The government is failing to address the problems revealed by the Covid Inquiry, as the NHS decays, and threats of a new pandemic loom, argues Terina Hine

Public inquiries into disasters take too long and rarely lead to change, so said the House of Lords committee tasked to examine the effectiveness of large-scale public inquiries. The Covid Inquiry is unlikely to be an exception. A lengthy inquiry, millions spent, with ‘lessons learned’ in danger of becoming a vacuous phrase as recommendations are either ignored or pushed into the long grass. And while we wait for action, and the media is focused elsewhere, the next pandemic looms.

The latest round (Module 3) of the Covid Inquiry began in early September and has so far been met with only half-hearted interest. This is perhaps not surprising given the state of the world and the fact that the last two modules have resulted in so little change. But it is imperative that decisive action is taken. The next pandemic may not be that far away – indeed some say it is already with us – and may be even more deadly.

The latest sessions in the Inquiry heard how nurses bore the brunt of the pandemic in the NHS. How the shortage of PPE meant front-line nurses were working ‘in fear’ for their lives. The Inquiry was told that cutting nursing bursaries was ‘a catastrophic decision’ which led to declining nurse numbers and gross understaffing. Former Chief Nurse, Dame Ruth May, said the Cameron/Osbourne 2015 austerity cut had direct consequences for the care received by Covid patients. In the pandemic, ICU nurses were left caring for up to six patients, when the ratio should have been 1-1.

The confusion/disinformation over masks was also given an airing. Professor Susan Hopkins, chief medical adviser at the UK Health Security Agency (UKHSA), defended the decision to provide only surgical masks rather than higher grade FFP3 masks to medical staff, claiming there was only ‘weak evidence’ supporting the need for high-grade face masks, a claim that flies in the face of most research, BMA demands and real-world studies. But ‘group think’ which denied the airborne nature of the virus meant that it was not until 2022 that the official line changed, and medical staff were told FFP3s ‘must be worn’ by those caring for Covid patients and others with infectious airborne disease.

According to the evidence submitted, the advisory board did not agree over the use of masks in 2020-21. The PPE recommendations of UKHSA appear not to have been led by evidence about what was needed but rather by what was available. The result: more than 2,000 health workers died from Covid during the pandemic. Many of these deaths could have been avoided, and clearly other countries managed to do just that. According to Amnesty International, by 2021, the UK had the highest healthcare-worker Covid death rate in Europe and the third highest in the world.

But this is not new. We know from the previous Inquiry modules that the UK’s pandemic preparedness was poor, and that the NHS was in dire straits before Covid-19 hit. We all witnessed in real time that before, during and after the pandemic, the government neglected public health and oversaw the destruction of the health service. What we need is for the issues to be addressed, but it seems that under Labour, things will hardly get better.

Escalating dangers

Rather than saving the NHS, Streeting and Starmer seem bent on continuing to hasten its demise as they push the privatisation agenda. Everyone has stories of the near impossible task of accessing preventative care or getting a GP appointment. Hospitals remain short staffed and there has been no progress in addressing the social-care crisis. With health and poverty so intrinsically linked, Labour’s refusal to invest in the welfare state will ensure poor public health declines further.

At the same time, Covid cases are on the rise, a new variant is spreading fast throughout Europe, and almost no one is eligible for the booster jab on the NHS. A properly funded vaccination programme could reduce spread, sickness and time off work, and for the very vulnerable, hospitalisation. Yet vaccines are only available to the very old or to those who pay the £100+ charge.

Concerns over the next pandemic – or Disease X – have been rising this summer. And are we any more prepared than we were last time? Is the population healthy, robust, inoculated? Are there more hospital beds and staff available to serve them? No, no and no again.

An increasing number of potential viruses that might trigger a future pandemic have been identified, and of course there will be many that are yet undiscovered. The spillover from animals to humans is responsible for 60% of emerging infectious diseases, a result of the increasing encroachment on land, of habitat degradation and biodiversity loss. This encroachment and degradation are only going in one direction.

In spring 2024, a mutated strain of the H5N1 influenza virus (bird flu) was detected in dairy cattle and believed to pose a risk of being transferred to humans. This risk is still very real. Some scientists have stressed that as Arctic ice melts, the Arctic could become a nursery for new zoonotic diseases. With ‘forever chemicals’ spreading around the globe and ancient microorganisms thawing, the immunity systems of humans and other animals will be challenged. Yet governments across the world (and ours is no exception) have done little to prepare. 

If lessons are not learned both here and across the world, if the Covid Inquiry is allowed to be just another exercise in deferring responsibility and pushing decisions to some undefined future date, the price we all pay could be very high indeed.