Former British Prime Minister David Cameron leaves Dorland House after giving evidence in the COVID … [+]
Witnesses have criticised the British government’s pandemic preparations as part of a public inquiry into the country’s response to Covid-19.
Multiple experts highlighted factors such as planning for the wrong kind of virus and diverting energy to Brexit plans.
Growing health inequalities and relatively low health funding fuelled by a decade of austerity politics had also put the country in a vulnerable position when the pandemic struck, the inquiry heard.
A coronavirus, not a flu
Before covid, the U.K. had largely focused on influenza as the most likely cause of a large-scale and deadly pandemic.
Covid-19 is caused by a coronavirus, not an influenza virus. Although it is also causes respiratory illness, the diseases can result in different symptoms and may spread in different ways. It also appears to be significantly deadlier than flu.
UK Health Security Agency chief executive Professor Jenny Harries told the inquiry that authorities had been aware of a gap in the U.K.’s pandemic planning — which had concentrated on flu — since 2018.
She told the inquiry in a statement that this gap had “been apparent since 2002.”
Steps were taken to start to rectify the situation in 2018 the year before the first covid cases emerged.
On Monday, former prime minister David Cameron admitted the country’s focus on flu had left it unprepared. He led the country from 2010 to 2016.
He said: “Much more time was spent on pandemic flu and the dangers of pandemic flu rather than on potential pandemics of other, more respiratory diseases, like Covid turned out to be.
“This is so important — so many consequences followed from that.”
Epidemiologist Dr Charlotte Hammer from the University of Cambridge said that although “any plan for a respiratory outbreak will be better than none”, there were “certain difficulties” with the plans in place.
Preparing for a no-deal Brexit
Lawyer Hugo Keith KC argued that efforts to prepare for a no-deal Brexit in 2018 had taken up resources that could have been directed towards pandemic planning.
He told the inquiry that “severe consequences of a no-deal exit on food and medicine supplies, travel and transport” had been considered ahead of the country’s departure from the European Union.
It was “clear that such planning, from 2018 onwards, crowded out and prevented some or perhaps a majority of the improvements that central government itself understood were required to be made to resilience planning and preparedness,” he added.
These efforts could have incidentally prepared the country for a pandemic, he said, but evidence seemed to suggest this had not been the case.
A decade of austerity
Much emphasis has already been placed on the impact of decade of austerity on Britain’s pandemic preparadeness.
Inequalities in health and income have grown starkly in the years since a Conservative and Liberal Democrat coalition government anounced a “deficit reduction” plan back in 2010.
Better known as “austerity,” lawmakers stripped back public spending following the 2008 global financial crash — trimming down welfare support in numerous forms.
Health spending was “ring-fenced” during Cameron’s austerity push and was not cut in the same way as housing, welfare and other social services.
But it rose much slower during this period than in the years before — while the demands of an ageing population grew markedly.
As think tanks like the Nuffield Trust have argued, the country’s high waiting lists for procedures like cataracts and hip replacements would have risen significantly, even without delays caused by covid-19.
This lack of capacity arguably left the public health system — which provides most of the country’s healthcare services — with little room to deal with shocks like a pandemic.
The government’s austerity programme has been controversial since it began, with experts such as epidemiologist Professor Michael Marmot arguing it has strongly fuelled health inequalities.
The impact of Covid-19 was felt along these lines of inequality in the U.K., with people living in more deprived areas disproportionately affected by the disease.
Prof Marmot, who leads the University College London Institute of Health Equity, and prepared a joint report for the inquiry with Professor Clare Bambra of the University of Newcastle.
It read: “The UK entered the pandemic with its public services depleted, health improvements stalled, health inequalities increased and health among the poorest people in a state of decline.”
One of the lawmakers behind austerity, however, argued the much-maligned government policy actually helped the country deal with the pandemic.
Former chancellor of the exchequer George Osborne told the inquiry in a statement: “I have no doubt that taking those steps to repair the UKs public finances in the years following the financial crisis of 2008/9 had a material and positive affect on the UKs ability to respond to the Covid-19 pandemic.”
Structural racism and inequality
The inquiry also asked Bambra and Marmot whether the government’s planning enabled proper consideration of the role of structural racism in Covid-19 outcomes.
Ethnic minority communities were disproportionately affected by the disease: a situation that is not exclusive to covid.
Although the pandemic put a lens on race as a social determinant of health in the U.K., governments, researchers and activists have long been aware of, for example, the higher risk of maternal mortality in black women, risk of diabetes among South Asian communities and death from cancer and dementia among white people.
As a recent report — unrelated to the inquiry – by the King’s Fund think tank states, the links between health and ethnicity are “complex” across different conditions. But structural racism, author Veena Raleigh wrote, “can reinforce inequalities… which in turn can have a negative impact on health.”
Bambra and Marmot said these factors did not seem to be considered as part of pandemic response plans.
Factors like austerity, health inequalities and structural racism were barely mentioned — if at all — in the written reports and practical exercises designed to prepare the country for events like covid.
“This is disappointing, as, in our view, pandemic plans are about how to best mitigate the adverse impacts (particularly in terms of hospitalisations, deaths and morbidity) of infectious disease outbreaks across the whole population,” Bambra and Marmot stated.
“To do this effectively, they should, in our view, also anticipate and develop ways to address who is most likely to be impacted and to address potential inequalities.”