Notes From the Margins…

Ventilator Blues

  • March 21, 2020
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When the coronavirus nightmare ends – as it will end one day – there are many things those of us who survive it will want to remember, and there are things that governments – including our own – will want us to forget.  One of them is the chronic lack of medical ventilator machines available to the NHS.

Last week, our prime minister asked sixty CEOs from British manufacturing companies to produce 30,000 ventilators in two weeks, in what he cheerily referred to as ‘Operation Last Gasp.’  No one can ever say that this is a man to let a national tragedy dampen his spirits, but for the non-sociopathic members of the public the government’s frantic quest for ventilators is unlikely to raise a giggle.

In Italy, for the last few weeks, doctors have been forced to ration these machines out, to the point when they have effectively had to prioritise which of their patients lives and dies.

This is an awful decision for anyone to have to make.  And if the numbers of hospitalised coronavirus victims meet predictions, British doctors will also be making it in the coming weeks and months.  According to last week’s modeling from Imperial College, between 60,000 to more than 100,000 people per week will require a ventilator in a three-week period between May and June.

At present there are only 5,000 ventilators in the UK.  This is more than Italy, which had 4,000 at the start of the crisis, but a lot less than Germany, which has 25,000.   So people will die because there are not enough of these machines, and they will die in the most horrible and loneliest circumstances imaginable.

This explains the frantic global search for these machines in which the British and many other governments are now engaged in, which is sending order forms through the roof for companies that already make these machines, and for engineering and manufacturing firms looking to make them.

The New York Times described Johnson’s call to carmakers and manufacturers  as ‘ a move reminiscent of the country’s mobilization to build Spitfire fighter planes during World War II.’

Stirring stuff, but medical ventilators aren’t Spitfires. They are complicated machines that are difficult to make, which require a range of different components sourced from different countries and specialised personnel to operate them.

All this will take time,  and many people will die before these machines become available in sufficient quantities.  That is a grim enough prospect.  But in this country at least, it’s made even worse by the fact that successive governments knew these machines would be needed long before the pandemic.

In October 2016, the UK government ran a three-day exercise, codenamed Exercise Cygnus, to test  co-ordination between hospitals, Whitehall and disease-tracking experts in a scenario in which tens of thousands of people were  exposed to a pandemic from a new strain of flu.

The report on the exercise was not made public, but in December that year the chief medical officer Dame Sally Davies told the World Innovation Summit for Health: “We’ve just had in the UK a three-day exercise on flu on a pandemic that killed a lot of people. It became clear that we could not cope with the excess bodies.”

Davies went on to point out: “If you don’t know you’ve got a new disease then you don’t isolate people. There was overcrowding in the emergency room, inadequate ventilation, family and friends going through. That could happen in any of our countries.”

At the time the Department of Health insisted: “ TheWorld Health Organisation recognises that the UK is one of the most prepared countries in the world for pandemic flu. We regularly test ourselves to make sure this remains the case. Any issues are thoroughly explored with the relevant agencies so that lessons are learnt.”

These claims don’t look quite so impressive now, do they?  And whatever lessons were learnt, they did not address the issue of ‘inadequate ventilation’ that Davies referred to, and there is no evidence that the May government commissioned  any ventilators as a result of that exercise of Davies’s claims.

To put this in perspective, consider the following.   Despite their complexity, medical ventilators are not that expensive, and cost between £21,000 and £43,000.

Compare that to the whopping £9.1 billion which the Ministry of Defence spent on 48 F-35 Lightning fighter jets as part of a 2006 procurement program from Lockheed Martin which is eventually expected to expand to 135 jets.

The RAF describes the Lightning as ‘ a multi-role machine capable of conducting missions including air-to-surface, electronic warfare, intelligence gathering and air-to-air simultaneously.’

This is the kind of weapon that makes a country great – according to some.  But it doesn’t look quite so glorious if you consider that 48 medical ventilators, priced at the top end of nearly £43,000 pounds each, would cost just over £2 million pounds.

Keeping to the same price, Johnson’s 30,000 ventilators would cost  about somewhere in the region of £1 billion.

No doubt the defenders of the MoD’s procurement program would claim that the Lightning jet protects us and keeps us safe, but medical ventilators also do that.  Comparing medical ventilators to fighter planes is not simply a guns and butter argument.   The lethal shortage of ventilators is a question of political priorities.  It represents a failure of government to exercise its responsibility to protect its own people.

For years governments have warned us about terrorist-borne pandemics, mass poisonings, dirty bombs, and nuclear weapons, and told us that the wars fought over there are intended to to protect us over here etc, etc.

Yet in 2016, the UK government could not bring itself to stockpile enough ventilators to ensure that its population was protected in the event of a pandemic, even though its own chief medical officer claimed that there was a shortage of these machines.

Now the pandemic is here, and many people will die who could have lived, and the virus is only partly responsible for that.

And just as this awful tragedy has cast a light on so many systemic failures and failures of governance that have accumulated over the years, let us never forget that some of these deaths could have been prevented, if we had  governments that actually cared enough about the people they were supposed to be protecting, to help them breathe when they get sick.

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About Me

I’m a writer, campaigner and journalist.  My latest book is The Savage Frontier: The Pyrenees in History and the Imagination (New Press/Hurst, 2018).  The Infernal Machine is where I write on politics, history, cinema and other things that interest me.

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