{"id":50698,"date":"2021-07-21T09:00:06","date_gmt":"2021-07-21T08:00:06","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=50698"},"modified":"2021-07-27T08:48:42","modified_gmt":"2021-07-27T07:48:42","slug":"what-dominic-cummings-said-next-the-case-for-an-urgent-inquiry-into-englands-pandemic-response-gets-stronger-and-stronger","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2021\/07\/21\/what-dominic-cummings-said-next-the-case-for-an-urgent-inquiry-into-englands-pandemic-response-gets-stronger-and-stronger\/","title":{"rendered":"What Dominic Cummings said next\u2014the case for an urgent inquiry into England\u2019s pandemic response gets stronger and stronger"},"content":{"rendered":"

What can we learn from Cummings’ recent interview, apart from what has long been obvious that the machinery of government is broken?<\/p>\n

<\/p>\n

One of the most common questions I get asked by my colleagues from other countries, many of whom trained in the United Kingdom, is how it could be that a country that they recall having had such strong public health capacity could have done so badly during the pandemic. In theory, it should have been extremely well prepared. Just before the pandemic struck, the United Kingdom came second in the <\/span>Global Health Security Index<\/span><\/a>, just behind the United States. The Index ranked 195 countries on 34 indicators chosen to assess each countries capability to prevent and mitigate epidemics and pandemics. And in many respects, these expectations have been realised. British scientists have excelled in many areas, and not just the much acclaimed development of the Oxford AstraZeneca vaccine. Other examples include the <\/span>RECOVERY<\/span><\/a> trial, which provided some of the first evidence on what worked and, as importantly, did not work in the treatment of covid-19, valuable insights using observational data, for example from the <\/span>OpenSAFELY<\/span><\/a> platform, and <\/span>COG-UK<\/span><\/a>, a world leader in rapid sequencing of SARS-CoV-2. The NHS has also excelled, with a widely admired programme to roll out vaccination. Yet despite these advantages, it has ended up with a <\/span>death rate<\/span><\/a> far higher than most comparable countries.\u00a0<\/span><\/p>\n

One might hope that the politicians who presided over the situation would show some curiosity about what went wrong. After all, the pandemic is not yet over. Indeed, Boris Johnson, the UK prime minister is embarking on an unprecedented experiment to remove restrictions at a time when cases are soaring, a decision that has been greeted with incredulity by many, both <\/span>here<\/span><\/a> and <\/span>abroad<\/span><\/a>. Yet they seem remarkably uninterested in finding out. The prime minister has promised an inquiry, but not for at least a year. His excuse is that this would distract those leading the response to the pandemic, an argument that does not seem to have prevented him from abolishing Public Health England and reorganising the NHS.\u00a0<\/span><\/p>\n

Others do want to find out. The <\/span>All Party Parliamentary Group on Coronavirus<\/span><\/a> has been conducting its own investigation, while the advocacy group Keep our NHS Public, has organised the <\/span>People\u2019s COVID Inquiry<\/span><\/a>. Both have collected extensive testimony from those affected by the pandemic, whether as victims of the disease or those caring for them. But these are no substitute for understanding the decision-making process in government.\u00a0<\/span><\/p>\n

Instead, we must depend on glimpses from inside the system. Extracts from Jeremy Farrar\u2019s forthcoming <\/span>book<\/span><\/a> published in <\/span>The Times<\/span><\/a> describe \u201corganisational mayhem,\u201d “dysfunctional state apparatus\u201d, and a prime minister described as being in thrall to contrarian scientists and journalists and frequently absent. However, despite Farrar\u2019s closeness to the decision making process, he was a political outsider. What we need is an account from someone who observed the political responses to the pandemic on a daily basis, someone whose relationship to Johnson was as close as, say, John Bolton\u2019s was to US President Donald Trump, able to observe from within \u201c<\/span>the room where it happened<\/span><\/a>\u201d. That someone is Dominic Cummings, who for many months was one of Johnson\u2019s closest confidantes and who, on the 20<\/span>\u00a0July 2021, gave an <\/span>hour long interview<\/span><\/a> to the BBC\u2019s political editor Laura Kuenssberg.\u00a0<\/span><\/p>\n

This was not the first time we hadve heard from Cummings. Since leaving Downing Street he has offered exceptionally long commentaries on <\/span>Twitter<\/span><\/a> on contemporary British politics and, especially, what he sees as the failings of the current government. He has also <\/span>given evidence<\/span><\/a> to a joint session of the <\/span>House of Commons<\/span>\u00a0Science and Technology Committee<\/span><\/a>\u00a0and<\/span>\u00a0Health and Social Care Committee<\/span><\/a>. So did we learn anything new? Not much. Much of the interview focused on his now notorious trip to Durham when London was in lockdown and he was ill with covid, and on his role in the Vote Leave campaign. In passing, his former colleagues on the campaign trail may have been surprised to hear him ask \u201cIs Brexit a good idea? No-one on earth knows,\u201d while some of the Brexit supporting MPs may not be happy to be described as \u201cmorons.\u201d However, our interest is in how Boris Johnson responded to the pandemic. The answer, as Cummings recounts it, is not very well.\u00a0<\/span><\/p>\n

Many of the juiciest quotes had been trailed in advance. Johnson\u2019s initial reaction to the developing pandemic was to avoid precipitous action, a decision widely accepted as contributing to the very many deaths in the first wave. Viewing it as similar to influenza he believed that lockdowns would not work. In words unlikely to appeal to the many older Conservative voters, he saw no need for alarm as <\/span>“the people who are dying are essentially all over 80”. <\/span>\u00a0Although he did take it more seriously for a short while after he recovered from his own covid infection, this did not last long and his scepticism returned. In messages in Cummings\u2019s possession he said that he did not believe in <\/span>“all this NHS overwhelmed stuff”, even though he was leading the nation most weeks in the \u201cclap for carers.\u201d<\/span><\/p>\n

While a failure to understand the seriousness of a newly discovered virus at the start of the pandemic, especially by someone who, according to Cummings, viewed becoming prime minister as \u201ca laughing matter\u201d may be understandable, his failure to reimpose restrictions when cases were rising again in September 2020 is less easy to understand. However, Cummings does offer us three reasons for this hesitation that, again, led to unnecessary suffering and loss of life. First, Keir Starmer, the leader of the opposition, had demanded a \u201ccircuit breaker\u201d and Johnson felt he could not be seen to agree with him. Second, many of his own MPs were strongly opposed, with Cummings describing them as having \u201clost their minds.\u201d Third, The Daily Telegraph<\/em>, which Johnson reputedly refers to as his \u201creal boss\u201d was against it. Clearly it is difficult to reconcile this account with \u201cfollowing the science.\u201d<\/span><\/p>\n

So what can we learn from this, apart from what has long been obvious that the machinery of government is broken, and not just in relation to the pandemic response. Sadly, not very much. Much of what Cummings said is supported by other accounts, such as the sources for Jonathan Calvert and George Arbuthnot\u2019s detailed account in <\/span>Failures of State<\/span><\/a>. In some cases, Johnson\u2019s own words, preserved in WhatsApp messages, offer additional support. But it is inevitably partial and our only hope of finding out something close to the whole truth will be the eventual public inquiry. It is interesting that Cummings, like <\/span>Jeremy Farrar<\/span><\/a>, wants this to happen as quickly as possible. Johnson, in contrast, seems in no hurry at all. Many observers will draw their own conclusion from that simple observation.<\/span><\/p>\n

Martin McKee<\/strong>, professor of European Public Health, <\/span>London School of Hygiene and Tropical Medicine<\/span><\/em><\/p>\n

Competing interests<\/strong>: Martin McKee is a member of Independent SAGE.\u00a0<\/span><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

What can we learn from Cummings’ recent interview, apart from what has long been obvious that the machinery of government is broken? […]<\/p>\n

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