Chris Whitty is the government’s tsar on the coronavirus pandemic. He’s the Chief Medical Officer for England (CMO), the Chief Medical Adviser to the UK Government, he’s Chief Scientific Adviser (CSA) at the Department of Health and Social Care and the he’s Head of the National Institute for Health Research (NIHR).
Much of the strategy of how to tackle the pandemic in the UK will have been guided by Whitty (at least the bits the government decides to pay attention to) so it occurred to me that it might be an idea to try and get a little background on Mr Whitty.
I stumbled across some anecdotal information to begin with and surprisingly discovered that Whitty’s father, Kenneth Whitty, was Director of the British Council in Athens in the 80’s but was shot dead in 1984. It’s believed that his killers we’re members of a Palestinian group who mistook him for the MI6 officer who had sold him the car that he was driving when he got shot. Curiously, the only other paper reporting this story, as far as I can ascertain, is the Jewish News (Times of Israel), however their interpretation of events is somewhat more elaborate and appears to be missing the ‘minor’ detail of the MI6 agent.
Asides from this clearly traumatic incident in Chris Whitty’s life, I struggled to find anything out of the ordinary but I did manage to stumble across a rather insightful lecture that he gave as Professor of Physics, at Gresham College, in October 2018. Whitty was talking about various methods for tackling different types of diseases, including airborne diseases like influenza and how the methodology has to be different because of how different diseases are transmitted.
Whitty explains how, from experience, we can see that in epidemics, Health Care Workers (HCW) were the most vulnerable and untrained HCW, who “didn’t know how to use personal protective equipment”, even more so. He demonstrates how in previous epidemics there had been a significantly high mortality rate amongst HCW because decisions had to be made to implement an early intervention, which meant taking the risk of having to use unprepared HCW.
At one point Whitty also talks about Vector-borne diseases (diseases carried by insects such as mosquitoes) and, in particular he makes some rather worrying projections about the Zika virus, which he explains presents a potentially global risk. In pregnant mothers, Zika can have a particularly devastating neurological impact on foetuses and babies are frequently born with Microcephaly (abnormally small heads with incomplete brain development).
Zika, he explains, is primarily carried by the Aedes Aegypti mosquito which prefers warmer climates but it has a close cousin called the Aedes Albopictus mosquito and, at the moment, there isn’t enough data to show how effective the Albopictus mosquito is at carrying the Zika virus but we do know that it is more tolerant of colder climates and that it is gradually spreading through Europe.
I think it’s fair to speculate here that rising global temperatures could have a direct impact on the global distribution of the Aedes mosquito and that, consequently, we are likely to see greater penetration throughout Europe in the near future.
In his lecture, Whitty outlines the various responses that need to be deployed in a pandemic situation and how the response can vary dependent on the different forms of transmission.
He then goes on to explains that, at the moment, the UK is most vulnerable to Flu pandemics because they carry more significant risks as they are airborne and indiscriminate and because it’s harder to intervene. He points out that, because viruses can mutate, even anti-viral drugs can quickly become ineffective.
Surprisingly, Whitty also states that he believes screening at airports and banning travel are “utterly useless”. However, he does believe that closing schools is effective at limiting spread but then he acknowledges the impact it would have on children’s education and also on the parents who would then be forced to stop working and stay at home. He then explains a possible strategy for dealing with such a pandemic and outlines what he says “we’ve got in place” and what we can do already…
- Mathematical models to predict global and national course from early data
- Global virus identification network
- Pre-decide which bits of the UK health system, education we turn off
- Optimise vaccine production but 4 months is the current shortest lead time
- Antiviral stockpile
Of course mathematical models are only as good as the data that’s available and if we’re unable (or unwilling) to test and/or trace then that data will be limited and, by all accounts, as a vaccine is more than a few months away at this time, it seems societal organisation and how we manage the health system are the primary tools available to the government at this time. For example, we learn today that a number of screening clinics have now been suspended in Northern Ireland, which means that unless you’re considered to be in a high risk category, you wont be called in for routine screening for cervical, breast and bowel cancer, abdominal aortic aneurysm screening and monitoring or diabetic eye screening and monitoring. England and Wales suspended screening clinics around mid-March and Scotland suspended them just over a week ago.
The Guardian also reported on the 17th March that the NHS had been forced to postpone millions of operations and that hospitals were urgently discharging patients to free up 30,000 hospital beds and resources to tackle coronavirus. The National Institute of Health Research also announced the suspension of non-COVID related clinical trials back on 19th March.
Of course delayed screening means delayed diagnosis and delayed treatment which, along with delayed clinical trials and early discharge, could prove fatal in some cases but this is now considered an acceptable strategy to fighting COVID-19 because of the scale of the threat.
Under the circumstances, I think it’s right to ask whether a properly funded and fully staffed NHS would have put us in a stronger position for dealing with a pandemic in the first place. If this Tory government hadn’t stripped the NHS bare over the last 10yrs, we’d have had more beds, more ventilators, more nurses and doctors, more and better personal protection equipment (PPE), more stockpiles of medicines etc. Perhaps having the extra capacity and staff and equipment and resources would have avoided the need to ration NHS health services and saved even more lives? Of course we can expect those who can afford to pay for private healthcare, like government ministers, to continue to have access to screening and treatments so perhaps it wasn’t really on their list of primary concerns?