Salisbury doctors feared ‘all-consuming’ nerve agent crisis following attack on Sergei Skripal and daughter

Medics who treated Sergei Skripal and his daughter have told how they feared that novichok exposure could spread through Salisbury and trigger an “all-consuming” crisis.

NHS staff at Salisbury District Hospital said they initially suspected the victims were suffering an opioid overdose but quickly realised they were dealing with a nerve agent.

When Detective Sergeant Nick Bailey was brought in with similar symptoms, there were fears that many more could fall victim to the chemical weapon.

Lorna Wilkinson, the hospital’s director of nursing, told the BBC’s Newsnight programme: “There was a real concern as to how big could this get.

“Have we just gone from having two index patients to having something that actually could become all-consuming and involve many casualties? Because we really didn’t know at that point.”

Mr Skripal, a former Russian double agent, and his daughter had passed out on a bench in The Maltings area of Salisbury after going for lunch and to a nearby pub.

Witnesses described them vomiting, twitching and being “slumped” together on 4 March.

Intensive care staff were only told that two “critically unwell” patients were being transferred from Accident and Emergency.

Police later informed them of their identity and made clear that the circumstances of their sudden illness appeared to be suspicious.

Dr Stephen Jukes, an intensive care consultant, said: “When we first were aware this was a nerve agent we were expecting them not to survive. We would try all our therapies. We would ensure the best clinical care. But all the evidence was there that they would not survive.”

Dr Duncan Murray, head of the department, said he had conversations with his staff about the night that he “could never have imagined in my wildest imagination having with anyone”.

He put the Skripals’ survival mainly down to “very good generic basic critical care” by Salisbury District Hospital’s doctors and nurses, who were “supported and supplemented by input from really well-informed international experts, some of whom happen to be on our doorstep at Porton Down”.

They were heavily sedated and given drugs that boost the body’s production of enzymes that replace those poisoned by the nerve agent.

Ms Skripal, 33, was discharged from hospital on 9 April and her father was released earlier this month.

Sources say both victims are being cared for in safe houses and have been interviewed by police, while security services consider whether to move them to a different country.

Ms Skripal said she and her father were “lucky to have both survived” in an interview filmed in a secret location, calling their recovery “slow and extremely painful”.

A Court of Protection hearing in March saw doctors raise concerns they could suffer permanent brain damage and doctors have not confirmed whether they will make a full recovery.

Asked to provide a long-term prognosis for the Skripals and DC Bailey, Dr Christine Blanshard told Newsnight that “the honest answer is we don’t know”.

The medical director of Salisbury District Hospital said that the attack currently makes up the “total world experience” of treating people who have been poisoned with novichok, adding: “It’s safe to say we’re still learning.”

The Independent understands police have still not yet identified a suspect in the poisoning, almost three months after the pair were attacked in Salisbury.

Counter-terror officers continue to investigate the case as attempted murder, after revealing the nerve agent was smeared on the handle of Mr Skripal’s front door.

Scotland Yard has declined to give any details of where the victims are being treated or security operations, amid Russian government accusations of “kidnapping”.

“This is a complex investigation and detectives continue to gather and piece together all the evidence to establish the full facts and circumstances behind this dreadful attack,” a spokesperson said.

“In the interests of Sergei and Yulia’s safety, we will not be discussing any protective or security arrangements that are in place.”

With the culprits still at large, national security adviser Sir Mark Sedwill said security services were reviewing arrangements for other Russian defectors living in the UK earlier this month.

Mr Skripal, a former military intelligence colonel, had been living openly under his real name after being handed over in a 2010 spy swap and the attempted assassination has increased fears held by other defectors.

Little over a week after the attack in Salisbury, Russian businessman Nikolai Glushkov was found strangled at his London home.

No one has been arrested in relation to his death and police investigations continue.

Scotland Yard said there was no immediate evidence of a link to the attack on Mr Skripal, but Mr Glushkov’s links to Russian dissident Boris Berezovsky sparked fresh scrutiny over a string of suspicious deaths.

The Kremlin has repeatedly denied involvement in the nerve agent attack, with state-owned Russian media publicising conspiracy theories implicating other states or the British government itself.

Vladimir Putin has cast doubt on analysis by the British military and the Organisation for the Prohibition of Chemical Weapons (OPCW) identifying novichok as the weapon used.

“I’m not an expert on those military grade toxic agents, but if such substance is used, then the victims die immediately... right on the spot,” he claimed on Friday.

Ahmet Üzümcü, the outgoing director-general of the OPCW, has called for the watchdog to go beyond analysis of the substances used in atrocities and start naming the culprits.

He said the Salisbury attack should be a “serious wake-up call” to the international community, warning: “If accountability is avoided, the potential re-emergence and acceptance of chemicals as weapons of war and terror will not be deterred.”

Decontamination work is ongoing in the Wiltshire city to rid sites of any traces of novichok, which was found to remain present in potentially toxic quantities at designated “hotspots”.

Businesses in The Maltings shopping district reopened for the first time since the attack on Saturday, although other sites including Mr Skripal’s home remain shut off.

Defra announced it had handed back the area from government control after an extensive clean-up and retesting, hailing a “massive step in the recovery for this beautiful city”.

The full BBC Newsnight report will be broadcast on BBC2 at 10.30pm, Tuesday 29 May