Corona Diaries: Boris is back. So?

As Boris Johnson, Britain’s Prime Minister, gets back to work after his near-death experience at the hands of the coronavirus, he must have a full in-tray.

No doubt there will Dominic Cummings and a stream of ministers whispering in his ear about the shortcomings of their colleagues. No doubt he will wish he could assassinate various journalists or at least lock them up in a place where they will be cruelly tortured. And no doubt he will have to deal with a phalanx of Members of Parliament, wealthy donors and industry lobbyists who believe, or are paid to believe, that saving the economy is more important than saving the lives of the elderly.

Concerning the donors and those who employ the lobbyists, I would like to think that they’ve come to their opinions after balancing humanitarian with financial concerns. But it’s a sad reflection on the state of British politics that I, and no doubt many others who are no fans of the ruling party, should be suspicious of their motives.

Wealthy donors are presumably donating to the Conservatives because they think that they will benefit financially from their support for a government they believe is more business-friendly than its opponents. And presumably these are people who have the most to lose in a pandemic.

I will say no more. Since the garden centres are closed, I have no nasturtiums to cast on their motives.

As for his ministers, he will want to congratulate Priti Patel for the most Trumpian statement since the epidemic began – as she delivered the impressive news that shop-lifting has declined dramatically since the lockdown, which is hardly surprising since most of the shops are closed. It would have been more interesting and more meaningful if she could have shared with us statistics on cyber-fraud and domestic violence. And it would be helpful if our Health Minister could tell us of any increases in hospital admissions on grounds of mental illness.

Mr Johnson’s to-do list is long. He must give us some sense of understanding as to the plan for lifting restrictions. Whether the government is waiting for him to decide on a roadmap, or the roadmap is already in place and his minions are waiting for him to be able to demonstrate his leadership by announcing, where we go from here is a question that may be answered before long.

But since he’s turned us into a nation of chart-watchers through the daily briefings that feature a bewildering array of ministers and chiefs of health organisations most of us never knew existed before the crisis, he owes it to us to bang heads together and give us information we can trust.

Why it’s beyond the power of our huge and expensive bureaucracy to capture deaths at home and in care homes at the same time as those in hospitals is a mystery. If there’s a lag between NHS reporting and ONS statistics (the source of care home deaths) it should be fixed, should it not? Otherwise we’re bumbling on with incomplete information.

There’s a further layer of analysis that we, the consumers of the NHS, should be made aware of, even if there’s no need for the information in real time. It’s this:

If, as I understand it, there’s a pathway, once a patient has been admitted to hospital, from nebulised oxygen, pressurised oxygen (CPAP) to ventilator, is there an entirely consistent treatment protocol being practised in every hospital and trust in the NHS? Given that the survival rate once a patient has been placed on a ventilator is 34.6% (as reported in a study by the Intensive Care National Audit and Research Centre), how quickly are patients moved to the ventilator stage – which, in other words, in the majority of cases, results in death?

If there’s a difference in practice between hospitals, I would certainly want to go to one whose results show that they offer me the best chance of surviving. And if there are differences, would it not be another example of the infamous postcode lottery, wherein I get different treatment depending on where I live?

I appreciate that I’m straying into ground on which I’m not remotely qualified to comment, hence the questions. Nevertheless, the government must be aware that its own announcements, as well as the blanket media coverage on the dynamics of the disease, the treatment, the technology and the data, have made many of us lay people better informed on medical matters than ever before. A little knowledge may be a dangerous thing. But equipping us with that knowledge and then expecting us to ignore its implications is also dangerous.

Every week we pour on to the streets to shower praise, even adulation, over the NHS for the job it’s doing to keep us alive. But surely that doesn’t make it immune to rational questions about the consistency of its clinical practice.

Of one thing you may be sure. If my wife developed severe symptoms, and statistics show that she would have a better chance of survival at St Thomas’ Hospital, where Boris was treated, rather than our local hospital, I might not wait for an ambulance. I would be sorely tempted to get her into the car, drive at top speed and deposit her, gasping for air, outside St Thomas’. Which is one reason why the government probably wouldn’t want to share that information too widely.

You might say, well if everyone did that, where would we be? And I would reply, convince us that there’s a level playing field for survivability, and the question wouldn’t even arise.

Anyway, I wish Boris all the best, and I hope he can make a positive impact on the government’s efforts. Though judging by observations of people who have recovered from the virus of the toll it takes on cognitive ability as well as physical fitness, I hope he’s fully recovered his marbles.

He will need them.