Why I fear a key Covid inquiry recommendation will fall foul of constitutional politics

In Baroness Hallett’s Covid inquiry report, dealing with the resilience and preparedness of the UK, it was easy for her to show why things did not go well in any nation within it. The making of policies and their implementation was done by a structure made up of a vast number of bodies that she accurately described as duplicative, diffuse, and labyrinthine.

Inefficiency was compounded in that many of the members of the explosion of committees didn't know what others were doing because there wasn't an overarching communication system.

However, she correctly emphasises that far worse was that whatever preparations had been done, they had focused on the wrong virus, influenza, and had failed to consider that the next pandemic might be caused by an agent for which antiviral drugs were not available and for which the development of a vaccine, if luck was on our side, would take many months.

Particularly deleterious was remembrance of the last influenza pandemic, swine flu in 2009, which in my opinion left memories that influenced policies in an unhelpful way. At its start, a best-case scenario of 50,000 deaths was suggested. In the event, 457 died.

As an almost non-event, it boosted Nicola Sturgeon's reputation as Health Secretary but probably put planning for PPE low on the list for pandemic preparedness, and I have little doubt that sticking with it as a model encouraged school closures, a traditional influenza control measure, but one with little effect on the spread of Covid, which causes infections in children that are so trivial that many have no symptoms and were no worse than the common cold in most of the rest, yet a measure that inflicted enormous educational damage. 

An antidote to groupthink

The Baroness identifies that groupthink accounts for the official pre-pandemic view that the UK was a global leader in pandemic preparedness. Groupthink is a term invented by the US psychologist Irving Janis. He described it as “the more amiability and esprit de corps among the members of a policy-making in-group, the greater is the danger that independent critical thinking will be replaced by groupthink".

The report proposes a groupthink antidote, red teams with expert and non-expert members independent from institutional structures. I endorse this remedy wholeheartedly, having chaired one in 1996 to deal with a lethal E.coli O157 outbreak. I was pleased to see that the first inquiry witness to be quoted in the report was from Edinburgh, Professor Mark Woolhouse, a voice of Covid common sense and a groupthink challenger.

Trouble ahead

However, I was disappointed in its coverage of the vulnerable. The list the report gives is fine, but by far the most important risk factor in determining fatality is age, which was not listed.  Residents of care homes suffered so much because of it. They aren't mentioned either.

Neither, except in passing, is obesity, which ranks second as the risk factor for a lethal infection. But many more reports will follow and I hope that these issues will be dealt with appropriately.

However, I fear that constitutional troubles may lie ahead. The Baroness recommends that a UK-wide, whole-system, civil emergency strategy be developed. UK-wide? A good test for the Starmer-Swinney love in!

Hugh Pennington is emeritus professor of bacteriology at the University of Aberdeen