During the pandemic two of the major sources of criticism of UKGOV’s performance involve lack of test and trace systems, and lack of PPE in the early days. But the lack of both was the result of decisions which predated the pandemic, and lessons have been learnt on the hoof.
FIRST, testing and tracing (T&T). It is evident that in a pandemic the ability to test people who may be infected, trace their contacts and isolate those at risk is a vital tool to minimise infections and control the virus. South Korea and Taiwan, nations which have suffered far less than Western nations, knew the value of T&T not least because of their MERS (coronavirus related) experience in 2015. They had developed the technology to contact track, using data collated from credit card and other personal sources to check people’s movements, among other things. So, they applied this in CV’s early days. It seems now that T&T is less effective when a pandemic has taken a firm hold. The UK had no significant T&T capability in early 2020. The UK health experts had not, and so UKGOV (pre-Boris Johnson) had not, recognised the possible need for T&T and so no investment was made in it. Many experts have said that the whole focus of UK preparations for a pandemic were on an influenza related virus not something else, and perhaps that explains UK under-preparation in T&T.
The lesson as to need has been learnt, in that vast investment has been made during the pandemic but there are question marks over the new UK system’s efficacy. Why did the UK not copy Taiwan? Was there insufficient planning by those who were charged with building and implementing T&T? Are shortcomings due to privacy of data attitudes? Or are difficulties as much due to the reluctance of UK citizens to comply with isolation demands? Maybe a public enquiry will find out. But the need to get T&T working now is vital, to control CV spread when infection rates come down, but also in case of another pandemic. But the T&T problem for the UK was baked in from day one due to past decisions. The Public Enquiry will no doubt focus hard on the failings of T&T in the UK. UKGOV provided plenty of money for it, and so an eye will be on the Ministers and executives charged with implementation and spending that money.
SECOND, considerable damage and a number of deaths may well have been indirectly caused due to lack of PPE in the first months of the pandemic. Media commentary was incessant on the issue. But again, the problem was baked in from decisions made long before 2020. The NHS thought it was as prepared as it could be, despite a previous test run in 2016 called “CYGNUS” (for a flu pandemic) which allegedly saw health services overwhelmed. Presumably any enquiry would look for example at previous Health Secretaries. Before CV was well understood, on 11 February 2020, the Chief Commercial Officer wrote “ NHS and other health systems are well prepared for these types of outbreak”; on 17 March NHS Officials told the Commons Health Select Committee “There is adequate supply of PPE to keep staff safe in the months ahead”; these and other records of Health Services expressing confidence in capacity in the broadest sense are referred to in a Financial Times article on PPE on 1 May 2020 entitled “How Poor Planning left the UK without Enough PPE”. The UK, with the U.S. was regarded by WHO as the best prepared for a pandemic pre-CV.
But all the preparation in the UK was, it seems, for another “flu” and there was plenty of PPE stock for that, but not something else! Once CV was better understood, the battle was then one of urgent procurement in competition with all other nations – and it was then realised that the UK had no production capacity relying on other countries for supply, especially China, a hostile nation. Of course, there will be much for a public enquiry to look at as regards the approach to procurement, and there has been much criticism of the cost already. But who was responsible for that? For once there will be no criticism of UKGOV failing to provide enough money: there could be a lot of focus on how it was spent by Ministers and the executives in charge? Now is not the time to blame for that.
Fortunately, the lesson of dependence on supply and the strategic imperative of diversity and self-reliance has been quickly learnt; and now the UK from a standing start itself produces the vast majority of the PPE it needs. The PPE problem too was baked in from long before the pandemic started in 2020. That lesson of the over-dependency on other countries, may well have influenced the UKGOV decision to rapidly build local vaccine manufacturing capacity which is now serving the UK so well.
And so, two of the very biggest practical problems of the early stages of the pandemic were created by decisions made long before it started. The UK was always ready to deal with the Flu but not Covid-19. At least the learning from the past errors has been absorbed and corrective action taken.
THE WIDER QUESTION OF PANDEMIC MANAGEMENT
The experiences of T&T setup and PPE procurement raise big question marks over the project management and procurement skills of the senior officials and managers charged with delivery of those tasks. To the extent delivery was outsourced similar questions may be asked of the private providers paid for their services. UKGOV made vast sums available. Irrespective of CV, the wastage and overspending generally by major government departments and the health services are a continuing sore, displaying a culture where stewardship and the idea of fiduciary responsibility for hard-earned taxpayers’ money are in short supply.
Perhaps there are many lessons to be learnt in these fields from the pandemic. If learnt quickly, future mistakes could be avoided and better habits adopted, perhaps also leading to better protection of the NHS, saving lives and an added bonus of saving much needed money.
The UK vaccine roll-out may suggest lessons learnt already.