Abstract
An authoritative report on the UK government's handling of the covid-19 pandemic has said that many thousands of deaths could have been avoided, reports Adam Vaughan
THE UK government was wrong to wait so long to implement a lockdown in England at the start of the covid-19 pandemic and made a “serious early error” by adopting a “fatalistic approach” to how much it could slow the spread of the coronavirus, UK members of parliament (MPs) say in a report published this week.
Other failings highlighted include the “serious mistake” of stopping community testing in March 2020, an “often chaotic” test-and-trace system and “many thousands” of deaths that could have been avoided if people who had tested positive hadn't been sent from hospitals to care homes.
The UK was also too narrowly prepared for a flu-like pandemic, according to the joint report by the 22 MPs on the Health and Social Care Committee and the Science and Technology Committee. The analysis is the most authoritative view on the government's handling of the crisis to date, with a public inquiry not due to start until next year.
“It was a bit like Dickens's Tale of Two Cities: the best of times and the worst of times, the best of policy and the worst of policy,” says Greg Clark, chair of the Science and Technology Committee. “You had the brilliance of the vaccine roll-out, scientifically and administratively. But then you had real failures such as the lack of testing.”
UK prime minister Boris Johnson promised that England's test-and-trace scheme would be “world-beating”, but it was hamstrung by inadequate capacity at the outset due to a lack of investment in public health for several years, says Clark. He says the system “seemed to stumble from crisis to crisis”, was too centralised and failed to anticipate even predictable problems such as a spike in demand for tests in September 2020 as children returned to schools.
The MPs were highly critical of the government's response at the start of the pandemic, when Johnson appeared to pursue a strategy of “herd immunity”, before a rethink in mid-March 2020 led to a lockdown. The report concludes there was “a degree of groupthink” among government officials and its science advisers, the Scientific Advisory Group for Emergencies (SAGE).
“Our criticism is there wasn't enough challenge to the official scientific advice. It's not to say there was anything deficient about the scientists concerned,” says Clark. However, he says, people in government should have looked at how countries such as South Korea responded much faster, to challenge the UK view of only gradually imposing restrictions.
The idea you can wait for scientists to find the facts and then make a policy decision is a bit naive
The UK government repeatedly said it would “follow the science” in its handling of covid-19, and the MPs conclude that it did until September 2020 – when it ignored SAGE's advice to implement a “circuit-breaker” lockdown. The committees say that decision is likely to have led to a faster spread of the Kent variant, later named alpha, in the winter.
Meanwhile, advice to the public was clear at the start of the pandemic but became “increasingly complex and harder to understand” when the first lockdown was lifted in May 2020. By contrast, the MPs hail the vaccine programme as being one of the most effective in the world for a country the size of the UK.
Asked how he views the UK's response overall, Clark says: “It was a mixed response. I think that was inevitable: you could never expect to get everything right.”
Trish Greenhalgh at the University of Oxford says: “I think it's a 'warts and all' report. They're being quite brave there.” She echoes the report, saying faster action should have been taken by the government on a precautionary principle rather than waiting for clearer answers from scientists. “The essential nature of a crisis is uncertainty, that's inherent. The whole idea you can commission a bunch of scientists to find the facts, wait for the facts and then make a policy decision is a bit naive.”
However, she says, one big omission is that the report doesn't mention failings around face masks, such as England's deputy chief medical officer Jenny Harries suggesting they could be harmful.
Gabriel Scally at the University of Bristol, UK, says the report was right in its criticism of the early advice that SAGE had given, in part due to a lack of public health experts in early internal discussions. What is missing from the report is a focus on poor health and inequalities that existed before the pandemic, he adds.
Scally also believes the MPs are overly positive about the vaccine roll-out. After being the first country to begin administering doses, in December 2020, only 66 per cent of the UK population are now fully vaccinated, putting the UK behind Italy and Spain. “We've been overtaken by other European countries and our approach to vaccinating children has been shambolic,” he says.
Stephen Griffin at the University of Leeds, UK, says one of the shocking elements of the report is that the UK's pre-pandemic efforts focused so much on flu, despite what he says were more “relevant exemplars” similar to covid-19 in South Asian countries.
A government spokesperson says: “Throughout the pandemic, we have been guided by scientific and medical experts and we never shied away from taking quick and decisive action to save lives and protect our national health system, including introducing restrictions and lockdowns.”