Recommendations & Conclusions
133 items
58
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
The UK has established procedures and structures to prepare for the nation’s major future risks, including a National Risk Register, the Civil Contingencies Secretariat and the Scientific Advisory Group for Emergencies (SAGE). However, the anticipated future risk of pandemic disease focused too closely on influenza rather than diseases like SARS …
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The UK has established procedures and structures to prepare for the nation’s major future risks, including a National Risk Register, the Civil Contingencies Secretariat and the Scientific Advisory Group for Emergencies (SAGE). However, the anticipated future risk of pandemic disease focused too closely on influenza rather than diseases like SARS and MERS that had in recent years appeared in Asian countries.
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Government response AI summary
The government states it partially accepts this conclusion, but provides no further details or specific actions in its response.
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Department for Science, Innovation and Technology
Department of Health and Social Care
63
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
The NHS responded quickly and strongly to the demands of the pandemic, but compared to other health systems it “runs hot”—with little spare capacity built in to cope with sudden and unexpected surges of demand such as in a pandemic. Recommendations and lessons learned
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The NHS responded quickly and strongly to the demands of the pandemic, but compared to other health systems it “runs hot”—with little spare capacity built in to cope with sudden and unexpected surges of demand such as in a pandemic. Recommendations and lessons learned
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Government response AI summary
The government's response is a verbatim restatement of a separate committee recommendation (ID 17545) and therefore does not provide a direct response to this conclusion about the NHS's lack of spare capacity.
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Department for Science, Innovation and Technology
Department of Health and Social Care
66
Recommendation
Sixth Report - Coronavirus: lessons lea…
Not Addressed
The Government should ensure comprehensive plans are made for future risks and emergencies. The UK should aim to be a world leader in co-ordinating international resilience planning, including reform of the World Health Organisation to ensure that it is able to play a more effective role in future pandemics.
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The Government should ensure comprehensive plans are made for future risks and emergencies. The UK should aim to be a world leader in co-ordinating international resilience planning, including reform of the World Health Organisation to ensure that it is able to play a more effective role in future pandemics.
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Government response AI summary
The government response reiterates the committee's recommendation without providing any specific action, commitment, or stance.
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Department for Science, Innovation and Technology
Department of Health and Social Care
67
Recommendation
Sixth Report - Coronavirus: lessons lea…
Not Addressed
The resourcing and capabilities of the Civil Contingencies Secretariat should be improved. The Civil Contingencies Secretariat should be empowered to ‘stress test’ plans and to ensure that Departments are able to carry out a contingency plan if required. The details and results of these stress tests should be included in …
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The resourcing and capabilities of the Civil Contingencies Secretariat should be improved. The Civil Contingencies Secretariat should be empowered to ‘stress test’ plans and to ensure that Departments are able to carry out a contingency plan if required. The details and results of these stress tests should be included in the Cabinet Office’s annual report.
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Government response AI summary
The government's response provides a generic statement about establishing and testing arrangements for data flows and dispute resolution during an emergency, failing to address the specific recommendations to improve CCS resourcing, empower stress testing, or include results in annual reports.
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Department for Science, Innovation and Technology
Department of Health and Social Care
77
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
The initial UK policy was to take a gradual and incremental approach to introducing non-pharmaceutical interventions. A comprehensive lockdown was not ordered until 23 March 2020—two months after SAGE first met to consider the national response to covid- 19.99 This slow and gradualist approach was not inadvertent, nor did it …
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The initial UK policy was to take a gradual and incremental approach to introducing non-pharmaceutical interventions. A comprehensive lockdown was not ordered until 23 March 2020—two months after SAGE first met to consider the national response to covid- 19.99 This slow and gradualist approach was not inadvertent, nor did it reflect bureaucratic delay or disagreement between Ministers and their advisers. It was a deliberate policy— proposed by official scientific advisers and adopted by the Governments of all of the nations of the United Kingdom.100 It is now clear that this was the wrong policy, and that it led to a higher initial death toll than would have resulted from a more emphatic early policy. In a pandemic spreading rapidly and exponentially every week counted. The former SAGE participant Professor Neil Ferguson told the Science and Technology Committee that if the national lockdown had been instituted even a week earlier “we would have reduced the final death toll by at least a half”.101
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Government response AI summary
The government claims to partially accept an unspecified recommendation, but its response describes measures to improve scientific challenge and international learning related to the NSRA process, failing to address the committee's conclusion about the initial slow lockdown policy.
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Department for Science, Innovation and Technology
Department of Health and Social Care
97
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
The UK’s structure of scientific advice in emergencies, in which a group is formed of relevant experts (SAGE) to advise the Government is a prominent feature of our arrangements—much more so than in many other countries. Initially, participation in SAGE was not disclosed, nor the papers on which its advice …
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The UK’s structure of scientific advice in emergencies, in which a group is formed of relevant experts (SAGE) to advise the Government is a prominent feature of our arrangements—much more so than in many other countries. Initially, participation in SAGE was not disclosed, nor the papers on which its advice drew, nor the minutes of its meetings. Following pressure, including from the House of Commons Science and Technology Committee, and supported by the Government Chief Scientific Adviser Sir Patrick Vallance,142 details of papers considered by SAGE were published from 20 March 2020; the individuals participating in SAGE were published from 4 May 2020; and minutes from 29 May 2020.143 Publication revealed that SAGE comprised a large number of scientific experts of high standing—over 85 individuals are listed as having participated in SAGE since its first meeting during the pandemic.144
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Government response AI summary
The government states it 'partially accepts this recommendation' but the item is a conclusion, not a recommendation. The response discusses learning from other countries and the NSRA process, but does not address the descriptive content of conclusion #97.
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Department for Science, Innovation and Technology
Department of Health and Social Care
99
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
We accept that it is difficult for Ministers to go against a scientific consensus among the body set up to provide scientific advice during a national emergency. We also understand the reluctance to introduce measures with significant negative economic impact. But the 141 Imperial College London, ‘COVID-19 transmission chains in …
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We accept that it is difficult for Ministers to go against a scientific consensus among the body set up to provide scientific advice during a national emergency. We also understand the reluctance to introduce measures with significant negative economic impact. But the 141 Imperial College London, ‘COVID-19 transmission chains in the UK traced back to Spain, France and Italy’, accessed 17 September 2021 142 Rt Hon Greg Clark MP, Chair, Science and Technology Committee (Qq75–76); Correspondence from the Chair to Sir Patrick Vallance, Chief Scientific Adviser, relating to SAGE Membership, 30 March 2020; and correspondence from Sir Patrick Vallance, Chief Scientific Adviser, relating to transparency of scientific evidence: social distancing, 28 May 2020 143 Science and Technology Committee, First Report of Session 2019–21, The UK response to covid-19: use of scientific advice, HC 136, paragraphs 55 and 71–72 144 GOV.UK, ‘List of participants of SAGE and related sub-groups’, accessed 17 August 2021 145 Oral evidence taken before the Science and Technology Committee on 25 March 2020, HC (2019–21) 136, Q81 Coronavirus: lessons learned to date 41 early weeks of the pandemic expose deficiencies in both scientific advice and Government action. In the early days of an emergency, formulating the best scientific advice is challenging: there are, for example, inevitable lags in acquiring and analysing data. Other countries took early decisions that were more seen as those of Government leaders rather than from established scientific evidence146 and it is possible that this provided a greater licence to take decisions more quickly, and on a more precautionary basis than happened in the UK—contributing to better overall outcomes. Was there sufficient challenge to scientific advice during the first weeks?
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Government response AI summary
The government response merely repeats the committee's conclusion without offering any government stance, commitment, or specific action in response.
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Department for Science, Innovation and Technology
Department of Health and Social Care
101
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
The then Secretary of State, Matt Hancock MP, made the same point regarding the difficulty of challenging a scientific consensus.148 On 28 January 2020, SAGE said that testing asymptomatic individuals would “not be useful”.149 However, at the same meeting, SAGE went on to say that there was “limited evidence of …
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The then Secretary of State, Matt Hancock MP, made the same point regarding the difficulty of challenging a scientific consensus.148 On 28 January 2020, SAGE said that testing asymptomatic individuals would “not be useful”.149 However, at the same meeting, SAGE went on to say that there was “limited evidence of asymptomatic transmission, but early indications imply some is occurring.”150 Matt Hancock told us that he thought asymptomatic transmission was occurring, but he found it difficult to challenge the scientific consensus: I was in a situation of not having hard evidence that a global scientific consensus of decades was wrong but having an instinct that it was. I bitterly regret that I did not overrule that scientific advice at the start and say that we should proceed on the basis that there is asymptomatic transmission until we know there is not, rather than the other way round. But when you are faced with a global consensus, and you do not have the evidence that you are right and the scientific consensus is wrong, it is hard to do that.151 146 For example, see “Coronavirus cases have dropped sharply in South Korea. What’s the secret to its success?”, 17 March 2020; and comments by Prof Balloux and Dr Groppelli, 10 March 2020 147 Q1008 148 Q1302 149 GOV.UK, SAGE 2, paragraph 16, 28 January 2020 150 GOV.UK, SAGE 2, paragraph 16, 28 January 2020 151 Q1302 42 Coronavirus: lessons learned to date We also note that Nobel Laureates Sir Paul Nurse and Sir Peter Ratcliffe wrote to the then Secretary of State to warn about asymptomatic transmission and the need for testing in April 2020. However, they did not receive a substantive response until July and only then from a correspondence clerk rather than the then Secretary of State.152 We continue to await a response from the Department on why action was not taken on asymptomatic transmission and testing earlier.153
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Government response AI summary
The government response outlines a future approach of greater questioning and challenge in policy development and scientific advice, but does not address the committee's specific query regarding why action was not taken earlier on asymptomatic transmission and testing.
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Department for Science, Innovation and Technology
Department of Health and Social Care
110
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
It transpired that the UK public were very compliant with the eventual lockdown measures.175 Professor Chris Whitty also said in November 2020: Across the board, my reflection is that the great majority of people—and this is reflected in all the polling and a variety of other things—both intend to stick …
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It transpired that the UK public were very compliant with the eventual lockdown measures.175 Professor Chris Whitty also said in November 2020: Across the board, my reflection is that the great majority of people—and this is reflected in all the polling and a variety of other things—both intend to stick to the rules and do stick to the rules to a remarkable degree. To go back to Patrick’s point, were that not the case, we would be in a massively worse place than we are at the moment. My expectation is that R would have shot right up if people had not massively reduced the number of people they have contact with, had not stuck to all the things we need to do in individual actions they can take—such as hands, face and space—and businesses had not done a huge amount to try to make them Covid secure. Without that, we would be in a very difficult place compared with where we are now.176
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Government response AI summary
The government's response does not address the committee's conclusion about the public's high compliance with lockdown measures, instead discussing the need for greater questioning and challenge in future policy development.
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Department for Science, Innovation and Technology
Department of Health and Social Care
130
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
The circumstances of the lockdown announced on 31 October were controversial. A Downing Street press conference had been hastily convened on the Saturday evening following leak to newspapers of the Government’s likely intention to bring in a further lockdown.
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The circumstances of the lockdown announced on 31 October were controversial. A Downing Street press conference had been hastily convened on the Saturday evening following leak to newspapers of the Government’s likely intention to bring in a further lockdown.
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Government response AI summary
The government's response, identical to another, focuses on learning from other countries and improvements to the National Security Risk Assessment (NSRA), which does not directly address the committee's conclusion regarding the controversial circumstances and leaks surrounding the October 31 lockdown.
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Department for Science, Innovation and Technology
Department of Health and Social Care
133
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
Whilst it is clear the first lockdown was called too late, it is not however possible to make such a clear cut judgement about the second lockdown from 31 October for two reasons. First, since the advice was taken and lockdown measures were introduced, the counterfactual—what would have happened to …
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Whilst it is clear the first lockdown was called too late, it is not however possible to make such a clear cut judgement about the second lockdown from 31 October for two reasons. First, since the advice was taken and lockdown measures were introduced, the counterfactual—what would have happened to infections, hospital admissions and deaths if the second lockdown had not been instigated—is unknowable. The second reason is that unknown to advisers at the time, a new variant of covid (B.1.1.7) which came to be described first as the Kent variant and later as the Alpha variant, was already transmitting within the population. We were eventually to learn that this variant was significantly more transmissible than the initial strain of covid-19.
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Government response AI summary
The government's response, despite stating "partially accepts," discusses learning from international engagement and reviewing the NSRA methodology, which is unrelated to the committee's conclusion about the unknowability of the second lockdown's impact.
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Department for Science, Innovation and Technology
Department of Health and Social Care
134
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
Following genomic sequencing, PHE found that the Alpha variant first appeared in Kent in September 2020 and rapidly became the dominant variant in Kent, and subsequently, the rest of England.207 The new variant was first brought to the attention of the Government on 11 December 2020.208 On 18 December, the …
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Following genomic sequencing, PHE found that the Alpha variant first appeared in Kent in September 2020 and rapidly became the dominant variant in Kent, and subsequently, the rest of England.207 The new variant was first brought to the attention of the Government on 11 December 2020.208 On 18 December, the Government was warned that the variant was significantly more transmissible than the initial strain of covid-19.209 The eventual knowledge of this new variant and its heightened transmissibility explained what had been observed earlier: that North Kent and neighbouring areas were experiencing unaccountably high and persistent levels of covid infections during the late autumn. For example, on 30 November 2020, the rate of confirmed covid-19 cases in Swale, in North Kent, was 568 per 100,000 population—over three times as high as the UK rate of 154 per 100,000.210
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Government response AI summary
Despite stating 'partially accepts,' the government's response discusses its commitment to learning from international practice and details the methodology review of the National Risk Assessment (NSRA) process, without directly addressing the committee's observation regarding the emergence and impact of the Alpha variant.
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Department for Science, Innovation and Technology
Department of Health and Social Care
135
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
Leading virologists who gave evidence to the Science and Technology Committee on 23 December said that the Government had acted quickly in response to the new evidence. For example, Professor Peter Horby, Chair of the New and Emerging Respiratory Virus 206 Oral evidence taken before the Science and Technology Committee …
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Leading virologists who gave evidence to the Science and Technology Committee on 23 December said that the Government had acted quickly in response to the new evidence. For example, Professor Peter Horby, Chair of the New and Emerging Respiratory Virus 206 Oral evidence taken before the Science and Technology Committee on 3 November 2020, HC (2019–21) 136, Qq1443–1445 207 GOV.UK, ‘COVID-19 (SARS-CoV-2): information about the new virus variant’, accessed 17 September 2021 208 Susan Hopkins, Strategic Response Director, COVID-19, PHE, explained in a media interview on 20 December that the Government was first notified of the new variant on 11 December: @RidgeonSunday Twitter, 20 December 2020, 12.53pm 209 Following work by modellers and academics, Dr Susan Hopkins explained to The Andrew Marr Show on 20 December that, a difference in transmissibility and infectiousness was identified and the Government was notified of this on 18 December and “immediately started to take action”: BBC One, ‘Professor Susan Hopkins on the new coronavirus variant’, accessed 17 August 2021. 210 GOV.UK, ‘Coronavirus (COVID-19) in the UK’, web archive, accessed 17 August 2021 Coronavirus: lessons learned to date 53 Threats Advisory Group (NERVTAG),211 gave a positive assessment of the timeliness of Government action on the new variant: “We sent our first note to them raising a significant concern on the 18th, and on the 19th measures were put in place.”.212 The Government moved to cancel most of the previously announced relaxations of restrictions at Christmas, and thereafter introducing a third national lockdown from 6 January 2021.213
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Government response AI summary
The government states it partially accepts 'this recommendation' and outlines its commitment to learning from other countries and disciplines, improving the NSRA process, and sharing international best practice for emergency preparedness, without directly addressing the committee's positive observation about swift past action.
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Department for Science, Innovation and Technology
Department of Health and Social Care
136
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
The second wave of the pandemic was more numerous in terms of hospital admissions and deaths than the first wave. It peaked on 8 January 2021 with 68,053 new infections per day reported in the UK,214 and on 20 January with 1,820 deaths.215 This wave was dominated by the Alpha …
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The second wave of the pandemic was more numerous in terms of hospital admissions and deaths than the first wave. It peaked on 8 January 2021 with 68,053 new infections per day reported in the UK,214 and on 20 January with 1,820 deaths.215 This wave was dominated by the Alpha variant. The Alpha variant was dominant at the time of the peak infections and deaths, and had represented over 50% of UK covid infections from 4 January 2021.216 Of the total deaths during second wave,217 56.9% took place after the Alpha variant was the dominant form.
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Government response AI summary
The government's response 'partially accepts' a non-recommendation and provides a general statement about learning from other countries and reviewing the National Security Risk Assessment methodology, without addressing the committee's factual observations about the scale or characteristics of the pandemic's second wave.
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Department for Science, Innovation and Technology
Department of Health and Social Care
138
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
But these decisions were taken before the existence of the Alpha variant was known. So the justification for an earlier lockdown is greatly influenced by information that was not available at the time. It serves to illustrate that, in a pandemic whose course is unknown, some decisions will be taken …
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But these decisions were taken before the existence of the Alpha variant was known. So the justification for an earlier lockdown is greatly influenced by information that was not available at the time. It serves to illustrate that, in a pandemic whose course is unknown, some decisions will be taken which turn out to have been wrong, but which it was not possible to know at the time. Public health messaging and communication
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Government response AI summary
Despite stating 'partially accepts,' the government's response discusses its commitment to learning from international practice and details the methodology review of the National Risk Assessment (NSRA) process, without directly addressing the committee's observation about decisions being made with incomplete information during the pandemic.
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Department for Science, Innovation and Technology
Department of Health and Social Care
145
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
Written evidence to our inquiry suggested that the loss of consistency across the four nations led to confusion, with “messages from numerous national bodies that, at times, appeared to contradict each other”.229 We heard that at this stage, these contradicting messages began to cause confusion. Professor Devi Sridhar, speaking to …
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Written evidence to our inquiry suggested that the loss of consistency across the four nations led to confusion, with “messages from numerous national bodies that, at times, appeared to contradict each other”.229 We heard that at this stage, these contradicting messages began to cause confusion. Professor Devi Sridhar, speaking to the Health and Social Care Committee in July 2020, explicitly linked this confusion to infection rates: One point where you can see that England and Scotland diverged was when England changed in May to: “Stay alert.” Many people did not fully understand what that meant. In Scotland, the message was very clear: “Stay at home.” When we started to see divergence in infection rates and death rates, it was around that time.230
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Government response AI summary
The government acknowledges the importance of public health communications but asserts its own early pandemic messaging was strong and effective, without addressing the committee's conclusion about inconsistent messaging causing public confusion.
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Department for Science, Innovation and Technology
Department of Health and Social Care
146
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
The three-tier approach to local lockdown restrictions in England (see paragraph 117) introduced more complexity to Government messaging which was, understandably different in different parts of the country.231 It was therefore unsurprising that this more differentiated messaging strategy meant that levels of public understanding and compliance began to deteriorate. Written …
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The three-tier approach to local lockdown restrictions in England (see paragraph 117) introduced more complexity to Government messaging which was, understandably different in different parts of the country.231 It was therefore unsurprising that this more differentiated messaging strategy meant that levels of public understanding and compliance began to deteriorate. Written evidence submitted by UCL showed much poorer comprehension of the rules than at the beginning of the pandemic. By October, fewer than half of the over 70,000 adults who took part in the survey reported broad understanding of the rules (45%), with just 14% understanding them ‘very much’. Self- reported compliance was consequently also much lower, with just over 40% reporting ‘complete compliance’ with guidelines, compared to 70% earlier in the pandemic.232
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Government response AI summary
The government acknowledges the importance of public health communications and the effectiveness of early messaging but does not address the committee's point about the deterioration of understanding due to messaging complexity.
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Department for Science, Innovation and Technology
Department of Health and Social Care
148
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
Lower levels of public trust and understanding of the regulations also created a gap into which misinformation was able to spread. Research conducted by Ofcom in the first six weeks of the pandemic found that 47% of respondents said they had come across false or misleading information about covid-19 in …
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Lower levels of public trust and understanding of the regulations also created a gap into which misinformation was able to spread. Research conducted by Ofcom in the first six weeks of the pandemic found that 47% of respondents said they had come across false or misleading information about covid-19 in the last week. Most commonly, respondents indicated that the misinformation they encountered was linked to “theories linking the origins or causes of covid-19 to 5G technology”.236 More recently, a study conducted by King’s College London in November 2020 found that 14% of respondents “believe the real purpose of a mass vaccination programme against coronavirus is simply to track and control the population”.237 Susceptibility to covid-19 misinformation has many causes, but research has found that lower levels of trust in both scientists and Government are associated with increased susceptibility to misinformation.238 This highlights the critical importance of a communications strategy which is clear, consistent and perceived as transparent by the public. Outcomes
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Government response AI summary
The government acknowledges the importance of public health communications but primarily responds by stating that its messaging early in the pandemic was strong, effective, and contributed to public understanding and compliance, without committing to specific future actions based on the report's highlighted critical importance.
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Department for Science, Innovation and Technology
Department of Health and Social Care
149
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
The covid pandemic is a global emergency that is not yet over. While the UK’s trajectory may have changed in recent months with vaccines, the vast majority of the world is still grappling with the disease. It would be prudent to reserve judgement on the UK’s performance until the pandemic …
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The covid pandemic is a global emergency that is not yet over. While the UK’s trajectory may have changed in recent months with vaccines, the vast majority of the world is still grappling with the disease. It would be prudent to reserve judgement on the UK’s performance until the pandemic is over across the world. When that time comes, we will be able to more accurately and fairly judge the UK’s performance against the rest of the world.
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Government response AI summary
The government's response, identical to others, focuses on learning from other countries and improving the National Security Risk Assessment (NSRA), which does not address the committee's conclusion about reserving judgment on the UK's pandemic performance until the global emergency has passed.
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Department for Science, Innovation and Technology
Department of Health and Social Care
150
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
One of the key ways to measure a country’s success in fighting covid-19 is to measure deaths from covid-19. However, countries across the world measure deaths in different ways. The UK has reported covid deaths as those who died within 28 days of a positive test. The UK also offers …
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One of the key ways to measure a country’s success in fighting covid-19 is to measure deaths from covid-19. However, countries across the world measure deaths in different ways. The UK has reported covid deaths as those who died within 28 days of a positive test. The UK also offers statistics on daily deaths with covid-19 on the death certificate. The US Centres for Disease Control includes both confirmed and probable cases and deaths.239 The historian, Professor Niall Ferguson, told the House of Commons Foreign Affairs Committee: I actually think there is a better way of looking at this, which is to look at excess mortality. We don’t have excess mortality data for all the countries in the world, but if you look at the ones for which we do have data, the UK and the US are firmly in the middle of the table, with 17% or 18% excess mortality, close to Belgium, close to Italy, close to Spain. 235 Q1115 236 Ofcom, ‘covid-19 news and information: consumption and attitudes- previous results’, accessed 17 September 2021 237 Kings College London, Coronavirus: vaccine misinformation and the role of social media, December 2020 238 See, for example: The Royal Society, Susceptibility to misinformation about COVID-19 around the world, October 2020; The Royal Society, COVID-19 vaccine deployment: Behaviour, ethics, misinformation and policy strategies, October 2020 239 CDC, ‘United States COVID-19 Cases and Deaths by State over Time’, accessed 17 September 2021 Coronavirus: lessons learned to date 57 Some countries in Europe did slightly better—France, Sweden, Switzerland— but there are a great many countries that did a good deal worse. I won’t recap the countries you are expecting to hear—once again, it is Latin American and east European countries that have the worst excess mortality. Of course, some countries in Europe have done significantly better, to the point, in the case of Denmark, of having no excess mortality, or virtually none in Norway. I think this is probably the be
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Government response AI summary
The government's response is phrased as a recommendation that the government, via the WHO, should advocate for international standards for reporting COVID-19 and future pandemic deaths, thus not addressing the committee's observation directly.
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Department for Science, Innovation and Technology
Department of Health and Social Care
151
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
There are also other factors to be considered. Each country has a unique set of characteristics which might have contributed to its health related covid-19 outcomes. For example, the UK has the tenth-highest rate of obesity in the world,241 which is linked to an increased risk of adverse outcomes.242 Conclusions …
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There are also other factors to be considered. Each country has a unique set of characteristics which might have contributed to its health related covid-19 outcomes. For example, the UK has the tenth-highest rate of obesity in the world,241 which is linked to an increased risk of adverse outcomes.242 Conclusions and recommendations Conclusions
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Government response AI summary
The government response focuses on the 'Build Back Better' plan for social care and its funding, and does not address the committee's conclusion about obesity and other country-specific factors influencing COVID-19 outcomes.
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Department for Science, Innovation and Technology
Department of Health and Social Care
152
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
During the first three months of the covid pandemic, the UK followed the wrong policy in its use of non-pharmaceutical interventions. When the UK moved from the ‘contain’ to ‘delay’ stage, there was a policy of seeking to only moderate the speed of infection through the population—flattening the curve—rather than …
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During the first three months of the covid pandemic, the UK followed the wrong policy in its use of non-pharmaceutical interventions. When the UK moved from the ‘contain’ to ‘delay’ stage, there was a policy of seeking to only moderate the speed of infection through the population—flattening the curve—rather than seeking to arrest its spread. The policy was pursued until 23 March because of the official scientific advice the Government received, not in spite of it. Questions remain about whether the containment phase was pursued aggressively enough—we believe it could have been pursued for longer. During this period Government policy did not deviate from the scientific advice it received in any material respect. The fact that the UK approach reflected a consensus between official scientific advisers and the Government indicates a degree of groupthink that was present at the time which meant we were not as open to approaches being taken elsewhere—such as earlier lockdowns, border controls and effective test and trace—as we should have been.
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Government response AI summary
The government generically stated that its decision-making was informed by science and evidence, and it took quick and decisive action, without directly addressing the committee's specific criticisms of past policy errors and 'groupthink'.
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Department for Science, Innovation and Technology
Department of Health and Social Care
154
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
There are several possible explanations for what was a significant error in policy and advice early in the pandemic. These include: • the lack of adequate data on the spread of covid-19, as a result of the inadequacy of the UK testing operation; • overreliance on specific mathematical models when …
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There are several possible explanations for what was a significant error in policy and advice early in the pandemic. These include: • the lack of adequate data on the spread of covid-19, as a result of the inadequacy of the UK testing operation; • overreliance on specific mathematical models when there were too many uncertainties; • assumptions about public compliance with rules that turned out to have underestimated the willingness to conform even for long periods; • the composition of SAGE suffered from a lack of representation from outside the United Kingdom; and • a preference for a particular UK approach may have been favoured above advice based on emulation of what was being pursued elsewhere.
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Government response AI summary
The government's response provides boilerplate text stating that decision-making was informed by science and evidence, and quick action was taken, but it does not address the committee's specific conclusions regarding errors in policy, advice, or listed inadequacies.
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Department for Science, Innovation and Technology
Department of Health and Social Care
156
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
The second wave of covid infections, hospitalisations and deaths during the autumn and winter of 2020/21 was significantly driven by the emergence of a new variant, known as the Kent or Alpha variant. It is likely that a “circuit break” of temporary lockdown measures if introduced in September 2020, and …
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The second wave of covid infections, hospitalisations and deaths during the autumn and winter of 2020/21 was significantly driven by the emergence of a new variant, known as the Kent or Alpha variant. It is likely that a “circuit break” of temporary lockdown measures if introduced in September 2020, and earlier lockdown measures during the winter, could have impeded the rapid seeding and spread of the Kent variant. However, the existence of the Kent or Alpha variant was not known by the Government until 11 December 2020 so that the justification for taking earlier measures could not rely on information available at the time.
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Government response AI summary
The government provides a general statement that its decisions were informed by science and that it took quick action, but does not specifically address the committee's conclusion about the impact of the Kent variant or the timing of potential "circuit break" measures.
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Department for Science, Innovation and Technology
Department of Health and Social Care
158
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
In the early days of a crisis, scientific advice may be necessarily uncertain: data may be unavailable, knowledge limited and time may be required for analysis to be conducted. In these circumstances it may be appropriate to act quickly, on a precautionary basis, rather than wait for more scientific certainty.
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In the early days of a crisis, scientific advice may be necessarily uncertain: data may be unavailable, knowledge limited and time may be required for analysis to be conducted. In these circumstances it may be appropriate to act quickly, on a precautionary basis, rather than wait for more scientific certainty.
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Government response AI summary
The government response exactly repeats the committee's conclusion about acting quickly on a precautionary basis during a crisis without providing any specific action or acknowledging its implications.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
159
Recommendation
Sixth Report - Coronavirus: lessons lea…
Not Addressed
In future an approach of greater questioning and challenge should characterise the development of policy. Ministers should have the confidence to follow a scientific approach themselves—being prepared to take a more robust approach to questioning and challenging the advice given. The Government and SAGE should also facilitate strong external and …
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In future an approach of greater questioning and challenge should characterise the development of policy. Ministers should have the confidence to follow a scientific approach themselves—being prepared to take a more robust approach to questioning and challenging the advice given. The Government and SAGE should also facilitate strong external and structured challenge to scientific advice, including from experts in countries around the world, and a wider range of disciplines.
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Government response AI summary
The government's response is an exact copy of the committee's recommendation and provides no actual stance or commitment to action.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
160
Recommendation
Sixth Report - Coronavirus: lessons lea…
Not Addressed
In bringing together many of the UK’s most accomplished scientists, SAGE became a very UK body. In future, it should include more representation and a wider range of disciplines, from other countries, especially those which have experienced, or are experiencing, the same emergency.
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In bringing together many of the UK’s most accomplished scientists, SAGE became a very UK body. In future, it should include more representation and a wider range of disciplines, from other countries, especially those which have experienced, or are experiencing, the same emergency.
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Government response AI summary
The government's response is an exact copy of the committee's recommendation and provides no actual stance or commitment to action.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
161
Recommendation
Sixth Report - Coronavirus: lessons lea…
Not Addressed
In a pandemic, the scientific advice from the SAGE co-chairs to the Government should be published within 24 hours of it being given, or the policy being decided, whichever is the later, to ensure the opportunity for rapid scientific challenge and guard against the risk of ‘groupthink’. In addition, minutes …
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In a pandemic, the scientific advice from the SAGE co-chairs to the Government should be published within 24 hours of it being given, or the policy being decided, whichever is the later, to ensure the opportunity for rapid scientific challenge and guard against the risk of ‘groupthink’. In addition, minutes and SAGE papers should be published within 48 hours of the meeting taking place.
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Government response AI summary
The government's response is a direct copy of the recommendation, not providing its own stance or committing to any specific action regarding the publication timelines for SAGE advice, minutes, and papers.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
162
Recommendation
Sixth Report - Coronavirus: lessons lea…
Not Addressed
The Government, via the World Health Organisation, should make the case for an international standard of reporting covid-19 deaths and a framework for reporting disease related deaths for future pandemics. 60 Coronavirus: lessons learned to date 4 Testing and contact tracing
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The Government, via the World Health Organisation, should make the case for an international standard of reporting covid-19 deaths and a framework for reporting disease related deaths for future pandemics. 60 Coronavirus: lessons learned to date 4 Testing and contact tracing
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Government response AI summary
The government's response is a direct copy of the recommendation, not providing its own stance or committing to any specific action to pursue an international standard for reporting COVID-19 deaths and future pandemic-related deaths.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
166
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
During the early days of the pandemic, the Government believed—and told the public—that testing for covid-19 was a field in which the UK had a leading position. This assessment was shared, and possibly arose out of, the views of scientific advisers. The minutes of the very first SAGE meeting on …
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During the early days of the pandemic, the Government believed—and told the public—that testing for covid-19 was a field in which the UK had a leading position. This assessment was shared, and possibly arose out of, the views of scientific advisers. The minutes of the very first SAGE meeting on covid-19 on 22 January 2020 stated: 243 On 2 April 2020, when the Government announced its new 5-pillar testing strategy, 4,522 Covid-19 cases were recorded. 244 GOV.UK, ‘Coronavirus in the UK: Testing’; European Centre for Disease Prevention and Control, ‘Data on testing for COVID-19 by week and country’. Coronavirus: lessons learned to date 61 The UK currently has good centralised diagnostic capacity for WN-CoV [covid-19]–and is days away from a specific test, which is scalable across the UK in weeks.245 The following day, on 23 January 2020, the then Secretary of State for Health and Social Care told the House that the UK is “one of the first countries to have developed a world-leading test for the new coronavirus.”246 When the Prime Minister claimed to have “growing confidence that we will have a test, track and trace operation that will be world-beating,” it may be that this early lead was what he had in mind.247 However, it rapidly became apparent that the scientific expertise in identifying the virus and the ability to deploy that operationally were very different. Public Health England was initially responsible for managing covid-19 testing as well as the scientific development of a test for covid-19, but it is in the former that its deficiencies were exposed.
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Government response AI summary
The government states it will build on the pandemic's legacy for test, trace, and isolate by ensuring resilient infrastructure and collaboration with local authorities, but does not address the committee's conclusion about past deficiencies in translating scientific leadership into operational testing success.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
169
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
However, throughout the pandemic, our Committees have taken a great interest in what might be learned and applied from how other countries tackled the virus. In March 2020, the World Health Organisation recommended that nations “plan for surge capacity by establishing decentralized testing capacity in sub-national laboratories”.252 Dr Seon Kui …
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However, throughout the pandemic, our Committees have taken a great interest in what might be learned and applied from how other countries tackled the virus. In March 2020, the World Health Organisation recommended that nations “plan for surge capacity by establishing decentralized testing capacity in sub-national laboratories”.252 Dr Seon Kui Erica Lee, of the Korea Centers for Disease Control and Prevention, told the Science and Technology Committee in April 2020 that testing capacity in the Republic of Korea had expanded rapidly because of lessons learned from the 2015 MERS outbreak.253 Dr 245 GOV.UK, SAGE 1, 22 January 2020 246 HC oral statement, 23 January 2020, Vol 670 [Commons Chamber] 247 HC oral questions, 20 May 2020, Vol 676 [Commons Chamber] 248 GOV.UK, SAGE 2, 28 January 2020 249 See, for example: oral evidence taken before the Health and Social Care Committee on 19 May 2020, HC (2019– 21) 36 and oral evidence taken before the Science and Technology Committee on 16 April 2020, HC (2019–21) 136 250 Department of Health and Social Care, via Twitter, 11 March 2020 251 Q343 252 World Health Organisation, ‘Laboratory testing strategy recommendations for COVID-19: interim guidance: 23 March 2020’, accessed 17 September 2021 253 Oral evidence taken before the Science and Technology Committee on 8 April 2020, HC (2019–21) 136, Q145 62 Coronavirus: lessons learned to date Max Roser also explained to us that “by mid-March [2020], Germany was testing 50,000 people per day”, whilst the UK was “very late” and reached the same capacity one and a half months later.254
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Government response AI summary
The government states it will build on the pandemic's legacy for test, trace, and isolate by ensuring resilient infrastructure and collaboration with local authorities, but does not address the committee's conclusion about learning from other countries regarding decentralized testing capacity.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
170
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
In evidence to the Science and Technology Committee on 25 March 2020 Public Health England claimed to have formally studied, but rejected, the South Korean approach.255 Despite repeated requests by the Committee no evidence of such an evaluation has ever been produced. We must conclude that no formal evaluation took …
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In evidence to the Science and Technology Committee on 25 March 2020 Public Health England claimed to have formally studied, but rejected, the South Korean approach.255 Despite repeated requests by the Committee no evidence of such an evaluation has ever been produced. We must conclude that no formal evaluation took place which amounts to an extraordinary and negligent omission given Korea’s success in containing the pandemic which was well-publicised at the time.
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Government response AI summary
The government's response discusses building resilient test, trace, and isolate infrastructure for future pandemics, but it does not address the committee's specific conclusion regarding the negligent omission of formally evaluating the South Korean pandemic response approach.
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Department for Science, Innovation and Technology
Department of Health and Social Care
173
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
The consequences of this initial failure were profound. Testing not only allowed individuals to be identified who had covid-19—and were infectious—but test results for an invisible virus were the only way to be able to accurately monitor the incidence and spread of the virus across the country, and to understand …
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The consequences of this initial failure were profound. Testing not only allowed individuals to be identified who had covid-19—and were infectious—but test results for an invisible virus were the only way to be able to accurately monitor the incidence and spread of the virus across the country, and to understand which groups it affected most and which it affected least.258 The UK was reduced to understanding the spread of covid-19 by waiting for people to be so sick that they needed to be admitted to hospital.
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Government response AI summary
The government's response 'partially accepts' a non-recommendation and provides general information about learning from other countries and reviewing the National Security Risk Assessment methodology, without specifically addressing the committee's conclusion about the failure of initial COVID-19 testing and monitoring.
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Department for Science, Innovation and Technology
Department of Health and Social Care
174
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
For a country with a world-class expertise in data analysis, to face the biggest health crisis in a hundred years with virtually no data to analyse was an almost unimaginable setback. The reasons for this initial inadequacy to translate testing technology into deployable testing capacity are varied. Public Health England …
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For a country with a world-class expertise in data analysis, to face the biggest health crisis in a hundred years with virtually no data to analyse was an almost unimaginable setback. The reasons for this initial inadequacy to translate testing technology into deployable testing capacity are varied. Public Health England seemed to be better at its scientific responsibilities than in its operational response to a mass outbreak of disease and was not clearly instructed to rectify the issue.259 Public Health England reported directly to the Department of Health and Social Care, with only limited operational independence, so the Department too should have been more aware of the issue.
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Government response AI summary
The government partially accepts, but the response details ongoing NSRA methodology review and plans to increase external expert engagement in future risk assessments, failing to directly address the committee's observation about initial data and testing capacity failures.
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Department for Science, Innovation and Technology
Department of Health and Social Care
175
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
We also consider that the Government’s scientific advisers were too passive in accepting assurances that the clinical operational capacity of Public Health England could not be changed. Even in March 2020, Professor Neil Ferguson explained that “much 254 Q129 255 Oral evidence taken before the Science and Technology Committee on …
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We also consider that the Government’s scientific advisers were too passive in accepting assurances that the clinical operational capacity of Public Health England could not be changed. Even in March 2020, Professor Neil Ferguson explained that “much 254 Q129 255 Oral evidence taken before the Science and Technology Committee on 25 March 2020, HC (2019–21) 136, Q121 256 Oral evidence taken before the Science and Technology Committee on 21 July 2020, HC (2019–21) 136, Q1176 257 GOV.UK, ‘Everyone in the UK with symptoms now eligible for coronavirus tests’, accessed 17 September 2021 258 Oral evidence taken before the Health and Social Care Committee on 17 March 2020, HC (2019–21) 36, Q78 259 See, for example: Q825, Q1256, Q1264 and Q1280 Coronavirus: lessons learned to date 63 more widespread testing” was required but that SAGE had received “very clear messages from PHE that we would have nowhere near enough testing capacity.”260 It would have been quite possible for SAGE to advise that a significant increase in testing capacity was needed. It may be that continued adherence to the early four-stage flu plan contributed to this absence of effective scientific pressure for more testing capacity.
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Government response AI summary
The government states it 'partially accepts' the recommendation but then discusses the National Security Risk Assessment (NSRA) process, its methodology review, and international learning, without addressing the committee's criticism regarding scientific advisors' passivity on testing capacity.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
176
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
It is clear that there should have been more challenge to Public Health England to increase testing capacity from the outset by Ministers, scientific advisers and the Department of Health and Social Care rather than accepting it as a fait accompli. Consequences of abandoning testing in the community
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It is clear that there should have been more challenge to Public Health England to increase testing capacity from the outset by Ministers, scientific advisers and the Department of Health and Social Care rather than accepting it as a fait accompli. Consequences of abandoning testing in the community
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Government response AI summary
The government states it partially accepts this recommendation, but its response focuses on general future learning, international engagement, and improving expert challenge within the NSRA process, rather than directly addressing the committee's critique of insufficient challenge to PHE on testing capacity.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
178
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
The lack of data resulting from suspending community testing also affected the UK’s understanding of the disease at that critical time. Professor Neil Ferguson explained to the Science and Technology Committee in June 2020 that low testing capacity meant it was difficult to estimate the proportion of imported cases which …
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The lack of data resulting from suspending community testing also affected the UK’s understanding of the disease at that critical time. Professor Neil Ferguson explained to the Science and Technology Committee in June 2020 that low testing capacity meant it was difficult to estimate the proportion of imported cases which had been missed: at the time we had a policy of trying to screen people at borders, and we estimated then that maybe two thirds of imported cases had been missed. What we now know, because the epidemic took off in Italy and Spain before anybody had realised, is that probably 90% of cases imported into this country were missed by those border measures, because we were not checking people. […] Had we had the testing capacity […] screening everybody with symptoms coming in would have given us a much better impression of where infection was coming from.262 260 Oral evidence taken before the Science and Technology Committee on 25 March 2020, HC (2019–21) 136, Q20 261 Q319 and Q323 262 Oral evidence taken before the Science and Technology Committee on 10 June 2020, HC (2019–21) 136, Q870, Q873 64 Coronavirus: lessons learned to date Arguably this lack of data could have contributed to the delay in the critical decision to instigate a nationwide lockdown. As Professor Chris Whitty explained: because we had very limited testing capacity, we did not realise quite how far along the curve we were, because we were having to use people in intensive care and who had sadly died, which is quite a late event. If we had the capacity on testing then that we have now, we would have come to very different conclusions using exactly the same science.263 Professor Whitty suggested that one key lesson was to “build our capacity to do testing […] at scale”, which he described would be “a problem with any pandemic we have in the future”.264 Impact on health and social care
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Government response AI summary
The government's response, identical to previous boilerplate replies, mentions international learning and NSRA review but completely fails to address the committee's conclusion regarding the critical impact of inadequate community testing and data on understanding the disease and informing lockdown decisions.
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Department for Science, Innovation and Technology
Department of Health and Social Care
179
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
Professor Chris Whitty told the Health and Social Care Committee in July 2020 that the lack of testing capacity available at the beginning of the pandemic meant that the Government had to focus resources very closely on the hospital sector, and in particular intensive care units.265 Within hospitals, the prioritisation …
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Professor Chris Whitty told the Health and Social Care Committee in July 2020 that the lack of testing capacity available at the beginning of the pandemic meant that the Government had to focus resources very closely on the hospital sector, and in particular intensive care units.265 Within hospitals, the prioritisation of patients admitted to intensive care meant less testing capacity was available for other patients in hospital, inhibiting the safe provision of non-covid NHS care and increasing the risk of nosocomial infections. The British Infection Association, the professional association for infection specialists, stated that “decisions about who to test and when early in the pandemic almost certainly led to […] nosocomial and [healthcare worker] infections in secondary care.”266 In February, a paper submitted to SAGE by Public Health England and the London School of Hygiene and Tropical Medicine estimated that during the first wave of covid-19 alone, 36,152 people in England contracted covid-19 while in hospital, representing 40.5% of all hospital cases.267
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Government response AI summary
The government partially accepts 'this recommendation' (despite it being a conclusion) and states it agrees on the importance of learning from other countries and improving the National Security Risk Assessment (NSRA) methodology, which does not directly address the conclusion's points on testing capacity failures and …
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
181
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
The Health and Social Care Committee’s Reports on social care and the delivery of core NHS and care services during the pandemic also highlighted the impact of a lack of testing for social care staff in the initial wave of the pandemic. Evidence from across the sector, including from staff …
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The Health and Social Care Committee’s Reports on social care and the delivery of core NHS and care services during the pandemic also highlighted the impact of a lack of testing for social care staff in the initial wave of the pandemic. Evidence from across the sector, including from staff themselves, was unanimous that the lack of provision of regular testing for social care staff had meant that social care staff were more likely to transmit the disease within care homes.269 263 Q825 264 Q825 265 Oral evidence taken before the Health and Social Care Committee on 21 July 2020, HC (2019–21) 36, Q620 266 British Infection Association (CLL0079)) 267 Public Health England, London School of Hygiene & Tropical Medicine, The contribution of nosocomial infections to the first wave, 28 January 2021. 268 See paragraphs 263–267. 269 Health and Social Care Committee, Third Report of Session 2019–21, Social care: funding and workforce, HC 206, paras 44, 45; Health and Social Care Committee, Second Report of Session 2019–21, Delivering core NHS and care services during the pandemic and beyond, HC 320, Paras 91, 92 Coronavirus: lessons learned to date 65 100,000 tests a day target introduced by Secretary of State
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Government response AI summary
The government's response outlines the ‘Build Back Better’ plan for general social care reform and funding, but does not specifically address the conclusion's point about the lack of testing for social care staff during the pandemic.
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Department for Science, Innovation and Technology
Department of Health and Social Care
187
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
However, both our Committees heard that other resources could have been used more effectively in the initial expansion of testing capacity. Professor Sir Chris Ham explained that initially the Government was “very much focused on building capacity in the commercial Lighthouse laboratories” but suggested that this focus was to the …
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However, both our Committees heard that other resources could have been used more effectively in the initial expansion of testing capacity. Professor Sir Chris Ham explained that initially the Government was “very much focused on building capacity in the commercial Lighthouse laboratories” but suggested that this focus was to the detriment of other potential capacity: if more had been done during the summer months […] for example, we could have made greater use of university laboratories and NHS laboratories—we might have been able to add capacity to avoid the bottlenecks that occurred [in September].279 Sir Paul Nurse also made this point, referring to an earlier press release by the Francis Crick Institute, stating: We argued very early on, in March it has to be said, that we should mobilise much more locally. We turned the Crick into a testing facility. We used that terrible metaphor of Dunkirk and little ships, and so on, but we produced a testing facility locally within two weeks that was doing 2,000 tests a day.280 275 Department of Health and Social Care, Coronavirus (COVID-19)—Scaling up our testing programmes, 4 April 2020 276 GOV.UK, ‘Health Secretary launches biggest diagnostic lab network in British history to test for coronavirus: 9 April 2020’, accessed 17 September 2021 277 Oral evidence taken before the Science and Technology Committee on 27 January 2021. HC (2019–21) 136, Q1812 278 Oral evidence taken before the Science and Technology Committee on 27 January 2021. HC (2019–21) 136, Q1812 279 Q338 280 Oral evidence taken before the Health and Social Care Committee on 21 July 2020, HC (19–21) 36, Q589; Francis Crick Institute, Francis Crick Institute and UCLH develop COVID-19 testing service for patients and NHS staff, 2 April 2020 Coronavirus: lessons learned to date 67 Professor Jo Martin, President of the Royal College of Pathologists, suggested that it was not strategically wrong to set up the Lighthouse Laboratory network to process testing on a
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Government response AI summary
The government states it 'partially accepts' the recommendation but then discusses the National Security Risk Assessment (NSRA) process, its methodology review, and international learning, without addressing the committee's findings on the under-utilisation of university and NHS laboratories for testing capacity.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
198
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
Two months earlier, in July 2020, the Government Chief Scientific Adviser, Sir Patrick Vallance, told the Science and Technology Committee that extra testing capacity would be “essential” ahead of schools reopening.306 However, he suggested that the Government did 298 GOV.UK, UK reaches 200,000 coronavirus testing capacity target a day early: …
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Two months earlier, in July 2020, the Government Chief Scientific Adviser, Sir Patrick Vallance, told the Science and Technology Committee that extra testing capacity would be “essential” ahead of schools reopening.306 However, he suggested that the Government did 298 GOV.UK, UK reaches 200,000 coronavirus testing capacity target a day early: 31 May 2020, accessed 17 September 2021 299 National Audit Office, The government’s approach to test and trace in England—interim report, 11 December 2020, page 10 300 Oral evidence taken before the Science and Technology Committee on 17 September 2020, HC (2019–21) 136, Qq1327–1329 301 Oral evidence taken before the Science and Technology Committee on 17 September 2020, HC (2019–21) 136, Qq1314–1326 302 Oral evidence taken before the Science and Technology Committee on 17 September 2020, HC (2019–21) 136, Q1306 303 HC Deb, 20 July 2020, col 1855 [Commons Chamber] 304 Q346 305 National Audit Office, The government’s approach to test and trace in England—interim report, 11 December 2020, page 50 306 Oral evidence taken before the Science and Technology Committee on 16 July 2020, HC (2019–21) 136, Qq1149– 1154 70 Coronavirus: lessons learned to date not have the capacity to meet the potential demand of over 350,000 tests per day, a figure suggested by the Academy of Medical Sciences at the time.307 Nevertheless, Baroness Harding suggested that the level of demand encountered in September was “in none of the modelling” used by NHS Test and Trace to assess capacity.308 She told the Science and Technology Committee that capacity plans had been “based on SAGE modelling for what we should be preparing for in the autumn”, and that it was SAGE’s assessment rather than NHS Test and Trace’s.309 However, she later wrote to the Committee in a follow-up letter to clarify that SAGE had not informed the capacity targets: SAGE has not been responsible for providing modelling analysis on operational testing capacity […] In order to model and for
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Government response AI summary
The government partially accepts 'this recommendation' (despite it being a conclusion) and states it agrees on the importance of learning from other countries and improving the National Security Risk Assessment (NSRA) methodology, which does not directly address the conclusion's points on testing capacity planning and …
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
199
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
Overall, the National Audit Office concluded that NHS Test and Trace “did not plan for a sharp rise in testing demand in early Autumn [2020]” and was therefore “unprepared.”311 Professor Chris Whitty reiterated to both Committees in December 2020 that one key learning was the need to scale up testing …
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Overall, the National Audit Office concluded that NHS Test and Trace “did not plan for a sharp rise in testing demand in early Autumn [2020]” and was therefore “unprepared.”311 Professor Chris Whitty reiterated to both Committees in December 2020 that one key learning was the need to scale up testing capacity, stating that the UK had been “caught out twice now with lack of testing, and three times would be too many”.312 By January 2021 testing capacity had reportedly increased to 800,000 per day and Baroness Harding expressed that she was “very confident” that there was sufficient capacity to handle future potential surges—citing the increased demand over Christmas as an example.313
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Government response AI summary
The government's response was generic, discussing learning from other countries and the National Risk Assessment process, but it did not specifically address the conclusion regarding the inadequate planning for surges in testing demand and the need to scale up testing capacity.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
1
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
The UK has established procedures and structures to prepare for the nation’s major future risks, including a National Risk Register, the Civil Contingencies Secretariat and the Scientific Advisory Group for Emergencies (SAGE). However, the anticipated future risk of pandemic disease focused too closely on influenza rather than diseases like SARS …
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The UK has established procedures and structures to prepare for the nation’s major future risks, including a National Risk Register, the Civil Contingencies Secretariat and the Scientific Advisory Group for Emergencies (SAGE). However, the anticipated future risk of pandemic disease focused too closely on influenza rather than diseases like SARS and MERS that had in recent years appeared in Asian countries.
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Government response AI summary
Despite stating "partially accepts," the government's response is generic, discussing international learning and reviewing the NSRA methodology, without specifically addressing the committee's conclusion that past pandemic preparedness focused too narrowly on influenza over other diseases like SARS and MERS.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
13
Recommendation
Sixth Report - Coronavirus: lessons lea…
Not Addressed
The Government and the NHS should consider establishing a volunteer reserve database so that volunteers who have had appropriate checks can be rapidly called up and deployed in an emergency rather than needing to begin from scratch.
Government response AI summary
The government's response was incomplete, repeating the first part of the recommendation without indicating any specific action or stance on establishing a volunteer reserve database.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
14
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
The experience of the demands placed on the NHS during the covid-19 pandemic should lead to a more explicit, and monitored, surge capacity being part of the long term organisation and funding of the NHS.
Government response AI summary
The government response is a verbatim repetition of the committee's conclusion, indicating no specific action, agreement, or disagreement has been provided.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
16
Recommendation
Sixth Report - Coronavirus: lessons lea…
Not Addressed
Comprehensive analysis should be carried out to assess the safety of running the NHS with the limited latent capacity that it currently has, particularly in Intensive Care Units, critical care units and high dependency units.
Government response AI summary
The government's response merely restates the committee's recommendation to carry out a comprehensive analysis of NHS latent capacity, without providing any specific action, commitment, or stance.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
21
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
Science proceeds through challenge and disputation, and new theories are tested unflinchingly against evidence. Yet Ministers and other advisers reported that they felt it difficult to challenge the views of their official scientific advisers. Those in Government have a duty to question and probe the assumptions behind any scientific advice …
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Science proceeds through challenge and disputation, and new theories are tested unflinchingly against evidence. Yet Ministers and other advisers reported that they felt it difficult to challenge the views of their official scientific advisers. Those in Government have a duty to question and probe the assumptions behind any scientific advice given, particularly in a national emergency, but there is little evidence sufficient challenge took place. However, even when UK policy had changed to bring in a comprehensive national lockdown, the role of non-pharmaceutical interventions against covid-19 was complex, inconsistent and opaque for most of the rest of 2020.
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Government response AI summary
Despite stating 'partially accepts,' the government's response discusses its commitment to learning from international practice and details the methodology review of the National Risk Assessment (NSRA) process, without directly addressing the committee's observation about insufficient challenge to scientific advice or the inconsistent role of non-pharmaceutical …
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
23
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
Government public health communications are key to the public’s understanding of and compliance with non-pharmaceutical interventions. Initial messaging from the Government early in the pandemic was strong, effective and undoubtedly contributed to the success of the first lockdown. After the gradual lifting of the first lockdown from May 2020, Government …
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Government public health communications are key to the public’s understanding of and compliance with non-pharmaceutical interventions. Initial messaging from the Government early in the pandemic was strong, effective and undoubtedly contributed to the success of the first lockdown. After the gradual lifting of the first lockdown from May 2020, Government guidance became increasingly complex and harder to understand, with restrictions varying in different parts of the country. Government communications did not always reflect this nuance, leading to perceived inconsistency and divergent strategies across the four nations of the UK.
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Government response AI summary
The government acknowledges the importance of public health communications and agrees that early pandemic messaging was strong and effective, but it does not address the conclusion's finding that later communications became complex and inconsistent.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
24
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
In the early days of a crisis, scientific advice may be necessarily uncertain: data may be unavailable, knowledge limited and time may be required for analysis to be conducted. In these circumstances it may be appropriate to act quickly, on a precautionary basis, rather than wait for more scientific certainty.
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In the early days of a crisis, scientific advice may be necessarily uncertain: data may be unavailable, knowledge limited and time may be required for analysis to be conducted. In these circumstances it may be appropriate to act quickly, on a precautionary basis, rather than wait for more scientific certainty.
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Government response AI summary
The government response is a verbatim repetition of the committee's conclusion, indicating no specific action, agreement, or disagreement has been provided.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
26
Recommendation
Sixth Report - Coronavirus: lessons lea…
Not Addressed
In bringing together many of the UK’s most accomplished scientists, SAGE became a very UK body. In future, it should include more representation and a wider range of disciplines, from other countries, especially those which have experienced, or are experiencing, the same emergency. (Paragraph 160) 128 Coronavirus: lessons learned to …
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In bringing together many of the UK’s most accomplished scientists, SAGE became a very UK body. In future, it should include more representation and a wider range of disciplines, from other countries, especially those which have experienced, or are experiencing, the same emergency. (Paragraph 160) 128 Coronavirus: lessons learned to date
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Government response AI summary
The government response merely repeats the committee's recommendation verbatim, without offering any specific action, agreement, or disagreement regarding SAGE including wider international representation.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
29
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
Despite being one of the first countries in the world to develop a test for covid in January 2020, the United Kingdom failed to translate that scientific leadership into operational success in establishing an effective test and trace system during the first year of the pandemic. Public Health England showed …
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Despite being one of the first countries in the world to develop a test for covid in January 2020, the United Kingdom failed to translate that scientific leadership into operational success in establishing an effective test and trace system during the first year of the pandemic. Public Health England showed itself to be scientifically accomplished, but poor at delivering an operational testing system at the scale and urgency required by a pandemic.
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Government response AI summary
The government partially accepts 'this recommendation' (despite it being a conclusion) and states it agrees on the importance of learning from other countries and improving the National Security Risk Assessment (NSRA) methodology, which does not directly address the conclusion's points on the UK's failure in …
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Department for Science, Innovation and Technology
Department of Health and Social Care
30
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
Testing capacity was treated too much as a parameter rather than a variable that could be changed by the Department of Health and Social Care and scientific advisers. What was being achieved in other countries, particularly East Asia, appeared to be of little interest in the initial weeks of the …
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Testing capacity was treated too much as a parameter rather than a variable that could be changed by the Department of Health and Social Care and scientific advisers. What was being achieved in other countries, particularly East Asia, appeared to be of little interest in the initial weeks of the pandemic. This was an inexcusable oversight. It took a personal intervention by the then Secretary of State in April 2020 to drive a major increase in testing capacity.
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Government response AI summary
The government's response, despite stating partial acceptance, broadly discusses learning from other countries and the National Security Risk Assessment process. It does not specifically address the committee's conclusion regarding the past failure to treat testing capacity as a variable or the initial disinterest in international …
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Department for Science, Innovation and Technology
Department of Health and Social Care
33
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
Vast sums of taxpayers’ money were directed to Test and Trace, justified by the benefits of avoiding further lockdowns. But ultimately those lockdowns happened. Were it not for the success of the Vaccine Taskforce and the NHS vaccination programme, it is likely that further lockdown restrictions would have been needed …
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Vast sums of taxpayers’ money were directed to Test and Trace, justified by the benefits of avoiding further lockdowns. But ultimately those lockdowns happened. Were it not for the success of the Vaccine Taskforce and the NHS vaccination programme, it is likely that further lockdown restrictions would have been needed in Summer 2021.
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Government response AI summary
The government's response did not address the committee's conclusion regarding the effectiveness and funding of Test and Trace and the subsequent lockdowns. Instead, it discussed learning from international practices and the National Security Risk Assessment (NSRA) methodology.
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Department for Science, Innovation and Technology
Department of Health and Social Care
34
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
We recognise that the effectiveness of test and trace in reducing transmission is likely to be reduced when the prevalence of the virus is high, as highlighted by Professor Whitty and others, but it is clear from the latest data and the experience of September 2020 that even at the …
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We recognise that the effectiveness of test and trace in reducing transmission is likely to be reduced when the prevalence of the virus is high, as highlighted by Professor Whitty and others, but it is clear from the latest data and the experience of September 2020 that even at the level of operational effectiveness, NHS Test and Trace has been unable to respond to rising rates of transmission of covid-19.
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Government response AI summary
The government's response, despite claiming partial acceptance, does not address the conclusion about NHS Test and Trace's inability to respond to rising transmission rates, instead discussing the National Security Risk Assessment process and international learning.
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Department for Science, Innovation and Technology
Department of Health and Social Care
35
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
The Test and Trace organisation has not, despite its branding, been run by the NHS, and has seen senior executives brought in from external bodies for short term contracts which reduces the institutional learning, from what was an intense period, that has been retained. It is a major concern that …
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The Test and Trace organisation has not, despite its branding, been run by the NHS, and has seen senior executives brought in from external bodies for short term contracts which reduces the institutional learning, from what was an intense period, that has been retained. It is a major concern that the new organisation responsible for test and trace is opaque in its structure and organisation.
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Government response AI summary
The government's response does not address the committee's specific concern about the opaque structure and non-NHS operation of the Test and Trace organisation, instead discussing learning from international practice and the National Security Risk Assessment process generally.
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Department for Science, Innovation and Technology
Department of Health and Social Care
36
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
Partly because it was set up too late, NHS Test and Trace ultimately fell short of the expectations set for it. It has failed to make a significant enough impact on the course of the pandemic to justify the level of public investment it received. It clearly failed on its …
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Partly because it was set up too late, NHS Test and Trace ultimately fell short of the expectations set for it. It has failed to make a significant enough impact on the course of the pandemic to justify the level of public investment it received. It clearly failed on its own terms, given its aim in September to “avoid the need for a second lockdown” by contributing to a reduction in the ‘R’ number. While we acknowledge that test, trace and isolate activities are just one—albeit crucial—component of the measures undertaken to tackle covid-19, NHS Test and Trace (NHSTT) clearly failed to achieve this central objective. NHSTT has also consistently failed to reach the 72- hour turnaround time as identified as necessary by SAGE, including a significant failure in September 2020. Further, although the Government first described the impact of NHSTT on reducing ‘R’ in December, it took an unacceptably long two months before the evidence and analysis behind this assertion was made public. When it was published it became clear that the analysis was outdated, invalidating claims made at the time. The use of inaccurate data and the lack of transparency impeded effective public scrutiny at a crucial time in the pandemic.
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Government response AI summary
The government partially accepts, but the response details ongoing NSRA methodology review and plans to increase external expert engagement in future risk assessments, failing to directly address the committee's specific criticisms of NHS Test and Trace's performance and transparency.
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Department for Science, Innovation and Technology
Department of Health and Social Care
37
Conclusion
Sixth Report - Coronavirus: lessons lea…
Not Addressed
The National Audit Office has stated that “to achieve value for money NHST&T must be able to demonstrate both that the interventions it delivers are effective in achieving its objective, and that the mix of interventions is the most cost-effective use of public resources.” After 18 months and many billions …
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The National Audit Office has stated that “to achieve value for money NHST&T must be able to demonstrate both that the interventions it delivers are effective in achieving its objective, and that the mix of interventions is the most cost-effective use of public resources.” After 18 months and many billions of pounds of taxpayers’ funds, there is hope that the UK now has a capacity for testing and tracing that is adequate. It is a bitter irony that this point may only have been reached at the point in which the vaccination programme makes testing less of a critical component than it was previously. (Paragraph 240) 130 Coronavirus: lessons learned to date
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Government response AI summary
The government's response, identical to previous boilerplate replies, discusses international learning and NSRA review but completely fails to address the committee's conclusion about the value for money and effectiveness of the NHST&T programme and its capacity development.
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Department for Science, Innovation and Technology
Department of Health and Social Care
40
Recommendation
Sixth Report - Coronavirus: lessons lea…
Not Addressed
Those responsible for future test and trace programmes should establish a culture and processes to learn rapidly from errors and to act to prevent them being repeated.
Government response AI summary
The government response reiterates the committee's recommendation without providing any specific action, commitment, or stance.
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Department for Science, Innovation and Technology
Department of Health and Social Care
41
Recommendation
Sixth Report - Coronavirus: lessons lea…
Not Addressed
The reactive, short-term horizon of test and trace for much of the pandemic must be replaced by a capacity for anticipation and preparation—even during the course of an emergency.
Government response AI summary
The government's response merely restates the committee's recommendation that the reactive approach of test and trace must be replaced by a capacity for anticipation and preparation, without providing any specific action, commitment, or stance.
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Department for Science, Innovation and Technology
Department of Health and Social Care
42
Recommendation
Sixth Report - Coronavirus: lessons lea…
Not Addressed
The organisation of the bodies responsible for testing and tracing should be open and transparent both about their operations and the basis of their decisions. (Paragraph 245) Social care
Government response AI summary
The government response reiterates the committee's recommendation without providing any specific action, commitment, or stance.
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Department for Science, Innovation and Technology
Department of Health and Social Care
57
Recommendation
Sixth Report - Coronavirus: lessons lea…
Not Addressed
The Government should ensure its ‘levelling up’ agenda includes specific policies to reduce health inequalities, with a particular focus on ensuring that certain groups, including people from Black, Asian and minority ethnic backgrounds, do not continue to face unequal health outcomes.
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The Government should ensure its ‘levelling up’ agenda includes specific policies to reduce health inequalities, with a particular focus on ensuring that certain groups, including people from Black, Asian and minority ethnic backgrounds, do not continue to face unequal health outcomes.
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Government response AI summary
The government response merely reiterates the committee's recommendation verbatim and then shifts to an unrelated recommendation without committing to any specific actions regarding the 'levelling up' agenda and health inequalities.
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Department for Science, Innovation and Technology
Department of Health and Social Care
62
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
Protocols to share data between public bodies involved in the response were too slow to establish and to become functional. This was especially true in the data flows from national to local government.
Government response AI summary
Despite stating 'partially accepts,' the government's response discusses its commitment to learning from international practice and details the methodology review of the National Risk Assessment (NSRA) process, without directly addressing the committee's observation about slow data sharing protocols between national and local government.
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Department for Science, Innovation and Technology
Department of Health and Social Care
68
Recommendation
Third Report - Coronavirus: lessons lea…
Not Addressed
Arrangements should be established and tested to allow immediate flows of data between bodies relevant to an emergency response with a mechanism to resolve immediately and decisively any disputes.
Government response AI summary
The government partially accepts, agreeing on general learning and engagement, but the response focuses on the National Risk Assessment (NSRA) process and international cooperation, without committing to specific arrangements for immediate data flows or dispute resolution mechanisms between emergency response bodies.
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Department for Science, Innovation and Technology
Department of Health and Social Care
69
Recommendation
Third Report - Coronavirus: lessons lea…
Not Addressed
The Armed Forces should have a more central and standing role in preparing for and responding to emergencies like pandemics, given the depth of capability and experience they have in planning, logistics and rapid mobilisation. The Civil Contingencies Secretariat should work with the Armed Forces to improve operational expertise in …
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The Armed Forces should have a more central and standing role in preparing for and responding to emergencies like pandemics, given the depth of capability and experience they have in planning, logistics and rapid mobilisation. The Civil Contingencies Secretariat should work with the Armed Forces to improve operational expertise in emergencies in public bodies. Coronavirus: lessons learned to date 31
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Government response AI summary
The government partially accepts, but the response details ongoing NSRA methodology review and plans to increase external expert engagement in future risk assessments, failing to address the recommendation regarding a more central role for the Armed Forces in emergency response.
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Department for Science, Innovation and Technology
Department of Health and Social Care
70
Recommendation
Third Report - Coronavirus: lessons lea…
Not Addressed
The Government and the NHS should consider establishing a volunteer reserve database so that volunteers who have had appropriate checks can be rapidly called up and deployed in an emergency rather than needing to begin from scratch.
Government response AI summary
The government states it 'partially accepts' the recommendation but then discusses the National Security Risk Assessment (NSRA) process, its methodology review, and international learning, without addressing the call to establish a volunteer reserve database.
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Department for Science, Innovation and Technology
Department of Health and Social Care
71
Recommendation
Third Report - Coronavirus: lessons lea…
Not Addressed
The experience of the demands placed on the NHS during the covid-19 pandemic should lead to a more explicit, and monitored, surge capacity being part of the long term organisation and funding of the NHS.
Government response AI summary
The government's response does not address the recommendation; instead, it merely reproduces the committee's own text, including the original recommendation and other unrelated recommendations from the report.
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Department for Science, Innovation and Technology
Department of Health and Social Care
72
Recommendation
Third Report - Coronavirus: lessons lea…
Not Addressed
The NHS should develop and publish new protocols for infection prevention and control in pandemics covering staffing, bed capacity and physical infrastructure. In developing these protocols the NHS should consider the importance of maintaining access for people accompanying some patients such as advocates for people with learning disabilities and birthing …
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The NHS should develop and publish new protocols for infection prevention and control in pandemics covering staffing, bed capacity and physical infrastructure. In developing these protocols the NHS should consider the importance of maintaining access for people accompanying some patients such as advocates for people with learning disabilities and birthing partners.
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Government response AI summary
The government's response is a verbatim restatement of the committee's recommendation, indicating no actual government response was provided for this item.
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Department for Science, Innovation and Technology
Department of Health and Social Care
79
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
There has been considerable debate as to whether the early policy of the Government was one of seeking to achieve so-called “herd-immunity”. The US Centres for Disease Control and Prevention defines community immunity/herd immunity as: A situation in which a sufficient proportion of a population is immune to an infectious …
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There has been considerable debate as to whether the early policy of the Government was one of seeking to achieve so-called “herd-immunity”. The US Centres for Disease Control and Prevention defines community immunity/herd immunity as: A situation in which a sufficient proportion of a population is immune to an infectious disease (through vaccination and/or prior illness) to make its spread from person to person unlikely. Even individuals not vaccinated (such as newborns and those with chronic illnesses) are offered some protection because the disease has little opportunity to spread within the community. Also known as herd immunity.102
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Government response AI summary
The government's response provides an unrelated statement about the publication of SAGE advice and minutes, failing to address the committee's observation regarding the debate around 'herd immunity'.
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Department for Science, Innovation and Technology
Department of Health and Social Care
80
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
Non-pharmaceutical interventions such as lockdowns, and the testing and isolation of covid cases and their contacts, are tools of temporary application. Once they are lifted, there is nothing to stop transmission resuming. When Sir Patrick Vallance said at a Government press conference on 12 March 2020 “it’s not possible to …
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Non-pharmaceutical interventions such as lockdowns, and the testing and isolation of covid cases and their contacts, are tools of temporary application. Once they are lifted, there is nothing to stop transmission resuming. When Sir Patrick Vallance said at a Government press conference on 12 March 2020 “it’s not possible to stop everybody getting it and it’s also actually not desirable because you want some immunity in the population. We need to have immunity to protect ourselves from this in the future”103 he was, in a sense, merely stating what were thought to be the facts of the time. Sir Patrick, and Ministers, have insisted that this statement was not a policy to seek herd immunity but a description of the situation. Matt Hancock wrote, as Secretary of State, on 14 March 2020: We have a plan, based on the expertise of world-leading scientists. Herd immunity is not a part of it. That is a scientific concept, not a goal or a strategy. Our goal is to protect life from this virus, our strategy is to protect the most vulnerable and protect the NHS through contain, delay, research and mitigate.104
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Government response AI summary
The government's response is entirely unrelated to the committee's conclusion about non-pharmaceutical interventions and past statements on herd immunity, instead making a recommendation about international standards for reporting COVID-19 deaths.
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Department for Science, Innovation and Technology
Department of Health and Social Care
81
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
From our evidence this appears to have led to a policy approach of fatalism about the prospects for covid in the community: seeking to manage, but not suppress, infection. This amounted in practice to accepting that herd immunity by infection was the inevitable outcome, given that the United Kingdom had …
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From our evidence this appears to have led to a policy approach of fatalism about the prospects for covid in the community: seeking to manage, but not suppress, infection. This amounted in practice to accepting that herd immunity by infection was the inevitable outcome, given that the United Kingdom had no firm prospect of a vaccine, limited testing capacity and there was a widespread view that the public would not accept a lockdown for a significant period.105 That said, an initial unwillingness to consider seriously and act on the approach being taken in Taiwan, Singapore or Korea was a serious error. But even without an effective test and trace system earlier, social distancing and locking down would have bought much-needed time: time for vaccine research to bear fruit; time for treatments to be developed that could mean that experiencing covid-19 was less serious; time for test and trace systems to be developed and made effective so that the prevalence of the disease could be lowered without the entire population being restricted. The loss of 102 US Centres for Disease Control and Prevention, ‘glossary’, accessed 17 September 2021 103 10 Downing Street YouTube Channel, ‘UK Prime Minister Boris Johnson holds a press conference on coronavirus: 12 March 2020’, timestamp 10:43, accessed 17 August 2021 104 The Telegraph, We must do everything in our power to protect lives, Matt Hancock, 14 March 2020 105 See paragraphs 108–111 34 Coronavirus: lessons learned to date that time was to prove fatal to many. It would, however, be an overstatement to say that the Government and its advisers were promoting the acquisition of covid-19 to accelerate herd immunity in the population. But, in early Spring 2020, given that no alternative strategy was being implemented, that was the effective consequence. It was principally the threat of the NHS being overwhelmed that forced—belatedly—a change in direction.
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Government response AI summary
The government's response details its commitment to developing greater operational competence in test and trace programs, including ensuring UKHSA and local authorities have capability and funding to establish surge capacity and contact tracing within seven days of an emergency, which does not address the committee's …
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Department for Science, Innovation and Technology
Department of Health and Social Care
82
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
So in the absence of a vaccine or an effective treatment being available at first, the UK faced a choice of doing everything possible to halt the virus, or seeking instead to moderate the pace of its spread. The UK chose the latter.106
Government response AI summary
The government's response outlines future actions regarding international collaboration and culture change but does not address the committee's observation about the UK's initial policy choice to moderate the virus's spread.
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Department for Science, Innovation and Technology
Department of Health and Social Care
83
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
Even as late as 12 March 2020, as noted in paragraph 80, Sir Patrick Vallance, Government Chief Scientific Adviser, told a Government press conference that it was not possible to stop everyone being infected, and nor was that a desirable objective. The following day in a media interview Sir Patrick …
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Even as late as 12 March 2020, as noted in paragraph 80, Sir Patrick Vallance, Government Chief Scientific Adviser, told a Government press conference that it was not possible to stop everyone being infected, and nor was that a desirable objective. The following day in a media interview Sir Patrick said that the aim of policy was: To try and reduce the peak, broaden the peak, not to suppress it completely. Also, because most people, the vast majority of people, get a mild illness, to build up some degree of herd immunity as well so that more people are immune to this disease and we reduce the transmission at the same time we protect those who are most vulnerable from it. Those are the key things we need to do.107 This reflected the views of the 23 people who participated in the SAGE meeting on 13 March, where the Group “was unanimous that measures seeking to completely suppress spread of Covid-19 will cause a second peak.”108 In practice this meant that social distancing policies were introduced gradually over a period of weeks.
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Government response AI summary
The government's response discusses the need for future test and trace programmes to learn from errors, which does not address the committee's historical observation about early pandemic strategy and herd immunity.
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Department for Science, Innovation and Technology
Department of Health and Social Care
84
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
The Government’s action plan of 3 March indicated that there was no intention to bring in a lockdown as strict as had been implemented in some other parts of the world. The action plan, under the heading ‘the Delay phase - next steps’ said: Action that would be considered could …
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The Government’s action plan of 3 March indicated that there was no intention to bring in a lockdown as strict as had been implemented in some other parts of the world. The action plan, under the heading ‘the Delay phase - next steps’ said: Action that would be considered could include population distancing strategies (such as school closures, encouraging greater home working, reducing the number of large-scale gatherings) to slow the spread of the disease throughout the population, while ensuring the country’s ability to continue to run as normally as possible.109 That approach meant that events that may have spread the virus proceeded—such as the football match between Liverpool FC and Atletico Madrid on 11 March—the day the coronavirus was categorised as a pandemic by the WHO—with a reported crowd of over 50,000110 and the Cheltenham Festival of Racing between 10 and 13 March, attracting more than 250,000 people.111 Subsequent analysis suggested that there were an additional 106 Evidence to the Science and Technology Committee in June 2020 from Professor Johan Giesecke, Former State Epidemiologist for Sweden and Professor Emeritus, Karolinska Institute, explained Sweden’s approach of a country asking individuals to change their behaviours without legislating for restrictions to be imposed. Q850 107 BBC Radio 4 Today, 13 March 2020—see Tweet by BBC Radio 4 Today (@BBCr4Today), 13/03/2020, 9.04am 108 GOV.UK, SAGE 15, 13 March 2020 109 GOV.UK, ‘Coronavirus: action plan’, accessed 17 September 2021 110 See, for example: ‘Liverpool vs Atletico Madrid: The Champions League match that should never have happened’, inews, 21 April 2020 111 ITV, ‘Coronavirus: Cheltenham festival and Liverpool Champions League game ‘likely increased suffering and death’’, 26 May 2020, accessed 2 September 2021 Coronavirus: lessons learned to date 35 37 and 41 deaths respectively at local hospitals after these events.112 However, it is not clear whether those deaths were as a result of atten
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Government response AI summary
The government states that the reactive approach to test and trace must be replaced by anticipation and preparation for emergencies, without directly addressing the committee's specific points about early lockdown decisions and event impacts.
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Department for Science, Innovation and Technology
Department of Health and Social Care
85
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
At its meeting of 5 March 2020, SAGE reconfirmed an explicitly gradual approach: There is epidemiological and modelling data to support implementation– within 1 to 2 weeks–of individual home isolation (symptomatic individuals to stay at home for 14 days) and whole family isolation (fellow household members of symptomatic individuals to …
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At its meeting of 5 March 2020, SAGE reconfirmed an explicitly gradual approach: There is epidemiological and modelling data to support implementation– within 1 to 2 weeks–of individual home isolation (symptomatic individuals to stay at home for 14 days) and whole family isolation (fellow household members of symptomatic individuals to stay at home for 14 days after last family member becomes unwell) to delay COVID-19 spread, modify the epidemic peak and reduce mortality rates. In addition, there is scientific data to support implementation–roughly 2 weeks later–of social isolation (cocooning) for those over 65 or with underlying medical conditions to delay spread, modify the epidemic peak and reduce mortality rates.113 SAGE had, however, considered advice to take a more robust precautionary approach. It received a paper, one of three, from the London School of Hygiene and Tropical Medicine on the considerations for non-pharmaceutical interventions. The paper said, with moderate confidence, that “NPIs that reduce transmission substantially should be introduced later but before the peak.”114 The same paper stated that: • Taking all into consideration, building up of NPIs in terms of intensity during the epidemic has many advantages: • It provides the opportunity for modification / improvement as we see the epidemic progress, i.e. it is robust to possible futures • It leaves room for policy modification during the epidemic, and avoids the situation in late summer if an epidemic has been curbed or greatly reduced that a larger epidemic is still expected.115
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Government response AI summary
The government's response states that testing and tracing bodies should be transparent, which does not address the committee's conclusion regarding SAGE's explicitly gradual approach to non-pharmaceutical interventions.
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Department for Science, Innovation and Technology
Department of Health and Social Care
86
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
On 9 March 2020, SAGE set out a number of non-pharmaceutical interventions that could in due course be introduced by the Government. SAGE advised that “measures relating to individual and household isolation will likely need to be enacted within the next two weeks to be fully effective, and those concerning …
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On 9 March 2020, SAGE set out a number of non-pharmaceutical interventions that could in due course be introduced by the Government. SAGE advised that “measures relating to individual and household isolation will likely need to be enacted within the next two weeks to be fully effective, and those concerning social distancing of the elderly and vulnerable 2–3 weeks after this”.116 On 12 March 2020, the Prime Minister said that anyone with a new continuous cough or a fever should self-isolate for seven days.117 Household isolation was announced on 16 March 2020.118 112 Edge Health, Understanding the role of large gatherings on the NHS, 28 May 2020. The analysis states that their findings cannot be used to establish causality 113 GOV.UK, SAGE 13, 5 March 2020 114 London School of Hygiene & Tropical Medicine, Considerations for NPI Policy – timing and sub-national targeting, 5 March 2020 115 London School of Hygiene & Tropical Medicine, Considerations for NPI Policy – timing and sub-national targeting, 5 March 2020 116 GOV.UK, Potential impact of behavioural and social interventions on an epidemic of Covid-19 in the UK, 9 March 2020 117 GOV.UK, ‘Prime Minister’s statement on COVID-19: 12 March 2020’, accessed 17 September 2021 118 GOV.UK, ‘Prime Minister’s statement on coronavirus (COVID-19): 16 March 2020’, accessed 17 September 2021 36 Coronavirus: lessons learned to date
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Government response AI summary
The government's response outlines several future actions for pandemic planning and enhancing social care prominence, which does not address the committee's observation about the timeline and advice for NPIs in 2020.
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Department for Science, Innovation and Technology
Department of Health and Social Care
87
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
It is striking, looking back, that it was accepted that the level of covid-19 infection in the UK could be controlled by turning on particular non-pharmaceutical interventions at particular times. Indeed such was the belief in this ability to calibrate closely the response that a forward programme of interventions was …
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It is striking, looking back, that it was accepted that the level of covid-19 infection in the UK could be controlled by turning on particular non-pharmaceutical interventions at particular times. Indeed such was the belief in this ability to calibrate closely the response that a forward programme of interventions was published with the suggestion that they would be deployed only at the appropriate moment.119 In hindsight it seems a dubious and risky assumption to think that a new, unknown and rampant virus could be regulated in such a precise way. Even more so when—due to the early failure to establish a meaningful testing programme—the UK had very little data on the prevalence and spread of the virus across different settings and different groups of people.
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Government response AI summary
The government's response concerns social care reform, which is entirely unrelated to the committee's conclusion about the flawed assumption of calibrated control over the virus and lack of data.
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Department for Science, Innovation and Technology
Department of Health and Social Care
88
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
This was not the only way to proceed, and indeed the UK was an outlier internationally in the gradualist approach that was being taken before late March.120 Countries in East Asia were the first to experience covid-19. Their response was a much more rapid and muscular imposition of social distancing …
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This was not the only way to proceed, and indeed the UK was an outlier internationally in the gradualist approach that was being taken before late March.120 Countries in East Asia were the first to experience covid-19. Their response was a much more rapid and muscular imposition of social distancing and requirements to isolate.121
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Government response AI summary
The government's response is entirely irrelevant to the conclusion, discussing social care funding instead of the UK's early gradualist approach to pandemic measures.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
89
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
On 24 February the World Health Organisation published the report of its international mission to Wuhan, and advised that countries should: (1) Immediately activate the highest level of national Response Management protocols to ensure the all-of-government and all-of-society approach needed to contain COVID-19 with non-pharmaceutical public health measures; (2) Prioritize …
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On 24 February the World Health Organisation published the report of its international mission to Wuhan, and advised that countries should: (1) Immediately activate the highest level of national Response Management protocols to ensure the all-of-government and all-of-society approach needed to contain COVID-19 with non-pharmaceutical public health measures; (2) Prioritize active, exhaustive case finding and immediate testing and isolation, painstaking contact tracing and rigorous quarantine of close contacts122 The same report identified the virus as highly contagious, and with a prima facie case fatality rate of 3.8%, rising to over 20% among over 80s.123
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Government response AI summary
The government provides a generic welcome to the report, acknowledging the crisis and agreeing that lessons should be learned, without engaging with the specific details of the WHO advice cited in the conclusion.
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Department for Science, Innovation and Technology
Department of Health and Social Care
90
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
In evidence to the Science and Technology Committee on 25 March 2020, the Editor of The Lancet, Dr Richard Horton, said that his journal had published articles on 24, 29 and 31 January with an analysis of the situation in China.124 He told the Committee: Those papers were truly alarming …
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In evidence to the Science and Technology Committee on 25 March 2020, the Editor of The Lancet, Dr Richard Horton, said that his journal had published articles on 24, 29 and 31 January with an analysis of the situation in China.124 He told the Committee: Those papers were truly alarming and showed that the disease caused a serious fatal pneumonia. A third of patients who had been reported in those papers required admission to the intensive care unit. The number of deaths that were being described was rising quickly. The authors of the papers were advocating the immediate provision of personal protective equipment and were urging the importance of testing and isolation. They were describing the fact that there was no effective treatment and also emphasising the pandemic potential. 119 GOV.UK, SAGE 12, Potential impact of behavioural and social interventions on an epidemic of Covid-19 in the UK, 9 March 2020 120 See footnote 108 121 See, for example: Q113, Q119 and Q474. 122 World Health Organisation, Report of the WHO-China Joint mission on Coronavirus Disease 2019 (COVID-19): 16–24 February 2020, p21 123 These were estimates of the fatality rate of covid-19 in February 2020 124 Oral evidence taken before the Science and Technology Committee on 25 March 2020, HC (2019–21) 136, Q39 Coronavirus: lessons learned to date 37 Those were the people from the frontlines of the epidemic at the end of January. Many of us at The Lancet felt that that was a red flag. We have had seven to eight weeks since that time, and February was the opportunity for the UK to really prepare, based on testing, isolation, quarantine, physical distancing, ICU capacity and so on. I think you described it as being critical and, yes, it was, in the sense that we missed that opportunity. We could have used the month of February, based on what we knew in January. When I look at the evidence that SAGE posted on the website—there is a lot of evidence and it is great that they have been so transparent—wh
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Government response AI summary
The government provides a generic response welcoming the report and acknowledging the scale of the pandemic and the need to learn lessons, but does not address the specific conclusion about missed opportunities for preparedness in February 2020.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
91
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
The UK policy was to change abruptly. During the days before 23 March, multiple people within the Government and its advisers experienced simultaneous epiphanies that the course the UK was following was wrong, possibly catastrophically so. In his evidence to our inquiry Dominic Cummings told us: On Friday the 13th …
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The UK policy was to change abruptly. During the days before 23 March, multiple people within the Government and its advisers experienced simultaneous epiphanies that the course the UK was following was wrong, possibly catastrophically so. In his evidence to our inquiry Dominic Cummings told us: On Friday the 13th [of March 2020], we then started to look through all the information and we started to pick apart all the different graphs. Ben [a No. 10 Specialist Adviser] spoke to Patrick; Patrick said, “I am also extremely concerned. It seems that something has gone fundamentally wrong in the wiring of the system. We have these graphs showing that even on the best- case scenario with the official plan, you are going to completely smash through the capacity of the NHS—not by a little bit but multiple times.” The evening of Friday the 13th, I am sitting with Ben Warner and the Prime Minister’s Private Secretary in the Prime Minister’s study. We were basically saying that we are going to have to sit down with the Prime Minister tomorrow and explain to him that we think that we are going to have to ditch the whole official plan, and we are heading for the biggest disaster this country has seen since 1940.127 125 Oral evidence taken before the Science and Technology Committee on 25 March 2020, HC (2019–21) 136, Q39 126 BBC, “Coronavirus: Italy extends emergency measures nationwide”, 10 March 2020; BBC, “Coronavirus: Spain set to declare national lockdown”, 14 March 2020; Metro, “ Netherlands becomes latest country to go into lockdown in battle against coronavirus”, 15 March 2020; France24, “Macron announces 15-day lockdown in French ‘war’ on coronavirus”, 16 March 2020 127 Q1003 38 Coronavirus: lessons learned to date Mr Cummings went on to tell us that other senior officials were recognising that the UK’s approach and epidemiological trajectory was on course for a “disaster”: At this point, the second most powerful official in the country, Helen MacNamara—the Deputy Cabin
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Government response AI summary
The government's response is a generic acknowledgement of the report and the need to learn lessons, but it does not specifically address the committee's conclusion about the abrupt policy change or internal recognition of an impending disaster.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
92
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
In evidence to the Science and Technology Committee in July 2020, Sir Patrick Vallance, said that SAGE advised the Government to implement the remainder of the menu of options for social distancing measures—in essence a full lockdown—on 16 or 18 March 2020: When the SAGE sub-group on modelling, SPI-M, saw …
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In evidence to the Science and Technology Committee in July 2020, Sir Patrick Vallance, said that SAGE advised the Government to implement the remainder of the menu of options for social distancing measures—in essence a full lockdown—on 16 or 18 March 2020: When the SAGE sub-group on modelling, SPI-M, saw that the doubling time had gone down to three days, which was in the middle of March, that was when the advice SAGE issued was that the remainder of the measures should be introduced as soon as possible. I think that advice was given on 16 or 18 March, and that was when those data became available. Looking 128 Q1003 129 Q1006 130 Q1293 Coronavirus: lessons learned to date 39 back, you can see that the data may have preceded that, but the data were not available before that. Knowledge of the three-day doubling rate became evident during the week before.131 On 16 March 2020, SAGE minutes show that the group concluded that additional measures, beyond those already in place, were required: “SAGE advises that there is clear evidence to support additional social distancing measures be introduced as soon as possible”.132 Sir Patrick explained that SAGE changed its advice on the basis that case numbers were doubling every three days, which was quicker than initially thought.133 Moreover, at the same meeting, SAGE considered a paper from Imperial College London academics, Impact of non-pharmaceutical interventions (NPIs) to reduce COVID19 mortality and healthcare demand.134 The paper concluded that “in an unmitigated epidemic, we would predict approximately 510,000 deaths in GB and 2.2 million in the US, not accounting for the potential negative effects of health systems being overwhelmed on mortality.”135 It was widely reported that this paper was a key factor in the Government’s decision to impose a full lockdown.136 SPI-M-O had also produced a consensus view that “general social distancing and school closures to case isolation, household isolation and social distancing o
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Government response AI summary
The government provided a general statement about learning lessons from the pandemic and adapting for future crises, but did not specifically address the committee's detailed conclusion regarding SAGE's advice for lockdown dates.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
93
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
It seems astonishing looking back that—despite the documented experiences of other countries; despite the then Secretary of State referring to data with a Reasonable Worst Case Scenario of 820,000 deaths;138 despite the raw mathematics of a virus which, if it affected two-thirds of the adult population and if one percent …
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It seems astonishing looking back that—despite the documented experiences of other countries; despite the then Secretary of State referring to data with a Reasonable Worst Case Scenario of 820,000 deaths;138 despite the raw mathematics of a virus which, if it affected two-thirds of the adult population and if one percent of people contracting it died would lead to 400,000 deaths—it was not until 16 March that SAGE advised the Government to embark on a full lockdown (having said on 13 March that “it was unanimous that measures seeking to completely suppress the spread of covid-19 will cause a second peak”)139 and not until 23 March that the Government announced it. Border controls
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Government response AI summary
The government provides a general introductory statement, acknowledging the crisis and the need to learn lessons, but it does not specifically address the committee's conclusion regarding the delay in the first lockdown despite available evidence and warnings.
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Department for Science, Innovation and Technology
Department of Health and Social Care
94
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
The UK did not impose blanket or rigorous border controls at the onset of the covid-19 pandemic as compared to other countries, particularly in East and South East Asia.140 Instead, the UK implemented light-touch border controls only on countries and regions where there was a recorded high incidence rate. While …
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The UK did not impose blanket or rigorous border controls at the onset of the covid-19 pandemic as compared to other countries, particularly in East and South East Asia.140 Instead, the UK implemented light-touch border controls only on countries and regions where there was a recorded high incidence rate. While the UK initially focused on China, Iran, South Korea and Italy, a significant number of cases came from elsewhere. A 131 Oral evidence taken before the Science and Technology Committee on 16 July 2020, HC (2019–21) 136, Q1079 132 GOV.UK, SAGE 16, 16 March 2020 133 Oral evidence taken before the Science and Technology Committee on 16 July 2020, HC (2019–21) 136, Q1079 134 Imperial College COVID-19 Response Team, Impact of non-pharmaceutical interventions (NPIs) to reduce COVID19 mortality and healthcare demand, 16 March 2020 135 Imperial College COVID-19 Response Team, Impact of non-pharmaceutical interventions (NPIs) to reduce COVID19 mortality and healthcare demand, 16 March 2020 136 For example, see: Financial Times, ‘The shocking coronavirus study that rocked the UK and US’ 137 GOV.UK, SPI-M-O: consensus view on behavioural and social interventions, 16 March 2020 138 See paragraph 91. 139 GOV.UK, SAGE 15, 13 March 2020 140 For example, on 28 January 2020, all inbound travellers from Wuhan were subject to isolation; from 26 February 2020, Singapore banned all arrivals from Cheongdo and Daegu in South Korea; from 3 February 2020, Hong Kong began to close border crossing posts. 40 Coronavirus: lessons learned to date study found that 33% of cases during the first wave were introduced from Spain and 29% were introduced from France.141 The number of seeding events that occurred early in the pandemic, coupled with the lack of data, made the lockdown almost inevitable.
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Government response AI summary
The government acknowledges the crisis and the need to learn lessons, stating it has adapted and learned throughout the pandemic to inform preparedness for future crises, but offers no specific response to the observations on border controls.
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Department for Science, Innovation and Technology
Department of Health and Social Care
95
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
By contrast, other countries implemented more rigorous border controls which were more effective at suppressing the virus and preventing the need for long and repeated lockdowns. However, even though it is not straightforward to make direct comparisons between countries, and it is yet to be seen how countries like New …
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By contrast, other countries implemented more rigorous border controls which were more effective at suppressing the virus and preventing the need for long and repeated lockdowns. However, even though it is not straightforward to make direct comparisons between countries, and it is yet to be seen how countries like New Zealand will fare when their borders are opened, it is reasonable to say that a more precautionary approach would have been beneficial at the start of the pandemic. Reasons for the delay in full lockdown
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Government response AI summary
The government provides a generic introductory statement acknowledging the report and its own efforts during the pandemic, without specifically addressing the conclusion regarding more rigorous border controls or a precautionary approach.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
96
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
In the paragraphs that follow we consider some of the potential explanations of why the initial decision-making on lockdowns was wrong, and what lessons can be drawn for the future from this. Should the Government have unilaterally taken a precautionary view in the first weeks, despite the SAGE advice?
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In the paragraphs that follow we consider some of the potential explanations of why the initial decision-making on lockdowns was wrong, and what lessons can be drawn for the future from this. Should the Government have unilaterally taken a precautionary view in the first weeks, despite the SAGE advice?
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Government response AI summary
The government provides a generic welcome to the report, acknowledging the crisis and agreeing that lessons should be learned, without engaging with the specific conclusion about initial lockdown decision-making.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
97
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
The UK’s structure of scientific advice in emergencies, in which a group is formed of relevant experts (SAGE) to advise the Government is a prominent feature of our arrangements—much more so than in many other countries. Initially, participation in SAGE was not disclosed, nor the papers on which its advice …
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The UK’s structure of scientific advice in emergencies, in which a group is formed of relevant experts (SAGE) to advise the Government is a prominent feature of our arrangements—much more so than in many other countries. Initially, participation in SAGE was not disclosed, nor the papers on which its advice drew, nor the minutes of its meetings. Following pressure, including from the House of Commons Science and Technology Committee, and supported by the Government Chief Scientific Adviser Sir Patrick Vallance,142 details of papers considered by SAGE were published from 20 March 2020; the individuals participating in SAGE were published from 4 May 2020; and minutes from 29 May 2020.143 Publication revealed that SAGE comprised a large number of scientific experts of high standing—over 85 individuals are listed as having participated in SAGE since its first meeting during the pandemic.144
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Government response AI summary
The government provides a generic introductory response, welcoming the report and acknowledging the importance of learning lessons from the pandemic without addressing the specific conclusion about SAGE's transparency evolution.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
98
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
SAGE provides advice to Ministers, whose responsibility it is to make policy decisions. However, witnesses to our Committees confirmed that during the early months of the pandemic the Government acted on the scientific advice it was given. Sir Patrick Vallance, for example, told the Science and Technology Committee on 25 …
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SAGE provides advice to Ministers, whose responsibility it is to make policy decisions. However, witnesses to our Committees confirmed that during the early months of the pandemic the Government acted on the scientific advice it was given. Sir Patrick Vallance, for example, told the Science and Technology Committee on 25 March 2020 that there had been no significant disagreement between the Government and its scientific advisers on anything material.145
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Government response AI summary
The government provides a generic response welcoming the report and acknowledging the scale of the pandemic and the need to learn lessons, but does not address the specific conclusion regarding SAGE advice and government decision-making.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
106
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
Professor Chris Whitty noted that he preferred advice to be given on the basis of observed data, telling the Science and Technology Committee in November 2020: “It is important to say that a lot of the advice that I have given is not based on significant forward modelling. It is …
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Professor Chris Whitty noted that he preferred advice to be given on the basis of observed data, telling the Science and Technology Committee in November 2020: “It is important to say that a lot of the advice that I have given is not based on significant forward modelling. It is based on what is happening and what is observable.”166
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Government response AI summary
The government's response does not address Professor Whitty's observation about advice being based on observed data. Instead, it makes its own recommendation that future policy development should involve greater questioning and challenge of scientific advice by Ministers, the government, and SAGE.
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Department for Science, Innovation and Technology
Department of Health and Social Care
110
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
It transpired that the UK public were very compliant with the eventual lockdown measures.175 Professor Chris Whitty also said in November 2020: Across the board, my reflection is that the great majority of people—and this is reflected in all the polling and a variety of other things—both intend to stick …
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It transpired that the UK public were very compliant with the eventual lockdown measures.175 Professor Chris Whitty also said in November 2020: Across the board, my reflection is that the great majority of people—and this is reflected in all the polling and a variety of other things—both intend to stick to the rules and do stick to the rules to a remarkable degree. To go back to Patrick’s point, were that not the case, we would be in a massively worse place than we are at the moment. My expectation is that R would have shot right up if people had not massively reduced the number of people they have contact with, had not stuck to all the things we need to do in individual actions they can take—such as hands, face and space—and businesses had not done a huge amount to try to make them Covid secure. Without that, we would be in a very difficult place compared with where we are now.176
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Government response AI summary
The government response does not address the committee's conclusion regarding public compliance with lockdown measures, instead discussing the need for greater questioning and challenge in future policy development and scientific advice.
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Department for Science, Innovation and Technology
Department of Health and Social Care
114
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
Dr Horton expressed concerns about the evidence base that SAGE in its early meetings drew upon. Referring to scientists in East Asia, Dr Horton told the Science and Technology Committee: If I had been Chair of SAGE, I would have wanted to go to those scientists on the frontline saying, …
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Dr Horton expressed concerns about the evidence base that SAGE in its early meetings drew upon. Referring to scientists in East Asia, Dr Horton told the Science and Technology Committee: If I had been Chair of SAGE, I would have wanted to go to those scientists on the frontline saying, “Please come and tell us your experience. What is coming for us in the UK? Why are you sending this warning signal?” because it is not there in the SAGE evidence.178 Local lockdowns: the tier system
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Government response AI summary
The government claims to partially accept an unspecified recommendation, but its response focuses on improving scientific challenge and international learning related to the NSRA process, rather than directly addressing the committee's conclusion about SAGE's early evidence base.
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Department for Science, Innovation and Technology
Department of Health and Social Care
133
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
Whilst it is clear the first lockdown was called too late, it is not however possible to make such a clear cut judgement about the second lockdown from 31 October for two reasons. First, since the advice was taken and lockdown measures were introduced, the counterfactual—what would have happened to …
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Whilst it is clear the first lockdown was called too late, it is not however possible to make such a clear cut judgement about the second lockdown from 31 October for two reasons. First, since the advice was taken and lockdown measures were introduced, the counterfactual—what would have happened to infections, hospital admissions and deaths if the second lockdown had not been instigated—is unknowable. The second reason is that unknown to advisers at the time, a new variant of covid (B.1.1.7) which came to be described first as the Kent variant and later as the Alpha variant, was already transmitting within the population. We were eventually to learn that this variant was significantly more transmissible than the initial strain of covid-19.
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Government response AI summary
The government's response discusses learning from other countries and reviewing the National Security Risk Assessment (NSRA) methodology to increase external expert challenge, which does not address the committee's specific conclusion about the difficulty of judging the second lockdown.
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Department for Science, Innovation and Technology
Department of Health and Social Care
134
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
Following genomic sequencing, PHE found that the Alpha variant first appeared in Kent in September 2020 and rapidly became the dominant variant in Kent, and subsequently, the rest of England.207 The new variant was first brought to the attention of the Government on 11 December 2020.208 On 18 December, the …
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Following genomic sequencing, PHE found that the Alpha variant first appeared in Kent in September 2020 and rapidly became the dominant variant in Kent, and subsequently, the rest of England.207 The new variant was first brought to the attention of the Government on 11 December 2020.208 On 18 December, the Government was warned that the variant was significantly more transmissible than the initial strain of covid-19.209 The eventual knowledge of this new variant and its heightened transmissibility explained what had been observed earlier: that North Kent and neighbouring areas were experiencing unaccountably high and persistent levels of covid infections during the late autumn. For example, on 30 November 2020, the rate of confirmed covid-19 cases in Swale, in North Kent, was 568 per 100,000 population—over three times as high as the UK rate of 154 per 100,000.210
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Government response AI summary
The government's response discusses learning from other countries and reviewing the National Security Risk Assessment (NSRA) methodology to increase external expert challenge, which does not address the committee's conclusion about the Alpha variant's emergence and impact.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
136
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
The second wave of the pandemic was more numerous in terms of hospital admissions and deaths than the first wave. It peaked on 8 January 2021 with 68,053 new infections per day reported in the UK,214 and on 20 January with 1,820 deaths.215 This wave was dominated by the Alpha …
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The second wave of the pandemic was more numerous in terms of hospital admissions and deaths than the first wave. It peaked on 8 January 2021 with 68,053 new infections per day reported in the UK,214 and on 20 January with 1,820 deaths.215 This wave was dominated by the Alpha variant. The Alpha variant was dominant at the time of the peak infections and deaths, and had represented over 50% of UK covid infections from 4 January 2021.216 Of the total deaths during second wave,217 56.9% took place after the Alpha variant was the dominant form.
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Government response AI summary
The government's response, despite claiming partial acceptance, fails to address the conclusion regarding the nature and impact of the second wave of the pandemic and the Alpha variant, instead focusing on the National Security Risk Assessment process.
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Department for Science, Innovation and Technology
Department of Health and Social Care
138
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
But these decisions were taken before the existence of the Alpha variant was known. So the justification for an earlier lockdown is greatly influenced by information that was not available at the time. It serves to illustrate that, in a pandemic whose course is unknown, some decisions will be taken …
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But these decisions were taken before the existence of the Alpha variant was known. So the justification for an earlier lockdown is greatly influenced by information that was not available at the time. It serves to illustrate that, in a pandemic whose course is unknown, some decisions will be taken which turn out to have been wrong, but which it was not possible to know at the time. Public health messaging and communication
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Government response AI summary
The government response is identical to its response to a different recommendation, focusing on expert diversity and international learning in risk assessment, and does not address the committee's conclusion about the difficulty of decision-making during a pandemic.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
143
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
Although the communications strategy in the initial phase of the pandemic was broadly successful, it is worth noting that there was some confusion over who the stay at home order applied to, and there was criticism of the Government’s decision not to provide a British Sign Language (BSL) interpreter on-set …
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Although the communications strategy in the initial phase of the pandemic was broadly successful, it is worth noting that there was some confusion over who the stay at home order applied to, and there was criticism of the Government’s decision not to provide a British Sign Language (BSL) interpreter on-set at the televised briefings. Similar briefings in Scotland and Wales did include an interpreter, socially distanced from Ministers. In the UK, there are more than 80,000 Deaf people whose first language is BSL.225 The decision not 219 Oral evidence taken before the Health and Social Care Committee on 21 July 2020, HC (2019–2021) 36, Q585 220 GOV.UK, Health and Social Care Secretary’s statement on coronavirus (COVID-19), 5 April 2020. 221 Q827 222 Nuffield Trust (CLL0087) 223 Oral evidence taken before the Health and Social Care Committee on 21 July 2020, HC (2019–2021) 36, Q584 224 University College London (CLL0023) 225 Equality and Human Rights Commission, Letter to the Prime Minister, April 2020. Coronavirus: lessons learned to date 55 to include an interpreter at these briefings, where important public health announcements were often made, may have reduced their ability to understand the messages provided and in turn potentially decreased trust and compliance among this group.
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Government response AI summary
The government's response generally praises the strength and effectiveness of its early public health messaging, but it does not address the specific criticisms regarding confusion over guidance or the lack of BSL interpreters.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
145
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
Written evidence to our inquiry suggested that the loss of consistency across the four nations led to confusion, with “messages from numerous national bodies that, at times, appeared to contradict each other”.229 We heard that at this stage, these contradicting messages began to cause confusion. Professor Devi Sridhar, speaking to …
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Written evidence to our inquiry suggested that the loss of consistency across the four nations led to confusion, with “messages from numerous national bodies that, at times, appeared to contradict each other”.229 We heard that at this stage, these contradicting messages began to cause confusion. Professor Devi Sridhar, speaking to the Health and Social Care Committee in July 2020, explicitly linked this confusion to infection rates: One point where you can see that England and Scotland diverged was when England changed in May to: “Stay alert.” Many people did not fully understand what that meant. In Scotland, the message was very clear: “Stay at home.” When we started to see divergence in infection rates and death rates, it was around that time.230
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Government response AI summary
The government acknowledges the importance of public health communications, but its response focuses only on the early, strong messaging, failing to address the committee's specific concerns about later inconsistent messaging across the four nations and resulting public confusion.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
146
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
The three-tier approach to local lockdown restrictions in England (see paragraph 117) introduced more complexity to Government messaging which was, understandably different in different parts of the country.231 It was therefore unsurprising that this more differentiated messaging strategy meant that levels of public understanding and compliance began to deteriorate. Written …
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The three-tier approach to local lockdown restrictions in England (see paragraph 117) introduced more complexity to Government messaging which was, understandably different in different parts of the country.231 It was therefore unsurprising that this more differentiated messaging strategy meant that levels of public understanding and compliance began to deteriorate. Written evidence submitted by UCL showed much poorer comprehension of the rules than at the beginning of the pandemic. By October, fewer than half of the over 70,000 adults who took part in the survey reported broad understanding of the rules (45%), with just 14% understanding them ‘very much’. Self- reported compliance was consequently also much lower, with just over 40% reporting ‘complete compliance’ with guidelines, compared to 70% earlier in the pandemic.232
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Government response AI summary
The government acknowledges the importance of public health communications, but its response only addresses the effectiveness of early messaging, without engaging with the committee's conclusion about the deteriorating public understanding and compliance due to the complexity of the three-tier system.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
147
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
Written evidence suggested that the inconsistency in Government messaging after the first wave of the pandemic was also damaging to public trust in official information.233 Analysis submitted by Leeds Beckett University showed that most members of the public did not trust information from the UK Government and that they were …
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Written evidence suggested that the inconsistency in Government messaging after the first wave of the pandemic was also damaging to public trust in official information.233 Analysis submitted by Leeds Beckett University showed that most members of the public did not trust information from the UK Government and that they were much more likely to trust information shared by the World Health Organisation.234 The perception that key Government figures, including the former assistant to the Prime Minister, had breached lockdown rules may have further undermined public trust during spring 2020. In oral 226 GOV.UK, ‘Prime Minister’s Statement on coronavirus (COVID-19): 10 May 2020’, accessed 17 September 2021 227 GOV.UK, ‘Prime Minister’s Statement on coronavirus (COVID-19): 10 May 2020’, accessed 17 September 2021 228 Gov.scot, ‘Coronavirus update: First Minister’s speech: 10 May 2020’, accessed 17 September 2021 229 Association of Anaesthetists (CLL0014) 230 Oral evidence taken before the Health and Social Care Committee on 21 July 2020, HC (2019–2021) 36, Q584 231 GOV.UK, ‘Prime Minister announces new local COVID Alert Levels: 12 October 2020’, accessed 17 September 2021 232 University College London (CLL0023) 233 For example, see: Nuffield Trust (CLL0087) 234 Leeds Beckett University (CLL0003) 56 Coronavirus: lessons learned to date evidence, Dominic Cummings acknowledged that his widely reported trip to Durham was “a complete disaster” and admitted that it “undermined public confidence in the whole thing”.235
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Government response AI summary
The government highlights the effectiveness of its *early* pandemic messaging but does not address the committee's conclusion regarding inconsistent messaging *after* the first wave or the impact of rule breaches on public trust.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
153
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
The flattening the curve policy was implemented by introducing new restrictions only gradually and slowly, acting as if the spread of the virus were susceptible to calibrated control. Modelling at the time suggested that to suppress the spread of covid-19 too firmly would cause a resurgence when restrictions were lifted. …
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The flattening the curve policy was implemented by introducing new restrictions only gradually and slowly, acting as if the spread of the virus were susceptible to calibrated control. Modelling at the time suggested that to suppress the spread of covid-19 too firmly would cause a resurgence when restrictions were lifted. This was thought likely to result in a peak in the autumn and winter when NHS pressures were already likely to be severe. In addition, it was thought that the public would only comply with severe restrictions for a limited period, and so those restrictions should not be applied before they were most needed. This approach should have been questioned at the time for a number of reasons: 240 Oral evidence taken before the Foreign Affairs Select Committee on 22 June 2021, HC (2021–22) 200, Q134 241 OECD, Obesity Update, 2017 242 GOV.UK, Disparities in the risk and outcomes of COVID-19, August 2020 58 Coronavirus: lessons learned to date • it entailed people contracting covid in large numbers with hundreds of thousands of deaths likely to result; • other countries, in Asia and in Europe, including some with experience of SARS and MERS, had chosen to implement earlier, more comprehensive strategies of non-pharmaceutical interventions, which were having success; and • suppressing the spread of the virus in the early period would have bought valuable time to consider what was the best way to manage the pandemic in the medium term.
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Government response AI summary
The government states that in early crises, scientific advice is uncertain, and acting quickly on a precautionary basis may be appropriate, but does not address the committee's critique of the 'flattening the curve' policy.
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Department for Science, Innovation and Technology
Department of Health and Social Care
154
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
There are several possible explanations for what was a significant error in policy and advice early in the pandemic. These include: • the lack of adequate data on the spread of covid-19, as a result of the inadequacy of the UK testing operation; • overreliance on specific mathematical models when …
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There are several possible explanations for what was a significant error in policy and advice early in the pandemic. These include: • the lack of adequate data on the spread of covid-19, as a result of the inadequacy of the UK testing operation; • overreliance on specific mathematical models when there were too many uncertainties; • assumptions about public compliance with rules that turned out to have underestimated the willingness to conform even for long periods; • the composition of SAGE suffered from a lack of representation from outside the United Kingdom; and • a preference for a particular UK approach may have been favoured above advice based on emulation of what was being pursued elsewhere.
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Government response AI summary
The government's response offers a general statement about scientific advice in early crises but does not address the committee's specific explanations for early policy errors.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
155
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
Science proceeds through challenge and disputation, and new theories are tested unflinchingly against evidence. Yet Ministers and other advisers reported that they felt it difficult to challenge the views of their official scientific advisers. Those in Government have a duty to question and probe the assumptions behind any scientific advice …
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Science proceeds through challenge and disputation, and new theories are tested unflinchingly against evidence. Yet Ministers and other advisers reported that they felt it difficult to challenge the views of their official scientific advisers. Those in Government have a duty to question and probe the assumptions behind any scientific advice given, particularly in a national emergency, but there is little evidence sufficient challenge took place. However, even when UK policy had changed to bring in a comprehensive national lockdown, the role of non-pharmaceutical interventions against covid-19 was complex, inconsistent and opaque for most of the rest of 2020.
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Government response AI summary
The government's response explains the nature of scientific advice during a crisis, stating that it may be uncertain and require quick, precautionary action. It does not address the committee's concern about ministers finding it difficult to challenge scientific advice or the lack of sufficient challenge …
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
157
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
Government public health communications are key to the public’s understanding of and compliance with non-pharmaceutical interventions. Initial messaging from the Government early in the pandemic was strong, effective and undoubtedly contributed to the success of the first lockdown. After the gradual lifting of the first lockdown Coronavirus: lessons learned to …
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Government public health communications are key to the public’s understanding of and compliance with non-pharmaceutical interventions. Initial messaging from the Government early in the pandemic was strong, effective and undoubtedly contributed to the success of the first lockdown. After the gradual lifting of the first lockdown Coronavirus: lessons learned to date 59 from May 2020, Government guidance became increasingly complex and harder to understand, with restrictions varying in different parts of the country. Government communications did not always reflect this nuance, leading to perceived inconsistency and divergent strategies across the four nations of the UK. Recommendations and lessons learned
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Government response AI summary
The government acknowledges the importance of public health communications and affirms its early pandemic messaging was strong and effective, but does not address the committee's concerns regarding later communication complexity and inconsistency.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
160
Recommendation
Third Report - Coronavirus: lessons lea…
Not Addressed
In bringing together many of the UK’s most accomplished scientists, SAGE became a very UK body. In future, it should include more representation and a wider range of disciplines, from other countries, especially those which have experienced, or are experiencing, the same emergency.
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In bringing together many of the UK’s most accomplished scientists, SAGE became a very UK body. In future, it should include more representation and a wider range of disciplines, from other countries, especially those which have experienced, or are experiencing, the same emergency.
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Government response AI summary
The government response is a verbatim repetition of the committee's recommendation and does not provide any specific commitment or stance on the proposed action.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
162
Recommendation
Third Report - Coronavirus: lessons lea…
Not Addressed
The Government, via the World Health Organisation, should make the case for an international standard of reporting covid-19 deaths and a framework for reporting disease related deaths for future pandemics. 60 Coronavirus: lessons learned to date 4 Testing and contact tracing
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The Government, via the World Health Organisation, should make the case for an international standard of reporting covid-19 deaths and a framework for reporting disease related deaths for future pandemics. 60 Coronavirus: lessons learned to date 4 Testing and contact tracing
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Government response AI summary
The government's response repeats the committee's recommendation verbatim without stating whether it accepts it or committing to any specific action.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
168
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
Professor Martin explained to us that early in the pandemic there were “very severe constraints in equipment and consumables” which acted as a drag on testing capacity: Bear in mind that those were all new tests coming on stream at the beginning of the pandemic. Effectively, there was not enough …
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Professor Martin explained to us that early in the pandemic there were “very severe constraints in equipment and consumables” which acted as a drag on testing capacity: Bear in mind that those were all new tests coming on stream at the beginning of the pandemic. Effectively, there was not enough to go round. It was global; it was not just the UK. There was a global shortage of the consumables. […] There are big international suppliers that have capped the UK supply of consumables251
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Government response AI summary
The government partially accepts the recommendation but offers a generic response about learning from international practices and improving the National Security Risk Assessment (NSRA) methodology, without addressing the specific issue of global constraints in equipment and consumables for testing.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
172
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
Shortly after this seminal failure, in mid-March 2020 responsibility for the testing strategy was taken over by the Department of Health and Social Care from Public Health England.256 It was not until 18 May 2020, when the first wave of covid-19 had begun to wane in the UK, that widespread …
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Shortly after this seminal failure, in mid-March 2020 responsibility for the testing strategy was taken over by the Department of Health and Social Care from Public Health England.256 It was not until 18 May 2020, when the first wave of covid-19 had begun to wane in the UK, that widespread community testing for covid-19—and therefore contact tracing—was able to resume.257
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Government response AI summary
The government partially accepts, but the response details ongoing NSRA methodology review and plans to increase external expert engagement in future risk assessments, rather than directly addressing the committee's observation on past failures in testing strategy and capacity.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
173
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
The consequences of this initial failure were profound. Testing not only allowed individuals to be identified who had covid-19—and were infectious—but test results for an invisible virus were the only way to be able to accurately monitor the incidence and spread of the virus across the country, and to understand …
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The consequences of this initial failure were profound. Testing not only allowed individuals to be identified who had covid-19—and were infectious—but test results for an invisible virus were the only way to be able to accurately monitor the incidence and spread of the virus across the country, and to understand which groups it affected most and which it affected least.258 The UK was reduced to understanding the spread of covid-19 by waiting for people to be so sick that they needed to be admitted to hospital.
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Government response AI summary
Despite stating 'partially accepts,' the government's response discusses its commitment to learning from international practice and details the methodology review of the National Risk Assessment (NSRA) process, without directly addressing the committee's observation about the profound failure of testing and monitoring capabilities early in the …
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Department for Science, Innovation and Technology
Department of Health and Social Care
175
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
We also consider that the Government’s scientific advisers were too passive in accepting assurances that the clinical operational capacity of Public Health England could not be changed. Even in March 2020, Professor Neil Ferguson explained that “much 254 Q129 255 Oral evidence taken before the Science and Technology Committee on …
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We also consider that the Government’s scientific advisers were too passive in accepting assurances that the clinical operational capacity of Public Health England could not be changed. Even in March 2020, Professor Neil Ferguson explained that “much 254 Q129 255 Oral evidence taken before the Science and Technology Committee on 25 March 2020, HC (2019–21) 136, Q121 256 Oral evidence taken before the Science and Technology Committee on 21 July 2020, HC (2019–21) 136, Q1176 257 GOV.UK, ‘Everyone in the UK with symptoms now eligible for coronavirus tests’, accessed 17 September 2021 258 Oral evidence taken before the Health and Social Care Committee on 17 March 2020, HC (2019–21) 36, Q78 259 See, for example: Q825, Q1256, Q1264 and Q1280 Coronavirus: lessons learned to date 63 more widespread testing” was required but that SAGE had received “very clear messages from PHE that we would have nowhere near enough testing capacity.”260 It would have been quite possible for SAGE to advise that a significant increase in testing capacity was needed. It may be that continued adherence to the early four-stage flu plan contributed to this absence of effective scientific pressure for more testing capacity.
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Government response AI summary
The government's response partially accepts a 'recommendation' and describes ongoing work related to international learning and the review of the National Risk Assessment (NSRA) methodology. However, this response does not address the committee's specific concern about scientific advisors being too passive in accepting assurances about …
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
177
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
As noted earlier, the failure to have enough testing capacity in the early weeks of the pandemic contributed to a lack of knowledge as to how the infection was spreading in the country. Speaking to us in November 2020, Professor Sir Chris Ham, Chair of the Coventry and Warwickshire Sustainability …
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As noted earlier, the failure to have enough testing capacity in the early weeks of the pandemic contributed to a lack of knowledge as to how the infection was spreading in the country. Speaking to us in November 2020, Professor Sir Chris Ham, Chair of the Coventry and Warwickshire Sustainability and Transformation Partnership, reflected that the decision to halt test and trace in the community had been a practical decision, and that any scientific advice behind it had “not been forthcoming”: if you go back to March, we simply did not have the capacity for testing, tracing and isolating that we needed in relation to the volume of cases. […] Testing capacity had to be focused on the high priorities—staff working in health and care and patients receiving that care. It was very sad that that decision had to be taken, but it was not about science. It was about practicalities.261
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Government response AI summary
The government's response, despite claiming partial acceptance, fails to address the conclusion regarding the lack of early testing capacity and the decision to halt community test and trace, instead discussing the National Security Risk Assessment process.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
179
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
Professor Chris Whitty told the Health and Social Care Committee in July 2020 that the lack of testing capacity available at the beginning of the pandemic meant that the Government had to focus resources very closely on the hospital sector, and in particular intensive care units.265 Within hospitals, the prioritisation …
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Professor Chris Whitty told the Health and Social Care Committee in July 2020 that the lack of testing capacity available at the beginning of the pandemic meant that the Government had to focus resources very closely on the hospital sector, and in particular intensive care units.265 Within hospitals, the prioritisation of patients admitted to intensive care meant less testing capacity was available for other patients in hospital, inhibiting the safe provision of non-covid NHS care and increasing the risk of nosocomial infections. The British Infection Association, the professional association for infection specialists, stated that “decisions about who to test and when early in the pandemic almost certainly led to […] nosocomial and [healthcare worker] infections in secondary care.”266 In February, a paper submitted to SAGE by Public Health England and the London School of Hygiene and Tropical Medicine estimated that during the first wave of covid-19 alone, 36,152 people in England contracted covid-19 while in hospital, representing 40.5% of all hospital cases.267
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Government response AI summary
The government's response discusses learning from other countries and reviewing the National Security Risk Assessment (NSRA) methodology to increase external expert challenge, which does not address the committee's specific conclusion about testing capacity limitations and nosocomial infections in hospitals.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
180
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
The lack of available testing for social care was particularly damaging, as we discuss in more detail later in this Report. Crucially, it was not until mid-April that covid-19 testing was made a requirement for people discharged from hospital to social care—even on 2 April 2020 guidance still stated that …
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The lack of available testing for social care was particularly damaging, as we discuss in more detail later in this Report. Crucially, it was not until mid-April that covid-19 testing was made a requirement for people discharged from hospital to social care—even on 2 April 2020 guidance still stated that negative tests were not required for a discharge to social care.268
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Government response AI summary
The government's response, despite claiming partial acceptance, does not address the conclusion about the damaging lack of testing for social care and hospital discharges, instead discussing the National Security Risk Assessment process.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
181
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
The Health and Social Care Committee’s Reports on social care and the delivery of core NHS and care services during the pandemic also highlighted the impact of a lack of testing for social care staff in the initial wave of the pandemic. Evidence from across the sector, including from staff …
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The Health and Social Care Committee’s Reports on social care and the delivery of core NHS and care services during the pandemic also highlighted the impact of a lack of testing for social care staff in the initial wave of the pandemic. Evidence from across the sector, including from staff themselves, was unanimous that the lack of provision of regular testing for social care staff had meant that social care staff were more likely to transmit the disease within care homes.269 263 Q825 264 Q825 265 Oral evidence taken before the Health and Social Care Committee on 21 July 2020, HC (2019–21) 36, Q620 266 British Infection Association (CLL0079)) 267 Public Health England, London School of Hygiene & Tropical Medicine, The contribution of nosocomial infections to the first wave, 28 January 2021. 268 See paragraphs 263–267. 269 Health and Social Care Committee, Third Report of Session 2019–21, Social care: funding and workforce, HC 206, paras 44, 45; Health and Social Care Committee, Second Report of Session 2019–21, Delivering core NHS and care services during the pandemic and beyond, HC 320, Paras 91, 92 Coronavirus: lessons learned to date 65 100,000 tests a day target introduced by Secretary of State
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Government response AI summary
The government's response, despite claiming partial acceptance, fails to address the conclusion regarding the impact of insufficient testing for social care staff and disease transmission in care homes, instead discussing the National Security Risk Assessment process.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
182
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
Following the initial shortage of testing capacity and the slow increase in the availability of tests during the critical first eight weeks of the pandemic, responsibility for the testing strategy was removed from Public Health England and vested in the Department of Health and Social Care. On 2 April the …
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Following the initial shortage of testing capacity and the slow increase in the availability of tests during the critical first eight weeks of the pandemic, responsibility for the testing strategy was removed from Public Health England and vested in the Department of Health and Social Care. On 2 April the then Secretary of State announced a target of carrying out 100,000 covid tests a day by the end of the month.270 This was a personal initiative on the part of the then Secretary of State, Matt Hancock MP, to jump start substantial testing capacity. At the time witnesses to the Committees distanced themselves from the 100,000 target. For example, even the then Government testing tsar, Professor John Newton, said to the Science and Technology Committee “It is not a SAGE target; it is the Secretary of State’s target […] you would have to ask the Secretary of State himself exactly where he got his advice from.”271
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Government response AI summary
The government states it partially accepts the recommendation but its response discusses the National Risk Register Assessment (NSRA) methodology and external expert challenge, which does not address the conclusion about testing capacity and targets.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
183
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
Subsequently, Dominic Cummings, in evidence to our inquiry, strongly criticised the then Secretary of State for naming this target, describing it as “an incredibly stupid thing to do.”272 However, Mr Hancock defended the target, saying to the Committees, “that 100,000 target was essential in galvanising the whole system and building …
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Subsequently, Dominic Cummings, in evidence to our inquiry, strongly criticised the then Secretary of State for naming this target, describing it as “an incredibly stupid thing to do.”272 However, Mr Hancock defended the target, saying to the Committees, “that 100,000 target was essential in galvanising the whole system and building a diagnostics organisation and ecosystem in this country.”273 The 100,000 target was announced as having been achieved by 30 April, although to do so required including tests which had been distributed by mail but which had not been processed.
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Government response AI summary
The government's response, despite claiming partial acceptance, does not address the conclusion about the 100,000 daily testing target and its contested achievement, instead discussing the National Security Risk Assessment process.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
199
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
Overall, the National Audit Office concluded that NHS Test and Trace “did not plan for a sharp rise in testing demand in early Autumn [2020]” and was therefore “unprepared.”311 Professor Chris Whitty reiterated to both Committees in December 2020 that one key learning was the need to scale up testing …
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Overall, the National Audit Office concluded that NHS Test and Trace “did not plan for a sharp rise in testing demand in early Autumn [2020]” and was therefore “unprepared.”311 Professor Chris Whitty reiterated to both Committees in December 2020 that one key learning was the need to scale up testing capacity, stating that the UK had been “caught out twice now with lack of testing, and three times would be too many”.312 By January 2021 testing capacity had reportedly increased to 800,000 per day and Baroness Harding expressed that she was “very confident” that there was sufficient capacity to handle future potential surges—citing the increased demand over Christmas as an example.313
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Government response AI summary
The government's response partially accepts a 'recommendation' and describes ongoing work related to international learning and the review of the National Risk Assessment (NSRA) methodology. However, this response does not address the committee's specific concern about NHS Test and Trace being unprepared for surges in …
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
200
Recommendation
Third Report - Coronavirus: lessons lea…
Not Addressed
The failure of the test and trace system to rise to meet even the most predictable of demands in Autumn 2020, especially given many weeks to prepare, suggests that lessons that were learnable during the pandemic were not applied. An urgent priority for the Government must be to satisfy itself …
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The failure of the test and trace system to rise to meet even the most predictable of demands in Autumn 2020, especially given many weeks to prepare, suggests that lessons that were learnable during the pandemic were not applied. An urgent priority for the Government must be to satisfy itself that there is now a dependable organisation for covid testing that can both anticipate and meet future demands. The role of Test and Trace in autumn lockdowns
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Government response AI summary
The government states it accepts the recommendation but primarily details its past efforts during the pandemic to provide accessible health advice and testing services to diverse communities, rather than committing to a dependable future organisation for testing capacity and demand.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
3
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
The operation of COBR was not well-suited to the modern demands of a pandemic response. It is especially concerning that its culture of confidentiality was considered by some to be so unreliable that alternative meetings were arranged that could command greater confidentiality among participants.
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The operation of COBR was not well-suited to the modern demands of a pandemic response. It is especially concerning that its culture of confidentiality was considered by some to be so unreliable that alternative meetings were arranged that could command greater confidentiality among participants.
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Government response AI summary
The government partially accepts, agreeing on the importance of learning, but the response focuses on the National Risk Assessment (NSRA) process and its external review, without directly addressing the committee's conclusion about COBR's operational suitability or confidentiality issues.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
9
Recommendation
Third Report - Coronavirus: lessons lea…
Not Addressed
The Government should ensure comprehensive plans are made for future risks and emergencies. The UK should aim to be a world leader in co-ordinating international resilience planning, including reform of the World Health Organisation to ensure that it is able to play a more effective role in future pandemics.
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The Government should ensure comprehensive plans are made for future risks and emergencies. The UK should aim to be a world leader in co-ordinating international resilience planning, including reform of the World Health Organisation to ensure that it is able to play a more effective role in future pandemics.
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Government response AI summary
The government response is a verbatim repetition of the committee's recommendation and does not provide any specific commitment or stance on the proposed action.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
14
Recommendation
Third Report - Coronavirus: lessons lea…
Not Addressed
The experience of the demands placed on the NHS during the covid-19 pandemic should lead to a more explicit, and monitored, surge capacity being part of the long term organisation and funding of the NHS.
Government response AI summary
The government response repeats the committee's statement verbatim without committing to any specific actions or plan to achieve surge capacity.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
15
Recommendation
Third Report - Coronavirus: lessons lea…
Not Addressed
The NHS should develop and publish new protocols for infection prevention and control in pandemics covering staffing, bed capacity and physical infrastructure. In developing these protocols the NHS should consider the importance of maintaining access for people accompanying some patients such as advocates for people with learning disabilities and birthing …
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The NHS should develop and publish new protocols for infection prevention and control in pandemics covering staffing, bed capacity and physical infrastructure. In developing these protocols the NHS should consider the importance of maintaining access for people accompanying some patients such as advocates for people with learning disabilities and birthing partners.
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Government response AI summary
The government's response merely restates the committee's recommendation verbatim without indicating acceptance, rejection, or any action being taken.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
16
Recommendation
Third Report - Coronavirus: lessons lea…
Not Addressed
Comprehensive analysis should be carried out to assess the safety of running the NHS with the limited latent capacity that it currently has, particularly in Intensive Care Units, critical care units and high dependency units.
Government response AI summary
The government response is identical to the committee's recommendation, providing no specific stance or commitment to action.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
17
Recommendation
Third Report - Coronavirus: lessons lea…
Not Addressed
Building on the experience of staff working more flexibly during the pandemic and to enable more flexible staffing in the NHS, NHS England and Health Education England should develop proposals to better enable NHS staff to change clinical specialty mid- career and train in sub-specialties. (Paragraph 74) Lockdowns and social …
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Building on the experience of staff working more flexibly during the pandemic and to enable more flexible staffing in the NHS, NHS England and Health Education England should develop proposals to better enable NHS staff to change clinical specialty mid- career and train in sub-specialties. (Paragraph 74) Lockdowns and social distancing
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Government response AI summary
The government response simply restates the committee's recommendation for NHS England and Health Education England to develop proposals for more flexible staff specialty changes mid-career, without providing its own stance or committed actions.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
18
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
During the first three months of the covid pandemic, the UK followed the wrong policy in its use of non-pharmaceutical interventions. When the UK moved from the ‘contain’ to ‘delay’ stage, there was a policy of seeking to only moderate the speed of infection through the population—flattening the curve—rather than …
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During the first three months of the covid pandemic, the UK followed the wrong policy in its use of non-pharmaceutical interventions. When the UK moved from the ‘contain’ to ‘delay’ stage, there was a policy of seeking to only moderate the speed of infection through the population—flattening the curve—rather than seeking to arrest its spread. The policy was pursued until 23 March because of the official 126 Coronavirus: lessons learned to date scientific advice the Government received, not in spite of it. Questions remain about whether the containment phase was pursued aggressively enough—we believe it could have been pursued for longer. During this period Government policy did not deviate from the scientific advice it received in any material respect. The fact that the UK approach reflected a consensus between official scientific advisers and the Government indicates a degree of groupthink that was present at the time which meant we were not as open to approaches being taken elsewhere—such as earlier lockdowns, border controls and effective test and trace—as we should have been.
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Government response AI summary
The government's response is a generic statement about acting quickly on a precautionary basis and does not address the committee's specific conclusion regarding past policy decisions and groupthink during the COVID-19 pandemic.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
23
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
Government public health communications are key to the public’s understanding of and compliance with non-pharmaceutical interventions. Initial messaging from the Government early in the pandemic was strong, effective and undoubtedly contributed to the success of the first lockdown. After the gradual lifting of the first lockdown from May 2020, Government …
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Government public health communications are key to the public’s understanding of and compliance with non-pharmaceutical interventions. Initial messaging from the Government early in the pandemic was strong, effective and undoubtedly contributed to the success of the first lockdown. After the gradual lifting of the first lockdown from May 2020, Government guidance became increasingly complex and harder to understand, with restrictions varying in different parts of the country. Government communications did not always reflect this nuance, leading to perceived inconsistency and divergent strategies across the four nations of the UK.
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Government response AI summary
The government agrees that early pandemic messaging was strong and effective, but does not address the conclusion's point about later complexity and inconsistency in guidance.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
24
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
In the early days of a crisis, scientific advice may be necessarily uncertain: data may be unavailable, knowledge limited and time may be required for analysis to be conducted. In these circumstances it may be appropriate to act quickly, on a precautionary basis, rather than wait for more scientific certainty.
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In the early days of a crisis, scientific advice may be necessarily uncertain: data may be unavailable, knowledge limited and time may be required for analysis to be conducted. In these circumstances it may be appropriate to act quickly, on a precautionary basis, rather than wait for more scientific certainty.
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Government response AI summary
The government response is a verbatim repetition of the committee's conclusion and does not provide any specific stance or commentary.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
27
Recommendation
Third Report - Coronavirus: lessons lea…
Not Addressed
In a pandemic, the scientific advice from the SAGE co-chairs to the Government should be published within 24 hours of it being given, or the policy being decided, whichever is the later, to ensure the opportunity for rapid scientific challenge and guard against the risk of ‘groupthink’. In addition, minutes …
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In a pandemic, the scientific advice from the SAGE co-chairs to the Government should be published within 24 hours of it being given, or the policy being decided, whichever is the later, to ensure the opportunity for rapid scientific challenge and guard against the risk of ‘groupthink’. In addition, minutes and SAGE papers should be published within 48 hours of the meeting taking place.
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Government response AI summary
Despite stating partial acceptance, the government's response completely deviates from the recommendation regarding the timely publication of SAGE advice, minutes, and papers, instead discussing the National Risk Assessment (NSRA) process and international engagement.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
29
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
Despite being one of the first countries in the world to develop a test for covid in January 2020, the United Kingdom failed to translate that scientific leadership into operational success in establishing an effective test and trace system during the first year of the pandemic. Public Health England showed …
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Despite being one of the first countries in the world to develop a test for covid in January 2020, the United Kingdom failed to translate that scientific leadership into operational success in establishing an effective test and trace system during the first year of the pandemic. Public Health England showed itself to be scientifically accomplished, but poor at delivering an operational testing system at the scale and urgency required by a pandemic.
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Government response AI summary
The government partially accepts, agreeing on positive learning and engagement, but the response details the National Risk Assessment (NSRA) process and its external review, without directly addressing the committee's conclusion about past operational failures in test and trace or Public Health England's performance.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
37
Conclusion
Third Report - Coronavirus: lessons lea…
Not Addressed
The National Audit Office has stated that “to achieve value for money NHST&T must be able to demonstrate both that the interventions it delivers are effective in achieving its objective, and that the mix of interventions is the most cost-effective use of public resources.” After 18 months and many billions …
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The National Audit Office has stated that “to achieve value for money NHST&T must be able to demonstrate both that the interventions it delivers are effective in achieving its objective, and that the mix of interventions is the most cost-effective use of public resources.” After 18 months and many billions of pounds of taxpayers’ funds, there is hope that the UK now has a capacity for testing and tracing that is adequate. It is a bitter irony that this point may only have been reached at the point in which the vaccination programme makes testing less of a critical component than it was previously. (Paragraph 240) 130 Coronavirus: lessons learned to date
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Government response AI summary
The government's response advocates for developing greater operational competence in future test and trace programmes, ensuring relevant agencies have surge capacity within seven days of an emergency, but does not address the committee's conclusion on past testing capacity.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
38
Recommendation
Third Report - Coronavirus: lessons lea…
Not Addressed
Scientific excellence is not enough in test and trace programmes: the UK must develop greater operational competence in deployment. In particular, the Government must ensure that both the new UK Health Security Agency and local authorities have the capability and funding to stand up both central surge capacity and locally-driven …
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Scientific excellence is not enough in test and trace programmes: the UK must develop greater operational competence in deployment. In particular, the Government must ensure that both the new UK Health Security Agency and local authorities have the capability and funding to stand up both central surge capacity and locally-driven testing and contact tracing within seven days of a public health emergency being declared.
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Government response AI summary
The government response repeats the committee's recommendation verbatim without committing to any specific actions or plans to achieve greater operational competence or surge capacity.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
39
Recommendation
Third Report - Coronavirus: lessons lea…
Not Addressed
Public Health England and its successor bodies, as well as Ministers and their scientific advisers, should be more willing to study and emulate the practice of other countries with urgency and agility, especially during a crisis. A culture must be established that looks proactively to collaborate with other organisations, rather …
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Public Health England and its successor bodies, as well as Ministers and their scientific advisers, should be more willing to study and emulate the practice of other countries with urgency and agility, especially during a crisis. A culture must be established that looks proactively to collaborate with other organisations, rather than to reject assistance.
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Government response AI summary
The government response reiterates the committee's recommendation without providing any specific action, commitment, or stance.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
40
Recommendation
Third Report - Coronavirus: lessons lea…
Not Addressed
Those responsible for future test and trace programmes should establish a culture and processes to learn rapidly from errors and to act to prevent them being repeated.
Government response AI summary
The government response merely restates the committee's recommendation verbatim, without providing any specific commitment, action plan, or official stance.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
41
Recommendation
Third Report - Coronavirus: lessons lea…
Not Addressed
The reactive, short-term horizon of test and trace for much of the pandemic must be replaced by a capacity for anticipation and preparation—even during the course of an emergency.
Government response AI summary
The government response reiterates the committee's recommendation verbatim, without providing any specific commitment, acceptance, or alternative action.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care
42
Recommendation
Third Report - Coronavirus: lessons lea…
Not Addressed
The organisation of the bodies responsible for testing and tracing should be open and transparent both about their operations and the basis of their decisions. (Paragraph 245) Social care
Government response AI summary
The government response merely repeats the committee's recommendation verbatim, without committing to specific actions or explaining how the transparency of testing and tracing bodies will be achieved.
Read full response →
Department for Science, Innovation and Technology
Department of Health and Social Care