The 7 major findings from the first UK Covid-19 Inquiry report, as Scotland relied on 'UK intelligence'

The UK Covid-19 Inquiry has published its first report and ten recommendations focused on pandemic resilience and preparedness.

Totalling 83,000 words, the report highlights failures of risk assessment, a lack of strategy, and the urgent need to reform Britain’s pandemic response. It comes after the Inquiry received 103,000 documents, 213 witness statements and heard from 86 witnesses across 23 days.

Inquiry chair Baroness Heather Hallett is now urging the UK government and devolved administrations to implement her recommendations to better “avoid the terrible losses and costs to society” caused by the pandemic.

A member of the public observing the National Covid Memorial Wall, a public mural painted by volunteers to commemorate the victims of the COVID-19 pandemic.

In her foreword, Lady Hallett said: “It is not a question of ‘if’ another pandemic will strike, but ‘when’. The evidence is overwhelmingly to the effect that another pandemic – potentially one that is even more transmissible and lethal – is likely to occur in the near to medium future.

“Unless the lessons are learned, and fundamental change is implemented, that effort and cost will have been in vain when it comes to the next pandemic. There must be radical reform. Never again can a disease be allowed to lead to so many deaths and so much suffering.”

Here are the key findings from the report.

Scotland relied on UK intelligence

The report found in Scotland, the chief medical officer had only a "limited role" in pandemic preparedness and resilience, while the chief scientific adviser to the Scottish Government did not hold primary responsibility for advice on public health, public health-related science or epidemiology. The chief scientist (health) also did not have a role in pandemic preparedness. Therefore the report found Scotland "substantially relied, in terms of expert medical and scientific advice, on 'UK intelligence'".

Failures of risk assessment

In the years prior to the pandemic, the Cabinet Office produced UK-wide risk assessments to inform responses at national and local levels. However, while the devolved administrations produced their own documents, they copied the method of the UK government. As such, the approach did not assess how particular risks would impact their individual nations, and failed to take into account "sufficiently, or at all", the underlying health, social and economic circumstances of their populations. In January 2015, the-then deputy first minister John Swinney commissioned the development of a Scottish risk assessment, which was published in 2018. However, while a separate document was created, the population figures from the UK-wide assessment were simply replaced with those of Scotland. There was no separate analysis for Scotland that "adequately" took into account specific factors that might particularly affect the Scottish population.

As for the UK-wide risk assessment, the problems were too much reliance on the idea of it being an influenza pandemic, planning was focused on the impact rather than preventing the spread, interconnected risks and a domino effect were not properly taken into account, there was a failure to appreciate long-term risks and their impact on the vulnerable, and there was a disconnect between the assessment of risk and the plan for dealing with it. With the devolved administrations copying the UK government's approach, the flaws flowed through their civil contingencies systems.

The report recommended the UK government and the devolved administrations should work together on developing a new approach that moves away from reliance on a single reasonable worst-case scenario.

Too many organisations made things confusing

The number of organisations across the UK with responsibility for pandemic preparedness multiplied over time to become "unnecessarily numerous and complex". It found the responsibilities within the UK government and devolved administrations were "duplicative, diffuse and delegated too far from ministers and senior officials to allow them to be effectively overseen". The report claims this led to an inefficient system, with lots of overlap and an absence of clarity about the division of responsibilities.

Groups advising the Government “did not have sufficient freedom and autonomy to express dissenting views”, there was a lack of challenge to what was said, and the advice was often undermined by “groupthink”.

Despite this, the report found there were still fundamental gaps, with the different bodies operating in silos. The document gave the example of Emma Reed, director of emergency preparedness and health protection in the Department of Health, who was never contacted to discuss quarantining or track and trace.

The report cited an absence of "clear leadership and oversight by both ministers and officials", with a lack of focus that saw no ministerial oversight of one of the UK's most significant risks.

Reform the civil service and let the Cabinet Office lead on civil emergencies

The report said the government model for whole-system civil emergencies should be abolished, with the Cabinet Office instead leading on them across UK government departments.

It also called for a standing group of ministers, in the UK government and in each of the devolved administrations, focusing on preparedness for and resilience to whole-system civil emergencies. There should also be a single Cabinet-level ministerial committee and a single cross-departmental group of senior officials to conduct a review to simplify the system.

Reform of civil service was also required, by reducing the number of structures responsible for preparing and building resilience to whole-system civic emergencies.

The core structures should be a single Cabinet-level or equivalent ministerial committee responsible for the whole-system civil emergency preparedness and resilience for each government, which meets regularly and is chaired by the leader or deputy leader of the relevant government.

Abandonment of strategy, and an ‘ad hoc’ lockdown

The UK “prepared for the wrong pandemic”, namely a flu pandemic. Furthermore, this flu plan was “inadequate for a global pandemic of the kind that struck”. Prior to the pandemic, the UK government had relied on a 2011 strategy, a plan for influenza that aimed to be flexible and adaptable for use in other pandemics. Deeply flawed and with multiple recommendations that it needed to be updated, instead, it was left in stasis. This meant the strategy learned nothing from the Ebola virus, Middle East respiratory syndrome or SARS, and learnt no lessons from after 2011. Former health secretary Matt Hancock could only say he had "no idea" why it wasn't updated.

Abandoned when the pandemic hit, this meant there was no coherent plan, with the report saying the UK government and devolved administrations instead responded with an untested approach, with the inquiry hearing lockdown was an “ad-hoc public health intervention".

While the 2011 strategy had flaws, the report questioned why ministers didn't use it as a prediction of what could happen and then adapting. Instead, it said they proceeded on the basis the outcome was "inevitable", which sent the wrong signal and focused on managing casualties, rather than mitigating or preventing the emergency.

The report lays the blame for this with the health secretary who followed this strategy, the experts and officials who advised it, as well as all the governments of the devolved nations who adopted it.

Practise makes perfect

Prior to the Covid-19 pandemic, “there was no exercising of measures such as mass testing, mass contact tracing mandated social distancing or lockdowns”.

The report calls for all four nations to hold a UK-wide pandemic response exercise at least every three years, to test the response to a pandemic at all stages, from the initial outbreak to multiple waves over a number of years. The nations should also consider a range of vulnerable people and how they would be helped in the event of a pandemic.

Brexit

The report also suggests, though does not make explicit, the impact that Brexit had on the pandemic. It referenced limited resources and that preparations for a no-deal Brexit meant pandemic preparedness tests in 2019 did not have enough attention, with social care flagged consistently as an issue, but not addressed. Oliver Dowden, the-then Minister for the Cabinet Office, said the government was "prioritising no-deal preparations".