Forget Covid, Britain would have collapsed even with the flu pandemic it had planned for
There is a great untruth that lurks at the heart of last week's cross-party parliamentary report on the UK’s response to the coronavirus pandemic.
It’s acknowledged with a nod and a wink in the corridors of the Lords and the clubs of Pall Mall but it’s in no one's interest to talk openly of it. Certainly not in Whitehall or the royal societies of Britain’s medico-scientific establishment. Not if you want to get on, that is.
The untruth goes like this: the UK prepared diligently for a pandemic but was hit by the wrong bug. Had it been influenza rather than Covid, all would have been well. We were ready for that. The whole episode was no more than a terrible stroke of bad luck.
This narrative frames last week’s 150-page parliamentary report. It has the function of allowing a little surface criticism (the PM might have locked down a day or so earlier in March 2020, don't you know) while deflecting from what is much closer to the truth: that the UK suffered a full-blown failure of state.
“The UK’s pandemic planning was too narrowly and inflexibly based on a flu model,” says the cross-party report in its very first bullet point. “The result was that whilst our pandemic planning had been globally acclaimed, it performed less well.”
But here’s the thing. There was not a pandemic plan in the world that was not based around what was and remains the number one pandemic risk - a new strain of flu or influenza. What separated the best plans from the worst was not the bug they focused on but whether they intended to stop it or not.
So while the UK pandemic plan talks only of “mitigating” the impact of a new flu virus, The New Zealand Influenza Pandemic Plan: A Framework for Action has a policy of “suppression” at its heart. “Plan for it, Keep it out, Stamp it out” are the first three planks of its six-point strategy.
It’s an approach that has served the Pacific nation, and several others in east Asia remarkably well.
New Zealand has recorded just five Covid per million - a figure 400 times lower than our own. Its economy fared better because - having suppressed the virus - it spent far fewer days in lockdown. And now that more than 70 per cent of its population has received one dose of vaccine, it is learning to live with the virus - points three to six in its pandemic plan.
Why didn’t the UK plan to stop a new virus, flu or otherwise? It is an important question, not least because it is one on which the British state and its medical establishment has form.
In the 1918 Spanish flu pandemic, Sir Arthur Newsholme, Britain’s then senior medical officer, drafted a memorandum which advised Britons to isolate themselves at home if they were sick and avoid any public gatherings - but it was never sent.
Instead, Sir Arthur told the Royal Society of Medicine that Britain’s “major duty” was to “carry on” largely as normal, “even when risk to health and life is involved”. In startlingly honest language, Sir Arthur told a conference: “The relentless needs of warfare justify the risks of spreading infection and the associated creation of a more virulent type of disease.”
The man responsible for the UK’s “acclaimed” pandemic planning between 2012 and 2018 was the parliamentary report's co-author, the former health secretary Jeremy Hunt.
“The person leading the investigation of our preparedness is the same person who failed to prepare us”, noted Dr Moosa Qureshi, whose legal actions have forced the disclosure of Exercise Cygnus and a string of other pandemic planning exercises which ministers, including Mr Hunt, had kept under wraps.
"Jeremy Hunt commissioned pandemic exercises for lots of different viruses when he was health secretary, so I don't buy his argument that 150,000 British lives were lost because the whole Western world was obsessed with flu.
“People would have died the same in flu or any other pandemic, because political leaders didn't listen to their own experts who said we needed contact tracing, PPE and more NHS beds. They failed to prepare the country for what they knew was coming."
It is not mentioned in last week’s parliamentary report, which feigns ignorance, but the idea the UK should follow a New Zealand-style “keep it out, stamp it out” strategy was considered in a Cabinet Office review of Britain's pandemic strategy shortly after the 2010 general election. It was rejected on grounds of evidence and cost, however.
“Overall the scientific evidence base for developing policy and/or guidance on social [suppression] measures is limited. Even more limited is the evidence on the cost impacts of these measures,” the authors said.
Like coronaviruses, influenza comes in 101 different forms - some fast, some slow and some very deadly indeed. The danger of pretending all would have been well had we been hit by flu instead of Covid is that it leaves the door open to the same thing happening again.
The British epidemiologist Prof Neil Ferguson is more optimistic and believes most western pandemic plans will major on suppression in future.
The lesson of the last two years is “politicians around the world decided that it wasn't acceptable to let a lethal pandemic like this run through the population” as they had in the past, he told a recent gathering of journalists and academics.
“I've been involved in pandemic planning for 20 years or more and lethal pandemics have been at the top of the UK risk register nearly all that time. But all the pandemic planning taking place in this country… focused on mitigation rather than stopping something in its tracks.”
Prof Ferguson accepted suppression policies had their “downsides” but said they had proved “very effective” at reducing mortality over the last two years.
“Given that lesson … we are not as an advanced species on this planet going to allow very lethal pandemics to spread in the way they were in the past”, he added.
