In 2015, the Cabinet Office published a national risk register of civil emergencies, which rated the chances of a flu pandemic higher than that of an emerging infectious disease. It rated the probability of a flu pandemic as high, but stated: “The likelihood of a new disease spreading to the UK is low.”
Former health secretary Jeremy Hunt has admitted the UK prepared for the wrong pandemic during his tenure by believing the next biggest threat would come from flu.
In an interview with The BMJ, Mr Hunt, who was health secretary from 2012 to 2018, acknowledged decisions he made while in office could have hampered the UK’s response to the pandemic.
Asked about mistakes in handling the coronavirus, he said: “We’ve really been on the back foot from the start on test and trace, and in some ways it dates back to the period when I was health secretary.”
In October the following year, the government carried out Exercise Cygnus, which involved 950 officials from central and local government, the NHS, prisons and local emergency response planners.
The aim was to test plans for a future “worst-case-scenario” flu pandemic affecting up to half of the population, causing up to 400,000 excess deaths.
Mr Hunt, who now chairs the Commons Health and Social Care Committee, said: “We did exhaustive pandemic preparations; we were lauded by Johns Hopkins University as being the second-best-prepared country in the world.
“But we were sadly also part of a groupthink that said that the primary way that you respond to a pandemic is the flu pandemic playbook (with a focus on areas like vaccination and boosting hospital capacity), rather than the methods that you would use for Sars and Mers (surveillance and containment, community testing, contact tracing and isolation, and stockpiling personal protective equipment, and ventilators).”
That thinking was not unique to the UK, he said, and was shared in the US and across Europe.
“But it’s why there is this stark difference in the effectiveness of our responses compared with countries in East Asia.”
Last year a memo revealed that a recommendation for all frontline NHS staff to be given protective equipment during a flu epidemic was rejected as too costly in 2017.
Mr Hunt said the decision to centralise testing in May helped create a structure quickly but “one of the big lessons of the future is to have localised contact tracing capability”.
He called for a long-term plan for recruiting and training doctors, nurses and other staff but suggested work could have been done earlier in his tenure.
“I was very proud to push through very large increases in recruitment in 2016,” Mr Hunt said. “But the truth is that not a single doctor has yetentered the workforce as a result of those changes.”
He added: “We should be asking ourselves, ‘What do we need to do now to turn this into a ‘1948 moment’ when the NHS was founded and give the workforce the confidence that there is a long-term strategic plan in place that will ultimately deal with the rota gaps, the pressures and the shortages?’”
The MP also said the biggest mistakes in the social care sector during the pandemic were over discharging Covid-positive patients into care homes”.
He added: “We have a lot to learn from countries like Germany that said that care homes were not allowed to take Covid-positive patients unless they were able to quarantine them for two weeks, and they were very strict about that.
“That may be the single reason why their death rate has been so much lower.”
Dame Donna Kinnair, chief executive of the Royal College of Nursing, agreed the UK needed a long-term plan to deal with the chronic shortage of nursing staff. “Successive secretaries of state have ducked this issue but the pandemic means the fragility of the nursing workforce is now aninescapable reality,” she said.
