“The excuse proffered by almost any minister, civil servant or government scientist you challenge about Britain’s response to the pandemic: that all would be have been well had we been hit by pandemic flu rather than a coronavirus.…There would have been no demand for masks, visors or droplet repellent PPE. Mass testing…would have been next to worthless. And there would have been no need for lockdown.…An influenza pandemic would have been unstoppable….There would have been nothing much to do, other than bury the dead.”
Aug. 15, 2020. “Analysis: Whitehall’s systemic failure exposed – why this was a disaster ten years in the making,” UK Telegraph, Paul Nuka
“When the UK Government finally got around to publishing its Covid-19 exit strategy in May, one paragraph above all others signalled radical change for Britain’s public health establishment.
Under the heading “Sustainable government structures”, the authors noted that as the Government fought Covid-19 it would “learn the right lessons from this crisis and act now to ensure that governmental structures are fit to cope with a future epidemic”.
“This will require a rapid re-engineering of government’s structures and institutions to deal with this historic emergency and also build new long-term foundations for the UK,” they added.
Three months later and the game to determine the future shape of Whitehall is in full swing. Mark Sedwill, Cabinet Secretary and Britain’s most senior civil servant, has been dismissed for a duck, clearing the way for those Conservative ministers, MPs and aides best known for their “strategic vision” to step up to the crease.
Meanwhile, at the boundary and in the slips, permanent secretaries and assorted mandarins are playing the long game and aiming for “management and efficiency” tweaks rather than anything resembling the last great structural shake-up of the Civil Service that followed the First World War and the Spanish flu pandemic of 1918….
So what are the lessons of this ongoing crisis and what reforms might be expected?
While virtually all independent experts say it will take years for the dust to settle, the knives are already out for Public Health England (PHE), the executive agency of the Department of Health and Social Care….
Iain Duncan Smith MP, the former Conservative Party leader and the brains behind Universal Credit, has said he would “abolish PHE tomorrow” if he was in charge, accusing the agency of “arrogance laced with incompetence”.
Others say the agency’s responsibilities are too broad, covering everything from infectious diseases to sexual health. Matthew Lesh, head of research at the Adam Smith Institute, is one of several calling for PHE’s responsibilities in the area of infectious diseases to be hived off into a dedicated agency-a UK centres for disease control or, as government sources propose today, a new National Institute for Health Protection.
Nick Davies, programme director at the Institute of Government, agreed PHE’s duties may be too broad. “I guess there are reasonable questions about whether campaigns to reduce smoking should sit with infectious disease control,” he said….
“I think it’s fair to say the crisis hasn’t exactly been a good advert for what happens for services directly under government control. If you look at, for example, NHS test and trace – directly under the control of ministers – that’s clearly been a bit of a disaster.”…
There can be little doubt Britain’s poor response to the pandemic will ultimately be explained by group think: a fatalistic and inflexible approach to pandemic planning that seduced not just Whitehall but much of Britain’s scientific establishment.
Today it is best seen in the excuse proffered by almost any minister, civil servant or government scientist you challenge about Britain’s response to the pandemic: that all would be have been well had we been hit by pandemic flu rather than a coronavirus.
Britain had a first-class influenza pandemic strategy – second in the world after the US for its preparedness–and would have performed well had it been another Spanish flu, so the argument goes. [“There would have been nothing much to do, other than bury the dead.“]
There would have been no demand for masks, visors or droplet repellent PPE. Mass testing and track and trace systems would have been next to worthless. And there would have been no need for lockdown.
Why? Because an influenza pandemic would have been unstoppable. Just as was shown by Excercise Cygnus in 2016 when ministers simulated a flu pandemic, many tens of thousands would have died but there would have been nothing much to do, other than bury the dead.
This is the narrative pushed by Jeremy Hunt, the former Health Secretary, and Sally Davies, the former chief medical officer, who were responsible for Britain’s pandemic planning, but it will never survive the scrutiny of the public inquiry to come.
As epidemiologists like Prof Francois Balloux, director of the Genetics Institute at University College London, have pointed out, past pandemic strains of influenza and SARS-CoV-2 are extraordinarily similar. Both are droplet spread, if anything Covid spreads faster than influenza, both cause asymptomatic infections and both have similar infection fatality rates.
“SARS-CoV-2 behaves in most ways like a pandemic influenza strain,” wrote Prof Balloux in a recent Twitter thread. “The only major epidemiological difference between COVID 19 and flu pandemics is the age risk distribution, with influenza being highly dangerous to young children in addition to the elderly. At this stage, COVID 19 is really ‘like pandemic flu’, but not like ‘seasonal endemic flu’ [which is much less lethal]”….