Failure of previous governments to follow the science, act on advice and prepare.
What was Exercise Cygnus?
Exercise Cygnus was a 2016 government simulation of a flu outbreak, carried out to war-game the UK’s pandemic readiness. It involved 950 officials from central and local government, NHS organisations, prisons and local emergency response planners. A report on the exercise was compiled the following year and distributed among its participants.
The government website says that the Tories “accepted all the recommendations from Exercise Cygnus…” but if that is true, why did they not act on them as is now clear? Could it be that the then Health Secretary Jeremy Hunt thought he knew better? That will be for the chair of the Health Select Committee to investigate. Although, as the chair of the Health Select Committee is…Jeremy Hunt, we will not hold our breath!
What did it involve?
The scenario imagined that a new virus had emerged in Thailand in June, later identified as a strain of H2N2. Within a month the World Health Organization had declared a public emergency, triggering the UK’s response plans as the world mobilised to tackle an outbreak of “swan flu”.
What were its findings?
The Cygnus report was frank about the state of the UK’s readiness. “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,” it found.
As the scenario practiced by the Tory government in 2016 so closely mirrored what actually happened in 2020, serious questions need to be asked.
Why were the Torie so slow to act on scientific advice? Why was the governments procurement of personal protective equipment (PPE) not improved? Why did the Tories continue to run down funding (and doctors, nurses and bed space) for the NHS when it knew a pandemic was imminent? Why has that led to over 115,000 deaths?
What about social care?
Social care appears to have been of particular concern. Participants discovered it was extremely difficult to locate capacity in the care homes sector, partly because care homes are almost entirely privately run, making it difficult to clear hospital beds by moving patients into care homes.
Concerns were raised about the social care system and its ability to provide the level of support that would be needed if the NHS were to implement its proposed reverse triage plans. The plans, which were put into action with dire consequences, involved the movement of patients from hospitals into social care facilities. Was this policy to blame for excess deaths seen in care homes?
What did Cygnus recommend?
The report listed four areas of “key learning” and 22 further “lessons identified” from the exercise, made as recommendations to government. While some, such as those concerning the distribution of antivirals, are not relevant to a coronavirus pandemic, others are.
The recommendations included further modelling to understand the capacity of the care sector, which it would appear did not take place as we saw hospitals and care homes overwhelmed leading to the construction of Nightingale Hospitals. The report suggested further work to understand how the public would react to the crisis. If any work was carried out to understand how the public would react, it would appear that Boris Johnson ignored any findings and recommendations when he created a “one rule for them” mentality by not sacking Dominic Cummings following his highly publicised breaking of lockdown rules in April 2020.
There are questions as to whether recommendations were followed in full. Care sector executives said that they were unaware of having been asked to contribute to any methodology for assessing care home capacity. Government ministers were informed that if we did not address our national shortage of ventilators, in the event of pandemic, we would be forced into lockdown…
If the Tories had just flipped a coin to make decisions, at least they may have got half of them right.