By Dr Minh Alexander NHS whistleblower and former consultant psychiatrist 3 January 2021
The NHS is currently under attack from deliberate disinformation by extremists, who seek to minimise the seriousness of the COVID-19 crisis, and to spur people into ignoring infection control guidance.
Unhelpfully, an NHS England comms blackout is reportedly in force.
Dr Marie-Louise Irvine NHS GP and former candidate for the NHA party asserts that this media blackout allows the government to control the narrative:
This context permitted an uncomfortable series of events to unfold over a BBC Radio 5 Live interview about NHS pressures in which a senior nurse, a matron, spoke of her perception of increased admission of children and younger people with COVID-19.
These were her words:
“It was minimally affecting children in the first wave. We have a whole ward of children here and I know some of my colleagues are in the same position with whole wards of children with Covid.”
“….20 and 30-year-olds with no underlying health conditions are coming in”
This is a link to the BBC interview recording:
It is not clear what effort, if any, the BBC made to corroborate her account, and whether it contacted her employing trust for more information.
A paediatric consultant from a different NHS organisation, who according to his official profile for Guys and St Thomas’ NHS Foundation Trust “was previously seconded as a clinical advisor to the English Chief Medical Officer at the Department of Health and health policy advisor to the Prime Minister’s Strategy Unit in the Cabinet Office”, made the following tweeted comments in response to the BBC Radio 5 Live interview:
His comments were reported yesterday by several media outlets, including the Sun and the Daily Mail, with the following headlines:
The Mail noted that Laura Duffell was a “vocal campaigner for nurses”:
“Ms Duffel – a vocal campaigner for nurses who previously appeared on Good Morning Britain to talk about paying £1,440 to park outside her place of work – defended herself against backlash online, as others accused her of lying about having a ward filled with children with coronavirus.”
The Mail did not note equivalent contextual information about Dr Cheung, such as the fact he was reportedly a signatory to a letter from paediatricians this summer, urging the government to re-open schools:
The BBC ran an article quoting Dr Cheung and four other senior doctors headed
No figures were actually given about the numbers of children currently being admitted with COVID. Instead, there were phrases such as “only small numbers” .
| Background information|
This is some of the existing quantitative data available on paediatric COVID-19 inpatients: Clinical characteristics of children and young people admitted to hospital with covid-19 in United Kingdom: prospective multicentre observational cohort study
This is a paper on children with COVID-19 in ITU care, based on data up to the end of September 2020:
PICANet report on COVID-19 confirmed cases admitted to paediatric intensive care
The most recent Office of National Statistics data release from the national coronavirus infection survey (based on community testing) estimated that as of 18 December 2020, 2.98% (1 in 33) children in school years 7-11 and 2.43% (1 in 41) of school year 12 to age 24% would test positive for COVID-19.
The BBC article contained no update quote from Laura Duffell, and it made no reference to whether her employing trust had confirmed or denied her original account about child COVID-19 admissions.
BBC Radio 5 Live helped to disseminate the BBC article:
It was difficult to tell how much balance was being restored to the debate. Or alternatively, whether there was a drive to limit interest in a matter which might impinge on the politically sensitive dispute about the government’s attempts to keep schools open (in spite of SAGE advice on 22 December 2020 that without secondary school closure, the virus will continue to spread).
Whatever, it was uncomfortable to see the wall of senior medics ranged in united chorus against the matron’s comments.
Information in the public domain indicates that Laura Duffell works at King’s College Hospital NHS Foundation Trust.
King’s previously produced a paper about the children whom it had admitted with COVID-19 earlier on in the pandemic:
The numbers were small, but the paper posited that children in the local catchment might be at greater risk of severe COVID-19 disease because of the socioeconomic context.
King’s has confirmed to me today that it has a 15 bedded paediatric COVID ward, currently with four patients and one further paediatric patient in ICU.
Laura Duffell has also featured in a Guardian article today on the experiences of staff at the frontline. In this article she reports that as paediatric matron, she has set up one paediatric COVID ward and is in the process of setting up another:
“Duffell, who is a paediatric nurse, says the south-east London hospital where she works is full, with intensive care beds being moved into operating theatres and recovery wards.
“We’re juggling which patients go where constantly: are they sick enough to go to intensive care? Or could we put them in a high-dependency ward? Where are we going to get ventilators from and where are we going to get the nurses trained to use them? It’s hour by hour,” she says. “It’s far worse than any winter I’ve ever experienced and we’re barely even in January yet.”
Her department worked hard over the summer to get through waiting lists after operations for sick children were cancelled but she fears they may soon be in the same situation again. “Unless something changes, we are going to be in a position where patients that don’t have Covid suffer,” she adds.
The new coronavirus variant, which is thought to be behind the spike in cases, appears to be hitting younger people harder. Duffell has been forced to turn over two paediatric wards to children with the disease. “We had the odd child here and there last time, but in this wave we are getting a lot of positive younger people,” she says. “We have one Covid ward for children already and we are just setting up a second one.”
It seems unlikely in these hugely strained times that an NHS trust would make such arrangements without reasonable belief that such a contingency is necessary.
But the dense fog of the centre’s media clampdown, and the fact-lite news reports, leave us guessing.
What we do know is that King’s, like other NHS trusts in London and the South East, has seen a very rapid recent expansion in the overall number of COVID-19 inpatients.
Such is the state of emergency that the trust has reportedly recalled staff from leave. The document below is apparently a leaked internal memo:
King’s had 90 COVID-19 inpatients on 16 December 2020.
In little over two weeks later, this number is now 572 as of this morning, which exceeds the peak that the trust saw in the first wave.
This is NHS England data for King’s up to 29 December 2020, by which point the trust had accumulated 470 COVID-19 inpatients:
In the recent analysis by the Health Service Journal, King’s had 35.8% of its beds occupied by COVID-19 patients by 29 December 2020:
No one can reasonably deny that this is a very difficult situation.
It is important that there is properly evidenced and contextualised reporting on the pandemic, to give an un-sensationalised but equally, an honest appraisal of risks.
It is also important that staff are not discouraged from speaking up by seeing others being treated ungently for doing so.
Of course, if the NHS centre was more open, or perhaps allowed to be more open, frontline staff would not be put in the uncomfortable position of having to speak out.
The COVID-19 pandemic has thrown into sharp relief something well known to whistleblowers – that UK whistleblowing governance is marred by conflicts of interest, and that the government of the day may deprive the public of its right to know out of political self-interest. Although it may take a long time, we need much better whistleblowing law and systems, including a central whistleblowing agency that is not subject to any government control and interference, and which reports directly to parliament.