• IT is welcome to remember Wilfrid Harding as last Medical Officer of Health for the London Borough of Camden, (Trusted public health officials would have helped us in the Covid-19 pandemic, February 29).

Wilfrid was indeed exceptional, leading (with Max Rosenheim and Archie Cochrane) the new Faculty of Community Medicine within the Royal College of Physicians.

Camden was a rich borough in the 1960s, when office rates went directly to the borough rather than to central government, and Wilfrid helped two progressive general practices to create new premises, Kentish Town Health Centre. On retirement, he told me he was going to be a councillor (in Kent), the people who really had power.

Yet it is wrong to believe that any individual MOH could control a pandemic. From 1974 the MOH was transferred into the National Health Service (with few staff), leaving environmental and social services in the local authority.

Hospitals consumed the NHS funds.

General practice remained independent and fragmented. Epidemic monitoring was with the (national) Public Health Laboratory Service.

Policy was somewhere under the minister for health.

Before Covid-19, as well as frequent flu outbreaks, we had three major epidemics, AIDS, BSE and SARS. They were untreatable but transmission could be limited by altering public behaviour.

With Covid, decisions (and money) were at governmental level, with the national public health services limited and local services ignored.

Crucially, there was inadequate disease-control for care homes, not even a register, and GPs sat behind their screens.

These separated structures gave the virus its opportunity.

MARK McCARTHY, NW1