Richard North, 20/04/2020  

Yesterday's Insight article from the Sunday Times has triggered a sharp response from the Department of Health, unusual in itself as the government usually maintains a dignified silence when attacked by the media.

This time round, though, a government spokesman pulls no punches. "This article", he says, "contains a series of falsehoods and errors and actively misrepresents the enormous amount of work which was going on in government at the earliest stages of the Coronavirus outbreak".

Clearly, the government is keen to deny the accusations of complacency levelled by the Sunday Times, in which respect it is instructive to note its answer to the charge of failing to learn from the pandemic preparedness exercise of 2016, codenamed Cygnus.

The government, we are told, "has been extremely proactive in implementing lessons learnt around pandemic preparedness, including from Exercise Cygnus".

This, we are assured, "includes being ready with legislative proposals that could rapidly be tailored to what became the Coronavirus Act, plans to strengthen excess death planning, planning for recruitment and deployment of retired staff and volunteers, and guidance for stakeholders and sectors across government".

One might recall that the Sunday Times, largely using the Telegraph as a source, claimed that Cygnus predicted that the health service would collapse and highlighted a long list of shortcomings - including, presciently, a lack of PPE and intensive care ventilators.

Perhaps, though, if we are looking for a more accurate indication of the government's state of mind, we could refer to a presentation made some time after 2017 to the European Union, when Professor Gina Radford, then Deputy Chief Medical Officer for England, took the floor.

She happily declared that evaluation of the exercise "highlighted the strengths of existing plans and UK command and control emergency response structures, as well as identifying areas where resilience could be further enhanced". Learning from the exercise, she said, "has informed [the] cross government work programme".

This doesn't exactly give any hints of the "collapse" that the Sunday Times alluded to. If anything, it really does support the charge that the authorities were indeed complacent about the state of UK preparedness.

What can't be said, though, was that there was an absence of planning, either at the national, European or global level. Trawling through the activities devoted to this end, one cannot help but be impressed by the amount of work, thinking and discussion that went into anticipating a pandemic and in considering what actions were necessary.

Interestingly, what emerged from some of the work (this from 2009) was that attempts to contain an outbreak would fail – when played through during some exercises.

This seems to have remained a theoretical issue and different countries throughout Europe went their own ways, with plans collated by the EU.

Here, for instance, one can see that the Germans kept contact tracing as a central part of their response, both at federal and state levels. The relative success of their programme is attributed to this singular difference, along with the resources allocated to testing.

The UK planning, however, confined contact tracing to the early stages of the pandemic, used merely to identify the point at which community spread was occurring, following which contact tracing was abandoned. The Telegraph has now picked this up, noting the contrast between the Asian plans and the stance taken by the UK.

It thus cites the Department of Health view that it would "not be possible to stop the spread of, or to eradicate, the pandemic influenza virus, either in the country of origin or in the UK, as it will spread too rapidly and too widely". The Department went on to say:
The expectation must be that the virus will inevitably spread and that any local measures taken to disrupt or reduce the spread are likely to have very limited or partial success at a national level and cannot be relied on as a way to "buy time".
This led to the 2014 Pandemic Influenza Strategic Framework which set out the bones of the plan. Simply, this involved a retreat from any attempt to contain the illness, with the government focussing on "preparing for targeted vaccinations as the vaccine becomes available" and the "escalation of surge management arrangements in health and other sectors".

Looking back at previous pandemics, one can see that this is not without sense, but the success of such a plan relied on several assumptions. The first was that we would get plenty of notice of the emergence of a pandemic strain, and that it would spread slowly, giving us time to develop a vaccine before (or shortly after) the disease reached us.

There was also an assumption that effective antiviral drugs would be available, either as prophylaxis, or for treatment of cases.

With Covid-19, however, the Department of Health (and Public Health England) has been comprehensively caught out. The suddenness of the emergence of Sars-Cov-2, and its rapid spread from its epicentre in China to the UK has meant that there is no vaccine available and no likelihood of one in the near future. Furthermore, there are no proven antivirals available.

But the main issue we now have to deal with is that, with the failure of the original plan, there is no Plan B. Furthermore, even if an alternative could have been developed in a hurry, the infrastructure which would enable it to be implemented no longer exists.

This, as I remarked yesterday, points to the weakness in the Sunday Times article but, given the coprophagic tendencies of the British media, we now see other newspapers pick up on exactly the points highlighted by the Times, replicating its errors.

The combination of personality politics and the inability of the media to pull together a chain of events longer than the span of a few years means that the focus is on the superficial, with the media collective comprehensively missing the point.

Yet, coincidentally, we see in the Guardian a long whinge from Jane Martinson about the parlous state of the press and how we are in danger of seeing "valuable journalism" getting "lost in a maelstrom of misinformation".

Of the two great events of this century though - Brexit and now the Covid-19 epidemic - we have seen the media constantly misrepresent and misinform, confusing the situation and spreading propaganda in pursuit of partisan agendas.

Where we now have Google News, direct access to news agencies such as Reuters, the availability of original sources, and the social media, however, we can pick up any amount of misinformation without having to go through the middle man of the popular media.

Martinson argues that journalism must be saved "as an essential public good", but if all we are getting from the media is low-grade coprophagia, then what it has to offer isn't worth having.

Currently, as Pete recently observed on Twitter, the only justification for reading the media is to find out how they are misleading the politicians – this being the last group on the planet which seems to believe what it reads. For that, it is not worth keeping the media together as it currently exists. In fact, a lower volume of output might be welcome.

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