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Ignore the Johnson and Sunak circus: these are the real lessons from the Covid inquiry | Devi Sridhar

I do not envy Heather Hallett, the chairperson of the Covid-19 inquiry. She has spent months carefully listening to numerous witnesses and examining countless statements, emails, policy notes, diaries, and WhatsApp messages. It can be overwhelming to navigate through all the details, especially when there are political conflicts and disputes in No 10. However, we must not forget the primary goals of this inquiry: to hold those accountable for decisions made during the pandemic and to gain valuable insights for future preparedness in the UK.

This is my perspective on the progress we have made in the second section. It is evident that the United Kingdom could have managed the pandemic more effectively. This is not a comparison to an idealized handling of 2020 with the advantage of hindsight, but rather to other countries with similar circumstances. Our excess mortality rate is the second highest in Western Europe, significantly surpassing that of Norway, Finland, and Denmark, as well as several East Asian countries, Australia, and New Zealand.

We also know what went wrong. The government was slow to acknowledge the threat of the pandemic to Britain, and didn’t act fast enough to contain Covid-19. This included no plan for containment, not having adequate PPE, lack of testing for months, no border restrictions to limit importation, and delays in pulling the emergency lever of lockdown.

Much of what we have heard was known at the time and covered extensively in articles and books. But it is useful to have confirmation and granular detail. We often knew what the best policy decision was, but seeing how the political processes failed should help us in the next emergency. The exact way things were dysfunctional has now been confirmed by those in government. Boris Johnson was indecisive, distracted by Brexit and changed his mind depending on whom he last spoke to.

According to Dominic Cummings, Rishi Sunak, who was referred to as “Dr Death” by a science adviser, believed that the government should simply allow people to die. It is evident that Sunak was primarily focused on his own ambition and support from the elite when implementing the “eat out to help out” program, which was costly and encouraged people to gather in settings with a high risk of Covid-19 transmission. This decision was made without consulting scientific advisers or the health secretary.

When directly questioned about his opinions, Sunak struggled to recall much. He evaded giving a definite answer and appeared to be in campaign mode, likely due to the upcoming general election. As a result, he did not provide any substantial statements.

At the time, Patrick Vallance, the chief scientific adviser, and Cummings advocated for prioritizing human life, suppressing the virus, and establishing a path for vaccine development. Meanwhile, Matt Hancock consistently shared misleading information, claiming that they had a plan when they didn’t, that they had sufficient PPE when they didn’t, and that he was unaware of asymptomatic transmission when he actually was. Despite appearing to be one of the few government officials taking the threat seriously, a recent inquiry uncovered that Hancock was also uninformed about crucial details and often attempted to conceal this.

There were opportunities for improvement in the scientific decision-making process, despite the challenging circumstances. Chris Whitty, the chief medical officer for England, initially believed that nothing could be done to prevent the spread of the disease and suggested delaying the initial lockdown due to concerns about behavioral fatigue. While this may have been a valid consideration based on previous flu plans, it should have been reevaluated after other countries, like South Korea, demonstrated in January and February of 2020 that suppression of the disease was achievable without extreme measures or a lockdown.

What can we learn from this chaotic situation about the mistakes made during the Covid-19 pandemic? One lesson may be the importance of electing capable leaders who can effectively run a government. While we may not pay attention to the functionality of our government during times of peace, any weaknesses are magnified during a crisis. Although the inquiry has not yet addressed it, corruption has also played a role, resulting in billions of pounds lost to Covid-related fraud.

Regardless of who holds power in the future, it is essential to have a strategy in place for handling a pathogen. This plan should allow for adaptability based on the most recent information and a willingness to learn from other countries who may have successful approaches. It is crucial to maintain an adequate supply of personal protective equipment to safeguard frontline workers. Waiting until a problem arises is not a practical approach; it is more effective to take action early as time can be critical in containing the rapid spread of a virus.

This is where testing would have changed the picture dramatically: functional testing early on would have meant that only those who were infectious could have isolated and reduced the spread. Without testing, everyone was treated as infectious and asked to stay at home. That is one key lesson: major loss of life and strict lockdown measures could have been avoided had the UK built up mass testing capacity at an early stage.

Johnson’s statement uncovered that upon meeting with the authors of the “Great Barrington Declaration” (also known as the “let it rip” perspective) and Swedish advisor Anders Tegnell, most of them still advocated for caution and significant government involvement. Those individuals who promoted unrealistic solutions and the idea that taking no action was a feasible option were completely mistaken. Even scientists who were skeptical of lockdowns recognized the need for some form of government intervention. The takeaway? There are no simple solutions, and we must always confront the intricacies and challenging paths ahead.

Furthermore, the individuals I have previously mentioned are all male. Even Johnson acknowledged that there were too many male-dominated meetings. Despite making up 51% of the British population, women often feel overlooked in high-ranking positions of authority. Embracing diversity can lead to more comprehensive discussions, recognition of overlooked aspects, and ultimately, more efficient decision-making.

One important takeaway is that leaders must have faith in science to discover solutions. In the last century, we have made great advancements in controlling diseases that harm us. In July 2020, the UK government made agreements to secure 190 million doses of promising vaccines, such as those from Pfizer/BioNTech and Oxford/AstraZeneca. Each infection prevented until after a vaccine is available could potentially save a life.

What is the potential number of individuals who could have survived if the government had taken action to prevent transmission until widespread vaccination efforts were implemented in early 2021? This is a query that has not yet been posed to witnesses. It is crucial in preparing for future pandemics: determining how to efficiently develop and produce scientific resources, while also allowing ample time for their widespread distribution, with minimal impact on lives and livelihoods. Hopefully, this will be a key focus when the investigation reconvenes in January 2024.

  • Devi Sridhar is the head of the University of Edinburgh’s global public health department.

Source: theguardian.com