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The lies of Matt Hancock

There may be another side to the story, who knows. I wouldn't trust Hancock to tell it though.

There's at least one PFM member who knows but then they don't contribute to these threads anymore.

WRT to all of the preparedness exercises, I am willing to bet that they were all conducted with an underlying assumption that supplies to deal with the pandemic would be available which we only know is a bad assumption this side of Covid-19.
 
WRT to all of the preparedness exercises, I am willing to bet that they were all conducted with an underlying assumption that supplies to deal with the pandemic would be available which we only know is a bad assumption this side of Covid-19.
Why do you say we only know it since Covid-19? It wouldn’t require a big leap of the imagination to anticipate disruption to supply chains in a pandemic, especially nowadays when JIT procurement is the norm. Nor does it take genius level insight to realise that demand for things like PPE will go through the roof in such circumstances. Saying these things couldn’t be anticipated is to let people who should have known better off the hook.
 
There's at least one PFM member who knows but then they don't contribute to these threads anymore.

WRT to all of the preparedness exercises, I am willing to bet that they were all conducted with an underlying assumption that supplies to deal with the pandemic would be available which we only know is a bad assumption this side of Covid-19.
I can recommend the book. I'm sure a lot of assumptions were made but we need to get past the idea that these only look bad in hindsight: our rulers had every reason to believe that something like Covid or worse was coming down the pipe. We're talking here about the politically motivated failure to apply the foresight that had been made available to them, followed by the failure to acknowledge that failure when the time came.
 
I understand fully why the risk of total loss of global access to PPE was tolerated; it was unlikely to happen (this is an extraordinary and unusual one in a hundred year event) and of the mitigation(s) available (stockpile or prepare business to respond when needed) prepare was the cheaper option and allowed money to be spent or things needed now, not some possible time in the future.

The fact that UK manufacturer's couldn't step up production to meet the shortage until global availability was restored means that from this point forward, a different strategy should be deployed to deal with that risk (which we also thinkis now more likely).
I understand your point about the cost of managing a stockpile as opposed to JIT, but I think epidemiologists would disagree that this was an unlikely event - uncommon and unpredictable, yes, but more of a "when" not an "if". Why else have regular pandemic readiness exercises?

Hancock's lie about PPE availability last year is probably preparing the ground to maintain the same JIT policy for next time.
 
Why do you say we only know it since Covid-19? It wouldn’t require a big leap of the imagination to anticipate disruption to supply chains in a pandemic, especially nowadays when JIT procurement is the norm. Nor does it take genius level insight to realise that demand for things like PPE will go through the roof in such circumstances. Saying these things couldn’t be anticipated is to let people who should have known better off the hook.

Simply because evidence from all of the previous global pandemics has not had shortages in PPE as an issue; they did not spread as widely as Covid-19 and thus not put such a huge stress on demand and the global supply chains. Before Covid 19, the only major pandemic in the National Risk Register (2017) was 'flu and that is a bit easier to manage than Covid. I am sure supply chains were discussed as part of the review process but with all historical information showing it not to be a problem, why would you plan for it?

Exercise Cygnus does not go into supplies (https://assets.publishing.service.g...t_data/file/927770/exercise-cygnus-report.pdf) beyond availability of antivirals and vaccines. Which, again, suggests it was not considered a risk to cover off in any exercise.


I'm not letting "people who should have known better off the hook" because ISTM the evidence was not there for a need to expect PPE shortages. People who work in the Cabinet Office preparing the NRR are not fortune tellers.
 
... our rulers had every reason to believe that something like Covid or worse was coming down the pipe.

Unless you or the authors have the evidence to support that assertion , the only info source is the NRR from 2017 and that considered 'flu as the most serious risk and other emerging diseases less so. So, unless you consider 'flu worse than Covid, no expectation that Covid or worse was coming.

Page 9 and 34 of https://assets.publishing.service.g...ile/644968/UK_National_Risk_Register_2017.pdf FYI
 
I understand your point about the cost of managing a stockpile as opposed to JIT, but I think epidemiologists would disagree that this was an unlikely event - uncommon and unpredictable, yes, but more of a "when" not an "if". Why else have regular pandemic readiness exercises?

The planning was always 'when' (see response to Seanm above re NRR 2017). But a pandemic does not automatically mean a global shortage of supplies, not until Covid-19. Any problems that did exist were in getting them and expertise to the affected areas (Ebola, SARS, MERS and Bird and Swine Flu).

Hancock's lie about PPE availability last year is probably preparing the ground to maintain the same JIT policy for next time.

The UK needs to revisit it's risk register and management thereof given we know likelihood and severity (and other factors) may have changed in light of Covid-19.
 
Unless you or the authors have the evidence to support that assertion , the only info source is the NRR from 2017 and that considered 'flu as the most serious risk and other emerging diseases less so. So, unless you consider 'flu worse than Covid, no expectation that Covid or worse was coming.

Page 9 and 34 of https://assets.publishing.service.g...ile/644968/UK_National_Risk_Register_2017.pdf FYI
Is it the "worse" bit you're taking exception to? It seems pretty tangential to the main point about no one seeing this coming, but OK. It depends how you look at it I suppose: their rehearsals in 2006 or thereabouts had 750,000 deaths as a reasonable worst case scenario for a flu epidemic, which is worse than most of the early Covid modelling. So that might qualify. A more virulent disease like MERS would qualify as well I suppose: I don't know if they thought something like that was inevitable, specifically.

But it's beside the point, which is that a deadly pandemic was seen as a real threat - as a when rather than an if. "No one could have seen this coming!" just isn't an excuse: not only could they, they did. They just didn't do anything about it.
 
Is it the "worse" bit you're taking exception to? It seems pretty tangential to the main point about no one seeing this coming, but OK. It depends how you look at it I suppose: their rehearsals in 2006 or thereabouts had 750,000 deaths as a reasonable worst case scenario for a flu epidemic, which is worse than most of the early Covid modelling.

The reasonable worst case figure was 210000-315000 (Page 14 https://assets.publishing.service.g...le/225869/Pandemic_Influenza_LRF_Guidance.pdf). Now before you accuse me of being tangential again, the reason I raise this is that in 2020, emergency mortuaries were set up quickly to deal with the excess deaths suggesting that aspects of the pandemic that were anticipated and planned for; in fact most of the guidance in that document was enacted. Things were bad in 2020 but they could have been a lot worse if some of the planning wasn't there.

But it's beside the point, which is that a deadly pandemic was seen as a real threat - as a when rather than an if. "No one could have seen this coming!" just isn't an excuse: not only could they, they did. They just didn't do anything about it.

I'm not arguing about no-one seeing a pandemic coming, the evidence is there that one was expected (page 9, NNR 2017).

I'm arguing that planning was for a 'flu pandemic. It is unreasonable to expect planning or exercising for a pandemic to include elements of which there are little or no historical evidence of it going to be a feature. Evidence that a PPE shortage was not considered a risk is that it is not part of the Scenario assumptions for Cygnus (Page 45 of https://assets.publishing.service.g...t_data/file/927770/exercise-cygnus-report.pdf) even though PPE ordering is.

Just to clarify something, I'm defending the planning and risk management process from what I believe to be unrealistic expectations; not what was done with the results of that process, not what happened once Covid-19 hit, nor what actions may or may not be taken as a consequence of this pandemic.
 
The reasonable worst case figure was 210000-315000 (Page 14 https://assets.publishing.service.g...le/225869/Pandemic_Influenza_LRF_Guidance.pdf). Now before you accuse me of being tangential again, the reason I raise this is that in 2020, emergency mortuaries were set up quickly to deal with the excess deaths suggesting that aspects of the pandemic that were anticipated and planned for; in fact most of the guidance in that document was enacted. Things were bad in 2020 but they could have been a lot worse if some of the planning wasn't there.



I'm not arguing about no-one seeing a pandemic coming, the evidence is there that one was expected (page 9, NNR 2017).

I'm arguing that planning was for a 'flu pandemic. It is unreasonable to expect planning or exercising for a pandemic to include elements of which there are little or no historical evidence of it going to be a feature. Evidence that a PPE shortage was not considered a risk is that it is not part of the Scenario assumptions for Cygnus (Page 45 of https://assets.publishing.service.g...t_data/file/927770/exercise-cygnus-report.pdf) even though PPE ordering is.

Just to clarify something, I'm defending the planning and risk management process from what I believe to be unrealistic expectations; not what was done with the results of that process, not what happened once Covid-19 hit, nor what actions may or may not be taken as a consequence of this pandemic.
I referred to the 2007 report, here (p.21) which speaks of 750,000 deaths.

What are the unprecedented features of Covid that you have in mind? That earlier exercises indicated the need to stockpile PPE would seem to be born out by the stockpiles themselves. Maybe there were good reasons to run the stock down: I guess it would be necessary to study the evolution of pandemic investigation and planning since 2007. Calvert and Arbuthnott's source attributes the general decline of pandemic planning, including investment in PPE, to austerity. A named source involved in Cygnus specifically says that building up the stock of PPE would have been a very obvious response to Cygnus.

As I say, there may be another side to the story but I'm not going to dismiss the one they tell, especially since it fits with their larger story of general unpreparedness - for a flu pandemic or the one we actually got - for which they marshal a fair few on the record sources, as they do for their account of the response once it was realised the pandemic had arrived.
 
I referred to the 2007 report, here (p.21) which speaks of 750,000 deaths.

That's six years older and superseded by the one I linked to. What is interesting is that in the intervening year "reasonable worst case" went from 750k to 315k. Still in the 15 week period though.

What are the unprecedented features of Covid that you have in mind?

As I stated previously, the fact that it raised a global demand for things like PPE and sanitizers (and bog roll ;-)) not just an increased demand in one or two areas of the globe as we had seen with Ebla, SARS etc etc. The only well documented case of something of this scale and spread was the 'Spanish' 'flu in the early 20th century and there was no PPE or sanitizers so there was simply no empirical evidence of a pandemic of that scale causing global supply chains to collapse.

The other differences are there from the measures suggested for 'flu, that recommendations in the 'flu advice:

Modelling suggests that internal travel restrictions would have little positive impact on the total number infected by influenza over the entire course of a pandemic. Even a 60% reduction in all travel, including commuting to work, would only result in a small flattening of the profile of the pandemic across the country – reducing the national peak incidence by 5–10% and lengthening its period by a week, but also exacerbating the economic impact, increasing social disruption and adding to business/service continuity problems.
On balance, the planning presumption should be that the Government is unlikely to impose any restrictions on internal travel unless it becomes necessary to do so as the pandemic develops for public health reasons, in which case it is likely to be on an advisory basis.
there is little direct evidence of the benefits or effects of cancelling such gatherings or events. Individuals may benefit from reduced exposure by not attending such events, but there would be very little benefit to the overall community. Reduction in travel to such events may also reduce spread, although the benefits of even major reductions in all travel are small.

...which suggests that some of Covid's 'behaviour' is different to that of the expected and planned for 'flu pandemic. ie, no great surprise (in retrospect) that our planned approach to deal with it was not going to be as effective as the planners thought.

That earlier exercises indicated the need to stockpile PPE would seem to be born out by the stockpiles themselves. Maybe there were good reasons to run the stock down: I guess it would be necessary to study the evolution of pandemic investigation and planning since 2007. Calvert and Arbuthnott's source attributes the general decline of pandemic planning, including investment in PPE, to austerity. A named source involved in Cygnus specifically says that building up the stock of PPE would have been a very obvious response to Cygnus..

If you read the Cygnus scenario (Annex 2, page 45 of https://assets.publishing.service.g...t_data/file/927770/exercise-cygnus-report.pdf) you'll see that demanding PPE was part of the response, 21 days after the UK started the "First Few Hundred (FF100) Protocol" (https://assets.publishing.service.g...360190/2012_13_FF100_Protocol_H7N9_ver_12.pdf).

What is clear from the exercise planning assumptions is that there would enough PPE for 4-5 weeks and there would be no problem receiving the PPE and Respirators ordered. There is nothing in the lessons identified about PPE, so, no, not an obvious course of action off the back of Cygnus. Most of the recommendations were around command and control of the UK response to the pandemic.


As I say, there may be another side to the story but I'm not going to dismiss the one they tell, especially since it fits with their larger story of general unpreparedness - for a flu pandemic or the one we actually got - for which they marshal a fair few on the record sources, as they do for their account of the response once it was realised the pandemic had arrived.

I agree we don't have the full picture but I think that some of your view on preparedness is not based on the evidence there but is understandably coloured by your wider view on the Governments since 2006 and the current Government's performance since the pandemic was first noticed.

But (sorry to repeat myself) I'm not arguing about the political decisions made on the information available.
 
Given the SARS and MERS scares in the last 20 years, it does seem to me that deciding that a flu epidemic is the scenario to plan for is a bit unimaginative, at best, and a dereliction of duty at worst.
 
Given the SARS and MERS scares in the last 20 years, it does seem to me that deciding that a flu epidemic is the scenario to plan for is a bit unimaginative, at best, and a dereliction of duty at worst.

I think they counted as "other emerging diseases" so, whilst likely, were assessed as lower impact. The imaginative stuff will have been done and discounted before it gets to the NRR which has to deal with evidence and assessment based on evidence which in 2017 wasn't there to support an assessment that something as bad and widespread as Covid was likely - you can't prepare for everything so you prepare for the most likely / greatest impact.
 
That's six years older and superseded by the one I linked to. What is interesting is that in the intervening year "reasonable worst case" went from 750k to 315k. Still in the 15 week period though.



As I stated previously, the fact that it raised a global demand for things like PPE and sanitizers (and bog roll ;-)) not just an increased demand in one or two areas of the globe as we had seen with Ebla, SARS etc etc. The only well documented case of something of this scale and spread was the 'Spanish' 'flu in the early 20th century and there was no PPE or sanitizers so there was simply no empirical evidence of a pandemic of that scale causing global supply chains to collapse.

The other differences are there from the measures suggested for 'flu, that recommendations in the 'flu advice:





...which suggests that some of Covid's 'behaviour' is different to that of the expected and planned for 'flu pandemic. ie, no great surprise (in retrospect) that our planned approach to deal with it was not going to be as effective as the planners thought.



If you read the Cygnus scenario (Annex 2, page 45 of https://assets.publishing.service.g...t_data/file/927770/exercise-cygnus-report.pdf) you'll see that demanding PPE was part of the response, 21 days after the UK started the "First Few Hundred (FF100) Protocol" (https://assets.publishing.service.g...360190/2012_13_FF100_Protocol_H7N9_ver_12.pdf).

What is clear from the exercise planning assumptions is that there would enough PPE for 4-5 weeks and there would be no problem receiving the PPE and Respirators ordered. There is nothing in the lessons identified about PPE, so, no, not an obvious course of action off the back of Cygnus. Most of the recommendations were around command and control of the UK response to the pandemic.




I agree we don't have the full picture but I think that some of your view on preparedness is not based on the evidence there but is understandably coloured by your wider view on the Governments since 2006 and the current Government's performance since the pandemic was first noticed.

But (sorry to repeat myself) I'm not arguing about the political decisions made on the information available.
Well that raise lots of interesting questions, among them the relationship between all these reports - the extent to which one "supersedes" the other - and how the reports relate to the political reality around them. What I don't think they can do by themselves is either support or disprove the story Calvert and Arbuthnott tell, with the help of several sources, named and unnamed, which is that 1) pandemic planning in general was run down after 2010 and 2) that Cygnus raised a lot of red flags that were not addressed. They quote (from a published source) Ian Boyd, a CSO at the time of Cygnus: "We learnt what would help, but did not necessarily implement those lessons." There's more of that sort of stuff. It does suggest as well that the report you're quoting is not the only report: others haven't been made available to the public and ministers have refused to answer questions on them.

Now, going back to the book, I am noticing for the first time how some of the more damning stuff around the *political* drivers of all this - austerity, Brexit - are attributed to the unnamed Downing Street source, who, let's face it, is probably Cummings (although I think they knife him in one of their Times reports, so I don't know). Nonetheless I'm inclined to buy the general picture of *avoidable* unpreparedness painted by C&A: no doubt partly because of my own political leanings but also because of the details and testimony they include, and the government's own attempts to cover its tracks, and the fact that it all fits with what we already know about the last several governments' priorities and general MO.

There are other questions about whether the plans indicated in the reports you quote would actually have worked even if the government had been totally prepared to implement them effectively - and even if we had actually got a flu pandemic: that some of the presumptions you mention were wrong *for Covid* is less significant than the possibility they were wrong for pandemics as such - a lot of basic presuppositions seem to have been modified in the fact of reality. This is obviously different from the question of whether or not the government neglected pandemic planning and then failed to deal with the consequences of that, but it does put a slightly different complexion on things. We do have to remember that *lots* of countries f___ed it, and presumably some of them were prepared - for what was expected, and according to pre-Covid thinking on pandemics.

I understand your reluctance to judge the political decisions on the information available - especially if you're restricting yourself to the reports you've quoted. Other information is available: the Failures of State book is definitely worth looking at, even with a sceptical eye, and of course we do know a lot about how the government operates, and there is also their inability to offer a credible account of things. At a certain stage you do have to draw the obvious conclusions. Happy to revise mine if new information comes to light.
 
Well that raise lots of interesting questions, among them the relationship between all these reports - the extent to which one "supersedes" the other

That one's quite simple. The document I linked to is the most up to date version of the guidance and thus makes the 2006 document you linked to for historical reference only (it's in an archive area). So what you have is a useful means to check what was and what wasn't adopted from the recommendations from Cygnus - the 2006 edition being written before and the 2013 after.

and how the reports relate to the political reality around them. What I don't think they can do by themselves is either support or disprove the story Calvert and Arbuthnott tell, with the help of several sources, named and unnamed, which is that 1) pandemic planning in general was run down after 2010 and 2) that Cygnus raised a lot of red flags that were not addressed. They quote (from a published source) Ian Boyd, a CSO at the time of Cygnus: "We learnt what would help, but did not necessarily implement those lessons." There's more of that sort of stuff. It does suggest as well that the report you're quoting is not the only report: others haven't been made available to the public and ministers have refused to answer questions on them.

The quote from Boyd refers to a whole raft of exercises that took place (the ones that came to light in the Graun this week, like "Alice"), so they're the reports you're thinking of. Of course the reports only tell half the story - what they won't tell you is the decision process behind each department's response to the lessons learned which will be part risk and evidence based in nature and some political.

There are other questions about whether the plans indicated in the reports you quote would actually have worked even if the government had been totally prepared to implement them effectively - and even if we had actually got a flu pandemic: that some of the presumptions you mention were wrong *for Covid* is less significant than the possibility they were wrong for pandemics as such - a lot of basic presuppositions seem to have been modified in the fact of reality. This is obviously different from the question of whether or not the government neglected pandemic planning and then failed to deal with the consequences of that, but it does put a slightly different complexion on things. We do have to remember that *lots* of countries f___ed it, and presumably some of them were prepared - for what was expected, and according to pre-Covid thinking on pandemics.

Interestingly in his article in Nature from March 2020 (https://www.nature.com/articles/d41586-020-00919-3), Boyd also says:

Plans provide only a template — command and control, reserve personnel and resources, computer models and communications tools and so on. How these are deployed and coordinated needs to be highly fluid.

So in essence, he's confirming what Mike Tyson said, "everyone has plan until they get punched in the mouth".

Just to pick up on your conjecture of the plans being not fit for a 'flu pandemic then that's the problem with insurance policies; you never know how good they are until you need to claim. It also shows the limitations of exercises.

The failure in countries that may have been better prepared for such things show that what needs to happen is to not just change the plan but prepare the plan in full knowledge it needs greater agility. Military commanders have a lot to teach in that respect.
 
That one's quite simple. The document I linked to is the most up to date version of the guidance and thus makes the 2006 document you linked to for historical reference only (it's in an archive area). So what you have is a useful means to check what was and what wasn't adopted from the recommendations from Cygnus - the 2006 edition being written before and the 2013 after.



The quote from Boyd refers to a whole raft of exercises that took place (the ones that came to light in the Graun this week, like "Alice"), so they're the reports you're thinking of. Of course the reports only tell half the story - what they won't tell you is the decision process behind each department's response to the lessons learned which will be part risk and evidence based in nature and some political.



Interestingly in his article in Nature from March 2020 (https://www.nature.com/articles/d41586-020-00919-3), Boyd also says:



So in essence, he's confirming what Mike Tyson said, "everyone has plan until they get punched in the mouth".

Just to pick up on your conjecture of the plans being not fit for a 'flu pandemic then that's the problem with insurance policies; you never know how good they are until you need to claim. It also shows the limitations of exercises.

The failure in countries that may have been better prepared for such things show that what needs to happen is to not just change the plan but prepare the plan in full knowledge it needs greater agility. Military commanders have a lot to teach in that respect.
Love your faith in progress! As Mandryka will tell me, there’s a book to be written on the evolution of those reports. I bet it’s messy AF.
 
But why can’t you stockpile and then rotate the lifed stock. So the NHS draws its working supplies from the stockpile, which is replenished regularly.

Agree. I have worked with several businesses that need to use stock rotation.
First in, first out
Its not rocket science.

Regarding MH. I find him a slippery character. I know you could say that about most MP's but he plays in his own league.
 
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If Hancock is insinuating that we had an adequate supply of ppe why was such a fuss made through the media of sourcing a million pounds worth from Turkey and sending a RAF plane to collect. In the end it wasn’t used as it wasn’t considered to be up to standard.
 
Our oldest lad is an optician.

He was furloughed as his business gave up their PPE when the shortage hit last year, to the local hospitals.
 


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