The Covid Inquiry: updates on module 2 – where is the fault in central decision-making?

13 November 2020; a gathering in No 10 Downing Street on the departure of a special adviser. Photo: Official Number Ten photographer,Wikimedia Commons

This week is turning out to be very revelatory…and shocking. Ed

We will update as and when…

From 30 October:

What we see from the Inquiry is intense focus on the period between Jan 30 and March 23r. This was the nearly two month period that would affect all of our lives so profoundly for years to come…

The line the Inquiry is taking is that we knew that Covid was transmissible and there was even asymptomatic spread and it was going to become a serious global pandemic by end of January.Had we acted then, tens of thousands of lives would have been saved and lockdowns avoided…

So why wasn’t preparation under way? And if not then, why not by mid to end February when Covid had reached Italy? The answers are deeply uncomfortable…

Primarily it was absence of leadership. Johnson and his ill-equipped Cabinet were no where near smart or engaged enough to respond and lead the country to even a semblance of a decent response Yet to be discussed (Module 4), were they also distracted by pandemic-profiteering?

Beyond this there is a deeply troubling reflection on our national institutions. They are too cowed by government. NHS, Education, Science, News, etc all failed to stand up to a clearly flawed strategy and an overtly incompetent maligned leadership This speaks to corruption and patronage.

It has held the U.K. back for decades…that often it is not the best person for the job but the best person for the govt’s intentions that get promoted. Very few push back on flawed policy or maligned priorities. There should have been outcries and resignations. There wasn’t.

And herein lay one of the important aspects of the Inquiry and having illuminating coverage of it…those involved need to be aware they failed. Those that come after them need to know with such influential jobs comes grave responsibilities. It is how we prevent it happening again

October 11:

My summary from today’s Covid Inquiry: Johnson thought he could blag his way through the pandemic… Turns out he was catastrophically wrong. And as we all paid the price for it… he got rich. The End

If you read anything about the Covid Inquiry, let it be this opening statement by the KC.

This is where the Inquiry sets out its current position. Based on the mass of evidence they have seen, where is the fault in the central decision-making?

Government ministers will say it was the scientists. But going from the KC’s opening statement, that will not wash. Indeed, it seems likely Ministers will be named and shamed for avoidable deaths and the ongoing damage prolonged lockdowns and restrictions caused. 

I will share the key parts of the KC’s opening statement.

The KC summarises where we were at the end of January. The pandemic was inevitable and it would cause death and disruption. Were we world-leading this is when we would have acted!

The KC goes through the timeline. SAGE is first under the spotlight. And while the KC makes it clear through his opening statement that government ministers and officials failed to follow SAGE advice on many occasions, here in Jan 2020, there seems a quite fatal flaw in SAGE thinking

Perhaps the thinking was “too scientific method”…

What I mean is, the lack of evidence was given too much weight and this meant basic common sense was often missing. “There is no current evidence to suggest prevention of mass gatherings is effective in limiting transmission”… 

Yet on a simple common sense basis, of course limiting mass gatherings would reduce transmission.

Equally, there seemed a sense that, ‘well, we cannot stop the pandemic so what’s the point of doing x,y,z’. 

Why such thinking was the case may relate to the selection of the SAGE members (the purview of Prof Vallance). There were very few members with practical experience. Also, there was the very real issue of groupthink. 

And, in January, this did lead to advice being given to ministers that cancelling big events was not worthwhile (note the ‘data did not support’).

This becomes highly relevant. The KC asks: had the UK acted quicker with more basic protections – travel restrictions, quarantine for high-risk travellers, limiting mass gatherings, proper test and trace, expanding healthcare capacity – would lockdowns have been necessary AT ALL?

The KC suggests it may relate to the initial strategy of natural herd immunity. Certainly, the KC talks as if there is little doubt the government strategy was herd immunity through mass infection (the evidence is overwhelming). Where such a strategy emanated from he does not reveal! 

But generally speaking, the notion of herd immunity is seen as lazy, ill-conceived, and frankly dangerous…

And really, it is this sense of chaos, disorganisation, and failure to grasp what was actually happening that predominates at the start of the pandemic. Why were we not doing much at all to contain the virus? In part, perhaps (initially) SAGE failed to convey the correct advice… 

But ultimately, it was the inability of cabinet ministers to grasp what was actually going on and ultimately I think we will find the failure stems from the lack of good intent of cabinet ministers; the lack of empathy or concern for the public…

By end of January it was again unclear whether it was the ineffectuality of the govt that led to little being done or was it the Herd Immunity strategy. Indeed, it is quite possible that the herd immunity strategy was chosen due in part to its simplicity.

The KC then drills down in detail on a very specific timeline March 12 to March 23 This will become a forensically-examined 11 days, as much of what happened next – deaths and lockdowns – came from decisions made during this period. 

On March 12, The World Health Organisation announced a global pandemic. On March 13, a “heated” SAGE meeting was held in which NHS representatives asked whether the NHS could cope with the now expected volume of cases… 

That evening, lockdown is mentioned as probably being required.

Then on March 15, the PM meets with the chief medical officer (CMO) and chief scientific officer (CSO). Johnson escalates to self-isolation and voluntary social distancing. Yes, the team is now talking lockdown and Johnson thinks self-isolation is enough.

Monday March 16, PM advises work from home and self-isolation for 14 days.

March 18, SAGE meets, and advises for school closures. Johnson does so on the same day!

The fact the KC mentions this in his opening statement is likely important. SAGE advised and the PM followed. Without seeing a record of the conversations between Vallance, Whitty and Johnson, it is difficult to understand what they were advising. 

On March 20 – pubs and restaurants were closed. Yes, it was deemed more important to keep pubs and restaurants open than schools!

On March 23, lockdown began. KC highlights that on the day lockdown began, 100,000 new cases were likely to have occurred (very late). 

I think it will be reasonably concluded that action should have been taken much sooner. The argument that taking proactive steps in January (e.g. travel restrictions or tracing passengers from high-risk areas) will be made. Under the chaotic Number 10, this was pie in the sky! 

The Inquiry will then move to mid to end Feb suggesting that if the pandemic had been taken more seriously and proper suppression techniques had been deployed then we could have avoided lockdowns altogether.

With the state of the NHS, it seems unlikely to be “avoided”… 

But the Inquiry may well conclude that the length of the lockdowns would have been drastically shorter had the government put mitigations in earlier.

We ended up in lockdown for months. It could have been weeks. 

And who’s fault is that? I struggle to see how SAGE don’t take some of the blame here. What they were actually thinking during Jan and Feb will be interesting to hear. But certainly, the clincher will be between March 12 and March 23. Johnson failed here… 

And it was this failure that had the most devastating consequences. Up until March 23, Johnson conceded to token mitigations (still focused on herd immunity). It was only when the reality/optics of an actual collapse of health services hit that he was forced to act. 

Johnson was not alone, though. Gavin Williamson made some specularly ignorant contributions…Expect him to get a roasting too.

As for Sunak, he may well avoid a roasting in relation to Eat Out to Help Out. Evidence linking surge in cases with his policy is deemed too unclear.

The same situation is met on the second lockdown. This time it is clear that SAGE were pushing for earlier action and Johnson wasn’t having any of it…delaying until it was simply too late!

The catastrophic Christmas of 2020 showed clearly that Johnson had learned nothing…

And this was truly tragic! Weeks away from vaccinations being implemented, Johnson failed to act in a timely fashion, despite a chorus of calls to act. And yes, tens of thousands of people died who would not have died. The NHS became even more overwhelmed. This is truly unforgivable. 

But, he had enough ‘yes men’ within the scientific community and at government adviser levels to allow this to happen. Indeed, the KC draws attention to a specific meeting of advisers (but gives little else away – expect this to hold some stark revelations).

No doubt, Johnson wanted something. He wanted to power through. Even if that meant suffering for millions of people. BUT, he was empowered to do so by others. Other ministers, advisers, scientists, media, and others. 

There is a good chance we will at least gain some insight into the points of the most significant failures, but will lessons be learned? I remain pessimistic that enough change will come from the Inquiry to avert another calamitous government response to a further pandemic. 

In part, those who facilitated Johnson’s will of letting it rip have prospered and now occupy senior positions in important positions. They will be the people who determine how we respond next time. As yet, there is little contrition from them that they made critical mistakes. 

The right strategy was maximal suppression until vaccines. Those who supported the Johnson let it rip approach need to correct their thinking. We now know, restrictions would have been much less harmful had they happened earlier. 

I leave you with a single piece of evidence to highlight that we have not learned (and perhaps even unlearned basic public health)…This is from the NHS website, advising how to manage breathlessness at home for Covid patients…in Oct 2023!

Here is the link to this unbelievable piece of advice on the NHS website

P.s. if you have covid and you are breathless don’t stay at home…get urgent medical attention!

How to look after yourself at home if you have COVID-19 or symptoms of COVID-19Find out more about how to ease symptoms of COVID-19 at home and how to avoid passing it to other people.

• • •

Undoubtedly this will be the most dramatic part of The Covid Inquiry. Module 2 explores the decision-making taken at the “highest levels of government” during the pandemic. We will learn about Johnson’s strategy, lockdowns, eat out to help out, closing hospitals/schools/workplaces.

Arguably the first part of the Inquiry dealt with factors that caused more deaths, disabilities, and economic harm than the decisions taken during the pandemic. For example, almost certainly the Inquiry will find that austerity and Brexit led to hundreds of thousands of deaths and huge damage.

But this part of the Inquiry will expose what was going on inside government during the pandemic. So far, it looks like it was an utter calamity! Beyond the chaos, they will expose the motives of ministers (almost certainly why Sunak’s WhatsApp’s have been lost). 

Will the Inquiry have teeth, here? It certainly looks like it. They have been forensic in their investigation so far; they have, in the main, not pulled their punches and have walked many MPs into concessions and admissions that will not reflect well on them in the final report 

Hancock’s appearance, in particular, was a colossal car crash. Cameron and Osborne came out looking like Bond villains. Johnson is yet to appear, but you can safely expect fireworks. 

Beyond all this, we are likely to get actual answers! Were they following a herd immunity approach? Did they actually say they were willing to sacrifice the elderly and vulnerable (and who said it)? [Stuff like PPE and Test & Trace will be in another module] 

So all in all, it will be quite revealing.

The question we don’t yet know is whether it will expose enough about certain MPs/officials to warrant a criminal case against specific individuals. [I wouldn’t bet against it!]

Here are a few snippets of the lead counsel, Hugo Keith KC’s opening.

Firstly, there is no debate in the mind of the KC (and the Inquiry) that the number of deaths the UK suffered (excess) was colossal. The first question posed: did it have to be that way?

They will ask whether ministerial decisions caused avoidable deaths!!!! 

Secondly, the KC raises the issues of damages during lockdown. But crucially, they ask not whether lockdowns should not have been used but whether the damage of them could have been limited?

Almost certainly this points to the delay in implementing controls in early 2020! 

The KC raises the issue of delayed treatment for other conditions.

In my view, this was a colossal failure of both government and NHS Execs. Of course, we had far too few resources to handle both Covid and non-Covid as we were before Covid, BUT we did not use the resources we had effectively, in my view. 

The KC raises equalities – the effect of restrictions on the vulnerable and minorities.

We will be hearing from Priti Patel, then Home Sec, Kemi Badenoch, then Minister for Equalities, and Justin Tomlinson, then Minister for Disabled People. They failed. Expect fireworks. 

The KC then goes through the numbers.

On all but the lowest expectation of the UK, the numbers are awful. Deaths, excess deaths, the picture of how the spread often got out of control, and comparisons with other nations such as France, Denmark, South Korea point to inadequacies! 

There is significant point of error (in my opinion). The KC has grouped together flu and pneumonia. This seems a common public misconception, that one leads to the other or they are interchangeable. In fact, pneumonia is predominantly made up of non-flu-related infections.

Nonetheless, even with this, the KC highlights that years of life lost during the first year of Covid were six times higher than flu and pneumonia.

The picture is of serious mass infection, causing death and disability.

The KC states:

“The overarching question for you in this module will be whether the massive casualties of the first and second waves were the direct result of a plain and obvious failure to put in place proper infection control across the country.” 

The KC then goes into the chronology of events. I will post a thread on this later.

I will try and provide regular updates when I can.

The Inquiry are exposing information we have never seen before and I think (controversies aside) will bring new revelations.