Thread by @MartinRemains

‘The upbeat tone of that briefing stood in sharp contrast with the growing unease of many of the government's scientific advisers behind the scenes. They were already convinced that Britain was on the brink of a disastrous outbreak’ reuters.com/article/us-hea…

‘From the outset... work by scientists had shown that, with only limited interventions, the virus would trigger an "overwhelming epidemic" in which Britain's health service was not going "to get anywhere near being able to cope with it. That was clear from the beginning."’

‘Johnson, who himself has sickened with the virus, moved more slowly than the leaders of many other prosperous countries to adopt a lockdown. He has been criticised for not moving more swiftly to organise mass tests and mobilise supplies of life-saving equipment and beds.’

‘...the option of the kind of stringent lockdown adopted early on in China, where the disease arose in December, and then followed by much of Europe and finally by Britain itself. The scientists' reasoning: Britons, many of them assumed, simply wouldn't accept such restrictions.’

‘Minutes of technical committees reviewed by Reuters indicate that almost no attention was paid to preparing a programme of mass testing.’

‘Other minutes and interviews show Britain was following closely a well-laid plan to fight a flu pandemic - not this deadlier disease. The scientists involved, however, deny that the flu focus ultimately made much difference.’

Wasn’t that plan tested and found wanting?

‘Now, as countries debate how to combat the virus, some experts here say, the lesson from the British experience may be that governments and scientists worldwide must increase the transparency of their planning so that their thinking and assumptions are open to challenge.’

Yes.

Advisors: ‘ They were too "narrowly drawn as scientists from a few institutions," he said. Their handling of COVID-19, Ashton said, shows the need for a broader approach. "In the future we need a much wider group of independent advisers."’

‘"Without faulting anyone so far, it's vital, where there is such a lot at stake, to throw the maximum possible light on the methods, assumptions and data built into our understanding of how this epidemic will develop," he told Reuters.’

‘At first, when NERVTAG met on January 13, it studied information from China that there was "no evidence of significant human to human transmission" of the new virus, according to minutes of the meeting. The scientists agreed the risk to the UK population was "very low."’

‘The evidence soon changed, but this wasn't reflected in the official threat level. By the end of January, scientists in China began releasing clinical data.’

‘Case studies published in the British medical journal, The Lancet, showed 17% of the first 99 coronavirus cases needed critical care. Eleven patients died.’

‘Another Chinese study, in the same magazine, warned starkly of a global spread and urged: "Preparedness plans and mitigation interventions should be readied for quick deployment globally."’

‘Edmunds recalled that "from about mid January onwards, it was absolutely obvious that this was serious, very serious." Graham Medley, a professor of infectious diseases modelling at the London School and chairman of SPI-M, agreed.’

‘He said that the committee was "clear that this was going to be big from the first meeting." At the end of January, his committee moved into "wartime" mode, he said, reporting directly into SAGE.’

‘Dr Jon Read, a senior lecturer in biostatistics at the University of Lancaster, also a member of SPI-M, said by the end of January it was apparent the virus had "pandemic potential" and that death rates for the elderly were brutal.’

‘In response to questions from Reuters, the government's Department of Health declined to clarify how the risk levels are defined... "Increasing the risk level in the UK is a belt and braces measure which allows the government to plan for all future eventualities."’

A guess?

‘As they watched China impose its lockdown, the British scientists assumed that such drastic actions would never be acceptable in a democracy like the UK. Among those modelling the outbreak, such stringent counter-measures were not, at first, examined.’

‘Assumed.’ Why? Mistake.

‘"We had milder interventions in place," said Edmunds, because no one thought it would be acceptable politically "to shut the country down." He added: "We didn't model it because it didn't seem to be on the agenda. And Imperial (College) didn't look at it either."’

‘The NERVTAG committee agreed, noting in its minutes that tough measures in the short term would be pointless, as they "would only delay the UK outbreak, not prevent it."’

Is not delay part of the point?

‘That limited approach mirrored the UK's longstanding pandemic flu strategy. The Department of Health declined a request from Reuters for a copy of its updated pandemic plan, without providing a reason.’

‘But a copy of the 2011 "UK Influenza Pandemic Preparedness Strategy 2011," which a spokesman said was still relevant, stated the "working presumption will be that Government will not impose any such restrictions.’

‘The emphasis will instead be on encouraging all those who have symptoms to follow the advice to stay at home and avoid spreading their illness."’

Well.

‘According to one senior Conservative Party politician, who was officially briefed as the crisis unfolded, the close involvement in the response to the coronavirus of the same scientific advisers and civil servants who drew up the flu plan may have created a "cognitive bias."’

‘"We had in our minds that COVID-19 was a nasty flu and needed to be treated as such," he said. "The implication was it was a disease that could not be stopped and that it was ultimately not that deadly."’

We knew that it was not from the early info on case fatality rate.

‘While the UK was prepared to fight the flu, Asian states like China, Hong Kong, Singapore and South Korea had built their pandemic plans with lessons learned from fighting the more lethal SARS outbreak that began in 2002, he said. SARS had a fatality rate of up to 14%.’

‘As a result, these countries, he said, were more ready to resort to widespread testing, lockdowns and other draconian measures to keep their citizens from spreading the virus.’

So the U.K. ignored the evidence of a Corona virus outbreak. Why?

‘Scientists involved in the UK response disagree that following the government's flu plan clouded their thinking or influenced the outbreak's course. The plan had a "reasonable worst case" scenario as devastating as the worst predictions for COVID-19, they note.’

‘By the end of January, the government's chief medical adviser, Whitty, was explaining to politicians in private, according to at least two people who spoke to him, that if the virus escaped China, it would in time infect the great majority of people in Britain.’

‘ It could only be slowed down, not stopped. On Jan 30, the government raised the threat level to "moderate" from "low."’

So at this time we knew it was lethal, particularly to the elderly, & it was certain to spread to the UK.

“Moderate” apparently was appropriate.

‘The country's medical officers "consider it prudent for our governments to escalate planning and preparation in case of a more widespread outbreak," a statement said at the time. Whitty did not respond to questions from Reuters for this article.’

Does he know too much?

‘On the evening of January 31, Boris Johnson sat before a fireplace in 10 Downing Street and told the nation, in a televised address: "This is the moment when the dawn breaks and the curtain goes up on a new act in our great national drama."’

Brexit was more important.

‘He was talking of finally delivering Brexit, or what he called "this recaptured sovereignty." Until that moment, Johnson's premiership had been utterly absorbed by delivering on that challenge.’

‘Between February 13 and March 30, Britain missed a total of eight conference calls or meetings about the coronavirus between EU heads of state or health ministers - meetings that Britain was still entitled to join.’

Johnson chose to do this. Brexit ideology had an impact.

‘Although Britain did later make an arrangement to attend lower-level meetings of officials, it had missed a deadline to participate in a common purchase scheme for ventilators, to which it was invited.’

‘In the medical and scientific world, there was growing concern about the threat of the virus to the UK. A report from Exeter University, published on February 12, warned a UK outbreak could peak within four months and, without mitigation, infect 45 million people.’

‘Even if disease transmission was reduced by half, he wrote in a report aimed at clinicians and actuaries in mid-February, a coronavirus outbreak in the UK would "have a chance of overwhelming the system."’

‘With Whitty stating in a BBC interview on February 13 that a UK outbreak was still an "if, not a when”’

...

What? We read earlier that he expected it to reach the U.K.

‘Richard Horton... said the government and public health service wasted an opportunity that month to prepare quarantine restriction measures and a programme of mass tests, and procure resources like ventilators and personal protective equipment for expanded intensive care.’

‘Calling the lost chance a "national scandal"... he would testify to parliament about a mismatch between "the urgent warning that was coming from the frontline in China" and the "somewhat pedestrian evaluation" of the threat from the scientific advice to the government.’

‘assigning a single public laboratory in north London to perform the tests. But, according to later government statements, there was no wider plan envisaged to make use of hundreds of laboratories across the country, both public and private, that could have been recruited.’

‘According to emails and more than a dozen scientists interviewed by Reuters, the government issued no requests to labs for assistance with staff or testing equipment until the middle of March’

They decided to test in the middle of March. Unbelievable. ‘Test. Test. Test.’

‘An executive at the Weatherall Institute of Molecular Medicine at the University of Oxford said he could have carried out up to 1,000 tests per day from February. But the call never came.

"You would have thought that they would be bashing down the door," said the executive.’

‘Nor was there an effective effort to expand the supply of ventilators. The Department of Health told Reuters in a statement that the government started talking to manufacturers of ventilators about procuring extra supplies in February.’

‘But it was not until March 16, after it was clear supplies could run out, that Johnson launched an appeal to industry to help ramp up production.’

At the end of Jan we knew it was lethal and it was going to spread to the U.K. Govt did nothing about PPE.

‘Charles Bellm, MD of Intersurgical, a global supplier of medical ventilation products based outside London, said he has been contacted by more than a dozen govts around the world, including France, New Zealand & Indonesia. But there had been no contact from the British govt.’

Hancock: ‘One reason Britain was behind some countries on testing, he said, was the absence of a large diagnostics industry at the outbreak of the epidemic. "We didn’t have the scale."’

Utter drivel. There are thousands and thousands of PCRs at Universities, etc in the UK.

‘ Then, on Friday the 21st, came a death in Italy and a bloom of cases in Lombardy and Veneto regions. Britain has close links to both countries. Thousands of Britons were holidaying in Italy that week.’

After all the early warnings. Why was this not enough?

‘But after Iran and Italy, it was obvious containment would not work. The contact tracing continued for a while. But as the cases in London built up, and the volume of calls to the helpline mushroomed, the priority began to shift to clinical care of the serious cases.”’

‘At a certain point you have to make a decision about where you put your efforts as a workforce."’

Not really. Contact tracing does not need to be done by the NHS. It isn’t as far as I know. It is done by PHE. Is that correct?

‘There was a rule of thumb that, in an outbreak's early stages, for each death there were probably 1,000 cases in a community. "And so it was quite clear that there were at least thousands of cases in Italy, possibly tens of thousands of cases in Italy right then."’

‘Amid the dreadful news from Italy, the scientists at NERVTAG convened by phone that Friday, 21st February. But they decided to recommend keeping the threat level at "moderate," where it had sat since January 30th. The minutes don't give a detailed explanation of the decision.’

‘Edmunds, who had technical difficulties and couldn't be heard on the call, emailed afterwards to ask the warning to be elevated to "high," the minutes revealed. But the warning level remained lower. It's unclear why.’

‘"I just thought, are we still, we still thinking that it's mild or something? It definitely isn't, you know," said Edmunds.’

We knew in January it was dangerous. It was expected to come to the U.K. When tourists returned from Italy in Feb it was certain.

What happened to the precautionary principle? Why was advice so conservative and even weak by this clique of scientists? Why was advice limited to such a small group focussed on flu? Why was the threat assessment only moderate?

‘Asked whether, with hindsight, the scientists' approach was the right one, the spokesperson said in a statement that "SAGE and advisers provide advice, while Ministers and the Government make decisions."’

True but evasive.

‘By now, Italian data was showing that a tenth of all infected patients needed intensive care.’

So? Are there no other countries in the world? Why wait for Italy? Why?

‘The following day, pandemic modelling committee SPI-M produced its "consensus report" that warned the coronavirus was now transmitting freely in the UK. That Thursday, March 5, the first death in the UK was announced.’

‘Italy, which reached 827 deaths by March 11, ordered a national lockdown. Spain and France prepared to follow suit.

Johnson held out against stringent measures’

‘Indeed, the government's Scientific Advisory Group for Emergencies, SAGE, had recommended that day, with no dissension recorded in its summary, that the UK reject a China-style lockdown.’

‘SAGE decided that "implementing a subset of measures would be ideal," according to a record of its conclusions. Tougher measures could create a "large second epidemic wave once the measures were lifted," SAGE said.’

Ignoring the now for a maybe future.

Why? Flu thinking.

‘On March 12 came a bombshell for the British public. Chris Whitty, the chief medical officer, announced Britain had moved the threat to UK citizens from "moderate" to "high."’

Weeks late.

‘New cases were not going to be tracked at all. "It is no longer necessary for us to identify every case," he said. Only hospital cases would, in future, be tested for the virus.’

The lesson of Asia should have shown this to be wrong. They ignored Asia.

‘The government had, for now, rejected what he called "eye-catching measures" like stopping mass gatherings such as football games or closing schools. The "aim is to try and reduce the peak, broaden the peak, not to suppress it completely."’

Mistake upon mistake.

‘Most people would get the virus mildly, and this would build up "herd immunity" which, in time, would stop the disease's progress.’

With hundreds of thousands of deaths.

Mr Hancock says this was not so even though there is video evidence of many saying it. Is he a liar?

‘But by now, the country was rebelling. Major institutions decided to close. After players began to get infected, the professional football leagues suspended their games. As Johnson still refused to close schools and ban mass gatherings’

The public have led the way, not govt.

‘The catalyst for a policy reversal came on March 16 with the publication of a report by Neil Ferguson's Imperial College team. It predicted that, unconstrained, the virus could kill 510,000 people. Even the government's "mitigation" approach could lead to 250,000 deaths’

‘Imperial's prediction of over half a million deaths was no different from the report by the government's own pandemic modelling committee two weeks earlier.’

And yet they waited.

‘"The revision was that, basically, estimates of the proportion of patients requiring invasive ventilation, mechanical ventilation, which is only done in a critical care unit, roughly doubled," he said.’

Is Italy the only country in the world?

‘Edmunds said these new studies together had demonstrated that if the British government imposed a lengthy period of tougher measures, perhaps relaxed periodically, then the size of the epidemic could be substantially reduced.’

‘Until you get to a vaccine, there is no way of getting out of this without certainly tens of thousands of deaths," he said. "And probably more than that."’

‘According to Medley, the chairman of the SPI-M pandemic modelling committee, no one now doubts, for all the initial reservations, that a lockdown was essential in Britain.’

‘Medley added: "At the moment we don't know what's going to happen in six months. All we know is that unless we stop transmission now, the health service will collapse. Yep, that's the only thing we know for sure."’

At the end of this article I feel dismay. Error and delay.