UK pandemic report delivers a somber warning

Chris Doyle

No country can afford to wait until the global pandemic has ended before determining the proper lessons to be learned. The stakes are too high. That is why a UK parliamentary select committee report into the coronavirus published on Oct. 12 received so much attention. The findings are stark, describing it as Britain’s worst-ever public health failure, with more than 138,000 deaths. The report should be read far and wide.

First, the pandemic — which has killed 5 million people worldwide, according to official figures, but maybe as many as 10 million — is clearly not over. New vaccine-busting variants may hit us. Preparedness for additional waves is vital.

Second, most states have accepted that COVID-19 is here to stay. The challenge will be how to manage it with vaccines, antivirals, pills and various treatments, and to ensure that poorer nations get the best protection as well.

Finally, given the way humanity lives, the ecosystems we have disrupted, and our overcrowded and interconnected way of life in the 21st century, novel pathogens are likely to challenge us on an ever more frequent basis. We shall face more pandemics.

Britain is a rich case study for those wishing to learn lessons. It still has the fourth-highest number of COVID-19 cases in the world after the US, India and Brazil. A wealthy economy with a strong scientific base, it was one of the first to develop a COVID-19 test, introduced in January 2020. It had the resources, financial and human, to face the disease, and was widely considered, along with the US, to be one of the countries most prepared to face a pandemic. So why was the UK hit so hard in 2020? It also has attempted a variety of methods, changing strategies from an apparent quest for so-called “herd immunity” in the early days of the outbreak, but then moving to suppression.

UK preparedness was based on the belief that it would be an influenza-like pandemic. There was a bias toward flu as opposed to novel and zoonotic-type diseases. The trouble was that COVID-19 had asymptomatic transmission. This placed great onus on testing. Sadly, the UK and others failed to take note of how countries such as South Korea, when faced with the SARS outbreak, had reformulated their preparations and, as a result, handled the coronavirus pandemic with considerably greater success.

A former chief medical officer for England was damning in her assessment. “Our infectious disease experts really did not believe that SARS, or another SARS, would get from Asia to us. It is a form of British exceptionalism.” Many were guilty of lazy groupthink. One recommendation is to publish scientific advice swiftly so that it can be challenged and debated to prevent this.

The reality was that in January 2020, the data was there to demonstrate that COVID-19 could reach pandemic status and all countries should prepare. An article in the medical journal The Lancet presented detailed findings from China about the nature of the virus. Britain did very little over the course of the next month and a half to prepare.

The delayed decision to lock down or impose proper social distancing and isolation measures stemmed from this. This was catastrophic in the UK. One professor said that closing down one week earlier “would have reduced the final death toll by at least a half.” Ministers argued that hindsight is a clever friend, but back in March 2020, many experts were pushing for a serious lockdown and closure of borders. By the time this eventually happened, the virus had spread too widely in the community.

The parliamentary committee backed the approach of many East and South Asian states that locked down hard and fast. Britain, along with many other European and North American countries, did not — a “serious early error.” The belief that the population would not tolerate a lockdown was eventually proved false but at great cost.

No doubt because these richer countries had not faced such a pandemic in decades, there was a lack of preparedness. Britain, as an advanced economy, should not have suffered from shortages of personal protective equipment, especially in hospitals and care homes. But perhaps the greatest failure was in the social care sector, responsible for protecting the most vulnerable.

At the root of both the equipment shortages and social care disasters was a long-term failure to fund the National Health Service and care system properly. The virus merely exposed this. Patients should never have been transferred to care homes from hospitals without appropriate safeguards — precautions that were in place, the report pointed out, in Germany and Hong Kong. The pandemic also exposed grotesque inequalities, not least that racial and ethnic minority groups suffered disproportionately.

Data is essential in combating a pandemic. Decisions can be based on the science only if the data is there. Britain’s data systems were found wanting too many times, including the failure to share vital information effectively.

The most damning example of this was the expensive “repeated inadequacies” of the test-and-trace system. Testing and isolating is vital to thwart the spread of a new pathogen. It took too long to get this working effectively, so that by the time testing was widespread the virus had spread widely. One major lesson is that test and trace did not work centrally as set up in the UK. A more localized model may have reaped dividends.

UK preparedness was based on the belief that it would be an influenza-like pandemic. There was a bias toward flu as opposed to novel and zoonotic-type diseases.

Britain did succeed in one crucial area where others lagged. The government recognized early that a vaccine was vital. It invested heavily and immediately into research and development, and reaped the rewards with the development of the AstraZeneca treatment that now accounts for a third of all jabs globally. The rollout was also fast and effective, with 80 percent of the UK population vaccinated by September 2021. Britain’s decision to lengthen the recommended period between doses was widely criticized internationally at the time, but it worked, allowing a much higher percentage of the population to get protection earlier.

Such a report will not and should not be the final word on the handling of the pandemic. It must be part of a process that sees other countries and international bodies doing likewise, and corralling their data and lessons to ensure that all of us are better prepared next time so that the efforts are anticipatory, not reactive. Our readiness must be tip-top.

The UK report examined how just one state fared, but few countries responded perfectly. One of the telling criticisms was that insufficient attention was paid in Britain to international findings about the virus. Tragically, countries and international bodies failed to work closely enough together. In facing such joint threats, international cooperation and openness has to improve — and that may be the biggest lesson of all.

The writer is director of the London-based Council for Arab-British Understanding (CAABU).