James Harness

Thank you for staying with us during today's session of the Covid Inquiry.

A high-profile witness was former Prime Minister David Cameron who said it was a "mistake" not to consider different types of diseases when preparing for future pandemics - read more here.

Inquiry proceedings resume tomorrow from 10:00.

But that's all from us, for now. Today's writers were Imogen James, Ben Morris, Thomas Mackintosh and Ece Goksedef.

The page was edited by me, James Harness.

As today’s sitting comes to end, let’s see what we have heard:

• Former Prime Minister David Cameron gave evidence. Both the British Medical Association and the Trade Unions Congress have said that Cameron’s years of austerity left the UK unprepared for a pandemic
• Counsel for the Inquiry, Kate Blackwell KC, questioned Cameron over “inadequate” health budgets, which he defended
• Cameron also praised Rishi Sunak for taking the furlough decision when he did
• Sir Chris Wormald, permanent secretary at the Department of Health, appeared this afternoon. He said the country “never nationally ran out of PPE”.
• The chair of the Inquiry, Baroness Hallett, interrupts and says that medical professionals would be surprised to hear that - Wormald admitted that there were significant challenges getting PPE to the right place
• Then we heard from Clara Swinson, who heads up the department of health and social care’s global health division since 2016.
• Swinson says, in terms of a UK wide strategy regarding a pandemic, "there would've been some areas that were worth updating” since the only one is from 2011.

Laura Foster
Health reporter at the inquiry

Sioux Vosper, who lost her dad during the pandemic, was inside the inquiry listening to David Cameron give evidence.

She says she was shocked by what she heard: "They knew these things would happen and nobody did anything."

"It’s shocking he’s not taken responsibility," she says, "We were not prepared at all".

"I’m shocked people like that ran the country. It’s frightening."

Matthew Cole
Reporting from the Covid inquiry

Image source, PA Media

The size, scale, and speed of the 2010 government's cuts were a matter of heated political debate back then.

In the hearing this morning, Kate Blackwell KC - one of the inquiry's legal team - said she didn't want to stray in the political areas of the rights or wrongs of the austerity policy, but wanted to ask about the impacts and consequences of those policies on health, inequality and structural resilience.

The hearing saw a print out of a statement from former Chancellor George Osborne in which he said: "I have no doubt that taking those steps to repair the UKs public finances in the years following the financial crisis of 2008/9 had a material and positive affect on the UKs ability to respond to the Covid-19 pandemic."

Responding hesitantly to questions about this on the stand, former Prime Minister David Cameron said he did not accept that during his time in government health budgets were inadequate and depleted the ability of the NHS to respond to the pandemic.

He has repeatedly said this morning that the best way to prepare for a pandemic was to "have a strong economy".

The politics behind the austerity policy are being placed in the spotlight here.

Before the inquiry was adjourned for the day, Allison Munroe KC asked questions relating to the World Health Organisation research and development blueprint reports.

The 2017 and 2018 reports determined there was an urgent need for research and development into Mers, Sars and other highly pathogenic coronavirus diseases.

Swinson said she did not read the reports at the time of publication, but the government did take actions that link back to the blueprints.

"These are very important documents for all countries," continued Swinson.

But was it part of the strategy, in 2017 and 2018, to prioritise these diseases and research and development, Munroe asked.

"Yes," Swinson said.

Baroness Hallett has adjourned the session for the day, until 10:00 tomorrow morning.

Before we go we'll bring you a few more moments from the day, plus analysis.

Stay with us.

Image source, UK Covid-19 Inquiry

Allison Munroe KC, representing Covid Bereaved Families UK, has taken over questioning now.

She represents one of many Covid Bereaved groups who will take part throughout the inquiry.

A risk identified in 2016 was that health and social care may be unable to cope with the extreme surge in demand for services, in the event of a pandemic.

Blackwell asks if Swinson is able to say what action was taken to mitigate this risk.

"Not from memory," she responds.

However, on what she would have expected to have taken place between this risk register and the next, Swinson says "it would depend obviously on resourcing and priorities across the department.

"I also note that the risk you pick up is a large one that has been identified over many years and it's not that two or three actions would be able to be taken forward in a six month period that would be able to solve it."

In December 2020, the risk is still present in reports.

A little earlier, when Kate Blackwell asked Clara Swinson about risks in health and social care systems an alarm sounded.

The alarm briefly rang for a second time. So far, we've not had any more interruptions.

Turning now to the Pandemic Influenza Preparedness Program (PiPP), of which Clara Swinson was the chair.

The group created pandemic risk registers. They have been provided for 2016, 2017, 2018, 2020 and 2021.

Blackwell asks why this system only began in 2016.

"I don't know whether that's the case," Swinson says, however she says she thinks they would have existed earlier.

And on the gap in 2019 where no register has been provided, Swinson says: "There were planned to be two meetings each year. There was one meeting in 2019, one meeting was taken out of the schedule to allow for resources on Operation Yellowhammer."

Operation Yellowhammer was the planning group tasked with looking at the effect of Britain's exit from the EU.

Risk registers were taken to the PiPP meetings and they set out the actions that need to be taken in order to improve work against pandemic risks.

Image source, UK Covid-19 Inquiry

Kate Blackwell KC is questioning Swinson.

She deals first with emergency preparedness.

Until a Coronavirus plan was made in 2020, the 2011 strategy was the only one in place for a UK wide plan regarding a pandemic.

Blackwell asks if Swinson thinks, knowing what she does now, there was good reason for the plan to be updated between 2011 and when the pandemic hit.

Swinson says in terms of its main areas, "there would've been some areas that were worth updating.

"For example, technology had changed since 2011... but the basic premise of the plan, there was not a different strategy that was in place that we needed to publish."

On the topic regarding the plan only dealing with influenza, "we had reflected in the new pandemic portfolio a recognition that we would like the strategy to be along all of the different routes of transmission," Swinson added.

Was that a mistake, in hindsight, Blackwell asks.

"I think it was a reasonable decision at the time," Swinson says.

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Image source, UK Covid-19 Inquiry

Hugo Keith KC has ended his questioning of Sir Christopher Wormald.

Now, Clara Swinson has been sworn in.

She heads up the DHSC’s Global Health division and has been in that position since 2016.

Swinson's questioning begins.

Hugo Keith KC briefly questioned Wormald again.

Keith says that when the department considered the impact of the pandemic on marginalised and vulnerable people in society the position they landed on was the impact would have different but clinical impacts, for example those with heart disease.

"Neither your department nor any pre-Covid exercise considered the issue of how a pandemic in reality or as part of a test would impact vulnerable people... other than insofar as they may be impacted clinically?" Keith poses.

Wormald says there was and still is a lot of thinking about the issues Keith points to, but "they were not thought of directly in the context of pandemic preparation."

We apologise for the loss of the live feed from the Covid inquiry.

We are working to get it back as soon as possible.

Please stay with us.

Baroness Hallett has returned to her seat and the inquiry gets underway again.

Sir Christopher Wormald is still being questioned by the counsel of the Inquiry, Hugo Keith KC.

Up next will be Clara Swinson, director general in the Department of Health and Social Care.

It is expected proceedings will end around 17:00.

Before the inquiry adjourned for a short break, Keith turned his attention back to Exercise Cygnus.

Exercise Cygnus was a cross-government exercise to test the UK's response to a serious influenza pandemic, that took place over three days in October 2016.

It concluded that the UK's preparedness and response in terms of its plans, policies and capability, were not sufficient to cope with the extreme demands of a severe pandemic.

Keith says that Wormald "must have been very concerned" over these findings.

Wormald says "I thought Cygnus had done its job properly," but he was concerned. "This was an area where I took specific meetings and reports in the follow up, in late 2017."

However, Keith says many work streams put into place after these findings were never finished.

"I think a lot of progress was made," Wormald rebuts.

The inquiry is adjourned now only until 15:55.

It will continue with further questions from Hugo Keith KC to Sir Chris Wormald.

Image source, PA Media

Keith now turns to the stockpile of PPE (personal protective equipment) prepared for an influenza pandemic, enough to last about three months.

"Was that a capability that was transferred to Covid, or did we run out?," he asks Wormald.

Wormald replied that is was transferred, as they used the pandemic stockpile that had been built up.

"We never nationally ran out of PPE. We were very short and we had significant logistical issues."

"The stockpile that we had built up was useful in the pandemic...it would have been much better were it to have been larger."

However, at this point chair of the Inquiry, Baroness Hallett, interrupts and says that medical professionals would be surprised to hear that we never nationally ran out of PPE.

Wormald says he chose his words very carefully: "There were huge pressures on PPE and we had, as I said, significant challenges getting PPE to the right place, so the department has never said and it would not be true to say that in individual places there were shortages of PPE.

"That's different from it having run out nationally."

Hugo Keith KC looks at the charts showing the risk and says that in 2019, on the eve of the pandemic, the risk picture changes.

“Because the chart now, top right hand corner, has the top arrow for possible catastrophic outcome of emerging infectious disease... above the reasonable worst case scenario,” he adds.

Sir Wormald replies, saying “That is a more accurate picture of risk than 2016. Clearly a high consequence infectious disease can be on the way to being a pandemic.”

Keith adds “Catastrophic in terms of massive fatalities, huge numbers of people infected, work absence - impact on the economy,” and Wormald agrees.

Image source, UK Covid-19 Inquiry