters questions about the threat level. Asked whether, with hindsight, the scientists’ approach was the right one, the spokesperson said in a statement that “SAGE and advisers provide advice, while Ministers and the Government make decisions.”

HERD IMMUNITY

On Sunday, March 1st, Ferguson, Edmunds and other advisers spent the day with NHS public health service experts trying to work out how many hospital beds and other key resources would be needed as the outbreak exploded. By now, Italian data was showing that a tenth of all infected patients needed intensive care.

The following day, pandemic modelling committee SPI-M produced its “consensus report” that warned the coronavirus was now transmitting freely in the UK. That Thursday, March 5, the first death in the UK was announced. Italy, which reached 827 deaths by March 11, ordered a national lockdown. Spain and France prepared to follow suit.

Johnson held out against stringent measures, saying he was following the advice of the government’s scientists. He asserted on March 9: “We are doing everything we can to combat this outbreak, based on the very latest scientific and medical advice.”

Indeed, the government’s Scientific Advisory Group for Emergencies, SAGE, had recommended that day, with no dissension recorded in its summary, that the UK reject a China-style lockdown. SAGE decided that “implementing a subset of measures would be ideal,” according to a record of its conclusions. Tougher measures could create a “large second epidemic wave once the measures were lifted,” SAGE said.

On March 12 came a bombshell for the British public. Chris Whitty, the chief medical officer, announced Britain had moved the threat to UK citizens from “moderate” to “high.” And he said the country had moved from trying to contain the disease to trying to slow its spread. New cases were not going to be tracked at all. “It is no longer necessary for us to identify every case,” he said. Only hospital cases would, in future, be tested for the virus. What had been an undisclosed policy was in the open: beyond a certain point, attempts to completely extinguish the virus would stop.

The same day, putting aside his jokey self, Johnson made a speech in Downing Street, flanked by two Union Jacks and evoking the spirit of Winston Churchill’s “darkest hour” address. He warned: “I must level with you, level with the British public – more families, many more families are going to lose loved ones before their time.”

For most Britons, it came as a shock. Several of the next day’s newspapers splashed Johnson’s words on their front pages.

Vallance, the government’s chief scientific adviser, who chaired SAGE, said in a BBC interview on March 13 that the plan was to simply control the pace of infection. The government had, for now, rejected what he called “eye-catching measures” like stopping mass gatherings such as football games or closing schools. The “aim is to try and reduce the peak, broaden the peak, not to suppress it completely.” Most people would get the virus mildly, and this would build up “herd immunity” which, in time, would stop the disease’s progress.

But by now, the country was rebelling. Major institutions decided to close. After players began to get infected, the professional football leagues suspended their games. As Johnson still refused to close schools and ban mass gatherings, the Daily Mirror’s banner headline, summing up a widespread feeling, asked on March 13: “Is It Enough?”

The catalyst for a policy reversal came on March 16 with the publication of a report by Neil Ferguson’s Imperial College team. It predicted that, unconstrained, the virus could kill 510,000 people. Even the government’s “mitigation” approach could lead to 250,000 deaths and intensive care units being overwhelmed at least eight times over.

Imperial’s prediction of over half a million deaths was no different from the report by the government’s own pandemic modelling committee two weeks earlier. Yet it helped trigger a policy turn-around, both in London and in Washington, culminating seven days later in Johnson announcing a full lockdown of Britain. The report also jarred the U.S. administration into tougher measures to slow the virus’ spread.

Ferguson was now in isolation himself after catching the virus. Testifying by video link to a committee in Parliament, he explained why he and other scientific advisers had shifted from advocating partial social-distancing measures to warning that without a rigorous shutdown, the NHS would be overwhelmed. The reason, he said, lay in data coming out of Italy that showed large numbers of patients required critical care.

“The revision was that, basically, estimates of the proportion of patients requiring invasive ventilation, mechanical ventilation, which is only done in a critical care unit, roughly doubled,” he said.

Edmunds had a different explanation for the policy shift.

What allowed Britain to alter course, said Edmunds, was a lockdown in Italy that “opened up the policy space” coupled with new data. First came a paper by Edmunds’ own London School team that examined intermittent lockdowns, sent to the modelling committee on March 11 and validated by Edinburgh University. Ferguson’s revised Imperial research followed.

Woolhouse, the Edinburgh professor, confirmed the sequence.

Edmunds said these new studies together had demonstrated that if the British government imposed a lengthy period of tougher measures, perhaps relaxed periodically, then the size of the epidemic could be substantially reduced.

Still, without a vaccine or effective treatments, it’s going to be hard to avoid a substantial part of the British population getting infected, said Edmunds. “Until you get to a vaccine, there is no way of getting out of this without certainly tens of thousands of deaths,” he said. “And probably more than that.”

Now subject to intense public scrutiny, the modelling teams at universities across Britain continue to work on different scenarios for how the world can escape the virus’s clutches. According to Medley, the chairman of the SPI-M pandemic modelling committee, no one now doubts, for all the initial reservations, that a lockdown was essential in Britain.

Medley added: “At the moment we don’t know what’s going to happen in six months. All we know is that unless we stop transmission now, the health service will collapse. Yep, that’s the only thing we know for sure.”

Reporting by Stephen Grey and Andrew MacAskill; Additional reporting by Elizabeth Piper in London, Gabriela Baczynska in Brussels; editing by Janet McBride

 

VALLETTA (Reuters) – One day in the summer of 2017, Vince Muscat dropped his friend Alfred Degiorgio at the Busy Bee, a harbour-front café near Malta’s capital renowned for its pastries stuffed with ricotta cheese. Degiorgio didn’t stay long.

A few minutes later, he jumped back into the car to report to Muscat that they had a contract: To kill the island’s top journalist, Daphne Caruana Galizia.

Daphne was blown up by a car bomb on Oct. 16, 2017. The murder shocked Europe and revealed the island’s violent, criminal underbelly. For years Daphne had run a popular blog famous for its punchy political opinions and allegations of corruption. It had made her many enemies.

This is the previously untold account of the plot to kill Daphne, a contract killing that earned the killers just 150,000 euros. Muscat revealed these sensational details to the police in April 2018, in the hope of getting a pardon. Details of his confession were passed to Reuters last year but were not published until now to avoid damaging the investigation.

Prime Minister Joseph Muscat (no relation) has so far refused Vince Muscat’s request for a pardon, even as he granted a pardon and immunity from prosecution to another figure in the plot, a taxi driver called Melvin Theuma. Theuma has admitted to police that he acted as a middleman between the killers and the person or people who ordered Daphne’s murder. He has been released under police protection, according to a police source, and is due to testify in court next week.

“It’s a complete injustice that Theuma should give evidence against Vince when Vince was the one that led police to him and helped solve this case. He is the one who should be pardoned, not Melvin,” said Pauline Muscat, Vince’s wife, speaking publicly for the first time.

Officials said Theuma was arrested on Nov. 14 as part of a separate investigation into illegal gambling, however. After his detention, he offered information about Daphne’s killing and provided evidence that led to the arrest six days later of Yorgen Fenech, one of Malta’s leading businessmen, they said. Fenech is being questioned by police.  Fenech’s lawyer declined to comment and Theuma’s lawyer didn’t respond to a request for comment.

SEEKING A PARDON

The first arrests in the investigation took place on Dec 3, 2017 when Muscat and his two alleged accomplices, brothers Alfred and George Degiorgio, were charged with Daphne’s murder. All three denied the charges. After lengthy preliminary hearings, they were indicted in July to stand trial by jury at an undetermined future date.

Muscat, who was known to police for minor misdemeanours, including importing birds, agreed to spill the beans in April 2018 after police said his statement would only be used as evidence if Muscat obtained a pardon. A person briefed in detail about Muscat’s confession relayed the contents to Reuters. Muscat told police that the killers were paid 150,000 euros to murder Daphne, with 30,000 euros delivered upfront, this person said. They used a bomb bought from Maltese gangsters and supplied by the Italian mafia.

Police have said they believe Muscat was a henchman for George Degiorgio, known by the nickname “Ic-Ciniz” (the Chinese), leader of an organised crime group. Alfred Degiorgio, known as “Il-Fulu” (the Bean), was a member of the same gang, according to police. The brothers continue to deny Daphne’s murder and have declined to answer police questions. Marc Sant, a lawyer defending Vince Muscat, declined to comment, as did lawyers for the brothers.

In interviews with police, Muscat named Theuma, the taxi driver, as the middleman who arranged Daphne’s killing, the person familiar with his confession said. Muscat drove Alfred Degiorgio to several meetings with Theuma, Muscat told police. He said he didn’t hear the two men’s discussions about killing Daphne, but Alfred Degiorgio briefed him after each meeting. Details of the meetings were also relayed by Alfred to George Degiorgio, Muscat said.

According to Muscat’s account, after getting the contract to kill Daphne, the plotters first decided to shoot her and bought a rifle with telescopic sights. Muscat told investigators the rifle was supplied from Italy, and that Alfred Degiorgio was to fire the weapon.

Muscat told investigators how, as surveillance continued, they followed Daphne on a family outing to the Phoenicia Hotel, by the gates of Malta’s capital Valletta, and to the airport when she and her husband, Peter, went on a foreign trip.

Muscat said that Theuma had helped watch the couple’s car in the airport carpark to identify when she returned home. A member of Daphne’s family confirmed she had visited the Phoenicia Hotel on Aug. 17 and 26 and had travelled abroad with Peter from Sept. 16 to Sept. 21.

After their scouting operation, the gang decided, for reasons not yet explained, that it would be too difficult to shoot Daphne, according to the account of Muscat’s confession given to Reuters.

Returning the rifle to the supplier, they were then provided with a bomb and shown how to detonate it, according to Muscat. Police say they have identified those suspected of supplying the weapons and hope to make arrests soon.

COMPOUND

Daphne lived in the village of Bidnija where she had a house in a walled compound. She usually parked her car inside the compound. That posed an obstacle to her would-be killers, who needed access to her vehicle to place the bomb. In case they had to climb into her garden to reach the car, they devised a special leash to control the dog that ran around inside.

But on the evening of Oct. 15, 2017, Muscat and the Degiorgio brothers realised the car had been parked outside the gate to the compound. In an interview with Reuters, Daphne’s son, Matthew, previously described how he had parked the car in the road that night, something he did quite often.

In the early hours of Oct. 16, police have said in court, the two Degiorgios and Muscat went to Bidnija to plant the bomb.

The person briefed on Muscat’s confession said Muscat alleges Alfred broke into the car by levering open the rear-quarter window passenger side. With George watching out from a high vantage point, and Muscat watching the lane outside Daphne’s house, Alfred crept inside the car and put the bomb under the driver’s seat.

In court hearings, police described how telephone data revealed that George Degiorgio later boarded a yacht and was in the Grand Harbour of Valletta when Daphne left her home just before 3 p.m. on Oct. 16.

According to the prosecution case, George Degiorgio sent a text message from the yacht to a device inside Daphne’s car which detonated the bomb and killed her.

According to Muscat’s account, the balance on the cash price for her killing was handed to Alfred Degiorgio by Melvin Theuma within 10 days of the bombing at a place called Ramla Taz-Zejtun in the south of Malta. Police sources declined to discuss details of any financial transactions. Lawyers for the brothers declined to comment.

reporting by Stephen Grey; editing by Janet McBride

No child should be afraid of growing up

It’s sometime easier to think about tragedy and wars in countries far away– much harder to think about the war on the next-door street. But for many Londoners these days, every radio news bulletin brings an ache in the gut and the question: is that my son they are talking about?

A week ago, I got a call early in the morning from my friend David Marriott, co-founder and lead coach of a major club in south London the Lambeth Tigers, at which I help out a bit. He told me the night before, he was coaching kids mostly eight years old, but with siblings as young as three watching the session. This was at a youth club in Brixton, the Marcus Lipton. He described how a young man was chased into the club and stabbed to death, right by where the children were training. David and two parents of the kids got directly involved trying to save the young man’s life – unfortunately unsuccessful.

David Marriott outside the Marcus Lipton centre

The coaches, parents and children were terribly traumatised. It’s been heart-breaking to hear how kids have reacted. To hear how eight-year-old boys are asking their mums: “When I grow old will I get stabbed?”. That should not be the worry  of anyone from any community growing up in London

No-one should be afraid of growing up.

We wondered who to turn to, and after all the stabbings that have occurred in London, we expected a slick response.

We spent all day trying to get a number for some counsellor, some psychologist who the parents and the coaches could speak to. We called it in as an emergency to Lambeth social services. The Tigers did get immediate help from the London Football Association and are grateful for that. But at the end of the day (Friday night) all we could offer parents was numbers for helplines like Victim Support. That isn’t a good enough – they wanted some real person to speak to.

After 5pm on Friday night everyone stopped even answering emails, by Sunday night, David was angered: “Not a single person from any authority has even called just to ask how the kids were doing.”

One of the mums, Sarah, said: “We felt completely abandoned. We feel like living victims.”

(You can hear more from Sarah in this BBC interview: https://www.bbc.co.uk/sounds/play/m0002yl7  – go to 1.35.45 and it starts there )

The club, co-founded by David and Jamahl Jarrett, works in some of the toughest places in London and it has been very successful. Two thirds of their 200+ signed players live in neighbourhoods ranked in the top 20% for crime in Britain. The club makes a difference in many people’s lives. We wrote a letter to Sadiq Khan and Lambeth Council. The letter said: “Regardless of where children and young people live, we believe they have a right to a safe place to play and take part in sport.”

As David put it, “Whatever is happening on the street, these things can’t happen in front of my eight year olds”

David has seen a lot. His own brother was murdered in a gun crime in 2008, which motivated him and Jamahl to found the club. In 2012, a 15-year-old Lambeth Tiger player was murdered, the innocent victim of a stabbing, that took place right oppose the same Brixton youth club, the Marcus Lipton

When David returned to the crime scene on Thursday, flowers were still left over from that 2012 tragedy, still attached to the railing right opposite.

After David and Jamahl sent the letter, Lambeth organised some counselling, and Sadiq Khan’s people got in touch. It seems authorities are getting a response together. The club will meet with them next week to work out what next. But parents still don’t think it’s enough.

This is more than a small football club should have to deal with alone – and the teenagers and youth workers who were there too at the Youth Centre need massive support and help.
The Tigers tried not to make too much publicity because they didn’t want to impact on kids at the club. They don’t want anyone to fear sport – to associate sport with danger.

But everyone does feel there are some important things to say, lessons to learn – and these kids still need plenty more help.

Lambeth Tigers also learned who our friends are. Telling people about a stabbing makes most people so shocked, they can’t wait to put down the phone. And they find excuses not to help.

We also  learned we have massive friends at Nike – who showed us that being a ‘partner club’ was not just a slogan.

Going forward, the football club’s going to work hard not only to these support parents and kids but to find and support efforts for safe sports facilities for kids in south London for all.

If you want to help you can get in touch with Lambeth Tigers: info@lambethtigersfc.org – or pledge something to the fundraising page of the club’s registered charity, the Lambeth Tigers Foundation: https://www.givey.com/lambethtigers

B-72: Chaos? Yes. But a fair, consensus Brexit deal is possible.

May’s plan has been defeated; politics is all at sea. But a solution stares us in the face, if both Conservatives and liberals re-think their approach.

The right Brexit plan stares us in the face. The only question is: will the Government and the Labour Leader put the interest of the country above the unity of their parties?

Yesterday, I watched the debate in the British parliament carefully and went also to Westminster and chatted to several MPs. Based on those observations, it seems  obvious to me there is a clear consensus in parliament and the country on the best form of Brexit. If Brexit must go ahead, a clear majority would accept a customs union.

A customs union will allow, just as in Switzerland, some key business regulations to be set in Brussels (without a UK say or vote) but most key areas of national policy to be set at Westminster.

A customs union avoids the need for a hard border in Northern Ireland, thus cancels the ‘backstop’ problem. It trades a loss of sovereignty on a few matters with a wider return of sovereignty over much else.

May has wrongly prioritised Party unity by spending two years preventing parliament from agreeing and ratifying a vision for what relationship Britain wants with the EU. Even now, the so-called ‘agreement’ is still to a large extent a ‘blind Brexit’ where key decisions are – dangerously – delayed until after we have left.

May has also wrongly prioritised Party unity with her ‘red line’ that rejects the European Court of Justice competence over policing the single market. Parliament could live with ECJ competence.

If May and parliament choose the customs union approach, some Tory rebels may quit the whip and she will lose her majority. At this point, she (or her successor) should attempt a government of national unity to exist only to agree the Brexit deal; if that fails, an election will be needed. As I observed, there is a clear Labour + Soft Tory majority for a soft Brexit; but perhaps not a majority within Tory ranks.

Liberals in Labour and Conservative and LibDem ranks meanwhile – hellbent on stopping Brexit — have been wrong to obfuscate and delay the creation of consensus plan for Brexit. (I count myself guilty on that score).

Liberals are right to campaign for a second referendum but their approach has been disingenuous and poorly calculated. Their approach needs to be reframed so that ardent Brexiteers themselves are begging for a second plebiscite. I’ll explain how and explain how it could be timed.

The public expect leaders to do their job and come up with a workable plan. People don’t want some ‘dogs dinner’ failed plan thrown back to them in a cynical ploy to cancel Brexit.

So if there is a second referendum (and there should be), it should put to the people the best possible plan for Brexit that already has consensus in parliament, namely a customs union.

Referenda work in democracies, for example in California and Switzerland, where they present clear fully-formulated propositions. The mistake of the first Brexit referendum was to offer Brexit without defining what it should mean.

The reason a second referendum is justified and necessary is that we simply do not know if a majority exists in the country for any Brexit solution; or if a majority would prefer the status quo (continued EU membership) over any particular Brexit plan.

So that nobody feels cheated, the correct referendum could ask two questions:

  1. Should Britain continue to exit the European Union? YES/NO
  2. If Brexit continues, do you approve of the plan approved by Parliament to leave the EU and remain in a Customs Union? YES / NO

On this basis, hard Brexiteers can campaign for a YES-NO, on the basis that if Parliament’s deal is rejected, Britain will opt for their clean break solution; soft Brexiteers can campaign for a YES-YES; and Remainers can campaign for a NO-YES, confident that even they lose on the existential Brexit question, a soft landing can occur.

Having wasted so much time without building a consensus in Parliament, it will be hard to make a deal before March. However, the Brexit ‘agreement’ is little more than a transition agreement that kicks the can of fundamental issues down the road. And most people can only really judge the merits of Brexit once those fundamentals are agreed.

On the timing, here I’d welcome the advice of technical experts but the correct approach maybe to go ahead with Brexit on the basis of two changes: 1) hardening the political agreement to build a clearer vision on the basis of eliminating the backstop on the basis of customs union; 2) establishing a ‘cooling off’ principle, that could allow Britain to think again on Brexit within the transition period.

The cooling off approach may seem novel, but since Britain will be fully compliant with EU rules during the transition period (and EU countries fully compliant for trading with Britain) a Brexit reversal would not come at a huge cost; most EU countries would also support the notion of the British people being given a chance to think again. Within the cooling off period, it seems to me would then allow a second vote to be put to be put to the people after a new trade deal / customs union had been negotiated, so that people could finally judge on what Brexit means.

One alternative approach – again seeking a vision that does not cheat people — is to delay Brexit in order to negotiate a much more fully-formed agreement, incorporating the customs union and thus removing the need for a Northern Ireland backstop, but, at the same time, shorten the transition so that full exit from the EU, if it goes ahead, is not shortened again.

Either way, there is an approach to go ahead that cheats nobody, slows down nothing, but still gives the people a final say.

B-DAY-80. Democracy is never over

There are fears our country may be rather divided. Many suggest it is time to ‘heal the wounds’, and to reconcile.

That’s piffle.

There is a battle in progress – a legitimate struggle to decide the UK’s future – and until the issue is decided, until Britain leaves the European Union irrevocably or cancels its exit, any priest, doom-monger or heckler that tries to block your participation in that debate is denying your right to have a say in your future.

Democracy is never over. Voters don’t dispatch their decisions to the political elite like ‘fire and forget missiles’ to be interpreted and re-interpreted ad infinitum by its leaders. Legitimacy is subject to constant refresh, directly through regular elections or plebiscites, and indirectly through the judgement of elected representatives.

Only in a dictatorship does one vote settle all.

When the Labour Party scored less than 5% of the vote in the 1906 election, it wasn’t some signal to abandon it struggle – no less than defeat at Dunkirk meant it was time to quit fighting Hitler.

Should a referendum result on an important constitutional question be binding? That’s indeed a debatable question. Don’t believe anyone who thinks there is clear answer, because Britain has no fixed constitution to consult.

But it is fair to say  that in many democracies, making a major decision, such as – to name one minor example — the Brexit plan to strip European citizenship from millions of people without their agreement, would typically involve jumping through several more hoops than just a single vote. An amendment to the US Constitution, for example, requires the support of two-thirds of both houses of Congress and two-thirds of all states before it can proceed.

If anything is divisive, it is to base a really import change to a country on one single narrow vote, and to rip up one key arrangement (EU membership) without securing any agreement (in any forum, whether in the cabinet, parliament, or the country) of what should replace it.

I just handed in my notice, to myself

Well, it looks like after years and years of working as an independent freelance, I’m off to join Reuters as a special correspondent, which is a roving role within Europe and the Middle East as part of a wider global enterprise team. It’s an exciting time to join the organisation as they’ve decided to give a real boost to long-form explanatory and investigative work. Serious journlism, in other words, of the sort that is often in short supply. Details announced today in Press Gazette. I’ll start there in December.

Man’s conquest of Space

As the Space Shuttle carries out it’s final mission, here is a look at the result of decades of space flight – the debris of missions and the clutter of so many satellites.
This view – from 8700km – is a visualisation in Google Earth with data from the Union of Concerned Scientists satellite database and the US Space Track record catalog, pulled together here.  (Click on the picture to enlarge)

Peace talks need a strategy

On another moonlit runway every month these days, another bearded man is hustled aboard a military jet. He is an ‘intermediary’ from the Taliban and  is about to be flown many hours before sitting down for another chance to talk about ending this war.

As Spiegel reported this week, Germany is one country that his hosting very preliminary “peace talks” in a hope of ending a war in Afghanistan that has cost so many lives. It’s not the only show in town. According to intelligence officials and senior diplomats I’ve interviewed, various “representatives” of the Taliban movement have also been flown to Norway and to Turkey in parallel tracks.

Fresh impetus to this process has been given by President Obama. As terrorism analyst Peter Bergen reports, a little-noticed shift of US policy has all but abandoned pre-conditions for talks to start.

Bergen is sceptical the Taliban is ready for talks – or, citing Pakistani truces with the Talban in its tribal areas, he argues they cannot be trusted anyway.

But while I judge the Taliban is becoming ever more extreme (despite attempts to argue the opposite by former Taliban ambassador Mullah Zaeef and indeed by Mullah Omar himself), if the White House is serious about a peace process, as I believe it is, then the critical question is what path could be chosen that could firstly make the Taliban less extreme and therefore an acceptable partner in a future accord and secondly make the peace process acceptable to the Taliban itself. Continue reading Peace talks need a strategy