An evaluation of Britain’s preparedness for a major public health risk made prior to the pandemic was “simply wrong”, an expert has told the Covid-19 Inquiry.
Professor David Alexander, who specialises in risk and disaster reduction, was giving evidence at the probe on Thursday alongside civil servant Bruce Mann.
The World Health Organisation (WHO) carries out joint external evaluations (JEEs) in collaboration with countries to assess their capacity to prevent, detect and respond to public health emergencies.
I think there are various criticisms that can be - and have been - levelled against the methodology used in the UK— Professor David Alexander
Lead counsel Hugo Keith KC said the UK “did well” in a JEE prior to the pandemic but added: “The evidence may show that in reality we didn’t do well.”
Professor Alexander said: “It does appear that at the time of the pandemic that the WHO evaluation of Britain’s ability to cope with a pandemic was simply wrong.
“It didn’t match up to the results that came out in comparing the British response to that of other countries or comparable countries.”
Thursday was the third day of public hearings in the first module of the inquiry, which is expected to go on until July 20.
Professor Alexander also said there are “problems” with the methodology used when planning for risks in the UK.
He added: “I think there are various criticisms that can be – and have been – levelled against the methodology used in the UK.
A plan for a severe pandemic has a lot of very common, very predictable features which ought to be identified and planned for specifically— Civil servant Bruce Mann
“One of the problems is that there is a failure in the scenarios to be sufficiently inclusive. There is serious accuracy but at the same time there is a failure to consider how things might develop in specific, particular cases. But it can be done.
“One problem with the methodology that is used in Britain is that it is utterly specific. In other words, there is a scenario for a pandemic. I believe the correct methodology would be to have an envelope – or suite – of scenarios; this is the best case, this is the worst case, this is the median case.
“What instead we have is an algorithm that gives us exact predictions, such as 48,324 deaths will occur.
“This, of course, is nonsense. It is indicative and in that sense it is helpful but I think we need a much broader way of describing our scenario.”
Mr Mann added: “There is a greater degree of specificity that can be done. The only thing that needs to be avoided is that there are 1,000 plans. There has to be some kind of aggregation to make the task manageable.
“A plan for a severe pandemic has a lot of very common, very predictable features which ought to be identified and planned for specifically.”
Both experts were asked about the findings of their report into pandemic preparedness.
There are most definitely lessons to be learned from Covid-19, as there are from previous events— Prof Alexander
They told the inquiry they had concluded that preparedness for an influenza pandemic in England, and for areas that were UK-wide, was “poor”.
But they indicated that the response could have been stronger in Scotland and, especially, Wales and Northern Ireland.
Looking at the key components necessary for a pandemic response, Mr Mann found that they “were poor or non-existent”.
He said: “And therefore it led to my conclusion that the overall preparedness of the pandemic was inadequate.”
He added that the pandemic response strategies put in place by the UK Government had not been adequately tested before the Covid-19 outbreak.
The report also referred to the novel disease preparedness as being “wholly inadequate”, the inquiry heard.
Mr Mann also said that it was clear from the Hine review into swine flu in 2010 that the health and social care sectors were liable to be overwhelmed.
He explained: “That was the clear advice not only from the Hine review in 2010, it appears on the Cygnus report – the report on Exercise Cygnus, it appears in officials’ advice to ministers … that they would be overwhelmed, which has to raise serious questions about whether the plan would have worked.”
The measure of a lesson learned is in fact in measurable positive change— Prof Alexander
Speaking earlier, Prof Alexander also told the inquiry there were “definitely” lessons to be learned from the pandemic.
He said: “The measure of a lesson learned is in fact in measurable positive change.
“There are most definitely lessons to be learned from Covid-19, as there are from previous events.”
He said one example of this is the 2005 London bombings, where there was a need for greater co-ordination between the emergency services, particularly in the declaration of a major incident.
Prof Alexander said: “Twelve years later, in the Manchester arena bombing, there was exactly the same problem, which implies that in the 12 years that intervened, that particular lesson – which is extremely important in terms of saving lives – had not been learned.”
Both experts further told the inquiry there was a need for the Government to re-write its strategy.
Asked by Mr Keith if the strategy needs a radical rewrite, they both said: “Yes.”
Mr Mann said there are a number of issues with the UK Government Resilience Framework published in December 2022.
There are a lot of good ideas in (the UK Government Resilience Framework) that are not brought together in a single, unified roadmap— Mr Mann
He said it started in the “wrong place”, adding: “It sets out a range of measures and implies if those measures are taken we will have a sufficiently adequate system to deal with the future we face.
“I don’t believe that to be the case. I think the document should have started in a different place.
“What do we need first to deal with catastrophic emergencies? Secondly, actually debate on international best practice, and I think it falls short in both of those areas.
“Second, it’s too slow. It suggests a range of measures for implementation in the period of 2025 to 2030.
“I think all of those can be done sooner and ideally should be done sooner.
“Third, it is not a strategy – it was advertised as a strategy.
“It does not set out: ‘This is where we’d like to get to, this is how we will know we’ll get there and these are the steps we’ll take on the way’.
“There are a lot of good ideas in there that are not brought together in a single, unified roadmap.”
