17 March 2020
¶4.95. On the morning of 17 March 2020, Mr Cummings informed Mr Johnson that further restrictions might be necessary to avoid the collapse of the NHS in England:
" We may have to close schools and order full curfew in London within days I think or else Italy collapse."217 INQ000048313_0009
¶4.96. At 10:30, Mr Johnson informed the UK Cabinet of the restrictions that he had announced the previous day.218 INQ000056135_0004 He also explained that people occupying beds in hospitals who would otherwise be in social care should be supported to leave hospital to free up capacity.219 INQ000056135_0011 That same day, Sir Simon Stevens instructed NHS England to "urgently discharge all hospital inpatients who are medically fit to leave" in order to free up 30,000 or more beds.220 INQ000087317_0002 Sir Simon Stevens also advised that trusts should assume that they would need to postpone all non-urgent elective operations from 15 April 2020 for at least three months.221 INQ000087317_0002
178¶4.97. Steps were also being taken to increase NHS capacity in Scotland on 17 March 2020. NHS Scotland was placed on an emergency footing in order to double intensive care unit capacity and increase NHS bed capacity from 13,000 to 16,000.222 'Coronavirus (COVID-19): speech by Cabinet Secretary for Health and Sport 17 March 2020', Scottish Government, 17 March 2020 (https://www.gov.scot/publications/coronavirus-covid-19-update-scottish-parliament; INQ000357367) Non-urgent elective operations would also be suspended and steps taken to increase NHS staff capacity.223 INQ000273984_0023-0024 para 101
¶4.98. The Scottish Cabinet also met that day. It agreed that managing the response to the virus should now be the Scottish Government's central objective.224 INQ000362664_0002 para 6 Ms Sturgeon told the Scottish Cabinet:
" [F]ar more stringent steps would now be required in order to suppress (as far as possible) the spread of the virus, to protect and allow time for the scaling up of the capacity of the NHS, and – ultimately – to save as many lives as possible."225 INQ000362664_0002 para 3
¶She also explained that the measures announced the previous day "were not necessarily the end point".226 INQ000362664_0002 para 4
¶4.99. Dr Calderwood explained that Scotland was "probably only days behind England in the spread of infection" and that if the clear messaging about limiting social contact proved ineffective "action would be taken to move to compulsory measures".227 INQ000362664_0003-0004 paras 13-14 She informed the Scottish Cabinet that the significant increase in cases in London was "one of the major factors" that had led to the decision to put in place further restrictions on 16 March 2020.228 INQ000362664_0003 para 13 She explained that "a 'zoned' response in different parts of the UK had been assessed as unsafe, given the risk of confusion over mixed messages".229 INQ000362664_0003 para 13
¶4.100. Dr Calderwood noted that a reduction in social contact by 75% "could have a significant impact on the outbreak and contribute to keeping the 'peak' level within the capacity of the NHS".230 INQ000362664_0004 para 14 Dr Calderwood advised that:
" [d]istancing measures would need to last for at least three to four months to be effective, and it would be vital to maintain public trust by being open with people about this from the outset, rather than suggesting that things would improve in a matter of weeks – which they would not".231 INQ000362664_0004 para 14
¶4.101. In Northern Ireland, in an email to David Sterling (later Sir David Sterling), Head of the Northern Ireland Civil Service and Permanent Secretary to The Executive Office from June 2017 to August 2020, and other senior civil servants, Karen Pearson (Director of Covid-19 Strategy and Recovery, Civil Contingencies and Programme for Government at The Executive Office from March 2020) mapped out a potential executive strategy and action plan.232 INQ000309139 Ms Pearson explained that her:
179" thinking was that co-ordinated effort across Departments, in a way which assisted Executive decision-making and monitoring would be essential".233 INQ000438173_0005 para 18
¶Dashboard 04:17 March 2020 Estimated population infected: 30,000–40,000 (awaiting SAGE confirmation) Total confirmed cases UK: 1,950 (1,557 in England, 195 in Scotland, 136 in Wales and 62 in Northern Ireland) Deaths: 74 (71 in England, 2 in Scotland, 1 in Wales and 0 in Northern Ireland) Number of tests carried out: 41,953 Source: INQ000055918_0003