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Major inquiry by MPs notes ‘big mistakes’ in UK handling of Covid

Parliamentarians detail failings of scientific advice, but some scientists highlight “glaring” omissions in their report

The government must learn from “serious errors” in its handling of the Covid-19 pandemic, including its failure to challenge scientific advice, according to a major inquiry by an influential group of MPs.

“The UK response has combined some big achievements with some big mistakes,” said the co-chairs of the inquiry, Jeremy Hunt and Greg Clark, on 12 October. “It is vital to learn from both to ensure that we perform as best as we possibly can during the remainder of the pandemic and in the future.” 

They praised the vaccine programme as “boldly planned and effectively executed” but said the test and trace programme “took too long to become effective” and also criticised science advice early on in the pandemic, which they say delayed the lockdown.

The joint House of Commons Health and Social Care, and Science and Technology select committees’ inquiry began in October 2020 and examined six key areas: pandemic preparedness; non-pharmaceutical interventions; test, trace and isolate strategy; social care; specific communities; and vaccines.

‘Serious early error’

It said the government made a “serious early error” in moving from the ‘contain’ to the ‘delay’ stage of its strategy, which involved managing the spread of Covid through the population rather than stopping it by imposing a lockdown.

“This amounted in practice to accepting that herd immunity by infection was the inevitable outcome,” the report said.

They said this approach reflected a consensus between scientific advisers and government, which “indicates a degree of groupthink that was present at the time, which meant we were not as open to approaches being taken elsewhere as we should have been”.

In future, the MPs recommended that “an approach of greater questioning and challenge should characterise the development of policy”.

“Ministers should have the confidence to follow a scientific approach themselves—being prepared to take a more robust approach to questioning and challenging the advice given,” they said.

Sage openness to guard against ‘groupthink’

Moreover, they recommended that the government and its Scientific Advisory Group for Emergencies should facilitate “strong external and structured challenge to scientific advice, including from experts in countries around the world, and a wider range of disciplines”.

The committees have been vocal about the so-called “secrecy” of Sage, which initially did not disclose its membership, minutes and evidence.

In future, the report suggested that the scientific advice from Sage co-chairs to the government “should be published within 24 hours of it being given, or the policy being decided, whichever is later, to ensure the opportunity for rapid scientific challenge and guard against the risk of ‘groupthink’”.

And it said that the minutes and Sage papers should be published within 48 hours of the meeting taking place.

R&D underpinning vaccines success

Elsewhere, the MPs said the strength of the UK scientific base and the government’s early investment in R&D were key contributors to the success of the vaccine programme.

They added that it was “essential that support for, and investment in, the UK science base is protected and enhanced” to safeguard against future threats.

“This should include delivering the government commitment from budget 2020 and the 2021 R&D Roadmap to invest £22 billion per year in R&D by 2024-25,” the report said.

A government spokesperson told Research Professional News: “Throughout the pandemic we have been guided by scientific and medical experts and we never shied away from taking quick and decisive action to save lives and protect our NHS, including introducing restrictions and lockdowns.

“Thanks to a collective national effort, we avoided NHS services becoming overwhelmed and our phenomenal vaccination programme has built a wall of defence, with over 24.3 million infections prevented and more than 130,000 lives saved so far.

“As the prime minister has said, we are committed to learning lessons from the pandemic and have committed to holding a full public inquiry in spring.”

‘This report would lead to resignations’

The report has received a mixed welcome from the scientific community, with some agreeing with its general conclusion and others pointing out omissions.

“We can expect government spokespeople to cherry-pick parts of the report that praised its actions, particularly the gamble that an effective vaccine would be produced,” said Robert West, professor of health psychology at UCL.

“However, there is no escaping the damning conclusion that it failed to take crucial public health advice on key decisions relating to test and trace and the timing of restrictions, and that led many thousands of British citizens to perish. In some countries, this report would lead to resignations.”

Trish Greenhalgh, professor of primary care health services at the University of Oxford, noted that the report “hints at a less-than-healthy relationship between government and its formal scientific advisory bodies”.

“It would appear that even senior government ministers were reluctant to push back on scientific advice that seemed to go against common-sense interpretations of the unfolding crisis,” she said.

Greenhalgh added that it seems the government and its various bodies, such as Sage and Public Health England, have “repeatedly dismissed the precautionary principle in favour of not taking decisive action until definitive evidence emerged and could be signed off as the truth”.

“Uncertainty is a defining feature of crises,” she said. “Unless we wish to continue to repeat the mistakes of the recent past,” she added, the UK must replace ‘following the science’ principle with “deliberating on what best to do when the problem is urgent but certainty eludes us”.

‘Glaring’ omissions

Others took aim at the committee for skipping over key issues.

“The most glaring omission is the lack of any commentary on the relevance of antiviral treatment in disease management,” said Penny Ward, visiting professor in pharmaceutical medicine at King’s College London. “Although the formation of an Antiviral Taskforce was announced in April, we have yet to hear any recommendations from the committee.”

Ward also said the report is “self-congratulatory on the ‘success’ of the vaccine and of the foresight of the Vaccines Taskforce” when the country has “failed to ensure sufficient uptake of the vaccination among younger adults and teenagers and some higher-risk communities—most notably those of African heritage—which is at least one possible reason for the continued circulation of infection resulting in more than 700 hospitalisations and 100 deaths daily, on average in the UK currently”.

Meanwhile, Marian Knight, professor of maternal and child population health at the University of Oxford, noted that a high proportion of those currently in intensive care and on breathing support with Covid-19 are pregnant women.

“Yet there is not a single mention of pregnant women and lessons learned in this report,” she said. “They are once again a forgotten and overlooked group. If they are ignored in reports such as this, how can we ensure that the same mistakes are not made again in the future?”

And Mark Woolhouse, professor of infectious disease epidemiology at the University of Edinburgh, said the report’s central conclusion that an earlier lockdown would have saved lives “is too simplistic, not least because there is disagreement as to how many lives would have been saved”.

“Moreover, lockdowns are harmful in their own right,” he said. “The Select Committee report does not examine these indirect harms in any detail.”

A version of this article also appeared in Research Fortnight