Systematic failures of the government’s exposed pandemic strategy

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Public health officials charged with defending the country from a major pandemic have never devised plans for mass community testing despite warnings from the World Health Organization, The Telegraph may disclose.

Emergency planners “did not argue” about the need for community testing because they mistakenly thought that a new strain of flu would be the next epidemic to hit the UK, a senior government adviser said.

Instead, the ministers, as well as public health officials in England, the Cabinet Office, and the Department of Health, decided not to schedule mass tests despite an official WHO warning that it would slow the spread of the disease.

“It may be a mistake,” said Professor Graham Medley, chair of the Pandemic Influenza Scientific Panel on Modeling (SPI-M), the official committee advising the government on infectious diseases, including coronavirus.

The government is now facing increasing questions about Britain’s state of defense against the coronavirus epidemic.

Senior Whitehall officials confirmed that the need for mass testing “was not on our minds” when drawing up the country’s protection plans.

Britain struggled to speed up its mass testing program, while other countries, including Germany and South Korea, were able to act faster, testing hundreds of thousands of their citizens.

“Mass public testing has never been our strategy for a pandemic to my knowledge,” he told the Telegraph.

“The current problem is based on the fact that we did not invest in preparation before all this.

“We always knew that in the event of a pandemic, it was, not so. But the focus has been on preparing for the flu. And for things like the flu, mass testing is not important and never figured out a potential strategy Public health in England is at the heart of it all.

“The focus was on pandemic influenza and that is because it happens much more regularly. Pandemics with other viruses occur more rarely – but they do happen, because HIV is a virus, Sars was one potential pandemic, Mers was another, and Ebola: It has always been understood that the next great pandemic could to be a virus, but in fact it was probably more likely to be flu than any other because we know it happens regularly.

“We always knew it was going to happen at some point, and preparation requires you to have planned it, and they planned it, but there was no investment, and that’s why we are in this situation.

“Looking back, I would have recruited another 200 laboratory positions in October. You can call it a mistake, but on the other hand, you can say that it was just pragmatic and that the government did not want to invest millions of pounds in something it is about preparation, rather than a real situation before them at the time.

“The tests can be extremely powerful, and we desperately need them at the population level to be able to understand what is going on. The best data we have is hospitalizations and deaths, so we’re always a little late, while serology would give us a much better idea of ​​what’s really going on.

“In the end, we can look back and say it probably wasn’t the right thing to do, and maybe we didn’t make the right decision. “

In 2008, a potential flu pandemic was listed at the top of the UK’s national threat risk register.

Professor Medley said that emergency planners decided that mass testing would not be effective during an influenza epidemic because the disease had different characteristics from more dangerous threats like the coronavirus.

“Mass tests are not suitable for the flu because they have a much shorter duration of infection. And the symptoms don’t start until you are infectious, ”he said.

Professor Medley admitted, however, that British officials were aware of South Korea’s mass public screening strategy launched after the end of the Sars epidemic in 2004.

“The South Koreans developed mass tests because they had experience with Sars and so they clearly decided that this was a potential route for them,” he said.

Despite this, preparations by the British government appeared to conflict with official guidelines on avian influenza issued to countries by the World Health Organization (WHO).

In a 2005 consultative document, Responding to the threat of an avian flu pandemic, WHO advised countries to prepare for mass testing in the event of a major influenza epidemic.

“Because the first symptoms of H5N1 (avian flu) infection mimic those of many common diseases in these countries, accurate detection of cases requires testing of a large number of samples,” the document said.

“Improving local capacity is therefore a more rational solution. “

Britain’s preparation for a pandemic now raises big questions. Last week, the Telegraph revealed that the NHS had failed a major intergovernmental test of its ability to manage an epidemic four years ago, but the “terrifying” results were being kept secret from the public.

Called Exercise Cygnus, the three-day dry test for an influenza pandemic in October 2016, revealed that Britain would quickly be overwhelmed by a serious epidemic due to a shortage of intensive care beds, morgue capacity and personal protective equipment (PPE).

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The report on Cygnus’ findings was deemed too sensitive by Whitehall officials to be made public.

A senior Whitehall official involved in the development of Cygnus admitted that because the epidemic imagined had been that of the flu, the need for mass testing had never been discussed.

“We had no plans to do mass community testing at all, no. You could say it was not the right thing to do, “said the source, who spoke on condition of anonymity.

“We focused on the flu because we thought it was the next one. It is fair to say that next time we would take a very different approach. “

However, the source blamed Public Health England for failing to grasp the moment when other countries began stepping up their own testing programs.

“There is no reason why Public Health England and the ministers could not contact and advance this matter earlier,” said the official.

“The problem with Public Health England is their absolute control, I fear. It’s been history for many years. They have had to be mastered repeatedly just because they don’t understand how to collaborate.

“This is why there has been a reluctance to involve people from outside. It’s a total culture shock. In the end, they are a group of scientists, and they do not want to give work to others. “

In the various pandemic strategies published by Public Health England and the Department of Health over the past decade, the need to plan mass tests involving private laboratories and universities does not arise once.

A source from Public Health England stressed that the agency was not “the owner of the pandemic plan” and said that preparations for an epidemic had been led by the Department of Health and the Cabinet Office.

The source added that PHE was not responsible for the increased testing for NHS workers and said the agency had met its goals for testing sick coronavirus patients in the hospital.

“The deployment of the Covid-19 diagnostic test by PHE in other regions of the United Kingdom is the fastest deployment of a new test in PHE and NHS laboratories in recent history, including in the pandemic of swine flu in 2009, “said a spokesperson for PHE.

The Ministry of Health did not respond to requests for comment.

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