Sunbathing in Mustique in the Caribbean on 2 January 2020, Boris assumed that his world was perfect. For one week, he could enjoy the sun and the sea, and ignore the problems erupting 4,000 miles away. After six months of non-stop campaigning, he was exhausted. Indigo, the three-bedroom villa near the shore, had been obtained by a friend. ‘Find me somewhere private,’ he pleaded before the election. ‘And somewhere for Carrie to relax because she’s pregnant.’ In Churchillian manner, he had arrived on the island with two PAs – not in order to dictate a book but to stay in touch with London.
For the first time in months, Boris was at peace with himself. Opinion polls reported that the mood in Britain was optimistic. No fewer than 60 per cent of Britons anticipated being better off by the end of the year. Trusting his promise of ‘a decade of prosperity and opportunity’, the Boris Bounce had encouraged a splurge in holiday bookings, a rise in house prices, record employment and a spurt of manufacturing. In London, Cameron Mackintosh announced a £220 million programme to rebuild the world’s most famous theatres. ‘It’s an extraordinary time,’ said the great impresario. Joining the chorus, Britain’s world-beating creative industry sang: ‘It’s a booming market.’ Despite the Bank of England’s forecast that Brexit would shrink the economy by £14 billion in 2022 – and that estimate would rise a few weeks later to £22 billion – Boris was guaranteed five years as prime minister. No one and nothing could stop the radical ‘Brexity Hezza’ to, in his words, ‘level up’ the nation.1
In Downing Street on that same day, Dominic Cummings published a blog post of a job advertisement he had written, intended to signal a revolution across Whitehall. Highlighting ‘profound problems at the core of how the British state makes decisions’, Cummings targeted the nation’s civil servants. Besides the ‘brilliant’ few, he identified the culprits as ‘the confident public school bluffers’ and the ‘Oxbridge humanities graduates’ spouting drivel about ‘identity’ and ‘diversity’. Whitehall, he sniped, lacked ‘the sort of expertise needed by the PM and ministers’.
His arch villain was Mark Sedwill, the fifty-five-year-old Cabinet Secretary. Unlike his predecessors trained in the Treasury to implement the intricacies of economic and domestic policies, Sedwill was a Foreign Office securocrat with diplomatic service in the Middle East, Pakistan and Afghanistan. Trusted by Theresa May as her permanent secretary while at the Home Office, she appointed him after arriving in Downing Street as both her Cabinet Secretary and the National Security Adviser. His handicaps were stark. Without any mastery of economics or science, Sedwill was ill-fitted to manage Brexit, trade agreements and the Treasury’s comprehensive public spending review. Cummings berated him and those departmental permanent secretaries below him for lacking proper understanding of maths, data management and the skills to manage major projects like the proposed HS2 rail network.
Too often, as Michael Gove would explain, in ‘the constant whirligig of Civil Service transfers and promotions’, careers depended on moving every eighteen months rather than developing deep knowledge to execute policies and procurement. Frowning on taking the initiative, the Whitehall cult incentivised officials to avoid bold ideas. ‘Submissions,’ Gove would complain, ‘the papers which are prepared to guide ministerial decisions, and which were once the glory of our Civil Service, have become in far too many cases formulaic, overlong, jargon-heavy and back-covering. The ability to make a tight, evidence-rich, fact-based argument which doesn’t waste words or evade hard choices is critical to effective government.’ Instead, the formal hierarchy was sticking to safe options and never executing original policies. Too many civil servants, Gove and Cummings agreed, were unable even to communicate in proper English.2
Cummings’ solution was an appeal for established experts in science and economics to work in Downing Street. His advertisement also called for applications from ‘some true wild cards, artists, people who never went to university and fought their way out of an appalling hellhole’, ‘weirdos from William Gibson novels’. Ideal ‘misfits’, he suggested, should bypass the formal recruitment process and email him direct. Those chosen would join him in Downing Street to transform radically the machinery of government. ‘It will seem chaotic and not proper Number 10 process to some,’ he wrote, ‘but the point of this government is to do things differently and better.’
Cummings’ plan included regular exams for senior civil servants. The trade unions immediately complained. Testing their members’ skills, complained a union leader, would cause discrimination on the grounds of age and ethnicity. Success rates in previous exams had been significantly lower for black and minority-ethnic workers and the over thirty-fives.3 That self-interested protest confirmed Cummings’ and Gove’s complaint: Whitehall’s culture ensured that ‘everyone rises to their position of incompetence’.4 The famed Rolls-Royce machine was worn out. In a crisis, they predicted, it would fail to deliver. Boris was not only convinced by their argument but agreed that fundamental changes should be implemented as soon as possible. Senior officials in all the departments needed to be replaced. As usual, he delegated the task and waited for the results.
On that same day, 2 January, Christopher Whitty, England’s fifty-three-year-old chief medical officer, was meeting his deputy, Jonathan Van-Tam, an expert in influenza and respiratory viruses.5 Appointed two months earlier, Whitty was a physician and epidemiologist who had specialised in controlling infectious tropical diseases. The two met in the Department of Health to discuss a message from the World Health Organisation (WHO) issued on 31 December. The Geneva-based organisation reported that the Municipal Health Commission in Wuhan, a Chinese city with a population of 19 million, had identified an outbreak of an ‘unusual pneumonia’ coronavirus. The first case was identified on 12 December. Since then, ‘a cluster of cases’ had developed but none had resulted in death. ‘We both agreed that it was something to watch,’ Whitty would recall. The potential danger, he knew, should not be underestimated. Any deadly strain of influenza based on high-impact respiratory pathogens which spread through breathing could quickly infect a large number of people.6 As an experienced epidemiologist, he recalled several global virus alerts in his career – SARS in 2003, swine flu in 2009 and MERS in 2012.
The following day, Whitty told Matt Hancock, the Health Secretary, about his plan to monitor the potential threat called 2019-nCoV. Unknown to Whitty, a Chinese ophthalmologist in Wuhan who had just warned colleagues of the danger was ordered by the local security police not to issue any more ‘false comments’.
In blissful ignorance, most of the world’s media was focused on America’s assassination in Baghdad of Qasem Soleimani, an Iranian general responsible for state terrorism across the region. Boris resisted knee-jerk demands that he return to Britain to respond. Four days later, on 7 January, the prime minister was back in Downing Street. That day, Hancock told him about Covid and that Whitty was monitoring the situation.7 In his normal manner, Boris expected Hancock and the government’s experts to manage any problems. His focus was on Brexit due at the end of the month, a Cabinet reshuffle soon after, and a landmark budget. He planned to remove the deadwood ministers who added neither originality nor electoral appeal to the government, and whose company he found uncongenial. Next, to great fanfare, he would unveil his vision for the future and lay the foundations for his legacy. For once in his life, he had no serious problems.
On 11 January, the Chinese reported the first Covid death. The cause, said the Chinese, was human contact with an infected animal. There was no evidence that the virus could be transmitted from one person to another. Still barred from visiting China for an investigation, WHO endorsed the Chinese report. Nevertheless, as a precaution, Whitty summoned a meeting of the New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG), chaired by Peter Horby, an epidemiologist already researching the virus with Chinese scientists. The limited function of the committee’s fifteen experts was to assess the risk posed by the new virus.
On the basis of the WHO report, NERVTAG concluded that the ‘Wuhan Novel Coronavirus does not look to be very transmissible’. In apparent contradiction, they also agreed that a travel ban was worthless.8 With three flights a week from Wuhan and dozens of flights from other Chinese cities experiencing multiple outbreaks, it was ‘unlikely that transmission [of the virus] to the UK could be prevented’.9 Screening of arrivals at Heathrow, they agreed, where 80 million passengers arrived every year, ‘has very low efficacy and the benefit is very unlikely to outweigh the substantial effort, cost and disruption’.10 The specialists categorised the risk as ‘Low’.
Despite the reassurances from WHO, Whitty also consulted Patrick Vallance, the government’s chief scientific adviser. Trained as a physician and pharmacologist, Vallance had had a conventional career as head of medicine at University College London and Glaxo before joining the government in 2018. With Vallance now involved, monitoring of the virus was under the control of two clinicians. They agreed to convene immediately the first meeting of the newly founded Scientific Advisory Group for Emergencies (SAGE).11 Under his chairmanship, Vallance could select about twenty experts from a rich pool. Britain’s epidemiologists, life scientists, experts in infectious diseases, behavioural scientists, public health executives and medical statisticians ranked among the world’s best. Inevitably those he did not select would feel professional jealousy. To avoid their inevitable carping, SAGE’s membership was kept secret. The scientists met with about ten senior Whitehall officials.12
Vallance was clear how SAGE would work: ‘It is not very useful to ministers or other decision-makers to say, “There are sixteen opinions. Here are all sixteen. Make up your mind.” Part of the process is to say in a unified way, “Here is the central view”, and then, if there are either dissenting views or a range of uncertainty quantitatively around that, to convey it in a way that is comprehensible to the people who are listening so that they understand the certainty with which the advice is being proffered. If they do not, it is clearly going to lead to bad decision-making. In SAGE, we try to come up with a consensus view, but we are always clear and open about how we arrive at that.’13
Vallance probably did not realise the contradiction within his explanation. A ‘central view’ is different from ‘a consensus view’. The issue was whether Vallance fully explained all the options to Boris, made a recommendation but allowed Boris to choose; or did Vallance offer what he considered to be the consensus and simply ask for the prime minister’s approval. If Boris heard the competing options around the ‘central view’, then he would have understood earlier the uncertainty of the science. If presented only with the ‘consensus’, he would not have understood the alternatives. In the traditional format of British government, Boris should have requested that Mark Sedwill as the Cabinet Secretary was present at Vallance’s briefings to offer an impartial opinion. In Vallance’s subsequent replies to MPs’ questions, he never referred to Sedwill’s presence.
On a key issue, Whitty and Vallance were reassured by the Global Health Security Index published in 2019. Britain had ranked as number one in the world able to produce a ‘rapid response to and mitigation of the spread of an epidemic’. South Korea was ranked sixth and Germany twenty-eighth.14 Less encouraging was Whitehall’s Exercise Cygnus report published in 2017 about Britain’s preparedness for a pandemic.15 Since both men had been appointed after the report was published, it was not clear whether they had understood its disturbing conclusions. The three-day exercise had assessed the impact of a pandemic influenza outbreak, especially on the NHS. The ‘key learning’ was that ‘the UK’s preparedness and response, in terms of its plans, policies and capability, is currently not sufficient to cope with the extreme demands of a severe pandemic that will have a nationwide impact across all sectors’.16 Operation Cygnus and other plans to cope with pandemics in Britain assumed the cause would be a Covid type of influenza. An attempt two years later, in autumn 2019, to mount a similar exercise to check whether Britain’s preparedness had improved, was cancelled. Many of the relevant officials were focused on preparing the country for crashing out of Europe without a deal. Months later, untested by a dress rehearsal, Whitty and Vallance adopted the textbook gospel to cope with a flu pandemic when SAGE held its first meeting on 22 January.17
The star was Neil Ferguson, a professor of mathematical biology and the leader of Imperial College’s modelling group with over twenty years’ experience monitoring viruses.18 As the leader of SAGE’s Scientific Pandemic Influenza Modelling committee (SPI-M), Ferguson’s doubts about the Chinese reports were striking. The Chinese government, he said, was under-reporting the extent of the infection and substantial human-to-human transmission was happening.19 ‘Heightened surveillance, prompt information-sharing and enhanced preparedness are recommended,’ he stated in his first report.20 After discussing the potential problems for hospitals and care homes, the group agreed that because of the uncertain data from China, ‘a reasonable worst-case scenario (RWCS) cannot be made reliably’.21
RWCS has been a critical aspect of ‘pandemic influenza planning’ by the National Risk Register since 2008. Flu hit Britain regularly every year. In 2017, the National Risk Register estimated that a flu epidemic could kill between 20,000 and 750,000 people. Britain’s annual deaths from flu between 2014 and 2018 ranged between 1,692 and 28,330 – making an annual average of about 17,000 people.22 ‘Spanish Flu’, the world’s worst outbreak between 1918–20, killed between 50 million and 100 million. The participants agreed to rely on the tried and tested plans for a flu pandemic.
Ferguson disagreed. In a report published on Imperial’s website the same day, he warned that the outbreak was probably larger than the Chinese had revealed: ‘Given the increasing evidence for human-to-human transmission, enhancing rapid case detection will be essential if the outbreak is to be controlled.’23 Within hours, Ferguson was proved correct.
Early the following day, Wuhan was closed down. The Chinese government told WHO there were 557 cases of Covid and seventeen deaths in the city. The agency did not question the Chinese report. Instead, WHO told the world’s governments that the virus was ‘not wildly spreading outside China’.24
By then, the British embassy in Beijing should have been seeking to discover the truth. Under Simon McDonald, however, the diplomats dispatched to China were not sleuths but focused on trade and championing diversity and human rights. Once again, the Foreign Office was failing to perform its traditional role to discover facts and also failing to match other governments’ initiatives and help British nationals to leave Wuhan quickly.
Briefed about the SAGE discussions, Hancock was reassured that the bureaucracy was functioning as planned. In his first Commons appearance concerning Covid, he told MPs that while a few Chinese had died, Britain’s experts were monitoring the outbreak.
During the day, Boris appeared in a People’s PMQ broadcast from Downing Street. He mentioned his recent discussion in London with Egypt’s president Abdel Fattah el-Sisi, a painting by Turner, the tampon tax and the planned EU negotiations after the Withdrawal Bill was given the royal assent the following day. He dodged a question about his shampoo. Although newspapers were reporting the Covid outbreak, Boris did not mention the topic.
The same day, 23 January, Lancet’s editor, Richard Horton, called for ‘caution’ and accused the media of ‘escalating anxiety by talking of a “killer virus”’ and ‘growing fears’. He wrote: ‘In truth, from what we currently know, 2019-nCoV has moderate transmissibility and relatively low pathogenicity. There is no reason to foster panic with exaggerated language.’ Horton’s error would have passed unnoticed had he not later become a vociferous critic of the government and SAGE. In reality, no one outside China, including WHO officials, knew the truth about the Wuhan outbreak.25 Moreover, contrary to Horton’s subsequent criticism of the government, especially about the supposed failure to acknowledge the importance of Public Health England (PHE), the Department of Health had positioned PHE at the front line of Britain’s defences.26 Its senior executives were members of SAGE.
PHE is an executive agency boasting ‘operational autonomy’ of the Department of Health and Social Care, directly answerable to Matt Hancock. Established in 2013 as part of drastic reform of the NHS designed by Andrew Lansley, the first Heath Secretary in David Cameron’s government, part of PHE’s responsibilities were defined as ‘maintaining the pandemic influenza stockpile’. That meant buying antivirals, antibiotics and consumables and managing the stockpiles of personal protective equipment (PPE) for use in hospitals. PHE’s principal ‘stockpile’ was stored in a warehouse in Merseyside.
PHE’s founding chief executive was fifty-eight-year-old Duncan Selbie, paid £190,000 a year. On his appointment in 2013, Selbie admitted on his Facebook page, ‘I am that well-known international expert. You can fit my public health credentials on a postage stamp.’27
At seventeen, Selbie had worked as a clerk in the health service, writing prescription pricing cards. At nineteen, he worked as a cashier at the former Queen’s Hospital in Croydon. Without medical or academic training, he was rejected for thirteen executive jobs before becoming an NHS lifer at a psychiatric hospital.28 Despite having no qualifications as a public health professional, he became a survivor of the wreckage unleashed by Andrew Lansley’s ‘reforms’. Selbie’s appointment illustrated the low importance assigned to PHE. Jeremy Hunt, the Health Secretary for the next six years, allowed PHE, cursed by a meagre budget, to exist as the NHS’s Cinderella.29 Selbie’s appointment justified Cummings’ despair about the qualifications of civil servants.
Selbie would not allow the Department of Health to undermine his self-importance. A glossy brochure boasted: ‘PHE plays a key role in planning for and responding to large-scale infectious disease threats locally, nationally and globally … It has the capability to respond to a rapid upsurge in activity as a result of outbreaks, epidemics or pandemics of infectious disease, and provides PHE with the resilience to sustain a long-term response to an emerging threat.’
PHE’s most relevant claim was: ‘Our experts have considerable experience at using contact tracing to prevent and contain outbreaks and to keep the public safe. We remain prepared for future imported cases and for other high-consequence infectious diseases that need to be managed in a similar way. We use our networks, data and capabilities to recognise and manage cases, clusters, outbreaks and incidents of infectious disease.’
To establish its efficacy, in January 2020 the Department of Health unveiled PHE’s match-winning status. The UK, said the department’s officials, was well prepared to combat any new diseases because PHE had already produced a diagnostic test for the Wuhan Covid, ‘making the UK one of the first countries outside China to have a prototype specific laboratory test for this new disease’. Britain’s public health measures, added the department, ‘are world-leading and the NHS is well prepared to manage and treat new diseases’.30
All those in Whitehall and Westminster not directly involved in health assumed that Britain could rely on Selbie and Chris Wormald, the Department of Health’s permanent secretary since 2016. ‘Everyone thought they were doing the right thing’ because they could trust the health professionals in the Civil Service, Bernard Jenkin would later observe.31 Unlike the outsiders, in January 2020, Selbie, Wormald, Hancock and other senior departmental officials knew, as did Jeremy Hunt, that the manifest weaknesses exposed by Operation Cygnus in 2017 remained unresolved.
To his credit, Selbie had foreseen in September 2019 ‘a global pandemic in the coming years, including pandemic influenza and a novel virus, the so-called Disease X’. The hypothetical epidemic, he wrote, is ‘a yet to be identified virus or bacteria’.32 But the country, he wrote reassuringly, could rely on Professor Sharon Peacock, the director of PHE’s National Infection Service and a professor of microbiology. Peacock exuded confidence. ‘Our mission is to prevent, detect, respond to and reduce the impact of infectious diseases in this country,’ she wrote. ‘PHE, and its predecessor organisations, have a long track record of using cutting-edge technologies to improve our ability to detect and contain outbreaks and treat people with infectious diseases.’
For obvious reasons, Duncan Selbie was not invited to SAGE’s meetings. PHE was represented by Peacock and Dr Yvonne Doyle, the medical director. Both were paid about £250,000 a year, and both would be responsible for testing and tracing the virus across England and Wales.
Assuming that the Wuhan Covid was a strain of influenza, the standard procedure for PHE was to ‘contain, delay, research, mitigate’. Since total containment of the infection was not feasible, a balance was to be struck between suppressing the first wave and reducing the country’s susceptibility to a second wave. Denied accurate information from China, there was one novel complication unknown to anyone outside China: unlike previous strains of flu, sufferers of Wuhan’s Covid could show no symptoms and yet infect other people. Unaware that sufferers could be asymptomatic, SAGE’s experts were working unusually blindfolded. ‘There is currently little evidence that people without symptoms are infectious to others,’ the Department of Health would mistakenly state.33
On 24 January, the first Covid case was detected in France. That morning’s Evening Standard headline was ‘Killer Virus: Cases in UK “Highly Likely”’. Tipped that Hancock would chair the first meeting of Cobra to discuss Covid, the newspaper did not report that Boris, like the leaders of the three other nations – Scotland, Wales and Northern Ireland – would not attend. As Nicola Sturgeon rightly assumed, the meeting was for health ministers. Notably, over the next ten weeks, Sturgeon did nothing materially different in preparing Scotland for the virus from the English government.
If the Wuhan Covid reached Britain, Ferguson forecast at the first Cobra meeting, there would be a maximum of 20,000 deaths.34 Whitty agreed. He told the meeting, ‘We think there’s a fair chance we may get some cases over time … I think we should definitely see this as a marathon, not a sprint. We need to have our entire response based on that principle.’35 Timing, they knew, was everything. At that stage, no one realised the speed of infection, how far the infection had spread and therefore when to trigger the response.36
Vallance presented Britain’s defences against the Wuhan Covid along the familiar line as a type of influenza and focused on schoolchildren. Unusually susceptible to getting flu, schoolchildren were prime spreaders of the infection. With the focus on schools, there was no particular provision for the elderly. Care homes were not included in Imperial’s model.37 ‘We made the rather optimistic assumption that somehow, as was policy, the elderly would be shielded,’ Ferguson said later.38
At the end of the Cobra meeting, Hancock was advised that Covid presented a ‘low danger’.39 In Berlin, Lothar Wieler, the president of the Robert Koch Institute, Germany’s centre for disease control, came to the same conclusion.
‘Coronaviruses,’ Hancock later told the Commons, echoing Whitty, ‘do not usually spread if people don’t have symptoms – however we cannot be 100 per cent certain.’40 That would prove to be a serious but understandable error. To signal the government’s concern, Hancock visited Porton Down to announce the allocation of £40 million to search for a vaccine.41 Hancock then went on to promote the government’s NHS funding bill in line with Boris’s election promise to increase spending by £33.9 billion over five years.
While waiting for the virus to hit Britain, the government’s reaction relied on the mathematical models created by Neil Ferguson’s team at Imperial College. By any measure, they were controversial. In 1999, Imperial’s model had predicted that BSE, or ‘mad cow disease’, could kill between 150,000 and 500,000 people. In the event, fewer than 200 died. In 2001, advice based on Imperial’s model suggested that the cure to a foot-and-mouth outbreak was to cull 6 million healthy cattle, sheep and pigs, at a cost of about £9 billion. An official inquiry criticised Ferguson’s modelling as ‘severely flawed’.42 Imperial’s model stated in 2003 that SARS posed a ‘25 per cent chance of killing tens of millions’. Instead, 813 people died worldwide. MERS killed 866 people, although some sources say about 2,000 people. Both viruses disappeared. Nor, contrary to Imperial’s forecast, did bird flu kill 200 million people or swine flu in 2009 kill 65,000 people in Britain. Instead, swine flu killed about 150,000 across the world. Called a pandemic by WHO, the organisation was later accused of panicking. In the aftermath, Britain was left with 34 million doses of unused and expensive vaccines. An inquiry called the Imperial’s modellers ‘astrologers’.
Models were distrusted, not least because the assumptions fed into the programs were questionable. Politicians and officials became reluctant to spend money on preparations for exaggerated scares. ‘All these models are forecasts,’ Matt Keeling, a professor of life sciences, warned. ‘We are used to weather forecasts. We expect them to be right today and maybe tomorrow, but the longer you go on, the more uncertainty there will be.’43
Scepticism about Imperial’s model was rooted, according to critics, in its age. It was based on a programming code called either ‘C’ or Fortran that had apparently been used twenty years earlier by NASA for Mariner 1. Critics claimed its outdated language and design flaws produced numerical inaccuracies. One file alone contained 15,000 lines of code. Modern industry best practice would use 500 separate files instead. It was ‘a tangled, buggy mess which looks more like a bowl of angel-hair pasta than a finely tuned piece of programming’, according to one informed critic.44 One prominent flaw was the code’s inability to distinguish between particular people’s susceptibility to the virus. An infected nurse in a hospital was more likely to transmit the virus than an asymptomatic child, but the model could not identify the difference.
Critics also discovered that even if they used the same initial set of parameters as Imperial, the model could produce different results if run on different computers. They condemned the results as crude mathematical guesswork.45
Mark Woolhouse, a professor of epidemiology specialising in infectious diseases and serving on Scotland’s SAGE, was particularly sceptical of the models created to monitor influenza. ‘I do not think it was ever possible to predict the course of this epidemic; there were too many fundamental unknowns to do that,’ he said.46 That accusation, which gained considerable traction over the months ahead, was contested by Ferguson: ‘You do not really have a flu model – you have models for directly transmitted diseases.’47 To many, Ferguson’s reply was nonsense. His model was focused on the transmission of flu.
Without any sense of alarm, Hancock chaired the second Cobra meeting about Covid on 29 January. Ministers were reassured by Vallance that PHE could contain ‘a new infectious disease’. Pertinently, no one commented about the agency’s failure to trace the vast majority of the 2,000 people who had arrived earlier in the month at Heathrow from Wuhan. Just two infected Chinese people in York were quarantined and no further transmission was discovered. Nevertheless, Hancock was reassured by PHE: ‘The UK is one of the first countries in the world to have developed an accurate test for this coronavirus and PHE is undertaking continuous refinement of this test.’ PHE’s capacity, Hancock was told, was to conduct 400–500 tests a day.48 PHE confirmed that it could ‘if necessary’ scale up testing.49 Both statements were considerable exaggerations, but in the nature of Whitehall’s culture of compliant relationships, no official discourteously questioned that information.50 Unaccustomed in their brief careers as civil servants to Whitehall’s practice of laying effective smokescreens, Vallance and Whitty proved to be equally persuadable. Yet they should have rigorously questioned Peacock and Doyle. If anyone should have outrightly asked how many more tests might be required, however, it was Hancock, but the minister failed to demand more information. In the non-confrontational and uninquisitive mood set by Boris, he was not prepared to vigorously interrogate the scientific experts. Instead, Hancock relied on his officials’ assurances, not least that NHS staff would be protected from infection.51 That was also wishful thinking. At the end of the meeting, the health officers of the four nations raised the risk level to ‘moderate’.52 (Germany would raise the level to ‘moderate’ five weeks later on 2 March.) Curiously, at the same time but without any publicity, Simon Stevens, the NHS’s chief executive, in constant contact with Vallance and Whitty, declared a Level 4 National Incident, the highest level.53 The next day, WHO declared the outbreak a ‘public health emergency of international concern’.54 BA stopped all flights to China.55 Boris prepared to celebrate Brexit day in Downing Street.
Anticipating the birth of a new nation, Boris launched a major review of British foreign and defence policy. ‘This is a defining moment in how the UK relates to the rest of the world,’ he said. The review would assess what manpower and equipment Britain needed to ‘address the risks and threats we face’.56 Boris’s address to the nation from Downing Street promised to ‘unleash the full potential of this brilliant country … This is the moment when the dawn breaks and the curtain goes up on a new act in our great national drama … And yes it is partly about using these new powers – this recaptured sovereignty – to deliver the changes people voted for … And if we can get this right I believe that with every month that goes by, we will grow in confidence not just at home but abroad … And whatever the bumps in the road ahead I know that we will succeed.’ On principle, the BBC refused to broadcast the address recorded in Downing Street because the disc of the recording was handed to them without the option of exercising their normal editorial control. His speech was slightly overshadowed by the news that the Britons evacuated from Wuhan were arriving in Brize Norton. They would be compelled to endure two weeks’ quarantine. None were found to be infected.
Otherwise, considering the importance, the day was an anticlimax. In the morning, Boris chaired an inconsequential Cabinet meeting in Sunderland, the first town to declare for Brexit in the referendum. During the day, he fired Claire Perry, a former Tory MP, from her post as president of the UN Climate Change Conference for failing to organise properly the conference to be held in Glasgow in the autumn; and that night, unwilling to appear in public with Carrie, he refused to participate in Nigel Farage’s street celebration. Considering the wrecked emotions over the past four years, he might have hosted a huge party. But he was both too good-mannered to rub the Remainers’ noses in it, and too sensitive to further aggravate his family. Instead, he invited about thirty members of Team Leave to Downing Street. All the food and drink was produced in Britain. The star, Dominic Cummings, dressed in a T-shirt, black tracksuit and trainers, was given the microphone to speak, but was overcome by emotion, while Boris, in a boisterous manner, grabbed a makeshift gong to mark time to 11 p.m. – the Brexit moment in Brussels – because Downing Street’s TV circuit had crashed. Then the epic battle was over. As the guests departed, Boris looked like an outsider in his own domain.
*
The first week of February was a milestone for Matt Hancock, the forty-one-year-old former economist. Lacking the serious demeanour of a graduate with a first in PPE from Oxford and an MPhil in economics from Cambridge, few would have realised from Hancock’s manner that he had been employed by the Bank of England and later by George Osborne as his chief of staff. In allowing him to continue as Secretary of State despite being a Remainer, Boris had recognised not only a loyal politician but also the unique demands of the Department of Health. Unlike most portfolios, new health ministers needed more than a year to understand the NHS’s complexities. Only in the second year could the minister begin to influence the highly paid bureaucrats controlling the NHS’s 1.4 million employees. Hancock’s efficacy depended on Chris Wormald, his permanent secretary. In his unremarkable Whitehall career, Wormald seemed to have succeeded by remaining low key, as performances before select committees showed. After four years as the Department of Health’s senior official, his impact appeared to be imperceptible. During Jeremy Hunt’s last two years, the NHS’s front-line services had barely improved. He too epitomised Cummings’ criticism.
In preparing for the third Cobra meeting on 5 February, Hancock relied entirely on the experts, on ‘the very rigorous, well-established and sophisticated policy advice structure that exists within the UK government in crises’, as Neil Ferguson described it.57
In anticipation of the Cobra meeting, SAGE had met for the second time on 3 February.58 Although the low-key newspaper reports from China described a limited threat to its economy, everyone at the meeting understood the lurking danger. In Yokohama, Japan, the Diamond Princess, a cruise ship hosting 3,711 people, was about to be quarantined after a former passenger was found with Covid-19. At the SAGE meeting, every aspect of controlling the virus was considered:59 closing schools, social distancing, home isolation, face masks (they were always against them), handwashing and quarantine. They agreed that the Wuhan outbreak was probably ten times bigger than the Chinese admitted and that even cutting travel into Britain by 90 per cent would only delay the virus’s arrival by a few weeks. There was also ‘very little’ benefit from stopping ‘large public events’.
While the Chinese government refused to disclose the truth, on 4 February Stanley Johnson – invited as the prime minister’s father – stood in the spotlight with Liu Xiaoming, China’s veteran ambassador in London, to pronounce a ‘China–UK Golden Era’ and his confidence that China would defeat the virus.60 On the same day, Boris met Giuseppe Conte, the Italian prime minister. Two Chinese tourists in Rome had been quarantined after testing positive for the virus. Boris’s mind remained firmly on Brexit, however, and it was this rather than Covid that he discussed with Conte. Also on that day, Doyle announced good news: PHE had sequenced Covid’s genome. As a ‘crucial step’, she said, ‘we can better understand the roots of this disease, predict its behaviour, and learn how tackle it’.61 She also revealed that PHE’s testing capacity was limited to just one hundred people a day through its new centralised laboratory in Colindale, north London. But, she said, PHE planned to increase its diagnostic capacity first to 500 tests per day and then to 1,000 daily by creating an extra twelve laboratories across the country.62 Testing, everyone agreed, was ‘essential’. The mechanics for increasing capacity were delegated to Sharon Peacock. Wormald was apparently unaware that Doyle and Peacock felt overwhelmed.
Instead of expanding the service in one huge effort, Peacock decided to focus her efforts on the Colindale laboratory and then enlarge PHE’s capacity bit by bit. Asked later to justify her decision, she obfuscated and refused to explain her reasoning.63 During February, her obduracy was noticed by many directors of laboratories in research institutes, universities and the private sector. Among those who offered their services to PHE was Matthew Freeman of Oxford University’s Dunn School of Pathology. Hundreds of the school’s staff and students, said Freeman, were ready to use their 119 PCR machines to identify genetic signs of the virus. He never received a reply. Similarly, an executive at the Weatherall Institute of Molecular Medicine at Oxford University offered to carry out 1,000 tests per day but the reply never came. ‘You would have thought that they would be bashing down the door,’ he later said.64 Paul Nurse, director of the Crick Institute, said that he had offered his laboratories and staff to the testing effort but he did ‘not think that [he] got a reply’ until he publicly complained weeks later.65 Apacor, based in Berkshire, and other privately owned laboratories also offered to supply millions of tests but there was no response. In total, over fifty laboratories in Britain, in universities and privately owned, could have been approached by PHE. Each had the capacity for between 1,000 and 2,000 tests a day. With expansion, by the end of the month they could have conducted up to 100,000 tests a day. PHE had decided not to trust the private sector or research institutes. By contrast the German government, which relied on sixty private and a few university laboratories under contract to hospitals, began conducting 160,000 tests a day in early February which expanded to 500,000 tests a day.
Utilising that testing capacity depended on directing a team of tracers to find those infected. At the beginning of February, PHE claimed that it could depend on 300 tracers. Neither Peacock nor Selbie explained why they refused to consider employing 5,000 experienced local authority health workers as tracers.
Britain’s capacity to test and trace was not raised at the Cobra meeting on 5 February. The responsibility for that misjudgement would be accepted by Whitty: ‘We were lulled into a false sense of security by the fact that we were so fast off the mark in developing a test,’ he would say.66 The requirement for PPE was also not discussed at the early Cobra meetings. Without Vallance, Wormald or Doyle mentioning the issue, Hancock would not have known that neither PHE nor the Department of Health had considered the NHS’s medical staff’s need for special PPE. In those early weeks, Hancock was unaware that PHE’s headquarters in Waterloo – his inheritance from Jeremy Hunt – was a building filled with overpaid, squabbling bureaucrats led by a medically unqualified chief executive.
To remedy one failing exposed by Operation Cygnus, the Department of Health had reorganised the responsibility for purchasing PPE. To prevent hospital trusts competing against each other for supplies and to secure the benefit of bulk buying, the responsibility for procuring equipment had been assigned in 2018 to Supply Chain Coordination Ltd, led by Jin Sahota. Paid £200,000 a year, the fifty-two-year-old was answerable to the Department of Health. Sahota relied on Unipart, a logistical corporation serving the motor industry, to provide the equipment on a just-in-time basis. In February, PHE’s guidance about the purchase and use of PPE was still focused on protection against influenza. The equipment would be unsuitable against Covid-19, a more dangerous virus. Reflecting the uncertainty in the SAGE discussions, Vallance remained unaware about the mystery of an asymptomatic infection.
A consensus had emerged among SAGE’s scientists and, by its very nature, consensus tended to deter challenge. Neil Ferguson would say that the traditional structures of Britain’s government ‘may have led to a certain degree of caution in decision-making – balancing evidence, balancing certainty and uncertainty, and being very aware of costs and the risks of second waves’.67 Confrontational debate was not encouraged by the centralisation in one department of politicians, civil servants and the 1.4 million employed by the NHS. Some would compare the British government’s centralised co-ordination unfavourably with that of Germany, a country of sixteen states. The structures – SAGE, Cobra and Whitehall – they complained, had encouraged complacency.68 Others would say that the lack of argument reflected the nature of the people involved.69
The flaws were first revealed on 11 February. PHE had been following up eight separate infections.70 No one knew how many more cases were undetected or how many people were involved. The only certainty, Vallance and Whitty agreed, was that ‘sustained transmission’ of the virus was underway in Britain and that at least ten times more people were infected than detected. That proved to be a woeful underestimate. Vallance and Whitty also agreed that the peak of infection was between two and four months away – between April and June.71
Over the previous two weeks, Sharon Peacock had considered the governments’ reactions in three Asian countries where the virus was already established. She needed to decide whether to massively increase PHE’s testing machinery. Based on its experience of combating SARS and MERS, South Korea was well prepared with seventy-nine laboratories. Despite a bad outbreak, it avoided a national lockdown. Taiwan had introduced mass temperature screening but kept shops and restaurants open. In Singapore restaurants and schools were open, and working from home was actively discouraged to protect the economy. In South Korea, deaths were limited to ten a day. In both other countries, only two people had died.
As expert epidemiologists in discussion with some of the country’s leading scientists, Vallance and Whitty had decided that mass test and tracing as in South Korea was impracticable in Britain. To enforce quarantine, Seoul’s authorities were empowered to compel every infected person to move without their family into special accommodation for at least two weeks. In addition, using facial recognition on CCTV and an app which compromised every citizen’s privacy, the government could rapidly identify anyone possibly infected by the quarantined person and also order them into confinement. Those like Jeremy Hunt who later advocated that Britain should adopt the South Korean model never explained how Boris’s government could successfully expect identical obedience from millions of Britons asserting their human rights. The refusal by 20 per cent of Britons to identify their contacts in the track-and-trace operation started in May confirmed that Britons would resist Korea-style regimentation. The challenge was to find a middle way.
Instead, Peacock decided that Britain could not ‘accelerate’ its testing capability. The accurate statistics were finally disclosed by her at a SAGE meeting on 18 February. PHE, she said, could only track and trace ‘five new cases’ a week which assumed following 800 contacts. She hoped, she said, to increase her workload to fifty cases a week which could mean checking 8,000 contacts.72 There was a threshold after widespread transmission, she said, when ‘contact tracing would no longer be useful or practical’.73 Peacock’s report and conclusion were not questioned by her fellow SAGE scientists. From the mood at the meeting, Neil Ferguson accepted that the capacity to test was PHE’s sole decision and not one that he or the others could discuss or dispute. In fixing his model, he assumed there would be no increased testing.74 Despite Peacock’s extraordinary revelation, Selbie had written on his blog four days earlier: ‘PHE now has a very extensive and complex contact tracing operation underway with health protection teams around the country diligently talking to people that might have been in close contact with carriers of the virus to assess their risk … Our experts have considerable experience at using contact tracing to prevent and contain outbreaks and to keep the public safe.’
Selbie’s self-congratulatory blog coincided with Ferguson’s first alarming report to SAGE. There was, he wrote, a ‘realistic probability’ that there is already ‘sustained transmission in the UK’.75 Because no one knew what was happening in China, and there was clear evidence that the Chinese government was deliberately providing false statistics, Ferguson’s predictions were unsurprisingly hazy.76,77 He speculated that the peak of infection would be in two to four months (in fact, it would be in just over one month) and he advised that schools should not be closed, not least because scientists did not know whether children would be infected.78 Using unreliable data from Wuhan, he also plundered the available data from an increasing number of quarantined cruise ships, where passengers were kept in poor conditions, to produce a surprise: only some passengers were infected. Clearly the majority of passengers had an unidentifiable immunity. This was unlike any previous Covid. The reason became apparent only about three months later as scientists established that people with a particularly tailored T-cell (a type of white blood cell that helps the immune system fight off viruses) did not suffer.79 Surprisingly, SAGE’s discussion about Ferguson’s predictions on 18 February ended in just one outstanding disagreement. Opinion was divided whether the virus had properly arrived or was actually spreading across the UK. In their view, there was a difference between the virus being present in one place, or many.
*
That was Europe’s last day of innocence. In Codogno, a small town in Lombardy, north Italy, doctors had just started to treat a man suffering respiratory problems but had no suspicions that there was anything unusual. The first case of Wuhan’s Covid had surfaced. There was no reason for Boris, like millions of other Britons, not to enjoy a holiday in half-term week. While many headed to ski in the Alps, Boris drove to Chevening with Carrie for a week. (Chequers was closed due to building work.) Their unexpected holiday coincided with his divorce being considered in the High Court. In a private hearing, a judge approved the financial agreement Boris had reached with Marina. The divorce could rapidly follow. The announcement disappointed those friends who had speculated how Boris pined for his wife and hoped for a reconciliation. In their opinion, Boris had always depended on Marina’s wisdom and stability. Above all, she was utterly trustworthy and loyal. Carrie, they lamented, was too young and inexperienced to offer the same unconditional friendship. They would blame Carrie’s demands in the seventh month of her pregnancy for Boris’s absence from London at the beginning of the Covid crisis. Five days after their arrival, Covid infections were erupting across Lombardy. Communes were being quarantined to control a virus that had already killed. But it wasn’t Covid that interrupted Boris’s holiday; it was Dominic Cummings.
Over the previous weeks, Cummings had not concealed his contempt of civil servants: none properly understood statistical modelling, quantum computation and synthetic biology. They deserved to be ‘whacked’. For better project management, he wanted Whitehall to recruit outstanding scientists – not only for their skills but also their absolute certainty based on evidence. Unlike politicians, they did not indulge in endless talk but, like himself, enthusiastically expounded technical ideas. At the same time, he respected overconfident, impatient mavericks, keen to sweep traditions aside. Again like himself, they focused on a goal without noticing or caring about the collateral damage. ‘He’s the Downing Street version of the Deliveroo guy,’ wrote Stefan Collini, a Cambridge professor of English, about Cummings, ‘who doesn’t care whether you’ve ordered pepperoni or four-cheese:80 his job is to make it happen, and if that involves cycling the wrong way up one-way streets then that’s probably a plus.’ Arcane debate among traditional civil servants aggrieved him. Abandon convoluted arguments, Cummings pronounced. This is what we want, let’s get it done.
Among the many who answered his call for ‘weirdos’ and ‘misfits’ to join him in Downing Street was Andrew Sabisky. Describing himself as a ‘super-forecaster’, Sabisky, aged twenty-seven, had advocated giving children a mental performance-enhancing drug and dismissed the risk of fatality as ‘probably worth a dead kid once a year’. He had also praised eugenics. ‘Intelligence,’ he said, ‘is largely inherited and correlates with better outcomes: physical health, income, lower mental illness.’ He had also argued that black Americans’ IQ was on average lower than that of white Americans and so ‘you will see a far greater percentage of blacks than whites in the range of IQs 75 or below, at which point we are close to the typical boundary for mild mental retardation’.
Drafted by Cummings onto the Downing Street staff without the usual vetting procedures, Sabisky was immediately assigned to work on Boris’s defence review, replacing those described by Cummings as ‘has-beens’. Soon after his arrival, newspapers began to report about his unusual background. If Sabisky was the solution to Cummings’ problem, the reports implied, then Britain’s government was about to fall under the control of extremists. Unease about Sabisky came to a climax after an online post was discovered by The Times. Posing as an ‘agony uncle’, he had told an enquirer that ‘Theologically speaking, she is your wife and should submit to you as unto the Lord … then it is your place to command her … and her place to obey.’
On Monday, Boris called from Chevening and ordered that Sabisky be fired. Cummings refused, arguing that the government should not remove a talented individual because of a media storm. In a second call later that day, Boris was emphatic. Sabisky resigned. Neither Boris nor Cummings realised that an unintended consequence was that talented civil servants and outside experts would be deterred by this episode from joining Downing Street.
Over the following days, Boris was advised to fire Cummings before more trouble erupted. Boris resisted. After his experience in the Foreign Office, he sympathised with Cummings’ antagonism towards the ‘Whitehall blob’. When Cummings warned, ‘See? They will destroy you. You always need me to sort the bastards out’, Boris was grateful.
He had persuaded Cummings to join him in Downing Street for his uncompromising ambitions and methods. He shared Cummings’ goals but lacked his insensitivity towards their common foes. Boris’s virtue was to identify the qualities he lacked and appoint like-minded people who had those qualities to use them on his behalf. That did not mean he gave those appointed his unqualified trust. Loners required proof of loyalty. Unlike Munira Mirza, Eddie Lister, Andrew Gilligan and Ben Gascoigne, the utterly faithful camp followers from City Hall, he recognised that Cummings’ loyalties were shared with Michael Gove, ensconced in the Cabinet Office. While Boris would never forget their treachery in 2016, their capitulation confirmed his victory. Unlike his City Hall friends, the duo were operators on the big stage, sharing an understanding of the obstacles to their agenda of change. Both were committed to revolutionising Whitehall and creating a new Britain. Impatient about any counter-arguments, they had supported his tactics during the Cabinet reshuffle a few days before Boris left for Chevening.
Boris had been looking for a way to remove Sajid Javid, the Chancellor. Javid was resisting Boris’s demands to honour the election promises and spend billions in northern England and on the HS2 rail network. Javid, a former banker, was reluctant to spend more than the country could afford. Just as in his private life, Boris had limited concern about profligate spending. Extra money, he had always found, somehow turned up, and he seemed to believe that this happy truth extended to the public purse. With his agreement, Cummings was deeply involved in drafting the new budget to ‘level up’ the economy and spend on the NHS. Javid’s opposition was intolerable. Gossip had also suggested that Javid had been plotting before the election to remove Cummings. Revenge was automatic. In the wake of the dismissal of Javid’s adviser Sonia Khan, Cummings insisted that all Javid’s special advisers come under Downing Street’s control. Javid refused and then resigned on 13 February.
*
In late February, China finally admitted that 2,236 people had died in Wuhan. Two passengers had died on the Diamond Princess (by mid-April, fourteen would die), and the first victim had died in northern Italy.81 New TV pictures from Lombardy’s hospitals showed a nation in crisis, convulsed by fear. The latest suggestion was that the virus had been brought to Italy one month earlier by Chinese workers returning from holidays in Wuhan. (In May 2020, water samples suggested that the virus had been already present in December.)
In London, PHE reported that while just nine people in England had been tested positive for the virus, 6,143 people had tested negative.82 By then, although the infection was much worse than realised, SAGE’s scientists were uncertain about the next steps.83 Every permutation of controls was discussed and, it was agreed, it was too early to do other than adopt a gradual approach while keeping the situation under daily review. School closures were discussed and opposed and there was talk about protecting the elderly.
The most important development was not discussed. On 25 February, PHE noted that with the end of the half-term break, thousands of British holidaymakers returning from skiing in northern Italy could be infected. PHE did not highlight the same dangers of those returning from France and Spain.84 Research later showed that most of the virus brought into Britain was by those returning from Italy and Spain that week, and not from China.85 In technical terms, PHE failed in the Case Definition. Convinced that China would be the source of a flu infection in Britain, Sharon Peacock and Yvonne Doyle were slow to realise that Covid-19 was different and that the source of infection would be Europe. Consequently, PHE did take seriously the reality that the returning tourists would carry the infection into every British city, a recipe for a simultaneous mass outbreak.86
Vallance and Whitty had long accepted that screening was pointless. Nothing could prevent the virus arriving in Britain but PHE’s failure to widely broadcast the danger of the returning skiers was another indictment of Duncan Selbie’s agency. The meeting’s minutes reflected no disagreement.
The only voice of dissent on SAGE was John Edmunds, a professor of infectious-disease modelling. Edmunds’ model predicted that 370,000 people would die by December 2021 and the NHS would require 220,000 intensive care units (ICU) compared to the existing 4,562 beds.87 On 21 February, he had suggested that the threat level be raised from moderate to high but he was ignored. Two months later, Edmunds would complain that the government did not listen to ‘a small little cadre of people in the middle’ like himself who ‘absolutely did realise from the beginning that there would be an overwhelming epidemic’ in which Britain’s health service was not going ‘to get anywhere near being able to cope with it’.88
The growing crisis in Italy might have made Boris susceptible to Edmunds’ warning but since he relied entirely on Vallance and Whitty he was unaware of any disagreement. In a show of solidarity, Downing Street announced that Boris had telephoned Giuseppe Conte and offered his reassurance, but that merely highlighted for a few that the holidaying prime minister was not in control.
On 25 February, with thirteen confirmed cases, PHE declared ‘the current position in the UK’ was that ‘there is currently no transmission of Covid-19 in the community’.89 PHE also published advice that it was ‘very unlikely that anyone receiving care in a care home or the community will become infected’. (That opinion was not withdrawn until 13 March.) On the following day, Hancock chaired the fifth Cobra meeting.
By then, the Cobra meetings had become less important for making decisions – since Vallance and Whitty were personally giving advice to Boris and Hancock – but were vital in trying to ensure that the devolved governments in Ulster, Wales and Scotland acted in unison with London. The meetings were also useful as the reference point for announcements.
Based on Whitty’s advice, Hancock told the Commons that afternoon, ‘The public can be assured that we have a clear plan to contain, delay, research and mitigate, and that we are working methodically through each step to keep the public safe.’ He also pledged, ‘We have put in place enhanced monitoring measures at UK airports.’ Britons returning from abroad saw no evidence of PHE officials at the airports.90 Hancock’s reassuring statement reflected self-deception but in the circumstances there was no obvious solution. With Vallance’s agreement, testing had not been increased, and the clear need for additional amounts of PPE was the responsibility of Wormald and Simon Stevens, the NHS’s chief executive. Both remained invisible to the public. Neither, it appears, specifically warned Downing Street of any unique problems.
At that critical moment, could a prime minister have been expected to authoritatively ignore Selbie’s emphatic statement, endorsed by Vallance, Whitty and Wormald, that there was ‘no transmission of Covid-19 in the community’? The experts had either an agreed opinion, or had decided not to disagree. Vallance offered no evidence to Boris that there was a stark dilemma. On what basis could a politician question the experts’ apparent unanimity? Perhaps Margaret Thatcher, a chemistry graduate, might have understood the unreliability of scientists, but neither Tony Blair nor Gordon Brown had challenged David King, their chief scientist, when he controversially supported the cull of 6 million healthy animals during the foot and mouth epidemic and advised about the other viruses which followed. Both Vallance and Whitty were sophisticated and experienced. On what basis could Boris have doubted their reassurance?
In the pyramid of Britain’s government, the person empowered to advise and expected to urge caution to a prime minister is the Cabinet Secretary. As Whitehall’s supreme ruler, Mark Sedwill was Boris’s eyes and ears, the official responsible for knowing whether the machinery of government was functioning. Previous Cabinet Secretaries, steeped in Whitehall’s folklore after intense periods in the Treasury, were better equipped than Sedwill. Margaret Thatcher had relied on her Cabinet Secretaries but Tony Blair intended from the outset to ignore his, and also not to rely on the Civil Service. Persuaded by Jonathan Powell, his shallow chief of staff, that the Civil Service would sabotage New Labour’s mission, Blair purposely excluded successive Cabinet Secretaries from critical meetings, not least in the run-up to the Iraq War.91 Blair relied instead on an army of New Labour supporters imported as advisers into Downing Street. David Cameron had trusted Jeremy Heywood, his Cabinet Secretary, but had equally relied on the cabal of friends he had brought into Downing Street. One exception was his negotiations with the EU. Foolishly, he relied on Foreign Office officials and ended up with a bad deal.
After his own experience in the Foreign Office, Boris had good reason to be suspicious of civil servants – but there was a twist. His predecessors never set themselves a mission to improve radically Whitehall. Empowering Cummings with that task was, in recent history, unique. Accordingly, with that inherent scepticism, Boris did not rely on Sedwill. Nevertheless, the Cabinet Secretary’s task in mid-February was to understand the developing crisis and assess the advice the prime minister was receiving, especially from the scientists. By then, Sedwill had good reason to understand Boris’s naivety about the machinery of government. Nevertheless, he failed to advise Boris to return to London as the Covid infection spread. The question remains whether Boris himself should have corrected his own weaknesses: his lack of involvement in the government machine beyond Downing Street, and his failure to scrutinise Hancock’s chairmanship of the Cobra meetings. He did neither. But with hindsight, the alternative to Boris’s overt reliance on the scientists’ advice would have been to announce that he was deliberately ignoring the experts. That disclosure would have outraged the public and his political opponents. After Donald Trump openly distrusted his scientific advisers and advocated drinking disinfectant to kill the infection, he was loudly criticised. Brazil’s president, Jair Bolsonaro, was equally lambasted for his dismissal of medical advice. There was no compromise: either Boris could follow the scientific advice or, like Trump, mock his advisers. The only conjecture is whether Boris, unlike Hancock, would have spotted the professionals’ frailties if he had attended the Cobra meetings in February.
*
26 February was a milestone in Whitehall’s planning for Covid. In Italy, twelve people had died of the virus and, amid panic and a new lockdown, many hospitals were overwhelmed. The sick were either lying on hospital floors or abandoned in their homes. Most Britons could still not believe that the plague would arrive. Their incredulity was supported by the refusal of WHO’s director general to declare a pandemic. Some would say Tedros Adhanom, an undistinguished Ethiopian public health official, wanted to avoid imposing unjustified fear on the world and a stigma on China. Others, including President Trump, would accuse him of fearing retribution from China’s leaders who had supported his questionable candidature. The president threatened to cut off American funding of WHO.
Vallance and the SAGE scientists had no doubt that the virus would arrive in Britain, and that would also have been clear to Ben Warner, Downing Street’s representative at the SAGE meeting the previous day. Warner, a digital expert formerly employed by Vote Leave, could report to Cummings that a disaster was coming.
In preparation for the SAGE meeting on the 25th, three papers had been prepared. Ferguson’s model, updated by using new data from Italy, predicted that in the classic ‘reasonable worst-case scenario’ (RWCS), 80 per cent of Britons would be infected and 1 per cent would die. The death toll would be 510,000 people.92 This was an improvement on Ferguson’s earlier assessment that between 2 per cent and 3 per cent would die – up to 1.5 million deaths. Even with mitigation measures, he said, the death toll could be 250,000 and the existing ICUs would be overwhelmed eight times over.93 The confidence among those at the meeting in Ferguson’s modelling was ‘low’. Sceptical about RWCS exaggerations, and without any definition of ‘reasonable’, his forecast was nevertheless accepted as the best available.94 ‘I much prefer to be accused of overreacting than under-reacting,’ Ferguson said. ‘We don’t have a crystal ball.’ Pertinently, although Ferguson hogged the media spotlight, several other models were used. All came to an alarming conclusion.
In a second paper, the meeting was warned that ‘without action, the NHS will be unable to meet all demands placed on it’.95 One-tenth of all infected patients would need an ICU bed. A third paper expected the peak of infection to be in two to three months and that 3.6 million people would need hospital care, overwhelming ICUs.96
Neither Vallance nor Whitty outrightly challenged Ferguson’s model or predictions. By contrast, in a series of messages from Michael Levitt, a Stanford University professor who would correctly predict the pandemic’s initial trajectory, Ferguson was warned that he had overestimated the potential death toll by ‘ten to twelve times’. ‘The problem with epidemiologists,’ Levitt wrote, ‘is that they feel their job is to frighten people into lockdown, social distancing. So you say “there’s going to be a million deaths” and when there are only 25,000 you say “it’s good you listened to my advice”. This happened with Ebola and bird flu. It’s just part of the madness.’97
Vallance’s own presentation left no doubt that the country faced a severe crisis.98 His priority was to manage the numbers infected in the first wave to avoid overwhelming the hospitals’ ICUs.99
For the first time, the committee considered ‘suppression’ or a lockdown. Wuhan’s experience proved the immediate benefits of ‘suppression’ while Lombardy’s lockdown on 22 February showed that Europeans would comply with that draconian measure.100 Vallance led the consensus that the country should avoid a draconian lockdown. Gradualism was best: start with a few measures and add more if required to manage the numbers infected.
In the range of his scenarios called ‘contain, delay, research, mitigate’, his experts preferred to allow the infection to spread while providing protection for those over sixty-five and ‘special measures around care homes’. Called managing national immunity, the choice was ultimately Boris’s. Lockdown or not would be ‘a political decision’.
At that stage on 25 February, Vallance still professed uncertainty whether immunity to Covid-19 among Britons existed or whether Covid was more complicated than previous coronaviruses.101 But he did assume that most people in the UK, in the absence of a vaccine, would contract the coronavirus. His only absolute certainty was the graph showing deaths in a second wave: it peaked horrifically high.102
Vallance’s and Whitty’s priority was to keep the virus under control to avoid that second wave. In the 1918 flu pandemic, the second wave killed more people than the first. ‘The second wave is the main concern,’ Vallance said. ‘The more you suppress [the infection] down to zero early on, the more likely you are to get a recurrence at some point. It is a very difficult thing to try to balance.’
If the peak of those infected in the first wave was kept artificially low, Vallance explained, there would inevitably be a second wave. Given the time needed to produce a reliable vaccine, the more Britons with immunity after the first wave, the better Britain was placed for a second wave. That would be proven, according to some British scientists, by their assumption that Germans, unlike other Europeans, had developed an immunity.103 Chris Whitty agreed. ‘The great majority of people who catch this virus,’ he would tell MPs, ‘will survive it – the great majority: over 90 per cent. It is easy to get a perception that if you are older and you get this virus, you are a goner.104 Absolutely not.’
Reflecting SAGE’s assessment, the National Security Communications Team warned that with 80 per cent of the population infected, ‘The current planning assumption is that 2–3 per cent of symptomatic cases will result in a fatality.’ That implied that at least 1.5 million would die to establish herd immunity.
In the House of Lords on 26 February, Lord Bethell, a minister at the Department of Health, minimised the validity of those very statistics.105 ‘I do not recognise the numbers,’ he told Baroness McIntosh, ‘and the government are not yet providing forecasts for the virus. Certainly, the worst-case situation could be of the order that she describes, but that estimate is not based on scientific forecasting.’ That was inaccurate: McIntosh’s numbers were based on the forecasts discussed at SAGE. But Bethell did admit, ‘We simply do not know the behaviours of the virus. We do not know exactly how infectious it will be; we do not know which demographics it will target; and we do not necessarily know how mortal it will be. We hope for the best but are planning for the absolute worst.’ He added, ‘The public can be assured that we have a clear plan to contain, delay, research and mitigate, and that we are working methodically through each step to keep the public safe.’
At that stage there was no ‘plan’, only options. The most favoured, Bethell explained, was ‘creating some kind of herd immunity, whereby a large proportion of the population has had the virus and is therefore inoculated [which] is clearly the objective – well, not the objective; rather, it is one of the results of the virus passing through, as flu viruses do regularly. It is expected that it will be a one-off experience, so herd immunity will actually provide resistance to future visits by the virus.’106 Bethell’s candour and misinformation reflected the confusion across Whitehall.
On that day, fifteen people in England were registered with the infection. As a result of the global search for information, the experts believed that the virus was transmitted through ‘aerosol’ droplets in human breath. The unresolved problem was to define the rate of asymptomatic infection. SAGE’s scientists assessed the chance between ‘rare’ and 80 per cent – proof that they could not provide certainty. But they did unanimously agree that stopping international travel and large sports meetings was ‘not significant’ to stop the infection spreading. Ben Warner returned to Downing Street to report a vacuum while Britain waited.
The newspaper headlines on 26 February were alarming. Schools were closing, £100 billion had been wiped off the value of leading shares the previous day and Ferguson’s warning of 500,000 possible deaths was splashed over the tabloids.
In anticipation of the crisis, the prime minister spent four hours discussing preparations with doctors in Kettering Hospital. At that moment, the hospitals relied on PHE to provide testing of patients and staff and issue advice on ordering protective clothing and equipment (just as the three other nations relied on their respective public health agencies). The hospital trust’s need for additional supplies of PPE was not mentioned. Boris returned to London amid reports from Italy of overwhelmed hospitals, fear in Rome and silence from the rest of the EU in reply to Italy’s request for help. Soon after, every EU country was acting in its own interest – closing borders and ignoring Brussels. International collaboration was minimal.
In the capital, Boris’s performance aroused concern. On Friday 28 February, George Osborne tweeted ‘The public is fearful, wants information and needs to know their leaders have got a grip.’ The country, he added, should be placed on a ‘war footing’ and ministers should ‘end the boycott’ of the BBC. Remarking on Boris’s long absence at Chevening and his decision to wait until the following Monday to chair his first Cobra meeting, Jeremy Corbyn called him a ‘part-time prime minister’. Boris replied that after a meeting with Whitty and Hancock his best advice was that people wash their hands for twenty seconds. To deflect attention from the criticism, Boris approved the announcement that Carrie was pregnant and their child would be born in early summer – and that they were engaged.
That ruse was swept aside by another crisis. Philip Rutnam, the Home Office’s permanent secretary, accused Home Secretary Priti Patel of orchestrating a ‘vicious’ campaign against him and of ‘shouting and swearing, belittling people, making unreasonable and repeated demands – behaviour that created fear and that needed some bravery to call out’. Boris had no sympathy for Rutnam. He was not only the Home Office’s senior civil servant when Amber Rudd misled the Commons about immigration targets, but was also at the heart of the Windrush scandal. Rutnam personified the officials targeted by Cummings for removal.
Over that first weekend of March, no one doubted that Britain faced a pandemic. According to Ferguson’s latest model, the infection was doubling every six days and the peak would be in three to five months.107 In an attempt to display his leadership, Boris visited PHE’s test centre in Colindale. Although the centre was testing only about eighty-five people a day, he announced that it was testing ‘thousands and thousands of people for coronavirus’.108 In reality, the ambition was to complete about 3,000 tests per day across the whole country one week later.109 Clearly not informed about PHE’s failure to fulfil its brief, Boris was also unaware that their tests would not spot asymptomatic Covid carriers.
Next, he visited the Royal Free Hospital in Hampstead, designated a centre to treat the virus. Once again, he was not briefed about the urgent need for PPE. His lack of awareness bred complacency in Downing Street. On his return, there were no fevered demands from his staff to challenge the Department of Health and PHE. His closest advisers’ mindset resembled his: rely on the experts and follow the scientists.
Others were more alert. In anticipation, the Care Provider Alliance issued urgent guidance advising care homes to consider restricting visits from all relatives until the outbreak was over.
Recognising the imminent danger, the representative of the care-home industry told members to restrict the use of new agency staff to lessen exposure to the virus, and to isolate residents if they were suspected of being infected.110 That advice was not endorsed by Whitty. SAGE’s advisers, Whitty said, were not keen on stringent measures like banning visitors from uninfected care homes, which would bring misery to the elderly and their relations.111 Whitty’s leniency was ignored by Wales’s chief medical officer, Dr Frank Atherton. Sick people were told ‘don’t go and visit your auntie in a care home’. It would be another ten days before Whitty also advised those who were ‘generally unwell’ to avoid visiting residents.
In preparation for the next Cobra meeting on Monday 2 March, the first to be chaired by Boris, Ferguson reported to SAGE that the danger had increased. The number of ICUs, he advised, should be doubled or even tripled. All would require ventilators. The statistics were alarming. Up to 570,000, he said, could die and the NHS would need 130,000 ICU beds.112 That new warning was not highlighted to Downing Street.
In what was still labelled ‘the containment phase’, Boris was assured that under the Department of Health’s ‘action plan … the UK maintains strategic stockpiles of the most important medicines and protective equipment for healthcare staff who may come into contact with patients with the virus. These stocks are being monitored daily, with additional stock being ordered where necessary.’113 Without an expert offering alternative information, there was no reason for Boris to doubt that assurance. The question is whether Boris should have appointed immediately an adviser in Downing Street to query the Department of Health’s statements.
The strategic plan, Boris was told by Whitty and Vallance, remained to ‘flatten the curve’, slowing the virus’s spread so the NHS could cope at peak infection. The government, said Whitty, should wait for ‘the right time and in the right phasing’. Echoing Whitty, Vallance added, ‘What you can’t do is suppress this thing completely … can’t and shouldn’t … timing is so important: right time, right combination, driven by the data and the science.’
Boris was also told by Vallance that no one on SAGE was recommending that the government should immediately lock down the country.114 That advice matched his own instinct that Britons should ‘go about their business as usual’ and even travel abroad on holiday.115 In the meantime, he read the prepared script: ‘there will be less emphasis on large-scale preventative measures such as intensive contact tracing. As the disease becomes established, these measures may lose their effectiveness and resources would be more effectively used elsewhere.’ Over the next twenty-fours, the number of infected people rose from thirty-nine to fifty-one. During the following week, no scientist or politician publicly criticised Boris’s script.
With the media dominated by alarming virus reports, highlighting a total of 107 deaths in Italy, Boris needed to reassure the nation. In preparing for his first press conference the following day, he calculated that the positive image was for him to be flanked by Vallance and Whitty. ‘The principle that will guide us in all these decisions,’ he told the audience, ‘is the scientific advice … it’s the science that will help us.’ The sight of two medical chiefs agreeing with the prime minister silenced even Boris’s fervent critics. ‘Our country remains extremely well prepared,’ he said. ‘We already have a fantastic NHS, fantastic testing systems and fantastic surveillance of the spread of disease.’116 Both scientists endorsed his erroneous hyperbole and emphatic advice to the nation: ‘We should all basically just go about our normal daily lives.’ He was also clear about the danger: ‘Let me be absolutely clear that for the overwhelming majority of people who contract the virus, this will be a mild disease from which they will speedily and fully recover as we’ve already seen. But I fully understand public concern, your concern, about the global spread of this virus. And it is highly likely that we will see a growing number of UK cases.’ Joshingly, he added with injudicious reassurance, ‘I was at a hospital the other night where I think there were actually a few coronavirus patients and I shook hands with everybody.’ He continued, ‘The best thing you can do is to wash your hands with soap and hot water while singing “Happy Birthday” twice.’ Echoing his master, Hancock later told BBC TV that handshaking was not dangerous: ‘We’ve taken the scientific advice … The impact of shaking hands is negligible … as long as you wash your hands more often.’ Across the world, every other government warned against shaking hands.
During that same day, SAGE members started to change their minds: ‘Government should advise against greetings such as shaking hands and hugging, given existing evidence about the importance of hand hygiene.’117 Instinctively, Boris disregarded that somersault. He refused to follow what was happening in Europe. ‘People obviously can make up their own minds,’ he told the public, ‘but I think the scientific evidence is, our judgement is, that washing your hands is the crucial thing.’ With Whitty’s support, he was shaking hands at a Downing Street reception that week. Among the guests was Nadine Dorries, a Tory MP. The next morning, she reported Covid symptoms and later isolated herself. Twenty-eight people died that day in Italy. Unknown to the SAGE scientists, the rate of ‘re-infection’ – passing the virus on to another person – was no longer four to six days but had accelerated to two to three days. Although Downing Street’s spokesman highlighted ‘the biggest crisis the country has faced in our lifetimes’, the reaction across the Channel to the oncoming Armageddon was very different than in London. In Paris, President Macron had decided to follow the Asian example and start restricting large indoor gatherings. The first edict on 4 March prohibited more than 5,000 people from meeting in an enclosed space. There was no doubt that Macron intended to eventually impose a total lockdown and end economic activity.
Aware of the tension across Europe, Dominic Cummings attended SAGE’s meeting on 5 March.118 Labour would criticise his presence as likely to interfere with the committee’s advice. ‘There have been a number of observers at those meetings,’ Ferguson retorted, ‘who have not interfered with business at all.’
Cummings heard the committee accept their behavioural scientists’ advice that it was ‘too early in the epidemic’ to impose distancing or a lockdown. Without public support, control measures would not work. If people started self-isolating ‘too early’, Whitty believed, there would be ‘no benefit’ and it would last too long.119 There was, Vallance calculated, ‘an incredibly difficult balancing act going on. Being too slow to react has potentially dangerous consequences. Overreacting is also potentially dangerous.’ The key was not to allow enthusiasm to flag and run out at the peak. People would get fed up being isolated for thirteen weeks just when it was necessary. Mark Woolhouse, the professor of epidemiology on Scotland’s SAGE, agreed: ‘I would characterise lockdown as a panic measure.’120 The message Cummings took back to Downing Street was that isolation measures could start in about one to two weeks but the committee was against a total lockdown or banning large sporting meetings.
Whitty’s reliance on behavioural scientists would be publicly praised by Deirdre Hine, a public health specialist and the author of a report about pandemics in 2010.121,122 But Whitty would be criticised by Stephen Reicher, a psychologist based in Scotland and an SNP sympathiser. Whitty, he complained, took advice from the wrong specialists.123
The early disputes among scientists did not trouble Boris. The politician saw no reason to doubt the accumulated wisdom offered by Vallance and Whitty. Even if Boris recalled Churchill’s famous quip about having ‘scientists on tap and not on top’, he was very probably unaware of Richard Feynman’s warning in his essay, ‘The value of science’. The pathfinding American physicist wrote: ‘When a scientist doesn’t know the answer to a problem, he is ignorant. When he has a hunch as to what the result is, he is uncertain. And when he is pretty darn sure of what the result is going to be, he is still in some doubt. We have found it of paramount importance that in order to progress we must recognise our ignorance and leave room for doubt. Scientific knowledge is a body of statements of varying degrees of certainty – some most unsure, some nearly sure, but none absolutely certain.’ Oblivious to the nuances of scientists arguing and the groupthink consensus dominating SAGE’s scientists, BBC news reporters – the country’s principle source of information – copied the politicians and did not challenge the scientists. Instead, the scientists’ subjective opinions were repeated as gospel. Lee Cain, Downing Street’s director of communications, did not grasp the potential problem of argumentative scientists undermining public confidence.
Whatever their qualifications, the behavioural scientists had not predicted that during that week, as fears of a lockdown loomed, vast numbers of people would storm the supermarkets to stockpile food and huge quantities of lavatory paper. By 10 a.m., supermarket shelves were bare. Similar frenzies did not occur elsewhere in Europe. Even in beleaguered Italy, shoppers behaved normally.
In a crisis, every nation looks to its leader for wisdom and reassurance. Even the Russians in 1941, as the Nazis invaded, put aside Stalin’s murderous purges, and trusted him to repel the enemy. Boris’s task was much simpler. In those early days of his administration, the majority of Britons trusted his judgement. Long praised as an outstanding communicator with an uncanny ability to read the nation, much depended on Boris’s language and tone to maintain public confidence. The first dilemma was whether he should follow Macron and ban mass gatherings. Vallance and Whitty urged resistance. Banning, Whitty told him, was pointless because that would not ‘contain’ the virus.124 As the 2011 report recommended, to avoid damaging public morale and economic damage, the government should not ‘impose any restrictions’.
To show that normal life should continue, Boris and Carrie joined 82,000 people at Twickenham on Saturday 7 March to watch the England versus Wales rugby match. By then four people had died in Britain of Covid. Boris was still undecided whether Britain should ‘take it on the chin, take it all in one go and allow the disease, as it were, to move through the population, without taking as many draconian measures’. On reflection, he thought ‘we need to strike a balance’.125 As a libertarian opposed to any restriction of movement, and also fearful of destroying the economy, he decided that the four-day Cheltenham Festival – attracting about 70,000 racing fans every day, starting on 10 March and worth £100 million to the economy – should go ahead. The bulldog wanted to show the nation that he would not be cowed by an invisible threat. Reassured that he was following Vallance’s and Whitty’s recommendations, he knew that if he ignored their advice, the presenters on the BBC’s Today programme would have led the attack. But for the first time, his message divided the country. Many were aghast that Boris had allowed the mass events.
On 10 March, Boris focused on the final details of the new Chancellor Rishi Sunak’s budget. (The cornerstone of Boris’s election promise to ‘level up’ northern Britain was to be presented the following morning.) With Ben Warner present, SAGE met the same day amid fearsome news. Italy had been completely locked down the previous day, eighteen days after the first lockdown in Lombardy. Ferguson’s model suggested that Britain was four to five weeks behind Italy in the curve. At most, he said, 10,000 Britons were infected.126 Ferguson’s model also predicted that the peak of the infection was ten to fourteen weeks away if no mitigation measures were taken. Otherwise, it could be later.127 Lockdown was discounted to avoid a serious second wave but held in reserve for two weeks later. As a footnote, the scientists suggested that the government should consider a ‘special policy’ about care homes but studiously avoided making any firm recommendations.
On 11 March, a few hours before Sunak delivered his budget to the Commons, WHO finally declared a global pandemic. Britain registered 590 cases and ten deaths.128 In Italy, about 500 deaths had been registered and the death rate was doubling every two days. That afternoon, Donald Trump imposed an international travel ban. On the same day, as 70,000 people enjoyed racing at Cheltenham, 3,000 Spaniards arrived in Liverpool to watch Atlético Madrid compete in the Champions League. Many commented with bewilderment that the Spaniards had flown in from an infected city which was closing down. Similar events were banned across Europe. Ferguson did not realise the extent of the infection in Europe.129 Nor did Whitty’s deputy Jenny Harries, who explained why mass gatherings were not banned: ‘Our experts and modellers basically haven’t recommended it because they were still judged “low risk”. Those events don’t have a big effect.’ Boris, she emphasised, was following the science. The ‘brilliant modellers’ and ‘timing’ would be critical in determining ‘when we should intervene’.130 Herd immunity ‘to flatten the curve’, or as Boris called it ‘squash the sombrero’, remained the agreed policy.131
By then, however, the concept of ‘herd immunity’ had aroused concern. To some, the government planned to let the disease rip through the community as part of a cold-blooded experiment in social engineering. Around this time, according to an alleged eyewitness, Cummings commented approvingly that ‘herd immunity’ would inevitably mean the premature death of the elderly, a suggestion he later condemned as a journalist’s ‘fabrication’.132
During the day, Vallance was challenged for the first time by some SAGE members for relying on herd immunity. Events in Europe, they said, proved that the virus was out of control. Ferguson’s latest model predicted that instead of 20,000 deaths, the infection rate was R3 and 250,000 could die. The committee’s mistake, said the critics, was to base British policy on combating traditional flu. While flu sufferers did emerge with immunity against re-infection, there was no evidence that Covid-19’s sufferers became immune. Although Vallance would deny proposing herd immunity, Robert Peston, the journalist, was authoritatively briefed about that strategy for an ITV broadcast.133,134
The argument for a ‘herd’ programme remained credible. The evidence from Italy suggested that those healthy and under sixty were not in danger. Children were probably safe. Only the elderly and those with serious sicknesses were vulnerable. Lockdown in Britain could be avoided if the vulnerable isolated themselves. The elderly and other at-risk groups, explained the behavioural scientist David Halpern on 11 March, should be ‘cocooned’ and would be released only when the rest of the community had immunity.135
Boris chaired Cobra on 12 March. The Italian death toll had risen in just twelve days from 52 to 1,266. PHE had identified about one hundred separate Covid outbreaks and contacted around 3,500 people who were possibly infected. Doyle and Peacock believed the official infection rate was a gross underestimate. They assumed that probably over 100,000 people were infected.136 In fact, it was worse. The infection rate was about to peak. Regardless, Doyle had realised a critical truth: PHE’s assurances about ramping up testing had been false. The reality had to be acknowledged.
At the SAGE meeting the following day, Doyle announced that PHE had abandoned testing in the community.137 Testing, Doyle said, would be restricted to hospital staff.138 With a capacity of 1,000 tests a day, that meant PHE could handle only three tests per day in each of Britain’s hospitals. After hearing her submission, the experts agreed that PHE’s plan to discontinue testing was ‘sensible’. Whitty also admitted that ‘containment was pointless’. Jenny Harries agreed that community testing was ‘not appropriate’. Still relying as an article of faith on the playbook of combating influenza, the scientists assumed that the level of infection could not be limited.
After unilaterally giving up PHE’s responsibility for testing, Doyle assigned her responsibilities to the Department of Health’s Office for Life Sciences.139 On 17 March, Vallance told MPs that even 4,000 tests a day was ‘not going to be enough’. Because there were thousands of unknown cases, ‘contact tracing was a lost cause’.140 Yet, at the same time, Boris promised ‘we will massively scale up our testing capacity in the weeks ahead so we hit 25,000 tests a day’.141 That was optimistic, to say the least. Even on 23 March, PHE employed just 280 people across the whole country for testing. They needed 280 in every town.142
On 25 March Yvonne Doyle chose not to explain to MPs why PHE’s testing had stopped.143 Sharon Peacock also refused to explain why PHE had chosen not to follow South Korea. She undertook to share ‘in the next few days’ with the Commons Science and Technology Committee the evidence and analysis on which the decision to reject South Korea-style mass testing at an early stage was taken. But despite requests by letter, email and telephone thereafter from Greg Clark, the committee’s chairman, she did not produce the basis for PHE’s decision to scale down testing.144 Instead, Peacock sent MPs a study undertaken by the Royal Society describing testing in other countries.145 Outraged by Peacock’s obstruction, Greg Clark told Duncan Selbie to answer the question. In a jargon-infected reply, Selbie disputed the accuracy of the SAGE minutes, and denied that testing and tracing was abandoned because there was no capacity.146
Clark was angry. PHE’s failure to publish the evidence about its testing policy, he wrote, was ‘unacceptable’. To restrict testing to hospitals, he stated, meant that no one knew where the virus was spreading and who was infected.147 He suspected that PHE’s refusal to explain meant that ‘no rigorous assessment was in fact made by PHE of other countries’ approach to testing. That would be of profound concern since the necessity to consider the approaches taken by others with experience of pandemics is obvious.’
His irritation was aggravated by Sharon Peacock’s proposal to order 21 million Chinese-produced home-testing kits done by a finger-prick. In a blaze of publicity, PHE said they would be distributed by Amazon, Boots and other retailers. Whitty’s scepticism proved justified. The product proved to be unreliable and was not ordered.
The Department of Health’s self-confidence was beginning to unravel. Not only had testing been abandoned but the media was filled with complaints that hospitals feared an insufficient supply both of PPE and of ventilators for ICU patients. The government had changed its advice issued on 1 March. Moving from the ‘containment’ stage to ‘delay’, all those infected were asked to self-isolate.
Among the outside experts condemning the government was Mark Woolhouse, the professor of epidemiology on Scotland’s SAGE. In an increasingly confusing pattern of contradictions, Woolhouse rejected Greg Clark’s protest about the lack of testing. ‘I think the focus on simply the number of tests,’ said Woolhouse, ‘is extremely unhelpful, and setting targets based on numbers is quite unhelpful. What is crucial is a strategy to which the testing contributes. Why are you using these tests, and what is the goal of that strategy? Some strategies that might be very effective require relatively small amounts of testing and others require extremely large amounts of testing, so it is not the numbers of the tests that count.’148
Woolhouse’s contribution coincided with Ferguson’s latest prediction. In the space of two days, he reassessed the numbers who were infected from 100,000 to 300,000. Ferguson still assumed that the number of cases was doubling every five days. By the end of the following week, about 1 million people would be infected. ‘Unless we radically change direction,’ warned Clark, ‘we will not know where those 1 million cases are.’149
The public disagreements fuelled public concern. Governments in Europe had become starkly interventionist. Large public gatherings were banned in Berlin; schools were being shut in Spain and Greece; Ireland had cancelled St Patrick’s Day parades; France announced school closures; and Portugal and Spain had ordered complete lockdowns on 14 March. SAGE’s behavioural scientists warned ministers that the public would lose trust in the government if measures imposed abroad were not adopted in Britain. ‘Not pursuing such routes,’ they advised, ‘needs to be well explained.’ Yet other behavioural scientists doubted that the public would obey restrictions and certainly not a lockdown.150
Whitty and Vallance had delayed signalling the whole danger to the public. But on 12 March, they had suggested that the threat level be increased to ‘high’. (Germany declared the level ‘high’ on 17 March.) And they advised Boris to hold his nerve. They were supported by Ian Boyd, a professor of biology and a former government chief scientific adviser. The public, said Boyd, were not ready for a lockdown: ‘I think some politicians would have loved to have reacted earlier but in their political opinion it probably wasn’t feasible because people wouldn’t have perhaps responded in the way they eventually did.’151 ‘Herd immunity’, agreed Boyd, was the best policy with warnings to the elderly and vulnerable. ‘The only way to stop this epidemic is indeed to achieve herd immunity,’ agreed John Edmunds.152 At the time, Edmunds did not openly criticise SAGE’s secrecy and endorsed the credibility of Ferguson’s models.
Whitty and Vallance refused to be panicked and follow Europe. Both, however, realised their mistake in initially suggesting they were dealing with a flu pandemic. Covid-19’s symptoms were different. Reports from Italy showed it lasted longer and, unlike flu, children were probably not carriers.153 ‘You would normally expect most of the outbreaks to be associated with schools,’ Whitty explained, ‘yet in the global literature at the moment there is only one documented outbreak.’ The evidence for closing schools, said Whitty, ‘is quite weak’.154 Closing schools until there was a ‘major epidemic’, they advised, would be ‘highly disruptive and present an unequal burden to different sections of society’.155 Parents, especially the poor and those employed by the health service, would have to take on childcare duties or else hand them over to grandparents, recognised as the most vulnerable to Covid and in need of special protection. ‘We’re not going to trigger draconian measures now,’ Boris agreed.156
Following the behavioural scientists’ advice, Boris had addressed the nation that afternoon. Flanked by Whitty and Vallance, he did not hold back. Adopting Churchill’s ‘Darkest Hour’ tone, he said ‘I must level with you, level with the British public, many more families are going to lose loved ones before their time … The best scientific advice is that this is now not just to attempt to contain the disease as far as possible, but to delay its spread and thereby minimise the suffering … This will help us slow the disease and save lives. The most important task will be to protect our elderly.’157 Those with symptoms were asked to isolate for seven days. Echoing the scientific advice, he repeated that ‘banning major public events such as sporting fixtures … will have little effect on the spread’ and there would be no lockdown as in Europe. ‘So the most dangerous period is not now but some weeks away depending on how fast it spreads.’ He did not rule out the gradual introduction of more draconian steps ‘at some point in the next few weeks’.158 At the end, Boris was asked whether he feared catching the virus. With a smile, he replied, ‘I am washing my hands, that’s the crucial thing.’
Overnight, despite 70,000 enjoying another day at Cheltenham races, the public began to ignore the government’s relaxed policies. After the Premier League suspended all games, Jenny Harries was repeatedly asked by Corbyn why Britain was taking a different approach from the rest of Europe. Her answers were unconvincing. On Sky TV, Vallance explained that herd immunity could be an ‘important part of controlling [the virus] in the long term’. Experts, he said, estimated that about 60 per cent of the UK’s 66 million population would have to contract the virus for effective immunity. In another interview with the BBC, Vallance described the disadvantage of total lockdown: ‘If you suppress something very, very hard, when you release those measures, it bounces back and it bounces back at the wrong time.’ He added: ‘Our aim is to try to reduce the peak, broaden the peak, not suppress it completely; also, because the vast majority of people get a mild illness, to build up some kind of herd immunity so more people are immune to this disease and we reduce the transmission, at the same time we protect those who are most vulnerable to it.’ In a conference call that day with health ministers of the G7 countries, Hancock asked the Italian health minister whether Italy was pursuing herd immunity. Brusquely, the Italian replied that sacrificing thousands of excess lives was unacceptable, especially in Lombardy’s care homes. There, the fatalities were already horrendous. Hancock was in no doubt about the risk to the elderly. Fearful of the image of ruthlessness, Hancock denied on TV that evening that the government had adopted a herd-immunity plan.
That same night, the public was introduced to a phenomenon which would become increasingly common over the following weeks. Just as Boris emphasised his reliance on scientists, other scientists bitterly disagreed with his trusted advisers. Professor John Ashton, the seventy-two-year-old former regional director of public health for north-west England, denounced Vallance and Whitty on BBC TV for failing to advise Boris to impose a complete lockdown over Britain. ‘I don’t know where to start really,’ he opened. ‘I’m embarrassed by the situation in this country. This talk of four stages – and we’re now moving on from the containment thing – we’ve lost the plot here. We haven’t taken the action we should have taken four or five weeks ago.’ Ashton also damned a herd-immunity strategy as ‘pathetic’ and ‘clinically negligent’. The policy, he warned, would lead to ‘huge numbers dying and catastrophic consequences for the NHS’.159
Ashton’s qualifications compared to Vallance’s and Whitty’s were thin. He was not an epidemiologist and he had no deep experience of infectious viruses. Within the profession, Ashton’s credentials were challenged. ‘The plans are sensible,’ said Professor Keith Neal, an emeritus professor in the epidemiology of infectious diseases. ‘It is very easy to say more needs to be done but there is little evidence to make any decision which would help contain the spread of the virus.’160 Ashton, according to Neal, was speaking with the benefit of hindsight. Five weeks earlier, no one had foreseen that Italy would be the centre of the virus, or that tens of thousands of untracked cases would so rapidly spread across Europe. Nor that it would spread so fast across the whole of Britain. Total containment in Britain, the epidemiologist knew, was impossible. Lockdown, added Johan Giesecke, Sweden’s virus expert, would do little to prevent the spread of infection and just delay the inevitable – ‘just pushing the deaths into the future’ was his phrase.161 By the end of a year, he speculated, most countries would have a similar number of deaths. Professor Matt Keeling, a professor of life sciences, agreed: ‘Hindsight is a wonderful thing when it comes to looking back at epidemics. It is always easier to say that we could have done something slightly different.’162 Concerned by the outbreak of scientists’ warfare, Hancock wrote in a newspaper article, ‘We have a plan based on the expertise of world-leading scientists … Herd immunity is not a part of it. That is a scientific concept, not a goal or a strategy.’163
Whatever the warnings, Boris was determined to let life continue as normal. SAGE’s advice that outdoor events should not be curtailed matched his own bulldog spirit that the British would not be cowed by any foe. While the Stereophonics played to 15,000 fans over the weekend in Cardiff, he hosted a baby-shower party with Carrie at Chequers for about ten people. That was his last hurrah. On Monday morning, 16 March, he realised that the world had irrevocably changed. The public were no longer prepared to share his appetite for risk or hold their nerve in the face of such uncertainty. Polling showed that two-thirds of people were already avoiding bars and public transport. Airlines were slashing services as people refused to fly. Few wore masks after scientists downplayed their effect. Six hundred academics openly protested about the government’s refusal to impose social distancing. They also questioned the scientific credibility of ‘behavioural fatigue’.164 That morning, the mood changed. His inclination to take risks abruptly ended.
Using fresh data from Italy, Neil Ferguson had produced over the weekend new predictions. If the government continued to rely on herd immunity, he reported, 1 per cent of those infected would die, meaning 510,000 people. If the government adopted a policy of ‘mitigation’, and ‘even if all patients were able to be treated, we predict there would still be in the order of 250,000 deaths in GB, and 1.1–1.2 million in the US.’ However, with lockdown or ‘suppression’, he estimated the number of deaths to be 20,000 ‘or fewer’ because the peak was due in two to three weeks and thereafter pressure on hospitals would fall.165,166,167 In reality, the infection had just reached the peak.
In the first serious proposal for lockdown in SAGE, Ferguson forecast that almost one-third of the over-eighties who were infected would be hospitalised and 71 per cent would need intensive care using ventilators. The hospitals would be overwhelmed by at least eight times the usual admittance. Not surprisingly, Vallance and Whitty were shocked by these new projections. Both knew that modelling created serious uncertainties but Ferguson had raised the stakes. Television reports of catastrophe in northern Italy showed harassed doctors being forced to take instant life-or-death decisions. The emotional impact was truly horrific. SAGE’s members feared that the underfunded NHS would inevitably run out of ICU beds and ventilators. Britain had to be protected from similar anguished scenes.
No one on the committee questioned Ferguson’s forecast. As they rushed to protect Britain from the horrors seen in Italy, no one mentioned that ventilators were rarely used for the elderly because the patients were often too frail to cope with such an invasive procedure; or that most of those with underlying bad health were destined to soon die from some other cause.
SAGE’s secrecy meant that rival modellers would only become aware of Imperial’s work later. ‘I am surprised that there has been such unqualified acceptance of the Imperial model,’ said Sunetra Gupta, a theoretical epidemiologist who led a modelling team in Oxford.168 Gupta’s study disputed the reliance on the tests for antibodies to decide who had immunity or resistance to the virus.169 She concluded that 68 per cent of Britons were already infected and therefore the projected 510,000 deaths was wrong.170 In her opinion, fewer than one in 1,000 of those infected would need hospitalisation. The vast majority would suffer mild or even no symptoms, and the death rate would be far lower than Ferguson predicted. Rather than waste money on the NHS, she recommended that people should avoid crowds and that the economy should not be shut down.
Gupta was not alone. The maverick pandemic forecaster at Stanford University, John Ioannidis, called the data collected by Ferguson ‘utterly unreliable’. One day, he claimed, it would be dismissed as ‘an evidence fiasco’. On the Diamond Princess cruise ship, a Covid ‘hothouse’ of high-risk older people, only 1 per cent had died. The Covid threat, he concluded, was exaggerated. The Swedish government took a similar view.
Anders Tegnell, an epidemiologist and Sweden’s chief medical officer, favoured herd immunity. Researchers at Uppsala University told him that on the basis of Imperial’s model up to 45,000 Swedes would die from the virus by the end of April if the country relied on herd immunity and not a lockdown. ‘The main problem that the Imperial paper has,’ Tegnell decided, ‘is that it underestimates the number of cases that are light or not severe and that do not bring people to the healthcare system.’
The Cambridge University statistician David Spiegelhalter was almost as sanguine on the BBC’s More or Less programme. He did not challenge the disease’s virulence but suggested it might compress the annual flu death rate into a few weeks – putting intense pressure on hospitals – with the only ‘extras’ coming from non-vulnerable groups. Yet more scepticism was expressed by a former NHS pathologist, John Lee. He suggested the deaths of elderly people were differently recorded in every country. How many, he asked, were actually dying ‘of’ Covid-19 rather than of another illness with Covid on top?
Connoisseurs of academic backbiting could enjoy the professional squabble. Eight scientists contacted by the Science Media Centre rubbished Gupta’s study, though others hedged their bets. To answer the doubts about his model, Ferguson explained, ‘I’m conscious that lots of people would like to see and run the pandemic simulation code we are using to model control measures against Covid-19. To explain the background – I wrote the code [thousands of lines of undocumented C] 13+ years ago to model flu pandemics.’171
On 16 March, the death toll in England was seventy-one. Over the previous three days, the sharp rise in hospital admissions confirmed that the virus had taken root. Vallance told MPs that 20,000 deaths would be ‘a good outcome’. SAGE would later be criticised for not recommending the lockdown on that day. Whitty and Vallance would reply that the restrictions applied on 16 March were aimed towards the lockdown.172 But they did not go further.173 Boris was grateful. The idea, he said, of taking away the ancient, inalienable right of freeborn people of the United Kingdom to go to the pub, would be a huge wrench.174
In a sign that Boris finally understood the inadequacy of the Whitehall machine, he summoned a meeting of ministers and key officials which would thereafter gather at 9.30 a.m. every day. Included were Hancock, Gove, Sunak, Vallance, Whitty and Cabinet Office specialists plus Sedwill and Lee Cain. For the first time, Simon Stevens and others from the Department of Health became directly involved with the prime minister. Stevens and Boris had been contemporaries at Balliol and Stevens had been a guest at Boris’s wedding to Allegra. Notably absent were Sharon Peacock and Yvonne Doyle. Boris understood PHE’s notable failure to painstakingly monitor the development of the infection in Italy over the previous month. For the first time, questioning, cajoling and deciding, Boris chaired the semblance of a War Cabinet. Boris took charge, ousting the Department of Health. Michael Gove and the Cabinet Office were the supremos.
Later that afternoon on the 16th, after a Cobra meeting, Boris held a televised press conference to sound a more strident warning. The virus, he said, had reached a ‘fast-growth stage’ and was doubling every five or six days. He did not mention Ferguson’s prediction that it would peak at the end of April. No one could tell Boris that the peak of infection was already occurring. That would be calculated later, after the peak of deaths would be fixed on 8 April.
People, Boris said on TV, should avoid pubs, clubs and theatres.175 Those with the symptoms should isolate for fourteen days and everyone else should stop non-essential travel and work at home if possible. Since the pressure on hospitals would intensify, he announced, he was ‘pushing very hard’ to increase tests, especially of NHS staff. To answer the outcry that the underfunded NHS lacked sufficient ventilators, he had scrambled an appeal to industry for help.176 At the time, most of the public grasped the growing danger. Those in doubt would have been convinced the following day.
Overnight, PHE and SAGE’s experts realised that their data was inadequate. Ferguson arrived in Downing Street to warn ministers personally that Britain was just two weeks behind Italy.177 Over the previous three days, he finally acknowledged, the doubling rate of infection had risen to two to three days. Boris returned to the TV briefing room.
Speaking from behind a placard stating ‘Stay Home, Protect the NHS, Save Lives’, Boris spoke again in 1940 tones: ‘We must act like any wartime government and do whatever it takes to support our economy,’ he told the country. ‘Yes this enemy can be deadly, but it is also beatable – and we know how to beat it and we know that if as a country we follow the scientific advice that is now being given we know that we will beat it. And however tough the months ahead we have the resolve and the resources to win the fight. And, to repeat, this government will do whatever it takes.’178 Then, with Sunak, he announced unprecedented help to enable working Britons avoid loans, get tax holidays and cash grants for businesses and individuals which would eventually benefit nearly 10 million employees.179 Wall Street had fallen about 30 per cent to its lowest point since 2008. Financial disaster was beckoning.
In the Department of Health there was increasing activity. Ferguson’s forecast that eight times more ICU beds would be needed was alarming. (Later, he would confusingly say that if lockdown had been introduced earlier, England had sufficient ICUs. But there never was a shortage of ICUs.180) The headline inspired by Ferguson was that 2 million Britons would need hospital beds – and the NHS had barely 100,000. Many had been awed by the TV reports of China building a huge hospital in Wuhan ‘in ten days’ (although in fact it took longer). Simon Stevens and the executives at the NHS headquarters decided that the British could do the same. The empty ExCeL Centre in Docklands was appropriated to build a 4,500-bed facility under the army’s command. Nine days after Matt Hancock’s announcement, the first Nightingale Hospital was opened in London by Prince Charles on 3 April. Eight more would follow across Britain. To match another of Ferguson’s forecasts, the government sought 30,000 ventilators. Provisionally, the department ordered 18,000 and finally bought 2,000 through a procurement programme with a budget of £454 million. Simultaneously, within twelve days, the government assembled a network of sequencing centres and analysis groups to understand how the virus was spreading, how it could be controlled and to begin to develop a vaccine.181
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The most important element at that moment was hospital capacity. The Department of Health’s priority was to empty the hospitals of non-urgent patients. The largest category were the 30,000 elderly and chronically ill occupying about one-third of the NHS’s beds. In past years, NHS administrators had been plagued by the so-called bed-blockers. Unable to persuade local authorities to find suitable care homes, they unnecessarily occupied hospital beds. Now, the emergency demanded that they be ejected.
On 13 March, PHE had withdrawn items of critical advice:182 that asymptomatic patients could not spread the infection; and that it was ‘very unlikely that anyone receiving care in a care home or the community will become infected’. Instead, care homes were urged to ‘review’ their visiting policy. Obeying SAGE’s behavioural scientists, PHE still resisted ordering old people to remain isolated from their relatives.
About 418,000 people in England were living in 11,109 care homes (plus about 4,400 nursing homes) cared for by 1.47 million staff.183 Over 90 per cent of the care homes were privately owned, subject to control by the Care Quality Commission, an inglorious quango, and local authorities. None were obliged to obey any government regulations for the provision of PPE or staff training.184 In hindsight, Ferguson would say that he assumed that government policy was to shield care homes and particularly the most vulnerable ‘as the top priority’.185 That had been Boris’s assurance on 12 March: ‘The most important task will be to protect our elderly and most vulnerable people during the peak weeks when there is the maximum risk of exposure to the disease and when the NHS will be under the most pressure.’186 But his promise had not been implemented by Whitehall.187 The government had merely advised the 1.5 million people in England identified as clinically vulnerable to avoid Covid by isolating for twelve weeks. Nothing more.
On 17 March, Amanda Pritchard, the NHS’s chief operating officer for England, instructed hospital trusts to discharge urgently all ‘medically fit’ patients as soon as it was clinically safe, but ideally within three hours.188 Her directive was endorsed by Hancock, ‘to allow the NHS to do what it needs to, and help move people out of hospital as soon as possible to get them back home with the right support’. Some would say that Hancock approved only after consulting Boris.
Pritchard’s rapid implementation of the ‘discharge to assess’ model was targeted to empty 15,000 acute beds by 27 March, and later another 10,000.189 Even that timetable would be criticised by SAGE’s scientists. Immediate action, they warned, would not stop London’s ICUs being overwhelmed.190 Testing patients for Covid was explicitly not required by the government before patients were discharged. The reason was simple: PHE could not provide 15,000 tests over the following ten days. The real danger was asymptomatic patients. Only a test could establish whether they were infected. There was no net to catch them.
Within a day, Pritchard’s directive provoked uproar from care-home managers. Key rules, they warned, had been abandoned. ‘Unless the NHS ups its game on this and gives us immediate access to the [PPE] we need,’ said Martin Green, the chief executive of Care England, ‘there will be no discharges from hospitals into care homes.’191 Green spoke for many who recognised the danger. ‘There’s a real problem with private care homes refusing to take patients back unless they’ve been tested for Covid,’ a senior director at a London acute trust said.192 As the Guardian reported, the care homes’ refusal was widespread. Quoting David Steedman, the manager of Arlington House care home in Sussex, the Guardian reported that despite having five empty rooms he had refused to accept people discharged from hospital: ‘I’d be mad to let anyone into my home without a test showing they’re free of the virus … It’s my responsibility to keep safe the hugely vulnerable residents who are in my care already.’ Steedman’s concerns were widespread, yet ignored by many in the business attracted by the government’s generous payments. Martin Green blamed Chris Whitty for the consequences: ‘Whitty knew our residents are the most at risk but it was all about the NHS. He should’ve been watching what went on in care homes in Spain and Italy.’193
The emergency Covid-19 Bill was introduced in the Commons on 19 March and became law on 25 March. Hospitals were relieved of their obligation to conduct ‘eligibility assessments’ and the government committed itself to fund all ‘out-of-hospital’ support packages during the emergency – an inducement to irresponsible care-home owners. The law removed the legal protection for patients to be safely discharged.194 The requirement to test patients before discharge would be reintroduced on 15 April.
The image later conjured by the Financial Times that 25,000 infected patients were dumped into the homes was disputed by Chris Hopson, the chief executive of NHS Providers.195 The representative of most of England’s hospital trusts would claim ‘only small numbers of asymptomatic Covid-19 patients may have been discharged into care homes … in the first few days after 17 March’. He assessed it was one in twenty, or at most three in twenty if community centres were included. ‘Within one or two days [hospitals] quickly became aware of the risk and had developed new agreed discharge arrangements.’ Thereafter, he asserted, if a patient could not be tested, they would be isolated in the care home.196 The department’s initiative was a success. Within one week, about 40 per cent of hospital beds were empty.
Within twenty-four hours of Pritchard’s directive, Patrick Vallance was under renewed pressure. Without testing, he had no idea about the extent of the infection. Ferguson’s predictions, his prime source of information, had pronounced that the ‘R’ rate of infection was between 2.4 and 4, and would need to fall below 1 to stop the pandemic. Vallance dithered and then, alarmingly, Ferguson revealed he himself was self-isolating with the virus. ‘There’s a lot of Covid in Westminster,’ he said, the day after his Downing Street presentation. Soon after, he tweeted that the virus was more transmissible than he had thought.
The conflicts and uncertainty among the SAGE scientists and those outside should have given Cummings good reason to reconsider his belief that scientists would make better Civil Service administrators than arts graduates. If he had any doubts, they should have been dispelled at the SAGE meeting the same day, at which Cummings asked why the lockdown had not started.197 (His critics would complain he was interfering. Others viewed his attendance as vital in order to elicit information for the prime minister.) Vallance hesitated. John Newton, a senior executive at PHE, later supported Vallance: ‘The infection was entering the exponential growth phase. At this point, access to limitless testing would have made no difference. The decision to enter lockdown would have been the same and would have been taken at the same time.’198 Professor Keeling, a professor of life sciences, agreed: ‘The early assumption was that lockdown probably was not sustainable for more than four to five weeks … Lockdown more than a week before we did would have been very difficult to put through … We vastly underestimated the general public and how reasonable they can be in the face of such an outbreak.’199
Amid all that competing advice, Boris relied on Vallance. ‘I think the government have listened to the advice of SAGE very carefully and followed it,’ Vallance would say. Asked whether there was any ‘significant disagreement between the government and their scientific advisers on anything material’, Vallance replied ‘No.’200 But in truth, the prime minister, who was never in total control, surrendered even more to his scientific advisers.
Contrary to his libertarian instincts and under public pressure, on 20 March he agreed to do what he called ‘extraordinary’.201 He ordered hospitality, entertainment and leisure centres to close, banned foreign travel and closed the schools. He no longer had any choice. People were staying at home and parents were keeping their children from school. He also advised Britons abroad to return home. Once again, Foreign Office officials proved themselves incompetent. In India, while German nationals were swiftly repatriated, the British acting high commissioner in Delhi was cursed by desperate British tourists, especially those stranded in Goa, as particularly unhelpful.202
The pleas for help by abandoned tourists was drowned out by NHS staff complaints about shortages of PPE.203 As global demand soared, every country competed for the same products manufactured in Asia. Unlike other countries, Britain no longer had a large-scale textile industry to produce PPE. The NHS’s staff protests were brushed aside by Jenny Harries. The few problems in deliveries, she said, had been ‘completely resolved’ and ‘the supply is there’ provided by ‘an entirely separate PPE oversight and supply chain’ in the Department of Health.204
The ultimate responsibility was arguably Chris Wormald’s, the Department of Health’s permanent secretary. Wormald preferred later to shy away from fully answering questions about PPE and the stockpiles and deflected probing on a range of other critical issues of how the health and social care sectors responded to Covid-19 to other officials and advisors.205 Tiger Eye protectors bought in 2009 and flimsy plastic gowns bearing a 2016 sell-by date were declared unsuitable, but he said nothing. Nor did he personally answer the complaint of Christopher Nieper, the chief executive of a women’s fashion company, whose offers to manufacture reusable gowns for front-line workers were ignored. ‘We’ve gotten nowhere at all, absolutely nowhere,’ Nieper said after approaching Deloitte, placed in charge of the government’s gown procurement under Michael Gove and Theodore Agnew in the Cabinet Office. ‘I proposed the exact gown, exact fabric but they’re not interested in a reusable product, only interested in disposables,’ he said, adding that Deloitte’s head of gown procurement ‘didn’t know how much fabric was required to make one garment’.206 Jin Sahota, the £200,000-a-year chief executive of Supply Chain Co-ordination Limited, appeared to have disappeared, leaving Simon Stevens to tell MPs that there were sufficient national supplies of PPE – 397 million pieces had been distributed by the army – but he could not explain why commercial procurement and distribution was failing.207 The media and hence the public were unimpressed by the excuses.
Britain was grinding to a halt. Unusually, the Queen urged the country to unite in face of the crisis, and retreated to Windsor to be joined by the ninety-eight-year-old Prince Philip, who arrived by helicopter from Sandringham. The police were given draconian powers to detain the sick and force the healthy off the streets. Long queues snaked outside supermarkets whose shelves were already bare; school exams were cancelled and interest rates cut to 0.1 per cent, the lowest in the Bank of England’s 326-year history.
On 23 March, unaware that his appeals for social distancing, washing hands and closures of social venues had already reduced the infection rate, Boris finally bowed to public pressure and announced a total lockdown. (He refused to use the word ‘lockdown’ itself, which he thought was ‘draconian’ and implied ‘captivity’.) The nation, he hoped, would rally to yet another TV address with a promise of support, sorrow for those who would die, and an appeal for unity.
‘From this evening I must give the British people a very simple instruction – you must stay at home. No prime minister wants to enact measures like this. But at present there are just no easy options. The way ahead is hard, and it is still true that many lives will sadly be lost.’208 With testing and new vaccines, he said, the virus would be beaten and Britain would return to normal in three months. Unlike leaders in some other European countries, he did not close down the economy. People were expected to continue working from home or in their office. Builders and others could continue to work in the open. He ended with a dose of optimism: ‘You are invincible.’
On lockdown day, around 70 per cent of those polled approved of the government’s conduct, but Boris was immediately under attack from familiar critics: either for leaving it too late or failing to keep his nerve.
Jeremy Hunt led the charge that the government’s response had systemically failed. Had SAGE’s advice been published in January, Hunt said, an army of other scientists combined with parliamentary scrutiny could have challenged the abandonment of test, track and trace, and the behavioural assumptions which delayed lockdown. ‘We cannot know for certain, but the result may well have been better subsequent advice and many lives saved,’ he judged. He would be reprimanded by Chris Whitty for misrepresenting some facts.209
Others disagreed. ‘I would characterise lockdown,’ commented Mark Woolhouse, ‘as a panic measure; it was something we did in the UK and was done around the world because we could not think of anything better to do given the information we had available … the costs of lockdown may be considerably worse than the disease itself.’210 Carl Heneghan, the director of the Centre for Evidence-Based Medicine at Oxford University, agreed. The lockdown, he said, was likely to do more damage than the virus. Too much attention was being given to models that often proved to be ‘some way out’ and there was insufficient testing.211 Sunetra Gupta criticised the lockdown as a mistake.212
Comparisons were quickly made with Germany, which had announced lockdown the previous day – to start the same day as the UK – six days after France where over 1,000 people had already died. Unlike Italy, Spain and France which forced people to stay inside, Germany adopted Sweden’s approach, warning people to take care rather than imposing criminal fines on those who left their homes. The difference between Britain and Germany, highlighted by the government’s critics, was Germany’s comprehensive testing scheme established many years earlier.213
That day, Britain announced 136 deaths while Germany reported eighty-three deaths. In total, 802 people had died in Britain, although the official figure was still 336 deaths. Unlike other European countries, British statisticians would honestly revise the death toll. The virus in Germany was not as widespread and the infection rate was starkly lower than Britain’s among the elderly but higher among the young who did not die.
Sir John Bell, Regius Professor of Medicine at the University of Oxford, did not believe that Germany’s lower mortality was linked only to testing. Germany, he noted, experienced a particularly virulent coronavirus outbreak in 2018–19. Possibly the legacy was a T-cell immunity from Covid-19.214 ‘There is something fundamentally different about Germany which to be honest I don’t understand because they have had a pretty easy go of it. I don’t think it can all be attributed to the quality of their healthcare system,’ he would comment. He also compared London’s much higher population density compared to Berlin and other German cities.
‘Lockdown Britain’ was the Daily Mail’s headline, reporting that Spain was about to overtake Italy’s 1,444 deaths in just two days and Britain would imminently experience the same. Convoys of trucks carrying coffins through Madrid’s empty streets to overflowing crematoria foretold what could happen in Britain. In this context, confidence in Boris was eroded by those scientists excluded from SAGE, who questioned their competitors’ advice. The critics blamed SAGE’s secret membership and the confidentiality of their working papers for Boris’s ‘error of following the scientists’ advice’. Boris, complained the academics, was ‘weaponising’ the scientists’ advice to protect himself from criticism about delaying the lockdown, the government’s reliance on Ferguson and the audacity to consider herd immunity. Boris by then had good reason to doubt Ferguson. On 25 March, the mathematician would predict that Britain’s death toll would be ‘substantially lower’ than 20,000 and he forecast that most of the dead would have in any event died in 2020 from other causes.215
Weeks later – with hindsight – Venki Ramakrishnan, the president of the Royal Society, pronounced ‘There is often no such thing as following “the” science.216 Reasonable scientists can disagree on important points.’
That was precisely Boris’s problem on the day Britain was locked down. He trusted the scientists but they did not trust each other.