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COVID: how incorrect assumptions and poor foresight hampered the UK's pandemic preparedness

Loveandrock/Shutterstock

Matt Hancock, the former health secretary, has told the recently opened COVID-19 Inquiry that the UKโ€™s pandemic planning was โ€œcompletely wrongโ€. According to Hancock, the doctrine was โ€œto plan for the consequences of a disasterโ€ rather than stopping or containing the virus in the first place.

While there is truth in this claim, it doesnโ€™t give us the whole picture. Hancock was repeatedly asked during his appearance about something called Exercise Cygnus. In 2016, the UK government engaged in a series of exercises including Cygnus to assess their preparedness and response to a pandemic outbreak of influenza.

As the global scale of the COVID pandemic was starting to become apparent in the first half of February 2020, the UK applied the lessons from these exercises to plan for a wide range of scenarios. Based on the scientific evidence available at that time, they anticipated that a โ€œreasonable worst-case scenarioโ€ could involve up to 80% of the UK population being infected (with only 50% of those infected showing symptoms). However, it was hoped that the majority of cases would have relatively mild disease.

This information was contained in planning assumptions labelled โ€œofficially sensitiveโ€ that were shared between a range of healthcare authorities and that I had access to at the time. Some of the figures were also published in the media.

The concept of โ€œherd immunityโ€ played a key role in the existing mathematical models. Herd immunity is the idea that once a sufficiently large proportion of the susceptible population is infected and subsequently acquires immunity, the whole population becomes protected. The thinking was that herd immunity for COVID might be achieved once 80% of the UK population had been infected, or perhaps even earlier.

Underlying all this was the assumption that, in the absence of effective vaccines at that time, the case fatality rate from the new virus (the proportion of infected people who end up dying) would not be so high that herd immunity could only be achieved at the cost of many lives.

Unfortunately, the actual COVID mortality figures โ€“ first from China, then other east and southeast Asian countries, and by the second half of February 2020 also from Italy โ€“ showed that the initial case fatality rate of COVID was much higher than had been modelled in the UK scenarios.

Without effective vaccines, any attempt at herd immunity had to be abandoned as too many people would have died in the meantime.

Flawed assumptions

The assumption that any new viral pandemic would develop along similar lines as previous influenza pandemics was arguably the key flaw in the UKโ€™s planning doctrine.

Countries that had been significantly affected by the severe acute respiratory syndrome (Sars) outbreak in 2002โ€“2004 โ€“ principally China but also other Asian countries โ€“ didnโ€™t make the same mistake. Those countries recognised important biological similarities between COVID (or SARS-CoV-2) and SARS (or SARS-CoV-1) and quickly took action against COVID by means of intensive testing and quarantine policies.

In contrast, the UK lost valuable time between mid-February and mid-March while COVID cases and subsequent deaths were rapidly beginning to rise. The effect on older adults and other vulnerable people in UK care homes was especially severe.

A healthcare worker wearing PPE looks at a clipboard.
The COVID inquiry is ongoing. Cryptographer/Shutterstock

In the end, the UKโ€™s first wave of COVID was only slowed and eventually stopped by the introduction of a lockdown in the fourth week of March 2020.

Poor planning

Hancockโ€™s statement raises a key question about the extent to which errors in the UKโ€™s pandemic planning could have been foreseen at the time. Notably, the UKโ€™s healthcare planning authorities could have taken a wider view of the potential nature of viral pandemics.

The earlier Sars outbreak had been largely confined to China, although it spread to more than 20 other countries through worldwide air travel, and was contained within a few short months. Therefore, the risk of future outbreaks of this type in the UK was regarded as relatively low. Nevertheless, it wouldnโ€™t have been unreasonable to include the global re-emergence of a Sars-type virus as one of the possible, albeit more extreme, pandemic scenarios analysed in the UKโ€™s planning exercises in 2016.

Even given the wrong assumption regarding the nature of the new virus, some issues could have been anticipated better. For example, it was well known that the supply chain for personal protective equipment (PPE), which is vital for health and care staff, had become increasingly dependent on low-cost suppliers in China. If the UKโ€™s pandemic planning exercises had taken a more global perspective, the breakdown in the PPE supply chain in the spring of 2020, which caused huge financial waste (and apparent corruption), could have been better anticipated.

Other questions, such as when effective COVID vaccines would become available, were much harder to predict.


Read more: How to prepare for a pandemic


In sum, no planning exercise can cover all eventualities. But a key requirement for policymakers should be to learn as fast and effectively as possible while events unfold.

The business concept of โ€œdynamic capabilityโ€ โ€“ that is, an organisationโ€™s ability to configure and reconfigure its assets, processes and capabilities so as to respond effectively to rapidly changing external circumstances โ€“ is useful here. Building and strengthening this capability should be a prerequisite for policymakers and planners in government.

In regards to Hancockโ€™s comment that the planning was โ€œcompletely wrongโ€, one could say that the UK plans were indeed flawed in their key assumption (of an influenza rather than a coronavirus pandemic), but also that policymakers should have learned the true nature of the new virus more quickly than they did.

The Conversation

Robert Van Der Meer receives funding from NHS Lanarkshire, NHS Golden Jubilee and the Scottish Government.

Estonian elections: conquered by Russia for centuries, why this Baltic country is worried about the Ukraine war

Russiaโ€™s war in Ukraine has quickly refocused the politics of its Baltic neighbours. Renewed threats to national security have swiftly risen to the top of each nationโ€™s priorities.

In autumn 2022, Estonia like other Baltic countries, restricted travel over its land borders from Russia. Flights were already banned from Russia as part of an EU-wide decision. St Petersburg is only 229 miles away from Estoniaโ€™s capital Tallinn, and Estonians are all too aware of their recent history with Russia including being conquered by the Russian empire from 1710 and forced to become part of the Soviet Union in the 20th century. It shares memories of Russification and suppression of its language with Ukraine.

Occupied by the Soviet Union until 1991 and sharing a 294km border with Russia, defence and security have risen up the agenda in the Estonian media and politics in the past 12 months. But itโ€™s not surprising with a militarised Russia on its doorstep the Ukraine war is focusing minds in the election of the countryโ€™s next parliament. Estonia is providing more military aid as a share of GDP than any other Nato country. Polls close on March 5 2023. National defence, crisis readiness and energy independence are all being covered in the campaigns.

Tensions are clear. Russia expelled Estoniaโ€™s ambassador Margus Laidre in January 2023 and Estonia responded by doing the same to the Russian ambassador Vladimir Lipajev. Just days before the election Estonia held a 105th anniversary parade of the Republic of Estonia in Tallinnโ€™s Freedom Square. The highly symbolic event also featured military equipment and representation from Estoniaโ€™s Nato allies and a speech from Nato secretary general Jens Stoltenberg, who evoked Estoniaโ€™s fight for freedom and the Ukrainian battle with Russia today. He said: โ€œYour history is a strong reminder that we cannot take our freedom for granted.โ€

The first televised debate of this election produced by the Estonian Public Broadcasting Service focused, not surprisingly given the international situation, on defence.

Estoniaโ€™s political parties seem to widely agree on security and defence policies. A cross-party consensus is committed to increasing national defence spending, with most parties pledging to bring defence spending to a minimum of 3% GDP. The radical right populist Estonian Conservative Peopleโ€™s party (EKRE) is, however, critical of the current governmentโ€™s decision to give Ukraine weapons and ammunition, which it claimed had depleted Estoniaโ€™s defences. And one prominent EKRE parliamentary candidate has called for a change of policy to establish better relations with Russia.

There is little disagreement over Estoniaโ€™s continued Nato membership or a pledge to invest in national crisis infrastructure (such as bomb shelters and emergency sirens), issues that have not received much attention in previous election manifestos.


Read more: Ukraine war is blurring the lines between Nato and the EU on defence policy


Putinโ€™s war in Ukraine and the consequent energy crisis has also highlighted the importance of energy policy, and all parties directly link the issue to national defence. While there is broad agreement across parties about the need to ensure electric energy independence by 2030, the ways in which to reach that vary by party and ideology. The liberal and centre-left parties emphasise renewable energy sources as the primary route to energy independence in their manifestos and public debates, right-wing EKRE openly opposes the โ€œmad green turnโ€ and pledges to continue fossil fuels use until Estonia transitions to nuclear energy.

Kallas is leading the polls

Despite the widespread agreement on defence, electoral research suggests that parties can still compete on issues that they primarily agree on by emphasising their competence and ability to manage the issue. The latest polls suggest that current prime minister Kaja Kallas, and her Reform Party, lead this competence battle and are set to win the most votes in the election.

Kallas, the first female prime minister of Estonia, enjoys a healthy lead as the most popular potential leader. She is an avid and vocal supporter of Ukraine, and public satisfaction with Kallas and her government has increased rapidly following the start of Russiaโ€™s full-scale armed offensive in Ukraine in February 2022.

Overall, her current support reflects an impressive turnaround as her popularity had dropped to all-time low of 16% in November 2021, when her government was perceived as indecisive in its handling of COVID-19 pandemic.

Kallas is regularly seen in leading western news outlets such as the New York Times, Der Spiegel, The Times. She now enjoys high approval ratings at home for her strong stance on Putin, effectively subverting common gender stereotypes of women being weak on national defence and security issues.

Nationalistic right-wing conservative parties including EKRE and Pro Patria are strongly emphasising their credentials in defending the Estonian language, culture and sustainability as a nation. Notably, EKRE avoids mentioning Ukraine or Ukrainian refugees in their manifesto, and instead emphasises the need to stop mass migration to Estonia.

Blue and yellow map of Estonia
Peter Hermes Furian/Shutterstock

Pro Patria and EKRE, and the liberal right-wing Reform party also use the current security situation to highlight nationalistic credentials. These parties pledge to remove the right to vote in local elections for Russian citizens who are permanent residents in Estonia. The Centre party, which currently has the largest support among Russian-speaking voters, and left-liberal Estonian Social Democrats both pledge to respect local election voting rights for all permanent residents.

With a 23.7% ethnic Russian minority, Estonia currently provides early and general education both in Estonian and Russian, in schools separated by language. The Ukraine war has brought this policy further up the agenda with most parties now pledging to create a unified school system with all or most classes taught in Estonian, with the exception of the Centre party.

The looming presence of the Russian war in Ukraine has far-reaching implications for Estonia and its neighbours. The threats created by a nearby war have further strengthened its hardline attitude towards Russia as Estonia, the other Baltic countries and Poland see (and fear) more than most what could happen next. Thereโ€™s no question that this will stay at the top of the agenda for whoever takes over as prime minister.

The Conversation

Zachary Greene receives funding from the Norface Network as part of the EU-in-Action research project and the EU Horizon 2020 OPTED project, designing infrastructure for computational text analysis in the social sciences.

Maarja Lรผhiste does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

New Brexit deal will be better for Northern Ireland's economy than the protocol, research suggests

UK prime minister Rishi Sunak has said Northern Ireland will be โ€œthe worldโ€™s most exciting economic zoneโ€ due to its access to the EU single market under the latest post-Brexit trading deal between the EU and UK.

The details of the Windsor framework are still being pored over by politicians and business leaders across the UK, and particularly those in Northern Ireland.

But the agreement in principle aims to address some of the weaknesses of the Northern Ireland protocol. This came into effect in January 2021 as a way to check goods travelling from Northern Ireland into the Republic of Ireland (an EU member) without creating a hard border between the two.

According to the government, it has been a โ€œsource of acute political, economic and societal difficulties in the two years since it has been operatingโ€. The main economically significant issues addressed by the new deal relate to goods movement, retail of agriculture and food products, and medicines.

The Windsor framework aims to cut trading costs by simplifying customs checks for goods entering Northern Ireland. It will do this by reducing paperwork and shortening customs processes by relaxing some rules for internal UK trade. Many of these improvements will result from improved IT systems, data sharing and market surveillance enforcement between the EU and the UK.

Research we published in 2021 on the impact of Brexit and the protocol showed it would cause Northern Irelandโ€™s economy to contract over the long run by up to 2.6%. And the same research suggests the new deal could mean a much smaller contraction.

We found that industries that primarily trade in goods โ€“ agriculture forestry and fishing, or food and drink โ€“ would be most affected by the protocol. Industries that mostly trade in services, such as the financial sector, would be less exposed but still negatively affected.

But with 80% of this contraction coming from trade barriers between Great Britain and Northern Ireland, any efforts to ease trade within the UK will help the regionโ€™s economy.

Our economic model used data for 2017 (pre-Brexit) to simulate how the economy might change over time after Brexit. This was based on differences in the trade costs of what Northern Irish firms buy from Great Britain (inputs), as well as sales of Northern Irish goods and services to the rest of the world including the EU (outputs).

Itโ€™s important to note that our simulation considers Northern Ireland in isolation. This means it assumes that the cost of inputs made outside the region are fixed, except for tariffs and non-tariff barriers, and that the same pre-Brexit trade agreements with non-EU countries are in place. But our results still provide some insight into how the new Windsor framework compares to the previous deal.

Great Britain is Northern Irelandโ€™s main trade partner, providing about 65% of its imports of goods. These are not just goods directly consumed by households, but also include intermediate goods used in production by Northern Irelandโ€™s industries. This makes the region particularly exposed to trade shocks with the rest of the UK.

Unsurprisingly, any non-tariff barrier (something other than charges or quotas) affecting inputs will increase the costs of production, which may cause increased prices for consumers.

Households in Northern Ireland also purchase products from industries that are dependent on trade with Great Britain. For example, 29% of spending on domestically produced goods occurs in the wholesale and retail industry, which is a major importer from Great Britain.

Why these results are still relevant today

A key area of focus of the Windsor framework is on the effort to reduce the paperwork need to transport and sell agricultural produce. According to the European Commission, movement of goods is simplified under the new deal by the need for โ€œonly a single general certificateโ€ for lorries, reduced checks and โ€œsimplified procedures for plants and agricultural machineryโ€.

Our research shows the agriculture, forestry and fishing, and food and drinks industries had both the greatest contractions in output and the largest non-tariff barriers under the Northern Ireland protocol. So, we expect any simplifications in this area to reduce the costs of trading with Great Britain, particularly in these sectors.

The special provisions made for these sectors should also reduce some of the non-tariff barriers faced, such as the bans on particular goods and higher rates of customs checks versus other products. More generally, we expect newly streamlined customs checks and processes to help other industries face lower non-tariff barriers than under the previous arrangement.

Agricultural food and retail will likely benefit the most from the new arrangements. Northern Irelandโ€™s GDP will still fall as a result of Brexit but if we were to repeat our simulation today, GDP would likely decrease by less than what we had predicted under the protocol.

The actual size of the economic gains from the framework versus the protocol are hard to measure at this stage. The framework does not entirely remove non-tariff barriers because goods at risk of being sold to the EU will still be checked by customs when they enter Northern Ireland.

Reductions in non-tariff barriers will also require firms to declare where goods are to be sold. And Northern Ireland will still face friction for services trade with the EU. We estimated this would account for 20% of the GDP cost of Brexit under the protocol.

So, even in the most optimistic case, where non-tariff barriers to trade between the two parts of the UK are significantly reduced, the Windsor agreement will not completely neutralise the economic impact of Brexit in Northern Ireland. But the new deal between the EU and the UK is still likely to do better for the Northern Irish economy than the protocol.

The Conversation

Geoffroy Duparc-Portier receives funding from the ESRC "Centre For Inclusive Trade Policy" (ES/W002434/1) and from the Scottish Graduate School of Social Science (project reference number 2277374).

Gioele Figus receives funding from the ESRC "Centre For Inclusive Trade Policy" (ES/W002434/1), and "Trade in Northern Ireland: Characteristics of businesses and workers" ES/X013502/1.

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