Now that the pandemic is over, would it not be a good time to look objectively and dispassionately at what happened and ask if we got some things wrong and how we might get these things right in the future, asks Terry Maguire
The UK Covid-19 inquiry, promised by the then prime minister Boris Johnson in the early days of the pandemic, is now meeting and poring over what happened in the pandemic mayhem of 2020-2021 with a view of learning lessons for next time. And yes, there will be a next time. Science and politics are on the stand. The terms of reference, “to examine, consider and report on preparations and the response to the pandemic in England, Wales, Scotland and Northern Ireland, up to and including the Inquiry’s formal setting-up date, 28 June 2022” is a mammoth task indeed.
Proceedings are attracting significant media attention and in the current part of the inquiry, Part 2, the chair, Lady Hallett, seeks to assess government policy response in the early part of 2020, the autumn/winter of 2020 and up to the end of 2021 when vaccination started and we all gave a collective sigh of relief.
What is clear is that the main scientific advisers to government – the Scientific Advisory Group for Emergencies (SAGE) – were very clear in their consensus early in 2020 that significant non-pharmaceutical interventions (NPIs) would be required. Those who delivered SAGE’s views to government, mainly the Chief Medical Officer and the Chief Scientific Officer, have given evidence and were pretty scathing of the politicians of the time. Boris Johnson has come in for particular criticism as somebody who had great difficulty understanding the science and as a consequence making the important decisions at the right time.
According to the advisers, the main decision he dithered too long over was to mandate a lockdown requested by SAGE as early as 12 March 2020. This did not happen until 23 March (27 March in Ireland). SAGE had a firm consensus that, to save lives and not overstretch the health service, the UK needed a mandated lockdown earlier. The inquiry seems focused on how the politicians finally got to and implemented this decision in what seems to have been a chaotic and messy affair. Johnson, in giving his evidence, apologised for this chaos.
The inquiry is not questioning the veracity of the policies pursued during the crisis. It seems to be accepted that a series of mandated lockdowns over 2020 and 2021 was the right policy and that it, along with other NPIs; mask wearing, social distancing etc, successfully reduced deaths from Covid and protected the NHS from being overwhelmed.
It is very difficult to get exact outcomes about Covid-19, even deaths. How many died during the pandemic is still being debated and contested. Bereaved families protesting at the inquiry claim that, in the UK, Covid caused 233,000 deaths according to their placards. Official statistics using excess deaths in the period March 2020 to December 2022 indicate that for England/Wales, Scotland and Northern Ireland, there were 134,000, 12,000 and 4,000 excess deaths, respectively. That makes a total of 160,000. But these are excess deaths and in this period the Office for National Statistics states that 69 per cent were attributable to Covid and this would bring the Covid deaths figure down to 110,000. What also confounds the figures is that these deaths were either ‘because of’ Covid or ‘with’ Covid. This is important. One patient who died of Covid-19 who I knew personally was 92 years old and had terminal cancer. He was taken to hospital due to a deterioration in his condition, caught Covid, died and ended up a death due to Covid. His daughter is one of those protesting that government policy during Covid caused her father’s death. It is difficult to remain objective in these emotional situations. So, the total number of UK Covid deaths might be a little more than 100,000 for a period of nearly two years during which, just to set things in context, there were more deaths attributed to smoking related causes. Perhaps this was because mandated lockdowns are so successful? Maybe, but you would think, with plenty of data available, somebody might try to work it out.
More surprisingly, during 2023 the UK, in common with Ireland and other European countries, continues to experience excess deaths – deaths greater than the previous five-year average – and this might be as high as 60,000 excess deaths for 12 months, which is greater than the excess deaths during the pandemic. We don’t know why this is happening, there is no inquiry and nobody seems too concerned.
Yes, Covid was a killer; certainly in the early forms of the virus; alpha and delta. Yes, it was vital that governments reacted to the threat and implemented strict NPIs. But now that it is over, would it not be a good time to look objectively and dispassionately at what happened and ask if we got some things wrong and how we might get these things right in the future?
The composition of SAGE was heavily biased towards infectious disease experts who saw a mandatory lockdown as the only solution given the ferocity of this new virus. SAGE saw only viral deaths and an overwhelmed health service and that narrow perspective ignored other consequences, many of which we now are living with. Nobody was advising government about the negative consequence of a mandate lockdown and, if they did, they were deemed fantasists. When asked about the composition of SAGE the CMO, Chris Whitty said that there needed to be a consensus
and if the number of members and the
range of expertise of the committee was extended it would be less easy to get a consensus. So SAGE was blinkered from
the start and anybody with a different view or prediction was shunned. It was a very bad time for science.
Early epidemiological studies based on scientific modelling used by SAGE predicted large effects from a mandatory lockdown. One model simulation study predicted that lockdown would reduce Covid-19 mortality by up to 98 per cent. These predictions were questioned by many scientists at the time but their concerns about the models were dismissed. Indeed, there was no clear negative correlation between the degree of lockdown and fatalities in the spring of 2020. Given the large effects predicted, a simple negative correlation between Covid-19 deaths and the degree to which lockdowns were imposed should have been observed but was not.
What seems forgotten is that people’s behaviour was much influenced by what was going on and, well before we were forced by law to stay at home, we were doing so and observing social distancing and wearing a face covering. Indeed, in Sweden this is what happened and it fared better than the UK in terms of Covid-19 deaths. It is said that Sweden was much worse than other Nordic countries, but that might be down to its decision, similar to the UK, to send elderly patients out of hospital untested and into care homes where the virus spread rapidly. That policy needs more scrutiny.
Mandatory lockdowns during the Covid-19 pandemic have had devastating effects. They have contributed to: reducing economic activity, raising unemployment, reducing schooling, political unrest and domestic violence. They are a key contributor to extended waiting-lists for essential medical interventions and possibly a driver for global non-Covid excess deaths that we are currently experiencing.
The costs to society of mandatory lockdowns must be compared to the benefits. This was not done at the time and is now being ignored by the UK’s official inquiry. Carl Heneghan, an epidemiologist and somebody who has given evidence at the UK Covid-19 Inquiry, has for these reasons voiced his concerns on the its direction and purpose. He wonders if the inquiry is not just a whitewash to keep those in positions of power where they are, but then that only makes him a conspiratorial fantasist, as I am, for writing about it.
