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Health & Social Care Committee Pandemic response report released

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ainsworth74

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Speaking of groupthink I'm sure that's not happening to this esteemed group and the general group consensus of being anti-restriction ;)
 
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DustyBin

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I wonder how much of the "XXXX" deaths could have been avoided figure is based on already discredited and dodgy modelling?

I suspect it would be more accurate to say “XXXX deaths could have been delayed by a few weeks or months”. As soon as you reopen the virus begins to circulate, it’s as simple as that. We needed to get through nine months without a vaccine, and there was no guarantee one would actually become available. What were we supposed to do? Let’s not forget as well that by the time the first lockdown was imposed infections and deaths were in decline.

The situation with care homes was terrible, there’s no getting away from that, it was a monumental disaster. Other than that though the biggest mistake was abandoning the original plan at such a late stage which achieved nothing but the worst of both worlds.
 

brad465

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You forgot to add “because that’s what other people did”.

I completely agree with the previous posters who’ve expressed concern over the reports facile pro-lockdown conclusion. Unfortunately I think large swathes of the population will buy into this and lockdowns will become part of our way of life. I honestly don’t think the government will let this go; this particular genie isn’t going back in the bottle, and it never was from the moment we demonstrated our willingness to trade freedom for (perceived) safety, to paraphrase Benjamin Franklin.
Something else to consider is that as the population has increased, so will the number of people dying at once, even if the proportion/rate is the same, simply because there are more people. The top end of the baby boomer generation is approaching life expectancy, and by the end of this decade their age range will be around 66-85.

If people are not conditioned to the reality of more deaths numerically because of this, there'll be alarm and demands for action to curtail them, which at best will only delay the inevitable slightly, so we risk restricting our way of life simply because of something that was always going to happen and wasn't preventable, when really what we need to do is prepare for this inevitability, both in mindset and in allowing effective and appropriate care to those affected.
 

MikeWM

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I haven't read the report, but given the chairmanship of the committee is held by an embittered former health secretary and rival for the conservative leadership, I'm not convinced that this is a body with much to say worth reading.

Indeed - and as a former, and very long-standing, health secretary, bears a good load of responsibility for many of the *actual* failings we saw early in the pandemic, such as out-of-date, inadequate and insufficiently stockpiled PPE.

This stinks of deflection, among many other issues.
 

DustyBin

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Something else to consider is that as the population has increased, so will the number of people dying at once, even if the proportion/rate is the same, simply because there are more people. The top end of the baby boomer generation is approaching life expectancy, and by the end of this decade their age range will be around 66-85.

If people are not conditioned to the reality of more deaths numerically because of this, there'll be alarm and demands for action to curtail them, which at best will only delay the inevitable slightly, so we risk restricting our way of life simply because of something that was always going to happen and wasn't preventable, when really what we need to do is prepare for this inevitability, both in mindset and in allowing effective and appropriate care to those affected.

Good point. Yet another thing to consider is the increasing number of people suffering from obesity, for example. Deaths in this group are rather more avoidable, although lockdowns should play no part whatsoever! (And are indeed counterproductive in this regard).
 

robbob700

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Personally I am of the opinion that a large number of the deaths could have been prevented if China had not covered up the existence of COVID-19 for several months. The clue is in the name COVID-19, not COVID-20, which suggests that the virus was circulating around the world long before March 2020.
Does anyone think China is going to commission an independent public enquiry into their government's response? My guess is they won't!
 

Typhoon

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Indeed - and as a former, and very long-standing, health secretary, bears a good load of responsibility for many of the *actual* failings we saw early in the pandemic, such as out-of-date, inadequate and insufficiently stockpiled PPE.

This stinks of deflection, among many other issues.
Exercise Cygnus was a national Command Post level simulation which took place in October 2016. The purpose of the exercise was to table-top test, in real time, the UK’s resilience to an influenza epidemic, and to identify both strengths and weaknesses in the planning.
It is generally reported that the exercise showed that the UK’s key health and care services would be rapidly overwhelmed.

In fact, the key learning points were:
  • Although each organisation had resilience plans in place, some were untested; they did not seamlessly interlock; and there was no mechanism of central coordination
  • It was unclear which information needed to be collected in what detail by whom, and which elements of it needed to be forwarded to aid central decision making
  • The estimate that only 20% of staff would be absent from work was thought to be too low. Estimates of up to 50% were suggested
  • There were plans for reverse triage of patients from hospital to the community, but it was unclear how this should be communicated to the public, or how the public might react
  • Messages from central bodies such as NHSE and PHE were often different-sometimes in emphasis, and sometimes in content-, and confusing. Tellingly the report suggested that such discrepancies could create uncertainty that would either undermine the response, or the confidence in it, breeding cynicism and unhelpful conspiracy theories
  • Ventilator and ITU capacity would be inadequate
  • There would be difficulty dealing with mass deaths on such a scale
  • There was no understanding as to how the public would respond to a pandemic situation
Between September 2012 and July 2018 the Secretary of State for Health and Social Care was Jeremy Hunt, Mr Hunt has claimed that the exercise looked at the 'wrong virus' but many of the key learning points held true for Covid-19. Little seems to have been done to implement them.
You are right, we can expect a 'finger pointing' exercise, in which no-one in the higher echelons comes out of it particularly well.

Source for both quotes is Whatever happened to Exercise Cygnus? | Journal of Anaesthesia Practice (japractice.co.uk) written by a practicing consultant anaesthetist. This is his conclusion:
There is a truism that there is a tendency in many armies to spend the peace time studying how to fight the last war. Whilst there have been some successes of the UK Government’s current pandemic strategy (eg vaccination programme) there have been some questionable decisions, and some actions which have had unintended consequences, which may be due to the planning assumption that there could be no worse pandemic than a type of flu. It is to be hoped that future strategies will identify the lessons to be learnt from the COVID-19 pandemic to produce an ultimately more robust and effective plan.
 

MikeWM

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Mr Hunt has claimed that the exercise looked at the 'wrong virus' but many of the key learning points held true for Covid-19. Little seems to have been done to implement them.

This 'wrong virus' thing just appears to be a convenient excuse which doesn't begin to hold up to scrutiny.

While *technically* Covid isn't a 'bad flu', it has so much in common with that to render any differences that would be required from a pandemic plan for flu fairly meaningless. It spreads in the same way and has a very similar risk profile. (Unlike say the Spanish flu, which had a very different risk profile - in that case, the excuse would hold more water).

The existing pandemic plan we had, based in tried-and-tested principles, allowed for up to 700,000 deaths from a 'bad flu' - worse than any of Ferguson's dire predictions for Covid. I still haven't seen a single good reason why we didn't proceed with implementing that.
 

deltic

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What I take from this report and Private Eye's MD fortnightly analysis is that

1) we made short term cost cutting measures in terms of planning for pandemics that turned out to cost us a fortune - so from claiming to be one of the best prepared nations for a pandemic we turned out to be no better than average
2) We are obsessed with secrecy in this country - far more information should have been shared throughout the pandemic
3) We failed to take advantage of the fact we are an island and hence have greater control over our borders than many other countries which could have helped reduce the flow of virus and variants
4) We gave up on track and trace to early in the process and ended up chopping and changing our strategies
5) Poor underlying health and diets probably played a major part in our and the US's high death rate compared to other European countries
6) Failed to observe what was actually happening on the ground - people effectively went into lockdown before being told to - offices were pretty empty in the week or so before people were told to work from home. In fact on 23 March when PM made the announcement that people must stay at home rail use was already down 75% from normal, tube use down by 85% and car use down by 36%
 

Bantamzen

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What I take from this report and Private Eye's MD fortnightly analysis is that

1) we made short term cost cutting measures in terms of planning for pandemics that turned out to cost us a fortune - so from claiming to be one of the best prepared nations for a pandemic we turned out to be no better than average
2) We are obsessed with secrecy in this country - far more information should have been shared throughout the pandemic
3) We failed to take advantage of the fact we are an island and hence have greater control over our borders than many other countries which could have helped reduce the flow of virus and variants
4) We gave up on track and trace to early in the process and ended up chopping and changing our strategies
5) Poor underlying health and diets probably played a major part in our and the US's high death rate compared to other European countries
6) Failed to observe what was actually happening on the ground - people effectively went into lockdown before being told to - offices were pretty empty in the week or so before people were told to work from home. In fact on 23 March when PM made the announcement that people must stay at home rail use was already down 75% from normal, tube use down by 85% and car use down by 36%
1) The NHS has always used cost cutting measures that have ended up costing more, this is nothing new and is down to a mixture of bad management & let's say vested interests.
2) What information where you hoping for?
3) This has been debunked more than the moon conspiracy theories. We are not, have have not been a self-supporting island for a very long time. We depend on imports, a lot of which come from Europe via road / rail, we don't have the logistics capacity to have a hope of shutting down the borders.
4) Track & Trace was never the answer, it was little more than a bean counting exercise for the armies of statisticians feeding the government.
5) I agree with this.
6) You are right, people did start to self-lockdown before the 23rd. But all of this ignores the fact that the virus was here and circulating even before we knew it was a problem. So even locking down at the start of March along with the likes of Italy would not have stopped it. It had already been on the move for almost 3 months.
 

MikeWM

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6) Failed to observe what was actually happening on the ground - people effectively went into lockdown before being told to - offices were pretty empty in the week or so before people were told to work from home. In fact on 23 March when PM made the announcement that people must stay at home rail use was already down 75% from normal, tube use down by 85% and car use down by 36%

Well, yes - people modify their behaviour when they feel it is necessary. Very heavy-handed government interventions into the behaviour of the population tend *not* to be necessary, for precisely this reason.
 

DustyBin

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This 'wrong virus' thing just appears to be a convenient excuse which doesn't begin to hold up to scrutiny.

While *technically* Covid isn't a 'bad flu', it has so much in common with that to render any differences that would be required from a pandemic plan for flu fairly meaningless. It spreads in the same way and has a very similar risk profile. (Unlike say the Spanish flu, which had a very different risk profile - in that case, the excuse would hold more water).

The existing pandemic plan we had, based in tried-and-tested principles, allowed for up to 700,000 deaths from a 'bad flu' - worse than any of Ferguson's dire predictions for Covid. I still haven't seen a single good reason why we didn't proceed with implementing that.

Reading the journal article linked by @Typhoon I'd suggest the Exercise Cygnus scenario was actually somewhat worse than the one we've had to deal with:

The following assumptions were made for the purposes of the scenario:

  • The clinical ‘attack rate’ of ‘Swan Flu’ was 25-40%
  • The case fatality rate was 1.5-2.5%
  • That by week 7 there would have been 400000 deaths
  • That approximately 50% of the UK population would have been infected
  • Up to 20% of staff would be absent for various reasons (sickness, child care, shielding etc.)
  • Schools would remain open, and fuel, utility, public transport and food infrastructure would remain unaffected
  • Anti-viral drugs would have an effect on disease spread
  • A vaccine would have been developed, but would not yet be available for delivery to the UK
It is generally reported that the exercise showed that the UK’s key health and care services would be rapidly overwhelmed. [3-6]

Whatever happened to Exercise Cygnus? | Journal of Anaesthesia Practice (japractice.co.uk)

I'm convinced that a light touch in terms of government interventions, accompanied by concise, accurate advise and information, is all that was required. We got our response very wrong, but the mistake wasn't failing to lock down hard and early, it was abandoning a plan based on decades of established epidemiological thinking, in which lockdowns played no part.
 

bramling

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Well, yes - people modify their behaviour when they feel it is necessary. Very heavy-handed government interventions into the behaviour of the population tend *not* to be necessary, for precisely this reason.

Yes I remember having Warwick Castle essentially to myself in the week prior to lockdown, and very enjoyable that was.

Having said that, I do think there was a core of people who probably *did* need a kick up the arse around that time. But perhaps if we hadn’t had several weeks of Boris essentially making light of things, such people might have taken it a little more seriously. Then even with the lockdown we still had oddities like the panic buying and the strange obsession with toilet rolls and pasta!

I think for most people it was a minor thing up until mid-March, yet the government must clearly have been receiving info to the contrary during January, February and March. To be fair we were all probably guilty to varying degrees of the “it can’t happen *here*” syndrome, though I do remember being pretty surprised that a local school wasn’t cancelling its ski trip to Italy as late as mid-March.
 

DustyBin

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Yes I remember having Warwick Castle essentially to myself in the week prior to lockdown, and very enjoyable that was.

Having said that, I do think there was a core of people who probably *did* need a kick up the arse around that time. But perhaps if we hadn’t had several weeks of Boris essentially making light of things, such people might have taken it a little more seriously. Then even with the lockdown we still had oddities like the panic buying and the strange obsession with toilet rolls and pasta!

I think for most people it was a minor thing up until mid-March, yet the government must clearly have been receiving info to the contrary during January, February and March. To be fair we were all probably guilty to varying degrees of the “it can’t happen *here*” syndrome, though I do remember being pretty surprised that a local school wasn’t cancelling its ski trip to Italy as late as mid-March.

I agree with all of this. I'd be very interested to know however what exactly the government (and their advisors) thought it was we were facing. I've said this before, but I suspect SARS, MERS etc. preyed on their minds and they "bottled it" for want of a better expression when it came to our response. Don't forget the scenes coming out of China at the time where people were (allegedly) dropping dead in the street....
 

ainsworth74

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5) Poor underlying health and diets probably played a major part in our and the US's high death rate compared to other European countries
MD in PrivateEye in particular has been banging that drum extremely hard in his recent columns and you know he has a point. The underlying health of our population (and include myself in this!!!) is terrible. Particularly in terms of being overweight or obese but also in various other areas as well. If it really was about "Saving the NHS", at least in the long term, you'd expect the Government to be driving, very hard, on trying to fix those issues.

Then again I suppose the cut to Universal Credit, rising inflation and energy bills will make sure that some are going to be forced to eat and drink less anyway...
I think for most people it was a minor thing up until mid-March, yet the government must clearly have been receiving info to the contrary during January, February and March. To be fair we were all probably guilty to varying degrees of the “it can’t happen *here*” syndrome, though I do remember being pretty surprised that a local school wasn’t cancelling its ski trip to Italy as late as mid-March.
I mean I trust him about as far as I can throw him but Dominic Cummings has been quite interesting on what was going on in Government in the first quarter of 2020 and it does rather seem like they probably were bumbling along like the rest of us in thinking it will be a minor thing until, as I recall, the week before the first full lockdown when they seemed to have finally realised that if they didn't do something it was going to be apocalyptically bad rather than 'just' very bad.
 

deltic

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1) The NHS has always used cost cutting measures that have ended up costing more, this is nothing new and is down to a mixture of bad management & let's say vested interests.
2) What information where you hoping for?
3) This has been debunked more than the moon conspiracy theories. We are not, have have not been a self-supporting island for a very long time. We depend on imports, a lot of which come from Europe via road / rail, we don't have the logistics capacity to have a hope of shutting down the borders.
4) Track & Trace was never the answer, it was little more than a bean counting exercise for the armies of statisticians feeding the government.
5) I agree with this.
6) You are right, people did start to self-lockdown before the 23rd. But all of this ignores the fact that the virus was here and circulating even before we knew it was a problem. So even locking down at the start of March along with the likes of Italy would not have stopped it. It had already been on the move for almost 3 months.

2) I wasnt wanting any information but many scientists who are experts and who have something to contribute did
3) this is missing the point - this is not about stopping imports but people who are mainly making leisure trips and testing those making essential trips
 

DustyBin

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MD in PrivateEye in particular has been banging that drum extremely hard in his recent columns and you know he has a point. The underlying health of our population (and include myself in this!!!) is terrible. Particularly in terms of being overweight or obese but also in various other areas as well. If it really was about "Saving the NHS", at least in the long term, you'd expect the Government to be driving, very hard, on trying to fix those issues.

Then again I suppose the cut to Universal Credit, rising inflation and energy bills will make sure that some are going to be forced to eat and drink less anyway...

I agree with your first point as per my post further up, and you may be on to something with your second as well....

I mean I trust him about as far as I can throw him but Dominic Cummings has been quite interesting on what was going on in Government in the first quarter of 2020 and it does rather seem like they probably were bumbling along like the rest of us in thinking it will be a minor thing until, as I recall, the week before the first full lockdown when they seemed to have finally realised that if they didn't do something it was going to be apocalyptically bad rather than 'just' very bad.

We're probably not going to agree here but how would it have been "apocalyptically bad"? The data suggests that the first wave was already subsiding by the time lockdown was implemented. The virus can't transmit exponentially, which is one of the criticisms levelled at the various SAGE (non) predictions we were presented with. In my opinion the reason the government decided to do "something" is because they thought they had to be seen to be doing "something", especially as that's what other countries were doing. Now, about that groupthink mentioned in the report....

Have to admit, that probably included me!

Guilty here too!

(Edited to add that we were only acting on the information available at the time though).
 

ainsworth74

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The data suggests that the first wave was already subsiding by the time lockdown was implemented. The virus can't transmit exponentially, which is one of the criticisms levelled at the various SAGE (non) predictions we were presented with. In my opinion the reason the government decided to do "something" is because they thought they had to be seen to be doing "something", especially as that's what other countries were doing.

Does it though? Cases kept increasing until they plateau in the first few days of April (and of course testing was an utter shambles so we will never have more than varying degrees of educated guesswork for how many cases there actually were) and deaths kept rising until until the 8th of April. I doubt we'll agree on this point but nothing I've read has ever suggested that the first proper lockdown was unnecessary by the time we got to where we were. The eventual length of time it went on for, the subsequent ones that followed in autumn and winter I'm more than happy to agree the evidence is far more sketchy as to whether they were a net benefit or not. But the first? Well I think we'll need to agree to disagree I suspect :)

Now, about that groupthink mentioned in the report....

Perhaps the real pandemic is groupthink!? ;) :lol:
 

Cdd89

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One of the reasons given by government advisors for not imposing lockdown earlier, was that tolerance for such measures was expected to be limited. The report waves this away, stating this assumption was not the case; but I have heard nothing to persuade me that this wrong.

The most notable breakdown in compliance followed Barnard Castle, which plays into the pro-Lockdown / anti-Government argument (strangely they are often one and the same, despite the government having been, by most measures and in comparison internationally, very pro-Lockdown); but I think it’s clear that compliance would have waned regardless. Looking at a similar lockdown, I certainly had no shortage of family and friends willing to quietly meet by late-Feb 2021, after a similar duration.
 

35B

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6) You are right, people did start to self-lockdown before the 23rd. But all of this ignores the fact that the virus was here and circulating even before we knew it was a problem. So even locking down at the start of March along with the likes of Italy would not have stopped it. It had already been on the move for almost 3 months.
That assumes that reductions in social contact are of no value in controlling an epidemic. The point about locking down 5 days earlier, whether or not it's fair, is that this would have reduced a lot of the interactions that helped drive that wave of the disease.
 

greyman42

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You forgot to add “because that’s what other people did”.

I completely agree with the previous posters who’ve expressed concern over the reports facile pro-lockdown conclusion. Unfortunately I think large swathes of the population will buy into this and lockdowns will become part of our way of life. I honestly don’t think the government will let this go; this particular genie isn’t going back in the bottle, and it never was from the moment we demonstrated our willingness to trade freedom for (perceived) safety, to paraphrase Benjamin Franklin.
Some people gladly demonstrated a willingness to trade freedom for not having to go to work.

Good point. Yet another thing to consider is the increasing number of people suffering from obesity, for example. Deaths in this group are rather more avoidable, although lockdowns should play no part whatsoever! (And are indeed counterproductive in this regard).
This is true but is considered far to sensitive a subject for the government to address.

5) Poor underlying health and diets probably played a major part in our and the US's high death rate compared to other European countries
Again true, but too sensitive to address.

MD in PrivateEye in particular has been banging that drum extremely hard in his recent columns and you know he has a point. The underlying health of our population (and include myself in this!!!) is terrible. Particularly in terms of being overweight or obese but also in various other areas as well. If it really was about "Saving the NHS", at least in the long term, you'd expect the Government to be driving, very hard, on trying to fix those issues.
As above.
 
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Bantamzen

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That assumes that reductions in social contact are of no value in controlling an epidemic. The point about locking down 5 days earlier, whether or not it's fair, is that this would have reduced a lot of the interactions that helped drive that wave of the disease.
You seem to assume that all social contacts are equal in transmission, but what if they are not? What if most transmission takes place in healthcare, care homes & in people's homes? What good would a week or two do if this were the case?
 

yorksrob

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Reading the journal article linked by @Typhoon I'd suggest the Exercise Cygnus scenario was actually somewhat worse than the one we've had to deal with:



Whatever happened to Exercise Cygnus? | Journal of Anaesthesia Practice (japractice.co.uk)

I'm convinced that a light touch in terms of government interventions, accompanied by concise, accurate advise and information, is all that was required. We got our response very wrong, but the mistake wasn't failing to lock down hard and early, it was abandoning a plan based on decades of established epidemiological thinking, in which lockdowns played no part.

I'm somewhat worried by the phrase about vaccines being "available for delivery" to the UK. It would be absolutely unacceptable that the UK to be dependant on foreign supply/manufacture for vaccines.
 

Ianno87

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I'm somewhat worried by the phrase about vaccines being "available for delivery" to the UK. It would be absolutely unacceptable that the UK to be dependant on foreign supply/manufacture for vaccines.

I've got news for you....

We just don't have the capability to produce it in the UK.

Hardly like it's caused any issues with how we've stormed ahead with vaccinations.
 

yorksrob

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I've got news for you....

We just don't have the capability to produce it in the UK.

Hardly like it's caused any issues with how we've stormed ahead with vaccinations.

Well actually we have been manufacturing vaccines in the UK. We need to ensure that that capacity is maintained and enhanced (much as it might horrify the free marketeers).
 

Ianno87

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Well actually we have been manufacturing vaccines in the UK. We need to ensure that that capacity is maintained and enhanced (much as it might horrify the free marketeers).

Why, when there's ample capacity in Europe?

Or is it just about having "British" stamped on them?
 
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