Via The Lancet, editor Richard Horton studies the UK's dismal government response to COVID-19: Offline: “Laughing at the Italians”.
A former minister for health in England wrote to me that “The COVID-19 inquiry will make us the laughing stock in the eyes of the world.” But it is worse than that. The level of criminal incompetence exposed by recent witnesses to the UK COVID-19 Inquiry, chaired by Baroness Heather Hallett, has proven that many, if not most, of over 230 000 deaths were preventable. Amid the claims of extreme misogyny, profanity, and chaos that litter the evidence is a story of complete government breakdown.
WHO declared a Public Health Emergency of International Concern on Jan 30, 2020. The UK Government was confident it could ride out the storm coming from China. Martin Reynolds, who was at the time Prime Minister Boris Johnson's Principal Private Secretary, believed “the system [was] gripping the challenge”. Lee Cain, who was Downing Street's Director of Communications, thought the outbreak was simply a matter for the Department of Health and Social Care. Chris Whitty, the Chief Medical Officer (CMO), briefed Johnson about the risk of a pandemic on Feb 4, 2020. Johnson expressed concern about over-reacting.
The discussion focused on repatriating UK nationals from China, according to Imran Shafi, then Private Secretary to the Prime Minister for Public Services. Government committees were waking up to the threat. COBR (Cabinet Office Briefing Rooms), a group responsible for managing national crises, concluded that the UK's public health system lacked capacity for dealing with a pandemic.
But the extent of the danger did not penetrate to the centre of government. The CMO reassured Downing Street that there was no sustained transmission outside Wuhan. Then something very strange took place. Johnson took a 2-week holiday. From Feb 14 to Feb 24, he absented himself from Cabinet and COBR meetings, and received little or no further information about the growing risk of COVID-19. Yet it was clear by mid-February that there was sustained coronavirus transmission in the UK.
Matt Hancock, then Secretary of State for Health and Social Care, reassured colleagues that a plan was in place. By the time Johnson returned from his vacation, clusters of infection were being reported in Italy's Lombardy region. The “macho culture” of No 10 translated into politicians and their advisers “laughing at the Italians”, according to Helen MacNamara, who was Deputy Cabinet Secretary.
They remained supremely confident that the UK would be world-beating at conquering COVID-19. A meeting of the Civil Contingencies Secretariat on Feb 28 concluded that a global pandemic was now likely (Shafi). Still Johnson and his closest advisers failed to engage.
Johnson chaired his first COBR meeting on March 2. A COVID-19 Action Plan appeared the next day but, according to Cain, it was nothing more than a “thin overview”. By the time Italy locked down on March 9, Reynolds readily agreed that the UK was “playing catch up”. But there was still no plan, no strategic direction, and no leadership. Instead, a debate raged about mitigation versus suppression.The evening of March 13 was the moment Downing Street realised that the NHS would be overwhelmed if it continued to pursue a policy of mitigation (herd immunity). Only now did the principals have NHS data showing that hospitalisations were rising faster than models predicted. Dominic Cummings, Johnson's main adviser, drew out the threat on a whiteboard that became the instrument for persuading politicians that lockdown was the only option. Treating coronavirus like influenza had been a monumental mistake—“something had gone horrifyingly wrong” (Cummings). “We were heading for a total disaster” (MacNamara).Yet Johnson still remained sceptical. In a meeting on March 19 between Johnson and Rishi Sunak, his Chancellor, Johnson said, “We’re killing the patient to tackle the tumour…Why are we destroying the economy for people who will die soon anyway” (Shafi). The UK Government finally locked the nation down on March 23.Officials who have given evidence looked wearily astonished as they described the country's biggest national crisis since World War 2. After Johnson's landslide election victory in December, 2019, they had expected to serve a two-term government. But as the pandemic spread, they admitted that “we weren’t ready for the crisis” (Reynolds). It was a “historic catastrophe” based on “disastrous groupthink” (Cummings).The lies, deceptions, and callous conceit that characterised the UK's initial response to COVID-19 must surely bring some kind of reckoning.
