Failure to challenge poor scientific advice during pandemic cost thousands of lives

Britain did not lock down sooner because ministers failed to challenge poor scientific advice, the first major report into the Government’s pandemic response has concluded. 

The error led to "one of most important public health failures the UK has ever experienced" and resulted in a higher death toll, MPs said.

A joint report by the Government’s health and science select committees found that many mistakes were made in the early days of the coronavirus outbreak, which had only been redeemed by Britain’s successful vaccination programme.

The MPs said a lack of testing early in the pandemic left the country "facing the biggest health crisis in a hundred years with virtually no data to analyse", while a failure to shut borders allowed an influx of new cases.

‘Fatalistic’ approach

Unaware of the true scale of spread, ministers and scientists adopted a "fatalistic" approach of trying to manage Covid-19, rather than stop it, which "amounted in practice" to accepting herd immunity through infection, the report concluded.

It was only when it became apparent that the NHS would be overwhelmed that the Government imposed a lockdown on March 23.

In an interview with BBC Radio Four, Sir Patrick Vallance, the Government’s chief scientific adviser, said his advice now for winter would be to go "sooner" and "harder" with restrictions to get on top of the spread.  

His comments are in contrast to Spring 2020, when scientists advising the Government warned that coming down too hard would push cases back to the winter when the NHS would be less able to cope, and argued the public would not accept a lockdown.

Poor pandemic planning

The report also concluded that Britain’s pandemic planning was too heavily based on influenza, and had failed to incorporate lessons from outbreaks of Sars, Mers and Ebola.

And MPs criticised the "slow, uncertain and chaotic" performance of the test, trace and isolate system, which "severely hampered" the UK’s response to the pandemic.

However, the report did praise Britain’s vaccine programme, labelling it "one of the most stunning achievements in history", which prevented a fourth lockdown this summer.

In a joint statement, Jeremy Hunt MP, the chairman of the Health and Social Care Committee, and Greg Clark MP, the chairman of the Science and Technology Committee, said: "The UK response has combined some big achievements with some big mistakes. 

"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."

Analysis: The terrible mistakes, and how vaccine programme turned things around

The first major report into the Government’s pandemic response has highlighted a series of errors which are likely to have cost thousands of lives.

The Science and Technology Committee and Health and Social Care Committee has published an initial report following months of evidence from witnesses including Matt Hancock, Prof Chris Whitty, Sir Patrick Vallance and Dominic Cummings.

MPs concluded that while Britain’s Covid-19 vaccine programme was one of the most effective in history, a series of early mistakes left the UK struggling to keep the virus under control. 

Here is what they found:

The mistakes
Pandemic preparedness

When Johns Hopkins University undertook a global survey of which countries were the best prepared for a pandemic in October 2019, it was Britain and the US that came out top. Yet, when it came to coronavirus, the UK found itself seriously on the back foot.

The problem was Britain had planned for an influenza epidemic, which is not driven by asymptomatic transmission and where community testing and tracing of cases was less important.

Exercises to test national response capacity – Cygnus and Winter Willow – had not addressed a disease with Covid-19’s characteristics, and the Government had seriously underestimated how bad things could get.

The 2019 National Risk Register concluded an emerging virus would lead to a maximum of 100 deaths.

In the report, MPs said: "An over-reliance on pandemic influenza as the most important disease threat clearly had consequences. It means that the emphasis of detailed preparations was for what turned out to be the wrong type of disease."

A lack of preparedness meant that the NHS was forced to divert resources to Covid-19 from across the health service, leading to a substantial increase in missed, delayed and cancelled appointments.

Lockdowns and social distancing

The large number of deaths in the first wave were largely driven by decisions made in the early weeks of the pandemic, when the Government was operating in a "fog of uncertainty". 

Despite the UK developing a test for Covid in January 2020, testing was not rolled out widely and it was abandoned completely in the community in March due to a lack of capacity.

Unaware of how widespread the virus was, ministers and scientists agreed the best option was to try to manage Covid-19 rather than stop it.

Boris Johnson described this policy as "squashing the sombrero" and asked people with symptoms to stay at home, while advising the over-70s to avoid cruises and schools to stop foreign trips.

Scientists had warned the Government that coming down too hard would push cases back to the winter when the NHS would be less able to cope, and argued the public would not accept a lockdown.

But MPs described it as "fatalistic" approach which in practice amounted to herd immunity and said it should have been challenged by ministers.

It was only when it became apparent that the NHS would be overwhelmed that the Government finally imposed a lockdown on March 23. 

Experts have estimated that half the number of people would have died had the country locked down a week earlier.

Test and trace

Early on in the pandemic it was clear that Britain’s testing capacity was not sufficient to keep the virus under control.

By the end of January, Public Health England (PHE) could only manage up to 500 tests a day and in the crucial period between January 25 and March 11, 2020, just 27,476 tests were carried out: the equivalent of one test a day for each parliamentary constituency.

In contrast, by mid-March, Germany was testing 50,000 people per day. Without adequate testing it was impossible to monitor the virus.

The MPs said that the lack of testing left the country "facing the biggest health crisis in a hundred years with virtually no data to analyse". 

"The UK was reduced to understanding the spread of Covid-19 by waiting for people to be so sick that they needed to be admitted to hospital," the report added.

Modelled data fails to hit the target

The NHS Test and Trace system was also singled out for criticism for failing to meet even the most predictable demands of Autumn 2020.

NHS Test and Trace had also asked for £37 billion on the grounds it could prevent the need for a second national lockdown. Yet, despite the promises, and the eye-watering costs, England underwent a second national lockdown in November and again in January.

"Vast sums of taxpayers money were directed to Test and Trace," MPs wrote. "Were it not for the success of the vaccines task force it is likely that further lockdown restrictions would have been needed in Summer 2021."

Profits of ping: the NHS Test and Trace directors paid more than Boris Johnson

Social care

The lack of testing was particularly damaging for care homes. It was not until mid-April that testing was made a requirement for people discharged from hospital to social care.

This was particularly dangerous because Covid-19 was known to impact the elderly far more than younger people, and many cases were seeded from hospitals.

"This, combined with untested staff bringing infection into homes from the community, led to many thousands of deaths which could have been avoided," said MPs.

Between March 2020 and April 30 2021, more than 41,000 care home residents died of Covid, nearly a quarter of all deaths.

MPs also warned that Do Not Resuscitate orders had been issued inappropriately for some people, including those with learning disabilities, which they branded "completely unacceptable". 

"The lack of priority attached to social care during the initial phase of the pandemic was illustrative of a longstanding failure to afford social care the same attention as the NHS."

The UK has one of the highest share of deaths amongst its care home residents

Border control

The UK did not impose blanket or rigorous border controls at the onset of the pandemic, initially focussing on China, Iran, South Korea and Italy.

Yet, a study by Imperial College found that 33 per cent of cases during the first wave were introduced from Spain and 29 per cent were introduced from France.

MPs concluded: "The number of seeding events that occurred early in the pandemic, coupled with the lack of data, made the lockdown almost inevitable.

"By contrast, other countries implemented more rigorous border controls which were more effective at suppressing the virus and preventing the need for long and repeated lockdowns."

Where things went well
Vaccines/Treatments

The most successful part of Britain’s Covid-19 response was the vaccine programme, which is estimated to have saved 112,000 lives in England alone and protected nearly 50 million people in the UK.

How are different countries' vaccine rollouts progressing?

The Government identified early that vaccination was the route out of the pandemic and poured funding into research and development of a number of jabs both in Britain and abroad.

The vaccine taskforce, led by Dame Kate Bingham, correctly predicted which vaccines would be ready first, ensuring Britain had early access and could begin its roll-out ahead of most other countries.

"Globally it is one of the most stunning achievements in history," said MPs. "Millions of lives will ultimately be saved as a result of the global vaccine effort, of which the UK has played a leading part."

"The success of the vaccine programme has redeemed many of the persistent failings of other parts of the national response such as the test and trace system."

Britain was also at the forefront of developing new treatments for Covid-19, harnessing the power of the NHS to recruit in-hospital trials which were quickly able to show the effectiveness of drugs like dexamethasone.

Hancock’s 100,000 test target

On April 2, Matt Hancock the former health secretary, set an arbitrary target of 100,000 tests a day by the end of the month, a decision criticised by Dominic Cummings as a "stupid thing to do". 

The target was achieved on April 30, and MPs concluded that the intervention had actually spurred on production and helped to improve testing capacity.

"Given the painfully slow increase in the availability of testing before April 2020, we consider that the impact of the Secretary of State’s target to have been an appropriate one to galvanise the rapid change the system needed," they said. 

"It is concerning to contemplate what would have happened without this unorthodox initiative."

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