The People’s Covid Inquiry has released a scathing report which finds Boris Johnson’s government responsible for tens of thousands of avoidable deaths, reports Tom Griffiths

The People’s Covid Inquiry was founded in January 2021 with the aim to learn lessons and save lives now. We believed then, and do still, that the government’s handling of the pandemic is not receiving enough scrutiny. A public inquiry should not wait until the pandemic is over, and much of the discussion of the pandemic, in both the media and government, overlooks the society-wide context of the pandemic. This includes more than a decade of austerity, increasing inequality, and the NHS being chronically underfunded, short staffed, and increasingly fragmented due to privatisation.

People’s Covid Inquiry chair Michael Mansfield QC, said:

‘Within this narrative lies a theme of behaviour amounting to gross negligence by the government, whether examined singularly or collectively. There were lives lost and lives devastated, which was foreseeable and preventable. From lack of preparation and coherent policy, unconscionable delay, through to preferred and wasteful procurement, to ministers themselves breaking the rules, the misconduct is earth-shattering.’

While the crisis became increasingly severe, it was ever more urgent that lessons were learned and implemented as quickly as possible. We hoped that the Government would heed calls for a public inquiry from organisations such as the Covid-19 Justice for Bereaved Families, and others. It did not.

As the pandemic took hold, it became manifestly obvious that there were key moments when the government’s response was delayed and inadequate, likely contributing to unnecessary deaths. These included the early adoption of the widely criticised ‘herd immunity’ approach; the early abandonment of contact tracing (12 March 2020); the premature easing of lockdown during the summer of 2020, and associated stunts such as ‘eat out to help out’; the hesitation to implement lockdown in the run up to Christmas 2020; and the refusal to close schools, which led to an unnecessary spike in deaths throughout the winter of 2020-2021.[1]

Despite being the sixth richest nation in the world, it is undeniable that Britain’s overall response is among the worst in terms of avoidable deaths among the richest nations in the world.

The inquiry also noted the disproportionate effect on people from Black, Asian, and Ethnically Diverse (BAED) communities. On 12 May 2020, an Independent Sage report expressed serious concern about the effects of Covid-19 on ethnic minority, marginalised, and low-income groups. While this was recognised by government, little was then done to protect those at high risk. In April 2020, 30% of those admitted to ITU were of ‘non-white ethnicity’ despite making up only 14% of the population. Poor health in low-income households was also a factor and it was clear that the most vulnerable to illness and death were the low paid, with insecure employment and a high proportion from BAED communities.

Our Inquiry panel was chaired by renowned human-rights lawyer, Michael Mansfield QC, and included Neena Modi, Professor of Neonatal Medicine, Imperial College London, president of the UK Medical Women’s Federation and past-president of the UK Royal College of Paediatrics and Child Health; Dr Tolullah Oni, Urban Epidemiologist and Public Health physician at the Medical Research Council Epidemiology Unit, University of Cambridge; Dr Jacky Davis, NHS consultant radiologist, author, and BMA council member (in a personal capacity); and Lorna Hackett, Barrister Hackett and Dabbs LLP, who was the counsel to the Inquiry.

Our sessions occurred regularly between February and June 2021. We received testimony from a variety of expert and citizen witnesses including Anthony Costello, Professor of Global Health and Sustainable Development, University College London, former Director at WHO; Jonathan Portes, Professor of Economics and Public Policy at King’s College London and former senior civil servant; as well as frontline workers, including nurses, transport workers, bereaved families, workers’ representatives, and many more.[2]

Our sessions ended on 7 July 2021, and work then began on putting together the report which was launched on Wednesday.

The pandemic continues

In the meantime, the death toll has once more begun to rise. On 7 July 2021, the average daily death toll from Covid-19 in the UK was 34.9. In late November, at the time writing, the average death rate sits at 141 Covid-19 deaths per day.

During these intervening months from July until now, the People’s Covid Inquiry has conducted further rigorous interrogation of the evidence gathered, looked again at evidence which exists in the public domain, referring to events as they continued to unfold, examined reports and information released by parliament and others, including the fiercely critical House of Commons Health and Social Care and Science and Technology Committees report, ‘Coronavirus: lessons learned to date’, published 12 October, and the recent joint report, ‘Building a consensus for health, care and support services fit for the pandemic era’ from Independent-Sage and Keep Our NHS Public, and much more.

We believe that there has been no serious commitment from the government to indicate that it wants to learn lessons from this tragedy, and the significance of the ongoing death toll in the UK is currently played down in official circles. We can only agree with the words of the joint select committee report, that the pandemic has proved ‘one of the UK’s worst ever public-health failures.’ That report, while outlining some mistakes in the government’s early response, attributes most of the blame to public-health bodies rather than the government itself. Rather, the attitude of government was perhaps most clearly expressed recently when Cabinet Office minister, Stephen Barclay, declined to say sorry eleven times for the government’s handling of the Covid-19 pandemic.

We believe these issues are not less urgent than they were in July 2021 but more so. We are now about to go into what will be a difficult winter with very little indication that the death rate will cease to rise, and with NHS and care services already under enormous pressure.[3]

While we wait to see how well the UK government handles the latest ‘Omicron Variant’ of the virus, they must implement the changes outlined in the recommendations of the People’s Covid Inquiry.

In the process of putting together the report, several overarching themes have emerged which we believe are essential for the government, public-health bodies, and the wider public to understand and reflect upon, if we are to avoid the repetition of the tragedy that the pandemic has wrought upon so many lives.

Recurring themes
 

1The depleted state of the NHS and other public services prior to the pandemic was a determining factor in poor outcomes and led to avoidable deaths.

We also find that this structural crisis is the result of an unnecessary, politically motivated attitude towards the NHS by this government, including a commitment to austerity, and the dismantling and neglect of public services in general, and was by no means necessary.

We find that since the structural crisis is the result of ideologically driven policy and not necessity, the government must be held accountable for the severity of the crisis.

We find that without reversing years of policy, which has stripped the NHS and public services of investment and undermined them by moving away from the public model, it will only be a matter of time before a tragedy like this happens again.

2The government was poorly prepared for the pandemic and moved too slowly, which led to avoidable death.

We find that the government’s response to the pandemic was too slow, and characterised by an unhelpful (ideologically motivated) pivot towards the private sector in formulating the nature of its response. This is best exemplified by the government’s failure to provide PPE (despite asserting that ‘we continue to stand by the efforts we made at the height of the early pandemic to prioritise and protect our staff in the frontline’) and it’s outsourcing of test and trace and other contracts.

Instead of being central to the pandemic response, General Practice and local public-health teams were overlooked in favour of inexperienced, profit motivated companies: a political decision which also led to an avoidable loss of life.

3The government adopted the wrong strategy leading to loss of life and growing mistrust in its advice.

We find that the early adoption of a ‘herd-immunity’ strategy was wrong, and appeared to represent a callous attitude towards the safety of the public with multiple negative effects, including a lack of trust and many avoidable deaths.

We found that lack of trust in the government was not innate, and the public had an incredible capacity to follow safety guidance. However, trust was eroded, not because of ‘lockdown fatigue’, but instead by poor messaging, and the behaviour of government ministers who frequently flouted their own rules, including Dominic Cummings, Matt Hancock, and the Prime Minister himself.[4]

4The government’s poor record on inequalities has put the most vulnerable at risk from illness and death from Covid-19.

The Covid-19 pandemic has shone a light on pre-existing discrimination as well as creating further inequalities for already marginalised members of society. Whilst the pandemic has had an impact on everyone in different ways, it has disproportionately affected BAED populations, the disabled, women, the elderly, and those in low-paid, frontline jobs.

In the context of recent revelations about Conservative Party government sleaze, it should be no surprise that we found a lack of transparency, together with cronyism and waste of public funds, as integral to the government’s contracting process throughout the pandemic. There has been extraordinary profligacy and profiteering exacerbated by unmonitored, and at times unlawful, procurement processes.

5Misconduct in public office

This People’s Covid Inquiry report is unequivocal: there has been dismal failure in the face of manifestly obvious risks. This Inquiry performed a much-needed and urgent public service when the nation was hit by a catastrophic pandemic coincident with an unprecedented period of democratic deficiency. It afforded an opportunity for the beleaguered citizen to be heard; for the victims to be addressed; for the frontline workers to be recognised; and for independent experts to be respected. When it mattered most and when lives could have been saved, the various postures adopted by government could not sustain scrutiny.

The pandemic is not over, and despite previous improvements, infection rates and death tolls are once again rising. As winter approaches and the Omicron Variant takes hold, the government must act now or more avoidable deaths will occur.

With political will and public support, there is no reason we can’t still emerge from the pandemic with an NHS that is not on the brink of collapse as it is now, but having learned lessons, gained experience, and seen proper investment in a publicly provided health-and-care service, in order to keep the nation safe as and when another crisis like this occurs.

The Executive Summary and the Full Report of the People’s Covid Inquiry is available to download here.