Managing a crisis…

Managing a crisis... NHS_Training_in_Primary_Care_General_Practice

When Switzerland was looking like everyone’s idea of a picture postcard, some big brain boxes met there, to discuss a Corona-Virus outbreak.

There are lots of  CV’s, the common cold is a derivative, as is the flu.  The concern was a novel virus.  Something no one has seen.  They urged governments to get ready. 

The rest, as they say, is ‘whatever’…

The world remained stubbornly unprepared.  The Far East, who dealt with a SARs outbreak, were readier than most.  As for the rest, the numbers speak for themselves.

Last Friday, the deaths looked like this;

Spain 2, Italy 87, Germany 24, France 52, Turkey 28, Belgium 42, Sweden 84, Portugal 14, Ireland 6, Poland 13, Romania 13, Hungary 8, and the Netherlands 28.

It’s quite a range and might be accounted for by the fact that not every outbreak occurred at the same time.  

Some nation’s counting systems are, shall we say… less sophisticated.  

Not all healthcare systems are the same. 

There is a mix of the state, federal, public-private partnerships, insurance.

Let’s not forget; density of populations, differences in reporting deaths and the issue of death certificates.  

There’s no international spreadsheet for this.

Last Friday, the number of deaths here, were 324.  I know the question that’s on your lips and the answers is… dunno…

We are doing something really wrong, the others are doing something really right?  Or, there is no basis of comparison.

We won’t know because HMG’s press pantomime no longer uses the international comparisons slide.  Like they are the only one with the internet and know how to work Google.

Are we not as good, as other countries, at the clinical management of Covid patients?  Dunno?  I shouldn’t think so.  Doc’s aren’t stupid, they have WhatsApp groups, telephone and talk to each other.  They collaborate and learn from each other, globally.

Are our hosptials ill-equipped?  We seem to have a surfeit of ventilators.  Dialysis machines were in short supply but I didn’t hear it reached critical.  Our hospitals over-run?  Apparently not.  The Nightingale Hospitals are looking like a medial-equipment showroom.

However you want to explain it, there is a big difference between our 324 and the countries, who collectively had an average of about 30 deaths, on the same day.

Science can only guess at where we are.  Clinicians can tell us who and how many souls they’ve released, gently into the after life.  Beyond that, there isn’t much certainty.  We have to rely on experience, common-sense and stuff we know for sure.

For sure, we know we came late to the Covid-party.  BoJo was clowning around in hosptials, shaking hands and making a fist of washing his hands on the six-o’clock news.  He announced we would ‘send the virus packing, in twelve weeks…’ like it was an unwelcome chugger in the high street.

It looks inept, riddled with contradictions, science undermined and used to camouflage the misdeeds of BoJo’s mate…. when all he had to do was to say, he tried to do the right thing, messed up and he is sorry.

Now our security hangs by the thread of a policy that is nowhere near stitched in.  Right now, track and tracing is about as scientific as an easter-egg hunt, at Christmas.  It needs more time.  It absolutely must work.

Three eminent scientists cutting loose from SAGE, all saying, we aren’t ready to unlock, is not a coincidence.  It’s a concerted act by scientists who’s colleagues, in the public eye, can only talk in code, like Patrick Vallance with his, last Thursday, lecture on caution.

Leaders must be prepared to discuss what they don’t know.  By pretending to know they risk all our futures.

Crisis management is approached in five steps;  

Prevention… anticipation… clear objectives… a dedicated team… communication…

... we’re too late for prevention, we’ve missed the bus, I can’t anticipate the end of this journey, the science-team are at odds with the conductor and communication and messaging is muddled and confusing.

Prof VanTam at the Saturday-5pm, said there were about 8,000 new Covid infections a day.  He didn’t know where they were coming from.  

Looks like he needs some infection detectives.

If that’s his best take, I know where I’m going to … the safest place, behind my front-door.

What should have been a doable exercise in crisis management, is turning into managing a crisis.

News and Comment from Roy Lilley
Contact Roy – please use this e-address roy.lilley@nhsmanagers.net
Reproduced at TrainingPrimaryCare.com by kind permission of Roy Lilley.