Medical mis-steps before Boris Johnson ended up in intensive care

Medical mis-steps: Boris Johnson saw a doctor (via Zoom) for first time in a week when ‘mild’ coronavirus symptoms worsened, having sat in meetings with coughing aides even after ‘patient zero’ scientist briefed ‘Cobra cluster’

  • PM unveiled social distancing on March 17,  but rules reportedly ignored in No10 
  • Scientist Neil Ferguson said to have met ministers the day before self-isolating
  • Reports of coughing aides crammed into meetings including the PM
  • He himself stood close to ministers for days after distancing rules came in 
  • PM self-isolated at home but spoke to a doctor via video only on Sunday 
  • He was immediately admitted to hospital and later to intensive care unit 

Like Boris Johnson, Winston Churchill had periods of serious ill health during his premiership, including recurrent bouts of pneumonia during the war, several of them serious

Coronavirus has been described as this generation’s ‘war’. But just like in the Second World War the Government seemed initially to be ill-prepared for the fight.

One area that has been thrust into stark relief this week is the health of the Prime Minister, as the nation continues to reel from Boris Johnson being admitted to intensive care.

Like Boris Johnson, Winston Churchill had periods of serious ill health during his premiership, including recurrent bouts of pneumonia during the war, several of them serious.

And like the PM he was an energetic risk-taker – he watched the Blitz from the rooftops of London – who did not like listening to doctors very much.

But while Churchill had his own personal physician who travelled with him on his many journeys during the conflict –  and even had six medics flown from Egypt to Tunisia when he became ill in North Africa in 1943 – Mr Johnson and his team appear to have taken a far more relaxed view until serious measures like hospitalisation had to be taken.

Mr Johnson was ‘stable’ after a second night in intensive care, with his fever said to have dipped as he remains under constant observation at St Thomas’ in central London.

However, there are fears that even the best outcome from his coronavirus struggle will see him out of action for weeks, with experts warning he could need a ‘phased return’ to work.

Foreign Secretary Dominic Raab has been ‘deputised’ to fill in for the PM, but the potential issues caused by Mr Johnson’s absence have been underlined as the crucial review of lockdown measures was postponed.

A lack of social distancing? 

Professor Neil Ferguson is believed to have visited Downing Street the day before self-isolating with suspected coronavirus

Boris Johnson remains in St Thomas’s Hospital in central London, where he is said to be responding well to treatment

One area of concern is the slow take-up of social distancing measures within Downing Street. 

Boris Johnson announced a clampdown on mass gatherings on March 16 and the following day flanked Chancellor Rishi Sunak to announce social- distancing measures that included keeping two metres apart from people.

But No 10 was slow to adopt these measures. Downing Street insiders told the Times today of meetings of dozens of people, including the Prime Minister present, where people were openly coughing and sitting close to each other.

On March 17 top Imperial College epidemiologist Professor Neil Ferguson is understood to have visited Downing Street to brief top officials. 

The following day he confirmed via Twitter that he was self-isolating at home with coronavirus symptoms. 

Although it is impossible to confirm, this will fuel suggestions that he could be the ‘patient’ zero into Downing Street. 

Cobra met on March 18, bringing the Prime Minister in to close contact with Matt Hancock, who confirmed he had coronavirus on march 27, the same day as the PM.

Chief Medical Officer Chris Whitty, who was also forced to self-isolated with symptoms, was also present. 

The press conferences fronted by the prime minister and other  ministers between March 17 (top), when social distancing guidance was issued by the PM, and March 24 (bottom), when the press conferences finally began to adhere to that guidance

Top Adviser Dominic Cummings, who remains absent from Downing Street after self-isolating, is also likely to have been present. 

Others said to have been self-isolating include Lee Cain, Mr Johnson’s director of communications, and Andrew Parsons, his personal photographer, both of whom have close access to the PM.  

And yet they continued to ignore distancing rules. Mt Johnson and Rishi Sunak stood close together at public news conferences for days afterwards.

It was not until March 24 that the trio of podiums were spaced out further to adhere to the Government’s own rules. 

The same day Mr Johnson chaired his Cabinet semi-remotely, with many ministers dialling in. But he was joined in No 10 by Matt Hancock and Prof Whitty, who would both later fall ill.

Boris working on through the illness 

There are also concerns about the PM’s care while he was in isolation, amid suggestions he was not physically monitored and only consulted a doctor by video link.  

Mr Johnson is said to view illness as a weakness and after his diagnoses indicated publicly that he intended to work though what were at the time said to be ‘minor symptoms. 

This is despite many reports of people suffering from the virus – even if not hospitalised – not being able to raise themselves from their sickbed 

Thus he shut himself away in a suite of rooms in 11 Downing Street, where he lives, and continued to chair meetings via videolink and work on official business.

Churchill’s wartime health battles 

Revered as a war hero and famous for his garrulous character and bustling, often champagne-fuelled energy, Winston Churchill none-the-less struggled with his health behind the scenes.

He suffered a mild heart attack while at the White House in Washington in 1941, just a year after taking over as prime minister.

But more seriously the heavy cigar smoker had several serious attacks of  pneumonia.

But as the leader of a world power during a mammoth conflict, he had top medical treatment on tap. 

Andrew Roberts, A biographer of the former leader, told the BBC this morning that Churchill had ‘absolutely first class care, just like Boris has at St Thomas’s’, including a personal physician who ‘flew around with him everywhere’.

‘The worst moment came in November 1943 when he was in Tunis, where they had to fly six doctors in from Cairo, including the famous Brigadier (Robert) Pulvertaft (of the Royal Army Medical Corp) and an x-ray machine as well. They very much feared for his life  over about  four or five days.’

Like Mr Johnson, Churchill was a ‘fighter’, he added, but a lucky one. He was able to be treated with antibiotics which had only been put into production a few months previously. 

‘He also took no notice of doctors either,’ Mr Roberts added. 

‘When he was convalescing we heard from his nurse Doris Miles his fluid intake. He was actually convalescing from this incredibly serious disease, pneumonia, and it includes 10 oz of champagne, 2oz of brandy, 8oz of whisky and soda.’

Churchill’s health remained suspect after the war.  

In 1949, while opposition leader, he suffered a stroke on holiday, which affected his health to the extent that the King gently suggested he resign as PM in 1951 in favour of Anthony Eden.  

He suffered a second one during an official dinner at No 10 while in office in 1953, leaving him paralysed on one side.

His aides and family conspired to keep news of his illness out of the press, at a time when the Cold War was very chilly and there were fears he may not survive.

Eden’s own illness meant that Churchill did not quit until 1955. He suffered a third stroke the following year and died in 1965. 

He continued to  tweet to the public and came to the door to join the weekly clapping for the NHS, perhaps keen to show that he was able to bear the symptoms and carry on while following the rules to self-isolate.

But by the end of his planned week of quarantine there were signs it was not going to plan. Last Thursday it was revealed by Downing Street that he still had a high temperature. 

Because of this he would not be breaking his self-isolation as planned on Friday.

However, at this stage his symptoms were still described as ‘minor’ and he continued to work. 

It may be that he wanted to follow the same path as was being advised to the public. He was leading by example, self-isolating for seven days, waiting for his symptoms to go away and  avoiding infecting others.

His pregnant fiancee Carrie Symonds went to live at the couple’s home in south London, although she too would later self-quarantine with 

Finally Boris consults a doctor 

It was not until a marked deterioration on Sunday, after ministers were shocked at his appearance in a Zoom conference, that he had a video conference with his GP who advised him to go to St Thomas’ Hospital, across the river from Parliament.

Tory MPs are calling for a review of the premier’s medical arrangements, saying the lack of protection has been ‘exposed’ by the latest crisis.

The UK leader has starkly different arrangements for their health support than in the US, where the president has a dedicated medical team and emergency facilities constantly on standby.

Conservative PM Marcus Fysh told MailOnline the situation was party an historical anomaly due to the different political systems.

‘We’ve got a constitutional monarchy so the monarch is the head of states and has all of that. In America the President is head of state, so that is probably why it has come through in this way. But it is worth considering whether there should in future be special measures for health within the NO10 operation.

‘I had the privilege of visiting the White House a couple of years ago… all his food is cooked by the US Navy.

‘He has got a special water system that is protected and separate from the rest of the public system. It is very well organised.

‘They are prepared for every eventuality there in a way I guess has been exposed that we need to think about a bit more.’

‘It is worth keeping these things under review because we need to protect our decision makers.’ 

 

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