Thrown under the bus – the disgraceful treatment of the clinically-vulnerable.

“rsv1 res” by Philippe Put is licensed under CC BY 2.0

‘Thrown under the bus’ has turned out to be one of the most-needed, most-overused phrases of the last two years. Fishers, farmers, touring musicians, small businesses and our young have all been chucked under the Brexit bus. The NHS has been subject to a sustained crushing from the bus which carries the greedy ambitions of private health providers and insurers and their supporters. Our human rights, the rights of asylum seekers and minority groups are being tossed under the bus pretty much as I write, unless the opposition parties in the Lords can stop the worst aspects of Patel’s nasty Police Bill.

And, of course, Johnson throws pretty much anyone within reach under the bus to avoid being caught in the wheels of justice himself.

But there is another group for whom being thrown under the bus has a much darker, much more deadly meaning…and a genuinely deadly meaning at that.

It is estimated that there are 3.7 million clinically vulnerable (CV) or clinically extremely vulnerable (CEV) people in the UK, according to the Office of National Statistics (ONS). Campaigners reckon that figure might be closer to 4 million now, with the increase in those who are immunosuppressed. The number includes thousands of children, with estimates varying between 96,000 and 260,000. These are people at the greatest risk of severe illness and death from Covid.

You will almost certainly have a relative, or a friend, or a neighbour or colleague who falls into this risk category. They will be people with cancer, undergoing treatment, (those taking high-dose steroids, transplant patients) or with Motor Neurone Disease, or asthma or COPD or with renal diseases, Parkinson’s, multiple sclerosis, autoimmune diseases, arthritis managed by immunosuppressive therapy, epilepsy… The list is a long one. It also includes Down’s syndrome and diabetes. Anyone who is immunosuppressed or immuno-compromised – those who are not generating high, if any, antibodies even after a third full vaccine – are in this category for vulnerability..

Early in the pandemic, the government chose to recognise these vulnerabilities, to give those at risk a status – CV or CEV – and introduced shielding as an intervention to mitigate their risk and to protect life. It was an explicit act that recognised their increased risk of serious illness or death. The status brought with it a number of support measures and safeguards to ensure that this group of people were not even more severely disadvantaged than they already were. Of course, the shielding guidance meant very draconian restrictions for those involved – a state of ‘permanent lockdown’ – but it resulted in safety for them and their families.

According to them, this status made us all more aware of the extreme threat from Covid to some of our fellow-citizens and, in most cases, people were sympathetic to their plight and happy to help by taking precautions to minimise their risk. It flagged up the whole issue and reminded the healthy that not everyone is so fortunate. Amongst other measures, it meant that vulnerable people could legitimately opt to work from home, although many were only able to access Statutory Sick Pay (SSP), which was one of the first fights for advocates to address. Others were able to be part of the furlough scheme, and children who were themselves vulnerable or living with a vulnerable parent could access remote learning.

I just want you to reflect what it must be like to be in this category. You know that a killer virus is on the loose and that you are at very serious risk of hospitalisation at best, and death at worst if you catch it. You stay holed up in your house, terrified that the virus will somehow find its way into your place of safety. You were already anxious, and possibly marginalised to a degree, because of your condition, but this situation is much, much more scary and stressful. BUT at least you know that your risk has been recognised and is being mitigated, and that there is evidence that your life is valued.

The vaccinations come in…fantastic. But there’s a problem: many in the CV/CEV community cannot take the vaccine because it, too, presents a risk. Many know that their inability to have the vaccine means that they are effectively ‘variant factories’, especially if immunosuppressed or immunocompromised (this risk was known pre-Covid). Incidentally, there is a patch test which can establish whether or not a patient can tolerate the vaccine but, guess what, most GPs do not know about it, let alone offer it . It requires referral to a clinical immunologist, which can take months.

Freedom Day?

Meanwhile, the general population is becoming inured to the rising death toll, barely pausing to express some transient outrage at the seeding of Covid in care homes etc, before moving on with their lives. Then the government gets antsy about the economy, and concerned about the rise of the anti-lockdown, anti-mask bodies, anti-vaxxers – many sitting on their own back benches. Johnson needs a boost. Everyone is bored with Covid. It’s summer. It’s the holidays. Hey! It’s Freedom Day!

And, just like that, the CV and CEV are told that by September they will miraculously no longer be CV or CEV…well, they will, medically – clinically – as they were before the pandemic, but for the government and society’s purposes, Covid is over and it’s time to get back to ‘normality’. Everyone back to work, back to school, back into the pubs. No more lockdowns EVER, no matter what. Death is part of life. Get over it. After all, the pandemic is over. The virus is on the way out.

But no-one told the virus.

It was still on the loose and it had bred some even more effective relatives – Delta, then Omicron.

No wonder, then, that CV and CEV people did not suddenly feel a whole lot safer because their vulnerable status had been taken away. No wonder that the vast majority are still, effectively, self-shielding – left to fight for their right to protect themselves but without the ‘power’ of the status.

This government strategy of going into denial about the ongoing pandemic, the ludicrous ‘eat out to help out’, the confused and confusing messaging over restrictions and mask-wearing, the billions squandered on an ineffectual test, track and trace programme, the growing sense that the oft-denied herd immunity strategy was back in play big time…all these things served to feed divisions in society and polarise us into two tribes: the still worried/still care/still taking precautions versus the anti-vax, anti-mask, freedom-toting don’t cares, who view CV and CEV people as ‘collateral damage’ or as obstacles to a return to ‘normal life’. And the government says ‘The pandemic is over. No money or resources for you!’

For many, the sense is overwhelming that their lives are deemed worthless, both by the government and much of the media. It really does seem that they are being thrown under that bus.

Emmy Kelly, founder of campaign group Fighting 4 Vulnerable Lives:

“Many CV/CEV felt their lives were valued and protected by the introduction of shielding: there was a genuine effort being made to protect life and future health; as the pandemic has progressed this has slipped further and further from our grasp to the point of ‘you must mitigate your own risk’, but with zero power to do so. Many feel we are just cannon fodder, measured as pressure on the NHS, which shows that government know we are still at risk or we wouldn’t be used as the checks and balances. Worse still, they are doing nothing to stop us from filling those precious ICU beds. We are now classed as ‘seasonal deaths’ which is utterly false and creates a narrative that we were going to die soon anyway. It’s cruel and removes public understanding. For our CEV/CV who are life-limited, how dare this Government jeopardise our precious days, weeks, months, which are being robbed by preventable exposure to this cruel virus? And if we were to survive, how much of ourselves would we lose? How much more of our ability would be lost to Long Covid or an ICU stay?

“While campaigning and supporting our CV/CEV I hear every day that people feel that this is just an easy way to get rid of the ‘burden’; it’s heartbreaking to hear people express how little they now feel their lives are valued. They genuinely feel that the government have given up on us.

“They say ‘vaccines are our way out of this’. For us this is not the case; between waning immunity, poor levels of antibodies being generated, if any at all, and what looks to be a continued vaccine cycle thanks to Omicron, we are constantly at risk.

“How can a government create a shielding programme only to abandon it, and us, when we desperately need it most? If our human rights to life, health and education had been at the forefront of Covid policy, our situation would be very different. As it is, we have been left stranded, left to mitigate our own risks and no power to do so. The mental toll is immeasurable and yet mental health has been weaponised and used against us to justify scrapping shielding, when we can tell you that, yes, shielding was hard, but the fact we’ve been abandoned and undervalued is the real cause of mental stress. We never clamoured for lockdown. We want mitigations. We want an acknowledgement that Omicron is not a mild disease and that children do get it…and get it badly.”

On top of this, the now status-less CV and CEV find themselves falling foul of the authorities for trying to ensure they keep Covid out of their households. Angry, isolated and marginalised, they are joined by the parents of Long Covid sufferers who are told that parental anxiety is making their children sick; that it’s an imaginary illness, that cases of Covid-induced myocarditis are just panic attacks.

Some who keep their children out of school for reasons which no-one would have questioned just a few months before, find themselves referred to social services, or interviewed under caution by the police. Yes. Really. Because now keeping their kids safe is child abuse. Keeping them out of schools where no mitigations have been put in place – potential death traps – is not an option unless they de-register and home-school.

The downplaying of risks to children is one of the ugliest aspects of recent pandemic history and Emmy’s campaign is determined to counter this dangerous false narrative:

“Look, we want our children in school, we hear of the sacrifices ALL children have made, but at no point do we hear the plight of our CEV CV kids: they deserve a safe education, but that means our schools must be safe. To write our children out of policy within education while many are still unvaccinated, and block access to legal obligations which were available to us pre- pandemic, and all the while Covid rips though our school – that’s why the fight and stress are immeasurable. In school without mitigation whilst a ferociously transmissible virus rages through the classrooms? What is the impact on a child’s mental health from hospitalisation in an intensive care unit? What is the impact on the mental health of kids forced into school when they know they may infect their vulnerable parent or carer, with deadly consequences? We completely underestimate kids’ maturity and ability to understand the issues. And it’s not as if there is nothing that can be done to reduce the risks. A HEPA filter in every classroom would have a dramatic effect on risk reduction, making teachers and pupils much, much safer. Instead we hear about schools on main roads, windows open in winter, classrooms filling with fumes. It’s wrong. It’s an abuse of rights.

“And we cannot continue to ignore the evidence that Long Covid does affect children. To date there are an estimated 114,000 children suffering Long Covid, with 20,000 still suffering symptoms 12 months on. The number of children suffering from Long Covid has doubled in the last three months and trebled in the last six months. In addition to myocarditis risks, neurocognitive impairment and other chronic conditions, the latest research points to increases in new type 1 or 2 diabetes diagnosis for under-18s as a consequence of Covid infection.

“Children’s stats for January 2022 are telling us unequivocally that schools are driving transmission. This means school attendance is also causing suffering and endangering future health. We have seen the number of children testing positive for Covid breaking previous records. On 11 January 43,211 children tested positive, with the latest numbers showing that child cases are running at just shy of 26 per cent of all new English cases. In England it is estimated that 1 child in 164 of that number who tested positive will be admitted to hospital; 6.1 per cent of all hospital admissions are children.

“Stats for 11 January in England saw child Covid hospital admissions rise to 15,011, with the risks of admission highest for under-5s and adolescents. But, sure, kids don’t get it badly”, Emmy says, bitterly. “These cases were preventable. What is the government doing to protect our children? Nothing. Now there are 315,000 children off school for Covid-related reasons and 44,000 staff, yet this is somehow acceptable. It doesn’t even make the news.

“Government cannot be allowed to fail a generation of children by abandoning them to an uncertain fate, exposing them to an unknown virus robbing their precious years of childhood through preventable disability, pain and suffering.”

It should horrify us all that there is a large cohort of fellow-citizens who have had support and mitigation withdrawn and have been made to feel that their lives are of lesser value, that their risks are their own to bear, that their deaths are just the inevitable collateral damage from the pandemic, and an unfortunate statistic. When the media and government talk about ‘living with the virus’, they glibly overlook that, for many, this will mean living in fear of dying from it, joining the 175,000 largely avoidable deaths under this government’s callous, careless watch.