Tuesday, May 05, 2020


Exclusive: Trump administration drafting 'Artemis Accords' pact for moon mining - sources
MAY 5, 2020 

WASHINGTON(Reuters) - The Trump administration is drafting a legal blueprint for mining on the moon under a new U.S.-sponsored international agreement called the Artemis Accords, people familiar with the proposed pact told Reuters.

The agreement would be the latest effort to cultivate allies around NASA’s plan to put humans and space stations on the moon within the next decade, and comes as the civilian space agency plays a growing role in implementing American foreign policy. The draft pact has not been formally shared with U.S. allies yet.

The Trump administration and other spacefaring countries see the moon as a key strategic asset in outer space. The moon also has value for long-term scientific research that could enable future missions to Mars - activities that fall under a regime of international space law widely viewed as outdated.

The Artemis Accords, named after the National Aeronautics and Space Administration’s new Artemis moon program, propose “safety zones” that would surround future moon bases to prevent damage or interference from rival countries or companies operating in close proximity.

The pact also aims to provide a framework under international law for companies to own the resources they mine, the sources said.

In the coming weeks, U.S. officials plan to formally negotiate the accords with space partners such as Canada, Japan, and European countries, as well as the United Arab Emirates, opening talks with countries the Trump administration sees as having “like-minded” interests in lunar mining.

Russia, a major partner with NASA on the International Space Station, won’t be an early partner in these accords, the sources said, as the Pentagon increasingly views Moscow as hostile for making “threatening” satellite maneuvers toward U.S. spy satellites in Earth orbit.

The United States is a member of the 1967 Outer Space Treaty and sees the “safety zones” as an implementation of one of its highly debated articles. It states that celestial bodies and the moon are “not subject to national appropriation by claim of sovereignty, by means of use or occupation, or by any other means.”

“This isn’t some territorial claim,” said one source, who requested anonymity to discuss the agreement. The safety zones - whose size would vary depending on the operation - would allow for coordination between space actors without technically claiming territory as sovereign, he said.

“The idea is if you are going to be coming near someone’s operations, and they’ve declared safety zones around it, then you need to reach out to them in advance, consult and figure out how you can do that safely for everyone.'


ARTEMIS AS ‘NATIONAL POWER’

The Artemis Accords are part of the Trump administration’s plan to forgo the treaty process at the United Nations and instead reach agreement with “like-minded nations,” partly because a treaty process would take too long and working with non-spacefaring states would be unproductive, a senior administration official told Reuters.

As countries increasingly treat space as a new military domain, the U.S.-led agreement is also emblematic of NASA’s growing role as a tool of American diplomacy and is expected to stoke controversy among Washington’s space rivals such as China.

“NASA’s all about science and technology and discovery, which are critically important, but I think less salient is the idea that NASA is a tool of diplomacy,” NASA administrator Jim Bridenstine said Tuesday.

“The important thing is, countries all around the world want to be a part of this. That’s the element of national power,” Bridenstine said, adding that participation in the Artemis program is contingent on countries adhering to “norms of behavior that we expect to see” in space.

NASA is investing tens of billions of dollars into the Artemis program, which calls for putting humans on the moon by 2024 and building up a “sustainable presence” on the lunar south pole thereafter, with private companies mining lunar rocks and subsurface water that can be converted to rocket fuel.

The United States enacted a law in 2015 granting companies the property rights to resources they mine in outer space, but no such laws exist in the international community.

Joanne Gabrynowicz, editor-in-chief emerita of the Journal of Space Law, said an international agreement must come before staking out “some kind of exclusive area for science or for whatever reason.”

“It is not anything any nation can do unilaterally and still have it be legal,” she said.

Reporting by Joey Roulette; editing by Bill Tarrant and Jonathan Oatis


U.N. Palestinian refugee agency operating on 'month-to-month' basis due to U.S. aid cut: official
JERUSALEM (Reuters) - Scrambling to tackle COVID-19 in camps across the Middle East, the U.N. agency supporting Palestinian refugees said on Tuesday it only has enough cash to operate until the end of May because of American funding cuts.

A Palestinian girl poses for a photo inside her family home in Jabalia refugee camp, one of the most densely populated areas in the world, amid concerns about the spread of the coronavirus disease (COVID-19), in the northern Gaza Strip May 5, 2020. REUTERS/Mohammed Salem


In 2018 President Donald Trump’s administration halted annual payments of $360 million to the United Nations Relief and Works Agency (UNRWA), which provides assistance to some 5.5 million registered refugees in the West Bank, Gaza Strip, East Jerusalem, Jordan, Lebanon and Syria.

Elizabeth Campbell, UNRWA’s director in Washington, told reporters that the loss of U.S. aid had a “corrosive impact” on the agency’s ability to help vulnerable people.

“We are basically operating on a month-to-month basis. Right now, we have funding to pay our 30,000 health care workers until the end of this month,” Campbell said in a Zoom conference call from Washington.

She said UNRWA had only secured a third of its $1.2 billion annual budget and that it was suffering its “worst financial crisis” since beginning operations some 70 years ago.


The agency is trying to plug the $800 million shortfall in part by appealing to European and Gulf countries for emergency donations, Campbell said.

Donations from the European Union, Britain, Germany, Sweden, Canada and Japan have helped fill UNRWA’s 2020 budget gap, Campbell said, while Saudi Arabia has also provided project-specific funding.

The United States was by far UNRWA’s biggest donor until it withdrew funding, calling for reforms and suggesting its services be transferred to refugee host countries.

Palestinian refugees are mostly descendants of some 700,000 Palestinians who were driven out of their homes or fled amid fighting in the 1948 war that led to Israel’s creation. Nearly a third live in 58 camps where UNRWA provides services.

Many refugees fear the dwindling aid they receive could fall further as the coronavirus crisis persists and donors shift priorities.


UNRWA has tried to halt the spread of COVID-19 in and around camps, closing all its 276 schools that are attended by close to 300,000 children.

It has launched a $14 million emergency appeal for coronavirus funding, and says it will issue another, larger, aid request in the coming days.
Reporting by Rami Ayyub in Jerusalem and Nidal al-Mughrabi in Gaza; Editing by Mark Heinrich
Ecuador indigenous community fears extinction from COVID-19
Alexandra Valencia

QUITO (Reuters) - One of Ecuador’s indigenous communities fears it could be wiped out as coronavirus infections rise in its territory, prompting dozens of its members to flee into the Amazon rainforest for shelter from the pandemic which has killed nearly 1,600 in the country.
A member of the Siekopai nation of Bella Vista Community sits down in a chair as he is being tested for antibodies of the coronavirus disease (COVID-19), at the territories of the Siekopai nation in Sucumbios, Ecuador, April 29, 2020 in this handout photo. Amazon Frontiles y Alianza Ceibo/Handout via REUTERS.  THIS IMAGE HAS BEEN SUPPLIED BY A THIRD PARTY. MANDATORY CREDIT. NO RESALES. NO ARCHIVES

A member of the Siekopai nation of Bella Vista Community sits down in a chair as he is being tested for antibodies of the coronavirus disease (COVID-19), at the territories of the Siekopai nation in Sucumbios, Ecuador, April 29, 2020 in this handout photo. Amazon Frontiles y Alianza Ceibo/Handout via REUTERS. THIS IMAGE HAS BEEN SUPPLIED BY A THIRD PARTY. MANDATORY CREDIT. NO RESALES. NO ARCHIVES


The Siekopai nation along the border between Ecuador and Peru, with some 744 members, has 15 confirmed cases of the virus and two elderly leaders died in the last two weeks after showing symptoms of COVID-19, the group said.

A large number of Siekopai have presented symptoms related to the outbreak but, after they sought help from a government health center in nearby Tarapoa city, doctors told them they just had a “nasty flu,” community President Justino Piaguaje said.

When the first of the elderly died in mid-April, Siekopai leaders urged Ecuador’s government to fence off the community and test the inhabitants but have received no response, he said.

“There are barely 700 of us. In the past we were victims of this type of disease and today we don’t want history to be repeated,” Piaguaje said in a meeting held via social media on Monday.


“We don’t want our people saying that there were 700 of us and now there are 100. What a scandal it would be for the Ecuadorian government to leave us with such a sad story in the 21st century,” he added.

Fearful of the coronavirus, dozens of children and elderly Siekopai fled in canoes to Lagartococha, one of Ecuador’s largest wetlands in the heart of the jungle, to avoid infection.

Siekopai who stayed behind in their territory in Ecuador’s Sucumbios province are turning to homeopathic medicines to cope with respiratory problems, said Piaguaje.

Other indigenous groups in Ecuador’s Amazon also have confirmed coronavirus cases, according to indigenous organization CONFENIAE. Ecuador has reported more than 30,000 cases.

In neighboring Peru, indigenous groups submitted a formal complaint to the United Nations in late April, saying the government had left them to fend for themselves against the coronavirus, risking “ethnocide by inaction.”


Human rights organizations working in Ecuador’s Amazonian regions say the health ministry is neglecting communities like the Siekopai, who have yet to receive tests or medical supplies despite their vulnerability.

“They are in serious risk of being physically and culturally wiped out by the spread of COVID-19 in their territory,” said Maria Espinosa, a human rights defender with the group Amazon Frontlines.
Transgender people face discrimination, violence amid Latin American quarantinesAngel Mendoza (2nd L) and Martin Juco (3rd L), who are transgender and non-binary, stand in line outside a bank during gender-based quarantine restrictions, amidst the outbreak of the coronavirus disease (COVID-19) in Bogota, Colombia May 5, 2020. REUTERS/Luisa Gonzalez

Julia Symmes Cobb

BOGOTA (Reuters) - Alis Nicolette Rodriguez is bracing themself, nervously looking over their shopping list and preparing in case someone tries to bar their way at the grocery store. It has happened before.

To keep crowds thin during the coronavirus quarantine, Colombian capital Bogota - like some other places in Latin America - has specified that men and women must go out on separate days. That has turned a routine food shopping trip into an outing fraught with tension for social work student Rodriguez, who is transgender and non-binary.

From Panama to Peru, transgender people say gender-based quarantine restrictions have exposed them to discrimination and violence from people questioning their right to be out.

In Bogota, women can only go out on days with even-numbered dates and men on odd, while transgender people are allowed to choose.

However, rights group Red Comunitaria Trans said it had received 18 discrimination complaints since the measure began. One of those complaints was from a transgender woman in southern Bogota stabbed by a man who said she was out on the wrong day, a case also reported in local media. The woman is recovering from her injuries.

“The last time I went out things happened that were really tense,” said Rodriguez, 20, who uses neutral pronouns and began hormone treatments four months ago. “My features are still very masculine so people still say ‘I see the body of a man’ and they deny who you are.”

Rodriguez said the previous Sunday an employee stopped them at a grocery entrance and a police officer asked to see their identification, although the mayor’s office has told police not demand ID to prove gender during the quarantine.

A spokeswoman for Bogota’s government department for women confirmed the police do not have the right to question anyone’s gender identity.

In response to questions about the accusations of discrimination, Bogota’s Metropolitan Police sent Reuters a publicity video of officers and members of the transgender community speaking to store employees, explaining that transgender people can choose their shopping day.

Rodriguez was eventually allowed into the store, but at the check-out one cashier asked another why “this man” had been able to shop, they said. Being non-binary complicates the choice about which day to go out, said Rodriguez, who has chosen the women’s days.

“If you don’t go out with make-up on, with a skirt... If you don’t comply with those stereotypes and gender roles then you can’t identify yourself or be in a public space,” said Rodriguez, who was wearing pink eye shadow and a sparkly silver jacket.
AFRAID TO REPORT DISCRIMINATION

Juli Salamanca, communications director for Red Comunitaria Trans, said the coronavirus pandemic had left transgender people particularly exposed.

“They’re trying to protect themselves from the violence of the police, the violence of the supermarkets, the violence of society in general,” Salamanca told Reuters, referring to the physical and emotional toll of discrimination and prejudice.

She said some transgender people may be afraid to report discrimination because of previous police abuse.

Colombia’s second-largest city, Medellin, has restricted outings based on ID numbers rather than gender, a valid alternative to enforce social distancing, Salamanca said.

Colombia is not the only Latin American country where restrictions have stoked fear among transgender people.

The Panamanian Association of Trans People has received more than 40 discrimination complaints since restrictions began in April, director Venus Tejada said, including problems getting into supermarkets or buying medicine.

Transgender people who are immunocompromised are particularly worried, according to Tejada, and some with HIV fear additional discrimination because of their illness.

“If they need anything we’ve advised them to ask a neighbor or someone else to get it,” Tejada said.

In Peru, the government canceled restrictions based on gender after just over a week, as retailers struggled to control crowds on women’s days and LGBT groups complained of discrimination.

Back in Bogota, Rodriguez is piling a shopping cart with items. They avert their eyes when two police officers walk into the store.

The officers escort out an older man who is violating the rules and then

The officers escort out an older man who is violating the rules and then stare briefly at Rodriguez before leaving.

Today, at least, they shopped in peace.
POSADA CINQUE DE MAYO PRINT

Jose Guadalupe Posada
HAPPY CINQUE DE MAYO
LOVED BY SURREALISTS AND REVOLUTIONARIES AROUND THE GLOBE

#SoyEncore y queremos compartir contigo algo acerca de la historia de las Catrinas y su creador José Guadalupe Posada

Jose Guadalupe Posada, was a lithographer and print maker in Mexico's pre-Revolution times; he is best known for the creation of La Calaca Garbancera, that later became La Catrina, the iconic skeleton lady used during the Day of the Dead celebrations and many folk art styles. Posada is considered by scholars the father of Mexican modern art.

Jose Guadalupe Posada's Work and Life


Posada was born on February 2, 1852 in Aguascalientes, a city in central Mexico, to Petra Aguilar a homemaker and German Posada a baker, both illiterate.

He received elemental education from his brother Jose Cirilo, 12 years his senior who was an elementary school teacher.

Jose Cirilo urged him to work at a kinder garden where Posada spent most of the time drawing portraits of the children and illustrations about the subjects taught to them.

Because his drawing ability was evident he pursued education at the art academy of Aguascalientes which he attended for a brief time.

In 1868 Posada began working at José Trinidad Pedroza's printing house, one of the best in the country.

Pedroza taught Posada the printmaking techniques for lithography and engraving on wood and metal. Three years later, at age 19, Posada was head cartoonist of El Jicote (The Wasp)
a critical newspaper edited by Pedroza with whom Posada became friends and later business partner.

With Posada's help Pedroza opened a second printing house in Leon, Guanajuato. There Jose Guadalupe got married in 1875 to Maria de Jesus Vela with whom he had a child who died at a young age.

Posada did very well illustrating newspapers, magazines, books and commercial items such as cigarette and match boxes and eventually dissolved the partnership with Pedroza. In 1888 a cataclysmic flood struck the city forcing Posada to move to Mexico City.




Right after he arrived to Mexico City he published a series of drawings in the weekly newspaper La Juventud Literaria (The Literary Youth) which were presented by Ireneo Paz with the following introduction:

"Our readers ought to appreciate the imagination of Jose Guadalupe Posada who has drawn these small drawings in his free time. We are very pleased to praise who deserves to be praised and we guess he will become the best Mexican cartoonist. We are waiting for his masterpiece and the praising he will receive from the press and the smart people. Until then we congratulate this young artist and wish him to continue on this path."

Posada opened a humble workshop where he engraved historic scenes, recipe books, news, songbooks, board games, stories, love letters, religious images, etc. The Mexican capital had then 350,000 inhabitants, 80% of them illiterate, therefore illustrations were a great way to communicate.



Posada's most prolific and important work was done in the printing shop of publisher Antonio Vanegas Arroyo, where he began as a staff artist around 1890 and soon became the publisher's chief artist.

There Posada met Manuel Manila, engraver who taught him how to create a rich shade of grays and a more precise and delicate drawing. Posada then abandoned lithography and began to work first with engraving on type metal and later with relief etching on zinc which gave him more flexibility.

Vanegas Arroyo, poet Constancio Suárez and Posada teamed up to publish cheap one-page leaflets with brightly printed, graphics that reported the news and social issues of the day.


They created the calaveras tradition, satirical rhymes illustrated with skulls and skeletons that usually refer to the hypothetic death circumstances of a politician or celebrity. Thanks to Posada's illustrations these verses became an economical success. It was in this gender that Posada created La Calaca Garbancera later known as La Catrina.

He described with originality the spirit of the Mexicans: the political matters, daily life, the terror for the end of the century and for the end of the world, besides the natural disasters, the religious beliefs and popular horror stories; a tireless worker he made 15,000 engravings during his life.

Jose Guadalupe Posada died a widower and without issue on January 20, 1913; he was buried in a common grave at the Dolores cemetery in Mexico City.


Posada, Precursor of Mexican Modern Art

Scholars and artists in Mexico and abroad consider Posada the precursor of Mexican modern art:

Diego Rivera deemed Posada his artistic father and compared him to Goya and Callot, he dedicated him his mural Sunday Evening's Dream, that depicts Posada in the center of the masterpiece holding hands with La Calaca Garbancera, who Rivera named La Catrina.

Painter Jose Clemente Orozco claimed that watching Posada working in at his workshop awoke him to the art of painting.

Mexican poet Octavio Paz, Nobel Prize winner, described his technique like a minimum of lines and a maximum of expression and said about him: "By birthright Posada belongs to expressionism but unlike most expressionists he never took himself seriously".


Posada's Museum in Aguascalientes

Painter, muralist and engraver Luis Seoane said about Posada: "Mexico, who has the most beautiful history in America, the most extraordinary monuments built before and after the Spanish Colony, the most rebellious blood and the weirdest talents has too with Jose Guadalupe Posada the greatest engraver in America, deeply Mexican thus highly universal"

Historian and museographer Fernando Gamboa wrote about him in 1944: "Jose Guadalupe Posada is a popular artist in the deepest and highest sense of the word; popular because of his humble origin; popular, because of the definite class feeling he brings into each of his works; popular, because he was not an artist without antecedents, a phenomenon foreign to the world in which he lived, but rather the outburst of the feelings of a striving people; popular, because of the way he studied and lived in direct contact with life and the way in which he conscientiously listened to the demands of the Mexican people."


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FOX NEWS STATE MEDIA SOUNDS LIKE RT RUSSIAN STATE MEDIA

Japan will draw up plans for potential UFO encounters, report says

Chris Ciaccia

© Provided by FOX News

After the Pentagon officially released videos of "unidentified aerial phenomena," Japan's Defense Ministry will draw up plans for any potential encounters with UFOs, according to a Japanese media report.

Nippon reports the government agency will "consider procedures to respond to, record and report encounters, but the unknown nature of such objects may confuse Self-Defense Forces pilots, including those of F-15 fighter jets."

Defense Minister Taro Kono noted the country's SDF pilots have yet to encounter UFOs, but protocols are being established "to cover the possibility," the report added.

'UFOs ARE REAL,' BLINK-182 FOUNDER SAYS

Fox News has reached out to the Defense Ministry with a request for comment.

The news comes just one week after the Pentagon officially released unclassified footage that showed "unidentified aerial phenomena" captured by Navy aircraft. The footage had circulated in the public for years.

"After a thorough review, the department has determined that the authorized release of these unclassified videos does not reveal any sensitive capabilities or systems, and does not impinge on any subsequent investigations of military air space incursions by unidentified aerial phenomena," said Pentagon spokesperson Sue Go

Japan will draw up plans for potential UFO encounters, report says

"DOD is releasing the videos in order to clear up any misconceptions by the public on whether or not the footage that has been circulating was real, or whether or not there is more to the videos,” Gough added. “The aerial phenomena observed in the videos remain characterized as ‘unidentified.’”

FORMER US DEFENSE OFFICIAL: WE KNOW UFOS ARE REAL - HERE'S WHY THAT'S CONCERNING

After the videos were released, the head of The Stars Academy of Arts & Science (TTSA) and former Blink-182 co-founder Tom DeLonge said "UFOs are real" in a now-deleted tweet.

Former Sen. Harry Reid, D-Nev., said the footage "scratches the surface of research and materials" made available by the Pentagon.

The videos, known as "FLIR1,” “Gimbal” and “GoFast,” were originally released to the New York Times and to TTSA.

The first video of the unidentified object was taken on Nov. 14, 2004, and shot by the F-18's gun camera. The second video was shot on Jan. 21, 2015, and shows another aerial vehicle with pilots commenting on how strange it is. The third video was also taken on Jan. 21, 2015, but it is unclear whether the third video was of the same object or a different one.

In December 2017, Fox News reported that the Pentagon had secretly set up a program to investigate UFOs at the request of Reid.
Top U.S. general: 'We don't know' if coronavirus emerged from Chinese lab
FILE PHOTO: U.S. Chairman of the Joint Chiefs of Staff Gen. Mark A. Milley testifies before a Senate Armed Services Committee hearing on "Department of Defense Budget Posture on Capitol Hill in Washington, U.S., March 4, 2020.  REUTERS/Tom Brenner
FILE PHOTO: U.S. Chairman of the Joint Chiefs of Staff Gen. Mark A. Milley testifies before a Senate Armed Services Committee hearing on "Department of Defense Budget Posture on Capitol Hill in Washington, U.S., March 4, 2020. REUTERS/Tom Brenner

WASHINGTON (Reuters) - The top U.S. general said on Tuesday it was still unknown whether the coronavirus emerged from a wet market in China, a laboratory or some other location, but reaffirmed the U.S. view that it was probably not man-made.

“Did it come out of the virology lab in Wuhan? Did it occur in a wet market there in Wuhan? Did it occur somewhere else? And the answer to that is: We don’t know,” Army General Mark Milley, chairman of the Joint Chiefs of Staff, told a news conference, adding the U.S. government was looking into it.

The remarks stood in contrast to Secretary of State Mike Pompeo’s assessment on Sunday that there was “a significant amount of evidence” that the new coronavirus emerged from a Chinese laboratory.
Special Report: In shielding its hospitals from COVID-19, Britain left many of the weakest exposed

LONDON (Reuters) - On a doorstep in the suburbs of north London, three-year-old Ayse picked up a tissue to wipe away her grandmother’s tears - tears for one more victim of the virus.
Ayse Mehmet, whose daughter Sonya Kaygan died from coronavirus disease (COVID-19), has tears wiped by her three-year-old granddaughter, also named Ayse, at her home in Enfield, Britain, April 27, 2020. Picture taken April 27, 2020.  REUTERS/Peter Nicholls
Ayse Mehmet, whose daughter Sonya Kaygan died from coronavirus disease (COVID-19), has tears wiped by her three-year-old granddaughter, also named Ayse, at her home in Enfield, Britain, April 27, 2020. Picture taken April 27, 2020. REUTERS/Peter Nicholls


The little girl was waiting for her mum, Sonya Kaygan. Her grandmother hadn’t broken the news that Kaygan, 26, who worked at a nearby care home, was dead, one of over 100 frontline health workers killed by the coronavirus in Great Britain.

The grandmother, also called Ayse, spoke through sobs. “Why? Why?” she repeated. Why couldn’t she visit the hospital to say her goodbyes? Why did so many die in her daughter’s workplace? At least 25 residents since the start of March, of whom at least 17 were linked to the coronavirus. It was one of the highest death tolls disclosed so far in a care home in England. And why did Kaygan and her colleagues resort to buying face masks on Amazon a month ago, protection that arrived only after she was in hospital?

A Reuters investigation into Kaygan’s case, the care home where she worked, and the wider community in which she lived provides an intimate view of the frontline of Britain’s war on the coronavirus. It exposes, too, a dangerous lag between promises made by Prime Minister Boris Johnson’s government and the reality on the ground.

Even as the government was promising to protect the elderly and vulnerable from the deadly virus, local councils say they didn’t have the tools to carry out the plan, and were often given just hours to implement new government instructions.

Policies designed to prevent hospitals from being overwhelmed pushed a greater burden onto care homes. With hospitals given priority by the government, care homes struggled to get access to tests and protective equipment. The elderly were also put at potentially greater risk by measures to admit only the sickest for hospital treatment and to clear out as many non-acute patients as possible from wards. These findings are based on documents from government agencies seen by Reuters, interviews with five leaders of local authorities and eight care home managers.

It is too early to reach final conclusions about the wisdom of these policies. Still, staff and managers of many care homes say they believe the British government made a crucial early mistake: It focused too much attention on protecting the country’s National Health Service at the expense of the most vulnerable in society, among them the estimated 400,000 mostly elderly or infirm people who live in care homes across Britain.

The government summed up that policy in the slogan “Protect the NHS.” The approach gave the country’s publicly-funded hospitals priority over its care homes. A UK government spokesman defended the strategy. “This is an unprecedented global pandemic and we have taken the right steps at the right time to combat it, guided by the best scientific advice.”

The effects of this approach have been felt desperately in Elizabeth Lodge, in Enfield, north London, where Kaygan worked.

The first coronavirus test of a resident of the Lodge only took place on April 29. That was 34 days after the first suspected case at the home, said Andrew Knight, chief executive of residential services at CareUK, a private company which operates the home. It was also 14 days after Matt Hancock, the UK health secretary, pledged tests would be available to “everyone who needs one” in a care home.

“The government’s response on testing has come way too late to have any meaningful effect on keeping the virus out of our homes,” said Knight, the CareUK executive, in a statement to Reuters.

So far, at least 32,300 people have died in Britain from the coronavirus, the highest toll in Europe, according to official UK data processed by 2 May. Out of those deaths, more than 5,890 were registered as occurring in care homes in England and Wales by April 24, the latest date available. These figures don’t include care home residents who were taken to hospital and died there.

Many care home providers believe the figures understate the number of deaths among care home residents because, in the absence of testing, not all are being captured. During the 10 weeks prior to the outbreak, including the height of the flu season, an average of 2,635 people died each week in care homes in England and Wales. By April 24, that weekly death toll had risen to 7,911. According to Reuters calculations, the pandemic has resulted in at least 12,700 excess deaths in care homes.

“I think the focus early on was very much on the acute sector,” or urgent hospital treatment, “and ensuring hospitals were able to respond in an effective way,” said Graeme Betts, acting chief executive of Birmingham City Council, which oversees the UK’s second-biggest city. “And I think early on care homes didn’t get the recognition that perhaps they should have.”

Helen Wildbore, director of the relatives and residents association, a national charity supporting families of people in residential care, said while it was right for the initial focus to be on protecting the NHS, “I think it has taken too long for the government to turn its attention” to vulnerable people outside hospital. “I think it’s fair to say that the sector has felt like an afterthought for quite a long time.”

Jeremy Hunt, a former Conservative Party health secretary and now chairman of the House of Commons health select committee, advocated banning visits to care homes by friends and family from early March, advice that wasn’t followed. Speaking to Reuters, he drew a parallel between the UK’s response to the coronavirus and the way it deals with peak winter demand for hospital services.

“What happens with any NHS winter crisis is the focus of attention immediately switches to the hospitals and dominates the system’s thinking,” he said. “Many people in the social care sector told me exactly the same thing happened with COVID-19.”

The government spokesman said protecting the elderly and most vulnerable members of society had always been a priority, “and we have been working day and night to battle coronavirus by delivering a strategy designed to protect our NHS and save lives.”
THE COCOON

Born in Northern Cyprus in 1993, Sonya Kaygan had come to the UK after studying English. She settled in Enfield, a north London borough of 334,000 people with a large community of Turkish origin, and one particularly hard-hit by the virus pandemic.

Kaygan lived with her mother and together they looked after her child. Both worked in different care homes: She worked night shifts and her mother worked the day shift. Kaygan’s monthly wages for three or four weekly 12-hour shifts added up to a take-home pay of about £1,500 - just short of the monthly rent of their home.

By the time a “lockdown” was imposed by the prime minister on March 23, the virus was spreading fast and Kaygan was beginning to feel sick. “She started feeling a bit uncomfortable,” her uncle Hasan Rusi said. “She had a temperature and was coughing. It might have been a cold, it might be a virus.”

Established plans drawn up by the government for dealing with a flu pandemic had always been clear that care homes could be a place for infection to spread. But on February 25, Public Health England, a government agency overseeing healthcare, stated it “remains very unlikely that people receiving care in a care home or the community will become infected.”

RELATED COVERAGE
A London community shattered by the coronavirus


The guidance was widely reproduced on care home websites and stayed in force until March 13. It meant that few care homes restricted visits and few families withdrew their relatives from homes. No plan was put in place for testing staff. A government spokesman said that advice “accurately reflected the situation at the time when there was a limited risk of the infection getting into a care home.”

On March 12, the government shifted from what it termed a “contain” to a “delay” phase, after the World Health Organisation declared an international pandemic. The UK now focused efforts on mitigating the spread of virus through the general population, allowing “some kind of herd immunity” to develop, as the chief scientific adviser, Sir Patrick Vallance, explained on BBC radio on March 13. But, said Vallance, “we protect those who are most vulnerable to it.”

David Halpern, a psychologist who heads a behavioural science team - once nicknamed the “nudge unit” - advising the UK government, had expanded on the idea in a separate media interview on March 11. As the epidemic grew, he said, a point would come “where you’ll want to cocoon, you’ll want to protect those at-risk groups so that they basically don’t catch the disease.”

Nonetheless, Reuters interviews with five leaders of large local authorities and eight care home managers indicate that key resources for such a cocoon approach were not in place.

There weren’t adequate supplies of protective equipment, nor lists of vulnerable people, they said. National supply chains for food were not identified, nor was there a plan in place to supply medicines, organise volunteers, or replace care staff temporarily off sick. Above all, those interviewed said, there was no plan for widespread testing in vulnerable places like care homes or prisons, let alone an infrastructure to deliver it.

On March 23, Johnson announced another shift in strategy, replacing the mitigate-plus-cocoon approach with a broader lockdown. Schools, pubs and restaurants were shuttered, sport cancelled and everyone was told to stay at home.

For local leaders, caring for the most vulnerable became increasingly challenging. Typically, they said, new plans were announced in an afternoon national press conference by a government minister, with instructions to implement them, sometimes the next day, arriving by email to councils later that night. Ministerial promises, handed off to the councils, included drawing up a “shield list” of the most vulnerable, delivering food to them and organising and delivering prescription medicines. Even plans for using volunteers were announced nationally, without taking account of volunteer infrastructures that many councils had in place.

“From our vantage point, it sometimes looked like policy made up on the hoof,” said Jack Hopkins, leader of Lambeth Council in south London, an early hotspot for the virus outbreak. Local councils knew they had to act quickly, but there was no dialogue about how things should happen. “It felt very much like government by press release, with local government left to pick up the pieces,” Hopkins said.

It was the same experience in Birmingham, which was also hit hard by the virus. Betts, the council’s chief executive, wants to avoid dishing out criticism in a situation that is “new for everyone.” But, he said, “it did make it quite challenging from a local authority perspective, when, you know, the prime minister says at 5 pm or 6 pm that something’s going to happen. Eleven o’clock or midnight you get some guidance on it, and you’re meant to be off and running in the next day.”

The most acute problem identified locally early on was the shortage of adequate personal protective equipment (PPE) for NHS and care home staff. Yet Jenny Harries, England’s deputy chief medical officer, declared on March 20 that there was a “perfectly adequate supply of PPE” for care workers and the supply pressures have been “completely resolved.”

Five days later, Johnson told parliament every care home worker would receive the personal protective equipment they needed “by the end of the week.” This didn’t happen, and more than a month later, the government’s chief medical officer conceded publicly that shortages remained.

According to Nesil Caliskan, leader of Enfield Council, early statements that local shortages were caused by distribution difficulties proved to be a “downright lie.” The government simply didn’t have enough kit, she said.

The government didn’t respond directly to claims that it gave false assurances or insufficient time and support to councils to implement ministers’ instructions. A spokesman said an alliance of the NHS, industry and the armed forces had built a “giant PPE distribution network almost from scratch.” Councils had been supported with £3.2 billion in extra funding to support their pandemic response, he said, and 900,000 parcels of food have been delivered to vulnerable people.

Three days into the lockdown, on 26 March, the nation was urged to stand at their doorstep or window on a Thursday evening and applaud the NHS. Boris Johnson, by now already infected himself, led the cheering on the first occasion.

For some workers in Enfield, the chants left them uneasy. Working 12 hours shifts for barely £9 per hour, below the non-statutory London Living Wage of £10.75, they wondered if those cheers for caregivers were also meant for them.

“I’m one of them,” one care home employee, who asked not to be named, recalls telling her 12-year-old daughter as her neighbours clapped. The daughter teased her: “Oh, Mummy, they don’t talk about you. They talk about the NHS. Mum, do you work for the NHS?”

The caregiver replied: “No. But it’s the same. We care for people.”

The caregiver was one of three workers who recounted their experiences at an Enfield care home run by a firm called Achieve Together. Each described how, after a patient was sent to hospital on March 13 and confirmed to have the coronavirus, staff were issued with thin paper masks. After a fortnight, staff were told the masks should be saved for dealing with patients with symptoms, and they were taken away. And although several staff developed symptoms and had to isolate, no tests were available. A spokesperson for Achieve Together said staff had access to “more than sufficient supplies of PPE, including face masks and face shields, which are supplied and worn directly in line with Government advice.”

One night, caring for a resident with a lung infection who hadn’t been tested, she’d worn a thin blue surgical mask as she performed close-up procedures like feeding him and brushing his teeth.

The day she spoke to Reuters, April 24, health secretary Matt Hancock had reiterated to the BBC that tests were available for care workers. But for now, none was available for this care worker. Her only option was a drive-through centre, but she had no car.

“I want to be checked and really want to be checked as soon as possible,” she said. “If I had the choice.”

The spokesperson for Achieve Together described the health and wellbeing of residents and staff as “our absolute priority.” Staff and residents were tested “when the Government made testing available.” The company did not specify when those tests took place. It declined to comment on details of the home, citing a need to protect patient privacy.

AN INVISIBLE TRAIL

Kaygan’s workplace, the Elizabeth Lodge, in a leafy Enfield suburb, was built in the grounds of two former hospitals of infectious diseases. It is operated by CareUK, a large privately owned healthcare provider, and normally home to about 90 residents, looked after by 125 staff.

The borough has been hit hard by the coronavirus, with Enfield Council recording outbreaks in at least 42 out of 82 care homes, according to the council. The council and the Care Quality Commission, which regulates the sector, declined to disclose individual death tolls, citing privacy.

Elizabeth Lodge, according to several people with direct knowledge, was one of two Enfield homes most savagely stricken by the virus. The other, these people said, is Autumn Gardens. A senior manager at Autumn Gardens, which is privately owned, declined to comment.

Determining how Kaygan and so many residents at Elizabeth Lodge and other homes became infected will be hard. That is partly because, as Reuters has previously reported, as the outbreak began Britain had no plan for widespread testing for the virus once it started spreading in the community.

The Lodge’s management says it hasn’t identified the source of the outbreak there. The home began cutting down on visitors from the start of March, with almost all non-emergency visits barred from March 17.

“At this point anyone coming into the home, including team members and essential health care professionals, had their temperatures checked and went through a health screening questionnaire,” CareUK said in a statement to Reuters.

Kaygan’s last day of work was Friday, March 20th, and she called in sick the following week.

On Sunday, March 22, Mother’s Day in England, Kaygan popped round to drop off a bunch of flowers to two relatives, Kenan and his wife Ozlem, who helped bring her up as a child. They spoke on the doorstep. “She told us she had to go back to work. But I was adamant she should stay at home,” Kenan said. The day after, Johnson announced the nationwide lockdown.

According to the Lodge’s management, none of the residents displayed symptoms until March 26, in the home’s York wing. This was six days after Kaygan last worked, and 11 days after she had last worked in the York wing.

Across Enfield care homes, 48 cases of COVID-19 had been identified by March 27 and at least two people had died of the disease. By then all homes had essentially banned all visitors.

So how did infection take hold in care homes?

According to several care home managers, a key route for infection was opened up by an NHS decision taken in mid-March, as Britain geared up for the pandemic, to transfer 15,000 patients out of hospitals and back into the community, including an unspecified number of patients to care homes. These were not only patients from general wards. They included some who had tested positive for COVID-19, but were judged better cared for outside hospital.

In a plan issued by the NHS on March 17, care homes were exhorted to assist with national priorities. “Timely discharge is important for individuals so they can recuperate in a setting appropriate for rehabilitation and recovery – and the NHS also needs to discharge people in order to maintain capacity for acutely ill patients,” the plan said.

A Department of Health guidance note dated April 2 and published online further stated that “negative tests are not required prior to transfers / admissions into the care home.”

Jamie Wilson, a former NHS dementia specialist and founder of Hometouch, which provides care to people in their own homes, said that, based on his discussions with colleagues in the industry, he believes that care homes across the country had taken dozens of patients at risk of spreading the infection. While noting he wasn’t aware of specific cases, he described what he called an egregious and reckless policy “of sending COVID positive patients back into care homes and knowing that it’s so infectious a disease.”

The UK government didn’t respond directly to the question of whether discharges from hospitals had put the vulnerable at risk. But a spokesman said enhanced funding, testing and quarantine procedures should address those concerns.

One NHS infectious diseases consultant, who manages COVID-19 patients, said sending people sick with the coronavirus back to a care home could, in many cases, be the best thing for the patient, provided they could be cared for in the right way. Ideally, she said, all patients should be tested before transfer, and quarantined for up to a fortnight.

The problem was that most patients had not been tested for COVID-19, and care homes have few facilities to quarantine new arrivals.

In Birmingham, over 300 people were discharged into care homes from the start of March, “which is significantly higher than normal,” said council chief executive Betts. In Enfield, 30 patients were sent to care homes, about average, according to Enfield Council. One care manager in the borough, who manages several homes, said some of those transfers caused concern.

This manager recalled that, shortly after Johnson announced the lockdown, she had an argument with officials at a nearby hospital who wanted her to take back a resident who had been treated for sepsis. The hospital had coronavirus patients at the time. The manager would not name the hospital, to avoid identifying the patient. She said she agreed to the demand on one condition: that the resident, who was not displaying coronavirus symptoms, be tested. But the hospital refused, saying it did not have enough tests to assess asymptomatic patients.

Eventually, the manager backed down. A week or so later, several residents in the home began displaying symptoms consistent with COVID-19, she said. She didn’t give a precise figure. It is not known whether the transferred patient was the source of the outbreak.

“It was just so reckless,” she said. “They were not thinking at all about us. It was like they were saying, let’s abandon the old people.”

At the Elizabeth Lodge, between March 1 and March 19, four new residents arrived - two from hospitals and another two from other care homes. The Lodge’s management said, in a statement, there was no evidence these residents brought the virus into the home, “but we are continuing to review.”


Knight, the residential services chief executive at Lodge operator CareUK, said it was essential that hospital patients be tested before they were transferred. “We need to ensure not just that the test has been done, but that the results are available prior to making the decision about admission” to the home, he said in a statement to Reuters.

TEST, TEST, TEST

On March 12, Britain’s chief medical officer, Chris Whitty, announced the ending of most testing of the general population to focus on patients admitted to hospital. But Vallance, the chief scientific adviser, clarified to parliament a week later there would still be testing in isolated clusters of cases in the wider population.

By April 6, the Enfield council had recorded at least 26 deaths in care homes, and 126 suspected cases. Yet only 10 tests per day were being offered for the thousands of care staff across the whole of north London, said Enfield Council leader Caliskan.

Knight said that at Elizabeth Lodge, no tests were available for staff until after April 15, when Health Minister Hancock announced plans to test all residents and care home workers if they had symptoms. Even after Hancock’s pledge, only six tests were made available to Lodge staff and none to residents, Knight added.

Guidance from the Government, which has struggled to rapidly increase the overall availability of tests, remained that staff should simply stay at home and isolate if symptomatic. In his statement to Reuters, Knight said he and others in the industry had appealed to “senior members of the government to explain the challenges we were facing and how best they could support us.” He didn’t say who he spoke to.

Finally, on April 28, Hancock said all care home residents and staff could be tested even if they were not displaying symptoms. Again, the words didn’t match the experience on the ground.

Lisa Coombs, manager of the Minchenden Lodge in Enfield, home to up to 25 residents, said she had only secured a pack of 10 tests. Eight of these had returned a positive result. She’d been unable to secure tests for a further 10 residents even though some were displaying symptoms.

“What the government says is a load of rubbish,” she said. I “I am angry because we are not being supported.” She declined to discuss how many residents have died.

At Elizabeth Lodge, no residents were tested until April 29, said Knight. Even after that date the government’s Care Quality Commission, which has been supplying tests to homes, only provided enough for residents showing symptoms of coronavirus. Things improved “in a very limited way” in the last two weeks of April, said Knight, and now “appear to be gaining momentum.”

Getting access to testing on a meaningful scale now could reduce the impact of the virus in the coming months, he added.

A government spokesman said that a policy of testing everyone prior to admission into care homes was now being instituted, with a recommendation that hospital patients discharged into care homes are isolated for 14 days, even with negative test results.
MASKS

Sonya Kaygan, her mother Ayse recalled, never said much about her work or conditions at the Lodge. But one day, at the start of the outbreak, Sonya saw the long-sleeved gloves that her mother, a caregiver at another home, was using. “We don’t have those at our place,” Kaygan said. The Lodge told Reuters staff had all the equipment that was required.

Unbeknown to her family, Kaygan had ordered surgical facemasks on Amazon. They arrived in early April after she was hospitalized. Other carers at the Lodge ordered masks, too, said another staff member. And after Kaygan’s death, a different fellow employee posted on Twitter: “I work there and all of this has (been) very hard on us all and every one is right. We as carers don’t have enough PPE.”

Another employee at Elizabeth Lodge told Reuters that although staff raised concerns, many had to operate for weeks without face masks or visors. “I was petrified. Every time I went in there, I worried for myself, my family, the people living there, my colleagues,” she said.

She said at the start of March, she remembers two meetings where managers discussed with staff how they would respond if there was a coronavirus outbreak. She said employees questioned why they did not have more protective equipment. The management responded saying they were doing their best to bring more in.

Reuters could not independently verify this account. The Lodge’s management told Reuters that neither Kaygan nor any other employee raised concerns to managers about protective equipment.

It said in a statement that at the time Kaygan worked at the Lodge, face masks were not being used. That, according to the home, was because official guidance then recommended such masks were only necessary when working within a metre (three feet) of someone with COVID-19 symptoms. Public Health England said the home’s interpretation was in line with advice then in force that masks were only needed when in personal contact with someone, such as washing.

Across Enfield, supply of PPE was a major problem. According to council leader Caliskan, by the end of March, supplies in some homes were inadequate, and others were running out. The government repeatedly promised to send supplies, but when a much-anticipated delivery by the army arrived at the council depot on March 28, it took just 6 minutes to unload, she said. It contained only 2,000 aprons and 6,000 masks, which aren’t designed for repeated or prolonged use, for Enfield’s 5,500 care workers.

GETTING TO HOSPITAL

On March 31, just after 2 pm, Sonya Kaygan was picked up by an ambulance from the two-up, two-down home she shared with her mother and daughter. Kaygan was finding it increasingly difficult to breathe. As she walked to the ambulance, she turned to her mother and said: “If I never make it back, look after my baby.”

The ambulance crew said Kaygan would be taken to the nearby North Middlesex Hospital, but when the family called there later, there was no one of that name. Uncle Hasan tracked her down to Whipps Cross Hospital in Leytonstone, northeast London. Kaygan made video calls to her family, and asked Ayse to come and visit. But, as is the case in many countries, the hospital wouldn’t allow it.

In an email to Reuters, the NHS trust managing Whipps Cross said all visiting was “currently suspended other than in exceptional circumstances” to stop the spread of COVID-19.

Then news came that Kaygan would be intubated - sedated and put on a ventilator. Her last call was to a family member in Cyprus, about 6 am on April 2. “I’m going in now,” she said.

Kaygan’s hospital admission was swift. Many others have reported difficulties getting in.

Munuse Nabi, 90, lived in a care home in Ilford, East London. She was extremely fragile, with heart, lung and kidney problems. But she was also mentally strong with a pin-sharp memory, able to talk on the phone and flick through TV channels. “She was all perfect,” said son Erkan Nabi, a driving instructor.

In early April, Munuse developed a temperature and a dry and persistent cough, and lost her voice. As she got worse, a doctor examined Munuse by video link. When she began to struggle to breathe, Nabi urged the home to send her to hospital.

A nurse, he said, told him: “We’ve been told not to send people to hospital. Just leave them here. They’re comfortable.” He was upset. “They were trying to encourage me to leave her there basically to die.” He insisted they call an ambulance, and she was taken to hospital.

A spokesperson for the care home involved said staff were “doing everything we can to make sure our residents and colleagues stay safe and well throughout these challenging times.”

This approach to hospitalisation reflects what many homes took to be national guidance. An NHS England policy document issued on April 10 listed care home residents among those who “should not ordinarily be conveyed to hospital unless authorised by a senior colleague.”

The document was withdrawn within five days, after public criticism. The NHS did not respond to a request to discuss the document.

London’s ambulance service also issued new guidance.

Ambulance crews assess patients using a standard scoring system of vital signs. According to the Royal College of Physicians, a professional body for doctors, a patient who scores five or more on a 20-point scale should be provided with clinical care and monitored each hour. A patient scoring five would normally be taken to hospital.

But in early March, London’s ambulance service raised the bar for COVID-19 patients to seven.

“I have never seen a score of seven being used before,” said one NHS paramedic interviewed by Reuters. The medic spoke on condition of anonymity.

On April 10, the required score was lowered to five. In a statement, the London Ambulance Service told Reuters its previous guidance was one of several assessments used and clinical judgment was the deciding factor. Asked if the guidance reflected the national approach, the NHS did not respond.

Possible evidence of restrictions on admissions came in a study of 17,000 patients admitted for COVID-19 to 166 NHS hospitals between February 6 and April 1. The study showed that one-third of these patients died, a high fatality rate.

Calum Semple, the lead author and professor of outbreak medicine at Liverpool University, said, in an interview with Reuters, this indicated, among other things, that England set a “high bar” for hospital admission. “Essentially, only those who are pretty sick get in.” But, he said, there was no data yet on whether that high bar ultimately made people in Britain with COVID-19 worse off. The NHS didn’t comment.
FALSE VICTORY

On the hospital wards of London, by Easter Sunday, April 12, there was a sense of light at the end of the tunnel. Over the long holiday weekend, according to several doctors contacted by Reuters, some hospitals saw just a handful of new admissions.

But on the frontline of the efforts to protect the capital’s most vulnerable people, the worst was far from over. According to an official closely involved in London’s response to the coronavirus, the capital’s mayor, Sadiq Khan, was getting reports that food banks were close to running out. Crisis meetings were held all weekend to replenish stocks.

In Enfield, by Easter Sunday a total of 39 care home deaths linked to COVID-19 had been recorded, and 142 residents had suspected infections. By the end of last month, nearly 100 more residents of Enfield care homes would die. The total in the borough, as recorded by the council, would rise to 136 deaths linked to the virus in care homes by April 30, including care home residents who died in hospital.

On the national stage, the government projected a picture of success. Prime Minister Boris Johnson, at his first daily Downing Street briefing since recovering from coronavirus, said on April 30 that Britain was past the peak and had avoided overwhelming the health service.

“It is thanks to that massive collective effort to shield the NHS that we avoided an uncontrollable and catastrophic epidemic,” said Johnson.

Even so, deaths in care homes were surging.

On the third night of 90-year-old Munuse Nabi’s hospital stay, a doctor called her son Erkan to say her COVID-19 test had come back positive. As her condition was worsening and she was too fragile for invasive treatment, they would not be able to save her life.

Erkan, urged to visit, went to the hospital and was dressed up by staff in what he calls the “full battledress” protective gear, including visor and gown.


As doctors gave Munuse small doses of morphine to make her comfortable, Erkan stayed by her bedside all through April 19 and into the early hours of April 20, holding her hand as she slipped away.

It was in the early hours of April 17 that Kaygan’s family got the call they dreaded. She, too, had passed away.

Her mother posted a message on Facebook: “My soul, my angel, I lost the most beautiful angel in this world. We lost the most beautiful angel in this world.”

She still hasn’t worked up the strength to tell Kaygan’s daughter, three-year-old Ayse, that her mother is dead.


reporting by Stephen Grey and Andrew MacAskill, additional reporting by Ryan McNeill, editing by Janet McBride and Peter Hirschberg
UK government 'using pandemic to transfer NHS duties to private sector'

Critics claim Matt Hancock has accelerated dismantling of state healthcare


Juliette Garside and Rupert Neate Mon 4 May 2020 THE GUARDIAN
 

Matt Hancock at the opening of the NHS Nightingale hospital in London. The consultancy firm KPMG coordinated its setting up. Photograph: Stefan Rousseau/PA

The government is using the coronavirus pandemic to transfer key public health duties from the NHS and other state bodies to the private sector without proper scrutiny, critics have warned.

Doctors, campaign groups, academics and MPs raised the concerns about a “power grab” after it emerged on Monday that Serco was in pole position to win a deal to supply 15,000 call-handlers for the government’s tracking and tracing operation.

They said the health secretary, Matt Hancock, had “accelerated” the dismantling of state healthcare and that the duty to keep the public safe was being “outsourced” to the private sector.

In recent weeks, ministers have used special powers to bypass normal tendering and award a string of contracts to private companies and management consultants without open competition.

Deloitte, KPMG, Serco, Sodexo, Mitie, Boots and the US data mining group Palantir have secured taxpayer-funded commissions to manage Covid-19 drive-in testing centres, the purchasing of personal protective equipment (PPE) and the building of Nightingale hospitals.

Now, the Guardian has seen a letter from the Department of Health to NHS trusts instructing them to stop buying any of their own PPE and ventilators.

From Monday, procurement of a list of 16 items must be handled centrally. Many of the items on the list, such as PPE, are in high demand during the pandemic, while others including CT scanners, mobile X-ray machines and ultrasounds are high-value machines that are used more widely in hospitals.

Centralising purchasing is likely to hand more responsibility to Deloitte. As well as co-ordinating Covid-19 test centres and logistics at three new “lighthouse” laboratories created to process samples, the accounting and management consultancy giant secured a contract several weeks ago to advise central government on PPE purchases.

The firm said it was providing operational support for the procurement process of PPE from existing and new manufacturers, but declined to comment further.

“The government must not allow the current crisis to be used as cover to extend the creeping privatisation of the NHS,” said Rachel Reeves, the shadow chancellor of the Duchy of Lancaster.

“The process for the management and purchase of medical supplies must be open, transparent and subject to full scrutiny. Deloitte’s track record of delivering PPE to the frontline since this virus began is not one of success and taking more decision-making authority from NHS managers and local authorities shifts power further from the frontline.”

Tony O’Sullivan, a retired paediatrician who co-chairs the campaign group Keep Our NHS Public, said this was a “dangerous time” for the NHS, and that the “error-ridden response” from government had exposed a decade of underfunding.

“Now, rather than learning from those errors they are compounding them by centralising decision-making but outsourcing huge responsibility for the safety of the population to private companies,” said O’Sullivan.

Allyson Pollock, the director of the Newcastle University Centre for Excellence in Regulatory Science, said tasks including testing, contact tracing and purchasing should be handled through regional authorities rather than central government.

“We are beginning to see the construction of parallel structures, having eviscerated the old ones,” she said. “I don’t think this is anything new, it just seems to be accelerated under Matt Hancock. These structures are completely divorced from local residents, local health services and local communities.”

Friday’s letter, signed by two officials from the Department of Health and Social Care, says that from Monday key equipment will be purchased through a procurement team comprising hundreds of staff from the government’s commercial function and other departments.

Global demand for equipment has been “unprecedented”, according to the letter, and it is therefore “vital that the UK government procures items nationally, rather than individual NHS organisations compete with each other for the same supplies”.

Trusts are told to flag any purchases already in progress so that these can be taken over by the central team and put into a central pot. “The national team can help you to conclude the deal, reimburse you, and manage the products through the national stocks.”

In a separate email, sent from NHS England on Saturday, trusts have been instructed to carry out a daily stock check from the beginning of this week. They must report down to the nearest 100 their stores of 13 types of protective equipment, including gloves, aprons, masks, gowns and eye protection. The information is being gathered by Palantir, a data processing company co-founded by the Silicon Valley billionaire Peter Thiel.

The information will be used to distribute equipment to those trusts most in need, and in some cases move stock from one hospital to another.

A purchasing manager, speaking anonymously, said hospitals were concerned they might be forced to hand over stock and then run out before it could be replaced. “The lead time on some of these orders is 90 days,” said the manager. “Centrally, there is nobody who is able to deliver things more quickly. What this is going to do is force people to hide what they’ve got.”

“This coronavirus pandemic is being used to privatise yet more of our NHS against the wishes of the public, and without transparency and accountability,” said Cat Hobbs, director of campaign group We Own It. “This work should be done within the NHS. It shouldn’t be outsourced.”

“This is not the time for a power grab,” said the Labour MP Rosie Cooper, who sits on the health and social care committee, which is conducting an inquiry into the management of the outbreak. “Whatever contracts are awarded they have got to have a sunset clause. Three months, six months, it has got to be shown to be cost effective for it to continue after a certain date,” she said.

The Department of Health was contacted for comment.

Outsourcing

Testing centres

Contracts to operate drive-through coronavirus testing centres were awarded under special pandemic rules through a fast-track process without open competition. The contracts, the value of which has not been disclosed, were granted to accountants Deloitte, which is managing logistics at a national level. Deloitte then appointed outsourcing specialists Serco, Mitie, G4S and Sodexo, and the pharmacy chain Boots, to manage the centres.

Lab tests

A coalition of private companies and public bodies have come together to form Lighthouse Labs, to test samples in three centres in Milton Keynes, Cheshire and Glasgow. Deloitte is handling payroll, rotas and other logistics, working alongside pharmaceutical giants GlaxoSmithKline and AstraZeneca, as well as the army and private companies Amazon and Boots.

Nightingale hospitals

Dozens of private companies have won contracts to build, run and support the Nightingale hospitals. Consultancy firm KPMG coordinated the setting up of the first Nightingale at the ExCel centre in east London alongside military planners. Infrastructure consultants including Mott MacDonald and Archus also had roles in the project.

Outsourcing firm Interserve worked on the construction of the Birmingham Nightingale hospital at the NEC, and was awarded a contract to hire about 1,500 staff to run the Manchester Nightingale. G4S secured the contract to supply security guards for all the Nightingale hospitals.

Recruiting extra NHS and hospital staff

Capita, another outsourcing firm, was awarded a contract to help the NHS “vet and onboard thousands of returning nurses and doctors”.

PPE


The government appointed Deloitte to help it ramp up British production of protective equipment and source stocks from the UK and abroad. Some figures in the UK manufacturing industry have described the project as a “disaster” and accused Deloitte of pursuing factories in China – where prices have leapt and supply is tight due to huge global demand – rather than focusing on retooling UK factories to make more kit.

Clipper Logistics, a Yorkshire-based logistics and supply chain firm founded by the Conservative donor Steve Parkin, was awarded government contract to supply and deliver protective equipment to NHS trusts, care homes other healthcare workers.

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