Due to the extraordinary nature of the crisis, the UK government has had an unprecedented opportunity to control the narrative about their response to the coronavirus pandemic. In addition to the daily Number 10 press briefings there has been a months-long, multi-faceted public information campaign using television and radio spots, social media posts, billboards, wrap around messaging on the front of all major newspapers and a letter to every household in the UK.
Despite this communications advantage, there has been increasing criticism of the government’s handling of the crisis from sections of the media, health and science experts, opposition political parties, trade unions and the general public.
In response, the government has rolled out a number of common retorts – they are ‘following the science’, their primary motivation has been to save lives, and it is easy to criticise in retrospect, as ex-cabinet minister baroness Nicky Morgan said on BBC Any Questions (22 May).
A careful reading of mainstream news reports tells a very different story – one which supports Lancet editor-in-chief Dr Richard Horton’s description of the government’s response as ‘a national scandal’ (BBC Question Time, 26 March). The UK’s official death toll of 41,969 as of 16 June – the highest in Europe, and the second highest in the world after the United States – confirms Horton’s criticism. Due to deficiencies in how deaths are recorded, the government’s figures are likely a significant underestimate: by the same date the Financial Times estimated the number of UK excess deaths linked to coronavirus to be 65,400.
‘It goes right back to 2010’
While nearly all media coverage has focused on the period since the outbreak in China in December 2019, the UK government’s reaction has much deeper roots. ‘It goes right back to 2010, when the [Tory-Liberal Democrat coalition] government came in with a very clear policy to reduce public spending across the board, including the National Health Service’, sir David King, the former chief scientific adviser, told LBC radio on 15 April when asked about the UK’s response being slower than other countries. ‘I’m afraid these austerity measures did lead to the cutting back on the risk management programmes’.
“You cannot fight a fire blindfolded. And we cannot stop this pandemic if we don’t know who is infected.”
The government also ignored several warnings about the possibility of a pandemic and its lack of preparedness. In October 2016 a three-day training called Exercise Cygnus was held on how to deal with a pandemic, involving all major government departments, the NHS and local authorities. According to the Sunday Telegraph (28 March) the unpublished report of the exercise concluded ‘There was not enough personal protective equipment (PPE) for the nation’s doctors and nurses’ and ‘the NHS was about to “fall over” due to a shortage of ventilators and critical care beds’.
Publishing a leaked copy of the report on 7 May, the Guardian provided more detail: ‘it contained 26 key recommendations, including boosting the capacity of care homes and the numbers of staff available to work in them’ and ‘warned of the challenge facing homes asked to take in patients from hospitals.’
A senior academic directly involved in Exercise Cygnus and the current pandemic noted ‘These exercises are supposed to prepare government for something like this - but it appears they were aware of the problem but didn’t do much about it’ (Sunday Telegraph, 28 March).
In September 2017 the National Risk Register Of Civil Emergencies was published by the Cabinet Office, noting ‘there is a high probability of a flu pandemic occurring’ with ‘up to 50% of the UK population experiencing symptoms, potentially leading to between 20,000 and 750,000 fatalities and high levels of absence from work.’
More recently, on 30 January 2020 the World Health Organisation (WHO) declared a ‘public health emergency of international concern’. According to David Nabarro, professor of global health at Imperial College, London, ‘That is the highest level of alert that WHO can issue… It made it very clear then – to every country in the world – that we were facing something very serious indeed’ (Guardian, 18 April).
Though ministers have repeatedly denied it, the concept of ‘herd immunity’ seems to have been central to the government’s response plan (herd immunity is when a large majority of the population are infected and therefore gain immunity and stop the spread of the virus).
The government’s stated ‘mitigation’ strategy – to delay the spread of the virus, and reduce and broaden the peak so the NHS is not overwhelmed – fits with the goal of herd immunity, as chief scientific advisor sir Patrick Vallance explained on the BBC Today programme (Guardian, 13 March).
“I’m afraid these austerity measures did lead to the cutting back on the risk management programmes”
According to a ‘senior politician’, the chief medical officer Chris Whitty was ‘absolutely focused on herd immunity’ when they spoke in late January (Sunday Times, 19 April). The prime minister Boris Johnson himself floated the idea – without naming it – on ITV’s This Morning on 5 March. Speaking to the BBC Today Programme on 13 March, sir Patrick said one of ‘the key things we need to do’ is ‘build up some kind of herd immunity so more people are immune to this disease and we reduce the transmission’.
There are two huge problems with herd immunity – both widely understood in March, if not before. First, the estimated mortality rates of the virus – around 1% (Guardian, 7 March) – means a large number of people would die by the time the UK achieved herd immunity. Putting these figures together with the 66.6 million population of the UK, we would end up with around half a million deaths in order to achieve the 80 percent level of people with antibodies.
Second, there was – and still is – ‘no clear evidence people who had suffered the virus would have lasting antibody protection’ (Sunday Times, 24 May). As WHO spokeswoman Margaret Harris told the BBC Today programme on 14 March: ‘We don’t know enough about the science of this virus, it hasn’t been in our population for long enough for us to know what it does in immunological terms’.
Despite these deadly flaws, the government’s herd immunity plan to manage rather than suppress the spread of the virus likely shaped other decisions that have led to thousands of unnecessary deaths, including ending the quarantining of people arriving at UK airports from coronavirus hotspots on 13 March (Financial Times, 23-24 May), the cancellation of contact tracing and mass testing, and the delayed national lockdown.
Ditching tracing and testing
When people started getting infected in the UK, the government established a programme to test suspected cases and trace people they had been in contact with. However, on 12 March the government announced it would no longer try to ‘track and trace’ everyone suspected of having the virus, while testing would be limited to patients in hospital with serious breathing problems (Guardian, 13 March).
This U-turn contradicted WHO recommendations. ‘The most effective way to prevent infections and save lives is breaking the chains of transmission. And to do that, you must test and isolate’, WHO Director General said on 16 March. ‘You cannot fight a fire blindfolded. And we cannot stop this pandemic if we don’t know who is infected.’
“That is the highest level of alert that WHO can issue… It made it very clear then – to every country in the world – that we were facing something very serious indeed”
‘We have a simple message for all countries: test, test, test. Test every suspected case’, he noted: ‘If they test positive, isolate them and find out who they have been in close contact with… and test those people too’ (WHO, 16 March).
On 17 April the Health Secretary belatedly announced the government would restart tracing the contacts of people who have had coronavirus symptoms, with 1 June as the planned start date.
Too slow to lockdown
On 24 January professor Neil Ferguson, from Imperial College’s School of Public Health and a member of the government’s Scientific Advisory Group for Emergencies (SAGE) committee, submitted a report to ministers and officials. According to the Sunday Times (19 April), the report noted ‘There needed to be a 60% cut in the transmission rate — which meant stopping contact between people. In layman’s terms it meant a lockdown’.
Similarly, on 26 February infectious disease modeller professor John Edmunds and his team from the London School of Hygiene and Tropical Medicine presented their latest ‘worst scenario’ predictions to the government’s Scientific Pandemic Influenza group on modelling (SPI-M).
This group advises the country’s scientific decision-makers on SAGE. ‘It warned that 27 million people could be infected and 220,000 intensive care beds would be needed if no action were taken to reduce infection rates’, the Sunday Times (19 April) reported. ‘The predicted death toll was 380,000. Edmunds’ colleague Nick Davies, who led the research, says the report emphasised the urgent need for a lockdown’.
A further investigation by the Sunday Times (24 May) reported that modelling teams from Imperial College London and the London School of Hygiene & Tropical Medicine separately concluded that if the government’s mitigation strategy continued, there could be approximately 250,000 deaths – results they passed onto SAGE on 3 March.
However, the government only implemented a national lockdown on 23 March. Back-dated modelling by Oxford University estimates there were just 14,000 infected people in the UK on 3 March. By 23 March the number was likely to have been 1.5 million. ‘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’, the Sunday Times (24 May) notes.
After coming under pressure to set out an ‘exit strategy’ from right-wing Tories and the leaders of the Scottish National Party (The Times, 24 April) and Labour party (Guardian, 15 April), on 10 May the prime minister Boris Johnson announced a loosening of the lockdown. He urged people in jobs such as construction and manufacturing to return to work, gave permission for unlimited outdoor exercise and suggested shops might open in June.
However, with new daily cases estimated to be 20,000 (The Times, 8 May) and a contact tracing programme still not in place, many experts were quick to warn it was too early to loosen the lockdown. Professor Edmunds warned that the current level of cases made it ‘probably impossible’ to control the outbreak through contact tracing (The Times, 8 May).
David Hunter, professor of Epidemiology and Medicine at the University of Oxford, noted ‘If we take the prime minister’s advice and return to work in large numbers now – and without the ability to test, trace and isolate – then virus spread will increase, there will be super-spreader events and local or regional lockdowns will have to be reconsidered’ (Guardian, 11 May). Professor Devi Sridhar, chair of global public health at the University of Edinburgh, said the UK did not ‘have in place the basic building blocks of surveillance to actually know who has the virus’ and therefore ‘what we are going to see is cases are going to go up… the virus is going to continue spreading and in a few weeks we are going to have this exact same debate again’ (BBC Question Time, 14 May).
The importance of activism
Notwithstanding the government’s criminally negligent response to the crisis and the huge UK death toll, there is some hopeful evidence the government and Tory party are worried about public opinion, and susceptible to public pressure.
Citing one senior MP, in early April the Guardian noted the Tory party was ‘watching the polls closely’ (2 April), while on 18 April the Telegraph published a revealing quote from a ‘cabinet source’ about the government’s exit strategy from the lockdown. ‘It [the government] is waiting for the public to change their mind’, they noted. ‘We didn’t want to go down this route in the first place — public and media pressure pushed the lockdown, we went with the science.’ And following reports the prime minister’s adviser Dominic Cummings had breached the lockdown, the Guardian noted MPs ‘said they were motivated by anger among their constituents’ (30 May), while the Telegraph reported some Tory MPs ‘said they would wait to see how their constituents responded before passing judgement’ (26 May).
Unlike the UK’s response to the climate crisis, post-9/11 foreign policy or anti-nuclear weapons activism, this influence has come about without any organised national grassroots campaign or group informing and directing public outrage and resistance.
Activists, then, have an important role to play in maximising pressure on the government, including tracking and drawing attention to government failures, establishing campaign groups and organising a coordinated response.