Was the Johnson government unprepared for Covid because it was distracted by Brexit? Was the virus itself caused by a lab leak? Did lockdowns do more harm than good? Are face masks a conspiracy? If the 2020s are indivisible from the pandemic, Covid offers endlessly fertile territory for the decade’s culture wars. They look irrational written down – what does remoaning have to do with face masks? – yet somehow we understand the faultlines, and how they connect, at a gut level.
Yet the public inquiry into the government’s handling of Covid, which opened on Tuesday in a neutral-looking building near Paddington, west London, with only the most sober-minded spectators still attending by Thursday – and without even a desultory anti-vax protest outside to liven anything up – kept insisting on one inconvenient, unarguable point. Governing isn’t about binary arguments in primary colours. The discourse may drown out reality but it can’t make it go away, and there bad decisions still cost lives and good ones still need homework.
This is the resilience and preparedness module of the Covid inquiry, tracking back to 2018, when Public Health England called attention to a “gap in strategy focusing on infectious diseases”; to 2016, when Exercise Alice wargamed what would happen had Middle East respiratory syndrome (Mers) taken on pandemic dimensions; to 2002, when the strategy void was first identified. The most neutral, factual language – “new, continuous cough”, “asymptomatic transmission”, “replication rate” – grabs you by the throat and drags you straight back to the shadowy, almost hallucinogenic state of March 2020, when every aspect of normal life, from a sneeze to a stranger, became freighted and ominous.
We pored over country comparisons back then, looking for clues about how to react, how seriously to take the disease, what the future might look like two weeks hence. But it seems that, certainly at the level of government, we weren’t looking at the right countries, and we didn’t start looking soon enough. Prof David Heymann talked about why the mortality rates in certain Asian countries – Japan, Korea, Singapore – were lower than those in Europe. Those countries learned more from, variously, the Sars outbreak 20 years ago and Mers in 2015, and had better surge capacity in hospitals, and superior contact tracing, in both directions – that is, who the infected patient might have transmitted to, and who they had likely been infected by. This enabled “precision lockdowns”, which are “good basic epidemiology”, Heymann said.
Kate Blackwell KC drew the inquiry’s attention to that table-top exercise in 2016, which specifically recommended that someone draw up a briefing paper on South Korea’s policy post-Mers and whether it had any lessons for the UK. Did Heymann know whether that had ever happened? He did not, unfortunately. We can work on the assumption that if it did, nobody read it; our contact tracing got demonstrably worse when Covid hit – previously, it was conducted at a local level, which is a high-trust environment. When it was centralised during the pandemic, that trust was watered down.
Probably the starkest evidence, from a political perspective, came from Prof Sir Michael Marmot: he was pressed on the state of healthcare immediately before Covid hit, and how much impact hospital capacity and staff shortages had on it. Most of the health differences we see are not attributable to healthcare, but to the underlying health of the population. “It’s hard to overstate how important this is: we used, as a country, to expect health to improve year on year. That’s what the history of the 20th century led us to expect,” he told the inquiry. That improvement slowed dramatically, in 2010, more in the UK than in any other country except Iceland and the United States. Furthermore, health inequalities got bigger; people in the most deprived decile saw a decline in life expectancy, in every region except London.
Neither Covid nor life after it, including the hundreds of thousands missing from the workforce, are comprehensible without looking squarely at what austerity has done to society. Even if the Conservatives hadn’t kept the NHS on a shoestring, even if we hadn’t had half the ICU capacity of Italy and France, the decisive factor would still have been this simple thing that we knew all along: the belt-tightening that Cameron sold as blitz spirit, and his successors have continued, was callous. People became ill and died as a result of it.
But even if the Covid inquiry has a galvanising effect, and reminds us of the value of compassion and competence in politics, that is not its purpose. David Alexander, professor of risk and disaster reduction at University College London, told the inquiry: “The bottom line is: do you think the British government within the limits of its competency keeps the public safe? My answer to that is no, or not sufficiently.” This painstaking exercise, which will take years, is not designed to pin the blame squarely on one administration, one prime minister. It’s not there to justify lockdowns or regret that Brexit eclipsed everything else. It exists for the one thing we don’t want to think about: the next pandemic.
Zoe Williams is a Guardian columnist
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