Preparing for a pandemic (war footing)

SAGE (Scientific Advisory Group for Emergencies) meeting on Wuhan Coronavirus (COVID 19) 22 January 2020

Current understanding of Wuhan Coronavirus (COVID 19).

There is evidence of person-to-person transmission. It is unknown whether transmission is sustainable.

The incubation period is unclear – but appears to be within 5 to 10 days: 14 days after contact is a sensible outer limit to use.

It is highly probable that the reproductive number is currently above 1.

It is currently estimated that the mortality rate for WN-CoV is lower than for SARS, but it is too early to reliably quantify that rate.

There is no evidence yet on whether individuals are infectious prior to showing symptoms.

COBRA (Civil Contingencies Committee) 24 January 2020

The meeting was told a silent and stealthy killer was creeping across the world. Passing from person to person and borne on ships and planes, the coronavirus was already leaving a trail of bodies.

The virus had spread from China to six countries and was almost certainly in many others. Sensing the coming danger, the British government briefly went into wartime mode that day, holding a meeting of Cobra, its national crisis committee.

But it took just an hour, that lunchtime, to brush aside the coronavirus threat. Matt Hancock, the health secretary, bounced out of Whitehall after chairing the meeting and breezily told reporters the risk to the UK public was “low”.

Third SAGE meeting on Wuhan Coronavirus (WN-CoV), 3 February 2020

On the expected impact of travel restrictions, SAGE estimates – with limited data – that if the UK reduces imported infections by 50%, this would maybe delay the onset of any

epidemic in the UK by about 5 days; 75% would maybe buy 10 additional days; 90% maybe buys 15 additional days; 95%+ maybe buys a month.

Only a month of additional preparation time for the NHS would be meaningful. It would also be meaningful if the outbreak were pushed out of usual winter respiratory season.

Boris Johnson skipped multiple emergency meetings on the coronavirus in January and February 2020 as it spread rapidly across the world.

By the time Johnson appeared at the first Cobra meeting to discuss the virus on 3 March 2020, more than 40 people had already tested positive for COVID-19.

The report also claimed that the government failed to act on warnings from scientists about the virus.

Boris Johnson skipped five Cobra meetings on the virus, calls to order protective gear were ignored and scientists’ warnings fell on deaf ears. Failings in February 2020 may have cost thousands of lives.

SAGE meeting dealing with covid 19 (May 2020)

Attendees; Five Sirs, Thirty-five Professors, Fifteen Doctors and one Mister.

The meeting noted that it is currently hard to interpret the biological consequences of sequence variations in the virus — but acknowledged the ramifications of mutation and virus recombination in areas such as diagnostics and vaccines.

The meeting agreed that the biology of the virus should be the focus of an open research call.

COBRA meetings & comments where Covid 19 was discussed

In 2020, COBRA met 20 times to discuss the Covid-19 pandemic, first meeting in January 2020, before any cases had been recorded in the UK. It met 15 times from January to May but did not meet at all between 10 May and 22 September. 

The prime minister, Boris Johnson, did not attend the first five Covid-related COBRA meetings in January and February 2020. While Boris Johnson was ill with Covid in late March/early April 2020, Foreign Secretary Dominic Raab chaired COBRA in his place. Michael Gove, minister for the Cabinet Office and chancellor of the duchy of Lancaster, has also on occasion chaired COBRA meetings, mostly during the second wave of Covid-19 which started in September.

One SAGE member described COBRA as a “void of decision making” at the centre of government. In the early stages of the crisis, it was not always clear to officials who was taking which decisions. And COBRA was not supported to commission specific pieces of scientific analysis from SAGE, meaning the scientific advisers were unable to provide useful answers.

SAGE meetings & comments where Covid 19 was discussed.

Decision making in a crisis Published: 01 September 2020

The government’s initial response to the Covid-19 crisis was hampered by the absence of a long-term strategy, lack of clarity about who was responsible for what and its poor use of evidence.

Covid crisis mistakes will be repeated unless government improves use of science advice Published: 18 December 2020

Event 201 (18 October 2019) New York USA.

The Johns Hopkins Center for Health Security in partnership with the World Economic Forum and the Bill and Melinda Gates Foundation hosted Event 201, a high-level pandemic exercise, in New York, NY. The exercise illustrated areas where public/private partnerships will be necessary during the response to a severe pandemic to diminish large-scale economic and societal consequences.

In recent years, the world has seen a growing number of epidemic events, amounting to approximately 200 events annually. These events are increasing, and they are disruptive to health, economies, and society. Managing these events already strains global capacity, even absent a pandemic threat. Experts agree that it is only a matter of time before one of these epidemics becomes global—a pandemic with potentially catastrophic consequences. A severe pandemic, which becomes “Event 201,” would require reliable cooperation among several industries, national governments, and key international institutions.

As an independent monitoring and advocacy body, the Global Preparedness Monitoring Board (hereafter referred to as the Board or GPMB) urges political action to prepare for and mitigate the effects of global health emergencies. Co convened in May 2018 by the World Bank Group and the World Health Organization, the Board builds on the work of the Global Health Crises Task Force and Panel, created by the United Nations Secretary-General in the wake of the 2014-2016 Ebola epidemic. The Board works independently of all parties, including its co-conveners, to provide the frankest assessments and recommendations possible.

And we must not forget

The New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG) is an advisory body that advises the United Kingdom Government’s Chief Medical Advisor / Chief Medical Officer for England, who in turn advises the UK Department of Health and Social Care and relevant ministers regarding threats from viral respiratory tract infections. The body replaced the UK Scientific Pandemic Influenza Advisory Committee (SPI).

And

The Advisory Committee on Dangerous Pathogens (ACDP) is a UK-wide advisory committee. It was established in 1981, and the terms of reference were revised in 1991 to allow for a wider remit.

Runcorn Shopping City a taste of the Future

Halton Borough Council and Warrington and Halton Teaching Hospitals (WHH) are creating a new Health Hub at nearby Runcorn Shopping City.  From this hub, WHH is planning to offer Ophthalmology, Audiology, and Dietetics outpatient appointments.

Offering these services in a retail environment will make it easier for patients to access these services, some of which will be expanded to offer a greater range of tests. Halton residents will no longer have to travel out of the borough to receive care.

As well as being more convenient for patients, the proposed move reduces the risk of having to enter a hospital environment during the COVID-19 pandemic, especially important for the most vulnerable and those with long term conditions.

Audiology and Ophthalmology would move just 300 meters from Halton Hospital’s outpatients to the Shopping City while Dietetics would move from St Paul’s Health Centre, a distance of 3.5km, served by public transport.

Current staff would relocate with their services and there will be no change to staffing levels.   The vacated space at Halton Hospital will be reallocated to clinically appropriate services – either those that require additional space or those that are relocating from Warrington, in line with the Trust’s plan of expanding and further developing Halton as its dedicated elective site – much of which is already underway as a result of the COVID-19 pandemic.

Back to the Future (1984)Widnes for Widnes- ions and Runcorn for Runcorn-ions.

Under the proposals, which could take effect from 2023, the electoral constituency of Halton – which is currently held by Labour’s Derek Twigg – would disappear altogether and be replaced by a new constituency of Widnes and Halewood.

The constituency of Weaver Vale – which includes parts of east Runcorn and is currently held by Labour’s Mike Amesbury, would also disappear, with part of it forming a new Runcorn and Helsby constituency.