By John Helmer, Moscow, and Liane Theuerkauf, Munich
The leading hospital doctors on Novichok poisoning in Britain and Germany are not allowed by their governments to reveal publicly the medical information they have exchanged with each other.
James Haslam, the chief doctor at Salisbury District Hospital treating Sergei Skripal and Yulia Skripal for Novichok poisoning in March 2018, and Elspeth Hulse, an anaesthetist at Newcastle upon Tyne hospital and co-author with Haslam of a medical research paper on the Skripal case, refused this week to say if they participated with German doctors in the treatment of Alexei Navalny for Novichok poisoning at Charité Hospital in Berlin in August 2020.
According to Hulse, she has been ordered to keep silent by the British Ministry of Defence. Asked what communications and consultations on their expertise in the Skripal case they exchanged with the Berlin doctors treating Navalny, Hulse replied: “I have been advised that you should in the first instance go though [sic] the UK MOD press office. Press Office 020 7218 7907 I hope that this helps.”
Haslam also refused to answer if he had communicated with Navalny’s doctors in Berlin, or when.
Cara Charles-Barks, chief executive of the Salisbury hospital, refused this week to say what collaboration there has been between Salisbury and the Charité — the only two hospitals in the world to claim to have successfully treated cases of Novichok poisoning.
However, the British and Germans did collaborate in secret. Last week Philipp Jacoby, the German doctor directing the medical evacuation of Navalny from Omsk Hospital in Russia to Charité in Berlin in August last year, revealed that when he brought Navalny to Charité, there was “a welcome committee (Empfangskomitee) of about 30 people present.” He added he didn’t know who they were except that they were an “international” group.
The lead German doctors treating Navalny, Kai-Uwe Eckardt and David Leindl, published last December a detailed clinical case report on the Navalny case; they reported the psychotropic drugs, lithium and benzodiazepines, in his blood and urine on arrival; his biochemical test scores for each of the days he was in hospital; and their course of treatment with atropine and blood plasma. Jacoby is one of their co-authors. This week Eckardt and Leindl were asked “to confirm the contacts and communications you had with British doctors of Salisbury District Hospital on the August 22 day of [Navalny’s] admission and subsequently?” They refuse to reply.
Since Jacoby’s fresh disclosure of the “welcome committee”, the record of what the British and German doctors did, and when they did it, is evidence of how the two governments planned the public disclosure of the two Novichok attacks and the Anglo-German allegation that the Russian government was behind both of them.
A leading British specialist on organophosphate poisoning commented: “Here is an irony. Jacoby and the Charité hospital group published in The Lancet every minute detail about Navalny’s diagnostics. Now Dr.Hulse defers to the Ministry of Defence. What is the secret they are concealing — that the British treatment of the Skripals for Novichok exposure was different from the German treatment of Navalny? Or is the secret that there was no Novichok in either case?”
Left to right: Dr James Haslam; Dr Elspeth Hulse; Dr Kai-Uwe Eckardt.
The weapons of chemical warfare are state secrets; their use is regulated by the international Chemical Weapons Convention (CWC)  and administered by the multinational Organisation for the Prohibition of Chemical Weapons (OPCW ). Medical research on the composition and effect of nerve agents and therapeutic treatment for organophosphate poisoning is open medical science, regulated for treating doctors by the Hippocratic Oath .
In their attempt to prove the Russians had used Novichok against the Skripals in Salisbury in March 2018, and against Navalny in Tomsk in 2020, the British and German governments have reported claims made by their military laboratories in Porton Down and Munich, but kept the details secret; no medical doctor has signed them for public release. For corroboration, the two governments requested OPCW to test the Skripals and Navalny and report the findings. Read the results here .
The German government also asked French and Swedish military laboratories to conduct parallel tests for Navalny. The results made public by the NATO governments appear to be uniform; the unpublished details are far from certain or conclusive; they fall short of the forensic standard required by British criminal courts. Read more .
In 2019 Haslam and Hulse published a research paper in the British Journal of Anaesthesia declaring their intention “to enlighten and signpost anaesthetists and intensivists towards the general management of OP [organophosphate] nerve agent poisoned patients.” They concluded their paper by saying: “The authors look forward to the publication of the lessons learned from the Salisbury OP nerve agent poisonings so that treatment guidelines can be optimised in the future.” Hulse & Haslam research paper 2019 .
Source: https://pubmed.ncbi.nlm.nih.gov/ 
In fact, there has been a British government blackout on the publications Haslam and Hulse promised. Hulse has now admitted this.
The German doctors treating Navalny published their report in The Lancet on December 22, 2020 . They cited Haslam and Hulse for research support of their findings and treatment. According to the Germans, after they had started Navalny on the organophosphate antidotes, atropine and obdoxime at 750 mg per day, “cholinergic signs returned to normal within 1h after the onset of this antidotal therapy. Analgo-sedation with sufentanil and propofol was supplemented with midazolam for neuroprotection”. This drug therapy is footnoted to the BJA report by Haslam and Hulse.
Source: https://www.thelancet.com/ 
What the German report does not mention is that their testing of Navalny on his arrival in Berlin showed the Russian doctors had already administered atropine and propofol in Omsk hospital .
The German doctors’ evidence over 42 days – presented in four technical appendices  — did not confirm that Navalny had been the target of a criminal attack and fell short of corroborating the Novichok allegation. Instead, the German doctors’ evidence indicated that Navalny had been using psychoactive drugs before his collapse, and his biochemical tests indicated what the Omsk Hospital doctors had earlier called a “metabolic disorder”.
Non-Russian doctors reviewing the German test results suggest they may indicate diabetes, pancreatitis, liver problems, and complications from staphylococcal infection; read more . Non-Russian psychiatrists claim Navalny’s drug use indicates the likelihood of bipolar disorder .
Navalny has accused the Russian doctors of lying. Jacoby repeated this allegation last week. For the full archive of evidence and forensic analysis in the case, read this .
In his three press interviews Jacoby (right) provided the first eyewitness account by a non-Russian doctor of Navalny’s symptoms in Omsk and his treatment on the medevac flight to Berlin. In two of the interviews, Jacoby also revealed details of pre-planning of his flight which occurred the day before Navalny fell ill. In addition, Jacoby testified that the first mention he heard of Novichok came from the Navalny staff assistant, Maria Pevchikh, at the Omsk hospital. Pevchikh, also according to Jacoby, gave him water bottles she said she had taken from Navalny’s hotel room on the morning after his collapse. Jacoby revealed he had smuggled the bottles past Omsk airport control and presented them to the “welcome committee” at the Charité hospital when he handed Navalny over.
According to a report from Der Spiegel, dated August 28, 2020 , the German doctors involved in Navalny’s treatment, including German Army medicos, requested information from the British chemical warfare laboratory at Porton Down. Porton Down doctors may have been in the Berlin “welcome committee” on August 22, 2020.
A British organophosphate specialist has noted the report which Eckardt and Jacoby published in The Lancet reveals that on the sixth day after their treatment of Navalny began, his butyrylcholinesterase level in blood was below normal. That, they reported, “prompted us to administer 6 units of fresh-frozen plasma; this transfusion led to a pronounced increase in activity with no subsequent decline”.
If plasma transfusion was an effective therapy for Novichok poisoning, did the Salisbury hospital doctors, Hulse, and the Porton Down experts use it for the Skripals?
The British expert replied: “The use of fresh frozen plasma (6 units which is about 1.5 litres) seems key in getting Navalny’s butyrylcholinesterase levels back to normal. Typical human volume is 5 litres, so quite a sizeable proportion. Why wait 6 days for the most important part of the therapy? There are no downsides to blood transfusions. So we see that 8 days after the attack [on Navalny], Porton Down taking a while to advise, or Berlin taking a while to ask. Why the secrecy? It seems medical common sense. Seems inconceivable that the Skripals and [Wiltshire police detective sergeant Nicholas] Bailey did not get plasma transfusions — unless they were not poisoned. Also seems more than strange that Berlin waited 6 days — unless he was not poisoned.”
A research report by Israeli doctors on the use of blood plasma transfusions as an antidote for organophosphate poisons, setting the standard for antidote therapy from 2004. Source: https://academic.oup.com/ 
On Thursday in Moscow, the Russian Foreign Ministry spokesman Maria Zakharova was asked eight questions for clarification of Jacoby’s account of the Navalny medevac operation, the subsequent German doctors’ report, and the official statements by the German government.
Source: https://www.mid.ru/ 
Zakharova replied: “Unfortunately, today we cannot reasonably judge the reliability of the statements of the German physician P. Jacoby who accompanied A. Navalny during the medical evacuation from Omsk on August 22, 2020, given that we only know about them from the words of John Helmer himself and his co-author Liane Theuerkauf. Nevertheless, the quoted statements of Jacoby largely echo our own doubts related to the numerous ‘dark spots’ in the story of the ‘poisoning’ of the blogger, which in retrospect increasingly take on the features of a planned action designed to denigrate our country, to come up with new reasons for future sanctions.”
Read the full Foreign Ministry statement here .
The British inquest into the alleged Novichok poisoning death of Dawn Sturgess at Salisbury hospital in July 2018 resumes its hearing of evidence on September 22. The coroner, Baronness Heather Hallett, will discuss an application from the British government’s lawyers to keep the medical evidence secret. For more details, click to read .