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‘The New Church of England’: Coronavirus Renews Pride in U.K.’s Health Service ‘The New Church of England’: Coronavirus Renews Pride in U.K.’s Health Service
(1 day later)
LONDON — Outside her home in south London, Gill Cronin bangs a metal pot with a wooden spoon as a motorbike passes, its horn blaring. On the dot of 8 p.m., the street erupts in a noisy tribute to Britain’s health workers.LONDON — Outside her home in south London, Gill Cronin bangs a metal pot with a wooden spoon as a motorbike passes, its horn blaring. On the dot of 8 p.m., the street erupts in a noisy tribute to Britain’s health workers.
“They are amazing and have not been appreciated enough,” said Ms. Cronin, a school support worker, who offers her thanks in this way every Thursday night, and described what Britain’s National Health Service means to her in one word: “Everything.”“They are amazing and have not been appreciated enough,” said Ms. Cronin, a school support worker, who offers her thanks in this way every Thursday night, and described what Britain’s National Health Service means to her in one word: “Everything.”
With its offer of free health care to all, based on need, the N.H.S. embodies qualities that Britons like to think represent the best of their nation.With its offer of free health care to all, based on need, the N.H.S. embodies qualities that Britons like to think represent the best of their nation.
Now, with the health workers risking, and sometimes losing, their lives while the government is accused of mishandling the coronavirus pandemic, the health service — which was regarded before the crisis as deeply troubled after 10 years of austerity and neglect — has become a rallying point for the nation.Now, with the health workers risking, and sometimes losing, their lives while the government is accused of mishandling the coronavirus pandemic, the health service — which was regarded before the crisis as deeply troubled after 10 years of austerity and neglect — has become a rallying point for the nation.
Premier League soccer players have organized a fund for donations, the street artist Banksy hung artwork at a hospital in Southampton, and a 100-year-old World War II veteran, Capt. Tom Moore, raised more than 30 million pounds (about $37 million) with a charity walk.Premier League soccer players have organized a fund for donations, the street artist Banksy hung artwork at a hospital in Southampton, and a 100-year-old World War II veteran, Capt. Tom Moore, raised more than 30 million pounds (about $37 million) with a charity walk.
“It is hard to explain how deeply embedded in our national psyche” the health service is, said Sarah Wollaston, a former lawmaker who chaired the House of Commons Health Select Committee. “Politicians mess with N.H.S. at their peril, because it is a national treasure.”“It is hard to explain how deeply embedded in our national psyche” the health service is, said Sarah Wollaston, a former lawmaker who chaired the House of Commons Health Select Committee. “Politicians mess with N.H.S. at their peril, because it is a national treasure.”
Even before the virus struck, the health service, though struggling, was probably still Britain’s most respected institution. As a source of national pride, it ranked first and significantly above the royal family in one 2016 survey.Even before the virus struck, the health service, though struggling, was probably still Britain’s most respected institution. As a source of national pride, it ranked first and significantly above the royal family in one 2016 survey.
At the opening ceremony of the 2012 Summer Olympics in London, the health service was featured alongside such symbols of Britishness as Queen Elizabeth II and James Bond. And it was so popular in a previous age that Nigel Lawson, a former chancellor of the Exchequer, famously described it as “the closest thing the English have to a religion.”At the opening ceremony of the 2012 Summer Olympics in London, the health service was featured alongside such symbols of Britishness as Queen Elizabeth II and James Bond. And it was so popular in a previous age that Nigel Lawson, a former chancellor of the Exchequer, famously described it as “the closest thing the English have to a religion.”
In normal times, such veneration tends to bemuse skeptics who associate Britain’s health service with dilapidated hospitals, overworked doctors and long waits for surgery. With an aging population and seemingly limitless demand — but extremely limited funding — the health service often struggles to cope.In normal times, such veneration tends to bemuse skeptics who associate Britain’s health service with dilapidated hospitals, overworked doctors and long waits for surgery. With an aging population and seemingly limitless demand — but extremely limited funding — the health service often struggles to cope.
When it fails, though, it tends to be politicians rather than clinicians who take the rap. So it is notable that politicians have in recent years tried to associate themselves with this national symbol wherever possible, none more so than Prime Minister Boris Johnson.When it fails, though, it tends to be politicians rather than clinicians who take the rap. So it is notable that politicians have in recent years tried to associate themselves with this national symbol wherever possible, none more so than Prime Minister Boris Johnson.
In the 2016 Brexit referendum, Mr. Johnson’s case for arguing to leave the European Union was based partly on a promise to divert the cost of Britain’s membership of the bloc (which he exaggerated) to an overstretched N.H.S.In the 2016 Brexit referendum, Mr. Johnson’s case for arguing to leave the European Union was based partly on a promise to divert the cost of Britain’s membership of the bloc (which he exaggerated) to an overstretched N.H.S.
In recent weeks, Mr. Johnson has depended on the health service in a far different way — and has talked about that, too. On being released from the hospital after being treated for Covid-19, the disease caused by the coronavirus, he thanked the health service for saving his life, offering an emotional statement in which he lavished praise on the nurses who had stood at his bedside.In recent weeks, Mr. Johnson has depended on the health service in a far different way — and has talked about that, too. On being released from the hospital after being treated for Covid-19, the disease caused by the coronavirus, he thanked the health service for saving his life, offering an emotional statement in which he lavished praise on the nurses who had stood at his bedside.
A couple of weeks later, when Mr. Johnson’s newest child, Wilfred, was born, the infant’s first view of the world was — like that of most newborns in Britain — the inside of an N.H.S. hospital. He was given the middle name Nicolas after two doctors who cared for Mr. Johnson last month.A couple of weeks later, when Mr. Johnson’s newest child, Wilfred, was born, the infant’s first view of the world was — like that of most newborns in Britain — the inside of an N.H.S. hospital. He was given the middle name Nicolas after two doctors who cared for Mr. Johnson last month.
As Mr. Johnson’s government has struggled to contain the coronavirus, it has tried to harness the popularity of the health service, featuring it prominently in a slogan urging compliance with a lockdown: “Stay home. Protect the N.H.S. Save lives.”As Mr. Johnson’s government has struggled to contain the coronavirus, it has tried to harness the popularity of the health service, featuring it prominently in a slogan urging compliance with a lockdown: “Stay home. Protect the N.H.S. Save lives.”
Health service bosses attend news conferences alongside their less trusted political masters, and a smartphone app to track people infected with the coronavirus is being developed by the health service, rather than the government, to reassure people worried about privacy.Health service bosses attend news conferences alongside their less trusted political masters, and a smartphone app to track people infected with the coronavirus is being developed by the health service, rather than the government, to reassure people worried about privacy.
Britons have, after all, trusted in the N.H.S. since 1948, when it was created by a Labour government after World War II to forge a country that would eradicate the “five evils”: want, disease, squalor, ignorance and idleness.Britons have, after all, trusted in the N.H.S. since 1948, when it was created by a Labour government after World War II to forge a country that would eradicate the “five evils”: want, disease, squalor, ignorance and idleness.
Paid for through general taxation and payroll deductions, treatment is delivered to all without money changing hands, with a few exceptions such as dentistry and medication charges.Paid for through general taxation and payroll deductions, treatment is delivered to all without money changing hands, with a few exceptions such as dentistry and medication charges.
With about 1.5 million employees, the N.H.S. is the world’s fifth biggest employer by one account, after the U.S. Department of Defense, the People’s Liberation Army of China, Walmart and McDonald’s. Like several of those organizations, it has a familiar logo, in this case emblazoned on the uniform of many nurses.With about 1.5 million employees, the N.H.S. is the world’s fifth biggest employer by one account, after the U.S. Department of Defense, the People’s Liberation Army of China, Walmart and McDonald’s. Like several of those organizations, it has a familiar logo, in this case emblazoned on the uniform of many nurses.
“I don’t think anybody sat down in the Ministry of Health in 1948 and said, ‘What we need is a strong brand,’ but that is what we got,” said John Appleby, the director of research and chief economist at the Nuffield Trust, a health research institute in London.“I don’t think anybody sat down in the Ministry of Health in 1948 and said, ‘What we need is a strong brand,’ but that is what we got,” said John Appleby, the director of research and chief economist at the Nuffield Trust, a health research institute in London.
“We all have respect for nurses, who are ‘angels,’ and doctors, who are ‘gods’ — that is the same as in lots of other countries,” Mr. Applebly said. “But here it is bound up with the institution they work for, and one of the differences is the existence of the N.H.S. as a brand.”“We all have respect for nurses, who are ‘angels,’ and doctors, who are ‘gods’ — that is the same as in lots of other countries,” Mr. Applebly said. “But here it is bound up with the institution they work for, and one of the differences is the existence of the N.H.S. as a brand.”
Health services in other European nations tend to be organized less centrally. They score better on some outcomes than the N.H.S., but most Britons tend to compare their system with America’s and recoil in alarm.Health services in other European nations tend to be organized less centrally. They score better on some outcomes than the N.H.S., but most Britons tend to compare their system with America’s and recoil in alarm.
“If you are not able to afford care in the U.S., you are often in a dire situation,” said Ms. Wollaston, who added that despite America’s higher spending on health, “the N.H.S. delivers equity and gives better bang for your buck.”“If you are not able to afford care in the U.S., you are often in a dire situation,” said Ms. Wollaston, who added that despite America’s higher spending on health, “the N.H.S. delivers equity and gives better bang for your buck.”
That sense helped Britain’s health service avoid the ideological conflicts that have marred the debate over health care in the United States and escape the free market revolution of Prime Minister Margaret Thatcher in the 1980s (though, under later governments, some market-style initiatives were introduced).That sense helped Britain’s health service avoid the ideological conflicts that have marred the debate over health care in the United States and escape the free market revolution of Prime Minister Margaret Thatcher in the 1980s (though, under later governments, some market-style initiatives were introduced).
In fact, the country’s health service is not the state monolith that it appears to be, but a morass of interlocking organizations, including groups of neighborhood doctors in what are mainly private businesses.In fact, the country’s health service is not the state monolith that it appears to be, but a morass of interlocking organizations, including groups of neighborhood doctors in what are mainly private businesses.
Updated June 5, 2020Updated June 5, 2020
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
“I always say that the N.H.S. is not so much an organization as an idea,” said Stephen Dorrell, a former health secretary who added that while patients have little idea of the financial plumbing behind the scenes, they like the basic principle that “people who are ill should have access to high-quality care.”“I always say that the N.H.S. is not so much an organization as an idea,” said Stephen Dorrell, a former health secretary who added that while patients have little idea of the financial plumbing behind the scenes, they like the basic principle that “people who are ill should have access to high-quality care.”
One of the downsides of the health service’s popularity is that resources tend to be drawn to hospitals at the expense of less glamorous areas like preventive health care, Mr. Dorrell said.One of the downsides of the health service’s popularity is that resources tend to be drawn to hospitals at the expense of less glamorous areas like preventive health care, Mr. Dorrell said.
Another disadvantage is that there is little incentive for clinicians to be friendly, or even particularly polite, since no money is changing hands. One joke is that the main difference in Britain for those who use private health care, as opposed to the public health service, is that a consultant will smile at them.Another disadvantage is that there is little incentive for clinicians to be friendly, or even particularly polite, since no money is changing hands. One joke is that the main difference in Britain for those who use private health care, as opposed to the public health service, is that a consultant will smile at them.
Yet those who have tried to change the N.H.S. have ultimately decided that it wasn’t worth the trouble. Reflecting on his time as a Conservative minister at the Health Department, Kenneth Clarke concluded that “you can declare war more peacefully than you can reform a health care system.”Yet those who have tried to change the N.H.S. have ultimately decided that it wasn’t worth the trouble. Reflecting on his time as a Conservative minister at the Health Department, Kenneth Clarke concluded that “you can declare war more peacefully than you can reform a health care system.”
Instead, governments have tended to curb its spending power. In the aftermath of the 2008 financial crisis, expenditure was squeezed during years of austerity, leaving the N.H.S. ill-prepared for the current pandemic, scrambling to expand its intensive care capacity and even to secure supplies of basic equipment like gowns and masks.Instead, governments have tended to curb its spending power. In the aftermath of the 2008 financial crisis, expenditure was squeezed during years of austerity, leaving the N.H.S. ill-prepared for the current pandemic, scrambling to expand its intensive care capacity and even to secure supplies of basic equipment like gowns and masks.
But at its moment of crisis, the one thing Britain’s health service does not lack is the support of its population.But at its moment of crisis, the one thing Britain’s health service does not lack is the support of its population.
“The N.H.S. is almost holy,” said Timothy Garton Ash, a professor of European studies at Oxford University. “It’s become the new Church of England.”“The N.H.S. is almost holy,” said Timothy Garton Ash, a professor of European studies at Oxford University. “It’s become the new Church of England.”
Mark Landler contributed reporting.Mark Landler contributed reporting.