The UK’s Response to the COVID 19 pandemic Part 3 – Lessons learned?

There are crucially important lessons that can be learned from the UK's experience during the COVID-19 pandemic, but overall, the COVID-19 pandemic has highlighted the importance of being prepared, early intervention, clear communication, collaboration, equity, and the legitimate (truthful?) use of science to guide decision-making. So, this paper tries to understand the reasons for these revealed issues – Adequate Preparation Early Intervention Legitimate (truthful) use of the “Science” involved. Basis and quality of decisions taken. Perceived Equity and Trust Clear communication of messages There seems to be an inevitable exponential progression of the impact of these successive factors. Apparent ignorance and inertia and the inability to grasp the scale of the projected health and economic impacts, seemed to lead to overcompensation and concern for political survival over societal safety. It’s also clear that the deaths in Italy, Britain and USA were heavily impacted by how we care for the elderly, and how we failed to protect them in care and nursing homes. The paper attempts to better understand the reasons for this escalation by examining in detail each of these issues, so it can be avoided in future. It is not clear that we have either understood or are prepared to undertake to implement the changes needed and suggested by this and most other independent analyses. The paper discusses and makes recommendations on how some of the underlying issues might be addressed. Recommendation 1 - We should look again at the design, effectiveness, and interactions of traditional Government Structures – particularly in the NHS. Recommendation 2 – The UK Government needs to rethink the status, roles and responsibilities of “Special” Advisers (SPAD’s) in managing independent advice to ministers. Recommendation 3 – As a basis for decisions and communication Governments need to be clearer about the difference between “Objective” and “Convenient” Truth. Recommendation 4 – We need the commitment of decision makers to accept responsibility for following, (or interpreting?), or not, (published?) advice. Recommendation 5 – The public needs best available information, and reasons for choice, not polarised opinions. Recommendation 6 – Governments should recognise, address and communicate the uncertainty, ambiguity, and complexity inherent in difficult decisions. Recommendation 7 – Governments should formally require a red teaming function in their planning and response organisations. Recommendation 8 – Governments should encourage a culture of challenge, and independent/ enlightened thinking. Recommendation 9 – In these kinds of pandemic challenges, Governments should adopt (sooner?) a more “military” versus “conventional / predictable” mindset / culture as they would in “wartime”. Recommendation 10 – In these situations, Governments should consider a mandatory requirement for inclusivity, acceptability and competence in crisis management. (War cabinet?).