IIn 2002, Sars, a dangerous coronavirus, spread across the world with a mortality rate of around 10%. Although it was contained relatively quickly, East Asian countries learned from this experience and updated their pandemic plans. Their governments wanted to be ready if the virus returned. On the other side of the world, the UK failed to respond and adapt. Complacency set in, especially with the assumption that Britain was one of the best prepared countries in the world for a pandemic.
The result, as Lady Hallett’s First Report from the Covid research notes, is that the UK government failed in its basic responsibility to keep its citizens safe. The UK had too many avoidable deaths, not just from Covid, but also from the closure of health services and a long lockdown that would have been unnecessary if public health systems had been in place.
There is little positive in the report about government preparedness in the years before 2020. It points to the lack of a containment strategy: why was there so little planning or thought about the public health infrastructure – namely test, trace, isolate – before 2020? Why did officials initially think the virus was unstoppable, when other countries showed in 2020 that containment was possible (and had shown it was possible with two other coronaviruses, Sars and Morein the years before)? Hallett specifically pointed to the health ministers – Jeremy Hunt, then Matt Hancock – who not only kept the flawed plan in place in the years before the Covid pandemic, but also left things in such a state that the wider government was unprepared to coordinate a broader response to what she called “civil emergencies across the system”.
Those who bore the cost were the social care and health care workers sent into wards and care homes without adequate personal protective equipment; people who lost their businesses and incomes as a result of prolonged lockdowns; the children who endured months of closed schools; and all those whose lives were negatively affected by the pandemic and the knee-jerk response to control it.
On top of the lack of preparation and strategy, the UK was further hampered by underlying health inequalities. Britain underperforms other European countries in terms of chronic disease, obesity and poverty, all of which were risk factors for hospitalisation and death from Covid. Large sections of the population suffered from health problems that left them vulnerable to serious illness. There is a longer trail of failure, less directly acknowledged by the report, that goes back to the austerity policies of the decade before 2020 that left people poorer and sicker and public services unable to cope.
Fortunately, the report makes 10 stark recommendations and sets a six-month timeline for a response and action plan. At its heart is the charge that the bureaucracy governing pandemic preparedness, and who is responsible for what, is too complex. When there are too many agencies and groups involved, there is no single body 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 those at risk; and for ensuring a diverse range of voices are at the table to avoid groupthink. All of these things would make the UK better prepared.
This report puts British complacency in 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 the years to contain various outbreaks. When it came time to act, rather than preach, other countries immediately outpaced Britain because they had a clear plan. Those countries that managed to contain without strict lockdowns saved lives and their economies, and then quickly moved to mass vaccination and opening up in 2021. Just compare the death rates of Japan and South Korea with those of the UK and Sweden.
We’ll have another pandemic. The question is not if, but when. Avian influenza (H5N1) is already mutating in cows and other mammals in ways we’ve never 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. That’s something we can all agree on, regardless of your position on the pandemic and its restrictions.