This article discusses illness, hospitals and bereavement. Readers may find some details upsetting.
On Thursday evenings during the first Covid-19 lockdown in 2020, many people across the UK came out on their doorsteps to clap for NHS workers.
It was perhaps one of the few occasions we saw our neighbours during those strange, isolated weeks, and at the time seemed a positive way of uniting streets and local neighbourhoods. As well as banging pots and pans, on my road children and adults started impromptu jam sessions with other instruments – a rare few moments of happiness, which overrode my natural cynicism that this was a token gesture.
Apart from healthcare workers themselves – some of whom called for personal protective equipment (PPE) not clapping – or Covid patients in hospital, few of us could imagine the horrific impact of the pandemic on the NHS. This is the focus of the next stage of the Covid Inquiry, led by Baroness Hallett.
“Fatal strategic flaws”: the first Covid inquiry report
I’ve been following the inquiry since its earlier stages in 2023. The first report, which came out in July 2024, said that “fatal strategic flaws” in pandemic planning had led to thousands of avoidable deaths.
The inquiry heard from former health ministers and advisors, and showed that preparations had mistakenly focused on a possible flu epidemic and ignored evidence from Asia and Europe. Former prime ministers Johnson and Sunak were both struck with (convenient) lapses of memory when trying to account for their actions and their apologies seemed half-hearted.
What NHS staff experienced was ‘shocking’ and ‘indescribable’
Unlike the hearings last year, which made headline news at times, the new round of public hearings has largely been taking place unreported.
Healthcare experts, nursing officers, medical advisors and Covid support charities such as Covid-19 Bereaved Families for Justice have all been giving evidence to the inquiry since early September. But the Thirlwall (Lucy Letby) and Post Office Horizon inquiries have been getting more public attention.
That is, until Prof Kevin Fong’s appearance at the end of the third week. A consultant anaesthetist who helped after the 7/7 bombings, Fong broke down in tears several times during his shocking testimony. He described the impact of the pandemic on NHS staff in hospitals as “like responding to a terrorist attack every day”.
Reporting on visits to over 40 intensive care units during 2020 and 2021, Fong said that nursing staff were “traumatised” and “overwhelmed”, with patients “raining from the sky”. Overcrowded hospitals were close to collapse: “the scale of death was truly, truly astounding.”
One especially upsetting detail that Fong described was nurses having to dispose of bodies in clear plastic bags because they had run out of body bags. This made nursing staff feel that they were virtually throwing bodies away:
“These people are used to seeing death, but not on that scale, and not like that, and whatever the figures show you, the experience for them was indescribable.”
A healthcare system “creaking at the seams”
Following Fong’s harrowing evidence, England’s chief medical officer, Prof Sir Chris Whitty, told the inquiry that NHS hospitals started the pandemic with a very low number of intensive care beds compared to other high-income countries. This was, he said, a “political choice”, but meant hospitals had “less in reserve when a major emergency happens”.
Because of the lack of suitable intensive care provision, Whitty argued that the UK had “no alternative” but imposing lockdown. Without this, the situation for medical staff would have been “substantially worse”.
Lead counsel Jacqueline Carey QC also emphasised the lack of nursing staff at the start of the pandemic, later compounded by the numbers contracting Covid themselves or being burnt out by their distressing experiences. It was a healthcare system “creaking at the seams”.
Higher mortality rates from other conditions
Both Carey and Whitty discussed the “indirect harms” that Covid brought about, because of the NHS being unable to treat patients with other health conditions. Whitty explained that “all diseases, not just Covid, [had] higher mortality rates than they would have had”.
For example, Carey talked about missed cancer diagnoses or people with heart problems staying away from hospital. Fear of catching Covid in hospital or overwhelming the NHS were other reasons people did not seek help.
“False claims” that the NHS coped well
The emotional descriptions of Fong and more dispassionate evidence of Whitty and others have one thing in common. They described a healthcare system that was overwhelmed and insufficiently prepared, despite the best efforts of dedicated but exhausted healthcare staff.
I was lucky enough not to lose anyone from Covid or have direct experience of the illness until much later, but those most affected are understandably angry. Support charity Covid-19 Bereaved Families for Justice are particularly critical of claims from Boris Johnson and Matt Hancock that “things went reasonably well”.
Pete Weatherby KC, their representative at the inquiry, said: “The narrative that the health service coped without becoming overwhelmed is a false one, and needs to called out as such.” Weatherby said the scenes described in intensive care units “were not inevitable, can never be considered acceptable, and must never be repeated”.
Are we any better prepared for future pandemics?
However, Whitty warned that another worldwide pandemic was a “certainty” and stressed that, as well as increasing capacity, it was vital to build up a healthcare workforce suitably trained for intensive care units. This could not be done in a matter of weeks.
Whitty also emphasised the need to reduce health inequalities. “If we’re not serious about trying to tackle health inequalities between pandemics, there is no way you’re going to be able to do it when the pandemics occur,” he said.
Let’s hope that Starmer’s government pays heed to the inquiry findings and recommendations and sets in motion remedial actions with immediate effect.
If you have been affected by the issues raised, please visit the following charities for further support.
Covid-19 Bereaved Families for Justice
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