In recent weeks the Covid-19 Inquiry has uncovered explosive details about how we were led during the early phases of the pandemic, showing that there was chaos, dysfunction and confusion in Number 10, as well as priority given to party politics before people. Polling now shows voters feel strongly that Boris Johnson and Rishi Sunak got the big calls wrong on Covid.
But with the exception of the two most senior figures, nearly all the same people remain in charge of the UK’s approach to battling Covid-19. Surely, if the Government got the big calls wrong then, we should be doing things differently now?
What have we found out?
Scientists were not consulted on major policy changes such as ‘Eat out to Help Out’, for which an impact analysis – health or economic – was not undertaken. The initiative was not supported by the most senior scientific advisors but imposed by the Treasury without consulting the government’s Covid-19 taskforce.
Evidence also reveals a toxic culture which particularly ignored, and certainly did not seek, the views of different sections of society on issues such as childcare, domestic abuse, and the impact on black and minority ethnic communities.
The well recognised good practice of ‘red teaming’ – bringing in knowledgeable, independent people to overcome cognitive errors such as groupthink and confirmation bias, which can impair decision-making or critical thinking ability – was not put in place, despite the enormity of the life-changing decisions being made.
The Inquiry also heard shocking revelations and explosive evidence that there was no pandemic plan, despite assurances from the Health Secretary to the contrary, women’s voices were “ignored”, and there was strong resistance to learn from what other countries were doing to protect their populations.
Lack of decisiveness appeared to carry on throughout the first year, with the prime minister hesitating over a lockdown in 2020 because, according to evidence given at the Inquiry, the Conservative Party was pushing him hard not to do so. Perhaps most controversially, the Chief Scientific Adviser wrote that “[Mr Johnson] says his party ‘thinks the whole thing is pathetic and Covid is just nature’s way of dealing with old people’.”
But with Johnson and Hancock no longer in government, does that mean the UK is now battling the Covid-19 pandemic differently — and in the best way it can? Is the Government finally getting the big calls right? Probably not, given that most of the main players in the Covid-19 team remain in the same jobs.
The same team
We still have the same four UK Chief Medical Officers – the most senior government advisers on matters relating to health; while the Chief Scientific adviser stepped down, his deputy (alongside him from the outbreak of the pandemic) took up the post. The Medical Director and Chief Nursing Officers for NHS England continue in post. The Deputy Chief Medical Officer for England has now been appointed Head of the UK Health Security Agency, responsible for England-wide public health protection. And the deputy CEO of the NHS, who led it operationally through the first years of Covid-19 and the vaccine rollout, is now the current Chief Executive.
Perhaps more importantly, many senior political figures also remain. The Chancellor, now Prime Minister, was a very significant figure in pandemic decision-making, especially during lockdown periods. Steve Barclay, up until a few days ago the Secretary of State for Health and Social Care, also held senior posts in the Johnson Government and was in the Treasury during the first three years of the pandemic, taking up this role in July 2022 after Johnson’s resignation as PM.
The Johnson Government policy, known as Living with COVID-19, is exactly the same policy under Sunak. So, given its effectively the same team with the same approach, why would we think the team’s results in 2023 would be any better than they were in 2020?
Where are we now?
The latest government data shows weekly deaths in England and Wales (in the seven days up to 20 October 2023) with Covid-19 on the death certificate, i.e. contributing to the death, was 304, including one teenager. Provisional data for the week ending 27 October shows a figure of 314 deaths, including two school-age children, and 332 deaths for week ending 3 November.
Long Covid continues to be a consequence of even mild infections, with the World Health Organization stating studies show that around 10–20% of people infected go on to develop symptoms that can be diagnosed as long Covid.
A recent comprehensive research study published in Nature Medicine looked at the effects of Covid-19 on 138,000 veterans, two years into the pandemic. Two of the most striking findings were that people infected multiple times are more likely to develop long Covid and, regardless of variant, half of long Covid patients failed to improve after 18 months.
With some people on four, five or even more infections, it is clear that immunity (either from vaccines or from previous infections) is not going to stop the spread of the virus, which mutates at a rapid pace and still has significant capacity to continue to do so.
And finally, and maybe most importantly in terms of government policy, whilst many other Western countries also follow a ‘living with the virus’ approach, they do so with many more protections than the UK.
The US, for example, offers vaccines to everyone over six months of age. There’s also a wider variety in the type of vaccines available, including both mRNA vaccines and Novavax – a protein vaccine which relies on a more traditional approach than the mRNA ones. In addition, free Covid-19 tests are available to all households, and antiviral treatments more readily accessible.
Now that it is understood that transmission occurs through the air, the US Government is also providing hundreds of billions of dollars to improve indoor air quality, including $350bn for state and local governments, as well as $122bn for schools.
By comparison, the UK’s strategy is one dimensional – a vaccine-only strategy limited to a minority of the population.
Why don’t we act now?
The 2023 National Risk Register shows that the country’s number one risk, by a long way, is another pandemic. So do we really want to wait till 2026 – when the Covid-19 Inquiry publishes its findings – to make changes? Surely, we can anticipate some of its findings and act now. For instance, it is undoubtedly time for a new team – for new voices, new ideas, and a diversity of experience and perspectives to be introduced.
Independent SAGE is one such body – a group of internationally renowned scientists still working together to provide independent scientific advice on how to minimise deaths and support Britain’s recovery from the crisis. There are also other experts we might call on, and other ways to improve the UK approach, including pursuing additional protections as leading Western countries are doing now.
Writing in the New Statesman, Christina Pagel comments that the Covid-19 Inquiry “has laid bare the government’s dereliction of duty”, and many now agree with her that “there were better international responses and better options for the UK throughout the pandemic. And these better options were knowable at the time”.
They are certainly known now, well evidenced now, and available to us now.