For some people, going to hospital may now be more dangerous than staying at home untreated. Many clinically vulnerable people fear, sometimes with good reason, that a visit to hospital or the doctors’ surgery could be the end of them. Of course, there have always been dangers where sick people gather. But, until now, health services have sought to minimise them. Astonishingly, this is often no longer the case.
Across the UK, over the past two years, the NHS has been standing down even the most basic precautions against Covid-19. For example, staff in many surgeries and hospitals are no longer required to wear face masks in most clinical settings. Reassuring posters have appeared even in cancer wards, where patients might be severely immunocompromised. A notice, photographed and posted on social media last week, tells people that while they are “no longer required to wear a mask in this area”, they should use hand sanitiser “to protect our vulnerable patients, visitors and our staff”. Sanitising is good practice. But Covid-19 is an airborne virus, which spreads further and faster by exhalation than by touch.
The story this policy tells, which the government would have us believe, is that Covid-19 is all but over. It’s not true. Despite a collapse in testing, which means the figures will be grossly understated, the number of death certificates giving Covid-19 as a cause has been climbing steadily as autumn approaches, rising from 80 per week in early August to 306 in late September. Who knows what the real number may be?
Forget it, be happy, keep shopping: if you don’t live and work as though the virus has vanished, you’re holding the country back. There could scarcely be a more powerful symbol of the all-clear than doctors and nurses greeting their patients without masks.
When we forget the virus, we forget the clinically vulnerable people – an estimated 2.2 million in the UK – trapped by our insouciance. Some can scarcely leave their homes, as the danger to them of infection is so great. They are the shadow that falls across the sunny story the government tells, a shadow that must be ignored and denied.
Clinical staff, long after the clapping died away, have continued to carry the weight of this disease. A recent British Medical Association (BMA) survey of hundreds of doctors with long Covid revealed its ruinous impact on their lives. From junior doctors to consultants, they’ve been abandoned by the system, unable to get appointments or referrals, left alone to face the loss of their careers and almost every other aspect of their lives.
Long Covid is so debilitating that a study in the British Medical Journal (BMJ) this year found many who suffer it reported a lower quality of life than people with stage 4 lung cancer. Another study found that typical symptoms of long Covid “had an impact on health as severe as the long-term effects of traumatic brain injury”. Some doctors, the BMA survey found, are unable to work, to care for their children, cook, perform basic arithmetic, even brush their hair. Some are now facing the loss of their homes, bankruptcy and destitution. Though most caught the virus in the line of duty, they’ve been bright-sided, sacrificed to the officially sanctioned delusion that it’s over, and we should all get on with our lives. They must wish they could.
Masks work, especially if they’re N95 respirators or equivalent. They work best when everyone uses them, and are kept on throughout the time we spend in an enclosed space. This is because the aerosols that carry the virus can keep circulating in a room, long after they’ve been exhaled.
But unmasking isn’t the end of it. Testing for Covid-19 in hospitals has also been largely curtailed. As the Observer revealed, clinical staff in some places are being discouraged from testing themselves. If they want a test, they must buy it. Why would hospitals want less information about infection?
Now we discover that the government is stockpiling vaccines rather than deploying them. It’s senseless for two reasons. First, because it should be maximising protection before the full autumn surge begins; second, because by the time they’re used, new mutations could render them worthless.
Bad enough? Oh no. Current government guidance advises staff who think they’re infected to stay at home, but only if they “have a high temperature or do not feel well enough to go to work”. Even then, they’re not required to take a test. If they feel well enough to work, it seems, they’re welcome to spread it around.
The same advice has been issued by the government to schools: “If your child has mild symptoms such as a runny nose, sore throat or mild cough, and they feel well enough, they can go to school or childcare.” Were you to devise a formula for spreading the disease as far and wide as possible, you could scarcely do better than this.
We know how to minimise infection: ventilation, air filtration and germicidal ultraviolet light in indoor public spaces; N95 masks and Covid tests provided free to those who want them; mask mandates in clinical settings; vaccines that are widely available and up to date; proper support for workers and for the parents of children who test positive, so they can stay at home without losing their income.
There’s plenty of masking going on, but not the kind that prevents infection. The government is masking its failure to get to grips with this virus. It’s masking the fact that, thanks to three years of such failures, Covid-19 is now a constantly evolving endemic infection likely to kill or disable many thousands every winter. It’s masking the ableism its rhetoric has encouraged: the othering and blaming of those who contract the disease, driven by the widespread but wholly mistaken belief that fit and healthy people don’t catch it. It’s masking the cruelty of a system that shuts down the lives of clinically vulnerable people.
These facts – and these people – are treated as social embarrassments, locked in the government’s moral attic like a relative with a mental illness in Victorian England. They’re the country’s family secret. That coughing noise upstairs? Nothing that need concern you.
George Monbiot is a Guardian columnist
