IIn 2002, Sars, a dangerous coronavirus, spread around the world with a fatality rate of around 10%. Although contained relatively quickly, East Asian countries learned from this experience and updated their pandemic preparedness plans. Their governments wanted to be ready if the virus returned. On the other side of the world, the UK has not responded or adapted. Complacency was in question, especially with the assumption that Britain was one of the most prepared countries in the world for a pandemic.
The result, if Lady Hallett’s first report from the Covid inquiry notes, is that the UK government has failed in its basic responsibility to its citizens to keep them safe. The UK has had too many preventable deaths not only from Covid but also from the closure of health services and a long lockdown that would have been unnecessary if public health systems were in place.
There is not much positive in the report about government preparedness in the years before 2020. This points to the lack of a containment strategy: why is there so little planning or thought about public health infrastructure – namely testing, tracing, isolating – before 2020? Why did officials initially think the virus was unstoppable when other countries showed that containment was possible in 2020 (and showed it was possible with two other coronaviruses, Sars and Mers, in the years before)? Hallett pointed specifically to the health secretaries – Jeremy Hunt, then Matt Hancock – who not only maintained the flawed plan in the years before the Covid pandemic but also left things in such a state that the wider government was unwilling to coordinate a wider response. to what she called “system-wide silent emergencies”.
Those who faced the cost of this were social care and health workers who were sent to wards and to care homes without appropriate PPE; people who lost their businesses and income due to prolonged restrictions; the children who confronted months of closed schools; and all those whose lives have been adversely affected by the pandemic and the knee-jerk response to managing it.
On top of the lack of preparedness and strategy, the UK is further hampered by underlying health inequalities. Britain fares poorly compared to other European countries in terms of chronic disease, obesity and poverty, all of which were risk factors for hospitalization and death from Covid. Substantial segments of the population faced health issues that made them vulnerable to becoming seriously ill from the disease. There is a longer trail of failure, less directly acknowledged by the report, leading to the austerity policy in the decade before 2020 that left people poorer and sicker, and public services unable to cope.
Fortunately, the report comes with 10 stark recommendations and a six-month timeline for a response and a plan of action. At its heart is the charge that the bureaucracy governing pandemic preparedness, and who is responsible for what, is too complex. When too many agencies and groups are involved, no one is responsible for a response. The report calls for a radical simplification of the system, including a single, independent body responsible for conducting pandemic planning exercises every three years and informing the public of the outcome; for assessing health inequalities in the population and identifying risk groups; and to ensure that a diverse set of voices is brought to the table to avoid groupthink. All of these will make the UK better prepared.
This report throws British complacency into stark relief. British officials and experts were used to going to less developed countries in Asia and Africa to tell them how to do things in health. Britain thought it knew best, instead of learning from the outbreak response systems these countries had set up over years of managing different outbreaks. When it came time to act, rather than lecture, other countries immediately overtook Britain because they had a clear plan. Those countries that managed to hold on without strict lockdown measures saved lives and their economies and then quickly switched to mass vaccination and reopened in 2021. Just compare the death rates of Japan and South Korea with the UK and Sweden.
We will have another pandemic. It’s not if, but when. Already bird flu (H5N1) is mutating in cows and other mammals in ways we haven’t seen before, increasing the risk of a human pandemic. The report’s call is a powerful one: let’s not let the loss and grief of 2020 to 2022 be in vain. Let’s learn now and do better next time. This is something we can all agree on, regardless of your stance on the pandemic and the restrictions.
