Covid inquiry: What did we learn this week?
BMJ 2024; 384 doi: https://doi.org/10.1136/bmj.q229 (Published 26 January 2024) Cite this as: BMJ 2024;384:q229
Is deletion of WhatsApps a “pre-bed ritual?”
Previously (19 January) the inquiry heard that Jason Leitch, Scotland’s national clinical director, had messaged a colleague that, “WhatsApp deletion is a pre-bed ritual.”1 Giving evidence on 23 January, Leitch said that his message “was slightly flippant” and “an exaggeration.”2 He said the record retention policy was that you could use informal messaging systems for Scottish government business but that any advice or decisions should be recorded by email or in a briefing document and then the informal messaging could be deleted. Giving evidence on 25 January, Humza Yousaf, former health secretary and now first minister, told the inquiry he used personal phones rather than a government device for WhatsApp messages during the pandemic.3 He said he deleted messages but was able to recover some from an old handset which he handed over to the inquiry. He confirmed there would be an external review into the use of WhatsApp and non-corporate technology in the Scottish government.
“Have a drink in your hand at all times”
Leitch said as the country reopened there was “ambiguity around mask wearing.” He said he had the impression that hardly anyone followed the rules about masking when standing up during a meal, at the time when dining was allowed unmasked. He told Yousaf in a message, “Officially you should wear a mask but literally no one does. Have a drink in your hand at all times. Then you’re exempt. So if someone comes over and you stand, lift your drink.” He said he understood the rules but the reality of life “suggests this guidance was nuanced rather than entirely right.”
There was a “sense of complacency” in high income countries
Devi Sridhar, chair of global public health at the University of Edinburgh, said the UK had had time to learn from other countries and from what had happened on the Diamond Princess cruise ship but had failed to do so. Giving evidence on 23 January, she said Ebola had caused lockdowns and school closures in West Africa in 2014 so in those countries such measures did not feel like a crazy idea. But Sridhar said that there was a sense of complacency across high income countries: “Well, we’ll be fine because we always are, and this is a low income issue and it won’t come here.” She said, “There was a lack of humility in terms of learning” from the experience of teams in countries such as Senegal and South Korea who had worked day to day to manage infectious diseases.
Other countries moved much quicker than the UK
Sridhar, who became a member of the Scottish government’s covid-19 advisory group in April 2020, told the inquiry she thought the UK had moved too quickly from containment to mitigation. “That pivot happened too early, given that other countries were showing that containment was possible.” She argued that Britain got stuck because it spent a long time discussing whether testing would make a difference outside of hospitals. “There was that feeling that testing was for poor countries. We can treat our way through this. We have a health service.” She said the UK was slower than other countries in buying the reagents for testing and setting up testing systems. She also said that borders should have been better controlled, such as in Australia and Norway, to control the influx of cases. Other countries also moved more quickly in adopting face coverings. Sridhar also said the Scientific Advisory Group for Emergencies was “incredibly secretive” in terms of who was on the committee and what evidence they had. “In the case of a pandemic, transparency should have been much better.”
Advice “not to bother” the NHS led to thousands of deaths
Mark Woolhouse, professor of infectious disease epidemiology at the University of Edinburgh and a member of the Scottish government’s covid-19 advisory group, told the inquiry that medical advisers were not listening to his warnings in the early months of 2020.4 He had sent an email in January 2020 warning that the health system would become overwhelmed within a year if action was not taken but felt that medical advisers to the government froze when confronted with the data. Giving evidence on 24 January he said he was “frustrated” that a detailed report into the management of influenza in Scotland in 2009-10 had not been acted on. This had made a series of recommendations including the need for mechanisms of obtaining, sharing, and analysing data which should be ready to go should another pandemic arise. He said the advice “not to bother the NHS” unless it was absolutely necessary led to thousands of deaths across the UK and probably hundreds in Scotland. “Most of the hospitals in Scotland had their quietest time in living memory during the first lockdown because no one else was going to hospital.”
Sturgeon described Boris Johnson as “a fucking clown”
The inquiry was shown messages in which Nicola Sturgeon, the former first minister, described Boris Johnson’s announcement about a second covid lockdown in England as “fucking excruciating.”5 In messages to Liz Lloyd, her former chief of staff, Sturgeon said, “His utter incompetence in every sense is now offending me on behalf of politicians everywhere.” She added, “He is a fucking clown.” Lloyd was asked if the relationship between Sturgeon and Johnson had broken down and replied, “I think ‘broken down’ overstates what was there to break.” She said previously there was “politeness between the two leaders but the relationship became much harder during the pandemic.” She said there was better communication between the two governments, particularly on health, but that discussions with the prime minister “didn’t get us anywhere.” Sturgeon is to give evidence to the inquiry next week.