Significant failings in the UK’s preparation for a pandemic saw Covid cause more deaths and long-lasting economic damage than it should have, the first report from the Covid-19 inquiry has concluded.
Amongst the findings identified by the inquiry was that the Governments of the UK and devolved nations planned for the wrong pandemic, with too narrow a focus on flu.
There was also a flawed approach to risk assessment and a failure to learn from past emergency exercises and other disease outbreaks, inquiry chair Baroness Heather Hallett said.
In the years leading up to the pandemic, there had been a lack of adequate leadership, coordination and oversight, the report concluded.
Previous health secretaries Jeremy Hunt and Matt Hancock were both criticised for their failure to better prepare and oversee contingency planning.
Baroness Hallett also noted that, going into the pandemic, the UK ‘lacked resilience’ with a slowdown in health improvement and widening health inequalities.
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‘High pre-existing levels of heart disease, diabetes, respiratory illness and obesity, and general levels of ill-health and health inequalities, meant that the UK was more vulnerable,’ the report said.
In addition, public services, particularly health and social care, ‘were running close to, if not beyond, capacity in normal times’.
Ministers were also criticised for not receiving a broad enough range of scientific advice and failing to challenge the advice they did get.
Repeated pandemic exercises had identified a lack of PPE, provision for contact tracing and testing and NHS surge capacity as issues, the report said.
It is vital that lessons are learned, the inquiry found, because it is not a question of ‘if’ another pandemic will strike but ‘when’ and the next one will potentially happen in the near to medium future and be even more transmissible and lethal. The swine flu pandemic had also lulled the Government ‘into a false sense of security’.
The report – the first of 9 separate modules looking at everything from healthcare systems, to vaccines, procurement and test, trace and isolate – made 10 recommendations which Baroness Hallett said she expected to be acted on.
They include:
- A ‘radical simplification’ of civil emergency preparedness and resilience systems, streamlining the current bureaucracy and improving leadership.
- A new approach to risk assessment for more comprehensive evaluation of a wider range of risks as well as better data collection and research
- Holding a UK-wide pandemic response at least every three years and publishing the outcome
- Using external expertise from outside government and the civil service to challenge ‘groupthink’
- And the creation of a single, independent statutory body responsible for whole system preparedness and response.
Baroness Hallett said: ‘My report recommends fundamental reform of the way in which the UK government and the devolved administrations prepare for whole-system civil emergencies.
‘If the reforms I recommend are implemented, the nation will be more resilient and better able to avoid the terrible losses and costs to society that the Covid-19 pandemic brought.’
But a spokesperson for the Covid-19 Bereaved Families for Justice UK group said the report did not go far enough in setting out how the UK can improve the inequalities laid bare by the inquiry.
‘While the inquiry has diagnosed much of what undermined our response, Lady Hallett has not gone far enough in setting out how we can challenge, address and improve inequalities and capacity of public services as opposed to just understanding the effects of these failures.
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‘We ask for this government to produce a plan to address health inequalities and in its first 100 days conduct a cross-departmental audit into pandemic preparedness.
The Royal College of Nursing’s (RCN) general secretary and chief executive Professor Nicola Ranger, described the report as ‘emotional reading’ saying that the thoughts of the profession were with the bereaved and those suffering from the long-term effects of Covid-19.
She said: ‘The response to the pandemic was deeply flawed, stemming from a failure at the very top of governments to plan, prepare and resource health and care services effectively for a respiratory disease outbreak. A sustained period of austerity widened health inequalities and weakened health service infrastructure, whilst a total failure to invest in the nursing workforce left every care setting chronically understaffed.’
Nursing professionals raised concerns about lack of appropriate clinical and protective equipment, but their voices were not heard, she said.
‘As the largest single workforce in the NHS, the nursing profession was isolated, hindering our participation in the development of clinical guidance and preparedness planning.’
There was a ‘lack of parity’ between the Chief Nursing Officer and Chief Medical Officer in England, which ‘held back the pandemic response,’ the RCN suggested.
‘Four years on from the outbreak of the pandemic, this report makes clear that health and care services remain unprepared for future expected health emergencies. The nursing profession is well placed to support the development of new approaches to risk assessments and pandemic planning, but today’s ministers in every country of the UK must ensure we are equal partners.’
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‘This report is a vital reminder that frontline health and care workers deserve nothing less than high-quality, fully funded mental health and wellbeing support from their employer.’
A version of this article first appeared in our sister publication, Pulse.
