I’m not convinced we need a public inquiry on COVID

We’re expecting a full public inquiry to follow the COVID-19 pandemic and that is generally seen to be a good thing. Some people want an inquiry because they believe that there are people culpable either through intent or at least wilful neglect and they should be held to account. Others are looking for lessons learnt to help prevent a future crisis.

I’m personally not convinced that there is benefit to public inquiries driven either by lawyers or politicians.  It’s not that I agree with the person the other day who said “can’t we just forget the last two years, pretend they never happened” although I think I understand that weary sentiment.  Rather, it’s that I’m not sure that inquiries are really that effective. We have had Chilcot and there are still people who are convinced that Tony Blair is yet to be held to account. There were inquiries after the Bradford Fire Disaster but in both cases there were those who strongly believed that justice had not been done, leading in one case to a book and the other to a long campaign for justice championed by people like Andy Burnham.

I also wonder if they really do deliver lessons learnt. To be sure, reports are produced urging that measures are implemented but did we need an inquiry chaired by a judge to identify the risks with standing on football terraces or that you couldn’t allow rubbish to pile up under wooden stands or that locking supporters in should have been unthinkable.  Moreover, the problem with inquiries is that they look back at specific circumstances and draw conclusions about how tom prevent them but lightening rarely strikes in the same place twice.

Indeed, one of the concerns raised by many is that the UK was geared up for a flu-pandemic and so the response measures were inadequate for a different type of pandemic, one where significant numbers of people contracted the virus without symptoms.  The risk is that we learn how to respond to one crisis but then end up trying to fight the next, entirely different one on the basis of the lessons learnt this time.

Then there is the risk that those holding the inquiry draw bold conclusions that go beyond their competence to judge. For example, the recent report from MPS makes three assertions. The first is that the timing of the lockdown in England was not a result of miscommunication or disagreement between scientists and the government but rather that there was consensus between scientists, civil-servants and politicians about the timing of things. That’s straight forward enough -the facts can be checked by looking at meeting minutes and checking back what people like Professors Vallance and Whitty were saying at the time. 

The second based on that is that there was “group think.” Well that ma or may not be true but really all that has happened there is that the MPs have made their own qualitative judgement on the existence of the consensus stated above.

Thirdly the assert that the “delay” to lockdown caused the avoidable and significant loss of lives.  This seems to be based on the views of Neil Ferguson but it is worth remembering that his models and assessments have come under significant challenge.  Is it true that a earlier lockdown would have prevented deaths? Well assessing that is tricky. For two reasons. First of all, how do we assess the cause of any excess deaths (assuming that there were avoidable excess deaths)?  You see, a couple of other potential factors have been identified. First of all, there were issues in terms of border quarantining.  Would that have reduced the number of deaths. Secondly, there has been much discussion about loss of life in care-homes as patients were returned from hospital to free up beds. A factor there is that we were not geared up for asymptomatic infection. Linked to that was the stuttering attempts to get a fully functioning testing regime in place.  It may be that without that combination of issues then we would not have seen as high a death toll with or without lockdown and that with this combination even the lockdown could not make much difference to mortality.

Furthermore, there is another problem. Lack of testing makes it hard for us to be certain exactly when cases peaked but we know that deaths peaked around the 8th -10th April suggesting that cases were probably peaking around about a month previously. It is possible then that cases had already peaked prior to lockdown due to the measures that were already being advised.**

Now, don’t hear me wrong on this. I’m not saying that if there are people who are culpable that they shouldn’t be held to account but that is probably best done through a focused legal case that identifies precisely what they are accused of.

Similarly, I’m not saying that we shouldn’t learn lessons but I believe that lessons are best learnt by continuous review and feed-back. I hope that such cultures are already in place within SAGE, UKHSA (formerly PHE) and the NHS.  My preference would be that we focus on improving checks, balances, learning and accountability so that we are more responsive to future crises. My personal opinion remains that once we realised that a pandemic is approaching that:

  1. There should be legislation in place detailing exactly what powers and what limits there are on the Government and state agencies during a  national emergency.
  2. Under the basis of such legislation, a national emergency should have been declared in March 2020. This should have been under a UK wide jurisdiction to ensure a joined up response across England, Scotland, Wales & Northern Ireland and to reduce the risk of competing political agendas.
  3. That under the terms set out within the national emergency legislation that there should have been regular reviews including Judicial Review, Parliamentary scrutiny and SAGE meetings looking back and assessing previous measures as well as advising forward.

It’s important when that review is timely, focused, responsive and leads to action.  I hope that such an approach will be taken to any future national emergency.  That’s far more important than a thick report getting produced that the press pick out a few headlines from, politicians use to serve their purposes, that  no-one actually reads properly or acts upon.

*** https://www.bbc.co.uk/news/health-58876089

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