Early warnings help but old strategy flawed

Cache of reports reveals that 2011 pandemic preparation plan misses the target catastrophically

AT MIDDAY yesterday a cache of some 30 documents dropped on to the government website, many of them stamped “official”. They detail the evidence, advice and thinking behind the UK’S response to the coronavirus pandemic and are an exercise in transparency.

When the Prime Minister says, as he now frequently does, that he is being guided by the experts, this is the advice he is looking at. It’s all there, M’lud – the pandemic modelling, the behavioural insights, the discussion on school closures, everything.

Journalists will be crawling over these papers for a long time to come, but there are some quick takeaways.

First, they highlight the role played by Prof Neil Ferguson and his team of epidemiologists at Imperial College London. If you are looking for superheros in this crisis, and we probably should be, this is the A-team.

They were on to the outbreak in Wuhan as soon as it was first reported in late December, correctly modelling both transmissibility of the virus and its virulence.

“It is likely that the Wuhan outbreak of a novel coronavirus has caused substantially more cases of moderate or severe respiratory illness than currently reported”, they told Whitehall on Jan 17.

And then on Feb 10: “For cases detected in Hubei, we estimate the case fatality ratio (CFR) to be 18 per cent. For cases detected in travellers outside mainland China, we obtain central estimates of the CFR in the range 1.2 to 5.6 per cent”.

These numbers would have triggered alarm bells. There is debate about whether the UK will follow Italy in terms of the epidemic’s fearful impact in the next few weeks. It is not a question that can be answered now with certainty, but if we avoid it, it will be in part because of these early warnings.

It is also clear there was a debate raging within government by late February – two weeks before any announcement – on the extent of the lockdown needed to stop the epidemic overwhelming the NHS. A paper dated Feb 26 shows they knew by then that China’s containment strategy was working, but were reluctant to adopt the same measures here – partly because of fears that, when lifted, they would spark a second outbreak in the run up to Christmas.

So why does it feel we were not ready for this pandemic? Why did the debate over lockdown come so late? And why are we only now working out the economic impact?

The answer, I think, is that the nation’s original pandemic strategy document – UK Influenza Pandemic Preparedness Strategy 2011 – catastrophically misses the target. I read it only a month ago and thought it pretty comprehensive. But when you look at it now with the benefit of hindsight it has two glaring holes.

First, it never imagines the sort of lockdown we are moving into might ever occur. Under the heading “Business as usual” on page 57, it breezily states: “During a pandemic, the Government will encourage those who are well to carry on with their normal daily lives for as long and as far as that is possible ... The UK Government does not plan to close borders, stop mass gatherings or impose controls on public transport during any pandemic.” There is, consequently perhaps, virtually no discussion of the economic impact a pandemic might have on the nation. It notes in a table that the Spanish flu knocked somewhere between 2.4 per cent and 16.9 per cent off GDP but there is no analysis.

When the inquisition comes, I suspect it will focus not so much on today’s documents, but the one published by the Department of Health back in 2011.

They will ask why, post Sars, which resulted in lockdown and an economic hit of £34 billion, we were not better prepared? The Prime Minister will be quick to point out it was David Cameron, George Osborne and Nick Clegg who were in charge back then.