UK

Jenny Harries interview: We’ll behave more like Sweden when the next pandemic hits

 “Her modus operandi: rationalism tempered with empathy” 

Paul Nuki
Sun, 24 September 2023 

'What we saw with later waves of the pandemic is that people will take action themselves,’ says Harries - Geoff Pugh

LONG READ

Dame Jenny Harries does not shake my hand as I’m ushered into her office and I wonder momentarily if this interview is going to be more difficult than anticipated.

“I’m just going to be very open,” she says in a way that only a doctor can. “The reason I haven’t shaken hands with you is, I’m just slightly under the weather. Not respiratory-wise – in other ways. I think I’ll be fine. But I’m just not not quite as buzzy as I usually am.”

I relax (and check I’m not blocking the most direct route to the exit). Harries has never been known as a bundle of laughs but her vigour has never been in doubt. She’s of a generation of medics that pulled three-and-a-half-day shifts as juniors and, while most of her contemporaries have long since been put out to graze, she, at 65, remains whippet lean and A* sharp.

It’s just as well. As we meet, the highly mutated BA.2.86 “pirola’’ variant of Covid-19 is spreading rapidly ahead of winter, a new booster shot for the most vulnerable is being rushed out and H5N1 bird flu is causing havoc around the world. And these are just some of the near-term risks she must deal with.

Harries’s doggedness has served her well. After a career in public health spanning over 25 years – much of it spent as a diligent deputy to alpha men – she’s emerged from the widespread bureaucratic and professional wreckage of the pandemic very much on top. Now, as head of the powerful new UK Health Security Agency (UKHSA), she’s responsible for protecting the country from everything from viruses to chemical, biological and nuclear threats – and she’s loving every minute of it.

It was in March 2020, as the first wave of Covid-19 was sweeping Europe, that Harries first came to national prominence. “Amid the bedlam, she is in our corner, soothing the country with an effortless bedside manner,” said Vogue magazine of the then Deputy Chief Medical Officer. “Her modus operandi: rationalism tempered with empathy,” it added.

'Amid the bedlam, she is in our corner, soothing the country with an effortless bedside manner,' said Vogue magazine in 2020

 - Pippa Fowles / No 10 Downing Street

Headline writers were especially taken with Harries’s response to a question thrown at her on the eve of the first national lockdown on how lovers should navigate the coming months. Standing at a lectern next to Matt Hancock (who we can surmise was not listening), she said: “I’m clearly going to start a new career here in relationship counselling, so I will tread very carefully... If the two halves of a couple are currently in separate households, ideally they should stay in those households. The alternative might be that, for quite a significant period going forwards, they should test the strength of their relationship and decide whether one wishes to be permanently resident in another household.”

“Shack up or break up,” the papers shouted as the shutters came down the next day.

Harries is big on the power of human experience and thinks we have learnt a huge amount as a population about infection control over the past few years. So much so that if we were to face another pandemic tomorrow the UK would take a more Swedish approach to social distancing, she suggests. Social contact fell broadly to the same extent in both countries during the pandemic but, while stay-at-home orders were legally mandated here, in Sweden they were voluntary for the most part.

“What we saw with omicron and later waves of the pandemic, and even now, is that people are good at watching the data and they will take action themselves,” says Harries. “You can see it in footfall going down. People actually start to manage their own socialisation, and the [viral] waves flatten off and come down.”

So next time round we will be more like Sweden, changing our behaviour but without the need for legislation?

Harries is far too savvy to have the word Sweden or – as I later try – South Korea put in her mouth, but the direction of travel is clear. The key, she says, is to be transparent about the risks and build trust with the public.

“The more people trust the organisation to give them early, accurate, honest and straightforward information, then, yes, the likelihood of us moving to extreme forms of transmission management reduce all the time, whether it be for coronavirus or anything else,” she says.

In public, Harries has a certain calmness about her, something she puts down to a “Jemima Puddle-Duck” approach: “paddle frantically beneath the surface but remain serene on top”. It’s helped her deal with all sorts of nasties over the years, including the Salisbury Novichok poisonings of 2018 – one of a series of events that first brought her to the attention of Whitehall.

The same cool confidence was evident when Harries appeared in June at the first part of the Covid inquiry, the part dealing with pandemic preparedness. While many were monstered under cross-examination (see David Cameron, George Osborne, Jeremy Hunt and virtually anyone who was anybody at the Department of Health and Social Care), Harries sailed through unscathed.

Austerity measures before the pandemic had left local directors of public health “under significant pressure” and their teams “denuded”, she told the inquiry. It was a lack of capacity across the health and social care system, and not the UK’s pandemic plan itself, that had been the main problem. “I don’t hold with the groupthink agenda,” she said of the idea, floated by the former chief medical officer Dame Sally Davies among others, that Britain’s experts had been blinded by exceptionalism and failed to learn the lessons of the earlier Sars and Mers outbreaks in south-east Asia.

When we meet, Harries sticks to her guns on this. The UK’s pandemic plan was not perfect but it was “pretty advanced” comparatively speaking given that “many parts of the world had no plans at all”.

What about South Korea, I ask. They escaped lockdowns and overstretched ICU wards by closing their borders and rolling out mass testing almost immediately.

“I think this is where we need to be really careful because the culture in South Korea was very different,” says Harries. She is not ruling out that we may be more like them in future but does not think Britain would have bought into more interventionist plans ahead of the pandemic, even if they had been proposed.

“In South Korea, they have had a different experience… communities, individuals and governments build on the experience and the culture that they have,” she says.

Harries says it is key to be transparent about risk and build trust with the public - 

Whether Harries’s cool will survive the next phase of the inquiry, which opens on Oct 3, remains unclear. Before the pandemic, she was responsible, as Deputy Chief Medical Officer, for non-communicable health threats such as tobacco control and obesity and so was never really going to be on the hook for failures in pandemic planning. However, module two of the inquiry looks at government decision-making during the outbreak – something she was very much more involved in.

A taste of the hard questions she will face came from the media last year when she was ennobled. Some said her damehood was not deserved and cast her as just another dissembling Whitehall apparatchik. “The health chief has had a torrid time during Covid while conversely boasting more lives than Lazarus,” said one. “Throughout the past 20 months, Harries has come to embody many of the worst aspects of Britain’s well-meaning yet under-performing bio-security state.”

It’s true that in the first few months of the outbreak Harries echoed the self-serving orthodoxies of the Department of Health and Social Care (DHSC), much of which would later be reversed. Face coverings, which had not been stockpiled for public use, were not a good idea for the “average member of the public” because they could “trap the virus” and spread it further, she told the BBC.

Mass testing – again not planned for in the UK – was also “unnecessary”, said Harries in March 2020, despite the World Health Organisation urging everyone to “test, test, test”. There was also a televised fireside moment with Boris Johnson in Downing Street when she played down the danger of attending mass events just as the Cheltenham Festival was opening. “Big gatherings are not seen to be something which is going to have a big effect so we don’t want to disrupt people’s lives,” she said.

To be fair to Harries, all of this reflected the Western scientific consensus of the time. And awkwardly for her loudest critics – most of whom are lockdown sceptics – the policy of minimal social intervention she was advocating for then is what they are advocating for now.

I put it to Harries that she and many of her public health colleagues have changed over the course of the pandemic; that they’ve shaken off the old fatalistic DHSC orthodoxies, many of which owed more to Treasury myopia than good science, and have become more confident and independent as a result.

She buys some of it but not all of it, declaring herself a “very proud senior civil servant” as well as being head of the UKHSA. On the other hand, she says it’s right that the pandemic has given many in public health a new confidence.

Systems like track and trace – that would have taken years to build in peacetime – were put together by public servants working with private companies around the clock in a matter of months. One of the UKHSA’s epidemiologists – Meaghan Kall – became a social media star, winning the agency plaudits and levels of trust most government agencies can only dream of. And, perhaps most important of all, from the public sector emerged some brilliant science.

“We are now going to be an exemplar, a new-style civil service organisation,” says Harries. “One that is directly public facing and where we work very openly and freely right across government in that collaborative way that we saw through the pandemic”.

‘UKHSA is now going to be an exemplar, a new-style civil service organisation’ - PA

As part of this, Harries recently opened a new vaccine development centre at the high-security Porton Down laboratories in Wiltshire in an effort to tackle “Disease X” and other unknown future threats. The Vaccine Development and Evaluation Centre (VDEC) will house more than 200 scientists working to support the development of vaccines to protect against threats including avian influenza, Mpox and Crimean-Congo haemorrhagic fever. The unit is part of the wider global “100 Days Mission” on vaccines, which aims to create prototype jabs for all major viral pathogens ahead of a new outbreak.

“The risks are growing around climate change and urbanisation,” Harries said at the launch last month. “As well as building on the legacy of the pandemic caused by Covid-19, VDEC will target a wide range of other deadly viruses and pathogens, helping to secure the health and prosperity of the UK and saving lives around the world.”

Harries builds on the theme of health security being good for business when we meet at her offices. The Treasury has a tendency to see money spent on pandemic planning as money down the drain. Harries – and many others within the sector – are now fighting hard for it to be seen as capital investment which will more than wash its face in decades to come. “I think there are huge opportunities in the science,” says Harries, “in terms of preparation and response, but actually in the economics of scientific growth as well.”

Hopefully the Treasury will listen this time round. In the last national pandemic plan, it estimated the cost to the UK of a major pandemic at just £28 billion, virtually ensuring that no major preparatory works were done. The actual bill is estimated to sit closer to £400 billion – a debt that the taxpayers will be paying down for generations to come.

And the health threats the UK faces have not gone away. Harries says the biggest infectious disease threat facing us today is pandemic flu which sits – as it has for more than a decade – at the top of the National Risk Register. “Things like bird flu are very much in our sights at the moment”, in reference to the H5N1 avian flu strain sweeping the world.

But Harries is clear that we should not focus on a single disease. We face a wide number of overlapping threats, she notes, including an array of infectious diseases but also non-communicable conditions like obesity and then issues like climate change and antibiotic resistance. The health security risk the UK faces is therefore “cumulative and growing”, she says. Our response must be multi-layered and ongoing.

Harries declares herself 'a “very proud senior civil servant' - Geoff Pugh

Harries was born in Watford, the second of two children. Her father was a virologist who worked in the public health laboratories she now oversees and who died, aged 93, at the very start of the pandemic.

By her own admission, Harries has always been “a bit of a nerd”. So much so that at the age 10 she insisted on leaving home for boarding school, much to her mother’s dismay. “The parental message afterwards was, ‘well, you said you wanted to go and we thought you’d hold it against us if we didn’t let you’,” she recalls.

Unusually for a future doctor, Harries ducked science in sixth form, taking A-levels in ancient Greek, Latin and ancient history instead. Her interest in classics is perhaps the only thing she has in common with Boris Johnson, and she has used it very differently.

“You have to construct sentences in those languages very precisely and very logically”, a vital skill for any disease detective, she says. “When you’re doing an outbreak investigation, you don’t want to be swayed by somebody saying, ‘Oh, well, I saw three cases of it over there’. You want to say ‘what is the evidence in front of you’ and construct it in a logical way to get to the right answer, not the red herring.”

At Birmingham University, Harries studied medicine and pharmacology, graduating in 1984. But rather than jump straight into a career, she packed a rucksack and set off on the hippy trail, starting in south-east Asia and taking in the Australian outback before settling in New Zealand for two years, where she married and had the first of her four children. “On the way back we bought a campervan and drove the whole way from Tasmania to Darwin along the coast,” she recalls.

The marriage didn’t last and Harries spent a long time as a single mother – a tough job at any time but especially hard in the late 1980s and 1990s when the mood was less supportive. Yet there were positives. She says the experience shaped her – she’s a huge DIY fan – and also some of the women she now works with. “Sometimes, if I tell them I was a single mum for many years, that actually is quite an important point for them. It makes them feel they can make it through as well.”

Harries says that only once, right at the start of her career, did she allow gender discrimination to steer her professional choices. “It’s the only time in my career I’ve made a gender-biased choice. I wanted to be a paediatric surgeon but, at the time, it was completely incompatible with having children. There were no female role models. They were just more or less non-existent.

“It’s the only time ever I’ve done anything where I’ve said ‘actually, you know, this isn’t going to work. I’m a woman’. I wouldn’t do any of that now. These are completely different times – fortunately.”

It’s impossible not to admire Harries’s work ethic and determination. There are parallels to be drawn with the hard-boiled cops of Hollywood legend – although she is a pescatarian and only drinks “two or three” glasses of wine each week.

True to form, she ended a talk at the new Pandemic Institute in Liverpool last week with the word “Panglossian”. “I wanted to encourage them to remain enthusiastic in the face of total adversity,” she explained. There was only the slightest hint of a smile.