London declares a major incident
Covering London's major-incident declaration as the Kent variant drove infections.
On the day
On 8 January 2021, at the peak of the second wave, the Mayor of London declared a major incident: the capital’s hospitals were close to being overwhelmed as a more transmissible variant drove infections, days after a Christmas of shifting rules. Sky News asked me, as an urgent care doctor, whether the declaration was the right call.
I said it plainly: yes, and sadly it was predictable. My argument that evening was about messaging, that people cannot be blamed for confusion when the guidance keeps changing, and about the cost of an overwhelmed health service, the preventable deaths at home that never reach a hospital. Some of what I called for was of that moment and is a matter of debate; the clip stands as a record of the case I made, under pressure, in January 2021.
What I said
The presenter’s questions are paraphrased. My answers are my own words from the recording, lightly edited for reading clarity; every turn has been checked against the recording.
Jonathan Samuels paraphrased, from 0:03
London’s mayor had declared a major incident as the spread of coronavirus threatened to overwhelm the capital’s hospitals. The presenter asked, as an urgent care doctor, what I made of the announcement: was it the right thing at the right time?
Dr Kishan Rees from the recording, 0:20
Good evening Jonathan, and one hundred per cent, it is absolutely the right thing. And unfortunately, sadly, it’s also entirely predictable. Anybody that has any understanding of how this disease works knows that it thrives on contact in close spaces, and many of my friends and colleagues on the frontline, clinicians and scientists that understand this disease, will have had their head in their hands when, before Christmas, we were being told that yes, we’ve clamped down enough so that it’s apparently safe to suddenly meet. Countries around the world are not doing this: if you look at Germany, Angela Merkel was saying that five excess deaths is too much, let alone five hundred, and so this year she told the German people that we’re just going to have to cancel Christmas. Unfortunately in this country we’ve had very mixed messaging. People made plans in accordance with what the guidance was, and then, quite frankly, it’s not enough for the Prime Minister to come out a few days before Christmas and say, oh actually, we’d like you to have a merry little Christmas.
Jonathan Samuels paraphrased, from 1:30
The presenter pushed back: it was not just the new strain; the numbers had been rising before. The government had stopped London households mixing at Christmas under tier four. Was I basically saying people did not obey the rules because the message came too late?
Dr Kishan Rees from the recording, 1:53
I think we need to get away from blaming people in terms of not obeying the rules, because the messaging is so different and so changing. What we need is clear, consistent messaging, and we also need a strategy. We need a strategy to move towards zero COVID, where we eradicate it. We had a head start, we were two weeks before Italy at the beginning of this pandemic, and unfortunately the plan that was instigated from a UK perspective was one based on flu, not one based on a SARS-type virus, which is what this is. And if you look at the countries that have dealt with this very well, Vietnam, Asian countries, people that have had experience of this in the past, they will wear masks, and they will be happy with that, they will wash their hands, they will practise the respiratory etiquette. Unfortunately the messaging has been so shambolic, and I said this right at the beginning, so shambolic, that people are confused, what we need is clear and consistent messaging. And we owe it to the people, my friends and colleagues that are full-time on the frontline, that are saying that it is like hell. Because what we need to understand is that this is a virus that can overwhelm any health care system in the world, whether it be the NHS or any other, no matter how well funded it is. If this virus runs out of control, you are talking about not being able to do routine care. We already know, in the original lockdown and the months after, people have been dying from preventable causes at home. They’ve been having their heart attack at home, where if they got to a hospital and had intervention they would potentially be with us today. That’s not even thinking about the people that have sadly lost their lives from COVID-19, and the healthcare professionals on the frontline as well.
Jonathan Samuels paraphrased, from 3:49
The presenter picked up a couple of points: it was hard to compare ourselves with other nations, particularly in Asia where the culture is very different; countries across Europe were struggling as we were; and no one could have predicted this much more transmissible strain.
Dr Kishan Rees from the recording, 4:11
I hate to chip in, but we could have predicted a more transmissible strain. We know, the scientific community know, that viruses left unchecked for the longest period of time, evolutionarily speaking, will change, will modify, will adapt, will do everything in their power to continue living and infecting more people. So we do know that. European countries had handled this worse than the Asian ones, though that was probably not helped by information not coming out in a particularly forthright way at the beginning.
Broadcast by Sky News, 8 January 2021; clip from the WatMed Media archive, my own upload. Sky News retains the rights in the broadcast. This page carries my own contributions with the presenter’s questions paraphrased, credits the programme, and I will amend or remove on request.