There's no space in the middle because no one can draw West Ham's players into committing to the challenge and leaving gaps in behind. Kane had a brief moment of influence where he held the ball up and let the runners off him get into the box (around the 25th minute, iirc), but other than that, he's struggled to keep the ball when it has fallen to him, and with no one in the midfield to carry it forward, we've struggled as a result.
Our attacks down the flanks have been pretty grim as well, so it plays into the hands of a team sitting in their own final third in ostensibly their 'home' ground, playing for a draw or a nicked goal on the counter.
Plenty of time yet, but we need Dembele. Don't ask me who to take off, because the obvious choice (Son for Dembele) isn't happening given that we need a goal and Son is more likely to get one.
Oh, and for having a midfield block composed of two DMs in Dier and Wanyama, we haven't exactly managed to pick up their runners on the ultra rare occasions when they do venture forward - Lanzini is getting a lot of time and space to ping balls around, and I don't think we need to give him that time.