Wales had highest Covid deaths during UK's second wave - inquiry

1. The UK Covid-19 inquiry is in Cardiff to scrutinise the Welsh government's handling of the pandemic
2. The inquiry covers decision-making during the pandemic by the UK government and the devolved governments in Wales, Scotland and Northern Ireland
3. First Minister Mark Drakeford only learned Wales would take charge of its own Covid response three days before the UK-wide lockdown was introduced, inquiry hears
4. More than 12,000 people in Wales have died with Covid since the pandemic was declared in March 2020
5. We’ll bring you text coverage here, and you’ll also be able to watch by pressing play at the top of the page

Goodbye for now

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The inquiry heard that the Welsh government only found out at the last minute that it was responsible for pandemic decision-making

The Covid inquiry in Wales has wrapped up for the day, and here are some of the main developments from its third session:

• Prof Dan Wincott, an expert in Welsh government decision-making, told the inquiry that structures to help the Welsh and UK governments work together are “much less well-developed than would be optimal in a system like the UK”. He said the Welsh government is “constrained” by the devolution settlement and can lead to “confusion over accountability”
• Wincott said the Welsh government and First Minister Mark Drakeford only learned Wales would take charge of its own Covid response three days before the UK-wide lockdown was introduced by Boris Johnson.
• Prof Sir Ian Diamond, chief executive of the UK Statistics Authority, went through the number of deaths involving Covid in Wales – especially how the second wave hit Wales hard. He said there was a “very strong peak of deaths” in April 2020, largely driven by Covid
• Dr Robert Hoyle, head of science at the Welsh government, also said that debate within the technical advisory group – its scientific advisory body – was not met with enough “really hard challenge” from members, who also "did not have the life experiences of people who lived in the more deprived areas" where compliance with restrictions was low.

Scientists didn't understand Covid rule-breakers from deprived areas

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Wales entered a two-week "firebreak" lockdown during the pandemic to help slow down a rise in Covid infections

Asked about hotspot areas of Covid transmission ahead of the "firebreak" lockdown in September 2020, Hoyle said most members of the technical advisory group (TAG) could work from home in the public sector and "did not fully understand" low levels of compliance to Covid rules in deprived areas.

"Most of the TAG members did not have the life experiences of people who lived in the more deprived areas of Wales,” he said.

Lack of 'hard challenges' in scientific advice group

Hoyle said debate within the technical advisory group (TAG) - the Welsh government's scientific advisory body - was not met with enough "really hard challenge" from members.

"I remember, on occasion there was serious challenge, really off the wall challenge and I felt at the time it wasn’t particularly well received," he said, adding that "soft challenges" were acceptable, but hard challenges were not.

But he said the advisory group was also not a place which would rubber-stamp ministers’ advice or information.

On whether their advice had an impact, Hoyle said the firebreak lockdown in autumn 2020 was debated “long and hard” and fed into policy.

Scientific adviser 'could and should have done more' before lockdown

Dr Robert Hoyle, head of science at the Welsh government, said he believes lockdown had been inevitable – but could have come at least a week earlier.

He also said that not all senior scientists in the government appreciated the urgency of Covid quickly enough.

Hoyle said he didn’t start discussing Covid with the chief scientific adviser for Wales, Prof Peter Halligan, until a week before lockdown.

“I raised it with him on occasion but the implication was that it was someone else’s problem… a health issue,” he said.

“I went out of my way to encourage him to engage with this, he eventually took that advice but not until very late in the day.

"I think he could and should have done more.”

Dr Hoyle said lockdown could possibly have come two weeks earlier and probably five to seven days earlier, but the issue had to be in people’s minds.

He believes earlier lockdown would have reduced fatalities in the first wave and smoothed the peak, although it may not have changed the eventual outcome in terms of infections and deaths.

Test delay figures difficult reading for ministers

Gareth Lewis

Political Editor, BBC Wales

The discharge of patients from hospitals into care homes during the first wave of the pandemic has cropped up again.

It has been a recurring theme during the hearings in this Wales-specific module. The Welsh government changed its discharge and testing guidance two weeks later than England in April 2020 - a source of concern for bereaved families, who want answers.

The graphs and stats today will have been difficult for them - some patients could have been discharged without a test for another month, until the end of May.

Wales's political decision makers, including First Minister Mark Drakeford and Vaughan Gething, health minister at the time, are expected to appear at the inquiry the week after next.

Lack of testing of patients highlighted

The inquiry heard more details about 1,729 hospital patients who were discharged into care homes between the start of March 2020 and the end of the following May – including a period when no Covid testing took place.

Stephanie Howarth, chief statistician for Wales, was asked about data which showed 81 of these patients had died from Covid by the end of June – and that more than three quarters of them had not been tested before discharge.

In March, there were 792 patients discharged without a test – and 296 discharged before a change in guidance in the last week of April.

The change brought in mass testing of patients being transferred to care homes from 27 April, but there were still 47 patients not tested after this date and across May, Howarth said.

She said there could have been instances when there were reporting issues, but it “could be because genuinely that no test was undertaken”.

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Excess deaths in homes

Prof Diamond discussed the higher excess deaths - which is the difference between the number of deaths recorded for a specific place and time, and the number of deaths that would have been expected anyway in the absence of a crisis.

He also covered the numbers of deaths in people’s homes, as well as care homes and communal housing such as sheltered housing.

Diamond said he believed that for a lot of illnesses people didn’t go to hospitals because health services were stretched, and this could have led to a small reduction in hospital deaths.

He also said more people with terminal illnesses may have died at home rather than in hospices.

He earlier talked about how the weekly Covid infection survey was introduced in Wales in August 2020, three months after a pilot in England. It took thousands of swabs from people to check if they were infected and said, with Covid fast moving, results were needed at pace.

“We didn’t have an accurate measure of how much Covid was in the population – the proportion at any moment who had Covid. It was unclear whether we could do a survey but I felt it was possible and we started and recruited.”

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Inquiry hears about Wales' mortality rates

Prof Sir Ian Diamond, chief executive of the UK Statistics Authority, took the inquiry through the mortality figures involving Covid in Wales – especially how the second wave hit Wales particularly hard.

He said there was no statistical difference between Wales and England on age-standardised mortality, but there was when compared with Scotland and Northern Ireland - with Wales being higher.

England had the higher percentage of excess expected deaths (11.9%) compared to Wales (9.2%) in the pandemic period up to February 2022.

In the second wave, mortality was higher in Wales than the other UK nations. There were 3,187 excess deaths in the second wave in Wales, and 4,429 deaths involving Covid, compared to 2,251 excess deaths in the first wave and 2,109 deaths involving Covid.

Prof Diamond said there was a “very strong peak of deaths” in April 20202, largely driven by Covid.

“There was also a very high peak in the autumn and early part of 2021 – again that was largely drive by Covid,” he said, adding that Covid deaths later began to “greatly” decrease due to better treatment as well as vaccines.

Inquiry paused for lunch

After a morning dominated by the relationships of the Welsh and UK governments as they responded to the pandemic, the inquiry has paused for lunch.

We’ll return soon to bring you the latest updates and analysis from the inquiry.

UK-Welsh government tensions on display

Hugh Pym

Health editor

Relationships between the Welsh and UK governments during the pandemic have been highlighted at different points during the Covid inquiry in Cardiff.

On Monday, perhaps the most intriguing was over the role of the Treasury with Prime Minister Rishi Sunak at the time heading that department as chancellor.

The issue of funding for the Coronavirus Job Retention Scheme led to a disagreement between Sunak and First Minister Mark Drakeford.

The Welsh government wanted to restore the funding when it implemented a limited firebreak lockdown in October 2020.

Sunak had refused, although finances were made available a couple of weeks later when Westminster announced a lockdown in England.

The prime minister has submitted evidence to this leg of the inquiry which will be heard in the days ahead.

Counsel for the Welsh government also argued on Monday that the Treasury only answered to central government and was not responsive to the requests of devolved nations.

Drakeford thought UK government would control Wales' Covid response

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Differences between First Minister Mark Drakeford's response to Covid for Wales and then-prime minister Boris Johnson's response for England were highlighted during the pandemic

The inquiry heard the Welsh government and Mark Drakeford only learned Wales would take charge of its own Covid response three days before the UK-wide lockdown was introduced by Boris Johnson.

The lockdown was announced on 23 March by the then-prime minister Johnson, who used public health powers rather than civil contingencies legislation to do so.

Prof Dan Wincott said that meant the Welsh government ended up in charge of decision-making in Wales instead of the UK government.

Tom Poole, inquiry counsel, said that once the decision had been made Drakeford agreed with the approach as it allowed him to “calibrate” a response specific to Wales.

In an earlier written statement to the inquiry, Johnson said “there is a respectable argument that we should have used civil contingencies legislation instead of public health legislation”.

"By allowing a least the appearance of a divergence in approach between the various parts of the UK we were risking considerable public confusion and frustration - when clarity of message was crucial,” he said, adding that civil contingency legislation would have allowed the UK to “bind together”.

The UK government had been advised that it could not use civil contingencies legislation because Covid was not an unforeseen event.

Welsh government 'constrained' by devolution settlement

Prof Dan Wincott told the inquiry that structures to help the Welsh and UK governments to work together are “much less well-developed than would be optimal in a system like the UK”.

He said there are many examples of the Welsh and UK governments working together well, “going back through the history of devolution, for example on city deals”.

But he said the Welsh government is “particularly constrained by the nature of the devolution settlement and those jagged edges and its relationship with the UK government”.

“There can be confusion over accountability,” he concluded.

Blame games between UK and Welsh governments a ‘feature of the system’

Prof Dan Wincott, an expert in Welsh government decision-making, is the first to speak to the inquiry this morning, and said "blame games" are played between Welsh and UK governments - describing them as a "feature of the system”.

Prof Wincott was asked whether Welsh ministers were responsible for decisions made in their names, and spoke about what he called the "jagged edges" of the devolution settlement.

"Welsh ministers are still responsible for decisions, but exercise those responsibilities in particularly tight and uncertain constraints," he said.

What happened yesterday?

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Day two of the Covid inquiry in Wales heard from a range of witnesses, including those representing bereaved families

On Wednesday the inquiry heard from witnesses including those representing bereaved families, older people, children, and disabled people.

Here are some of the key moments from yesterday:

• Elizabeth Grant, whose mother died of Covid, said the Welsh government was "caught with [its] trousers down” when the pandemic started, raising concerns about the PPE not being used as well as the lack of testing in hospitals
• Helena Herklots, the older people’s commissioner for Wales, said many people were being discharged into care homes from hospital without testing, while people within care homes were also not being tested
• Prof Emmanuel Ogbonna, from the first minister’s black, Asian and minority ethnic (BAME) Covid advisory group, said language barriers and cultural differences played a part in hindering messages around Covid reaching ethnic minorities
• Debbie Foster, from Cardiff University, said disabled people were “generally seen as dispensable throughout Covid”, adding that many of the issues facing them “should have been understood” earlier
• Sally Holland, the former children’s commissioner for Wales, said children’s needs were not taken into account during the pandemic, something she said was highlighted by the fact that pubs were reopened before parks and play spaces

Good morning

Welcome back to our live coverage of day three of the Covid inquiry in Wales.

Today we'll hear from people like Prof Dan Wincott, an expert in Welsh government decision-making, Stephanie Howarth, chief statistician of the Welsh government, and Dr Robert Hoyle, its head of science. We’ll also hear from Prof Sir Ian Diamond, chief executive of UK Statistics Authority.

This page will bring you key lines and analysis as they emerge from the hearing.

But if you want to be across everything that is said in today's session you can watch the hearing live by clicking the Play button at the top of this page.