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Sunday, May 24, 2020

How UK Government's dither and delay cost thousands of lives

The Sunday Times Insight Team has produced a detailed and scathing analysis of the UK government's response to the coronavirus, which sets out at length the key trigger points when ministerial failure to act decisively has led to many more deaths than were necessary. Here are some of the key passages:

The government pursued its contain and delay strategy through the first two weeks of March despite the strong warnings from its two main modelling teams that it could lead to a catastrophic number of people being killed by the virus. The teams from Imperial College London and the London School of Hygiene & Tropical Medicine (LSHTM) both concluded separately that if the mitigation measures under the delay strategy were followed, it could result in about 250,000 deaths. They delivered papers detailing those findings to a meeting of Sage, the scientific advisory group for emergencies, on March 3 attended by government officials.

It was only in the middle weekend of March that the key decision makers would fully engage with the fact that their mitigation measures risked a death sentence for a quarter of a million people and something far tougher was required.

What is more, this realisation came only after the academic teams took it upon themselves to model a lockdown as the only solution that could avoid overwhelming the NHS — showing how deaths could be kept to the tens of thousands.

The failure to act quickly on the scientific evidence was very costly for many families:

That prevarication proved, for some, to be fatal. New back-dated modelling assessing the historic spread of the disease — which is published for the first time today — estimates the number of people infected in the UK was indeed doubling every three days during late February and early March, just as some of the initial reports from China in late January had suggested they might.

The work, produced jointly by an Imperial College London team led by Samir Bhatt and Oxford University, suggests that on March 3 — the day the government committee gave the warning about the dire consequences of a mitigation approach — there were about 14,000 infections in the UK. Such was the speed of the spread of the virus that 200,000 people were estimated to be infected by the time the government began to change its mind about its policy on Saturday, March 14.

The last nine days while Johnson wrestled over the decision on when and how to go for lockdown were particularly brutal. By the time the lockdown was announced on Monday, March 23, such large numbers were doubling over such a short period that infections are estimated to have soared to 1.5 million.

According to the data, no other large European country allowed infections to sky-rocket to such a high level before finally deciding to go into lockdown. Those 20 days of government delay are the single most important reason why the UK has the second highest number of deaths from the coronavirus in the world.

In the meantime, countries like New Zealand were showing how decisive action could make a big difference. Their early intervention proved highly successful and enabled the country to start to return to normality last month after a relatively short lockdown with just over 1,500 cases and 21 deaths.

In contrast the example being set by Boris Johnson, mingling with the 81,000-strong crowd that watched England beat Wales at Twickenham for example, and shaking hands with COVID-19 patients, was sending out all the wrong messages. Despite denials now, the UK Government was still pursuing a herd immunity strategy with disastrous consequences.

Once the scientists took matters into their own hands, the Prime Minister started to understand the gravity of the situation:

The government’s strategy was in shreds: ripped apart by its own modelling scientists and looking creepily Darwinian after the unfortunate introduction of the words “herd immunity”. More than 200 scientists and academics signed a letter condemning the delay policy and saying thousands of lives could be saved by introducing stricter social distancing measures immediately.

These were the problems confronting Johnson when he summoned a meeting of his inner team at 9.15am that Saturday morning. By then it is understood that his most influential adviser Cummings had gone through a “Damoscene conversion” to being a strong advocate of the kind of suppression strategy that would lead to lockdown.

A source who attended Cobra meetings at the time said: “The libertarian in Boris didn’t want lockdown.” However, Johnson is said to have been won over at the meeting because of the seriousness of the threat, and a decision was made in principle to lock down Britain. He told those around him “we need to be taking all measures necessary”.

But the key issues of how and when to introduce a lockdown would not be resolved for another nine days. A senior Tory source said Johnson “bottled” lockdown during the following week because of concerns about the economy.

The failure to seize the initiative and go into lockdown at that point was a decision that cost many lives. After deliberating over the weekend, the government waited until the evening of Monday March 16 to introduce a package of advisory measures. People were told to work from home if possible, avoid pubs and restaurants and self-isolate at home if someone in their household was ill.

Even scientists on the government’s own advisory committees were alarmed by the delays in introducing more stringent measures. Professor Peter Openshaw, a member of the government’s Nervtag (new and emerging respiratory virus threats advisory group) committee said: “Many of us on the scientific advisory committees were quite keen that action should be taken a couple of weeks before action actually was taken.”

“I think that critical period of delay made the big difference to the peak numbers, both of hospitalisations and of deaths. I think everyone would accept now in retrospect that if we’d gone for lockdown a couple of weeks earlier that would have greatly reduced the numbers of hospitalisations and deaths.”

Every day was vital now as the UK already had an estimated 320,000 infections on March 16, according to the Imperial and Oxford back-dated modelling, and it would double again almost every three days despite the advisory measures which were introduced.

Sir David King, one of Vallance’s predecessors as chief scientific adviser and a critic of the current administration, said the lockdown delay was “grossly negligent”:

“The fact they were short of PPE, the fact they were short of testing equipment. The response of the government has not just been tardy. It has been totally disrespectful of British lives,” he said. “We created an unmanageable situation.”

There had been too much delay. The sheer number of people who had been allowed to become infected meant the country was riddled with the virus and the only defence was the workers of the NHS who had been left critically short of testing and protective equipment.

The UK Government's negligence and failure to act as outlined by the Insight Team must surely be looked into by a subsequent public inquiry.
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