Boris Johnson had been in power for six months when Covid hit Britain and sparked the greatest peacetime crisis in a century. His departure, with the worst of the pandemic surely behind us, means his tenure will be framed by his handling of the virus. To some he got “the big decisions right”. To others he oversaw one of the UK’s worst ever public health failures. Here we look back at the prime minister’s Covid battle and assess how he fared.
Costly confusion
Clear communication is crucial in a crisis, but confusion undermined public health messaging from the start. In February 2020, days after the UK confirmed its first cases, the government urged everyone to wash their hands regularly. On 3 March, Sage’s behavioural science experts said ministers should advise people to avoid hugging and shaking hands too. If the PM got the memo, he didn’t act on it.
At a press briefing the same evening, he said: “I’m shaking hands continuously. I was at a hospital the other night where I think there were actually a few coronavirus patients and I shook hands with everybody … I continue to shake hands.” Downing Street said Johnson may not have seen the advice. But he was at it again days later, shaking hands with the TV presenter Phillip Schofield on 5 March and the boxer Anthony Joshua on 9 March.
Herd immunity
On 12 March, the country switched tactics from containing Covid to delaying its spread. Rather than trying to stop all new infections, the aim was to “flatten the curve” and avoid everyone getting Covid at once. This would protect the NHS and, in the words of Sir Patrick Vallance, the government’s chief scientific adviser, lead to the build up of “some kind of herd immunity”. An inquiry by MPs in October 2021 was scathing about this strategy. The “fatalistic approach” was a serious error, the MPs said, and they accused the government and its advisers of “groupthink” for not considering firmer tactics such as those adopted in parts of Asia.
Hospitals
NHS staff needed personal protective equipment (PPE) to protect themselves, reduce the spread of the virus and prevent mass absences. In December 2019, ministers were warned of a PPE shortage but failed to address the problem. When demand for PPE rocketed, the government established a fast-track VIP lane that awarded lucrative PPE contracts to firms with political connections. Jason Coppel QC told the high court that “enormous quantities of equipment were purchased without proper technical checks, at inflated prices,” that were “useless to the NHS”. Johnson declared himself “very proud” of the PPE procurement process, but the high court ruled the VIP lane unlawful.
In anticipation of a huge wave of infections, the government ramped up hospital capacity with the Nightingale field hospitals. But while the number of beds could be expanded at speed, healthcare workers could not – thanks tothe NHS having entered the pandemic in a staffing crisis. The lack of staff meant patients bound for the Nightingales were sometimes turned away. As the Kings Fund put it: “The Nightingales have shown that … there is no magic NHS staffing tree to shake.”
First national lockdown
In mid-March 2020, people were advised to work from home and avoid unnecessary travel. Schools and indoor hospitality closed soon after. On 19 March, Johnson declared “we can turn the tide within the next 12 weeks”, adding: “I’m absolutely confident that we can send coronavirus packing in this country.” The nation went into lockdown four days later. The MPs’ inquiry criticised the government and its scientific advisers for the “gradual and incremental approach” of the first few months, calling it “one of the most important public health failures the United Kingdom has ever experienced”.
Johnson hospitalised
Covid was rife in Westminster at the time of the first lockdown. On 27 March 2020, the prime minister and Matt Hancock, then health secretary, both tested positive. Johnson was admitted to hospital on 6 April and spent time in intensive care. “The NHS has saved my life, no question,” he said on being discharged. “It’s hard to find the words to express my debt.”
Care homes
Despite claims that the government had thrown a “protective ring” around care homes, there was a devastating death toll among residents. Johnson blamed this on a failure to follow proper procedures, drawing a furious backlash from care providers. Nadra Ahmed, the chair of the National Care Association, called Johnson’s response “a huge slap in the face” for a sector that looked after a million vulnerable people. The MPs’ inquiry found that insufficient tests on Covid patients being discharged into care homes, and untested staff spreading the virus, led to “many thousands” of avoidable deaths.
Test and trace
The UK was one of the first countries to develop a Covid test, but daily infections topped 2,000 before test and trace was operational. Johnson celebrated the “world-beating” feat, but MPs lamented the “slow, uncertain and often chaotic” rollout of a system that consistently failed to capture more than half of the infected, in part because many could not afford to self-isolate. The system failed in its main objective of preventing future lockdowns despite what the public accounts committee called an unimaginable £37bn bill.
The winter lockdowns
After a quiet summer in 2020, Covid picked up again. On 21 September, Sage warned that without urgent action the country faced an epidemic with “catastrophic consequences”. The group’s call for an immediate circuit breaker and other measures to slow transmission was brushed aside. Instead, Johnson waited three weeks and then announced the three-tier Covid alert system, which failed to curb soaring cases. Johnson later faced allegations that he resisted a second lockdown by claiming the disease only killed 80-year-olds and reportedly shouted: “No more fucking lockdowns. Let the bodies pile high in their thousands.”
From the first days of the pandemic, Johnson and his ministers routinely claimed they were following, or being guided by, the science. Their failure to act quickly in the autumn and winter of 2020 is the most glaring example of that not being the case. Sir Jeremy Farrar, a member of Sage and director of the Wellcome Trust, said the government’s lack of action set the scene for the “carnage” of January 2021.
Drugs and vaccines
Johnson can, and does, point to some major successes in the crisis. The UK led the world in identifying drugs for Covid patients and developing vaccines to transform the course of the pandemic. The groundbreaking Recovery trial at Oxford University showed that dexamethasone reduced deaths among hospitalised Covid patients by a third. By March 2021, the cheap and widely available drug was estimated to have saved a million lives globally. Importantly, Recovery also showed when drugs did not work, as with the much-hyped antimalarial hydroxychloroquine.
But it is the vaccination programme that Johnson can claim as his most important success. Early decisions to set up the vaccine taskforce outside the Department of Health and install Kate Bingham at the helm were crucial in securing a fast and resilient supply. Separately, Oxford University was funded to develop its adenovirus Covid shot. In record-breaking time – less than a year – the vaccine was approved and ready for awaiting arms. The most important detail is often skipped over: while other vaccine firms such as Pfizer and Moderna sought profit from their vaccines, the Oxford/AstraZeneca jab was distributed globally at cost. Johnson told Tory MPs it was all down to “capitalism” and “greed”, prompting criticism that he had learned the wrong economic lessons from the crisis.
Omicron
Despite a spike in cases driven by Euro 2020, people’s behaviour and building immunity in summer 2021 largely kept the Delta variant in check. But if Covid appeared to be under control, the illusion was swiftly shattered when scientists in South Africa spotted another new variant, ushering in the era of Omicron.
Omicron reached the UK fast. Its astonishing transmissibility, aided by its ability to dodge Covid antibodies, led the UK Health Security Agency to anticipate a million infections a day by the end of December. But as Omicron gained ground, Johnson urged people not to cancel Christmas parties, leaving Prof Chris Whitty, England’s chief medical officer, to step in. He told people not to mix with others unnecessarily and to “prioritise social interactions”.
Johnson moved England to “plan B”, mandating face masks and Covid passes and encouraging more working from home. He declared an “Omicron emergency” and pulled in the military to help ramp up the vaccination programme. Other parts of the UK brought in fresh restrictions, but Johnson held off in England. Amid a narrative that the NHS coped with the wave, some doctors made clear it had not.
Public trust
Johnson and his team squandered public trust. When Dominic Cummings took his family to Durham, and then drove to Barnard Castle on his wife’s birthday “to test his eyesight”, Johnson argued he had “acted responsibly, legally and with integrity”. Public health experts and behavioural scientists said it smacked of one rule for them, another for us. Next came the Matt Hancock incident. The former health secretary was caught in a socially undistanced, rule-breaking tryst with a work colleague. Johnson accepted Hancock’s apology and declared the matter closed, but when criticism rumbled on he accepted Hancock’s resignation and tried to take credit for his departure.
With Partygate, the spotlight turned on Johnson himself. He was forced to apologise to the Queen after lockdown parties were thrown on the eve of Prince Philip’s funeral. Then he was fined by the Met, making Johnson the first sitting prime minister found to have broken the law. After weathering a vote of confidence, Johnson clung on, but it was only a matter of time before the curtain would close.
