While You Were Away, Prime Minister: The ‘Lessons Learnt’ Report Pt. 1
This article is a particularly long read that hopefully assesses the House of Commons Health and Social Care, and Science and Technology Committees ‘Lessons Learnt’ report, which was released on Monday evening.
It is divided up into two parts.
This one [Part #1] focuses on the Executive Summary from the ‘Lessons Learnt’ report - it’s also free, but if you would like to subscribe to this page then you’re more than welcome to if you value the work that has gone into what’s been written here.
Part #2 - hopefully published tomorrow - will focus on the response to this by Boris Johnson’s supporters and those who have come out in the last 48 hours to defend the seemingly indefensible - this will not be free, it’ll be behind the paywall for those who subscribe and help keep this page sustainable.
On The Topic of Coronavirus
Coronavirus is one of those things that has affected so many different lives in so many different ways that it’s difficult not to have it in one’s thoughts every single day - news does continue in other forms and stories evolve over time, true, but the ‘feeling’ of coronavirus permeates, and is omnipresent - even if it isn’t being mentioned; it is there, and it is always there for those who have lost their loved ones to the virus.
I could be writing about another issue [be it the fuel crisis, be it food shortages, be it Brexit], but whatever it might be, an article I read through a process of mindfulness at least once a week comes from The Guardian.
It was published in January 2021 and is written by somebody who [I believe] still follows the Facebook page and comments occasionally; a lady named Sarah, who sadly lost both of her parents to COVID.
It’s imperative that readers not only read that article but also understand it and try and put themselves in Sarah’s shoes - for if they did so, would understand her grief, sadness, her joy [above all else, of beautiful memories she shares of her parents] and Sarah’s fury - which is shared by many; others whose names I don’t mention that I’ve spoken to directly that are always in my thoughts.
What is also imperative for readers to do is to read this
This is the condensed ‘Executive Summary’ collated by the House of Commons Health and Social Care and Science and Technology Committees.
It’s important.
It’s important because every single word of that summary - and probably the entire ‘Lessons Learnt’ report, too - will be read and ruminated on by people just like Sarah, just as every word that came out of Dominic Cummings’ 7-hour testimony back in May was listened to as well, however one might feel about the man.
It’s also important because in the absence of any judgement from any future inquiry, thus far it is the only concise and mostly forensic [and public] examination that has taken place of the government’s handling of the pandemic in the early days.
It is not, as some call it, ‘The Hindsight Report’ - but we will discuss this in another article.
The Executive Summary - Preface
Last year, I wrote about the ISC report on Russian interference - this is incidental, by the way, but it’s to offer context on how I have approached this.
This report - the Lessons Learnt report - conversely, is perhaps more important - so it deserves the same level of analysis and consideration.
For sake of length however, I’ll be focussing mostly on the ‘Executive Summary’ and go through the rest of the report [that I, too, have read in detail] at certain points.
The ‘Executive Summary’ is surprisingly concise in itself - ‘surprising’ because it was led by Conservatives Jeremy Hunt and Greg Clarke.
There is some concern over its bias but broadly speaking, it does a fairly concise job beyond the preoccupation it has with the vaccine roll-out success, and apportioning some of the blame to the NHS on the matter of care home deaths.
Another aspect it falls short on is the mention of the private contracts awarded via VIP lanes, and in particular the £37 Billion allocated to the Test & Trace system - only referring to it once by proxy through a quote from Prof. Sir Chris Ham on p.75/.216 but at least acknowledging the use of private sector services on p60/.163
It’s not a distraction, however - or an obfuscation of ‘the truth’; the vaccine roll-out in particular was a success; one attributed to the combined efforts of the NHS and volunteers and one of the few political decisions the Conservatives perhaps ‘got right’ - indeed, perhaps the only one.
Hence why the Conservatives expected [and received] a ‘Vaccine bounce’ in the polls and have pandered it so desperately since it began in December last year.
But as a standalone document, it’s perhaps up to now the most damning assessment made by any official body on the government’s handling of the COVID pandemic in the UK.
The Executive Summary Pt. 1 - The Detail
It states:
“In the first three months the strategy reflected official scientific advice to the Government which was accepted and implemented. When the Government moved from the ‘contain’ stage to the ‘delay’ stage, that approach involved trying to manage the spread of covid through the population rather than to stop it spreading altogether. This amounted in practice to accepting that herd immunity by infection was the inevitable outcome...The UK...made a serious early error in adopting this fatalistic approach and not considering a more emphatic and rigorous approach to stopping the spread of the virus.”
It notes a little further on:
“Even when the UK strategy did change dramatically in March 2020, it was because of domestic concern about the NHS being overwhelmed rather than a serious decision to follow emerging international best practice.”
This reflects in predictions made by NERVTAG and SAGE as early as February, with implementation of strategy compounded by absence of the executive [ie. Boris Johnson] who didn’t attend a COBRA meeting until March 2 2020, by which time it was too late [p.32.77]
The indication that ‘herd immunity’ was accepted [p.33/.81] would mean - if Vallance’s predictions that to achieve it as an outcome [c. March 2020] would require “between 60% and 80%” of the population to become infected - essentially, an acceptable number of deaths based on CFR[ Case Fatality Rate] would fall anywhere between 2.5% to 4% of 60% to 80% of the adult population.
Or - Approx. 800,000+ deaths if mitigating factors were not introduced and we pursued this strategy alone. This was accepted by the government at one point, it seems, while voices from the international community warned the UK of what lay ahead [p.18/.25]
Actually, as noted on p.38/.91, it was then-DHSC Secretary Matt Hancock who said that he’d been given a “planning assumption for 820,000 deaths” on January 31. Earlier, in the same point, the report notes that Dominic Cummings indicated:
So in terms of a timeline - Hancock knew the predictions were 820,000+ dead and yet they had no plan to mitigate the cost to life whatsoever [according to Cummings] until at least after March 14 but before March 23 when the UK finally went into lockdown.
It goes on:
“...Problem was compounded by a failure of national public bodies involved in the response... Protocols to share vital information between public bodies were absent...Scientific accomplishment was hampered by operational inadequacy”
It’s always worth pointing out that the Conservatives have been in power since 2010 - so any deficiencies in operational capacity and civil contingencies y [p.20/.29] are largely their responsibility.
Interestingly, one of the chairs of the Committee was Jeremy Hunt who himself was DHSC Secretary and presided over Exercise Cygnus, an NHS war-game designed to highlight some of the deficiencies for when something like COVID-19 occurred - we can reasonably apportion some of the blame to him as an opportunity missed on his part.
By contrast, later in the report, it does note in Chapter 2 [on ‘Pandemic Preparedness’] ‘Winter Willow’, which was another exercise to establish preparedness for any future pandemic, performed in 2007.
It continues:
“There was a desire to avoid a lockdown because of the immense harm it would entail to the economy, normal health services and society.”
We’ll discuss this but essentially this attitude served as the basis for the argument on delaying the Autumn circuit break in spite of scientific guidance and despite pleas from opposition] - the latter date was when Boris Johnson was heard to have screamed, “let the bodies pile high in their thousands.”
This is also when the Prime Minister entertained the views of Prof. Sunetra Gupta and Prof. Carl Heneghan, as noted both here in a Times article from October last year, and on p50/.127 of the ‘Lessons Learnt’ report, and facilitated by the chancellor Rishi Sunak.
It continues:
“Despite being one of the first countries in the world to develop a test for covid in January 2020, the United Kingdom failed to translate that scientific leadership into operational success in establishing an effective test and trace system during the first year of the pandemic.”
A “failure” - a “drag anchor” [p.60/.163] that has been allocated £37 Billion, up to now - and despite being described as a failure [p.47/.118] it was considered a vital part of the strategy used to bolster the tier-systems the government implemented.
Tier systems which were also largely considered useless based on ‘contradictory’ public messaging [p.55/.145].
“It is now clear that the optimal structure for test and trace is one that is locally driven.”
Indeed, the effectiveness of locally driven contact tracing was first highlighted in April 2020 in The Guardian. Prior to this, it was mentioned in the BMJ on March 24, only a day after the UK went into lockdown.
Care Homes: The Case for Democide?
“The Government and the NHS both failed adequately to recognise the significant risks to the social care sector at the beginning of the pandemic.”
“And the NHS’ is doing a lot of heavy lifting there when it comes to pointing fingers; it can only act on government advice, which stated [as early as February 10 2020 and didn’t change right up until March 13 2020] that it was, “very unlikely that anyone receiving care in a care home or the community will become infected.”
It goes on:
“This, coupled with staff shortages, a lack of sufficient testing and PPE, and the design of care settings to enable communal living hampered isolation and infection control, meant that some care providers were unable to respond to risks as effectively as they should. This had devastating and preventable repercussions...led to many thousands of deaths which could have been avoided”
And as clear as that - it’s spoken about on p.64/.179 in a sub-header titled ‘Impact on Health & Social Care’
Actually, according to ITV’s Paul Brand, Government policy dictated that it was acceptable to send hospital patients back into care homes and without making it mandatory for them to be tested for Covid-19. This did not begin until April 15.
The guidance said [April 2], "negative tests are not required prior to transfers/admissions into the care home."
On June 12 2020, The National Audit Office released a report called ‘Readying the NHS and adult social care in England for COVID-19’ - you can read it here
It states:
“Between 17 March and 15 April, around 25,000 people were discharged from hospitals into care homes… Due to government policy at the time, not all patients were tested for COVID-19 before discharge. On 15 April, the policy was changed to test all those being discharged into care homes.”
The report adds the crucial detail:
“It is not known how many patients discharged to care homes had COVID-19 at the point they left hospital.”
In July, Boris Johnson blamed care homes for the spread of coronavirus. He stated that, “too many care homes didn’t really follow procedures.” - including getting tested, which as noted on p.63/.177 of the ‘Lessons Learnt’ report, they couldn’t actually do.
Former President of the British Geriatrics Society and physician David Oliver wrote a piece on July 15 for the BMJ broadly condemning Boris Johnson’s comments, concluding that:
“…the prime minister must realise that its current perilous predicament results partly from serial policy decisions made, over the past decade, by the party he now leads.”
“I’ve seen no credible evidence,” Oliver says, “to back up Johnson’s assertion that care homes weren’t following correct procedures.”
He goes on, mirroring the ‘Lessons Learnt’ report, and says:
“...care homes were left with a woeful shortage of PPE and no access to testing, largely from poor government policy.”
Oliver was quoted, too, in p.84/.255 to discuss the matter of social care, featured between pages 83 and 95.
Interestingly, one of the most brutal pieces on the early days of the pandemic came from The Telegraph courtesy of Ambrose Evans-Pritchard who wrote:
Except in this instance, the care home residents and staff were not the enemies in some 14th-century war.
They appear to have been casualties to a 21st-century Conservative policy towards achieving a ‘herd immunity outcome’ - deaths, “which could have been avoided” according to the ‘Lessons Learnt’ report.
The Executive Summary Pt. 2 - Further Detail
It states:
“It is impossible to know whether a circuit breaker in the early autumn of 2020 would have had a material effect in preventing a second lockdown…”
Ah, but…
“...In this decision not to have a circuit breaker, the UK Government did not follow the official scientific advice.”
And again on p.50/.128 where it states: “...it seems that Ministers were mistaken in the weeks after the first wave abated in taking an optimistic assumption that the worst was behind us.”
SAGE advice in September 2020 recommended that the government should consider a short lockdown of two or three weeks - immediately - to bring down the number of cases.
This didn’t happen. The government opted for businesses to remain open and household contact allowed for most of the country - with only the threat that if people didn’t abide by the rules, future lockdowns would be inevitable.
It continues with some positive feedback including the vaccine rollout, the establishment of the Vaccine Taskforce and the development of the Oxford/AstraZeneca vaccine - none of which are completely attributable to the government’s response - but ends on a rather sombre note discussing those affected from within the BAME community [p.96/300] and those living with learning disabilities.
It states:
“...existing social, economic and health inequalities were exacerbated by the pandemic and combined with possible biological factors contributed to unequal outcomes including unacceptably high death rates amongst people from Black, Asian and Minority Ethnic communities.”
Although the analysis is extensive, it does little to discuss the fact that racism was one of the causes - according to a suppressed/censored report from PHE that was released in June last year and only barely discussed on pg.100/.313 where it says, “be aware that minority ethnic communities may be less willing to trust health communication that comes from Government.”
One of the primary reasons, according to The Guardian, for its suppression was due to the heightened tensions that may have arisen after the protests around the US and UK sparked by the George Floyd murder - which occurred around the same time.
Dr. Michelle King-Okeje wrote in the BMJ that racism was noted as a “key factor” in the disproportionate number of members of the BAME community being affected by COVID, and wrote last year that this aspect had been “downplayed.”
The final aspect of the Executive Summary discusses the emotive subject of DNR orders which, “were issued inappropriately for some people with learning disabilities.” [pg.103/.326]
Those living with learning disabilities are discussed as part of the broader sub-headline ‘People with learning disabilities’ on pg.100/.314
The HSJ wrote about this in April last year, quoting learning disability Turning Point’s Julie Bass who said that, “Making an advance decision not to administer CPR if a person’s heart stops, solely because they have a learning disability, is not only illegal, it is an outrage.”
Indeed, the Executive Summary came to the conclusion that this was:
“Completely unacceptable.”