Semua Kabar

Treating patients during the pandemic was like responding to a daily terror attack, the Covid inquiry has heard.

Giving testimony, Professor Kevin Fong, spoke of staff he met during a hospital visit being in “total bits”.

The former national clinical adviser in emergency preparedness at NHS England recalled a conversation with an intensive care doctor during a visit in December 2020.

“I asked him immediately what things had been like and… I’ll never forget, he replied it’s been like a terrorist attack every day since it started, and we don’t know when the attacks are going to stop.”

Prof Fong described Covid as the “biggest national emergency this country has faced since World War Two”, and repeatedly broke down in tears on the stand while describing what he had seen and his conversations with other staff members.

During the pandemic, Prof Fong, a consultant anaesthetist, conducted around 40 visits of the “hardest hit” intensive care units on behalf of NHS England to offer peer support to the doctors and nurses working there.

He wrote reports which were sent back to senior managers including England’s chief medical officer Prof Sir Chris Whitty.

He said the “scale of death” was “very difficult to capture in the figures”.

“It was truly, truly astounding… We had nurses talking about patients ‘raining from the sky’, where one of the nurses told me they got tired of putting people in body bags.”

“We went to another unit where things got so bad they were so short of resources, they ran out of body bags and instead were stuck with nine-foot clear plastic sacks and cable ties.”

“These are people who are used to seeing death but not on that scale and not like that.”

Prof Fong said that “despite the best efforts of everyone in the system” the surge of demand for healthcare caused by Covid meant it was “not possible to deliver the standard of care that would ordinarily be expected.”

He described the situation as the worst he had witnessed: “I was on the scene of the Soho bombing in 1999, I worked in the emergency department during the 7th July suicide bombing with the helicopter medical service. And nothing I saw during all of those events was as bad as really Covid was every single day for every single one of these hospitals through the pandemic surges.

“It’s painful now because it was very clear what was happening to the patients, it was very clear what was happening to the staff. The staff were very injured by just how overwhelmed they were by the whole thing.”

In December 2020 as Covid rates were rising again across the UK, he said he was asked to visit an unnamed hospital with a medium-sized intensive care unit.

“I’ll never forget it,” he said. “It was a scene from hell.”

“This was a hospital in massive, massive trouble…. there were so few staff that some of the nurses had chosen to either use the patient commodes [or] wear adult diapers because there was literally no one to give them a toilet break,” he added.

“This was a hospital breaking at the seams.”

At the end of his evidence, he was thanked by the inquiry’s chairwoman Baroness Hallett who said “it was obvious how distressing it was for you and reliving such an ordeal is never easy.”

England’s chief medical officer Prof Sir Chris Whitty, who was next to speak at the inquiry, said he agreed with the evidence “very powerfully laid out” by Prof Fong.

He said that NHS hospitals in England entered the pandemic in early 2020 with a “very low” level of beds in intensive care compared to similar high-income countries.

“That’s a political choice. It’s a system configuration choice, but it is a choice,” he told the inquiry.

“Therefore, you have less in reserve when a major emergency happens, even if it’s short of something of the scale of covid.”

Sir Chris suggested that countries like the UK had no alternative but to impose lockdown and other social restrictions to avoid a “catastrophic” amount of pressure on the healthcare system.

He accepted that “in many individual cases” doctors and nurses found the situation “incredibly difficult” but said without lockdown restrictions “the expectation is it would have got worse. Not a trivial amount worse, but really quite substantially worse”.

Asked about PPE for healthcare workers, Sir Chris said that messaging around which masks NHS staff should wear was “confused” at the start of the pandemic, leading to an “erosion of trust”.

He suggested that more research was needed to see if a higher grade FFP3 mask offered more protection than a basic surgical mask in real-life hospital use, rather than in a laboratory.

“The question is what happens when people are using it day-in and day-out in operational circumstances, and if it doesn’t hold up in that situation, it’s not doing a heck of a lot of good,” he said.

In a future pandemic, he said he would give healthcare workers the choice of which mask to wear “within reason”.

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Ambulance crews faced crucial delays trying to save dying patients in the pandemic because of the time it took to put on protective equipment, the Covid inquiry has been told.

Ambulance technician Mark Tilley appeared close to tears when he described how the experience still “played on his mind”.

“I bottle things away. I’m told quite a lot of times I’m cold. I just deal with it in the way that I deal with it,” he said.

During the pandemic, some ambulance staff moved into budget hotels for weeks at a time to avoid putting family members in danger, he added.

Mr Tilley, who works for South East Coast Ambulance Service, was giving evidence as a representative of the GMB union.

In January 2021, at the peak of the winter wave of the pandemic, he volunteered to move to Sittingbourne, in north Kent, for three weeks, along with 40 colleagues.

A new variant of Covid which appeared to transmit more quickly had recently emerged in the area, and hospitals were coming under increased pressure.

He told the inquiry that, on one occasion, he had to queue in his ambulance outside A&E for an entire ten-hour shift because there was not enough room to transfer a “heavily deteriorating” patient into the building.

“We’d run out of oxygen, so we’d had to scan the hospital to try and find [more],” he said. “We ordered pizza to the vehicle because otherwise we wouldn’t have had anything to eat.”

Because of lockdown rules at the time, volunteer ambulance crews were sleeping in a budget hotel, with some deciding not to return home to avoid placing family members in danger.

“You had nowhere to go, so it was just the facilities that were there: the television and a phone,” he said.

“You had 12 hours [after your shift] to mull over what you’d been seeing; the queues at the hospital, the poor patients.”

In his testimony, Mr Tilley described arriving at residential homes where patients were dying “inside the front window or on the pathway”.

Under guidance, paramedics and other ambulance staff were told they had to wait until arriving at the scene before they could put on plastic Tyvek suits and protective hoods or masks.

He said that could cost crews a crucial minute and a half before they were able to start treatment: “I would have normally gone over and started bouncing up and down on their chest [to perform CPR].

“But [instead] we went and got our masks and suits on and all of that – that plays on my mind all the time.

“For me, you can’t change history no matter what you talk about, it’s history. We can’t change it.”

Counsel to the inquiry Alice Hands said research commissioned by the inquiry had revealed similar accounts, with other ambulance crews saying they were “forced not to intervene… and watch people die” while they put on equipment.

In his evidence, Anthony Marsh, national ambulance adviser to NHS England and former chairman of the Association of Ambulance Chief Executives, said he was aware of those concerns at the time and did raise the matter with senior colleagues.

But he said allowing crews to put on PPE when they were travelling to the scene to cut the total response time would “not have been safe”.

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A mother of premature twins has told the Covid inquiry she did not feel like she was treated as a parent after giving birth in the early stages of the pandemic.

Tamsin Mullen said she was kept in a side room for 27 hours after giving birth by caesarean section while her sons were taken to neonatal intensive care.

She said “rigid” visiting restrictions meant that, for the next month, only one parent was allowed to visit her newborn babies at a time.

“We needed the hospital to understand we were a family,” she told the inquiry.

“We didn’t feel like a mother and father to our children in the way we should have done.”

The Covid inquiry has been taking evidence about the impact on maternity services as part of its third section, or module, which is investigating the impact on the NHS and healthcare.

Ms Mullen, a mother of three, was giving first-hand “impact” evidence on behalf of 13 pregnancy, baby and parent organisations.

She found out she was expecting twin boys in 2019 and was considered high-risk. When pregnant with her first child, she was diagnosed with preeclampsia – a condition which can cause high blood pressure and lead to serious complications.

Her pregnancy was being monitored closely with scans every week because of concerns about the development of one of the babies.

Initially she said her husband was able to come with her to scanning appointments, but as Covid spread in March 2020, he was forced to wait in the car park outside after driving 50 miles from their home to the nearest hospital.

“It was just before the first lockdown came into effect,” she said.

“I was very nervous. It was very difficult to do that alone knowing [the pregnancy] was high-risk.”

In April 2020, Ms Mullen’s two sons were born prematurely, at 34 weeks, by caesarean section.

Her husband was able to be with her in the operating theatre and then in the recovery room for an hour, before being told Covid restrictions meant he had to leave.

Their two young boys then spent a total of 31 days in neonatal intensive care before they could be discharged.

Ms Mullen said Covid restrictions meant only one parent could be with them at a time, even after they had been moved to a single room away from other babies.

The hospital had shut off access to side rooms used for breastfeeding and Ms Mullen said she was told to use a toilet to express milk, something she did not want to do because of the infection risk.

She said the restrictions were “baffling” when both parents lived together and were driving to hospital each morning in the same car.

She was looking after both babies by herself in intensive care when hospital staff from outside the unit told her they had tested positive for a bacterial infection called MRSA.

“I was holding our son who was on oxygen at the time,” she said.

“I was in a state of shock so didn’t really say very much. They [the staff] left me and I was there on my own.

“I didn’t know what it all meant, so I really panicked.”

Later a doctor explained the form of MRSA involved was a less serious type that could be treated with soap and water.

“We didn’t feel like we were being treated as parents. It was like we were visitors, and we were visiting two patients,” she said.

The inquiry later heard from Jenny Ward, the chief executive of the Lullaby Trust, who chairs the pregnancy and baby charities network.

She said that, before Covid, most parents would have had 24/7 unrestricted access to their young children in neonatal intensive care.

It was not until April 2022 in England and Scotland, and May 2022 in Wales, that the guidance reverted back.

She said the decision to suspend visiting from March 2020 for a large number of maternity services had been “hugely damaging”.

Restrictions during antenatal scans had a particularly negative impact on some women who had to receive bad news about the health of their baby on their own, she added.

For much of the pandemic, pregnant women were often told they were only allowed to have a birthing partner present when in so-called “active” labour.

As a result, some were left alone in individual birthing rooms without anyone else to “advocate for them, to say they seem to be in extreme pain”, Ms Ward told the inquiry.

After giving birth, others had to recover from surgery in hospital while looking after a newborn baby without their partners able to be present.

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At least one NHS trust put in place a blanket “do-not-resuscitate” order for sick patients in the pandemic, the Covid inquiry has heard.

It would mean individuals were considered ineligible for potentially lifesaving CPR, solely on the basis of age or disability, without being individually assessed.

Former Resuscitation Council UK president Prof Jonathan Wyllie said he knew of one trust implementing the policy, although he had not seen a document setting it out.

Groups representing the families of people who died from Covid said they were “horrified but not surprised”.

Under NHS guidance, a Do Not Attempt Cardiopulmonary Resuscitation (DNCPR) order can be added to someone’s medical notes after consultation with the patient or their family members.

It means medical staff will not attempt chest compressions or defibrillation, where an electric shock is applied to restore normal heart rhythm, if the patient’s heart or breathing stops.

Only 15-20% of those who have CPR in hospital survive, with success rates dropping to 5-10% outside of a hospital setting.

Groups representing bereaved families believe some hospital departments became so overwhelmed in the pandemic that blanket DNACPR rules were applied, based solely on age, disability or medical condition.

At the time, the charity Mencap said some people with learning disabilities had reported being told they would not be resuscitated if taken ill with Covid.

NHS England says a blanket DNACPR rule for every person with a specific medical condition or over a certain age would be unlawful.

It wrote to NHS trusts a number of times during the pandemic, to remind clinicians the orders should only ever be applied with the “appropriate consent”.

Prof Wyllie told the inquiry he had not seen a document from the NHS trust concerned but had heard about the policy from a fellow member of the Resuscitation Council.

The charity, which develops guidelines and training for medical staff, had then released a “very clear” public statement that blanket DNACPR orders were “not an appropriate way forward and should not be implemented”.

“That was our stance and that has never changed,” Prof Wyllie added.

Covid-19 Bereaved Families for Justice UK said the use of blanket policies would be “irrefutable evidence” some NHS services had been overwhelmed in the pandemic.

“The inquiry has heard repeatedly from those at the top that blanket DNACPRs were not appropriate and that there was no directive in place,” the group’s solicitor Nicola Brook said.

“The bereaved families have known for a long time that the realities on the ground were very different.

“Their worst fears have now been confirmed but this brings with it more questions, ‘If it happened at this trust, did it happen at the trust where my loved one was?’”

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Listen to Jim read this article

Five times Prof Kevin Fong broke down in tears in a nondescript hearing room in West London, while giving evidence to the Covid inquiry.

The 53-year-old has the kind of CV that makes you pay attention: a consultant anaesthetist in London who also works for the air ambulance service and specialises in space medicine.

In 2020, as Covid spread around the world, he was seconded to NHS England and sent out to the worst hit areas to support other medics.

We’ve long been told that hospitals were struggling to cope during the pandemic. In January 2021, then prime minister Boris Johnson warned the NHS was “under unprecedented pressure”.

But now many hours of testimony to the Covid inquiry this autumn is offering our clearest understanding yet of what was really going on at the height of the pandemic.

The inquiry restarts its live hearings this week with evidence from doctors and patient groups. Health ministers and senior NHS managers are also expected to appear before the end of the year.

I was at the inquiry the day Prof Fong calmly talked through more than 40 visits he led to intensive care units, his voice cracking at times.

What Prof Fong discovered at the hospitals he visited was something he said could not be found in the official NHS data or the main evening news bulletins at the time.

“It really was like nothing else I’ve ever seen,” he said.

“These people were used to seeing death but not on that scale, and not like that.”

In late 2020, for example, he was sent to a midsize district hospital somewhere in England that was “bursting at the seams”.

This was just as the second wave of Covid was hitting its peak. England was days away from its third national lockdown. The first vaccines were being rolled out but not yet in large numbers.

In that hospital, he found the intensive care unit, the overflow areas and the respiratory wards all full with Covid patients.

The previous night someone had died in an ambulance outside waiting to be admitted. The same thing had happened that morning.

The staff were “in total bits”. Some of the nurses were wearing adult nappies or using patient commodes because there wasn’t time for toilet breaks.

One told him: “It was overwhelming, the things we would normally do to help people didn’t work. It was too much.”

That night, Prof Fong and his team helped to transfer 17 critically ill patients to other NHS sites – an emergency measure unheard of outside the pandemic.

“It is the closest I have ever seen a hospital to being in a state of operational collapse,” he said.

“It was just a scene from hell.”

In the pandemic we heard reports of swamped hospitals in danger of being overwhelmed though to what extent was never fully clear.

On the face of it bed occupancy in England – that’s the total number of hospital beds taken up by all patients – did not hit more than 90% in January 2021, the peak of the largest Covid wave.

That’s above the 85% level considered safe but not any higher than a typical winter outside the pandemic.

That doesn’t tell the full story. At that point hospitals had cancelled all their usual planned work – from hip replacements to hernia repairs. Strict Covid rules meant the public were told to stay at home and protect the NHS. The numbers coming in through A&E in England fell by almost 40% compared to the previous year, to 1.3 million in January 2021.

That was why, when anti-lockdown protestors sneaked into hospitals to film, they found deserted corridors and rows of empty seats.

The pressure though was often being felt elsewhere – on the main wards and in intensive care units (ICUs), where thousands of the sickest Covid patients needed help to breathe on ventilators.

“At our peak we ran out of physical bed spaces and had to resort to putting two patients into one space,” one ICU nurse at a different hospital told Prof Fong.

“Patients were dying daily, bad news was being broken over the phone or via an iPad.”

Later research by the Intensive Care Society found that in January 2021, 6,099 ICU beds were filled across the UK, well above the pre-Covid capacity of 3,848.

This huge spike in demand, equivalent to building another 141 entire intensive care units, was being driven by the length of time Covid patients needed treatment.

On average they would spend 16 days in ICU, normally on a ventilator, compared with just four to seven days for a patient admitted for another reason.

As a result, hospitals had to rush to convert operating theatres, side rooms or other wards into makeshift intensive care units. NHS trusts often ended up juggling shortages of equipment, medicines and oxygen.

But while it might have been possible to cram in more beds, finding the extra skilled workers to staff them was far more difficult.

Prof Charlotte Summers, who led the intensive care team at Addenbrooke’s hospital in Cambridge, said: “We can’t just magic up specialist care staff because it takes a good couple of years, at least, for minimum critical care speciality training.”

“What we had, we had, and we had to stretch further and further.”

As a result staffing ratios were pushed to the limit in Covid, something she said politicians, the media and the public didn’t fully understand at the time.

Outside of a pandemic, specialist critical care nurses would be responsible for just a single patient. In Covid they were looking after four, five or even six – often all on a ventilator.

“Staff didn’t have time to process or accept the losses,” the lead ICU matron at one large teaching hospital told Prof Fong.

“As soon as one patient had passed away they had to get the bed cleared and ready for the next patient.”

Others in intensive care and Covid wards – from doctors to pharmacists to dietitians – saw their workloads stretched well beyond normal safe levels.

This was the main reason why temporary Nightingale hospitals, built in the first Covid wave at a cost of more than £500m, only ever treated a handful of patients. It was possible to build the critical care infrastructure almost overnight, but quite another thing to find trained medics to work in them.

To help plug these staff shortages in ICU, volunteers were frequently brought in from other parts of the hospital, often with no experience of intensive care medicine or of dealing with that level of trauma and death.

“They were being exposed to things which they wouldn’t necessarily be [exposed to] in their normal jobs, people deteriorating and dying in front of them, the emotional distress of that,” said Dr Ganesh Suntharalingam, an ICU doctor and former president of the Intensive Care Society.

Another hospital doctor said he felt some junior members of staff were “thrown in at the deep end” with little training and no choice about where they were sent.

The inquiry heard that all this “inevitably” had an impact on some of the sickest patients.

At no point did the NHS have to impose a formal ‘national triage’, where someone was refused treatment because they could not get a hospital bed.

But using that as measure of health system collapse may be too simplistic anyway.

Prof Summers said it would be mistake to think of “catastrophic failure” as a switch that goes “from everything being okay to everything not being okay the next second.”

“It is in the dilution of a million and one tiny little things, particularly in intensive care.”

She said when the system becomes so overstretched it feels like “we are failing our patients” and not providing the care “that we would want for our own families”.

New research suggests those hospital units under the greatest pressure also saw the highest mortality rates for both Covid and non-Covid cases.

Difficult decisions were having to be made about which of the sickest patients to move up to intensive care.

Those Covid patients who needed CPAP, a form of pressurised oxygen support, rather than a ventilator, often had to be cared for in general wards instead, where staff may have been less used to the technology.

One anonymous ICU doctor in Wales said: “We didn’t have enough space to ‘give people a go’ who had a very remote chance of getting better. If we had had more capacity, we might have been in a position to try.”

The inquiry was also told that at least one NHS trust was under so much pressure it implemented a blanket “do-not-resuscitate order” at the height of the pandemic. If a patient went into cardiac arrest or stopped breathing, it would mean they should not be given chest compressions or defibrillation to try to save their life.

In normal times, that difficult decision should only be made after an individual clinical assessment, and a discussion with the patient or their family.

But Prof Jonathan Wyllie, ex-president of the Resuscitation Council, said he knew of one unnamed trust that put in place a blanket order based instead on age, condition and disability.

Groups representing bereaved families said they were horrified, adding it was “irrefutable evidence the NHS was overwhelmed”.

At times, the impact on intensive care was so great that some units had to undergo “rapid depressurisation” with dozens of patients transferred out, sometimes over long distances, to other hospitals.

Before the pandemic, from December 2019 to February 2020, only 68 of these capacity transfers had taken place in England. Between December 2020 and February 2021, 2,152 were needed, either by road or air ambulance.

Often it was the most stable patients in smaller district hospitals who would be selected for transfer as – bluntly – they were the most likely to survive in a moving vehicle for several hours.

“But what that meant for the smaller units is that they were left with a cohort of patients who were most likely to die,” said Prof Fong.

“Those units would experience mortality rates in excess of 70% in some cases.”

In normal times between 15% and 20% of ICU patients die in hospital, according to the Faculty of Intensive Care Medicine.

Through the pandemic the NHS did continue to operate and, on a national basis, patients who really needed hospital treatment were not turned away.

But Prof Charlotte Summers, in her evidence, said staff are still “carrying the scars” of that time.

“You cannot see what we’ve seen, hear what we’ve heard, and do what we’ve had to do and be untouched by it,” she said.

“You cannot and be human. And we are very much human.”

Health services in all four UK nations started the pandemic with the number of beds in ICU and staffing levels well below average compared to other rich countries.

Five years on and there are still almost 130,000 job vacancies in the NHS across the UK. Sickness rates among the 1.5 million NHS employees in England are running well above pre-pandemic levels, with days lost to stress, anxiety and mental illness rising from 371,000 in May 2019 to 562,000 in May 2024.

All this comes as the health service struggles to recover from Covid with waiting lists for surgery and other planned treatments still hovering near record levels.

“We coped, but only just,” said Prof Summers and Dr Suntharalingam in their evidence to the inquiry.

“We would have failed if the pandemic had doubled for even one more week, or if a higher proportion of the NHS workforce had fallen sick.

“It is crucial to understand how very close we came to a catastrophic failure of the healthcare system.”

With the inquiry ongoing none of the agencies are currently commenting.

Additional reporting and research by Yaya Egwaikhide

Top photo credit: Getty

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The most senior doctor in NHS England has said he was “personally terrified” that hospitals could have been overwhelmed in the early stages of the pandemic.

Prof Sir Stephen Powis told the Covid inquiry officials had drawn up a draft document advising whose care should be prioritised if the NHS found itself unable to cope with the surge in patients.

The ‘Covid-19 decision tool’ assigned points based on a patient’s age, frailty and underlying conditions. A high score meant they might not be admitted to intensive care if services were overwhelmed.

The tool was never issued publicly, after it became clear infections might have already reached a peak in March 2020.

Sir Stephen, who still serves as national medical director at NHS England, said the senior clinicians who were asked to draw up the plans at short notice “did a magnificent job” that “nobody ever wants to do”.

“But it became absolutely clear to me that this was going to be controversial, [and] that it hadn’t had the opportunity to be discussed more widely with patient groups, [or] with the public,” he added.

The draft document advised doctors to score Covid patients based on three criteria, using a frailty scale.

It detailed how those with a total score of more than eight points should not be admitted to intensive care if services became overwhelmed.

Patients aged 70 to 75 were to be automatically assigned four points, while those aged over 80 would receive six.

Extra points would be added for chronic conditions, such as heart disease or diabetes.

People who were terminally ill, with a life expectancy of less than six months, would automatically be given nine points.

Sir Stephen said work on the guidance document had started early in the pandemic, at a time when the number of patients in intensive care in England was doubling every 5-7 days.

“It was not clear that the public would respond to lockdown – they did wonderfully – but that wasn’t clear [at that point],” he said.

“Frankly, I was personally terrified that the NHS was going to be overwhelmed.”

The project was halted on 28 March 2020, after it became clear the peak of the first Covid wave was approaching and the health service would not “breach capacity”.

Sir Stephen said there was also a danger the point-scoring system could have been “used inappropriately”, replacing the individual clinical judgement of doctors.

“My recommendation to the inquiry is that we should absolutely, in the future, not try and develop one of these tools in the midst of a pandemic,” he added.

He said it was a piece of work that needed to be carried out in consultation with the public “in normal times”.

“In my view, it’s a discussion that shouldn’t be government-led, it shouldn’t even be led by the profession, it needs to be located within society.”

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Boris Johnson’s government blocked a request to fund another 10,000 hospital beds at the height of the Covid pandemic, the chief executive of NHS England has said.

Amanda Pritchard told the UK Covid-19 Inquiry the decision, made by the Treasury in July 2020, had been “very disappointing”.

Extra beds and staff would have been used to cut waiting lists for planned care and “build resilience” going into a second winter wave of the pandemic, she said.

The government has said it cannot comment while the inquiry is in progress.

Health ministers from the time are expected to give evidence later this month, to the third section of the inquiry, looking at Covid’s impact on the NHS and healthcare systems across the UK.

Ms Pritchard served as NHS England’s chief operating officer from 2019 until she was promoted to chief executive, in August 2021.

In her evidence, she said a request had been made to the government, for 10,000 extra permanent, staffed hospital beds, in July 2020.

The demand had been based on modelling the spread of the virus, along with the need to deal with other pressures that coming winter and resume more planned, or elective, surgery and other treatments for non-Covid patients.

But the inquiry heard the Treasury and the prime minister’s private office had refused the request, saying they wanted more use made of temporary Nightingale hospitals along with the private sector.

And Ms Prichard had been told the decision would be looked at again as part of a wider spending review expected in the autumn of 2021.

She called the decision “very disappointing”, saying waiting lists for planned NHS treatment in England would be in “quite a different position” today had the extra funding been agreed.

“If we had had that capacity, we could certainly have treated thousands more patients… as well as being more resilient going into the second wave of the pandemic and into winter more generally,” Ms Prichard said.

In the summer of 2020, the NHS in England had a total permanent bed capacity to treat about 95,000 patients in acute hospitals.

That was increased by another 4,000 from winter 2023, under a recovery plan agreed by then Prime Minister Rishi Sunak.

Later in her evidence, Ms Pritchard said the health service had faced a period of “extreme pressure” in the winter of 2020-21, as another wave of Covid spread across the country.

By that point, new treatments had been discovered, including the cheap steroid dexamethasone, and the first Covid vaccines were starting to be rolled out in small numbers.

But the level of community transmission at the time meant some intensive-care units were still being pushed “to the brink” and were “right on the edge” of running out of bed space.

Nationally, the health service had never had to “systematically limit” access to treatments because hospitals could not cope with demand, Ms Pritchard said.

“That does not mean, though, that it did not feel completely overwhelming to staff at this time in those places – and it does not mean that the kind of care that was being provided was anything like normal,” she added.

Ms Pritchard was also asked about the seven temporary Nightingale hospitals built quickly, in March and April 2020, across England to treat Covid patients.

Data seen by the inquiry shows the total cost to the taxpayer, including setting up and decommissioning, is now estimated at £358.5m.

The hospitals – in Birmingham, Bristol, Exeter, Harrogate, London, Manchester and Sunderland – treated 141 Covid patients in the first wave of the virus and 1,097 Covid and other patients in the second wave.

In total, £50.4m was spent on one site, Birmingham, which was never used by patients in the pandemic.

The site in Bristol also carried out 6,554 assessments for patients from the eye hospital in the city.

Ms Pritchard told the inquiry the programme had still been “useful”, as the sites had been envisaged as “military field hospitals” at the time.

“We thought we were doing it to avoid a northern Italy situation,” she said, referring to scenes in Lombardy, where intensive-care units had been overwhelmed.

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Separate bills to let terminally ill people end their life are being considered at Westminster and in Scotland.

But the NHS in England is still well below its target for seeing patients within 18 weeks.

The trial, involving patients in Yeovil and Taunton, is looking at reducing courses of antibiotics.

Marine pilot Ian Lawrence and his family spent a year volunteering on a hospital ship.

A medical tribunal has found a senior doctor’s failings amounted to gross negligence and misconduct.

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The NHS in England came within “six or seven hours” of running out of gowns and other protective equipment during the Covid pandemic, Matt Hancock has said.

The former health secretary was giving evidence for the third time at the Covid inquiry, about the impact on healthcare systems.

He stated there was never a “national shortage” of PPE for healthcare workers but “in some places, they did run out – and it was awful”.

Asked about reports that some nurses had to wear binbags early in the Covid crisis, he said the NHS needed to “learn the lessons of what went wrong” and put in place “better stockpiles” for the future.

Mr Hancock – who was health secretary at the start of the pandemic in 2020 – will be giving evidence over two days, as the inquiry investigates the impact on the NHS and healthcare across all four UK nations.

On Thursday, the inquiry’s chair, Baroness Hallett, had to occasionally interrupt the hearing to tell bereaved families in the public gallery – some of whom were clearly highly emotional – to lower photographs of their deceased relatives.

Earlier, the former MP faced robust questioning about the squeeze on facilities many hospitals had endured at the peak of the two most significant waves of Covid.

In March 2020, Mr Hancock said he was “petrified” newly announced lockdown rules might not be stringent enough to avoid a repeat of scenes in northern Italy, where some Covid patients had struggled to access any care.

But while some hospitals in England came under “extraordinary pressure”, the wider NHS system was never overwhelmed, he added.

Mr Hancock was then asked about the case of Suzie Sullivan, who died of Covid in 2020.

Medical notes written at the time stated Suzie was not suitable for a transfer to intensive care due to a pre-existing heart condition and having Down’s syndrome. Her father, John, told an earlier session of the inquiry she was “left to die” because of her disability.

Mr Hancock accepted that a bed in intensive care could not be found for every individual patient who needed it at the height of the pandemic.

“Of course there was enormous pressure, and of course, it has consequences,” he said.

He said, at times, staff ratios had to be stretched, meaning specialist critical care nurses had to look after six patients rather than give the one-to-one care they would in normal times.

But he added: “What we successfully avoided, was an overall rationing – to say, ‘people, according to these characteristics, aren’t going to be cared for’.”

“That’s what would have happened if we had let the virus get more out of control.

“Did people get as good care as they would have done in normal times? Of course not. There was a pandemic,” he told the inquiry.

Asked about the imposed visiting restrictions, which meant some relatives could not be with dying family members in their final hours, and elsewhere, expectant fathers could not attend ante-natal scans, he said “on balance” he believed the government got the rules “about right”.

“Where I think we got it wrong, for instance, was the way that the funeral guidance was applied on the ground – it wasn’t as had been intended.”

Other witnesses, including the first minister of Wales, Eluned Morgan, and Scotland’s former health minister Jeane Freeman, have suggested some of those restrictions, or they way they were implemented, might have gone too far.

Mr Hancock also defended the government’s ‘Stay Home, Save Lives, Protect the NHS’ messaging, saying that it was “literally true” that “if we didn’t stop the spread of the virus, the NHS would be overwhelmed”.

Giving evidence recently, England’s chief medical officer, Prof Sir Chris Whitty, said, with hindsight, the authorities did not suceed in letting the public know the NHS was still open for non-Covid patients during the pandemic.

Mr Hancock alluded to how he had had to “ruffle some feathers” to protect the NHS from political interference.

He said he felt it was his job to “shield” the health service from “people being difficult in Number 10”.

Some of the interference by political appointees in Downing Street caused “incredible difficulties” when it came to rolling out Covid testing, he added.

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Families of those harmed by Covid vaccines told the UK Covid Inquiry they were forced to support each other during the pandemic because there was no other help.

Kate Scott, who represents the group Vaccine Injured and Bereaved UK (VIBUK), said they felt they were “almost being pushed into the shadows during the pandemic”.

The inquiry also heard from a victims’ group in Scotland which raised concerns that the vaccine had been rolled out too quickly, and that safety had been sacrificed for speed.

This is the Inquiry’s fourth module, which will consider issues relating to the development of Covid-19 vaccines and their implementation.

Mrs Scott, whose husband Jamie was left severely disabled by a vaccine, said: “We are an uncomfortable truth, but we are a truth and the truth is for everyone in our group – the vaccine caused serious harm and death.”

Jamie Scott, a father of two boys, worked in a high-powered job until he was severely injured by a Covid vaccine.

He spent four weeks and five days in a coma and suffered an extremely rare, life-threatening side effect called VITT, or vaccine-induced immune thrombosis and thrombocytopenia.

Jamie survived, but suffered a significant brain injury, which affected his thinking processes. He is now partially blind and his wife says he will never live independently.

Jamie has received £120,000 – the maximum payout from the government’s Vaccine Damage Payment Scheme.

His wife, who is clear that neither of them is against vaccines, says he will never work again and that this is not a fair or adequate amount.

“The scheme is inadequate and inefficient – offers too little too late and to too few,” she said.

The inquiry heard that figures from a Freedom of Information request by VIBUK show that, as of 30 November 2024, victims and their families have made 17,519 claims to the scheme.

Covid Inquiry chairwoman Baroness Heather Hallett spoke with a trembling voice as she told Jean Rossiter, whose son Peter died after contracting Covid-19: “I too am the mother of two sons of a similar age to Peter, so I can only imagine the pain and the grief that you are going through.”

Peter Rossiter was a highly talented, classical pianist who brought music to life while head of music in a school, Jean told the inquiry.

However, despite being a key worker, he only received his first vaccine in May 2021 – five months after the first jab was given in the UK.

That summer he was infected with Covid and became seriously ill, was admitted to intensive care in hospital but died on 11 August 2021.

Peter had kept himself fit, said his mother Jean who helped set up the group Covid-19 Bereaved Families for Justice UK.

“He followed the rules, we all did and it seems to us as parents that we did everything right and yet Peter lost his life still, as did so many of the families who’re in our group,” she said.

Baroness Hallett said: “So many people said that Covid-19 only affects the older people.

“You had a fit and healthy young son, under 40, and so it helps to remind people that we are not just about protecting people who some may think have had a good innings; we are about protecting the whole population.”

The bereaved families also raised concerns about:

The Scottish Vaccine Injury Group (SVIG), which represents 750 people, said it had concerns that the vaccine had been rolled out too quickly and that safety had been sacrificed for speed.

It also raised serious concerns about the government’s vaccine damage payment scheme.

Ruth O’Rafferty, from the SVIG, said it was “a traumatic experience” for anyone applying.

Being 60% disabled is a criteria for the award. She questioned how anyone could prove that when their condition fluctuates. She also said many of their members had suffered neurological damage and struggled to fill out forms.

The inquiry will hear evidence over the next three weeks on this issue, in London.

Jagoda Rubaszko made up administrative service company which she claimed had a turnover of £210,000.

The NHS says just 49% of people eligible in Surrey have received their most recent booster jab.

The pandemic was a “catalyst for some entrepreneurial soul-searching”, a business expert says.

The former workers claim they contracted Covid-19 as a result of a breach of duty and negligence.

A new documentary follows the bra firm founder’s journey from poverty to fame, fortune and controversy.

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Emergency service teams, local councils and government officials will take part in a full, multi-day pandemic preparedness exercise, to help the UK prepare for potential future threats.

The test, which is likely to take place in the autumn, will involve thousands of people across different parts of the UK, minister Pat McFadden has announced.

The plans come in response to the first set of recommendations made by the Covid-19 Inquiry – the ongoing public inquiry into the handling of the pandemic.

The chair of the inquiry, Baroness Hallett, found the UK was “ill-prepared” for the coronavirus pandemic, and “failed” its citizens.

The national pandemic response exercise will be the first of its kind in nearly a decade, designed to test capabilities, plans and procedures in the face of new threats, the government says.

The findings and lessons will be made public, as requested by Baroness Hallett, who made a series of recommendations in a 217-page report published in July 2023.

Another measure will be a full test of the emergency alert system – which sounds an alarm through mobile phones – later this year.

The alert has been used four times since its launch in 2023, including in areas hit hardest by recent storms.

The government has also committed to training 4,000 people a year to be better prepared for crises such as pandemics, through a UK resilience academy, planned to open in April.

The Covid-19 inquiry report found the pandemic had a disproportionate impact on vulnerable groups.

A new national “vulnerability map” will be produced, Mr McFadden says, to highlight populations who may be vulnerable in a crisis, using data on age, disability, ethnicity and whether someone is receiving care.

It is designed to help people get more targeted local support.

Mr McFadden said: “We must learn lessons from the Covid pandemic, as we cannot afford to make the same mistakes again.

“But we will plan in a way that recognises the next crisis may not be the same as the last.”

Pandemic planning and resilience are also about making sure the underlying fundamentals of the country are strong, he added.

Baroness Hallett’s first report called for a major overhaul of the systems involved in preparing the country for civil emergencies.

It also pointed out the UK lacked resilience, with high rates of ill-health and public services running close to – if not beyond – capacity.

Jagoda Rubaszko made up administrative service company which she claimed had a turnover of £210,000.

The NHS says just 49% of people eligible in Surrey have received their most recent booster jab.

The pandemic was a “catalyst for some entrepreneurial soul-searching”, a business expert says.

The former workers claim they contracted Covid-19 as a result of a breach of duty and negligence.

A new documentary follows the bra firm founder’s journey from poverty to fame, fortune and controversy.

Copyright 2025 BBC. All rights reserved.  The BBC is not responsible for the content of external sites. Read about our approach to external linking.