The wrong kind of government to deal with a pandemic | Letter

There is an abyss between plans and their implementation, and the UK lacks a joined-up system with a nested hierarchy of compatible plans, from local to national, says Prof David E Alexander

To ask “did the UK Government prepare for the wrong kind of pandemic?” (21 May) is a little too reminiscent of British Rail’s “wrong kind of snow”. Granted, stockpiling influenza antivirals could be seen as a waste of money if no pandemic materialises before they expire. However, at least 90% of the preparedness measures for Sars are the same as those for an influenza pandemic. We are dealing with a medical, epidemiological, social, economic and psychological problem, and exactly what type of virus is involved is not so important.

In the successive versions of the UK’s National Risk Register (2008-17), influenza is consistently the No 1 risk. That Sars is not an influenza virus is immaterial, as “influenza” is a surrogate for any virus with high reproducibility in humans and a significant case-fatality rate. In the government’s response to the current crisis, the deficiencies have not been in scientific advice, but in the marginalisation of emergency planning and management – in the context, of course, of declining health, social care and welfare services.

UK pandemic planning has suffered from an abyss between the plans and their implementation, and the lack of a joined-up system with a nested hierarchy of compatible plans, from local to national. The UK’s resolutely top-down approach to local problems is at the heart of this failure. To cap it all, we are now treated to the unedifying spectacle of the UK government endeavouring to treat Covid-19 as if it were a terrorism problem.

Not the wrong kind of pandemic: the wrong kind of government.
Prof David E Alexander
Institute for Risk and Disaster Reduction, University College London

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