The UK government, devolved administrations and the civil service "failed" citizens during the pandemic, according to the damning first report from the Covid inquiry.
There were "several significant flaws" in the pandemic response, found retired judge Baroness Heather Hallett, chair of the public inquiry. The 83,000-word document, based on witness statements including from former health secretaries Matt Hancock and Jeremy Hunt, also highlighted the brutal effect of austerity. Cuts to public spending and resulting health inequalities, including high rates of disease and obesity, had overstretched the health system and made the UK "more vulnerable".
Some of the 235,000 deaths involving Covid-19 (one of Europe's highest death tolls), as well as "grief, untold misery and economic turmoil", could have been prevented, she concluded. But the human, societal and economic cost suffered "will have been in vain" if "radical reform" is not carried out before the next pandemic.
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1. Brexit distraction
Resources were taken away from pandemic preparedness because of Brexit, said the report. This was especially so in 2018 and 2019, when officials "scrambled to draw up a contingency plan for medicine, food and fuel shortages" in the event of a "no-deal" Brexit, known as Operation Yellowhammer, said The New York Times.
Brexit was prioritised over implementing recommendations from Exercise Cygnus, the government's 2016 pandemic readiness exercises. The programme, which by 2019 was already running two years behind schedule, was further delayed by the demands of Operation Yellowhammer. Health officials in the devolved nations who should have been focused on pandemic preparedness were also "diverted" to deal with Yellowhammer, said the i news site.
2. Wrong pandemic, outdated strategy
The UK "prepared for the wrong pandemic", said the report. The country had long assumed that an outbreak would involve influenza, preparing its plan in 2011 when Andrew Lansley was health secretary. But both subsequent health secretaries, Jeremy Hunt and then Matt Hancock, failed to update it.
This led to "an over-reliance on vaccines and antivirals that would have no impact on the Covid virus", said the BBC.
Although there are similarities between Covid and flu viruses, there are differences in terms of infection periods, which "affects the feasibility of border screening, quarantining and contact tracing", said The Times.
The strategy was "outdated and lacked adaptability", said the report. Even Hancock described it as "woefully inadequate".
In March 2020, when the government realised how lethal Covid was, it had to abandon the strategy. Ministers then took a "new, untested approach" and sent the country into lockdown, with "no idea how vast the economic and social damage would be", said The Times.
3. Not a 'black swan' event
The report rejected claims that the pandemic was unprecedented: an unforeseeable "black swan event". The scientific community had considered it a "reasonable bet" before 2020, "given there were four large coronavirus outbreaks that nearly became pandemics earlier in the 21st century", said The Guardian.
Asian countries, which had experienced outbreaks of Sars in 2003 and Middle East respiratory syndrome (Mers) in 2016, suppressed initial waves with testing, tracing and quarantining, as well as border controls, while limiting the use of lockdowns.
After both outbreaks, pandemic planning exercises in the UK stressed the importance of PPE and testing. "Lessons that could and should have been learned were not learned," said Hallett.
4. Groupthink and spaghetti bureaucracy
In 2019, there was widespread hubris, partly resulting from government "groupthink", that the UK was "one of the best-prepared countries in the world to respond to a pandemic", said Hallett.
But the "number of organisations across the UK with responsibility for pandemic preparedness had multiplied over time and become unnecessarily numerous", she wrote. It was a "labyrinthine" civil emergency system based on complex "spaghetti diagrams" of institutions that had "ultimately grown to become too complex and disjointed".
There was "constant reorganisation and rebranding" of the departments responsible – and it was not even apparent who was in charge. There was a "lack of adequate leadership" in rectifying contingency planning, including from the then prime minister Boris Johnson.
5. Next pandemic: 'not if but when'
"The evidence is overwhelmingly to the effect that another pandemic – potentially one that is even more transmissible and lethal – is likely to occur in the near to medium future," Hallett said. "It is not a question of 'if' another pandemic will strike but 'when'."
She urged a "fundamental reform" of preparation for civil emergencies, adding that the changes made since the Covid pandemic had "fail[ed] on a number of grounds".
The report made 10 recommendations, including planning for a wider range of scenarios and creating a more coordinated response, as well as taking responsibility away from the Department of Health and Social Care. "Never again can a disease be allowed to lead to so many deaths and so much suffering," she said.
