Category: Covid-19

Key Takeaways

As we head into cold and flu season, many people are wondering if they can get a COVID-19 vaccine on the same day as their weekly injection of diabetes and weight management drugs like Ozempic, Wegovy, and Mounjaro. Theyre also wondering if they can still do their injection if they currently have COVID.

While these drugs shouldnt be taken alongside certain other diabetes medications, like insulin or sulfonylurea, none of the ingredients should react poorly with a COVID vaccine. But that doesnt mean youll feel great. Heres what experts recommend.

Rehka Kumar, MD, the chief medical officer at Found and an associate professor of clinical medicine at Weill Cornell Medicine, told Verywell theres little concern about Ozempic and vaccines like COVID, flu, and RSV.

However, if you just started taking a GLP-1 receptor agonistthe class of drugs that encompass Ozempic, Wegovy, and Mounjaro (the latter is also a GIP receptor agonist)you may have some side effects. Kumar said that scheduling your weekly injection around any planned vaccines could be beneficial while youre adjusting to the medication.

If it is the first dose of a GLP-1, I dont recommend taking it on the same day as a vaccine to avoid confusion in regards to which might be causing any side effects, said Kumar. Considering that both vaccines and GLP-1s can have side effects, it is possible that taking them the same day (or within a few days of each other) can increase fatigue.

Another reason to stagger your GLP-1 dose and any vaccines is to make sure you can be on the lookout for the serious risks of taking the medication. For example, the Food and Drug Administration (FDA) recently updated Ozempics label with a warning that it may lead to intestinal blockages (a warning that was already on the labels for Mounjaro and Wegovy).

Its important to stay on schedule if youre taking medications like Mounjaro, Ozempic, or Wegovy, which are usually prescribed for weekly use, Raoul Manalac, MD, the senior director of product strategy at Ro, told Verywell. However, if you catch COVID, doing your weekly injection could make your viral symptoms worse.

Semaglutide also has common side effects of nausea, vomiting, and diarrhea, said Manalac. If youre experiencing symptoms of COVID, Manalac recommends consulting with your provider to ensure that its safe to take your regularly scheduled dose of semaglutide.

Kumar said that if youre sick but are staying hydrated, still have an appetite, and your bowel function is normal, its fine to take your scheduled dose of medication. However, if you have symptoms like lack of appetite or are dehydrated, Kumar said a dose of the GLP-1 can be delayed or skipped.

If youre taking a GLP-1 drug weekly, you can get your COVID-19 vaccine on the same day as you do your injection. However, you may want to do them on different days if youre new to the drug and want to avoid making any side effects worse.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit ourcoronavirus news page.

By Rachel Murphy Rachel Murphy is a Kansas City, MO, journalist with more than 10 years of experience.

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Can You Take Ozempic on the Same Day You Get a COVID Vaccine? - Verywell Health

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Despite COVID-19 triggering autoimmune conditions in healthy individuals, it does not appear to increase the risk for clinical and MRI disease activity or motor and cognitive worsening in people with multiple sclerosis (MS), a new study shows.

The analysis included 136 people with MS who had a history of COVID-19 (median age 41 years; MS-COVID group), and 186 people with MS with no history of COVID-19 who were matched for age, sex, Expanded Disability Status Scale (EDSS), disease duration, and treatment type (MS-NCOVID group).

Patients underwent regular neurologic follow-up, brain MRI, neuropsychological evaluations, and assessments of fatigue using the Modified Fatigue Impact Scale (MFIS), depression and anxiety using the Hospital Anxiety and Depression Scale (HADS), sleep using the Pittsburgh Sleep Quality Index (PSQI), and psychological and posttraumatic effects related to COVID using the Impact of Event Scale-Revised (IES- R).

Researchers also measured immune response to SARS-CoV-2 in the two groups.

During the 18-24 months following COVID infection, there was no significant difference between groups in EDSS worsening, percentages of patients with relapses, need for change in disease-modifying therapy, new/enlarging brain T2-hyperintense lesions, and gadolinium-enhancing lesions.

At follow-up, 28 (22%) MS-COVID and 40 (23%) MS-NCOVID patients were cognitively impaired, with no significant between-group difference, which was also the case for global cognitive functions, verbal and visual memory, information processing speed, attention, and verbal fluency.

There were no significant differences in MFIS, HADS anxiety, HADS depression, PSQI, and IES-R scores.

There was also no significant difference in tests for cellular immune response to SARS-CoV-2.

"Based on these findings, it may be appropriate to suggest that people with MS can begin to return to their normal lives," the authors write. However, they stress that good hygiene should continue to be encouraged as the virus can still pose a risk and future variants may have a different spectrum of neurologic symptoms.

The study was carried out by Federico Montini, San Raffaele Hospital, Milan, Italy, and colleagues. It was published online October 19 in the Journal of Neurology, Neurosurgery & Psychiatry.

Most patients from both groups were vaccinated 18-24 months after the baseline evaluation, significantly reducing the likelihood of detecting a difference in T-cell response. As COVID-19 severity was generally mild, the study does not shed light on the presence of sequelae among people with MS with severe COVID-19 infection. The follow-up period was relatively short and the sample size relatively small.

The study received support from Fondazione Italiana Sclerosi Multipla. Montini has no relevant conflicts of interest. See the original article for disclosures of other authors.

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BIRMINGHAM, Ala (WBMA)

The Centers for Disease Control and Prevention (CDC) believes the country is in for another rough season of respiratory disease.

Some health experts claims COVID-19 will be the worst perpetrator followed by the flu and RSV.

The three viruses, influenza, respiratory syncytial virus and COVID-19, present many of the same symptoms and depending on the person, the symptoms vary. Doctors say the best way to determine what you have is to get tested.

At American Family Care, doctors call it a triple threat. AFC'S Chief Medical Officer Dr. Louanne Giangreco spoke on the risks.

Giangreco said for most, it's hard to know what you have based on symptoms alone.

She said that's why they do tests.

All throughout the year, AFC is testing swabs because symptoms can show up differently in each person.

"We had asymptotic individuals who were positive for COVID," she said, "people with just a little bit of runny nose too. and then people who had more severe symptoms and are incubated in ICU."

To protect yourself, Dr. Giangreco said people need to get vaccinated and take care of yourself.

"Making sure that you're eating well. You're getting good rest, that you're staying active and moving and that you're managing stress are all really important in staying healthy during this time of year," she said.

As many prepare to gather with family and friends for the holidays, doctors say try to do things outdoors where there's better ventilation.

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Can you tell the difference in symptoms of the triple threat: COVID, Flu, RSV? - WTVC

Opinion

From pensions to health to social care, this government has done precious little to prepare for an ageing population

Let the bodies pile high in their thousands, Boris Johnson supposedly said. Not once but often, the Covid inquiry has heard that he was for killing off elderly people, obsessed with older people accepting their fate. According to the invaluable diary of the chief scientific adviser, Sir Patrick Vallance, our prime minister was saying thats natures way of dealing with old people as he complained we are destroying the economy for people who will die anyway soon.

It wasnt just him. The chief whip, Mark Spencer, allegedly said: I think we should let the old people get it and protect the others, to which Johnson replied: A lot of my backbenchers agree with that, and I must say I agree with them. So this was not one irritable remark, but a theme aired many times around tables where people didnt get up and leave the room: many are still in government, presumably including Rishi Sunak, the eat-out-to-help-spread-Covid chancellor at the time.

Members of Covid-19 Bereaved Families for Justice say the evidence they are hearing is even worse than they feared. Age UKs charity director, Caroline Abrahams, watching the inquiry equally aghast, tells me: The pandemic inquiry is laying bare just how ageist many senior decision-makers are.

Politically, the plan for a slaughter of the ancients was insane, since older people are the ones who vote Tory overwhelmingly, voted Brexit and voted in Johnson. The Tory problem is that they are dying out too fast, not too slowly, while young people no longer turn Tory as they age, the way their parents did. In every sense this is the dying party.

But for the sake of argument, lets take a leaf out of Jonathan Swifts satirical modest proposal for butchering children starving in the Irish famine to serve to English landlords.

Old people are very expensive and growing as a proportion of the population, as births of new children to pay for them fall. The government has done nothing to prepare for this long-foreseen demographic change, and now complains of the soaring cost of pensions, NHS and social care.

The state pension costs it more than 100bn a year, a cost that has risen threefold since 2000. An 85-year-olds health costs 5.6 times more than a 30-year-olds: there are 1.7 million over-85s, and this number is rising. Across the UK, 10% of health spending goes to those over the age of 85, with 32% to those aged 65 to 84.

Ahead, needs will rise as the government has reneged on its promised social care reform, now denied to many very frail people. The Health Foundation says adult social care in England will cost an extra 8.3bn over the next decade, and thats just to maintain its current decayed state. It would cost an additional 18.4bn to cover its full cost and to improve access to care.

So if the Tories want a smaller state, eliminating everyone of pension age could pay for luxurious tax cuts. Indeed Covid must have saved a fair bit, as Sir John Edmunds, a member of the Scientific Advisory Group for Emergencies (Sage), told Andrew Marr on LBC this week: If wed have moved the lockdown forward by a week, we would have saved thousands of deaths. Another saver: the poorest who cost the state more died at a far greater rate than those who were well off.

Johnsons delinquent Covid policy still has prominent supporters. Jacob Rees-Mogg said on GB News: Boris Johnsons instincts on lockdown and Covid policy were broadly right. The inquiry heard that the cabinet secretary, Mark Sedwill, suggested a herd immunity policy of deliberately spreading Covid, like chickenpox parties for children: that seems to have happened in care homes.

The idea that most of those who died were already at deaths door, or suffering terminal pre-existing conditions, was wrong. The average number of years of life lost by each Covid victim was 10.2. Those aged over 75 lost an average 6.5 years.

That is an important calculation, because healthcare is rationed by counting in quality-adjusted life years (QALYs): how many years of good-quality life a treatment will deliver. Thats how the National Institute for Health and Care Excellence (Nice) decides which new drugs give real value for money. A great many QALYs were needlessly lost through bad political decisions on Covid.

Although older people are now the group least likely to be poor, there are still many pensioners living very low-quality lives, without care, their day centres closed. About 850,000 pensioner households fail to claim the pension credit they are entitled to, in order to top up poverty incomes: presumably that suits the government, since it knows where every pensioner lives, and so could rectify this if it chose.

But inequality among older people is extreme. They are also the richest cohort. In 2018/19 79% of them in England were homeowners. One in five over-65s live in households with assets worth more than 1m. Meanwhile, the half of the population who are under 40 own only 3.9% of all wealth, says the International Longevity Centre UK. The Treasury did well out of Covid deaths, raising a record-breaking inheritance tax take.

The politics of social care and who should pay for it prove toxic: they did for Theresa Mays 2017 election campaign, and added to Labours troubles in 2010 when its social care plan was dubbed a death tax. The money is right there for the taking, in wealthy pensioners assets, for any government brave enough to redistribute some of that wealth. I doubt many older Tory voters will forget the terminal plans being hatched for them inside No 10, not just by Johnson but also by all those around him, who discussed them willingly. But it was far from the only Tory policy driving a wedge between generations.

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A former Air Force officer who challenged the Pentagon's COVID-19 vaccine mandate all the way to the U.S. Supreme Court has been accused of threatening to shoot the captain of a Delta Air Lines flight while serving as the co-pilot.

Jonathan J. Dunn, who was authorized to carry a firearm in the cockpit, was indicted last month by a grand jury in the U.S. District Court of Utah for "interfering with the crew of a commercial airline" and for "using a dangerous weapon to assault and intimidate" the captain, according to a press release from the U.S. Department of Transportation's inspector general.

Dunn, who now serves as a lieutenant colonel in the Air Force Reserve, argued to the Supreme Court in 2022 that the COVID-19 vaccine took on a "sacramental quality" as the military sought to roll out the protection to the force, according to The Hill, and that it violated his morals.

Read Next: Senate Finally Confirms 3 Top Military Officers After Fellow Republicans Erupt in Anger over Tuberville Blockade

"That makes COVID-19 vaccination a religious ritual required as a condition of participating fully in civil society -- like ancient Roman laws requiring sacrifices to Caesar, or Nebuchadnezzar's edict requiring worship of the golden statue," his lawyers told the justices, The Hill reported. "After much prayer, [Dunn] concluded that he cannot participate in such a religious ritual -- and thus cannot take the vaccine -- because, as a Christian, he must render worship to God only."

The Supreme Court ultimately denied his defense and protections from punishment.

A source familiar with his service confirmed that he was the same person who challenged the vaccine mandate while in the Air Force and who was indicted.

Meanwhile, a military command in Europe confirmed to Military.com that Dunn is an Air Force Reserve officer. He is "currently on orders as a reserve augmentee to the 603rd Air Operations Center (AOC) at Ramstein Air Base, Germany," a spokesman for U.S. Air Forces in Europe said in a statement.

The statement added that Dunn was "in qualification training to serve in the AOC at the time of the indictment and his absence will not impact the AOC's daily operations." Furthermore, the service said Dunn's access to sensitive information and the center's facilities was suspended, pending the outcome of judicial proceedings.

The Oct. 18 indictment, obtained by Military.com, alleges that Dunn did "assault and intimidate a crew member of an aircraft thereby interfering with the performance of the duties of the crew member."

Dunn had gotten into a disagreement with the captain about a potential flight diversion "due to a passenger medical event," according to the Department of Transportation's inspector general's office release.

"Dunn told the captain they would be shot multiple times if the captain diverted the flight," according to the inspector general.

Dunn was allowed to carry a firearm as part of the Transportation Security Administration's Federal Flight Deck Officer program -- a post-9/11 program from 2002 that allowed trained and licensed pilots to carry weapons to protect commercial airlines.

Neither the Department of Transportation's news release nor the federal indictment name the airline he flew for. Dunn faces one count of interfering with a flight crew, and his arraignment is set for Nov. 16. Contact information for Dunn's attorney was not listed in federal documents.

Delta Air Lines issued a statement this week saying that Dunn was no longer employed by the commercial carrier, according to The Associated Press. The news service also reported that his authority to carry a gun on board flights was revoked.

Delta did not immediately return a request for comment from Military.com.

Dunn was prior-active duty from 2003 to 2014 and reached the rank of major. He was commissioned as an officer through a four-year ROTC program, according to his service biography provided to Military.com.

-- Thomas Novelly can be reached at thomas.novelly@military.com. Follow him on Twitter @TomNovelly.

Related: Report: Air Force Leaders Want More High-Tech Flight Simulators to Train New Pilots for War

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Air Force Officer Accused of Threatening to Shoot Airline Captain Fought Military's COVID Vaccine Mandate to ... - Military.com

PORTAGE, MI -- About 200 people have been laid off at Pfizers facility in Portage, the company confirmed.

The laid-off employees were notified on Thursday, Nov. 2, the company told MLive/Kalamazoo Gazette, citing a lower demand than what the company expected for its COVID-19 products.

Pfizer regularly evaluates its manufacturing network to ensure capacity is effectively utilized based on product demands, Pfizer media contact Steven Danehy told MLive/Kalamazoo Gazette.

Considering the lower-than-expected utilization for our COVID-19 products Comirnaty and Paxlovid Pfizer launched an enterprise-wide cost realignment program to support future revenue expectations, Danehy said.

Comirnaty is Pfizers vaccine to prevent COVID-19 in people 12 and older.

Paxlovid is an oral COVID-19 drug that can be used by people 12 and older with mild to moderate illness who are considered high risk of severe illness.

The reduced demand for the two products resulted in the layoffs, the company said.

The company announced this week it recorded third-quarter 2023 revenues of $13.2 billion. Thats a 41% operational decrease, thanks to major declines in Comirnaty and Paxlovid sales.

The financial report mentions an expected decline in Paxlovid and Comirnaty revenues. Their 2023 projections are as follows:

Excluding COVID-19 products, Pfizer is expecting 6% to 8% operational revenue growth for the year, the report says.

Pfizer does not take these changes lightly, Danehy said in a company statement about the layoffs. All decisions that impact people, processes and initiatives will be made with transparency, compassion and respect. We also remain committed to our patients and will continue to produce the COVID-19 vaccine to meet demand.

Related: Gov. Whitmer urges President Biden to coordinate federal COVID-19 vaccination distribution with state

In February 2021, President Joe Biden toured Pfizers vaccine manufacturing facility in Portage at a time when the country was struggling to meet the high demand for COVID-19 vaccines.

In June 2022, Pfizer announced plans to invest another $120 million into the Portage manufacturing facility to expand production of Paxlovid. That expansion would create 250 new jobs, Pfizer said at the time.

In 2022, MLive reported the facility employed 3,000 people. The company did not immediately respond with an updated number.

MLive/Kalamazoo Gazette has reached out to the city of Portage seeking a comment.

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Pfizer lays off hundreds at Michigan site, cites low demand for COVID products - MLive.com

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Hancock thought he should decide who lived or died if NHS overwhelmed, Covid inquiry told video Covid inquiry

Fortunately this horrible dilemma never crystallised, former NHS England head Simon Stevens tells inquiry

Former health secretary Matt Hancock told officials that he rather than the medical profession should ultimately decide who should live or die if the NHS was overwhelmed during the pandemic, the Covid inquiry heard.

Fortunately this horrible dilemma never crystalised, the former head of the NHS, Lord Simon Stevens, said in his evidence to the inquiry on Thursday.

Stevens, who led NHS England until 2021, said he stressed at the time that no individual secretary of state should be able to decide how care was provided, other than in the most exceptional circumstances.

Hancocks position, which materialised during a planning exercise at the Cabinet Office in February 2020, was a different one from his predecessor, Jeremy Hunt, who had wanted such decisions to be reserved for clinical staff.

Stevens told the inquiry that this ethical question was never resolved and cropped up again during the pandemic when rationing of NHS services was discussed.

The former NHS chief was largely uncritical of Hancock, unlike other figures who appeared before Heather Halletts inquiry this week, including former No 10 senior adviser Dominic Cummings and ex-civil servant Helen MacNamara.

Stevens witness statement referred to the Operation Nimbus planning exercise, which he said was helpful in terms of outlining the pressures government departments might have faced.

It did however result in to my mind at least an unresolved but fundamental ethical debate about a scenario in which a rising number of Covid-19 patients overwhelmed the ability of hospitals to look after them and other non-Covid-19 patients, he said.

The secretary of state for health and social care took the position that in this situation he rather than, say, the medical profession or the public should ultimately decide who should live and who should die.

On the final day of evidence this week, the inquiry saw new details of Johnsons witness statement, in which he expressed his frustrations with the NHS, blaming the health service for the first lockdown.

The former prime minister blamed bedblocking in the NHS for locking down the country as Covid took hold.

He said: It was very frustrating to think that we were being forced to extreme measures to lock down the country and protect the NHS because the NHS and social services had failed to grip the decades-old problem of delayed discharges, commonly known as bedblocking.

Before the pandemic began I was doing regular tours of hospitals and finding that about 30% of patients did not strictly need to be in acute sector beds.

Stevens rejected Johnsons claims, noting the sheer number of coronavirus patients needing a hospital bed was far higher than the number of beds that could have been freed up.

We, and indeed he, were being told that if action was not taken on reducing the spread of coronavirus, there wouldnt be 30,000 hospital inpatients, there would be maybe 200,000 or 800,000 hospital inpatients, Stevens told the inquiry.

Even if all of those 30,000 beds were freed up for every one coronavirus patient who was then admitted to that bed, there would be another five patients who needed that care but werent able to get it, he added.

While Stevens declined to criticise Hancock when giving evidence, the inquiry heard that Cummings had repeatedly pushed Johnson to sack his health secretary because he had lied his way through this and killed people and dozens and dozens of people have seen it.

In one message, Cummings complained about Stevens and Hancock bullshitting again.

Stevens was shown messages, but said: There were occasional moments of tension and flashpoints, which are probably inevitable during the course of a 15-month pandemic, but I was brought up always to look to the best in people.

Appearing later, the top civil servant in the Department of Health, Sir Christopher Wormald, said that Hancock would probably be surprised by how widespread the perception was regarding his frequency of alleged untruths.

Wormald was also questioned at the inquiry over why he and the UKs most powerful official, Mark Sedwill, were discussing how the virus was like chickenpox as late as mid-March 2020.

Wormald, who remains the permanent secretary in the department, believed Johnson did not understand difference between minimising mortality and minimising overall spread.

Lord Sedwill messaged Wormald weeks before the first lockdown, saying: Indeed presumably like chickenpox we want people to get it and develop herd immunity before the next wave. We just want them not to get it all at once and preferably when its warn (sic) and dry etc.

This message exchange came on the same day that Cummings had complained in a WhatsApp message that Sedwill had been babbling about chickenpox, adding god fucking help us.

Giving evidence to the inquiry this week, Cummings claimed that Sedwill had told Johnson: PM, you should go on TV and should explain that this is like the old days with chickenpox and people are going to have chickenpox parties. And the sooner a lot of people get this and get it over with the better sort of thing.

Stevens also told the inquiry that senior ministers sometimes avoided Cobra meetings chaired by Hancock in the early days of the pandemic.

In his witness statement, he said the meetings usefully brought together a cross-section of departments, agencies and the devolved administrations.

However, these meetings were arguably not optimally effective. They were very large, and when Cobra meetings were chaired by the health and social care secretary other secretaries of state sometimes avoided attending and delegated to their junior ministers instead, he added.

This phase of the Covid inquiry assessed government decision making, with more witnesses scheduled to appear next week.

These include Sedwill, former No 10 special adviser Dr Ben Warner and former home secretary Priti Patel.

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Politics

Former health secretary was seen as an overconfident liar during the pandemic, according to former colleagues

Ever since he left government, Matt Hancocks closest allies have claimed that Boris Johnson and his top team at No 10 would try to set him up as the fall guy for the governments mistakes during the pandemic.

Over the last few days at the Covid inquiry in central London, it looked like these fears had been realised. Witnesses opening up to the inquiry have only lightly rejected repeated claims that Hancock regularly said things during the pandemic that were not true.

Here are the top things we have learned about the former health secretary from the inquiry so far.

The former chief executive of NHS England, Lord Simon Stevens, was discussing the ethical debate over whether the medical profession or ministers should have the final say if worst case scenarios occurred.

Matt Hancock took the position that he rather than, say, the medical profession or the public, should ultimately decide who should live and who should die, Lord Stevens said.

Fortunately this horrible dilemma never crystallised, he added, insisting he discouraged the idea that any secretary of state should be able to decide how care was provided.

Hancocks position, which materialised during a planning exercise at the Cabinet Office in February 2020, was different from that of his predecessor, Jeremy Hunt, who had wanted such decisions to be reserved for clinical staff.

Helen MacNamara, who served as deputy cabinet secretary, told the inquiry Hancock displayed nuclear levels of overconfidence and a pattern of reassuring colleagues the pandemic was being dealt with in ways that were not true.

She recalled a jarring episode when she offered Hancock help, concerned about the toll the pandemic had taken on his mental health.

Hancock took a cricket batsmans stance to demonstrate how much he was enjoying the responsibility during the pandemic.

They bowl them at me, I knock them away, he said confidently in one of the dark moments of the early pandemic, according to her testimony to the inquiry.

McNamara also criticised Hancock, saying that he would suggest in meetings things were under control or would be sorted but then days or weeks later they would discover that was not in fact the case.

Lord Stevens told the inquiry senior ministers sometimes avoided Cobra meetings in the early days of the pandemic if they were chaired by Hancock.

Lord Stevens said Cobra meetings usefully brought together a cross-section of departments, agencies and the devolved administrations.

But he said they were not optimally effective as they were quite large, so ministers would leave them to their junior ministers.

Dominic Cummings and other senior advisors in No 10 had repeatedly urged Boris Johnson to sack his health secretary.

In a message sent to the then prime minister in May 2020, Cummings said: You need to think through timing of binning Hancock. Theres no way the guy can stay. Hes lied his way through this and killed people and dozens and dozens of people have seen it.

Another message sent by Cummings to Johnson in August 2020, read: I also must stress I think leaving Hancock in post is a big mistake he is a proven liar who nobody believes or shd (sic) believe on anything, and we face going into autumn crisis with the cunt in charge of NHS still.

Sir Christopher Wormald, a top civil servant in the department of health, told the inquiry he was not aware of the extent of views about Hancocks truth-telling.

Boris Johnson may have wanted to keep Matt Hancock in post as health secretary as a sacrifice for the Covid-19 inquiry, Dominic Cummings has claimed.

Hancock was a frequent target of criticism by Cummings during the pandemic, with Cummings claiming that the then-Cabinet minister killed people during the crisis.

Cummings said that Johnsons political secretary, Ben Gascoigne, had told him that the PM wanted to keep Hancock as the sacrifice for the inquiry.

If wed replaced Hancock before August then things like rapid testing would have been smoother, planning would have been more honest and effective, and thousands would have survived.

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What we learned about Matt Hancock from the Covid inquiry - The Guardian

Opinion

The state was completely unprepared for the pandemic and the next crisis wont wait for us to fix it

Yes, Dominic Cummings was in almost every way the ultimate colleague from hell. Yes, Boris Johnson was in a different way the sum of all nightmares as a national leader. Yes, the macho culture of the Downing Street in which they strutted their stuff was a disgrace. And, yes, many people died of Covid-19 in every part of the United Kingdom who should not have done so, partly because of their responses to the Covid pandemic.

In its hour of need, our country was lamentably governed by Johnson and Cummings. Thats indisputable. But, shameful as it is, this is not really the most important lesson emerging from Heather Halletts official inquiry into the pandemic. Focusing too much on the individuals who were faced with making pandemic policy decisions, understandable though that is and reprehensible though many of them proved, risks missing the larger picture that will matter more for the future.

The Covid-19 inquiry is revealing a broader problem than individual pathologies, inadequacies and incompetences, important though these are. It is showing an institutional failure in a system of government, and above all in the UK state, that did not work well enough when faced with a life and death national situation in early 2020. Poor leaders and advisers made all this worse, but the system failed too. Johnson and Cummings have now gone. The system has not. It needs to change.

The former deputy cabinet secretary Helen MacNamara was exceptionally clear about some of the structural things that went wrong in her evidence yesterday. The contingency plans for governing in an all-consuming crisis of the kind that arrived with Covid-19 simply did not exist, she said. Nor did those for responding to the public health needs caused by a global pandemic. MacNamara spoke in more measured language than Cummings had done the previous day, when discussing the same period. But her message was just as devastating about the lack of preparedness.

Where there ought to have been plans and tools in early 2020, properly tested and regularly reviewed, with a clear strategy and a comprehensive set of jobs, meetings, and messaging to be put into effect, there was, in effect, nothing. Faced with Covid, government then had to make up a lot of its own priorities and solutions on the hoof. It is a tribute to some of those involved, notably the governments chief scientific adviser Patrick Vallance, chief medical officer Chris Whitty, and Kate Bingham of the vaccine taskforce, not to mention the thousands in the frontline, that we survived as well as we did.

For all his faults and all his defects, of which he showed off a dazzling variety when he answered questions from the inquiry on Tuesday, Cummings is actually right about a lot of this. Many will not want to acknowledge this, because his behaviour has been so egregious and has done such harm. But read his evidence statement. Look at some of his long blogs. Listen to what he said to the inquiry on Tuesday. Cut through the self-justificatory language and the inability to work with others, and you will find a significant critique, flawed and incomplete though it is in some ways, that no British government can afford to dismiss.

Of course, Cummings is not a trustworthy guide through the failures of the UK state. He has too many character flaws, too many scores to settle and too many intellectual prejudices to indulge for that. He is beguiled by the conceit that everyone he disapproves of suffers from groupthink and a fear of new ideas. His WhatsApp abuse of MacNamara marks a new personal low, even for him.

But Cummings did, and does, grasp one big thing all the same. Unlike Johnson, who with characteristically slapdash optimism thought the pandemic might all blow away in a few weeks, Cummings saw that a pandemic is a moment when only the state can provide the necessary protection or remedy for its inhabitants. Yet in early 2020 the UK state was in many ways too badly damaged to play the role that was expected of it.

The absence of meaningful contingency planning exposed by MacNamara was a disgrace. But it was only one example. As the Covid months passed, others would join it and become more acute. Government epidemiological data was inconsistent and disorganised. There were not enough hospital beds or dedicated wards. Supplies of personal protective equipment for health workers was soon in a shambles. Testing and tracing was a non-starter. Procurement policies verged on the corrupt. The care sector was not properly integrated. More generally, the NHS was bureaucratic and many staff alienated, even before the stresses of the pandemic.

Some of this reflected the years of public sector austerity since 2010. Some the difficulty of keeping up with the expansion of the elderly population. Some reflected upward spurts in inequalities of race and class in the wake of the 2008 financial crisis. Although the NHS remained dear to British hearts, substantial parts of the governing party believed in a private good, public bad approach to welfare. The idea that the state should be the universal provider had morphed over the decades in favour of a range of mixed public-private provisions.

When Covid struck there was thus no consistent approach to ensuring state needs in a modern way. Covid quickly exposed the cost to the state of this uneven approach, leaving Johnson and his ministers with few levers that they could confidently pull to secure national objectives, even if they had agreed which they did not about what those objectives should be. The devolution settlement made things even more complicated. Cummingss support for so-called red teams who would stress-test contingency arrangements would have been a fine idea if the contingency arrangements had existed. But they did not.

So the big question arising out of Covid that will continue to face all future governments, not just a badly run one like Johnsons, is whether they can be any better prepared. There is little evidence of that so far. Yet it would be foolish to leave the whole problem to Hallett to solve. Another pandemic, a climate catastrophe or another border control crisis will not wait for the Whitehall machine to process her report.

The problem is not whether Britains civil servants or politicians are up to the task of dealing with the challenges of the 21st century. Cummings is wrong to dismiss both groups so arrogantly. But he is right that one of the great lessons of the Covid pandemic is that the British state was not up to the job. If Keir Starmers Labour wants to be better at dealing with its own inevitable emergencies than Johnson and Cummings were three years ago, it should have its own red team already working on the case.

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The Covid inquiry has exposed more than just a few bad apples the whole system is rotten - The Guardian