Conspiracy theorist David Icke has released a long video that has been shared on social media, talking about the use of a drug called midazolam during the Covid-19 pandemic. He claims that midazolam was used to facilitate the “culling of old people”, and that Covid-19 is a faked pandemic used as a guise to allow this.
He also claims that tests for Covid-19 are “fake” and death certificates issued during the pandemic are fraudulent.
There is no evidence for any of these claims.
Honesty in public debate matters
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Covid-19 is real
Covid-19 is the disease caused by the SARS-Cov-2 virus. We have written many times before about the Covid-19 pandemic, and the evidence behind proof of its existence. It has been isolated many times, been recognised worldwide and was declared a pandemic by the World Health Organisation in March 2020.
We also know that tests for Covid-19 are largely accurate. We have written more about tests for Covid-19 previously.
There has been some controversy around the way that deaths from Covid-19 have been recorded. Sometimes death tolls count anybody who has died within 28 days of a positive test for Covid-19. Others, however, only include deaths which have Covid-19 recorded as the cause of death on the death certificate by a doctor (the government’s Covid-19 dashboard includes both of these tolls).
Up until the week ending 28 May 2021, the Office for National Statistics data shows there have been 138,367 deaths in England and Wales involving Covid-19 (where Covid-19 is mentioned anywhere on the death certificate), and 123,717 with Covid-19 documented as the underlying cause of death on the death certificate.
As of April 2021, there were approximately 42,341 deaths of care home residents involving Covid-19 in England and Wales. This is an approximate figure, as testing availability in the community was variable, particularly during the first wave.
What is midazolam and how is it used?
Midazolam is a type of benzodiazepine medication, used as a conscious sedative, anaesthetic agent, anticonvulsant and is also licensed to help manage restlessness and agitation in palliative care.
Midazolam is often prescribed as an ‘anticipatory medication’. These are medications that are prescribed in advance for patients who are nearing the end of life should they experience any common and unpleasant symptoms such as anxiety, pain, nausea and vomiting associated with the dying process. They do not necessarily have to be used, and should be given ‘as required’.
Midazolam can also be used more generally for patients who are not nearing end of life, and for sedation for certain medical procedures.
There is no evidence that midazolam was being used with the intention of ending care home residents’ lives, or that this was a formal policy.
The Department of Health and Social Care (DHSC) told Full Fact: “These claims are deeply misleading. The government’s top priority throughout this pandemic has always been doing everything possible to save lives.”
Euthanasia remains illegal in the UK.
The government did stockpile midazolam
During the Covid-19 pandemic, the government did stockpile certain medications, including midazolam.
DHSC told Full Fact: “COVID-19 has brought about an increase in global and UK demand for a number of medicines, including midazolam to support patients in intensive care or at the end of their lives.”
In his video post, Mr Icke says that the UK supplemented stocks by getting midazolam from France.
A DHSC spokesperson previously told Full Fact that: “To manage increases in demand, we have been building UK stockpiles of key medicines, including midazolam.
“All of the Midazolam purchased for the UK Covid-19 medicines stockpile was sourced within the UK, has been licensed for use in the UK and was destined for the UK market.”
There has been some confusion around where the stock came from, as an article published in the Pharmaceutical Journal in May 2020, in which the DHSC reportedly confirmed that “some French label stock” of midazolam was being sold in the UK. It is unclear whether this stock had already reached France or had been produced and held in the UK.
We have written more about this previously.
Using midazolam is not the same as re-introducing the Liverpool Care Pathway
In the video, Mr Icke suggests that the use of midazolam, and practices around end of life care are a return to the Liverpool Care Pathway, which was abolished in 2014.
The Liverpool Care Pathway (LCP) was a generic approach to care for the dying, intended to improve end of life care and allow some of the essentials of palliative medicine and hospice model end of life practices into hospitals and other healthcare settings.
It became controversial and was criticised by patient and family groups, media and by some medical professionals who referenced cases where individuals had been ‘put on’ the pathway without consent or discussion and where the pathway had been used as an excuse for depersonalised and substandard care. Complaints included anger around medications being stopped, patients not being offered food and drink, or being inappropriately identified as dying. There were also criticisms that the use of the LCP had hastened people’s deaths through over-prescription of painkillers and/or the withdrawal of hydration or nutrition.
This led to an independent review in 2013, which concluded that although the principles behind the LCP could promote good practice and prevent suffering at the end of life, there had been failings. It was recommended that the LCP be replaced by an individualised end of life care plan for each patient. The review also recommended structural change, education, planning and inspection around end of life care.
Therefore, while midazolam was included as a symptom control option in the LCP, its use has continued as a tenet of good end of life care.
There is no evidence that the LCP has been reinstated. DHSC confirmed that it is not aware of any trusts using the LCP since it was phased out, and NHS England is clear that the LCP must not be used.