The Clown and the Thunderer - The Sunday Times Investigates UK Coronavirus Strategy

The Sunday Times Insight team has published an investigation into the UK Government's handling of the coronavirus pandemic (Coronavirus: 38 days when Britain sleepwalked into disaster). It's devastating. The Sunday Times says:

"One day there will inevitably be an inquiry into the lack of preparations during those lost five weeks from January 24. There will be questions about when politicians understood the severity of the threat, what the scientists told them and why so little was done to equip the National Health Service for the coming crisis. It will be the politicians who will face the most intense scrutiny."

The Prime Minister's future is surely now in doubt. The Sunday Times investigation also invites questions about the Scottish Government's response over the same period.

Did the Scottish Government recognise the indecision that marked UK Government's actions? Did Scottish Ministers notice the alarm bells that were discreetly ringing in the scientific circles advising the UK Government? What did the Scottish Government's own advisers say? Did Scottish Ministers discuss possible strategies to mitigate the ineffectual UK Government response?

Some of key points to emerge from the investigation are:

• On 31 December China alerted the WHO to the new virus.
• On 6 January Professor Devi Sridhar of Edinburgh University tweeted:

  "Been asked by journalists how serious #WuhanPneumonia outbreak is. My answer: take it seriously because of cross-border spread (planes means bugs travel far & fast), likely human-to-human transmission and previous outbreaks have taught overresponding is better than delaying action."

• On 22 January the government convened its first meeting of Sage (Scientific Advisory Group for Emergencies) to discuss the virus. Sage's membership is secret but it is usually chaired by the government’s chief scientific adviser, Sir Patrick Vallance, and chief medical adviser, Professor Chris Whitty. Downing Street advisers are also present. The Sunday Times says that Professor Neil Ferguson of Imperial College was present on this occasion.
• On 24 January Neil Ferguson sent a report to ministers and officials estimating the infectivity rate (the average number of people infected by each person with the virus) at 2.6 and possibly as high as 3.5. He said there needed to be a 60% cut in the transmission rate - which would mean lockdown. The Sunday Times comments: "At the time such a suggestion was unthinkable in the government and belonged to the world of post-apocalypse movies."
• A Cobra meeting was held on 24 January (the same day that Neil Ferguson sent his report to ministers) in response to the spread of coronavirus beyond Chinese borders. Boris Johnson didn't attend the meeting. It lasted just one hour. Afterward, health secretary Matt Hancock said the risk to the UK public was "low" and a Downing Street spokesman said the UK was "well prepared for any new diseases".
• An article published in The Lancet on the same day suggested that the virus was comparable to the 1918 flu pandemic.
• Another Lancet article published on the same day provided findings on the first 41 laboratory confirmed case in Wuhan. The authors said:

  "The severity of illness is concerning: almost a third of patients developed acute respiratory distress syndrome requiring intensive care; six patients died; five had acute cardiac injury; and four required ventilation."

• Boris Johnson missed four further Cobra meetings on coronavirus. A senior Downing Street adviser said last week:

  "There’s no way you’re at war if your PM isn’t there... And what you learn about Boris was he didn’t chair any meetings. He liked his country breaks. He didn’t work weekends. It was like working for an old-fashioned chief executive in a local authority 20 years ago. There was a real sense that he didn’t do urgent crisis planning. It was exactly like people feared he would be."

• On 29 January the first coronavirus cases were identified in Britain - two Chinese nationals who fell ill in a hotel in York.
• On 30 January the WHO declared the coronavirus outbreak to be a "Public Health Emergency of International Concern." The UK Government raised the threat level from the virus from "low" to "moderate".
• At around this time scientists at the London School of Hygiene and Tropical Medicine had confirmed to chief medical adviser Chris Whitty in a private meeting of the Nervtag advisory committee on respiratory illness that coronavirus's infectivity could be as bad as Ferguson’s worst estimate several days earlier.
• Government scientists said publicly that plans for pandemic were robust. But a Downing Street adviser told the Sunday Times that  pandemic planning, after being well-funded for a decade after 9/11, became "a casualty of the austerity years when there were more pressing needs" and then Brexit planning "sucked all the blood out of pandemic planning" .
• The adviser told the Sunday Times:

  "If you were with senior NHS managers at all during the last two years, you were aware that their biggest fear, their sweatiest nightmare, was a pandemic because they weren’t prepared for it."

• There was little or no preparation for large-scale testing. The adviser told the Sunday Times: "We should have communicated with every commercial testing laboratory that might volunteer to become part of the government’s testing regime but that didn’t happen". The British In Vitro Diagnostics Association, which represents 110 companies that make up most of the UK’s testing sector did not receive a meaningful approach from the government asking for help until 1 April, accoording to organisations's Chief Executive, Doris-Ann Williams.
• Stockpiles of Personal Protective Equipment (PPE) had dwindled and were out of date. The shortfall was supposed to be filled by "just in time" contracts, but these ran into difficulty in February because Chinese manufacturers were facing unprecedented demand. The British Healthcare Trades Association (BHTA) offered to help, but its offer was not accepted by the Government until 1 April.
• A "senior politician" told the Sunday Times:

  "I had conversations with Chris Whitty at the end of January and they were absolutely focused on herd immunity. The reason is that with flu, herd immunity is the right response if you haven’t got a vaccine. All of our planning was for pandemic flu. There has basically been a divide between scientists in Asia who saw this as a horrible, deadly disease on the lines of Sars, which requires immediate lockdown, and those in the West, particularly in the US and UK, who saw this as flu."

• The government disputes this picture. The Sunday Times says that the Department of Health firmly denies that herd immunity was ever its aim and rejects suggestions that Whitty supported it.  Cummings is also said to deny backing the concept.
• On 21 February Nervtag decided to keep the threat level set at "moderate". At least two members disagreed. John Edmunds, from the London School of Hygiene and Tropical Medicine, thought the level should be "high". Unable to say so because of a failing video link, he emailed his view aferwards. It was minuted, but the decision had been taken. Another Nervag member, Professor Peter Openshaw of Imperial College, was in America and missed the meeting but told the Sunday Times he would have recommended raising the threat level to "high". At a seminar three days earlier he had said that if no action were taken 400,000 people would died in the UK.
• On 24 February the UK Government supplied 1,800 pairs of goggles and 43,000 disposable gloves, 194,000 sanitising wipes, 37,500 medical gowns and 2,500 face masks to China.
• A "senior departhment of health insider" told the Sunday Times:

  "We missed the boat on testing and PPE . . . I remember being called into some of the meetings about this in February and thinking, ‘Well it’s a good thing this isn’t the big one.’ I had watched Wuhan but I assumed we must have not been worried because we did nothing. We just watched. A pandemic was always at the top of our national risk register - always - but when it came we just slowly watched. We could have been Germany but instead we were doomed by our incompetence, our hubris and our austerity."

• On 26 February ministers were given worst-case predictions presented by John Edmonds to the scientific pandemic influenza group on modelling (SPI-M) which directly advises Sage. The report warned that 27 million people could be infected, 380,000 people could die and 220,000 intensive care beds could be needed if no action were taken to reduce infection rates. Edmunds’s colleague Nick Davies, who led the research, says the report emphasised the urgent need for a lockdown. The research modelled a 12-week lockdown and estimated this would delay the impact of the pandemic but there still might be 280,000 deaths over the year.
• On 1 March there was a there was a meeting between Sage committee members and officials from the Department of Health and NHS. It was shown fresh modelling based on figures from Italy suggesting that 8% of infected people might need hospital treatment in a worst-case scenario. The previous estimate had been 4%-5%.  A "Whitehall source" told the Sunday Times: "I think that meeting focused minds. You realise it’s time to pull the trigger on the starting gun." 
• A Cobra meeting was held on 2 March, chaired by Boris Johnson. It resulted in the creation of the Nightingale hospitals. There was a further delay as Johnson and his advisers debated lockdown measures. And then, as the Sunday Times puts it, "the government would be left rudderless again after Johnson himself contracted the virus."
• On 11 March (though the Sunday Times doesn't mention this), the WHO declared COVID-19 a pandemic.
• On 26 March lockdown regulations came into effect everywhere in the UK except Northern Ireland (which followed on 28 March).

Photo: Secretary of State for Health and Social Care Matt Hancock leaving after attending a Cabinet meeting at 10 Downing Street, in London on Tuesday, Feb. 25, 2020. © Vudi Xhymshit/Shutterstock