UK was not as prepared for Covid as it could have been, ex-chief medic says

UK has been "found wanting", Dame Sally Davies says, with the government responding too slowly to the pandemic
Photo: Louise Haywood-Schiefer for CSW

Dame Sally Davies, England’s former chief medical officer, has admitted the UK’s response to coronavirus has been “found wanting” and that the government was not as prepared as it should have been to deal with a pandemic.

In an interview with the Telegraph, Davies, who stepped down from the role she held for a decade last September, said advice from Public Health England had been to focus on influenza in the UK’s pandemic planning.

"We didn't practise how to stop a coronavirus spreading because we were told by Public Health England that the next big one would be influenza, and they didn't believe it could be stopped," Davies, now master of Trinity College Cambridge, told the newspaper.

The UK’s 2011 pandemic preparedness strategy said it would be "a waste of public health resources and capacity" to attempt to stamp out flu in a pandemic as it would spread too quickly.

"Compared to other countries, we've been found wanting. We were not as well prepared as we should have been,” Davies said.

She also said the government responded too slowly to the Covid-19 outbreak. 

"Covid overtook us because we didn't react when we knew it was happening. If we'd moved quickly, it would have been very different. There was an article in the Lancet at the end of January from the Chinese Center for Disease Control and Prevention laying out the risk... We could have and we should have locked down earlier, so I would argue that we need to be more agile and responsive,” she said.

The clinician is likely to be a witness at the inevitable public inquiry into the government’s handling of the Covid-19 crisis, and told the Telegraph: "I think the public deserves to know everything.”

She predicted the inquiry would uncover “horror stories” in the coronavirus response. Failures included the decision not to involve university labs in coronavirus testing, advising people it was not necessary to wear face coverings early in the pandemic, and the over-centralised nature of the test and trace system.

‘That has to be one of the failings of scenario planning’

Davies said she had brought up the possibility of modelling an outbreak of Sars – another kind of coronavirus – in 2015. “But I was told no, because it wouldn't reach us properly. They said it would die out and would never travel this far. So I did ask, but it was the Public Health England people who said we didn't need to do it, and I'll say that to parliament.”

She said “to some degree” she accepted the scientific advice she was given, which was that “none of the experts seemed to think a coronavirus would be relevant”. The 2016 Cygnus exercise modelling the response to a pandemic, therefore, did not look at coronaviruses.

"I'm not a trained public health doctor – my background is haematology and sickle cell disease. You can't be an expert at everything, even if you're the chief medical officer,” she said. CMOs are expected to draw on the expertise and advice of a wide network of experts both within and outside government.

Chris Whitty, Davies’s successor as chief medical officer, has also said that the UK’s response to coronavirus has been adapted from its planning for pandemic flu. Davies shared some of the thinking behind that planning. "The general view among the infectious disease people was that the flu spreads terribly, much worse than a coronavirus. It spreads not only respiratory wise, but it spreads on surfaces much more than it turns out Covid-19 is doing.

"The other feeling was that you wouldn't bother to test for it because you'd know pretty much beyond doubt that it was flu from the symptoms, and it would crowd out other infections. And of course we had Tamiflu and pandemic vaccines, whereas when Covid arrived we had nothing," she said.

The assumption that a pandemic would be influenza has attracted much criticism this year. In June, the National Audit Office noted that the only central stockpile of personal protective equipment available to the health and social care sector at the start of the outbreak “was designed for a flu pandemic”.

Davies admitted to having “regrets” that she and other public health experts did not look at coronaviruses in the Cygnus drill.

She said when Public Health England presented experts and ministers with the pandemic scenario, "the exercise was focused on the illness end, rather than preventing a disease spreading”.

“And that has to be one of the failings of scenario planning in that way, because what you're doing is responding rather than thinking: 'How do I intervene?' It didn't cross my mind at the time, but that's the truth.”

David added that she did not consider the flu-pandemic planning wasted. "I still think Cygnus was useful because it showed a number of areas where work was needed,” she said.

"One day we will certainly get another flu pandemic, so we prepared for that, and I think we prepared well,” she added.

'The claim that PHE ignored threats is wrong'

Responding to Davies's comments, a Public Health England spokesperson said: “The claim that PHE ignored threats other than flu is wrong. Dame Sally Davies participated in exercises which planned specifically for a Mers coronavirus scenario in the UK amongst other health threats.

"DHSC and the Cabinet Office have overall responsibility for pandemic planning and the focus was on planning for an influenza pandemic as this was top of the national risk assessment. In all of our time working with Dame Sally Davies we agreed that the country should prepare for all health protection threats including infections caused by different organisms such as coronaviruses."

A Department of Health and Social Carespokesperson said: "This is an unprecedented pandemic and we have taken the right steps at the right time to combat it, guided at all times by the best scientific advice, to protect the NHS and save lives.

"There is a huge amount of work going on behind the scenes, all of which would not be possible without the years of preparation undertaken for a pandemic, including flu and other infectious diseases like Mers, Sars and Ebola."

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