Did the UK government prepare for the wrong kind of pandemic? – The Guardian

When the coronavirus struck, the British authorities repeatedly stated it was among the many best-prepared nations on this planet – with some justification. As just lately as October, an worldwide assessment of pandemic planning ranked the UK the second finest ready nation on this planet (behind the US).

Two months on, any breezy confidence has evaporated. The federal government is going through rising complaints over a sequence of coverage missteps that critics say are answerable for the worst loss of life toll in Europe.

How did a rustic that supposedly had the most effective pandemic plans on this planet find yourself struggling one of many worst outbreaks?

A assessment of official paperwork and interviews with politicians, nationwide safety advisers and specialists in danger administration suggests one reply could also be that ministers caught intently to the suggestions of a well-honed plan for a unique illness: the flu.

The origin of the UK’s technique for a catastrophic influenza pandemic was a tractor blockade at a Cheshire oil refinery in September 2000. A number of dozen farmers, indignant about the price of gasoline, blockaded the Stanlow oil refinery and refused to go away till the Labour authorities agreed to a discount in obligation.

Farmers with a tractor blockade the Stanlow oil refinery in 2000

The 2000 refinery blockade led civil servants to worry that civil emergencies may deliver down a rustic. {Photograph}: Ian Hodgson/Reuters

The blockade started on a Friday. By Wednesday, the UK was on the point of collapse. Copycat teams obstructed different gasoline depots. Huge tailbacks of panic-buying motorists stretched out of petrol stations and down motorways. Hearth engines and ambulances had been days away from operating dry, and NHS trusts confronted cancelling elective surgical procedures. One grocery store began rationing.

The protests ended and ministers later agreed to freeze gasoline obligation. However based on politicians and civil servants in authorities at the moment, the shock of the gasoline disaster sparked a realisation on the highest ranges of Whitehall that civil emergencies may deliver down a rustic.

“For just a few days, just a few hundred protesting folks outdoors gasoline depots introduced the nation to a halt,” stated Sir Peter Ricketts, a diplomat and later David Cameron’s nationwide safety adviser. “The shock of all of the sudden discovering the nation stopped due to just a few gasoline depots being blockaded was an actual wake-up name.”

Inside simply the next yr, the UK suffered extra gasoline protests, floods, foot-and-mouth illness, and the aftermath of September 11. Tony Blair’s authorities determined a totally new strategy to civil emergencies was required, and established a revised and expanded civil contingencies secretariat within the Cupboard Workplace, backed by new laws.

The ambition was “to create one thing which was higher suited to the best way by which the UK is run”, stated Bruce Mann, the director of the unit from 2004 to 2010. Civil contingency planning would cascade downwards by tiers of presidency, he stated, all the best way from Whitehall to networks of native emergency response teams.

Mann’s unit handled a “relentless” sequence of civil emergencies throughout his six years in cost, together with periodic outbreaks of infectious illness, infinite gasoline provide crises together with the explosion on the Buncefield gasoline refinery, hen flu scares, and the aftermath of terrorist atrocities each home and abroad, together with the 7 July 2005 bombings.

However the workforce additionally had a second accountability: predicting completely new dangers and anticipating how the federal government may reply. Inside its first yr the unit drew up the nationwide danger register, a complete catalogue of all of the civil emergencies that might conceivably strike the UK, which continues to be up to date yearly. On the high of the checklist – then and now – was an influenza pandemic.

Early variations of the register now learn as eerily prescient. “Along with the extreme well being results, a pandemic can also be more likely to trigger vital wider social and financial harm and disruption,” said the 2008 register. “Regular life is more likely to face wider social and financial disruption, vital threats to the continuity of important companies, decrease manufacturing ranges, shortages and distribution difficulties.” Deaths would vary from 50,000 to 750,000.

“Pandemic influenza has been one of many high dangers within the danger register for a very long time,” stated Miles Elsden, a mathematician and former authorities scientist who specialises in contingency planning. Elsden helped coordinate conferences of the federal government’s Scientific Advisory Group for Emergencies (Sage) in the course of the 2009 swine flu outbreak. “Everyone had been anticipating one thing to come back alongside,” he stated. “The affordable worst-case situation that was the premise for many of the planning was Spanish influenza,” he added, referring to the 1918 flu pandemic that killed between 50 million and 100 million folks worldwide.

Prof Lindsey Davies, a public well being physician, was introduced in because the UK’s first nationwide director of pandemic influenza preparedness in 2006. Having been handed the “pretty skeletal” current plan, Davies started battling for extra assets. To get them, she would want to drive ministers to understand the potential scale of a pandemic disaster. Along with Mann she coordinated the primary main nationwide simulation of a flu pandemic in 2007, codenamed Winter Willow.

One query surrounding the federal government’s dealing with of the coronavirus is whether or not it carried out suggestions from a second, 2016 flu pandemic simulation, codenamed Train Cygnus. The report, which was leaked to the Guardian, made a number of suggestions that seem to have been neglected.

However Winter Willow was the far bigger train. The place Cygnus concerned 950 folks, Winter Willow marshalled greater than 5,000 folks, together with authorities ministers, civil servants, emergency planners, NHS workers, and emergency companies personnel to coordinate the primary actual try to check how the UK would maintain up beneath the pressure of a pandemic.

The outcome was transformative. “That was completely a turning level for us, as a result of folks at that stage realised what [a flu pandemic] may do,” Davies stated. “We didn’t exaggerate it in any respect; if something we underplayed it. We had a type of average pandemic situation, somewhat than the worst-case one. However even then,” she added, “we ran out of face masks.”

In addition to pinpointing holes within the planning, Winter Willow galvanised ministers into taking the specter of a pandemic critically. “Ministers, once they had been confronted with the fact of it, all of the sudden realised that this truly might be disastrous,” Davies added.

A number of adjustments of presidency later, and after a decade of austerity, pandemic planning seems to have slowly dropped off the radar. The worth of the UK’s pandemic influenza stockpile, estimated at £831m in 2013, declined by 40% over six years. Ricketts says that whereas the federal government had a faultless file anticipating pandemic influenza as a danger, “someplace alongside the road that didn’t get translated into choices on funding, preparedness shares, the in-case shares of significant gear to make it actual”.

However a second consensus has additionally emerged: that one of many UK’s large errors, somewhat than failing to plan, was planning for the unsuitable sickness.

Do you will have details about this story? Electronic mail david.pegg@theguardian.com, or (utilizing a non-work telephone) use Sign or WhatsApp to message +44 7584 640566

Complete tracts of the UK’s complete pandemic technique flip upon any pandemic being flu – a unique kind of illness to a coronavirus. The emergency pandemic stockpile comprises thousands and thousands of doses of Tamiflu and Relenza to assist alleviate the worst of the signs for anybody catching the brand new flu illness, and a Nationwide Flu Pandemic Service would distribute them. Stockpiles of current flu vaccines that may be efficient towards the brand new pressure can be distributed to inoculate well being employees, whereas contingency contracts with pharmaceutical corporations can be spun as much as manufacture extra flu medication.

The federal government’s most up-to-date nationwide safety danger evaluation, compiled final yr, predicted a possible disaster within the occasion of a flu pandemic: trillions of kilos in damages, deaths within the 5 figures, disruption lasting for months.

Nonetheless, the chance evaluation’s prediction for the potential influence of a brand new illness like a coronavirus was staggeringly off track. The worst-case situation for a novel infectious illness within the UK, the federal government’s danger evaluation stated, “might be on the dimensions of the Sars outbreak in Toronto, Canada”, which concerned 438 possible and suspected instances and 44 deaths. Financial harm can be restricted to a couple billion kilos, largely from nervous vacationers staying away.

The British authorities’s give attention to flu, and the failure to take a look at how Asian nations had been responding to the coronavirus, was just lately described by the previous well being secretary Jeremy Hunt as “one of many greatest failures of scientific recommendation to ministers in our lifetimes”. “It’s now clear {that a} main blind spot within the strategy taken in Europe and America was our give attention to pandemic flu somewhat than pandemic coronaviruses, equivalent to Sars or Mers,” he informed parliament.

A postman delivers swine flu leaflets in Glasgow

Nearly each main UK illness outbreak within the final 100 years has been some type of flu. {Photograph}: Andrew Milligan/PA

The extent to which Boris Johnson’s authorities caught to a protocol specified by its flu pandemic plans is made clear by reviewing the 2011 technique for responding to a flu pandemic (the latest revealed model obtainable). It reads like an awfully exact description of the steps the UK authorities did (and didn’t) absorb its preliminary response to Covid-19.

Mass gatherings equivalent to soccer matches and stay music occasions would proceed, partially to “assist preserve public morale”. There can be no quarantining of worldwide arrivals at airports, although passengers can be inspired to report any signs upon arrival. Face masks wouldn’t be really helpful to be used by the general public. There isn’t a point out in anyway of wholesome folks being confined to their houses in an try to stop transmission.

Maybe most putting is that the choice to wind down contact tracing on 12 March, extensively seen as an error that has hamstrung the UK’s capability to combat again towards the coronavirus, can also be alluded to within the authorities’s flu pandemic technique.

Its first “detection and evaluation” part ( seemingly an analogue for the “comprise” part of the coronavirus response) describes how the main focus would shift away from “actively discovering” and isolating confirmed and suspected instances, and as an alternative flip to therapy of the illness as soon as there was “proof of sustained neighborhood transmission of the virus”. It even anticipates that detection and evaluation may itself be a “comparatively brief” part, relying on the circumstances.

How Covid-19 contact tracing may also help beat the pandemic

The flu technique bluntly concludes: “It is not going to be potential to halt the unfold of a brand new pandemic influenza virus, and it could be a waste of public well being assets and capability to aim to take action.”

There’s one apparent however vital purpose why the UK might have centered its consideration a lot on planning for influenza: following Spanish flu in 1918, subsequent pandemics included Asian flu in 1957, Hong Kong flu in 1967, and swine flu in 2009. Barring HIV/Aids, virtually each vital illness outbreak for the previous hundred years has been some type of flu.

A Division of Well being spokesperson acknowledged that a number of steps taken by the federal government resemble these set out within the technique, however cautioned towards deciphering this as the results of some blinkered give attention to the doc. Whereas helpful, they confused, the technique would have been solely considered one of a number of parts thought-about by authorities scientific advisers, alongside rising information from Wuhan in addition to new analysis into the character of the virus.

They added that contact tracing didn’t cease when Britain moved to the delay part, however was as an alternative centered on particular settings vulnerable to an infection equivalent to residential care houses. “That is an unprecedented world pandemic and we’ve taken the correct steps on the proper time to fight it, guided always by the very best scientific recommendation,” they stated.

Prof David Tuckett, an skilled in decision-making beneath uncertainty who runs a analysis group referred to as CRUISSE at College School London exploring how organisations can reply to “radical uncertainty”, has some sympathy for ministers. It could be pure for ministers to show to their flu pandemic plan, he stated, as a result of it was the one one that they had – however that may be exactly the peril of inserting assumptions into the core of your plan.

“You’ve a mannequin based mostly in your central case, and you’ve got an entire set of helpful belongings you’ve discovered from some train or different,” Tuckett stated. But when the disaster being handled is considerably totally different from the one a authorities has deliberate for “then a central case will distract you from considering. That’s, in a approach, what occurred.”

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