Health

‘Extraordinary omission’: key findings in scathing UK Covid report

The joint report by the Commons health and science committees on lessons to be learned from the UK’s response to Covid spans 150 pages and is divided into six themes. Here are the main findings from each.

Planning for a pandemic

The section on preparedness draws on concerns highlighted as far back as May 2020 and finds that the UK was confident of the extent of its pandemic planning despite most of it being “too narrowly and inflexibly” based on the idea of a flu-type outbreak.

The planning did not properly consider asymptomatic transmission or take into account earlier outbreaks that failed to reach pandemic level, such as the Sars virus affecting east Asian countries in 2002-04, or the Mers virus first identified in the Middle East in 2012, the report found.

Detailing various government exercises about hypothetical pandemics, it said an “over-reliance on pandemic influenza as the most important infectious disease threat clearly had consequences – it meant that the emphasis of detailed preparations was for what turned out to be the wrong type of disease”.

Perhaps the most vivid piece of evidence in this section came from Dame Sally Davies, England’s former chief medical officer, who blamed what she called “groupthink”. The report quoted her as saying: “Our infectious disease experts really did not believe that Sars, or another Sars, would get from Asia to us. It is a form of British exceptionalism.”

Lockdowns and their timing

Among the most fractious debates in the response to coronavirus has been over the timing of England’s lockdowns, both when the first one was imposed in March 2020 and apparent delays in putting in place another in the autumn and winter of that year.

On the first lockdown, the report is clear and condemnatory: factors including a lack of testing capacity and doubts over whether British people would accept a lockdown prompted scientists and politicians to adopt a “policy approach of fatalism”, which would seek to manage but not suppress the extent of an outbreak. While this was not an active decision to seek so-called herd immunity, it amounted to this in effect, the report said.

Following what the committees called “simultaneous epiphanies” by ministers and advisers about the catastrophic effects of this approach, a UK-wide lockdown was finally announced on 23 March. The report said: “It is now clear that this was the wrong policy, and that it led to a higher initial death toll than would have resulted from a more emphatic early policy.”

It adds, more damningly still: “As a result, decisions on lockdowns and social distancing during the early weeks of the pandemic – and the advice that led to them – rank as one of the most important public health failures the United Kingdom has ever experienced.”

The report was, however, more equivocal on whether the ministers should have imposed a “circuit breaker” lockdown in England in late October 2020, saying the emergence of the more transmissible Alpha, or Kent, variant could have prevented this being effective anyway, and that a circuit breaker in Wales did not prevent a winter lockdown.

Test, trace and isolate

The report’s most consistent and vehement condemnation came in this section, beginning with what it described as a hugely serious failure to even try to copy the rapid rollout of mass testing in places like South Korea.

Public Health England claimed to have studied and then rejected the South Korean approach but could provide no evidence for this, the report said, adding: “We must conclude that no formal evaluation took place, which amounts to an extraordinary and negligent omission.”

This meant testing in everywhere but hospitals was halted, and so new cases or contacts could not be tracked. “As a result the UK squandered a leading position in diagnostics and converted it into one of permanent crisis … The consequences of this initial failure were profound … For a country with a world-class expertise in data analysis, to face the biggest health crisis in 100 years with virtually no data to analyse was an almost unimaginable setback.”

While testing capacity was later increased hugely, the report noted that government rhetoric was still often notably more impressive that the reality. “Ministers began by promising the test and trace system would be ‘world-beating’ in May 2020 when the truth was that it was that it was a laggard,” it said of the system, which had a budget of £37bn.

The report also castigated the low numbers of people who complied with self-isolation rules, citing a lack of financial support and the continued requirement to self-isolate for 10 days, long after tests were freely available to show they did not have the virus. As well as the impact this delay had on the economy and people’s lives, the report said, “by providing a powerful disincentive to take a Covid test and to disclose all contacts, it seems likely that it will have also caused more infections and cost lives”.

Social care

More than 39,000 care home residents died with coronavirus between 10 April 2020 and 31 March 2021, with the report finding that ministers and the NHS “both failed adequately to recognise the significant risks to the social care sector at the beginning of the pandemic”.

The committees concludes: “The UK was not alone in suffering significant loss of life in care homes, but the tragic scale of loss was among the worst in Europe and could have been mitigated.”

Some of these failures were specific to the pandemic, the report said, including the decision to focus on freeing up NHS capacity and thus release many patients into care homes without Covid tests, and problems with a lack of personal protective equipment. Others, such as a shortage of staff and funding difficulties, were “illustrative of a longstanding failure to afford social care the same attention as the NHS”.

Wider health inequalities

The report stressed that “the experience of the Covid pandemic underlines the need for an urgent and long-term strategy to tackle health inequalities”, a point highlighted by politicians and experts during the pandemic.

It noted the particularly high toll of Covid on people from minority ethnic backgrounds and on people with learning disabilities. It said: “It is telling that the first 10 NHS staff to die from Covid-19 were from black, Asian and minority ethnic (BAME) backgrounds, and evidence has since confirmed that the impact of Covid-19 on this section of the workforce has been significant.

“While the NHS has made progress in recent years, the experience of people from BAME groups during the pandemic has made it clear that inequalities persist.”

Vaccines

While the report gives recommendations on lessons to be learned from the development, procurement and distribution of vaccines, these were mainly based around other areas of government learning from it – particularly the flexibility and speed of the vaccines taskforce headed by Kate Bingham. The Covid vaccine programme overall, the report said, “has been one of the most successful and effective initiatives in the history of UK science and public administration”.

Health

No new COVID-19 variant in Nigeria- FG

The Federal Government has clarified that the newly detected XEC COVID-19 variant, identified in Australia and some other countries in Europe, is not in Nigeria.

Ministry of Health and Social Welfare, Kachollum Daju confirmed that a recently leaked letter addressed to the Committee of Chief Medical Directors and Medical Directors was precautionary and not intended to cause panic.

Speaking further, Daju noted that the XEC COVID-19 variant has been detected in 29 countries, and due to the festive season, when travellers arrive from various parts of the world, it is crucial for hospitals to implement measures to ensure the country is not caught off guard.

In a letter dated December 5, 2024, the Federal Ministry of Health and Social Welfare, had urged health authorities to activate heightened alert systems across hospitals and maintain a high index of suspicion for patients with COVID-like symptoms.

The letter Signed by the Head of the Teaching Hospital Division, Dr O.N. Anuma, on behalf of the Permanent Secretary, the letter called for collaboration with relevant stakeholders to share critical data regarding the variant and implement enhanced monitoring protocols.

“I am directed to inform you of a newly detected XEC COVID-19 variant, which has been reported in Australia and has already spread to 29 countries globally.

“You may wish to know that this variant has shown a growth advantage over other circulating strains, raising concerns about its potential impact on public health,” the letter read.

“Alert systems should be immediately activated throughout our hospitals for high index of suspicion in patients with COVID-like symptoms.

“Timely information sharing among relevant stakeholders, including the Federal Ministry of Health, will be vital for effective response strategies.”

The Permanent Secretary stressed the importance of preventive measures during this period to prevent any potential spread of the variant into Nigeria.

Health

Oyo confirms 4 deaths in suspected Lassa fever outbreak

The Oyo State Rapid Response Team, on Thursday, confirmed four deaths linked to a suspected Lassa fever outbreak in the Saki West Local Government Area of the state.

A statement by the Commissioner for Information and Orientation, Dotun Oyelade, in Ibadan, the state capital, quoted his counterpart from the Ministry of Health, Oluwaserimi Ajetunmobi, saying the fatalities consisted three males and one 32-year-old female who was preparing for her marriage.

The report was that an owner of a hospital, alongside three others, died in the town mysteriously.

Following numerous calls reporting deaths in the town, the commissioner tasked the team to Saki to investigate.

“The background information gathered that one of the apprentices at the hospital who had returned from Iwajowa and fell ill about two weeks before the incident was suspected to have introduced the infection.

“She likely transmitted it to her co-workers and the hospital owner.

“Three of the deceased exhibited typical symptoms of Lassa fever, including craniofacial bleeding, while the hospital owner showed fatigue and self-medicated with antimalarials and antibiotics.

“His condition only prompted hospital admission when his self-treatment failed,” the statement read.

It added, “Extensive contact tracing was conducted, with particular focus on high-risk contacts who had been involved in the bathing and burial of the deceased.

“The hospital where all the deceased were associated was closed down for decontamination.

“The hospital that admitted the deceased health facility owner, without being informed of the deaths from an ‘unknown’ illness, was also shut down for decontamination, and the doctor was placed under surveillance.

“Public awareness campaigns were held to educate the community about Lassa fever, its transmission, symptoms, and preventive measures.

“The RRT provided on-the-job training to health workers in the affected areas to reinforce Infection Prevention Control protocols and prevent further spread of the disease.

“Sample collection was also carried out on a person exhibiting symptoms, pending laboratory confirmation. The line listing of contacts is still in progress, focusing on individuals at high risk”.

The government team also conducted an advocacy visit to the palace of the Okere of Saki, who was represented by his second-in-command, and was briefed on the outbreak and the necessary containment measures.

“Local government authorities within Saki West were equally informed and aligned with the efforts to manage the situation”, the statement added.

Investigation, according to the commissioner, also revealed that the outbreak initially involved the council, but had extended to Iwajowa and Kajola local government areas.

He said the State Disease Notification Officer in the respective areas had been instructed to begin preliminary containment efforts while awaiting the full deployment of the State RRT.

The team, comprising the Director of Public Health, the State Epidemiologist, DSNOs, State Laboratory Focal Persons, representatives from the World Health Organisation and Red Cross, as well as the PHC Coordinator of Saki West and the LGA DSNO, embarked on a comprehensive investigation to the scene of the incidence.

Health

NCDC issues public advisory on Lassa Fever, warns of increased spread

FG issues Lassa fever alert, death toll hits 102, cases now 4,632

The Nigeria Centre for Disease Control and Prevention, NCDC has issued a public health advisory on Lassa fever warning of increased case detection and spread of the viral infection.

The Director General of the NCDC, Dr Jide Idris, raised the concerns following increased reporting of the outbreak by its surveillance teams across the country.

At a press briefing in Abuja, Dr Idris said the death toll from Lassa Fever in Nigeria has risen to 174 out of 1,035 confirmed cases across 28 states and 129 LGAs as of October 13, 2024.

”Lassa fever outbreaks are highly virulent and the loss of human lives resulting from disease are not just statistics but represent the death of beloved family members, spouses and parents.

”In 2022, Nigeria reported 1,067 confirmed cases across 27 states and 112 LGAs. In 2023, 28 states and 114 LGAs reported confirmed cases, with 9,155 suspected cases, 1,270 confirmed cases, and 227 deaths.

”While we continue to intensify efforts using an all-of-society approach, the public is hereby advised to note that the virus spreads through direct contact with urine, faeces, saliva, or blood of infected rats. Contact with objects, household items, and surfaces contaminated with the urine, faeces, saliva, or blood of infected rats.

”Consuming food or water contaminated with the urine, faeces, saliva, or blood of infected rats or person-to-person transmission through body fluids of an infected person.

Dr Idris also warned health care professionals to be alert as Lassa fever presents like other common illnesses accompanied by fever, headache, general body weakness, cough, nausea, vomiting,

While noting that early diagnosis and treatment of the disease greatly increase the chances of patient survival, Dr Idris highlighted the economic cost of Lassa Fever to communities and the healthcare system.

”The disease is also associated with significant loss of livelihood in the communities it ravages. Heads of households are unable to work when exposed to Lassa fever and when other household members are infected, the cost of care and treatment of the disease strains existing household income pushing households toward poverty.

”Healthcare workers are also vulnerable and the loss of experienced medical personnel due to infection further strains the country’s limited healthcare workforce.”