One of the advisers who helped draft Boris Johnson’s slogan that defined the UK’s Covid lockdowns has rejected claims by an inquiry that it prevented people from seeking urgent medical treatment.
In her latest report on the pandemic, Baroness Hallett said the slogan “Stay Home, Protect the NHS, Save Lives” “may have inadvertently sent the message that healthcare was closed” and that people were deterred from seeking help for serious non-Covid conditions such as heart attacks.
But Lee Cain, who was Downing Street director of communications during the crisis in 2020, said if the “Stay Home” messaging had been softened or diluted, the virus would have had an even more devastating effect on the NHS and led to more deaths, not fewer.
He said it was “staggeringly naive” to suggest that a softer message would have been preferable.
Cain, who sat around the Cabinet table in Johnson’s No10 when the slogan was being drafted, told The i Paper a weaker message would have risked “armed soldiers at the entrances of hospitals stopping desperate people entering and ice rinks being used as mass morgues”.
A poster encouraging people to stay at home to protect the NHS during the first Covid lockdown (Photo by Matthew Horwood/Getty Images)The “Stay Home” slogan appeared prominently in government communication campaigns during the early stages of the pandemic, including as branding on the podiums during Downing Street press conferences led by Johnson, chief medical officer Sir Chris Whitty and chief scientific adviser Sir Patrick Valance.
In her report on the healthcare response to Covid, published on Thursday, Hallett listed the “Stay Home” advice as one of the reasons people were “deterred from accessing healthcare”.
The report added: “There was a decline in attendances at emergency departments and other healthcare settings for non-Covid-19 conditions, even for life-threatening medical emergencies such as heart attacks.
“This suggests that the public messaging of Stay Home, Protect the NHS, Save Lives may have, inadvertently, sent the message that healthcare was closed.”
Lee Cain served as Boris Johnson’s director of communications (Photo by Leon Neal/Getty Images)However, Hallett’s report also concluded that the NHS in all four nations came “close to collapse” due to the overwhelming number of patients needing treatment for the virus.
Cain said: “The Covid inquiry has criticised the ‘Stay at Home’ message for being too successful – claiming it may have stopped some people from leaving home to seek help for urgent health conditions.
“The argument is staggeringly naive, resting on the assumption that there was an alternative world where those people could safely access the care they needed. This didn’t exist.
“If the ‘Stay at Home’ message had been softened, more nuanced, more caveated, more complicated, compliance would have dropped, the R rate would have risen faster and an already strained NHS would have been overwhelmed.
‘Very real scenario’ of ‘mass morgues’ and soldiers stationed at hospitals
“I was around the Cabinet table when this very real scenario was discussed. It would have meant tens-of-thousands of additional avoidable deaths, many dying in horrific ways with too few ventilators and beds for the vast numbers of patients.
“We would have seen even more patients on hospital floors urgently needing treatment, armed soldiers at the entrances of hospitals stopping desperate people entering and ice rinks being used as mass morgues.
“In this situation a person having a heart attack would be far less likely to get a bed, a cancer patient wouldn’t be able to access chemotherapy.
“The very people the inquiry is worried about, the ones with urgent, non-Covid medical needs, would have been the ones who suffered most.”
Cain added that at the time of the outbreak, given the rapid increase in cases of the virus, there was no scenario “where everybody was protected from every risk”.
He added: “It was the job of communicators to assess the risk and decide on the messaging that would save the maximum number of lives, and I believe we were successful.
“Great messaging is about simplicity and clarity. People need a clear call to action, especially when facing a public health crisis. The Covid messaging achieved this, with 91 percent of people understanding the ‘Stay at Home’ message clearly – and then acting in the correct way. A weaker message would have led to more deaths, not fewer.
“Vulnerable groups were not forgotten. Important targeted campaigns were developed and ran in parallel for domestic abuse survivors, for those shielding, for people with mental health conditions.
“They didn’t run as part of the main message, because diluting the core call to action would have undermined our aim of keeping the health service functioning and saving lives.That was a deliberate and, I believe, correct decision.
“Fundamentally the inquiry has totally missed the point when examining messaging. When the NHS collapses, it doesn’t discriminate – everyone loses access to care. The purpose of ‘Stay at Home’ was to prevent that from happening and the evidence suggests it did.
“Scrutinising the message without weighing that outcome isn’t a full accounting of what happened. It’s half the story and it will lead to more deaths when we face the next national health crisis.”
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