Health and social care workers were often let down by the government whose claims that it was ‘guided by the science’ when developing policy to deal with the Covid-19 pandemic were questionable, according to an editorial published online today in The BMJ.
Many questions need to be answered when assessing how well the UK responded to the pandemic, says an opinion piece written by editor in chief of The BMJ, Kamran Abbasi, and Martin McKee and Kara Hanson, both from the London School of Hygiene and Tropical Medicine in London.
The BMJ has commissioned a series of articles to examine how evidence was used to shape the UK’s response to the pandemic as well as how information was sometimes “misused, abused, and manipulated” by some parties.
The first two of these articles, published today, question the evidence behind government decisions on how Covid-19 spreads and children and schools.
In the first article, Professor Trisha Greenhalgh at the University of Oxford and colleagues explore how flawed narratives about SARS-CoV-2 transmission arose and became entrenched early in the pandemic, leading to misplaced policies and avoidable deaths.
They say: “At the root of the UK’s limited success in controlling transmission of SARS-CoV-2 lie flawed droplet-but-not-airborne and situationally airborne narratives.
“These narratives, and the false certainty with which they were conveyed, produced ineffective public health measures, contributed to shocking levels of care home deaths, exacerbated toxic discourse on masking, and justified withholding adequate protection from most health and care staff.”
They invite the inquiry "to consider not just those specific flawed decisions but also the culture of premature scientific conclusions and reluctance to engage with uncertainty."
In the second article, Dr Deepti Gurdasani at Queen Mary University of London and colleagues argue that the UK government relied on evidence that downplayed the seriousness of Covid-19 in children, underestimated the benefits of precautionary measures, and overestimated the harms of vaccination.
They say: “Government policy seems to have been based on three assumptions – namely that children had a minimal role in community spread, particularly to vulnerable relatives; that schools were not loci of transmission; and that children were not harmed by infection.
“However, none of these assumptions is true, and this was knowable early on, when key decisions were made.”
They recommend the public inquiry "should explore why the UK was an international outlier in its approach to protecting children and making schools and communities safer."
In the editorial published today, Abbasi and co-authors say The BMJ’s series of articles will help inform the ongoing UK Covid-19 Inquiry being chaired by Heather Hallett.
That inquiry will document decisions made and examine the reasons for them as well as look at international comparisons and consider the experiences of bereaved families.
It will not be easy, warn the editorial authors who say: “One challenge will be getting at the truth, given the government’s track record of rejecting requests under the Freedom of Information Act, refusals by ministers to attend parliamentary committees, and [Boris] Johnson’s habit of not answering the questions put to him in parliament each week. This is a government that is uncomfortable with scrutiny.”
Another challenge that lays ahead for the inquiry will be assessing how the decision-making process was informed and influenced, they add.
“Throughout the pandemic politicians and their scientific advisers insisted that decision making would be ‘guided by the science’” they say. “However, evidence is socially constructed and can be highly contested. Different sources, and indeed types, of evidence are given different weight in developing policy: it is important to consider whose science counts, and why.”
The editorial says there were some successes in how the pandemic was handled, such as the early stages of the vaccine programme, how the NHS responded to rolling it out, and health service innovation.
However, mistakes were also made, they add, saying: “The evidence that SARS-CoV-2 transmits through the air, in crowded and poorly ventilated places, was clear relatively early on. Even now, many policies ignore this vital fact.
“Children have been harmed through Covid affecting them or family members, and through loss of education. The measures that would protect them, such as vaccination and improved ventilation in schools, attract lukewarm support at best.”
They conclude that the UK’s response should have been better, given the death toll was approaching 200,000 deaths in the UK.
“While debate continues about how best to compare the resilience of national health systems to shocks such as pandemics, there is little doubt that the UK’s response fell far short of its potential,” they say.
Each article in The BMJ series will, say the authors, offer messages to help inform the national inquiry, but they add: “One message is universal and unequivocal: scientists and health workers on the front line of the response, and therefore the public, were too often let down by politicians.”