Thread by @chrischirp

THREAD:
I wrote about Baroness Hallett's Inquiry Module 1 report for @bmj_latest .

She found that there was *never* a plan to keep a pandemic death toll down - I discuss this and what it means going foward.

Main points below: 1/14

The headline most seen is that the UK planned for the wrong pandemic.

While it is true that was far too narrow a focus on a flu pandemic, that is not the most telling bit.

To me the most telling bit, is what the plan did NOT do 2/14

The issue is less the wrong disease, but that there was never a plan to prevent one at all – of any disease type.

The plan was *never* about reducing the number of pandemic deaths. 3/14

Baroness Hallett spelt it out explicitly. Under the existing flu plan, up to 835,000 deaths were considered *possible* - more than 3x the number the who have died from Covid so far (!).

More to the point - this number was considered *acceptable*. 4/14

It could not be clearer: 800,000+ deaths was considered acceptable and planning was about how best to cope with that number.

During the Inquiry, Hancock called this a “flawed doctrine” and others testified that not enough consideration had been given to prevention, 5/14

And prevention - or at least reducing the number of deaths - *was* possible.

WHO had warned of the need to consider non-flu diseases in 2017/8. Lessons from SARS-CoV-1 and MERS in the 2000s would have left us better prepared. 6/14

Instead, when Covid hit, there were NO plans which had *thought through* quarantine/isolation, border controls, contract tracing.

Hallett called this an "obvious gap". Just read some of these screenshots of the report! 7/14

Of course when reality hit, this plan crumbled. 100,000s of deaths were NOT acceptable after all.

But our lack of planning meant that these crucial policies on isolation, education, key workers, furlough etc were made on the hoof. And vulnerable populations were harmed. 8/14

Hallett said that the strategy's flaws were obvious. So why did no one do something?

Yes - issues of too narrow remits and lack of oversight were clear (report paragraphs 2.46; 2.90; 6.18) but I think this misses a key point. 9/14

Who decided that 800,000 deaths were acceptable in 2011 strategy?

Later, When Covid hit, the policies enacted were informed by some (opaque) underlying values (no policy is value-free).

Whose values were they? The govt? Hancock? Parliament? The Public? 10/14

I belive that public deliberation is needed IN ADVANCE during pandemic (or any emergency) planning - what ARE our national values that will inform the difficult trade offs in any response?

This process will also help with public buy-in & the success of difficult policies 11/14

There are methods for this - citizens' assemblies, juries or panels.

Incorporated into Hallett’s proposed new independent statutory body should be concrete plans to elicit, codify, and communicate our nation’s values and priorities in future emergencies. 12/14

Essentially Hallett's Module 1 report confirms that we gave up long before it even started.

More people died and more ended up with Long Covid than needed to.

Countries that had a plan based on controlling the pandemic saw just that. 13/14

Read her report here:


My @bmj_latest article is here:


I have more thoughts on the report which I may write about later! 14/14 covid19.public-inquiry.uk/reports/module…
bmj.com/content/386/bm…