Over 3 million people have died in the world as a result of contracting the highly infectious Covid19 virus. 128,000 in the UK and of that 7,661 have been in Scotland.

As the vaccination programme continues to roll out, organisations and governments have been looking at what they could have done differently, better and quicker.

Some countries did a lot better than others at managing the pandemic and protecting their citizens: Vietnam 35 deaths; New Zealand 26 deaths; Taiwan 12 deaths. World Covid19 tracker

The UK, despite having one of the best health services in the world, is also one of the worst states for the number of people who have died due to this deadly and life changing virus. It is crucial we learn from this.

Did the governments get the right advice from the experts?

Experts and the public watched as news of the virus spread started to appear in news channels from Wuhan, China, on 31 December 2019. A study from the University of Cambridge has found that experts such as epidemiologists and statisticians made far more accurate predictions than the public, but both groups substantially underestimated the true extent of the pandemic.

Dr Gabriel Recchia from the Winton Centre for Risk and Evidence Communication explained:

“Experts perhaps didn’t predict as accurately as we hoped they might, but the fact that they were far more accurate than the non-expert group reminds us that they have expertise that’s worth listening to.

“Predicting the course of a brand-new disease like COVID-19 just a few months after it had first been identified is incredibly difficult, but the important thing is for experts to be able to acknowledge uncertainty and adapt their predictions as more data become available.”

Throughout the COVID-19 pandemic, social and traditional media have disseminated predictions from experts and nonexperts about its expected magnitude.

Dr Recchia , whose research has been published in the journal PLOS ONE continued:

“People mean different things by ‘expert’: these are not necessarily people working on COVID-19 or developing the models to inform the response.

“Many of the people approached to provide comment or make predictions have relevant expertise, but not necessarily the most relevant.”

How an Outbreak Became a Pandemic by the Independent Panel for Pandemic Preparedness and Response, examines the worldwide response by governments and showed that ‘decisions mattered and had consequences‘.

The world was not prepared.

There have been many outbreaks of highly infectious diseases. They are becoming more frequent . In the 21st century: SARS, influenza, Ebola virus disease and Zika virus disease. At the end of the 20thC there was the HIV pandemic for which there is still no vaccine.

The countries who have been most successful in protecting their citizens against Covid19 used the experiences from combatting SARS. In all the countries of the UK the initial response was to react as if we were dealing with Flu.

Covid19- The Start

On 30 December 2019, the Wuhan Municipal Health Commission issued two urgent notices to hospital networks in the city about cases of pneumonia of unknown origin

How an Outbreak Became a Pandemic

On the 5th of January 2020 The World Health Organisation (WHO) officially notified governments of the outbreak. – Taiwan, China and Hong Kong had already started screening travellers. On 30th of January 2020 WHO declared a public health emergency of international concern (PHEIC). Up to that point there had been 98 cases in 18 countries outside of China. On 11th March 2020 WHO stated that COVID-19 was a global pandemic with 118,000 cases in 114 countries. By the end of March Covid19 had spread to nearly every country in the world.

Too slow to respond

The virus spreads from person to person rapidly. Countries like Thailand reacted before they even had their first case. Vietnam and Singapore also quickly put into place procedures that would protect their citizens.

The Africa Centres for Disease Control and Prevention coordinated a continent-wide approach, for instance through the Africa Medical Supplies Platform.

The UK Government was confident it was well prepared – but it wasn’t. The UK’s Scientific Advisory Group for Emergencies (SAGE) rejected lockdown even though cases were spreading rapidly in countries like Italy where the death toll was mounting.

In a paper published in May 2020 in the medical journal the BMJ The UK’s public health response to covid-19 the authors explain how the response in the UK was too little and too late. Older patients were transferred from hospitals into Care Homes without being tested a move which was to have tragic consequences for our most vulnerable.

If the government failed in its duty to protect the public, it also failed to protect staff in the NHS and social care by not delivering sufficient amounts of personal protective equipment (PPE) of the right specification, again deviating from WHO advice.

The UKs public health response to covid19

Our Health and Care Workers

The pandemic has taken a terrible toll on those in the front line – our health and care workers. Many have lost their lives. Over 850 UK healthcare workers are thought to have died of covid between March and December 2020

Depression, anxiety, post traumatic stress, exhaustion are affecting all our health and social care workers, tragically in some cases it has resulted in suicide. The personal risk that health and care workers were put under as the pandemic was taking hold in the UK should never be forgotten or forgiven.

There was a shortage of PPE both in the UK and worldwide, some countries limited exports of what they had. In the UK the Tory Government was embroiled in a PPE scandal. The UK’s PPE procurement scandal reminds us why we need ways to hold ministers to account

In one of the most visible cases, only a fraction of 400 000 gowns ordered from a Turkish t shirt manufacturer arrived. When they did arrive they were late, despite the Royal Air Force being sent to collect them, and they were found to be unusable. Fifty million face masks, purchased through a company specialising in currency trading and offshore property, part of a £252m (€291m; $348m) contract, were also unusable. A Miami jewellery designer, awarded a £250m contract for PPE, was found to have paid £21m to a consultant to broker the deal. A pest control company with net assets of £19 000 was given a £108m contract for PPE. A highly critical report by the National Audit Office provides more examples.

Martin McKee The UK’s PPE procurement scandal reminds us why we need ways to hold ministers to account

Misinformation and Distrust

Before the pandemic took hold and the search of the vaccine was on, there were already vax deniers. Social media had been rife with misinformation about vaccinations and the world’s greatest power, the USA, was led by one of the worst.

Social media companies early this year started to ‘police’ posts which were publishing misinformation about Covid19 and vaccine effectiveness. Sites like Facebook also played an important role in providing users with public health information important to them locally. This made access to the internet crucial. Meetings held online, education delivered digitally – all these elements in responding to the pandemic illuminated a digital divide and issues of equality.

How countries communicated with citizens displayed a level of trust which helped to limit the spread of the virus in their communities. New Zealand presented clear and easily readable public health information.

Research has been rapid and the response by scientists had been truly remarkable. Surely one of the most successful outcomes of the pandemic is an appreciation of the work researchers do globally. The sharing of knowledge across borders has been essential in developing digital tools, vaccines and responses to Covid19.

The Economy

Worldwide economies have been hit by the necessary precautions required in a public health emergency. Locally we can see this too in Orkney which had become increasingly dependent on tourism and especially the cruise ship industry.

Restrictions to travel affected not only tourists but food supplies and supermarkets emptied as customers rushed to stockpile food and strangely, toilet paper. Small local shops demonstrated their worth by being able to adapt quickly to the changing situation and delivering goods to people in lockdown.

Recovery from COVID-19 will be protracted. Even optimistic forecasts suggest major advanced economies will have depressed output levels until at least 2024.

How an Outbreak Becomes a Pandemic

What is clear is that communities which rely on tourism are not sustainable. Housing in many rural and island communities is at crisis level as those with the means to do so purchase ‘bolt holes’, second homes that push up the price, out of the range of local people. Some towns and villages, for example Stromness, during the first lockdown in 2020, were empty of people as the extent of holiday and second homes became apparent.

Inequalities in income and infrastructure have been exposed by the pandemic. The worst and most long lasting effect this has had is on education.

11 million of the poorest girls in the world may never go back to the classroom, and an additional 10 million girls are at risk of early marriage

How an Outbreak Became a Pandemic

Unemployment and poverty resulted in increasing numbers in the UK visiting Foodbanks which had already increased rapidly since the Tory Government introduced its austerity measures.

In 2020/21 approximately 2.5 million people used a foodbank in the United Kingdom, over 600 thousand more than the previous year. Throughout the provided time period the number of foodbank users has increased in every year, from just under 26 thousand in 2008/09.

Statista

980,000 of the food parcels went to children. In Scotland The Trussell Trust, which is one provider, issued 221,554 food parcels between April 2020 and March 2021.

Vaccines

The whole world needs access to Covid19 vaccines. In Scotland there has been widespread support by the public and compliance with getting vaccinated. The type of vaccines being used require 2 doses. It will be several months before the adult population has received both.

Richer countries have been able to buy up supplies of vaccine but they have a responsibility to ensure there is equal access globally.

UNICEF calculates 5.3 billion doses by the end of 2021 would be needed to take care only of all of the world’s essential workers, people over 65, and people with comorbidities.

How an Outbreak Became a Pandemic

So far the distribution of vaccines worldwide has failed. It is estimated that 5 billion booster shots will be required every year once people have been vaccinated.

Keeping our NHS free, properly funded and valued is essential to our future responses to public health crises. The care we deliver to our most vulnerable and the support for our care givers must improve. The SNP has committed the Scottish Government to developing a National Care Service. Currently there is a mixed delivery of private and council operated Care Homes in Scotland and Integrated Health and Social Care Boards have had varied success. There is an aging demographic and a shortage of care workers who until this pandemic occurred, have been undervalued.

And what next?

In Scotland, First Minister Nicola Sturgeon has announced that there will be a public inquiry into Care Home deaths where a third of all deaths due to Covid took place. Prime Minster, Boris Johnson has also committed to a public inquiry perhaps in the Spring of 2022. In England and Wales, up to 30th April 2021, there had been 32,104 deaths in Care Homes.

The pandemic is not yet over. It is continuing to surprise us…The “defining moment” of the end of the pandemic is the most important one of all, but that is yet to come. How we approach that moment will depend on how willing the world is to take stock honestly, but without blame or rancour, and determine what could have been done better, and how to ensure that is the path that is taken in the future.

How an Outbreak Became a Pandemic

Link: How an Outbreak Became a Pandemic

I’d like to thank Orkney News reader Susanne Davidson for sending this report on to me

Reporter: Fiona Grahame