Covid: When Muddling Through Won’t Do provided a detailed account of the government response to the Covid emergency up to July 2020.
It showed that room to manoeuvre by March 2020 been lost by lack of preparedness; lack of foresight; and by a related lack of focused but flexible institutional planning arrangements.
Lack of preparedness, to take two crucial examples, in relation to stockpiling and then procuring adequate PPE in both and quality terms, and in providing a fit for purpose test and track infrastructure in waiting for a pandemic that had been previously identified as the biggest future risk to UK national security.
Lack of focused flexibility, in terms of an absence of effective and creative civil service and special adviser scanning of what was happening across the world in real time and translating the lessons of that experience into effective mechanisms of policy planning and action at the necessary pace.
Lack of foresight, in terms of government failure to identify the need and act upon it to protect the care home population against an epidemic, which, even by early February 2020, was identified as mainly a killer of the very elderly and the otherwise medically vulnerable.
The care home population given its characteristics and setting was clearly a group likely to be the most susceptible and exposed to the virus.
Yet 25,000 people were discharged from hospitals into care homes in England, without testing for Covid, contributing to the care residents accounting for half of the total excess deaths reported for the period.
This shameful feature of the Covid public policy response in England as not an aberration, but was intrinsically related to, and a product of, the long-standing fragmentation of its health and social care systems.
The UK’s high per capita Covid death rates – England’s especially – cannot be divorced from societal value-base and patterned inequalities, as well as from systemic government failures.
It is these connected failures that can truly and fairly be laid at the door of the UK government, from which lessons should be drawn.
The post’s further conclusion that a national health and care system funded in a sustainable and equitable manner is the required legacy combined with a related recasting of the working conditions across the catering, cleaning, and care sectors, is easy to say, of course, given such given the additional public spending implications, whether funded from national or local sources, during a period of public finance pressure; but it is a case of you get what you pay for: change requires cross-party support for a new settlement, not tinkering at the edge: something that the new 2024 government should put on its radar as a basic social democratic imperative.
Subsequent Covid waves, with the winter 2021 wave proving the deadliest of all, exhibited further system failures.
Covid Restrictions Timeline records the shifting and inconsistent regulatory responses. In short, lessons from the first wave, largely and inexcusably, were not learnt.
Luckily, vaccine development and roll out – a UK success story – prevented worse outcomes.
Cobra proved itself as inadequate institutional mechanism to respond to the Covid crisis. Whether that failure was the result of intrinsic and endemic problems in the wider machinery of government is the crucial question that hopefully the Resilience and Preparedness (Module 1) Covid Inquiry Report, due to be published in mid-2024, will focus on rather than on the theatrics of individuals.
A March 2023 ONS bulletin reported that total number of excess deaths due to all causes (when compared with the five-year average) registered in England and Wales between March 2020 and December 2022 was 167,356; of these, 103,585 were males and 63,770 females.
Other data sources indicate that excess deaths exceeded those reported by our near European neighbours, notably France and Germany, noting, however, that comparative international excess deaths data is subject to methodological and cross-national definitional complexities and uncertainties, which on-going work by the ONS is endeavouring to refine.
That said, continuing excess deaths in the UK context, underline that the UK health and social care systems are not well for reasons connected not only to the aftermath of Covid but their basic organisation and funding.