Paper: Offline: COVID-19 and the NHS—“a national scandal”
Horton, R. (2020). Offline: COVID-19 and the NHS—“a national scandal”. Lancet (London, England), 395(10229), 1022.
Important quotation:
1. Health workers' voice in health setting during Pandemic:
Still no access to personal protective equipment [PPE] or testing.”
“Rigid command structures make decision making impossible.”
“There's been no guidelines, it's chaos.”
“I don't feel safe. I don't feel protected.”
“We are literally making it up as we go along.”
“It feels as if we are actively harming patients.”
“We need protection and prevention.”
“Total carnage.”
“NHS Trusts continue to fail miserably.”
“Humanitarian crisis.”
“Forget lockdown—we are going into meltdown.”
“When I was country director in many conflict zones, we had better preparedness.”
“The hospitals in London are overwhelmed.”
“The public and media are not aware that today we no longer live in a city with a properly functioning western health-care system.”
“How will we protect our patients and staff…I am speechless. It is utterly unconscionable. How can we do this? It is criminal…NHS England was not prepared…We feel completely helpless.”
England's Deputy Chief Medical Officer, Jenny Harries, said on March 20, 2020: “The country has a perfectly adequate supply of PPE.” She claimed that supply pressures had now been “completely resolved”. I am sure Dr Harries believed what she said.
But she was wrong and she should apologise to the thousands of health workers who still have no access to WHO-standard PPE.
Offline: COVID-19 and the NHS—“a national scandal”
Important quotation:
1. Health workers' voice in health setting during Pandemic:
Still no access to personal protective equipment [PPE] or testing.”
“Rigid command structures make decision making impossible.”
“There's been no guidelines, it's chaos.”
“I don't feel safe. I don't feel protected.”
“We are literally making it up as we go along.”
“It feels as if we are actively harming patients.”
“We need protection and prevention.”
“Total carnage.”
“NHS Trusts continue to fail miserably.”
“Humanitarian crisis.”
“Forget lockdown—we are going into meltdown.”
“When I was country director in many conflict zones, we had better preparedness.”
“The hospitals in London are overwhelmed.”
“The public and media are not aware that today we no longer live in a city with a properly functioning western health-care system.”
“How will we protect our patients and staff…I am speechless. It is utterly unconscionable. How can we do this? It is criminal…NHS England was not prepared…We feel completely helpless.”
2. Voices of Public Health Policy and the critics
England's Deputy Chief Medical Officer, Jenny Harries, said on March 20, 2020: “The country has a perfectly adequate supply of PPE.” She claimed that supply pressures had now been “completely resolved”. I am sure Dr Harries believed what she said.
But she was wrong and she should apologise to the thousands of health workers who still have no access to WHO-standard PPE.
I receive examples daily of doctors having to assess patients with respiratory symptoms but who do so without the necessary PPE to complete their jobs safely.
Health workers are challenged if they ask for face masks.
Even where there is PPE, there may be no training. WHO standards are not being met. Proper testing of masks is being omitted.
Stickers with new expiry dates are being put on PPE that expired in 2016.
Doctors have been forced to go to hardware stores to buy their own face masks. Patients with suspected COVID-19 are mixing with non-COVID-19 patients.
The situation is so dire that staff are frequently breaking down in tears.
As one physician wrote, “The utter failure of sound clinical leadership will lead to an absolute explosion of nosocomial COVID-19 infection.”
Front-line staff are already contracting and dying from the disease.
3. The NHS has been wholly unprepared for this pandemic
The NHS has been wholly unprepared for this pandemic.
It's impossible to understand why. Based on their modelling of the Wuhan outbreak of COVID-19, Joseph Wu and his colleagues wrote in The Lancet on Jan 31, 2020: “On the present trajectory, 2019-nCoV could be about to become a global epidemic…for health protection within China and internationally…preparedness plans should be readied for deployment at short notice, including securing supply chains of pharmaceuticals, personal protective equipment, hospital supplies, and the necessary human resources to deal with the consequences of a global outbreak of this magnitude.”
This warning wasn't made lightly. It should have been read by the Chief Medical Officer, the Chief Executive Officer of the NHS in England, and the Chief Scientific Adviser. They had a duty to immediately put the NHS and British public on high alert. February should have been used to expand coronavirus testing capacity, ensure the distribution of WHO-approved PPE, and establish training programmes and guidelines to protect NHS staff. They didn't take any of those actions. The result has been chaos and panic across the NHS. Patients will die unnecessarily. NHS staff will die unnecessarily. It is, indeed, as one health worker wrote last week, “a national scandal”. The gravity of that scandal has yet to be understood.
REFLECTION BY WANTI ONETE:
Ini kategori yg tidak bisa masuk di Indonesia karena berbeda system nya dg England.
Di banyak negara Eropa, kesehatan dan pendidikan sepenuhnya dibiayai oleh pemerintah sedangkan di Indonesia system ini tidak ada, sehingga pemerintah hanya separuh saja hatinya pada rakyat mereka. Mulai dari level paling atas sampai bawah hanya tidak hanya bersimpati pada rakyat untuk kepentingan pemilu saja. Kesinambungan dan kekompakan di jajaran pemerintah juga jadi ukuran di negara2 tsb.
Jika sepenuhnya hati pada rakyat, saat menjabat, semua system dibuat untuk meringankan beban mereka, bukan menambah beban. Jadi saat Pemerintah tersebut mengalami kegagalan melindungi rakyat, mereka merasa amat bersalah dan menggolongkan kasus kegagalan mereka sebagai "kriminal". Karena mereka merasa bersalah. Dimana merekalah harusnya pengayom, pelindung dan solusi bagi rakyat, namun gagal.
Itu sebabnya kegagalan itu yg menyebabkan Mentri kesehatan NZ mengundurkan diri. Keberhasilan dirjen kesehatan saat menuntaskan Covid19 dan melindungi petugas paramedic dirusak oleh kepentingan pribadinya, yaitu melanggar lockdown dan membully dirjen kesehatan pak Bloomfield. Rakyat ngga banyak ngomong tapi pada kirim bunga dan kata2 indah ke pak Dirjen. Jadilah malu dia.
Cuma yg kayak gini mungkin ngga membuat malu kalau di Indonesia. Jadi ya itu tadi...levelnya beda dari mulai system, budaya dan hati. Ngga bisa dibandingkan.
Perancis misalnya...bisa jadi pengecualian, karena pemerintahnya berbuat begitu banyak, tapi ya dasarnya rakyat sana demen banget protes.
Kalau Amerika, memang welfare & health system nya ngga sebagus Eropa. Yang mati sebanyak itu, presiden nya tenang aja. Tapi bedanya, gubernur & rakyat yg kesel sama system ngga ditangkeo & ngga dianggap berghibah krn itu memang dibuka sendiri aibnya sama pemerintahnya.
Jadi ngga bisa dibandingkan juga. Salut dg negara yg merasa spt artikel tsb di atas. Rakyatnya terlindungi walaupun pemerintahnya masih juga merasa gagal.
kalau Korsel, Singapore & Cina mungkin bisa selevel karena mereka negara terbuka tapi tidak demokrasi. Mustinya Indonesia masih di level mereka.
India justru mirip Indonesia, demokrasi setengah hati dan terbentur budaya serta kebiasaan. Sebetulnya kalau dimasukkan dalam tata negara, status Republik itu bukan demokrasi.
Negara Republik itu, status pemilihan presiden nya dilakukan oleh wakil rakyat. Seperti jaman Gus Dur dan Presiden sebelumnya. Bukan pemilihan langsung. Di Indonesia pemilihan nya sangat demokratis karena dipilih langsung tapi tatanan peraturan dan UU kenegaraan dan system nya belum sampai kesana. Jadi memang setengah demokrasi ya. Tapi bukan lagi Republik. 
ruwet
ruwet
Indonesia ..., dalam beberapa research yg aku baca hambatan terbesar bangsa Indonesia di bidang adalah budaya “tidak mau di kritik”. Sehingga mereka tidak bisa membedakan antara kritik system dan kritik pribadi.
Seringkali masukan dan ide juga dianggap kritik. Jadi secara literasi saja, belum sampai ke pembahasan, itu sudah jadi hambatan tersendiri untuk memperbaiki semua system.
Setelah literasi yang tidak sampai, hambatan lain adalah “tidak me literasi diri” alias tidak membaca sepenuhnya arti dari sebuah ucapan, kata ataupun tulisan. Sehingga jawabannya jadi sering salah.
Bahkan UU pun seringkali tidak sinkron satu dan lainnya karena hambatan literasi ini. Tidak mau membaca dan tidak mengerti isi yg dituliskan. Jadi selama bbrp tahun menjadi anggota Diaspora capeknya adalah membahas UU yg ngga sinkron dan tidak bisa dilaksanakan karena tidak relevan satu dan lainnya.
Seru.., iya. Tapi kebayang bahwa UU itu menyangkut hajat orang banyak.., jadi sedih. Kasihan liat teman2 yg membawa UU tersebut tapi yg bikin dan yg baca juga ngga ngerti arti tulisan UU tersebut. Amat sulit memperbaikinya. Karena aparat yg diajak bicara memang ngga banyak yang mau sepenuh hati me literasi diri.
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