Richard North, 24/05/2021  

For want of the findings of the official inquiry into the government's handling of the Covid-19 epidemic in the UK – which will probably be about as illuminating as any other official inquiry – the field is wide open to just about anybody who can get a media hearing to offer their own personal views as to what went wrong.

High up on the list of those with media access is former super-genius Dominic Cummings, the knower of all things and a man with the sacred mission of dragging his former assistant into the mire – none other than prime minister Johnson.

No-one could dispute that, when it comes to gaining access to the media, Cummings is indeed a star performer, probably second only to the Harry person who used to be part of the royal family, or something like that.

But, as we see confirmed by the coverage in the Sunday papers, access is one thing. Knowledge is quite another. Knowing what you are talking about does not get you media access and can often be a handicap. The ability to contribute to an ongoing soap opera is much more important.

In the case of Cummings, while he is still able to conjure up the headlines, it is unlikely that his working knowledge of epidemiology and the nature of the government's pandemic contingency plans, were – or are – any better that his understanding of the workings of the EU. And that, as we have seen, is perilously slender.

It is nonetheless a given that the government's initial response to the Covid-19 was – to put it at its kindest – sub-optimal. And you don't have to be a super-genius to have worked that one out. But we don't seem to be hearing an awful lot from Mr Cummings about that, despite its obvious importance.

Instead, it seems, our intrepid former super-genius is more concerned with the response to the response, although even that is not entirely clear from the reports of his accusations carried by the Sunday Times, repeated in today's Times.

The thrust of the accusation can be gleaned from the headline, which tells us: "Government's Covid response was a 'bodged plan B amid utter chaos', Dominic Cummings says", followed by the sub-heading: "Cummings said the government's original plan was to achieve herd immunity but ministers dropped the plan when warned of the consequences".

In fact, as we read through the report, the nature (or accuracy) of the accusation is very far from clear, when we learn that "Boris Johnson was forced into a 'bodged' Covid plan because the government did not realise its initial strategy would cost hundreds of thousands of lives and lead to an economic disaster".

And that "initial strategy" – the "Plan A" - according to Cummings was to "flatten the curve" and to get herd immunity by summer, thus avoiding a second peak during annual NHS winter crisis.

But then, our super-genius tells us, in the week of 9 March last year, it became clear that health secretary Matt Hancock, and the Cabinet Office, did not understand the implications of aiming for herd immunity. In Cummings's words – via a tweet – it would have meant: "100s of 1,000s choking to death + no NHS for *anybody* for months + dead unburied + econ implosion".

Cummings adds that while he was critical of Johnson "in all sorts of ways", it i vital to understand the disaster was not just his fault. The official plan was "disastrously misconceived". And "once this became clear", "a Plan B had to be bodged "amid total and utter chaos". We "moved to Plan B: suppression + Manhattan Project for drugs/vaccines + test & trace etc".

Of the many problems with this narrative, though, one of the most important must be that Cummings's recollection of the initial plan is utterly flawed. We know that because there are copious official records which set out the Plan A, and there are multiple occasions on which it was confirmed that this plan was being put into effect.

The central flaw with this plan – which very quickly became apparent - was to treat the Covid-19 epidemic in exactly the same way as pandemic influenza.

In short, this required monitoring the early incidence of the disease, but only until community transmission had been established, whence efforts would be focused jointly on treating in hospitals those affected with stocks of anti-viral medicines kept for the purpose, while pushing for the rapid development of a vaccine and an emergency vaccination programme.

There was no secret about this, or about the fact that this wholly inappropriate plan quickly can unstuck, not least because the disease was appeared to be spreading more rapidly than flu and was potentially far more dangerous. Furthermore, the stocks of anti-virals held were of very little use and there was no prospect of the early development of a vaccine.

Nor was there any secret about the response to the failure of the original plan. I was writing about it on 14 March 2020, after it had been set out in a number of media reports, such as here, where the concept of herd immunity was discussed at length.

But there was further elaboration here, when officials – although still under the thrall of the influenza plan - gave a more nuanced response.

The main line came from Patrick Vallance, England's chief scientific adviser, who said of herd immunity only that it was "the benefit" of the government's approach to tackling the coronavirus problem.

Vallance said the approach was aimed at broadening the peak of the epidemic, and allowing immunity to build up among the population. His concern was to prevent everybody getting the disease in a short period of time, swamping NHS services. That's "flattening the peak", he told BBC Radio 4's Today programme, at the time.

"Our aim", he said, "is to try and reduce the peak, broaden the peak, not suppress it completely". Then, because the vast majority of people got a mild illness, the idea was "to build up some kind of herd immunity so more people are immune to this disease and we reduce the transmission". But – crucially – he added – "at the same time we protect those who are most vulnerable to it".

Vallance sought to underline that it was the "epidemiology" that was guiding the decision not to impose more draconian restrictions on the public's day-to-day lives immediately. In fact, it was the failed influenza plan, which advocated a "business as usual" model.

The theory was, according to the plan, as articulated by Vallance: "If you suppress something very, very hard, when you release those measures it bounces back and it bounces back at the wrong time". Thus, the government is concerned that if not enough people catch the virus now, it will re-emerge in the winter, when the NHS is already overstretched".

As it turns out, this was quite the wrong thing to do, and for many reasons. It was not possible, using the influenza plan, to protect those who were most vulnerable to the disease, and the epidemic was growing at such a pace that there was already a risk that the NHS would be overwhelmed – as was happening with health services in Italy.

Nevertheless, it cannot be said that developing herd immunity (by naturally acquired infection) was ever the primary aim of government policy – merely a happy (if unrealistic) consequence of a policy that sought to protect the vulnerable and allow the disease to spread through the rest of the community which – in theory – would be largely unaffected by it.

If it is understanding that officials were, at this time, still heavily influenced by the influenza plan, then it is quite easy to understand the thinking behind this. All the time, the purpose was to buy time for a vaccine to be developed.

What should have been done to protect the vulnerable was to implement an effective regime of trace, test and isolate cases and contacts, to take the infection out of the community.

But, with the government-inspired collapse of the national public health systems, this was not going to be possible, despite the failed attempt to activate a national system. Thus, the lockdown became the only credible alternative – which Johnson was slow to realise.

How much of this Cummings understands is highly questionable. However, he will be questioned by MPs on the health and science select committee on Wednesday about his perception of the government's handling of the epidemic.

From past experience though, the MPs will have little better understanding than Cummings and all we may see is the blind leading the blind. On the face of it, he will be re-writing history. It will be interesting to see if he gets away with it, and how far he will go in his attempts to "napalm" Johnson.

Also published on Turbulent Times.

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