How the UK became the “sick old man of Europe”
Pandemic Plan 2011 – 4 phases
For many years, the UK Government has published strategy documents outlining measures necessary in the case of a disease pandemic. In 2007 and 2011, the reports focused on flu as the likely pandemic disease.
Simplifying, the 2011 report indicated that Britain was not ready for a pandemic outbreak and highlighted a number of failure points –
- Slow response, risking wide spread of virus before action taken
- Risk of overwhelming the NHS
- Severe risk to occupants of care homes
- Lack of PPE and relevant training
- Absence of comprehensive test, track and trace capability
Among others, there were a series of guidelines concerning the devolved governments, NHS and care systems. There was poor PPE provision, protection measures in public transport, industry, hospitality and social interactions. In particular, the guidance notes stressed the importance of keeping the devolved Government actions consistent and synchronous. There were at least 23 sector-specific guideline and protocol documents published and still available on the Gov.UK website.
Basically, there were to be 4 (or 5) phases of tackling an outbreak, namely –
- Detection (basically test, track and trace)
- Assessment (quarantine, treatment, self isolation)
- Treatment (scaling up, PPE, testing, NHS beds, lockdown)
- and Escalation
- Recovery (re-establishing normality, easing lockdown, vaccine)
In the current crisis, it seems the UK missed the first phase completely. Britain stumbled into the Assessment and Treatment phases some weeks after first alerts. Many leading scientists have been somewhat critical. They indicate both complacency and shortages brought on by years of austerity. Thus, utterly undermining the capability of the UK to actually implement the plans in place to combat pandemic disease outbreaks. No possibility of easing lockdown early.
For example, those of us who watched the earliest daily briefings, vaguely recall talk of the initial phase. This was then “vanished magically”. It appears with hindsight that critical delays and shortages meant phase one of the response was simply not an option. This in turn led to compounded shortages of
- hospital IC beds,
- and the enormous impact on our economy and society after the virus spread was allowed to ramp up unchecked.
Exercise Cygnus findings. Government warnings in 2016
In 2016, Exercise Cygnus tested the country’s readiness for a pandemic. This time the study was based on the H2N2 flu virus. (Although the findings would be applicable to almost all viral pandemics). The UK Government made the findings secret (to avoid public alarm) but the Guardian (among others) published some major findings.
- Cygnus stated Britain was NOT ready for a pandemic
- Care homes would be particularly at risk
- NHS at risk
- Many of the 26 recommendations appear to have been ignored
The current Gov.UK Coronavirus Action Plan refers to 4 phases and makes little or no mention of the Cygnus or previous reports.
- Contain (Test, track and trace)
- Delay (wash hands, isolate, social distance, closures)
- Research (vaccines, drugs, alternative treatment, public response)
- Mitigate (support NHS, care, community, economy)
Again, to the casual Observer (no pun intended!) it looks like phase 1 was missed. Only now is it operating on the Isle of Wight. Also, all three other phases feel like they are a hasty mix together and we now call them the new “Phase 1”.
Containment abandoned: Preparations delayed 30+ days
Of course, we have no idea when, where or how the Prime Minister was infected with the SARS-CoV-2 virus. But it just possibly could have been during this alleged missed COBRA Meeting. In any event, like President Trump and President Bolsonaro, it appears he was not taking adequate precautions. (As suggested in the various editions of the pandemic plans from 2007, 2011, Cygnus Exercise 2016 etc).
Britain’s first confirmed case was on January 31st. Imagine how much different the outcome could have been if, like South Korea, we had pounced on that first victim and quarantined every contact ! We could have been easing lockdown in April.
NHS extreme hard work and heroism rescued Government from an even worse crisis
The relentless under-funding and cutbacks afflicting the NHS have been very well documented, for many years. We do not intend to repeat the multiple accusations here. Our view is that the formation of Hospital Trusts (1990) has been an unmitigated disaster for the NHS. It settled an extra burden of bureaucracy and costs upon an already over-burdened system while draining resources and arbitrarily closing valuable departments and whole hospitals along the way. We also believe Jeremy Hunt to have been one of the worst Health Ministers in History.
In many ways, the current Health Minister, Matt Hancock, has been saddled with an impossible task in the face of the Covid-19 emergency. And, yet, the front line staff at the NHS (and care homes) have risen to the challenge. Like latter-day Battle of Britain pilots, they have fought to save the day. This is despite many years of austerity, starvation of resources, burdensome extra bureaucracy, dilution of effort and multiple closures by successive waves of indifferent governance and governments of various political flavours.
How South Korea stayed on top of Covid-19
Despite geographic proximity to China, the initial source of the SARS-Cov-” virus outbreak, South Korea has not suffered too greatly. The country appears to have kept a lid firmly on the spread of the disease. Speed of response and the people’s willingness to cooperate helps response greatly. This also Involves personal movement monitoring and safety measures.
Action instead of slogans: Containment
It is illuminating to mention the article in National Geographic Journal (since apparently removed). This relates how the first 30 victims of Covid-19 in South Korea were successfully tracked and isolated. Victim 31 was a “super-carrier”. She infected hundreds of others during a week of attending gatherings, parties, clubs and restaurants. All contacts were tracked, traced, tested and quarantined. How different from the UK !
Notable differences to the UK in the way the South Korean Government and public reacted to the threat of the Covid-19 outbreak were –
- No panic-buying
- No hoarding
- Queues were only for face-masks or voting
- BEFORE the WHO started urging nations to start testing, South Korea had already ramped up testing to 12,000 per day at hundreds of walk-in and drive-through centres
- CRITICALLY, the public had no qualms about movement tracking and contact tracing
- IMMEDIATE actions saved an estimated 96% of PPE requirement, reduced the huge numbers of tests that might have been needed and allowed quarantining of victims and suspected cases.
The much-vaunted “test, track and trace” experiment started in the Isle of Wight in May, week 7, will not likely provide meaningful data till the end of June. Meanwhile, South Korea was using mobile device tracking, credit card payments, surveillance cameras and case-histories to carry out their containment phase in January !
Fast actions key to combatting pandemics
One of the early actions taken in South Korea was to set up walk-in testing booths. These were mainly at the entrances of major hospitals. Here, individual booths isolated members of the public from members of the health professionals. Staff handled test swabs via rubber gloves passing through the walls of the booths. After each test, the booth was immediately and rapidly sprayed and squeegeed clean. Ready for the next person to use, in a matter of minutes. Normally, test results AND contact data are available to each person tested within 24 hours. Fast, correct actions meant easing lockdown was not necessary.