Panorama 2020 E27
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00:00Tonight, Panorama investigates the UK's plans to fight coronavirus.
00:08It was just this fatalism that we're all going to get it and we might as well just get it
00:11over with.
00:12We speak to scientists at the heart of the government's response.
00:16We mustn't be catastrophists. We could do a lot of damage by raising false alarms.
00:21The World Health Organization was calling for urgent action.
00:27We have rang the alarm bell loud and clear.
00:33The only way you really deal with this virus is by actually stopping transmission.
00:41We reveal the early warning that hundreds of thousands could die.
00:46I mean with benefit in hindsight, clearly it would have been beneficial to lock down
00:50earlier.
00:52How many lives could have been saved if the government had acted sooner?
00:55It was a gamble that we had no right to take with the British public.
01:16From this evening, I must give the British people a very simple instruction.
01:21You must stay at home.
01:23The start of lockdown four months ago. It wasn't how the government saw this crisis
01:29unfolding.
01:30The UK had planned for a pandemic and rehearsed its response.
01:36This was the starting point for the government's response to coronavirus, the 2011 flu pandemic
01:42plan.
01:43It spells out in detail the likely stages of an outbreak and the measures to deal with
01:47it.
01:48Here are some lessons learned from previous pandemics, including one a hundred years ago.
01:58The Spanish flu of 1918 killed 200,000 in the UK and millions worldwide.
02:06Influenza is still considered one of the most serious peacetime threats to the UK.
02:12We've had sort of five documented pandemics of flu in the last hundred or so years.
02:17So it was sort of reasonable to base most of the planning around flu.
02:23Back then, efforts to stop the virus failed. It kept on coming. The second wave deadlier
02:30than the first.
02:32It took two years for Spanish flu to burn itself out.
02:43A century later, the government's flu plan assumed future pandemics could follow a similar
02:48path.
02:49If you read the 2011 pandemic flu plan, they say don't cause social disruption, keep people
02:55calm. It's going to run through. It's inevitable. It's unstoppable.
03:03In early January, the government started to put its plans into action. They'd been monitoring
03:08events in China.
03:13Good evening. The Chinese authorities are taking drastic action to try to stop the spread
03:18of the new coronavirus.
03:20Wuhan, the city at the epicentre of the coronavirus outbreak, was locked down. The World Health
03:27Organisation said prepare for the worst.
03:31Make no mistake, it has not yet become a global health emergency. It may yet become
03:42one.
03:44The chief medical officer has revised the risk to the UK population from very low to
03:49low and has concluded that while there is an increased likelihood that cases may arise
03:55in this country, we are well prepared and well equipped to deal with them.
04:04Advising the government on the response to coronavirus was SAGE, the Scientific Advisory
04:08Group for Emergencies. It asked several academics to analyse data on the virus and to assess
04:13the threat to the UK.
04:17We started working on this in mid-January when we realised that the epidemic in Wuhan
04:22had to be much larger than we thought. As to how we would navigate it, one of the key
04:27things there is how lethal is the disease, because that really determines how much one
04:34spends and invests in a response.
04:40Initially there was uncertainty about how COVID-19 might take hold in the UK.
04:46There is still a great deal of care needed when you're translating one country to another.
04:53You think about the structure of China, it's a bigger country, it's just very difficult
04:58to translate one social cultural setting to another.
05:05There's a lot of emerging disease all the time, it's a big problem. And so I think it's
05:11fair to say that we could do a lot of damage by raising false alarms. We mustn't be catastrophists.
05:18With no vaccine or treatments, the WHO was urging strong measures to stop the virus spreading.
05:25Any delay is likely to have long-term and major consequences. I believe that we have
05:32to have a no-regrets policy, otherwise we will always be basically pulling our punches.
05:44By the end of January, coronavirus had spread to 19 countries. The WHO put the world on
05:50alert, declaring a health emergency of international concern.
05:57The medical journal, The Lancet, published a series of articles by Chinese doctors.
06:02This new virus was deadly.
06:05It was absolutely clear by the very end of January that we were dealing with a virus
06:11that had a high mortality rate for those people who were admitted to hospital. This was not
06:16a simple viral pneumonia, this was a lethal multi-organ illness.
06:25Please, the world wake up, hammer this virus and prevent it from being a serious problem
06:33or a crisis in the rest of the world.
06:39People arriving here from China and other high-risk countries were quarantined or told
06:43to self-isolate. In February, travellers returning from Italy were already seeding the virus
06:49across the UK.
06:56At the beginning of March, the government told the country how it plans to fight the
07:00virus.
07:01The plan has four strands. Containing the virus, delaying its spread, researching its
07:09origins and cure, and finally mitigating the impact should the virus become more widespread.
07:21The government said protecting the NHS and saving lives was central to its planning.
07:26It said spread of the virus may be inevitable and its aim was to slow it down.
07:32I don't think we ever thought the pandemic could be stopped. I mean, it hasn't been stopped
07:36in a global sense. There's no way we could eliminate this virus from the human population.
07:42From the start of the crisis, the government asked scientists to model or predict what
07:46might happen. Doing nothing, it was told, would mean half a million dead.
07:51Can you give me an idea about the conversations that were going on in SAGE when you were looking
07:57at half a million deaths?
08:00Well I think that half a million deaths, I have to stress that half a million deaths
08:04is the do-nothing scenario and we never really expected half a million deaths to be seen
08:09because obviously the government will act on that and the question is, what is the policy?
08:15Basically you have two options when a disease like this is coming. Suppression means you're
08:19trying to get to zero cases. Mitigation is you kind of think it's happening and the trick
08:26is just to minimise the problem, right? So if a tsunami is coming, we don't try to stop
08:31the tsunami, we just try to ensure that the minimum number of people are harmed by it.
08:39Some scientists advise against suppressing viruses for fear of creating a second wave
08:44of infection as soon as suppression measures are lifted. Mitigation looked like the best
08:49option.
08:50One of the theories is that perhaps you could take it on the chin, take it all in one go
08:57and allow the disease as it were to move through the population without really taking
09:05as many draconian measures. I think we need to strike a balance.
09:11It was never the government's intention to let the virus spread unchecked. Its strategy,
09:17mitigation, was to manage its spread and limit the damage. The government said the most vulnerable
09:23would be protected, but people would still die.
09:28It was just this fatalism that we're all going to get it and we might as well just get it
09:31over with, where I think that's fine if you think of people as data points, but if you
09:35see their faces and you know their histories, it does raise alarm bells.
09:40Sir David King is a former chief scientific adviser. He now leads a group of scientists
09:47who have been critical of the government's response to coronavirus.
09:51I can only give you one rational explanation for the strategy, and that is that they had
09:57decided to go for herd immunity. We did hear the phrase herd immunity, although the government
10:03subsequently somehow denied that they were doing that.
10:07Herd immunity is a term used by scientists who study the spread of infection. When a
10:13new disease appears and there's no vaccine, everyone is susceptible, so it spreads rapidly.
10:20As people recover, they're assumed to become immune. Once enough people have had the disease,
10:27infections naturally begin to reduce.
10:29So herd immunity means that people get it, whoever dies, dies, whoever is ill hopefully
10:37has access to medical treatment and recovers, and then whoever makes it has immunity to
10:42this virus, which means that over time you have a population of whoever's left who has
10:46immunity.
10:49Advancing herd immunity is a balancing act. You accept people will catch the virus, but
10:54not too many all at once so the NHS can cope.
11:01The government's scientific advisers call it flattening the curve.
11:05There are a number of measures that could be taken to try and reduce the peak and flatten
11:11it a bit so we haven't got such a sharp number of people at any one time.
11:18The government said these measures could include closing schools, quarantining the
11:22sick and reducing social contact.
11:27Kit Yates is a biological mathematician who's followed the UK's response to coronavirus.
11:33Flattening the curve is all about still letting the disease pass through the population but
11:39at a slower rate so that we don't overwhelm the NHS and the potential outcome of that
11:44is that you achieve some degree of herd immunity.
11:47But there was a problem. By the 5th of March a team of scientists had delivered their findings
11:53on the likely number of deaths if a mitigation strategy was pursued.
11:58At least 305,000 and the NHS could be overwhelmed.
12:05I mean our projections of the potential health impact of the pandemic were known from about
12:10the 5th of March onwards and being I think actively discussed within government.
12:16Professor Ferguson says he told SAGE the findings were his best estimate of what was most likely
12:21to happen. He says other scientists had reached similar conclusions too.
12:27But there was scepticism within SAGE so the professor had to accept that his findings
12:32wouldn't be used as a forecast of what might be to come.
12:37If that result was known on March the 5th that's devastating. That means we wasted over
12:44two weeks when the virus was exponentially growing through communities up and down the
12:52country. This information should have been publicly available to be scrutinised by other
12:58scientists, by other experts so that we could have had a public discussion and built public
13:04support for an early lockdown.
13:07Meanwhile, for the UK, it was business as usual. Most big events went ahead as planned.
13:24On March the 11th, the WHO escalated the threat level.
13:28We're deeply concerned both by the alarming levels of spread and severity and by the alarming
13:38levels of inaction. We have therefore made the assessment that COVID-19 can be characterised
13:48as a pandemic.
13:51The WHO urged countries to test, trace and isolate people with the virus in order to
13:57drive down the number of infections.
14:01Containing these outbreaks and suppressing them is the only strategy to use. Don't anticipate
14:07a switch to the alternative strategy of mitigation. Certainly not in a country like the UK where
14:14it should be possible to continue doing case finding and indeed contact tracing. We said
14:21please sustain the capacity to suppress outbreaks right throughout your outbreak management.
14:30That is the only way to get ahead of this virus.
14:35The government's testing capacity was limited and on the 12th of March it all but abandoned
14:40testing and tracing outside of hospitals. The same day, the Prime Minister prepared
14:45us for how bad things could get.
14:48I must level with you, level with the British public. More families, many more families
14:55are going to lose loved ones before their time.
15:00Coronavirus was now in 118 countries and more than 4,600 people were dead. Europe was locking
15:09down. Italy was first. In the UK, the Prime Minister told those with a fever or cough
15:17to stay at home and he repeated advice first introduced in January.
15:23It is still vital, perhaps more vital than ever, that we remember to wash our hands.
15:31What did you think in March when other European countries were locking down and we were being
15:35told to wash our hands?
15:37It was absolutely baffling. I didn't really understand what was happening in the sense
15:41of like, what is the plan? I expected at that point for us to go into a hard lockdown and
15:46instead it seemed like giving up.
15:49At all stages, we have been guided by the science.
15:56So we've adopted a balanced approach, guided at all times by the science.
16:01Every day the science gets better.
16:03The government kept saying they were following the science and so several colleagues and
16:07myself wrote a letter to the Times asking, can we see the science? We don't understand
16:11it.
16:12The UK was still following its mitigation strategy, assuming we would be building up
16:17herd immunity. But had the government been clear enough with the British people?
16:23There are huge moral questions to this kind of strategy and also not doing it in a public
16:27way, not having a public discussion about it.
16:31That was about to change. Senior scientific advisors began talking about herd immunity.
16:38It's not possible to stop everybody getting it. And it's also actually not desirable because
16:43you want some immunity in the population. We need to have immunity to protect ourselves
16:48from this in the future.
16:50And that included people working on the UK's response to coronavirus.
16:56I've been leaked a set of notes from a conference call on the 13th of March between NHS England's
17:01director of communications and the communications teams from the medical royal colleges.
17:08The colleges were told there was no need to cancel face-to-face meetings for fear of catching
17:13the virus and that herd immunity was government strategy.
17:18NHS England says it was just echoing what the chief scientific advisor, Sir Patrick
17:24Vallance, had been saying in the media that day.
17:28Companies will become immune to it and that's going to be an important part of controlling
17:32this longer term. 60% is the sort of figure you need to get herd immunity.
17:40On the same day Sir Patrick Vallance talked about herd immunity, NHS England's medical
17:44director attended a SAGE meeting.
17:48Panorama's been told he made it clear the government's mitigation strategy would result
17:53in more sick people than the NHS could cope with.
17:59Two days later Health Secretary Matt Hancock denied herd immunity was government policy.
18:06Herd immunity is not our policy, it's not our goal. Our goal is to protect life and
18:11our policy is to fight the virus and protect the vulnerable and protect the NHS and that's
18:18what we're doing.
18:19It seems strange to me that one wants to rewrite the history of the way this epidemic
18:25has been managed to erase herd immunity from the story.
18:29Ministers have now said herd immunity was not our goal, it was not our policy.
18:34Well I think it really came down to a public backlash where it was publicly unacceptable
18:39to say to people, you know, kiss goodbye to granny.
18:45It was a huge gamble and it was an unnecessary gamble. It was a gamble that we had no right
18:55to take with the British public.
18:57The government has said herd immunity is the natural by-product of an epidemic. It told
19:03Panorama it is categorically wrong to suggest herd immunity was the government's aim.
19:14By the middle of March there had been 43 deaths in the UK. In Italy parts of the health
19:20service were already becoming overwhelmed.
19:25They were now in the middle of a storm our government had been warned could be heading
19:30to the UK.
19:34On the 16th March, nearly two weeks after Professor Ferguson delivered his estimate
19:39to government of the likely death toll if it continued with the mitigation strategy,
19:44he made his findings public.
19:47The paper said that if the government continued on that course, critical care capacity could
19:51be overwhelmed and suppression of infections was now the only viable option and that needed
19:57to happen imminently.
20:00He'd revised the number of deaths down to 250,000 and the NHS would still be swamped.
20:08All the modelling indicated by really by before the 16th March that the NHS just would
20:14not be able to cope. We would not be able to protect the elderly and vulnerable population
20:18well enough to avoid anything but a catastrophic epidemic.
20:24That evening the Prime Minister made an announcement. We were now on the road to lockdown.
20:31Now is the time for everyone to stop non-essential contact with others and to stop all unnecessary
20:39travel.
20:42Responding to the warnings it had received, the government now introduced tougher measures
20:46but full lockdown was still seven days away.
20:51Simultaneously with our report coming out, I mean the government announced the most stringent
20:56social distancing policies they had up to that point but of course they were voluntary
21:01and there's a big distinction between voluntary and compulsory policies.
21:07The government knew it could be heading for huge numbers of deaths. But how soon?
21:12Patrick Vallant said on the 12th March that we were four weeks behind Italy. In fact we
21:16were really only two weeks behind and that was a consequence of getting this doubling
21:19time wrong. It gave us a false sense of security.
21:24The doubling time showed how fast the epidemic was growing. The scientists thought it was
21:29every five days. But they didn't have accurate data.
21:35We had a relatively poor handle on true extent of infection in the country at that time.
21:40It was literally only that week that systematic NHS surveillance was stood up. What I mean
21:46by that is that started testing all hospital patients coming into hospitals with relevant
21:52symptoms.
21:54In the days leading to lockdown, it became clear the doubling time was not every five
21:59days, but closer to three. That meant possible disaster for the NHS was much closer than
22:06anyone in government thought.
22:09We were probably days away from reaching capacity in the NHS.
22:13Do you remember how many?
22:16I think we were. We were probably a fortnight, within a fortnight we'd have hit capacity.
22:23I think the biggest thing which would have made the difference, both to the scientists
22:27like me and to the policy makers in understanding the extent of the crisis, is to have had better
22:32surveillance in place, more testing in place, so we actually understood how much infection
22:37there was in the country. I regret, I mean I do push fairly hard, I regret not pushing
22:41harder on the testing front.
22:46On the 23rd of March, a week after scientists had warned of 250,000 deaths, the government
22:53changed course. Lockdown became compulsory.
22:59The Prime Minister has announced the most drastic limits to our lives that the UK has
23:04ever seen in living memory.
23:07As the UK hunkered down, coronavirus was already spreading among some of the country's most
23:13vulnerable, despite government promises to protect them. In the weeks before lockdown,
23:19the NHS had been freeing up space for a surge of Covid-19 patients.
23:26People who were in hospital were sent back to care homes without any testing and this
23:32meant that many of our care homes got the virus and we got a very large number of deaths.
23:42Care home residents have accounted for almost a third of all UK Covid-19 deaths.
23:51This is Cramlington House in Northumberland. Panorama was here the week before lockdown.
23:56To Maxine, lots of love and happiness from Tom.
24:01The owner Lucy Craig filmed for us inside.
24:04There's so much separation going on with people being inside and people not being able to
24:09come in and see them. What are these guys going to be doing?
24:13It's been such an emotional journey. It's been heartbreaking at times. It's been incredibly
24:18demanding. One of my homes had had a Covid outbreak and that has gone right through the
24:24home.
24:26Lucy did what she could to keep her residents safe. She stopped staff moving between homes
24:31and paid for taxis for them to get to work. She also agreed with her local authority that
24:36Anyone who might be positive was quarantined before being sent to her. But still, the virus
24:41got through.
24:42Perfectly frank with you, we've had 53 positive residents in the home and we've had six Covid
24:51deaths. And I've got people saying to me, wow, those numbers are great. No they're not.
24:57Those numbers are horrendous for me personally. Any death is a horrendous death.
25:04So far, more than 45,000 people have lost their lives to coronavirus. Some initial vaccine
25:10results are promising. For those who've already had the virus, it's too early to say what
25:16immunity they have and how long it will last.
25:21Throughout the crisis, the government has said it did the right thing, at the right
25:25time. But Professor Ferguson believes that had the government ordered lockdown just one
25:32week earlier, between 20 and 30,000 lives could have been saved.
25:38I mean, with benefit in hindsight, clearly it would have been beneficial to lockdown
25:42earlier. If you can imagine everything that happened a week earlier, that would have made
25:47a big difference.
25:50Not only has the timing of lockdown been a factor in the UK's death toll, it's had other
25:55consequences too.
25:58If we'd locked down a week earlier, we would have either been able to come down out of
26:02lockdown a lot sooner, or if we'd stayed in lockdown for the same length of time, to come
26:06out with far fewer cases.
26:07The key trade-off here is between the health impacts of an epidemic and the economic costs
26:14and how you can manage things long term. The challenge with suppression, which we're experiencing
26:22at the moment, is that you don't really have a long-term exit strategy. You're stuck in
26:27the same policy until you really have a vaccine.
26:32The government says this is an unprecedented global pandemic. It says at every stage it's
26:39been guided by the advice of experts from SAGE, and that its response ensured the NHS
26:44was not overwhelmed, even at the peak of the virus, so that everyone was always able to
26:49get the best possible care.
26:51Order, order. The committee is now in session.
26:56Earlier this week, the chief scientific advisor signalled that mistakes have been made, and
27:00said SAGE urged government to lock down a week earlier.
27:05It's clear that the outcome has not been good in the UK. I think we can be absolutely clear
27:09about that. And there will be decisions made that will turn out not to have been the right
27:14decisions at the time, I'm sure, about that as well.
27:18I'm incredibly worried that this winter will be rough, and we might see a second wave and
27:24a second lockdown to control it. If you just look at the numbers, we have to learn from
27:28March and not repeat those mistakes.
27:32I don't think there's any perfect system, and I think our system is actually very good
27:36at what it does, but certainly I think some reflection needs to be given to how agile
27:43it is in decision-making.
27:45There's no shame in admitting that the system made mistakes. This isn't about blaming individuals.
27:51This is understanding why our system failed.
27:56The government says there will be an independent inquiry into the coronavirus crisis. No date
28:02has yet been set. The government says it must remain focused on tackling the pandemic and
28:08saving lives. But there are calls for an inquiry now to help prepare us for what might come
28:15next.
28:21We might have seen clips on the news, but what was everyday life like for those who
28:25were in Iraq during the war? Once Upon a Time in Iraq continues with personal and emotional
28:30recollections on BBC Two tonight at nine.