LONG READ
A study has outlined serious errors and delays at the hands of the Government and scientific advisers that cost lives
“Decisions on lockdowns and social distancing during the early weeks of the pandemic rank as one of the most important public health failures the United Kingdom has ever experienced” according to a new report.
Serious errors and delays at the hands of the Government and scientific advisers cost lives during the Covid-19 pandemic, according to a study from the cross-party Science and Technology Committee and the Health and Social Care Committee.
The report found that the UK's preparation for a pandemic was far too focused on flu, while ministers waited too long to push through lockdown measures in early 2020.
In a wide-ranging report, which is very focused on England, MPs said the UK's pandemic planning was too "narrowly and inflexibly based on a flu model" that failed to learn the lessons from Sars, Mers and Ebola.
WalesOnline has already conducted substantial investigations into both the Welsh and UK Government responses to Covid that you can read below:
19 mistakes the UK Government made during the Covid pandemic which cost Welsh lives
These are some (but by no means all) of the issues outlined in the report:
Pandemic preparedness
The anticipated future risk of pandemic disease focused too closely on influenza rather than diseases like SARS and MERS that had in recent years appeared in Asian countries.
COBRA was not well-suited to the modern demands of a pandemic response. It is especially concerning that its culture of confidentiality was considered by some to be so unreliable that alternative meetings were arranged .
Protocols to share data between public bodies involved in the response were too slow to establish and to become functional. This was especially true in the data flows from national to local government.
The NHS responded quickly and strongly to the demands of the pandemic, but compared to other health systems it “runs hot”—with little spare capacity builtin to cope with sudden and unexpected surges of demand such as in a pandemic.
Lockdowns and social distancing
During the first three months of the Covid pandemic, the UK followed the wrong policy in its use of non-pharmaceutical interventions. When the UK moved from the "contain" to "delay" stage, there was a policy of seeking to only moderate the speed of infection through the population—flattening the curve—rather than seeking to arrest its spread.
The lack of adequate data on the spread of covid-19, as a result of the inadequacy of the UK testing operation.
Overreliance on specific mathematical models when there were too many uncertainties
Assumptions about public compliance with rules that turned out to have underestimated the willingness to conform even for long periods.
The composition of SAGE suffered from a lack of representation from outside the United Kingdom.
A preference for a particular UK approach may have been favoured above advice based on emulation of what was being pursued elsewhere.
In the autumn it is likely that a “circuit break” with temporary lockdown measures if introduced in September 2020, and earlier lockdown measures during the winter, could have impeded the rapid seeding and spread of the Kent variant.
Testing and contact tracing
Despite being one of the first countries in the world to develop a test for covid in January 2020, the United Kingdom failed to translate that scientific leadership into operational success in establishing an effective test and trace system during the first year of the pandemic.
Testing capacity was treated too much as a parameter rather than a variable that could be changed by the Department of Health and Social Care and scientific advisers. What was being achieved in other countries, particularly East Asia, appeared to be of little interest in the initial weeks of the pandemic. This was "an inexcusable oversight".
The new Test and Trace (England only but wales had similar problems) operation eventually established in May 2020 was a step in the right direction but set up much too late.
Vast sums of taxpayers’ money were directed to Test and Trace, justified by the benefits of avoiding further lockdowns. But ultimately those lockdowns happened. Were it not for the success of the NHS vaccination programme, it is likely that further lockdown restrictions would have been needed in the summer 2021.
The Test and Trace organisation has not, despite its branding, been run by the NHS, and has seen senior executives brought in from external bodies for short term contracts which reduces the institutional learning, from what was an intense period, that has been retained.
Partly because it was set up too late, NHS Test and Trace ultimately fell short of the expectations set for it. It has failed to make a significant enough impact on the course of the pandemic to justify the level of public investment it received. It clearly failed on its own terms, given its aim in September to “avoid the need for a second lockdown” by contributing to a reduction in the ‘R’ number.
Social care
Social care had a less prominent voice in Government during the early stages of the pandemic than did the NHS.
Staff shortages, the lack of testing, difficulties in obtaining PPE and the design of care settings to enable communal living hampered isolation and infection control and the ability to keep Covid at bay. Social care staff in care homes and providing domiciliary care worked under strenuous conditions, at risk to themselves, to provide care to people. This was directed at England but Wales had exactly the same issues.
The discharge of elderly people from NHS hospitals into care homes without having been tested at the beginning of the pandemic—while understandable as the NHS prepared to accept a surge of Covid patients—had the unintended consequence of contributing to the spread of infection in care homes.. Again this is focused on England but you can see that Wales had the same issues here.
Former chief medical officer Professor Dame Sally Davies told MPs there was "groupthink", with infectious disease experts not believing that "Sars, or another Sars, would get from Asia to us".
The UK's national risk register, which was in place at the start of the pandemic, said "the likelihood of an emerging infectious disease spreading within the UK is assessed to be lower than that of a pandemic flu". It also said only up to 100 people may die during any outbreak of an emerging infectious disease.
Once Covid emerged in China, MPs said the UK policy was to take a "gradual and incremental approach" to interventions such as social distancing, isolation and lockdowns.
In their study, they said this was "a deliberate policy" proposed by scientists and adopted by UK governments, which has now been shown to be "wrong" and led to a higher death toll.
The MPs said the "decisions on lockdowns and social distancing during the early weeks of the pandemic - and the advice that led to them - rank as one of the most important public health failures the United Kingdom has ever experienced".
On the issue of whether the Government was pursuing a policy of herd immunity, which has proved controversial, MPs said that while it was not an official Government strategy, there was a "policy approach of fatalism about the prospects for Covid in the community".
Experts and ministers sought to "only moderate the speed of infection" through the population - flattening the curve - rather than seeking to stop its spread altogether.
The report added: "The policy was pursued until March 23 because of the official scientific advice the Government received, not in spite of it."
Even as late as March 12, 2020, Sir Patrick Vallance, the Government's chief scientific adviser, told a Government press conference that it was not possible to stop everyone being infected, and nor was that a desirable objective.
The following day, members of the Scientific Advisory Group for Emergencies (Sage) also said they were "unanimous that measures seeking to completely suppress spread of Covid-19 will cause a second peak".
After hearing evidence from people including the Prime Minister's former adviser Dominic Cummings, and former health secretary Matt Hancock, the MPs concluded it was only in the days leading up to the March 23 lockdown that people within Government and advisers "experienced simultaneous epiphanies that the course the UK was following was wrong, possibly catastrophically so".
A paper from Imperial College London, presented to Sage, was among models showing that an unmitigated epidemic could result in around 500,000 UK deaths.
MPs concluded it was "astonishing" it took so long for Sage to say a full lockdown was needed and for the Government to implement one, adding they thought the evidence showed a lockdown was "inevitable".
In other criticisms, MPs said the UK also implemented "light-touch border controls" only on countries with high Covid rates, even though 33% of cases during the first wave were introduced from Spain and 29% from France.
They also argued that earlier social distancing and locking down "would have bought much-needed time" for vaccine research to bear fruit, for Covid treatments to be developed and for a proper test and trace system to be set up.
They said the "early weeks of the pandemic expose deficiencies in both scientific advice and Government action", with no real idea of how far the virus had spread and a downplaying of the role of asymptomatic transmission.
Furthermore, there was a false belief that the public would not accept lockdown, or would only do so for a short period of time.
The lack of testing capacity also meant there was nowhere near enough data on Covid spread, while abandoning community testing on March 12 was regarded by MPs as a "seminal failure".
Elsewhere, MPs said that thousands of elderly people died in care homes during the first wave of the pandemic, something that showed "social care had a less prominent voice in Government during the early stages of the pandemic than did the NHS".
The decision not to test people discharged from hospitals to care homes early on was a failure and led to deaths, they added.
In a joint statement, Tory MPs Greg Clark and Jeremy Hunt, who chair the committees, said: "The UK response has combined some big achievements with some big mistakes. It is vital to learn from both to ensure that we perform as best as we possibly can during the remainder of the pandemic and in the future.
"Our vaccine programme was boldly planned and effectively executed. Our test and trace programme took too long to become effective.
"The Government took seriously scientific advice but there should have been more challenge from all to the early UK consensus that delayed a more comprehensive lockdown when countries like South Korea showed a different approach was possible.
"In responding to an emergency, when much is unknown, it is impossible to get everything right.
"We record our gratitude to all those - NHS and care workers, scientists, officials in national and local government, workers in our public services and in private businesses and millions of volunteers - who responded to the challenge with dedication, compassion and hard work to help the whole nation at one of our darkest times."
The report also pointed to the regional tier system as being confusing for the public, adding that it was not "watertight" enough to prevent infection spreading.
Elsewhere, scientific evidence for some measures was lacking, such as the imposition from September 24 2020 of a 10pm curfew on pubs, or the banning of outdoor children's sports clubs, MPs said.
Regarding the second lockdown, MPs said that had more stringent social distancing measures been adopted during the autumn, they could have "reduced the seeding of the Alpha variant across the country, slowed its spread and therefore have saved lives".
However, MPs also noted it was true that the Alpha variant only became known about in December 2020.
Across the board, the report criticised a national failure to share data between central and local government, adding that the NHS was squeezed due to shortages of staff.
Regarding test and trace, the "slow, uncertain, and often chaotic performance of the test, trace and isolate system severely hampered the UK's response to the pandemic", MPs said.
They also noted "unacceptably high death rates among people from black, Asian and minority ethnic communities" and those with learning disabilities.
But MPs offered praise in two areas - treatments and vaccines - saying ministers were "correct to identify that a vaccine would be the long-term route out of the pandemic" and supported research and development.
Shadow health secretary Jonathan Ashworth said of the report: "This is a damning report by a cross-party group of MPs into the monumental errors made by ministers in responding to the pandemic."
A study has outlined serious errors and delays at the hands of the Government and scientific advisers that cost lives
“Decisions on lockdowns and social distancing during the early weeks of the pandemic rank as one of the most important public health failures the United Kingdom has ever experienced” according to a new report.
Serious errors and delays at the hands of the Government and scientific advisers cost lives during the Covid-19 pandemic, according to a study from the cross-party Science and Technology Committee and the Health and Social Care Committee.
The report found that the UK's preparation for a pandemic was far too focused on flu, while ministers waited too long to push through lockdown measures in early 2020.
In a wide-ranging report, which is very focused on England, MPs said the UK's pandemic planning was too "narrowly and inflexibly based on a flu model" that failed to learn the lessons from Sars, Mers and Ebola.
WalesOnline has already conducted substantial investigations into both the Welsh and UK Government responses to Covid that you can read below:
19 mistakes the UK Government made during the Covid pandemic which cost Welsh lives
These are some (but by no means all) of the issues outlined in the report:
Pandemic preparedness
The anticipated future risk of pandemic disease focused too closely on influenza rather than diseases like SARS and MERS that had in recent years appeared in Asian countries.
COBRA was not well-suited to the modern demands of a pandemic response. It is especially concerning that its culture of confidentiality was considered by some to be so unreliable that alternative meetings were arranged .
Protocols to share data between public bodies involved in the response were too slow to establish and to become functional. This was especially true in the data flows from national to local government.
The NHS responded quickly and strongly to the demands of the pandemic, but compared to other health systems it “runs hot”—with little spare capacity builtin to cope with sudden and unexpected surges of demand such as in a pandemic.
Lockdowns and social distancing
During the first three months of the Covid pandemic, the UK followed the wrong policy in its use of non-pharmaceutical interventions. When the UK moved from the "contain" to "delay" stage, there was a policy of seeking to only moderate the speed of infection through the population—flattening the curve—rather than seeking to arrest its spread.
The lack of adequate data on the spread of covid-19, as a result of the inadequacy of the UK testing operation.
Overreliance on specific mathematical models when there were too many uncertainties
Assumptions about public compliance with rules that turned out to have underestimated the willingness to conform even for long periods.
The composition of SAGE suffered from a lack of representation from outside the United Kingdom.
A preference for a particular UK approach may have been favoured above advice based on emulation of what was being pursued elsewhere.
In the autumn it is likely that a “circuit break” with temporary lockdown measures if introduced in September 2020, and earlier lockdown measures during the winter, could have impeded the rapid seeding and spread of the Kent variant.
Testing and contact tracing
Despite being one of the first countries in the world to develop a test for covid in January 2020, the United Kingdom failed to translate that scientific leadership into operational success in establishing an effective test and trace system during the first year of the pandemic.
Testing capacity was treated too much as a parameter rather than a variable that could be changed by the Department of Health and Social Care and scientific advisers. What was being achieved in other countries, particularly East Asia, appeared to be of little interest in the initial weeks of the pandemic. This was "an inexcusable oversight".
The new Test and Trace (England only but wales had similar problems) operation eventually established in May 2020 was a step in the right direction but set up much too late.
Vast sums of taxpayers’ money were directed to Test and Trace, justified by the benefits of avoiding further lockdowns. But ultimately those lockdowns happened. Were it not for the success of the NHS vaccination programme, it is likely that further lockdown restrictions would have been needed in the summer 2021.
The Test and Trace organisation has not, despite its branding, been run by the NHS, and has seen senior executives brought in from external bodies for short term contracts which reduces the institutional learning, from what was an intense period, that has been retained.
Partly because it was set up too late, NHS Test and Trace ultimately fell short of the expectations set for it. It has failed to make a significant enough impact on the course of the pandemic to justify the level of public investment it received. It clearly failed on its own terms, given its aim in September to “avoid the need for a second lockdown” by contributing to a reduction in the ‘R’ number.
Social care
Social care had a less prominent voice in Government during the early stages of the pandemic than did the NHS.
Staff shortages, the lack of testing, difficulties in obtaining PPE and the design of care settings to enable communal living hampered isolation and infection control and the ability to keep Covid at bay. Social care staff in care homes and providing domiciliary care worked under strenuous conditions, at risk to themselves, to provide care to people. This was directed at England but Wales had exactly the same issues.
The discharge of elderly people from NHS hospitals into care homes without having been tested at the beginning of the pandemic—while understandable as the NHS prepared to accept a surge of Covid patients—had the unintended consequence of contributing to the spread of infection in care homes.. Again this is focused on England but you can see that Wales had the same issues here.
Former chief medical officer Professor Dame Sally Davies told MPs there was "groupthink", with infectious disease experts not believing that "Sars, or another Sars, would get from Asia to us".
The UK's national risk register, which was in place at the start of the pandemic, said "the likelihood of an emerging infectious disease spreading within the UK is assessed to be lower than that of a pandemic flu". It also said only up to 100 people may die during any outbreak of an emerging infectious disease.
Once Covid emerged in China, MPs said the UK policy was to take a "gradual and incremental approach" to interventions such as social distancing, isolation and lockdowns.
In their study, they said this was "a deliberate policy" proposed by scientists and adopted by UK governments, which has now been shown to be "wrong" and led to a higher death toll.
The MPs said the "decisions on lockdowns and social distancing during the early weeks of the pandemic - and the advice that led to them - rank as one of the most important public health failures the United Kingdom has ever experienced".
On the issue of whether the Government was pursuing a policy of herd immunity, which has proved controversial, MPs said that while it was not an official Government strategy, there was a "policy approach of fatalism about the prospects for Covid in the community".
Experts and ministers sought to "only moderate the speed of infection" through the population - flattening the curve - rather than seeking to stop its spread altogether.
The report added: "The policy was pursued until March 23 because of the official scientific advice the Government received, not in spite of it."
Even as late as March 12, 2020, Sir Patrick Vallance, the Government's chief scientific adviser, told a Government press conference that it was not possible to stop everyone being infected, and nor was that a desirable objective.
The following day, members of the Scientific Advisory Group for Emergencies (Sage) also said they were "unanimous that measures seeking to completely suppress spread of Covid-19 will cause a second peak".
After hearing evidence from people including the Prime Minister's former adviser Dominic Cummings, and former health secretary Matt Hancock, the MPs concluded it was only in the days leading up to the March 23 lockdown that people within Government and advisers "experienced simultaneous epiphanies that the course the UK was following was wrong, possibly catastrophically so".
A paper from Imperial College London, presented to Sage, was among models showing that an unmitigated epidemic could result in around 500,000 UK deaths.
MPs concluded it was "astonishing" it took so long for Sage to say a full lockdown was needed and for the Government to implement one, adding they thought the evidence showed a lockdown was "inevitable".
In other criticisms, MPs said the UK also implemented "light-touch border controls" only on countries with high Covid rates, even though 33% of cases during the first wave were introduced from Spain and 29% from France.
They also argued that earlier social distancing and locking down "would have bought much-needed time" for vaccine research to bear fruit, for Covid treatments to be developed and for a proper test and trace system to be set up.
They said the "early weeks of the pandemic expose deficiencies in both scientific advice and Government action", with no real idea of how far the virus had spread and a downplaying of the role of asymptomatic transmission.
Furthermore, there was a false belief that the public would not accept lockdown, or would only do so for a short period of time.
The lack of testing capacity also meant there was nowhere near enough data on Covid spread, while abandoning community testing on March 12 was regarded by MPs as a "seminal failure".
Elsewhere, MPs said that thousands of elderly people died in care homes during the first wave of the pandemic, something that showed "social care had a less prominent voice in Government during the early stages of the pandemic than did the NHS".
The decision not to test people discharged from hospitals to care homes early on was a failure and led to deaths, they added.
In a joint statement, Tory MPs Greg Clark and Jeremy Hunt, who chair the committees, said: "The UK response has combined some big achievements with some big mistakes. It is vital to learn from both to ensure that we perform as best as we possibly can during the remainder of the pandemic and in the future.
"Our vaccine programme was boldly planned and effectively executed. Our test and trace programme took too long to become effective.
"The Government took seriously scientific advice but there should have been more challenge from all to the early UK consensus that delayed a more comprehensive lockdown when countries like South Korea showed a different approach was possible.
"In responding to an emergency, when much is unknown, it is impossible to get everything right.
"We record our gratitude to all those - NHS and care workers, scientists, officials in national and local government, workers in our public services and in private businesses and millions of volunteers - who responded to the challenge with dedication, compassion and hard work to help the whole nation at one of our darkest times."
The report also pointed to the regional tier system as being confusing for the public, adding that it was not "watertight" enough to prevent infection spreading.
Elsewhere, scientific evidence for some measures was lacking, such as the imposition from September 24 2020 of a 10pm curfew on pubs, or the banning of outdoor children's sports clubs, MPs said.
Regarding the second lockdown, MPs said that had more stringent social distancing measures been adopted during the autumn, they could have "reduced the seeding of the Alpha variant across the country, slowed its spread and therefore have saved lives".
However, MPs also noted it was true that the Alpha variant only became known about in December 2020.
Across the board, the report criticised a national failure to share data between central and local government, adding that the NHS was squeezed due to shortages of staff.
Regarding test and trace, the "slow, uncertain, and often chaotic performance of the test, trace and isolate system severely hampered the UK's response to the pandemic", MPs said.
They also noted "unacceptably high death rates among people from black, Asian and minority ethnic communities" and those with learning disabilities.
But MPs offered praise in two areas - treatments and vaccines - saying ministers were "correct to identify that a vaccine would be the long-term route out of the pandemic" and supported research and development.
Shadow health secretary Jonathan Ashworth said of the report: "This is a damning report by a cross-party group of MPs into the monumental errors made by ministers in responding to the pandemic."
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