Sorry, Piers Morgan, but there are far more essential workers than you think

The current situation reminds us how many people are needed to keep the country functioning

We commentators like controversy. Nothing wrong with that, but too often we start pointing the finger of rebuke at individuals or groups we disagree with. Take what Remainers said about Brexiteers, and vice versa. This may not matter much in normal times – politics, in particular, being a rough old trade. But in a real crisis, such as Covid-19, it is dangerous to start accusing other people. It causes panic, and panic spreads a lot faster and wider than the coronavirus itself. It makes people behave worse.

So this column is making untypical efforts to be friendly to all involved. It declines to search out “hoarders”, “profiteers” or people going for a “non-essential” walk in the Peak District and heap them with obloquy. It makes one exception: it reserves the right to point the finger at the people who love pointing the finger.

One example will suffice. Piers Morgan has many media incarnations. Currently, he is co-presenter of ITV’S Good Morning Britain. He is also the most inveterate tweeter. In the time of Covid-19, he tweets even faster and more furiously. The ministers, officials and members of the public whom he decides to blacken he describes as “ridiculous”, “shameful”, “disgusting”, “imbeciles”.

On Wednesday, Morgan tweeted: “Boris Johnson just said Britain will beat this virus by staying at home: ‘That is how we’ll save lives’ … why is he allowing millions of non-essential workers to continue going to work? This makes no sense and is not what any other country is doing.”

I have known Morgan slightly for many years. I know that, despite his nickname (“Moron”), he is not stupid. So it makes it worse that he is saying stupid things, because he could say something more intelligent if he wanted. Or he could do the most intelligent thing of all, and shut up.

The reason there is some “mixed messaging” from the authorities is that the truth itself is mixed. On the one hand, it is important to maintain social distancing and to self-isolate where necessary. On the other, it is important to work (which cannot always be done at home). An extreme example is our Prime Minister: Boris was bound, in the course of his work, to run more risk of infection than most of us, with the result he announced yesterday.

It is also important not to define what is “essential” too narrowly. To achieve the best collective response to the virus one must recognise that our civilisation is a complicated organism. Everything depends on everything else. For the front-line nurse to do her job, she needs not only personal protection equipment (PPE) and a supply of testing equipment, ventilators from public funds, etc. She also needs food, somewhere to lay her weary head, petrol for her car, a computer to keep her records, a teacher for her daughter, a mobile phone to speak to her mother, maybe even a plumber to mend her boiler.

For her to obtain all these things in this crisis, she needs not only decisive state action, but the back-up of a prosperous, free, well-skilled, marketbased society with good public services. Once you start thinking this way, you see that people you might describe as “non-essential” are actually essential. Without each link in the chain, it breaks.

I should like to give an example of the need for public and private, the great and the small, to link up which may soon become relevant to many readers of this newspaper.

We all know that medical treatment in London is at greatest risk of being overrun by Covid-19. It therefore, rightly, receives the most urgent attention. But the projected wave of new infections is also expected to reach most parts of the UK, even rural ones, over the next fortnight. When this happens, GPS (“primary care”) will, in most cases, be the first doctors to deal with the patients presenting. Indeed, it is essential that they should be, because otherwise hospitals (“secondary care”) will be overwhelmed.

In my own county of Sussex, the Clinical Commissioning Group (CCG) which administers these matters has ordered each local primary care network to set up “hot hubs” and “cold hubs”. I believe something similar is happening in most counties.

The hot hubs are exclusively for Covid-19 patients (including Covid-19 victims acutely ill with other, unrelated things, such as appendicitis). The patients will be those who, after an initial telephone conversation, the doctors decide need further attention. Seeing them in the hubs, the GPS will decide who is very seriously ill and has to go on to hospital for ventilation, and who would better remain at home. They will examine the patients’ oxygen saturation, respiratory rate, pulse and temperature. Judging that some patients are too frail to go on to hospital, they will have what doctors call “difficult conversations” to persuade them and their families they should stay at home.

The “cold hubs” will be for all patients who are free of the virus and of contact with its victims, for normal ailments and prescriptions.

These hubs are basically a good idea. The concept has been developed in the light of the frightening recent experiences in Italy, where the flow of patients to hospitals has been too great, many medical staff have fallen ill and a small but significant minority has died. The hubs provide an offsite, infectionfree place for triage. There is a problem, however, in our small local primary care network of about seven practices, 25 doctors and 40,000 patients, and, I gather, in most comparable practices nationwide. Such networks just cannot implement their CCG’S order.

The GPS have not got the expertise. They are doctors, not planners or builders. Their small surgeries cannot serve as cold and hot hubs in one because they are not big enough and rarely have the separate entrances needed to prevent the spread of infection. Wholly new sites therefore have to be found, “modular”

Portakabin-type buildings have to be erected to contain perhaps 80 patients, and fitted with hot and cold water, temporary lavatories, IT, telephony. The hot hubs also need a fleet of “dirty” cars (ones carrying infected people) which can be kept apart from cars that carry uninfected people.

Our small group of mainly quite old GPS cannot do this. They have not got the time, the money or the skill. They also lack full PPE (visors, for example). They naturally worry about this for their own sakes, but also for their patients. If they get infected, they will infect those whom they treat and/or put themselves out of action.

According to the GPS’ spokesman, Dr Camilla Pashley, primary care will also need to merge the arrangements in hours with that provided out of hours to provide urgent seamless care at all times, but the CCG orders make no allowance for this. “If you cannot do your job,” she tells me, “you naturally want to resign, but of course I won’t.” The CCG is itself inexperienced in this field, but is belatedly beginning to see that something drastic must be done.

What the GPS need is a cross-county co-ordination group with some heft to get the right sites. Such a body could secure some experts – not in medicine, but in building temporary structures fast. Such people exist, for example, in security firms or in companies which, in normal times, set up the staging for music festivals. They could solve this problem. Piers Morgan would probably see such people as “non-essential”. In fact, they matter more than ever.