In 1831, the first “Asiatic cholera” pandemic reached the UK via the port of Sunderland. Although the terrible nature of the disease was evident to local doctors, vested interests delayed the notification of authorities in London because of concern about negative effects on business. Of course, more people died, and the port was quarantined.
This cholera pandemic was probably the first time the international dimensions of managing a public health emergency became clear. With 90,000 coronavirus infections and 3,000 deaths worldwide, there is now a new spectre haunting the globe.
The Organisation for Economic Cooperation and Development warns that coronavirus could slash global economic growth rates in half, as factories shut down and supply chains are broken apart. Meanwhile, the European Union has raised the risk of infection from moderate to high.
The UK appears woefully unprepared for coronavirus. The NHS is already in bad shape, with the worst ever A&E waiting times, over 95% bed occupancy, 100,000 staff vacancies and the prospect that a no-deal Brexit will majorly disrupt the supply of medicines. With the worst-case scenario suggesting up to 50 million infections and up to 250,000 deaths in the UK alone, there can be little doubt that both health and social care services will be severely challenged by even a modest intensification of the outbreak.
More worryingly still, it appears the UK government is allowing petty infighting to hamper its preparations for a pandemic. It is staggering to hear that, as the virus continues its rapid spread, Downing Street and the Department of Health and Social Care (DHSC) are locked in a row about Brexit – specifically, the UK’s continued access to the EU Early Warning and Response System (EWRS) for communicable diseases. The DHSC, it is reported, wish to remain in the EWRS, the prime minister decidedly does not.
The EWRS was created by the European Commission to "ensure a rapid and effective response by the EU to events (including emergencies) related to communicable diseases." In the web-based system – which links the European Commission, public health authorities and the European Centre for Disease Prevention and Control – appointed contacts in member states receive real-time notifications of emerging communicable disease threats, and proposed measures to control them. This allows prompt and coordinated action to fight outbreaks of infectious disease.
A number of organisations have attempted to steer the government away from the disastrous course of leaving the EWRS. The Brexit Health Alliance (BHA), for example, brings medical researchers, patient groups and public health bodies to safeguard the health service during Brexit negotiations. It argues that it is in both Europe and the UK’s interests to cooperate in handling public health issues, and BHA lists the EWRS is as an important mechanism for doing so – not that the government seems to care.
The Faculty of Public Health (FPH) is another expert body whose advice is being ignored. The FPH praised then health secretary Jeremy Hunt for acknowledging that public health emergencies transcend global boundaries, and for committing to making health security central to our Brexit negotiating position. These are commitments over which the government is now riding roughshod, and for what appear to be political reasons.
Under Johnson, Britain appears to be adopting similar isolationism in its public health policy as in its foreign policy. Yet we have known since at least 1831 that pandemics do not respect borders. A "Little Britain" approach to coronavirus is not merely unwise – it is dangerous. Fighting Covid-19 requires us to work with our European neighbours – if we do not, we are putting lives at risk.
The government’s plans to fight coronavirus include recruiting retired doctors like me. Yet domestic skills can be no substitute for international collaboration. As a former consultant paediatrician, I am asking Number 10: for patients’ sake, do not take us out of the EWRS.
Dr John Puntis is co-chair of the campaign group Keep Our NHS Public.
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