A terrible, terrible failure’: Richard Horton on the COVID-19 response

From The Medical Republic, 28 September 2020:

Richard Horton is angry.

Early in the COVID-19 pandemic in the United Kingdom, the editor-in-chief of international medical journal The Lancet began receiving messages from frontline healthcare workers. Increasingly terrified and desperate staff with inadequate or no PPE were being sent in to deal with what was clearly a deadly virus.

“I would wake up in the morning, and then I would have 20 messages from people who were saying they were like lambs going into slaughter,” Horton says.

The Lancet had just published five papers – all in late January – which set out very clearly the nature and scale of the threat from the 2019 novel coronavirus, or 2019-nCoV.

One of these papers could not have been more explicit in its warning. Based on data from just under 200 confirmed cases of the illness in Wuhan, China, researchers estimated the virus was spreading on average to 2.68 individuals from each infected person, and the epidemic doubling time was just over six days.

The authors’ assessment was frightening: that human-to-human spread was already well under way across China, in cities that were global transport hubs connected to metropolises around the world. “Preparedness plans and mitigation interventions should be readied for quick deployment globally,” the authors wrote.

A second paper reported that of 41 patients admitted to hospital in Wuhan with confirmed infection, one-third required intensive care, one in ten ended up on ventilators, and six died.

“The evidence was there in January about the severity of the disease,” Horton says. As hospitals began to be overwhelmed, as bodies began piling up, as healthcare workers started screaming for help, he kept coming back to those papers.

“What struck me in March and April was just the sheer gap between what we knew in January – in January, for heaven’s sake – and the fact that nobody did anything through February and early March.

“I was in a fury about it.” Read more.

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