U.K. Lockdown Likely to Continue as Johnson Stays in Hospital - Bloomberg

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1. U.K. Lockdown Likely to Continue as Johnson Stays in Hospital  Bloomberg
2. Boris Johnson in hospital for second night fighting coronavirus  CNN
3. Coronavirus: Boris Johnson 'improving' as intensive care treatment continues  BBC News
4. Boris Johnson's personal coronavirus battle – podcast | News  The Guardian
5. The last thing we need to hear right now is that Boris Johnson will defeat coronavirus because he's a 'fighter'  The Independent
6. View Full Coverage on Google News

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2020-04-09 07:51:50Z
52780704870161

750000 people volunteered to help Britain's NHS. Now they're being deployed. - The Washington Post

Justin Setterfield Getty Images Taxi driver Michael Hayes has been offering free rides home to health workers at Newham University Hospital in East London.

LONDON — When the British government asked people to help the National Health Service during the coronavirus crisis, it called for a “volunteer army.” Within four days, 750,000 people had signed up — three times the original target and four times the size of the British armed forces.

Britain hasn’t seen such a surge in volunteers since World War II, when the country pulled together in a way still remembered with immense pride. Now — with more than 60,000 people here having tested positive for the novel coronavirus, and with the prime minister among those who have been hospitalized — organizers are figuring out how to deploy the army, while individuals and companies are engaged in informal volunteer activities throughout the British Isles.

Michael Hayes, 55, is a taxi driver who joined the volunteer army and is awaiting his first official assignment. In the meantime, he spends about five hours a day driving NHS staff home, at no cost, from Newham University Hospital in East London, where his three children were born.

“Some of them come out, they’ve had dreadful days, the worst . . . and they are walking out thinking, ‘I still got to get home,’ I’m sort of like a little ray of sunshine,” Hayes said. “They see me sitting there and I whiz them home.”

Justin Setterfield

Getty Images

Michael Hayes waits outside Newham University Hospital. He has also answered a separate volunteer initiative run by the Royal Voluntary Service and is awaiting his assignment.

The organizers of the government effort said they were “starting slowly” with a soft launch last week, and an official launch Tuesday, when “thousands” of volunteers were offered assignments.

They aren’t involved in medical care. Another 12,000 former NHS workers said they would come back for that. Rather, the volunteers are supposed to help the elderly and others deemed especially vulnerable to the virus by doing such tasks as delivering groceries and medicine, driving people to appointments and conducting check-ins on those in self-isolation.

[Retired doctors in Italy are heading back into the fray to treat coronavirus patients]

“I was so excited I pushed ‘accept’ before I even read the job,” said Steve Pepper, 34, a warehouse manager in Norfolk who got a ping Sunday evening. The request: Buy groceries for a man with covid-19 symptoms who lived about a quarter-mile away.

Pepper said he hesitated over the question of how to pay. “I can’t afford to risk buying groceries for everyone around town,” he said. But he went ahead and spent $36 for “bread, milk, comfort food.” He said the recipient transferred him the money shortly after he dropped the groceries off outside of his door. Pepper said organizers called him to say next time he should use payment methods on their site.

“I think they are still fine-tuning it — this is my one and only task. But it was really good to get out there and finally help someone,” he said.

Starting this week, health professionals, pharmacists and local government authorities can upload requests to an app called GoodSam, which then connects them to an approved volunteer.

Julian Finney

Getty Images

A volunteer from GoodGym takes an order from a woman who can’t leave her house.

Many people are still waiting for assignments, and some have taken to social media to express confusion or frustration that their offer of services has so far been rejected or ignored.

Those who work in the volunteer sector say that the logistics of mobilizing 750,000 people, vetting volunteers, matching supply and demand, and ensuring that everyone is safe is a huge endeavor.

“I have admiration for how they have done it, but it’s a big task for anyone,” said Mark Lever, chief executive of Helpforce, a charity that works with volunteers in the NHS but isn’t involved in this particular project. “A big challenge is matching supply of volunteers, with the demand for their support. You could have loads of volunteers, but in the wrong place. Or volunteers happy to do three things, but your need is for the fourth one.”

Matthew McMurray, an archivist at the Royal Voluntary Service, a charity helping to organize the effort, said that one of the parallels between World War II and today is that a spike in volunteering followed a specific event. McMurray said that after bombs began falling in January and February of 1940, volunteers signed up in droves. Likewise, he noted that the government’s call for volunteers came the day after lockdown measures were announced. “People need to see a crisis and experience it,” he said.

[In fight against coronavirus, the world gives medical heroes a standing ovation]

Up and down the country, individuals and companies are doing their part — including helping local charities and organizing neighborhood WhatsApp groups. In West Sussex, Rolls-Royce Motor Cars has made its fleet of autos, including limousines, available for essential deliveries. In London, museums have donated masks and gloves they normally use to handle artwork. In Cornwall, a volunteer group called Flu Friends — formed 10 years ago to help ill and isolated people during the swine flu pandemic — is back in action in the rugged tip of England.

Julian Finney

Getty Images

A runner from GoodGym returns from delivering food to a woman in London.

GoodGym is a charity group that for years combined exercise and outreach with runners as fleet-footed do-gooders completing fix-it jobs for the community. Now, its runners are answering a spike in food and pharmacy delivery requests.

“What I’m amazed about is people’s appetite for doing this under difficult circumstances,” said founder Ivo Gormley.

Damian Lewis, the British star of the drama series “Homeland,” and his wife, actress Helen McCrory, count dozens of NHS doctors and nurses as their London neighbors. McCrory is the daughter of a retired NHS worker, as well. At first, the couple sent pizzas to local hospitals to show their support. Then, with comedian Matt Lucas, they created FeedNHS to raise money — over $1 million so far — and partnered with fast-food chain Leon with the goal of delivering 6,000 meals a day.

“I don’t think NHS will mind me saying this: It’s not known for the quality of its food. And there are only so many grilled cheese sandwiches you can eat,” Lewis said.

John Vincent, Leon’s chief executive, said the teams were working flat out. Everyone’s contribution is seen as vital, he said: “I think it is waking people up. . . . We are learning about reconnecting with each other.”

George Selley

Lucy Zacaria and Andy Smith work as volunteers from the Imperial Health Charity, receiving food at Charing Cross Hospital from FeedNHS.

Tom George, 50, retired deputy commissioner for the London Fire Brigade, signed up to be an NHS volunteer and has had his app set to “on duty” for over a week, waiting for the siren to ring. In the meantime, he’s helping out his neighbors and his mother.

“In Britain, when we need to, when the going gets tough, most people want to help where possibly they can,” he said, adding, “everyone is locked down anyway, so in that sense, I’m not surprised that 750,000 have signed up.”

Read more

Meals on Wheels volunteers are staying home. College kids are filling the gap.

A Virginia man wanted to help those in need. He surprised shoppers by paying for their groceries.

How you can help during the coronavirus outbreak

Today’s coverage from Post correspondents around the world

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2020-04-09 07:25:09Z
CAIiEAbfAscItAzAh-SSV9u61XAqGAgEKg8IACoHCAowjtSUCjC30XQwn6G5AQ

Eight U.K. Doctors Died From Coronavirus. All Were Immigrants. - The New York Times

LONDON — The eight men moved to Britain from different corners of its former empire, all of them doctors or doctors-to-be, becoming foot soldiers in the effort to build a free universal health service after World War II.

Now their names have become stacked atop a grim list: the first, and so far only, doctors publicly reported to have died after catching the coronavirus in Britain’s aching National Health Service.

For a country ripped apart in recent years by Brexit and the anti-immigrant movement that birthed it, the deaths of the eight doctors — from Egypt, India, Nigeria, Pakistan, Sri Lanka and Sudan — attest to the extraordinary dependence of Britain’s treasured health service on workers from abroad.

It is a story tinged with racism, as white, British doctors have largely dominated the prestigious disciplines while foreign doctors have typically found work in places and practices that are apparently putting them on the dangerous front lines of the coronavirus pandemic.

“When people were standing on the street clapping for N.H.S. workers, I thought, ‘A year and a half ago, they were talking about Brexit and how these immigrants have come into our country and want to take our jobs,’” said Dr. Hisham el-Khidir, whose cousin Dr. Adil el-Tayar, a transplant surgeon, died on March 25 from the coronavirus in western London.

“Now today, it’s the same immigrants that are trying to work with the locals,” said Dr. el-Khidir, a surgeon in Norwich, “and they are dying on the front lines.”

By Tuesday, 7,097 people had died in British hospitals from the coronavirus, the government said on Wednesday, a leap of 938 from the day before, the largest daily rise in the death toll.

And the victims have included not just the eight doctors but a number of nurses who worked alongside them, at least one from overseas. Health workers are stretched thin as hospitals across the country are filled with patients, including Prime Minister Boris Johnson, who this week was moved into intensive care with the coronavirus.

Britain is not the only country reckoning with its debt to foreign doctors amid the terror and chaos of the pandemic. In the United States, where immigrants make up more than a quarter of all doctors but often face long waits for green cards, New York and New Jersey have already cleared the way for graduates of overseas medical schools to suit up in the coronavirus response.

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But Britain, where nearly a third of doctors in National Health Service hospitals are immigrants, has especially strong links to the medical school systems of its former colonies, making it a natural landing place.

That was true for Dr. el-Tayar, 64, the oldest son of a government clerk and a housewife from Atbara, Sudan, a railway city on the Nile.

He had 11 siblings, and one left a special impression: Osman, a brother, who became ill as a child and died without suitable medical treatment. Though Dr. el-Tayar rarely spoke of his brother’s death, he gave the same name to his oldest son.

“In my mind, I think that’s what led him to medicine,” Dr. el-Khidir said. “He didn’t want anyone else in his family to feel that.”

Dr. Adil El-Tayar

After graduating from the University of Khartoum, Dr. el-Tayar decided to help address a tide of kidney disease sweeping across sub-Saharan Africa. So he moved to Britain in the early 1990s to train as a specialist transplant surgeon. He returned to Sudan around 2010 and helped set up a transplant program there.

But the deteriorating political situation in Sudan and the recent birth of a son persuaded Dr. el-Tayar to settle back in Britain, where he went to work once again for the health service. Having lost his status as a senior doctor when he left for Sudan, he had taken up work filling in at a surgical assessment unit in Herefordshire, northwest of London, examining patients coming through the emergency room.

It was there that his family believes Dr. el-Tayar, working with only rudimentary protective gear, contracted the virus. Sequestered in the western London home where he loved sitting next to his 12-year-old son, he became so short of breath recently that he could not string together a sentence. While on a ventilator, his heart failed him.

Had the health service started screening hospital patients for the virus sooner or supplied doctors with better protective gear, Dr. el-Tayar might have lived, said his cousin, Dr. el-Khidir.

“In our morbidity analyses, we go through each and every case and ask, ‘Was it preventable? Was it avoidable?’” he said. “I’m trying to answer this question with my cousin now. Even with all the difficulties, I’ve got to say the answer has to be yes.”

Analysts warn that doctor shortages across countries ravaged by the coronavirus will worsen as the virus spreads. While ventilators may be the scarcest resource for now, a shortage of doctors and nurses trained to operate them could leave hospitals struggling to make use even of what they have.

By recruiting foreign doctors, Britain saves the roughly $270,000 in taxpayer money that it costs to train doctors locally, a boon to a system that does not spend enough on medical education to staff its own hospitals. That effectively leaves Britain depending on the largess of countries with weaker health care systems to train its own work force.

Even so, the doctors are hampered by thousands of dollars in annual visa fees and, on top of that, a $500 surcharge for using the very health service they work for.

Excluded from the most prestigious disciplines, immigrant doctors have come to dominate so-called Cinderella specialties, like family and elderly medicine, turning them into pillars of Britain’s health system. And unlike choosier Britain-born doctors, they have historically gone to work in what one lawmaker in 1961 called “the rottenest, worst hospitals in the country,” the very ones that most needed a doctor.

Those same places are now squarely in the path of the virus.

“Migrant doctors are architects of the N.H.S. — they’re what built it and held it together and worked in the most unpopular, most difficult areas, where white British doctors don’t want to go and work,” said Dr. Aneez Esmail, a professor of general practice at the University of Manchester. “It’s a hidden story.”

When Dr. el-Tayar moved to Britain in the 1990s, he was following a pipeline laid by the family of another doctor who has now died after contracting the coronavirus: Dr. Amged el-Hawrani, 55.

An ear, nose and throat specialist, Dr. el-Hawrani was about 11 when his father, a radiologist, brought the family in 1975 from Khartoum to Taunton, a town in southwestern England, and then Bristol, a bigger city nearby.

Dr. Amged el-HawraniCredit...University Hospitals of Derby and Burton NHS Foundation Trust/Agence France-Presse — Getty Images

Many Sudanese doctors at the time were burnishing their skills in Britain before returning home or moving to Persian Gulf countries for higher wages. But Dr. el-Hawrani’s family turned their home into a staging post for Sudanese doctors interested in longer-term stays, hosting their families during exams or house hunts.

“The more the merrier,” said Amal el-Hawrani, a younger brother of Dr. el-Hawrani. “My mum always liked that.”

Being British-Sudanese in the 1980s was not easy. Race riots flared in cities across the country. Mosques were scarce. Dr. el-Hawrani went to school almost exclusively with white British classmates.

The young doctor quietly stood up for his family: When someone once tried to kill a 100-year-old fern in their garden by cutting out a ring of bark, Dr. el-Hawrani snapped off branches and nailed them across the gap so that nutrients could get across.

Still, discrimination bothered him. When it came time to follow his father into medicine, Dr. el-Hawrani told his brother that he “wanted to be an orthopedic surgeon but felt that maybe because of certain prejudices he didn’t get it.”

His resolve only grew stronger after an older brother, Ashraf, a fellow doctor, died at 29 of causes related to asthma. Dr. el-Hawrani discovered his brother’s body.

Before Dr. el-Hawrani’s death, on March 28, he had finally come around to the idea that his only son, Ashraf, named in his brother’s memory, would study English instead of the family trade. Ashraf said in a statement that his father “was dedicated towards his family.”

“Now he has to make his decisions about which university to go to on his own,” Amal el-Hawrani said of Ashraf. “He was expecting to have his father’s help.”

The coronavirus has taken a devastating toll on migrant doctors across Britain, leaving at least six others dead: Dr. Habib Zaidi, 76, a longtime general practitioner from Pakistan; Dr. Alfa Sa’adu, 68, a geriatric doctor from Nigeria; Dr. Jitendra Rathod, 62, a heart surgeon from India; Dr. Anton Sebastianpillai, in his 70s, a geriatric doctor from Sri Lanka; Dr. Mohamed Sami Shousha, 79, a breast tissue specialist from Egypt; and Dr. Syed Haider, in his 80s, a general practitioner from Pakistan.

Barry Hudson, a longtime patient of Dr. Zaidi in southeastern England, recalled their exam table conversations about England’s cricket team.

“He was a big figure in the community,” Mr. Hudson said. “He had a proper doctor’s manner. He didn’t rush anybody.”

Dr. Habib ZaidiCredit...NHS Southend CCG

For families that love to gather, grieving at a distance has been wrenching.

Dr. el-Tayar was buried beside his father and grandfather in Sudan, as he had wanted. But because only cargo planes were flying there, his wife and children could not accompany the coffin.

At Dr. el-Hawrani’s burial, an imam said a prayer before a small, spread-out crowd, and the doctor’s four living brothers and son lowered his coffin into the ground. Then they dispersed.

His brother, Amal el-Hawrani, permitted himself a single intimacy: a hug with his mother, because “I couldn’t turn that away,” he said.

Then she returned to her home in Bristol, along with a son who had visited Dr. el-Hawrani in the hospital. Fearful of passing on the virus, he had to forbid her from his room to keep her from bringing in food.

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2020-04-08 20:30:02Z
CAIiEIkxDU7OT5BzlrboWjB6sx4qFwgEKg8IACoHCAowjuuKAzCWrzwwt4QY

750000 people volunteered to help Britain's NHS. Now they're being deployed. - The Washington Post

Justin Setterfield Getty Images Taxi driver Michael Hayes has been offering free rides home to health workers at Newham University Hospital in East London.

LONDON — When the British government asked people to help the National Health Service during the coronavirus crisis, it called for a “volunteer army.” Within four days, 750,000 people had signed up — three times the original target and four times the size of the British armed forces.

Britain hasn’t seen such a surge in volunteers since World War II, when the country pulled together in a way still remembered with immense pride. Now — with more than 60,000 people here having tested positive for the coronavirus, and with the prime minister among those who have been hospitalized — organizers are figuring out how to deploy the army, while individuals and companies are engaged in informal volunteer activities throughout the British Isles.

Michael Hayes, 55, is a taxi driver who joined the volunteer army and is awaiting his first official assignment. In the meantime, he spends about five hours a day driving NHS staff home, at no cost, from Newham University Hospital in East London, where his three children were born.

“Some of them come out, they’ve had dreadful days, the worst . . . and they are walking out thinking, ‘I still got to get home,’ I’m sort of like a little ray of sunshine,” Hayes said. “They see me sitting there and I whiz them home.”

Justin Setterfield

Getty Images

Michael Hayes waits outside Newham University Hospital. He has also answered a separate volunteer initiative run by the Royal Voluntary Service and is awaiting his assignment.

The organizers of the government effort said they were “starting slowly” with a soft launch last week, and an official launch Tuesday, when “thousands” of volunteers were offered assignments.

They aren’t involved in medical care. Another 12,000 former NHS workers said they would come back for that. Rather, the volunteers are supposed to help the elderly and others deemed especially vulnerable to the virus by doing such tasks as delivering groceries and medicine, driving people to appointments and conducting check-ins on those in self-isolation.

[Retired doctors in Italy are heading back into the fray to treat coronavirus patients]

“I was so excited I pushed ‘accept’ before I even read the job,” said Steve Pepper, 34, a warehouse manager in Norfolk who got a ping Sunday evening. The request: Buy groceries for a man with covid-19 symptoms who lived about a quarter mile away.

Pepper said he hesitated over the question of how to pay. “I can’t afford to risk buying groceries for everyone around town,” he said. But he went ahead and spent $36 for “bread, milk, comfort food.” He said the recipient transferred him the money shortly after he dropped the groceries off outside of his door. Pepper said organizers called him to say next time he should use payment methods on their site.

“I think they are still fine-tuning it — this is my one and only task. But it was really good to get out there and finally help someone,” he said.

Starting this week, health professionals, pharmacists and local government authorities can upload requests to an app called GoodSam, which then connects them to an approved volunteer.

Julian Finney

Getty Images

A volunteer from GoodGym takes an order from a woman who can’t leave her house.

Many people are still waiting for assignments, and some have taken to social media to express confusion or frustration that their offer of services has so far been rejected or ignored.

Those who work in the volunteer sector say that the logistics of mobilizing 750,000 people, vetting volunteers, matching supply and demand, and ensuring that everyone is safe is a massive challenge.

“I have admiration for how they have done it, but it’s a big task for anyone,” said Mark Lever, chief executive of Helpforce, a charity that works with volunteers in the NHS but isn’t involved in this particular project. “A big challenge is matching supply of volunteers, with the demand for their support. You could have loads of volunteers, but in the wrong place. Or volunteers happy to do three things, but your need is for the fourth one.”

Matthew McMurray, an archivist at the Royal Voluntary Service, a charity helping to organize the effort, said that one of the parallels between WWII and today is that a spike in volunteering followed a specific event. McMurray said that after bombs began falling in January and February of 1940, volunteers signed up in droves. Likewise, he noted that the government’s call for volunteers came the day after lockdown measures were announced. “People need to see a crisis and experience it,” he said.

[In fight against coronavirus, the world gives medical heroes a standing ovation]

Up and down the country, individuals and companies are doing their part — including helping local charities and organizing neighborhood WhatsApp groups. In West Sussex, Rolls-Royce Motor Cars has made its fleet of cars, including limousines, available for essential deliveries. In London, museums have donated masks and gloves they normally use to handle artwork. In Cornwall, a volunteer group called Flu Friends — formed 10 years ago to help ill and isolated people during the swine flu pandemic — is back in action in the rugged tip of England.

Julian Finney

Getty Images

A runner from GoodGym returns from delivering food to a woman in London.

GoodGym is a charity group that for years combined exercise and outreach with runners as fleet-footed do-gooders completing fix-it jobs for the community. Now, its runners are answering a spike in food and pharmacy delivery requests.

“What I’m amazed about is people’s appetite for doing this under difficult circumstances,” said founder Ivo Gormley.

Damian Lewis, the British star of the drama series “Homeland,” and his wife, actress Helen McCrory, count dozens of NHS doctors and nurses as their London neighbors. McCrory is the daughter of a retired NHS worker, as well. At first, the couple sent pizzas to local hospitals to show their support. Then, with comedian Matt Lucas, they created FeedNHS to raise money — over $1 million so far — and partnered with fast-food chain Leon with the goal of delivering 6,000 meals a day.

“I don’t think NHS will mind me saying this: It’s not known for the quality of its food. And there are only so many grilled cheese sandwiches you can eat,” Lewis said.

John Vincent, Leon chief executive, said the teams were working flat out. Everyone’s contribution is seen as vital, he said. “I think it is waking people up. . . . We are learning about reconnecting with each other.”

George Selley

Lucy Zacaria and Andy Smith work as volunteers from the Imperial Health Charity, receiving food at Charing Cross Hospital from FeedNHS.

Tom George, 50, retired deputy commissioner for the London Fire Brigade, signed up to be an NHS volunteer and has had his app set to “on duty” for over a week, waiting for the siren to ring. In the meantime, he’s helping out his neighbors and his mother.

“In Britain, when we need to, when the going gets tough, most people want to help where possibly they can,” he said, adding, “everyone is locked down anyway, so in that sense, I’m not surprised that 750,000 have signed up.”

Read more

Meals on Wheels volunteers are staying home. College kids are filling the gap.

A Virginia man wanted to help those in need. He surprised shoppers by paying for their groceries.

How you can help during the coronavirus outbreak

Today’s coverage from Post correspondents around the world

Like Washington Post World on Facebook and stay updated on foreign news

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2020-04-08 20:14:10Z
CAIiEAbfAscItAzAh-SSV9u61XAqGAgEKg8IACoHCAowjtSUCjC30XQwn6G5AQ

New US model predicts much higher Covid-19 death toll in UK. But British scientists are skeptical - CNN

The grim forecast came from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington's School of Medicine in Seattle on Tuesday. It predicted 66,314 people would die of Covid-19 in the UK by early August.

The British government's plan for tackling the epidemic has been largely informed by a study from the Imperial College London, which said that a lockdown and social distancing measures would -- hopefully -- limit the number of deaths to between 20,000 and 30,000.

But several high-profile scientists in the UK have already voiced their concerns over the IHME model.

Professor Sylvia Richardson, of Cambridge University and the co-chair of the Royal Statistical Society Task Force on Covid-19, told the Science Media Centre the projections are based on "very strong assumptions about the way the epidemic will progress."

She said the model was "based mostly on using the experience in other countries to fit a smooth curve to the counts of deaths reported so far in the UK, rather than any modeling of the epidemic itself."

"Methods like this are well known for being extremely sensitive, and are likely to change dramatically as new information comes in," Richardson added.

Racing against the clock

Like most other countries, the UK has been racing to increase its healthcare capacity ahead of the predicted peak of the epidemic. A new field hospital in east London with a capacity of up to 5,000 beds, the NHS Nightingale, accepted its first patients on Wednesday.

However, the IHME model suggests this might not be enough. It said the shortage of intensive care (ICU) beds would peak at 23,745 on April 17.

The IHME said the peak demand in the UK is expected to total 102,794 hospital beds, which compares to the 17,765 currently available. It added that 24,544 ICU beds will be needed, compared to the 799 beds it estimates will be available.

Professor David Spiegelhalter, who chairs the Winton Centre for Risk and Evidence Communication at University of Cambridge, told the Science Media Centre he was "very skeptical" of the projections.

"[They] are based on assuming a rather simple mathematical model for the whole course of the epidemic," he said. "I suspect they will change a lot as new data arrives -- we shall see."

Epidemiological modeling is a tricky discipline, because it relies in part on assumptions. The models often need updating as more data comes in.

"The outputs of any model should not really be treated as a prediction of what is going to happen," said Dr. Simon Gubbins, head of the Transmission Biology Group at The Pirbright Institute in England. "Rather they represent plausible scenarios, based on knowledge at the time they were generated and assumptions made in the model ... that can be used to help inform decisions of policy makers," he told the Science Media Centre.

The authors of the IHME forecast admit their model is highly uncertain, giving the range of possible deaths in the UK as between 55,022 and 79,995.

This was the first time the IHME team published models for several European countries, including the UK. On Wednesday, the institute updated its US forecast, predicting 60,415 deaths in the country, significantly fewer than the 82,000 it predicted on Tuesday.

The researchers based their findings on models of the peak in death rates and hospital usage in Wuhan, the Chinese city which was the original epicenter of the outbreak, as well as data from seven European locations that have peaked, including the Spanish capital of Madrid and the Lombardy region in Italy.

They also factored in data from local and national governments, the World Health Organization and information on each country's social distancing policies.

CNN's Vasco Cotovio in London contributed to this report.

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2020-04-08 18:28:00Z
52780711171702

Eight U.K. Doctors Died From Coronavirus. All Were Immigrants. - The New York Times

LONDON — The eight men moved to Britain from different corners of its former empire, all of them doctors or doctors-to-be, becoming foot soldiers in the effort to build a free universal health service after World War II.

Now their names have become stacked atop a grim list: the first, and so far only, doctors publicly reported to have died after catching the coronavirus in Britain’s aching National Health Service.

For a country ripped apart in recent years by Brexit and the anti-immigrant movement that birthed it, the deaths of the eight doctors — from Egypt, India, Nigeria, Pakistan, Sri Lanka and Sudan — attest to the extraordinary dependence of Britain’s treasured health service on workers from abroad.

It is a story tinged with racism, as white, British doctors have largely dominated the prestigious disciplines while foreign doctors have typically found work in places and practices that are apparently putting them on the dangerous front lines of the coronavirus pandemic.

“When people were standing on the street clapping for N.H.S. workers, I thought, ‘A year and a half ago, they were talking about Brexit and how these immigrants have come into our country and want to take our jobs,’” said Dr. Hisham el-Khidir, whose cousin Dr. Adil el-Tayar, a transplant surgeon, died on March 25 from the coronavirus in western London.

“Now today, it’s the same immigrants that are trying to work with the locals,” said Dr. el-Khidir, a surgeon in Norwich, “and they are dying on the front lines.”

By Tuesday, 7,097 people had died in British hospitals from the coronavirus, the government said on Wednesday, a leap of 938 from the day before, the largest daily rise in the death toll.

And the victims have included not just the eight doctors but a number of nurses who worked alongside them, at least one from overseas. Health workers are stretched thin as hospitals across the country are filled with patients, including Prime Minister Boris Johnson, who this week was moved into intensive care with the coronavirus.

Britain is not the only country reckoning with its debt to foreign doctors amid the terror and chaos of the pandemic. In the United States, where immigrants make up more than a quarter of all doctors but often face long waits for green cards, New York and New Jersey have already cleared the way for graduates of overseas medical schools to suit up in the coronavirus response.

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But Britain, where nearly a third of doctors in National Health Service hospitals are immigrants, has especially strong links to the medical school systems of its former colonies, making it a natural landing place.

That was true for Dr. el-Tayar, 64, the oldest son of a government clerk and a housewife from Atbara, Sudan, a railway city on the Nile.

He had 11 siblings, and one left a special impression: Osman, a brother, who became ill as a child and died without suitable medical treatment. Though Dr. el-Tayar rarely spoke of his brother’s death, he gave the same name to his oldest son.

“In my mind, I think that’s what led him to medicine,” Dr. el-Khidir said. “He didn’t want anyone else in his family to feel that.”

Dr. Adil El-Tayar

After graduating from the University of Khartoum, Dr. el-Tayar decided to help address a tide of kidney disease sweeping across sub-Saharan Africa. So he moved to Britain in the early 1990s to train as a specialist transplant surgeon. He returned to Sudan around 2010 and helped set up a transplant program there.

But the deteriorating political situation in Sudan and the recent birth of a son persuaded Dr. el-Tayar to settle back in Britain, where he went to work once again for the health service. Having lost his status as a senior doctor when he left for Sudan, he had taken up work filling in at a surgical assessment unit in Herefordshire, northwest of London, examining patients coming through the emergency room.

It was there that his family believes Dr. el-Tayar, working with only rudimentary protective gear, contracted the virus. Sequestered in the western London home where he loved sitting next to his 12-year-old son, he became so short of breath recently that he could not string together a sentence. While on a ventilator, his heart failed him.

Had the health service started screening hospital patients for the virus sooner or supplied doctors with better protective gear, Dr. el-Tayar might have lived, said his cousin, Dr. el-Khidir.

“In our morbidity analyses, we go through each and every case and ask, ‘Was it preventable? Was it avoidable?’” he said. “I’m trying to answer this question with my cousin now. Even with all the difficulties, I’ve got to say the answer has to be yes.”

Analysts warn that doctor shortages across countries ravaged by the coronavirus will worsen as the virus spreads. While ventilators may be the scarcest resource for now, a shortage of doctors and nurses trained to operate them could leave hospitals struggling to make use even of what they have.

By recruiting foreign doctors, Britain saves the roughly $270,000 in taxpayer money that it costs to train doctors locally, a boon to a system that does not spend enough on medical education to staff its own hospitals. That effectively leaves Britain depending on the largess of countries with weaker health care systems to train its own work force.

Even so, the doctors are hampered by thousands of dollars in annual visa fees and, on top of that, a $500 surcharge for using the very health service they work for.

Excluded from the most prestigious disciplines, immigrant doctors have come to dominate so-called Cinderella specialties, like family and elderly medicine, turning them into pillars of Britain’s health system. And unlike choosier Britain-born doctors, they have historically gone to work in what one lawmaker in 1961 called “the rottenest, worst hospitals in the country,” the very ones that most needed a doctor.

Those same places are now squarely in the path of the virus.

“Migrant doctors are architects of the N.H.S. — they’re what built it and held it together and worked in the most unpopular, most difficult areas, where white British doctors don’t want to go and work,” said Dr. Aneez Esmail, a professor of general practice at the University of Manchester. “It’s a hidden story.”

When Dr. el-Tayar moved to Britain in the 1990s, he was following a pipeline laid by the family of another doctor who has now died after contracting the coronavirus: Dr. Amged el-Hawrani, 55.

An ear, nose and throat specialist, Dr. el-Hawrani was about 11 when his father, a radiologist, brought the family in 1975 from Khartoum to Taunton, a town in southwestern England, and then Bristol, a bigger city nearby.

Dr. Amged el-HawraniCredit...University Hospitals of Derby and Burton NHS Foundation Trust/Agence France-Presse — Getty Images

Many Sudanese doctors at the time were burnishing their skills in Britain before returning home or moving to Persian Gulf countries for higher wages. But Dr. el-Hawrani’s family turned their home into a staging post for Sudanese doctors interested in longer-term stays, hosting their families during exams or house hunts.

“The more the merrier,” said Amal el-Hawrani, a younger brother of Dr. el-Hawrani. “My mum always liked that.”

Being British-Sudanese in the 1980s was not easy. Race riots flared in cities across the country. Mosques were scarce. Dr. el-Hawrani went to school almost exclusively with white British classmates.

The young doctor quietly stood up for his family: When someone once tried to kill a 100-year-old fern in their garden by cutting out a ring of bark, Dr. el-Hawrani snapped off branches and nailed them across the gap so that nutrients could get across.

Still, discrimination bothered him. When it came time to follow his father into medicine, Dr. el-Hawrani told his brother that he “wanted to be an orthopedic surgeon but felt that maybe because of certain prejudices he didn’t get it.”

His resolve only grew stronger after an older brother, Ashraf, a fellow doctor, died at 29 of causes related to asthma. Dr. el-Hawrani discovered his brother’s body.

Before Dr. el-Hawrani’s death, on March 28, he had finally come around to the idea that his only son, Ashraf, named in his brother’s memory, would study English instead of the family trade. Ashraf said in a statement that his father “was dedicated towards his family.”

“Now he has to make his decisions about which university to go to on his own,” Amal el-Hawrani said of Ashraf. “He was expecting to have his father’s help.”

The coronavirus has taken a devastating toll on migrant doctors across Britain, leaving at least six others dead: Dr. Habib Zaidi, 76, a longtime general practitioner from Pakistan; Dr. Alfa Sa’adu, 68, a geriatric doctor from Nigeria; Dr. Jitendra Rathod, 62, a heart surgeon from India; Dr. Anton Sebastianpillai, in his 70s, a geriatric doctor from Sri Lanka; Dr. Mohamed Sami Shousha, 79, a breast tissue specialist from Egypt; and Dr. Syed Haider, in his 80s, a general practitioner from Pakistan.

Barry Hudson, a longtime patient of Dr. Zaidi in southeastern England, recalled their exam table conversations about England’s cricket team.

“He was a big figure in the community,” Mr. Hudson said. “He had a proper doctor’s manner. He didn’t rush anybody.”

Dr. Habib ZaidiCredit...NHS Southend CCG

For families that love to gather, grieving at a distance has been wrenching.

Dr. el-Tayar was buried beside his father and grandfather in Sudan, as he had wanted. But because only cargo planes were flying there, his wife and children could not accompany the coffin.

At Dr. el-Hawrani’s burial, an imam said a prayer before a small, spread-out crowd, and the doctor’s four living brothers and son lowered his coffin into the ground. Then they dispersed.

His brother, Amal el-Hawrani, permitted himself a single intimacy: a hug with his mother, because “I couldn’t turn that away,” he said.

Then she returned to her home in Bristol, along with a son who had visited Dr. el-Hawrani in the hospital. Fearful of passing on the virus, he had to forbid her from his room to keep her from bringing in food.

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2020-04-08 16:27:05Z
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Boris Johnson is 'stable' in ICU amid questions about who's running the UK - CNN

Johnson's condition is stable and he "remains in good spirits," his spokesperson said. He has not required invasive or non-invasive ventilation and does not have pneumonia.

But the seriousness of the Prime Minister's condition at a time of national emergency, combined with the lack of a formal succession procedure for heads of government in the UK, has raised questions about who is leading the country.

Johnson has nominated his Foreign Secretary, Dominic Raab, to deputize for him "as necessary" but there is no recent precedent for a sitting UK prime minister becoming incapacitated for a lengthy period.

In its daily update to reporters, Downing Street moved to head off concerns, stressing that Raab was running the country from the Foreign and Commonwealth Office with the support of government officials.

Raab would chair meetings of the National Security Council if any were needed while he was deputizing for the Prime Minister, a spokesperson said. Raab, 46, and the UK's Cabinet have the authority and ability to respond in the PM's absence on military action, the spokesperson added.

Decisions relating to Covid-19 would be taken in the usual way through the daily morning meeting, chaired by Raab, and other ministerial groupings. But Raab would not have the power to hire and fire ministers or officials, the spokesperson said.

The UK lockdown will remain in place with the government "focused on stopping the spread of the infection." The spokesperson said that if there were evidence that more needed to be done to slow the rate of transmission, "we would be prepared to do that."

Who is running the UK?

Few formal powers are invested specifically in the UK prime minister and key decisions are taken collectively by the Cabinet or its sub-committees. Many statutory powers are held by individual secretaries of state. But in recent decades, holders of the UK's top political office have adopted a more presidential style, and the sweeping nature of the ruling Conservative Party's most recent election victory was attributed to Johnson's personal appeal with voters.

"The Prime Minister has a team around him who ensure the work of government goes on," a senior Cabinet minister, Michael Gove, told the BBC earlier. He sidestepped a question about who would take decisions in the event of a nuclear attack, saying he would not discuss national security issues.

Conservative MP Tobias Ellwood, who chairs the House of Commons defense select committee, tweeted good wishes to Johnson but added: "It is important to have 100% clarity as to where responsibility for UK national security decisions now lies. We must anticipate adversaries attempting to exploit any perceived weakness."

Buckingham Palace and the Queen have been regularly updated on Johnson's condition, Downing Street said. The Prime Minister's two most senior officials, the cabinet secretary and his principal private secretary, will maintain contact with the palace on the Prime Minister's behalf, but the weekly audiences with the Queen will not continue for the time being.

The Queen has sent a message to Johnson's pregnant fiancée Carrie Symonds and the Johnson family. "Her Majesty said they were in her thoughts and that she wished the Prime Minister a full and speedy recovery," Buckingham Palace said.

The Duke of Cambridge also sent his best wishes. "Our thoughts are with the Prime Minister and his family, who like so many in the UK and around the world are affected by coronavirus," said Prince William.

Johnson's spokesperson said that despite the lack of a formal succession procedure in the UK, there was an established order of ministerial precedence, with the top finance minister, Rishi Sunak following Raab. The "letters of last resort," sealed documents written by the Prime Minister to ballistic missile submarine commanders in case of a nuclear attack, still stand. "The Prime Minister remains the Prime Minister," the spokesperson said.

US President Donald Trump said at a Monday news conference that his administration had been in contact with Johnson's doctors. The Prime Minister's spokesperson said the government was "grateful for all of the warm wishes the PM has received overnight" and "confident he is receiving the best care from the NHS. Any treatment he receives is a matter for his doctors."

Gove told BBC Radio 4's Today program earlier that Johnson was "receiving the very best care" at St. Thomas' Hospital in London, after being taken into intensive care at 7 p.m. local time (2 p.m. ET) on Monday. Gove later said that he was self-isolating at home because a member of his family was displaying coronavirus symptoms. Gove said on Twitter that he did not have any symptoms and was continuing to work.

The coronavirus has hit the top of the British government hard. The Health Secretary, Matt Hancock, said on March 27 that he had the virus, on the same day that the chief medical officer, Chris Whitty, announced that he would begin self-isolation after displaying Covid-19 symptoms. Neil Ferguson, a top UK government adviser on the virus, said on March 18 he believed he had been infected.

Various other senior government ministers and advisers have been forced to self-isolate. Dominic Cummings, the Prime Minister's senior adviser, who self-isolated soon after Johnson's diagnosis, has not yet returned to work, Downing Street said.

Johnson was taken to hospital on Sunday evening. At the time, Downing Street said the decision was a precaution because he continued to suffer from a cough and a fever ten days after testing positive for the coronavirus. But his condition deteriorated on Monday, Downing Street said, and he was moved to the intensive care unit at St. Thomas' Hospital.

Gove told Sky News on Tuesday morning that Cabinet ministers were not told about the Prime Minister's deteriorating condition until nearly an hour after Johnson was taken into intensive care.

Asked whether the government had been up front with the public about Johnson's condition, and whether the Cabinet had been taken by surprise, he replied: "Yes we were. The [daily coronavirus] briefing that was given at 5 o'clock was given at a time when we didn't know about the deterioration in the Prime Minister's condition."

"We were informed subsequently. The Prime Minister was admitted to intensive care at 7 o'clock, and that information wasn't given to us in government -- to those in the cabinet -- until just before 8 o'clock."

Words of support

Politicians around the world sent best wishes for the Prime Minister's recovery.

Finance minister Sunak said on Twitter that his thoughts were with Johnson and his fiancée, Symonds. "I know he'll be getting the best care possible and will come out of this even stronger," he said.

Symonds has also experienced Covid-19 symptoms but said over the weekend she was "on the mend."

The Speaker of the UK's House of Commons, Lindsay Hoyle, said: "I know the thoughts and prayers of everyone across the House are with the Prime Minister and his family right now. We all wish him a speedy recovery."

Keir Starmer, the newly elected leader of the UK's main opposition Labour Party leader, tweeted: "Terribly sad news. All the country's thoughts are with the Prime Minister and his family during this incredibly difficult time."

Former Prime Minister Theresa May, who was replaced by Johnson in the country's Brexit crisis, wrote on Twitter said her "thoughts and prayers" were with Johnson and his family. "This horrific virus does not discriminate," she added.

French President Emmanuel Macron sent his "support to Boris Johnson, to his family and to the British people at this difficult moment," wishing him a "speedy recovery at this testing time."

Irish leader Leo Varadkar, who has returned to work as a doctor during the outbreak, tweeted that Johnson was "in our thoughts" on Monday night and wished him "a rapid return to health."

President Trump said on Monday: "We're very saddened to hear that he was taken into intensive care this a little while ago. He's been a really good friend. He's been really something very special. Strong. Resolute."

Clarification: This story has been updated to reflect Hoyle's role.

CNN's Angela Dewan also contributed reporting.

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2020-04-08 11:42:49Z
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