Thread by @LawDavF

I am posting this again. To be clear not advocating official inquiry into HMG’s response, at least not now. That would be enormous distraction for those trying to cope with this situation. 1/n

https://twitter.com/LawDavF/status/1241867820117491714

My main point is that for those interested it is possible to look at primary sources rather than just what appears in media. However we only have one set of papers for now (not COBRA minutes for example).2/n

Easy to forget how quickly crisis has escalated. Early measures taken by most states involved travel bans, first international and then internally. More drastic measures only began on 8 March but they now seem quite tame (ie French ban on gatherings of more than 1,000). 3/n

Italy acted few days early in terms of closing schools and universities (but only for ten days). It put Lombardy under quarantine on 8 March and the whole country a day later, when it closed gyms, museums, nightclubs but not restaurants and bars.4/n

We can look at advice from World Health Organisation. Again it is possible to look at actual publications. This is advice circulated on 19 March. It does not discuss lockdowns.
apps.who.int/iris/bitstream… 5/n

Here is WHO report from team in Italy on 6 March. Not about lockdown measures, yet to be implemented in Italy, but more generally about 'surveillance, clinical management, infection prevention and control, and risk communication.’
euro.who.int/en/health-topi… 6/n

One thing to note in this report, relevant to question of importance of Italian data in updating modelling. It describes Italy as ‘a “knowledge-generating platform” on COVID-19 within the scientific community’. 7/n

One area where UK was seen to lag was in banning large gatherings. Again we can look at advice from the group known as SPI-M-O. This was addressed as early as 11 February
SPI-M-O: Consensus view on public gatherings
assets.publishing.service.gov.uk/government/upl… 8/n

‘On one hand,’ it states, ‘ stopping some public gatherings could mean people replace this with other activities (i.e. playing football behind closed doors could mean fans watch the match in the pub), potentially slightly accelerating epidemic spread.’ 9/n

‘On the other hand, the message sent by stopping them would be expected to change people’s behaviour in other ways, potentially slowing epidemic spread. It is not possible to quantify either of these effects.’ 10/n

This issue kept under review. The advisory group (SAGE) asked all subgroups to review evidence ‘on public gatherings, including risk to individuals and the impact of restricting gatherings on UK epidemic evolution’, for report to COBRA on 12 March.
assets.publishing.service.gov.uk/government/upl… 11/n

Here it stuck to earlier view on the comparative benefits but now with more caveats. The document reveals that polling had begun as early as 10 February on how people would respond to measures. 12/n

Whereas about a third agreed that large sporting events should be cancelled in polling up to start of March by 11 March this had more than doubled. As attitudes shifted the group now saw risk of being behind the curve of public opinion. 13/n

In this 12 March report the group notes that on 4 March, it had noted that: “SPI-B have divergent opinions on the impact of not applying widescale social isolation at the same time as recommending [protective] isolation to at-risk groups. 14/n

‘One view is that explaining that healthy members of the community are building some immunity will make this acceptable. Another view is that recommending isolation to only one section of society risks causing discontent.” This position had not changed.’ 15/n

This is the herd immunity point (I’d missed it before). What is important to note that it is not about doing nothing for everyone but urging social isolation for some but not others. 16/n

It was not about culling the old but whether at risk groups including elderly had to accept social isolation while there might be benefits for wider community if young people built up immunity. 17/n

This was clearly a contentious issue even within the group, had a brief flurry of (damaging) publicity and then went away. It was never a strategy on its own. 18/n

The concern that slow responses might lose trust of wider community evident in addendum added after COBRA meeting on 12 March, when government said was only ‘considering’ banning major public events. The advisors came back with a warning to the government 19/n

‘SPI-B has pointed out repeatedly that trust will be lost in sections of the public if measures witnessed in other countries are not adopted in the UK and that not pursuing such routes needs to be well explained. 20/n

It concluded:
Communications is not within SPI-B’s remit, but this point bears repeating again.’ End