UK Covid-19 Inquiry, Modules 2, 2A, 2B, 2C: Core decision-making and political governance, Volume I · 2025
April 2020: Reviews of lockdown
April 2020: Reviews of lockdown
¶5.18. On 2 April 2020, the Scottish Government Resilience Room agreed to:
¶" [b]uild active rebuttal of the idea perpetuated by UKG [UK government] that
social distancing measures may be lifted at Easter into marketing campaigns and communications".39 INQ000233346_0001
¶It was anticipated that lockdown measures would need to be in place for at least two months to avoid a much higher peak. As such, the Scottish Government would work towards "the possibility of a different approach" from the UK government.40 INQ000233346_0002
¶5.19. On 4 April 2020, the First Ministers of Scotland and Wales and the First Minister and deputy First Minister of Northern Ireland wrote jointly to Mr Johnson in anticipation of "a further set of co-ordinated announcements on or around 13 April".41 INQ000256826_0001 They suggested a COBR meeting the following week to discuss the upcoming review of the lockdown, commenting that there was "no reason not to ensure an orderly process is established ahead of this predictable milestone".42 INQ000256826_0001 They also requested a:
221" transparent and collaborative approach to sharing and producing analysis, options appraisal, and papers for any COBR meeting next week".43 INQ000256826_0002
¶Regular four-nation meetings were yet to be established, but a COBR meeting was subsequently convened on 9 April.
¶5.20. On 5 April 2020, Dr Catherine Calderwood, Chief Medical Officer for Scotland from April 2015 to April 2020, resigned after making two trips to her second home during the lockdown.44 Nicola Sturgeon 31 January 2024 119/2-121/1; INQ000273978_0005 para 24 (The impact of alleged rule-breaking by advisers and decision-makers is examined in Chapter 11: Government decision-making, in Volume II.) Dr Calderwood was succeeded on an interim basis by Professor (later Sir) Gregor Smith, who had been Deputy Chief Medical Officer for Scotland from April 2015. His appointment was made permanent in December 2020.
¶5.21. That same day, Professors Whitty and Vallance shared a paper they had drafted on possible approaches to the next phases of the pandemic with the Cabinet Office and 10 Downing Street.45 INQ000148847 One of the paper's central conclusions was that variations of social distancing, possibly enhanced by "track and trace" and shielding the most vulnerable, were "the most realistic routes to controlling the effects of this epidemic".46 INQ000148847_0003-0004; see also INQ000238826_0104-0105 para 317 It also warned that, although vaccines or drugs might assist in the longer term:
" [T]hey will take time and should not be relied on as the easy way out. It is a policy choice whether to run R as low as it can be achieved … or running R as near to 1 as it can be managed within the boundaries the NHS can cope with. The latter would imply an ongoing significant direct COVID-19 mortality but potentially with less social damage and indirect mortality, and quicker although still lengthy exit from the epidemic as population immunity accumulates (assuming it does)."47 INQ000238826_0104-0105 para 317; INQ000148847
¶5.22. Also on 5 April 2020, Sir Mark Sedwill provided Mr Johnson with a paper concerning the next phase of the pandemic. It set out key questions in advance of the first review of the lockdown restrictions, as the government aimed to "navigate the country through the next few months and seek to turn the tide by early summer".48 INQ000182368_0001 para 1 It advised that it was necessary to consider whether it was now possible to allow the economy and society to recover:
222" some normalcy while also managing the immediate and subsequent peak public health risks".49 INQ000182368_0003 para 9
¶Sir Mark Sedwill advised that modelling from SAGE indicated that the first review of the lockdown restrictions at a COBR meeting in mid-April 2020 would be likely to coincide with the peak in deaths and pressure on the NHS. Therefore, that now might be "the wrong moment to contemplate any relaxation of the restrictions".50 INQ000182368_0004 para 15
¶However, since:
" the practical effect of the 'stay home' measures had exceeded the requirements set out by SAGE, notably on work in the workplace … [w]e could use the political theatre of the review to re-set the public narrative, and bring others like the mayors and DAs [devolved administrations] into alignment, by confirming that people should work safely in the workplace or outdoors if they cannot work from home."51 INQ000182368_0005 paras 16, 17
¶5.23. Mr Johnson was admitted to hospital later on 5 April 2020, having contracted Covid‑19.52 INQ000255836_0092 para 345 Following a deterioration in his condition, he was admitted to intensive care where he remained for several days.53 INQ000255836_0092 para 345 (Chapter 11: Government decision-making, in Volume II, examines the lack of leadership contingency arrangements in place when Mr Johnson was admitted to hospital.)
¶5.24. In Scotland, Nicola Sturgeon MSP, First Minister of Scotland from November 2014 to March 2023, led a 'deep dive' meeting into social distancing measures on 6 April 2020. The briefing paper said that it was "highly unlikely" that any easing of lockdown measures would be advised for COBR's mid-April review but demand was growing for "an exit strategy".54 INQ000233375_0006
¶5.25. On 7 April 2020, the Private Office at 10 Downing Street sent Dominic Raab MP, Secretary of State for Foreign and Commonwealth Affairs and First Secretary of State from July 2019 to September 2021 – who deputised for Mr Johnson while he was in hospital – a note ahead of the first review of the lockdown regulations.55 INQ000220042; 'Statement from Downing Street: 6 April 2020', Prime Minister's Office, 6 April 2020 (https://www.gov.uk/government/news/statement-from-downing-street-6-april-2020; INQ000182383) It stated that it was "not likely we'll recommend changing the social distancing measures immediately", given the review would potentially coincide with peak deaths.56 INQ000220042_0001 However, one possible exception to this concerned attendance at work, which was lower than had been anticipated due to compliance with the 'Stay Home' order. The note advised that Mr Raab might wish to "consider setting out a strategy for the months ahead for managing the spread and exit from the pandemic".57 INQ000220042_0001
¶5.26. A SAGE meeting held on the same day concluded that "there is no current evidence that transmission is accelerating; it may be slowing".58 INQ000061531
223¶5.27. SAGE advice on 9 April 2020 stated that the World Health Organization had "concluded there is currently no conclusive evidence that facemasks are beneficial for community use". However, SAGE advised that at its next meeting it would review a paper on the matter from the New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG).59 INQ000120504_0002 paras 12, 13
¶5.28. A COBR meeting was held on the afternoon of 9 April 2020, chaired by Mr Raab.60 INQ000268041 _0040-0041 para 132; INQ000083830_0001 Mark Drakeford MS, First Minister of Wales from December 2018 to March 2024, had spoken the previous day to Michael Gove MP (later Lord Gove), Chancellor of the Duchy of Lancaster from July 2019 to September 2021, Minister for the Cabinet Office from February 2020 to September 2021, but "no commitment was made by him to hold a further COBR meeting" at that time.61 INQ000273747_0023-0024 para 73 The devolved administrations therefore received less than 24 hours' notice of this meeting. The agenda contained three brief items: "1) Current situation update 2) Update on social distancing 3) Communications over Easter".62 INQ000061811
¶5.29. In the absence of any clarity about the purpose of the meeting, the First Ministers of Scotland, Wales and Northern Ireland, the deputy First Minister of Northern Ireland and the Mayor of London agreed a joint position of their own: that they "expect[ed] restrictions to remain in place for some weeks yet".63 INQ000256839_0001; INQ000256829 A paper presented at the meeting advised that public communications in advance of Easter should emphasise the importance of continued compliance with the lockdown. It also confirmed that restrictions were being kept under review and SAGE would meet the following week to assess their impact in light of further data becoming available.64 INQ000083787_0002 It was agreed that communications should set out the:
" need for continued compliance with social distancing measures, without raising expectations that the measures will be lifted the following week".65 INQ000083830_0004
¶5.30. On 10 April 2020, the Cabinet Office sent Mr Raab a note setting out the need for a medium-term strategy for the Covid-19 response.66 INQ000220051 It explained that a 12-month plan was needed for a "new normal" that balanced the health, social and economic impacts of the virus.67 INQ000220051 This required an integrated approach of interventions that best controlled the virus while allowing society to open up again – "not a simple trade- off" between health and economic considerations.68 INQ000220051 The note set out proposed programmes of work, including work on population segmentation, the development of new measures that better balanced health, social and economic impacts (described as 'smart' interventions) and support for vulnerable groups.
224¶5.31. A working group meeting of SAGE considered "'[t]he science of exit' from lockdown" on 10 April.69 INQ000309529_0039-0040 para 131; INQ000216188 On 14 April, this working group produced a paper on lockdown exit strategies. It compared the benefits and disbenefits of exiting lockdown at a time when there were low or high levels of Covid-19 infections circulating in the population.70 INQ000216188 The paper was subsequently discussed at meetings of this SAGE working group on 24 April and 27 April.71 INQ000216188; INQ000309529_0040 para 132
¶5.32. On 14 April 2020, SAGE advised that "[e]vidence does not currently support use of face masks to protect the wearer in the general population".72 INQ000061533_0004 para 15 It explained that the evidence that cloth face coverings could prevent spread was "weak, but probably marginally in favour of a small effect".73 INQ000061533_0004 paras 16, 18
The first review of the lockdown regulations
¶5.33. The first review of the lockdown regulations was due to take place by 16 April 2020 in England, Scotland and Wales and by 18 April in Northern Ireland. On 15 April, Mr Gove met with the devolved administrations and the Mayor of London. They agreed to aim for a single approach to lifting the restrictions as far as possible.74 INQ000198990; INQ000259848_0034 para 56 However, this was a decision for each government.
¶5.34. On 14 April 2020, the Scottish Government Covid-19 Advisory Group recommended to the Scottish Government that lockdown measures should be retained, advising that it would "not be possible (for the foreseeable future) to eradicate the virus" in Scotland and "[w]e therefore need to find ways of living with the virus".75 INQ000217506_0001; INQ000217503 The Scottish Government agreed to extend the lockdown for another three weeks.76 'Coronavirus (COVID-19) update: First Minister's speech 16 April 2020', Scottish Government, 16 April 2020 (https://www.gov.scot/publications/first-minister-covid-19-update-17; INQ000357360)
¶5.35. On the same day, the Scottish Cabinet observed that there "had been no discussion of when easing of the restrictions might begin" across the four nations but that detailed discussions were required.77 INQ000214644_0002 para 6 The Scottish Government Covid-19 Advisory Group had prepared a paper for the Scottish Government entitled Covid-19 Lockdown Exit Strategies, which considered a wide range of options for relaxing lockdown measures.78 INQ000352514; INQ000217505 The group identified the most promising approaches as being likely to involve a combination of: (i) active surveillance, contact tracing and quarantine; (ii) enhanced shielding of vulnerable groups; and (iii) innovative approaches to maintain and enhance social distancing.79 INQ000352514_0005 para 28 The Covid-19 Advisory Group noted that these measures would be reliant on increasing testing capacity to 16,000 tests per day and improving real-time data flows from the health and social care sectors.80 INQ000352514_0005 para 30
225¶5.36. In England, the Cabinet Office advised the UK government that lockdown restrictions should be maintained, given advice from SAGE that there was a risk that changing the restrictions might push R above 1.81 INQ000220052_0001 paras 1, 2; see also INQ000220054; INQ000109278 On 15 April 2020, the UK government ministerial 'Quad' – comprising Mr Raab, Mr Hancock, Mr Gove and Rishi Sunak MP, Chancellor of the Exchequer from February 2020 to July 2022 – agreed that the lockdown should continue for at least another three weeks in England.82 INQ000195907; INQ000220057 That decision was approved by the UK Cabinet the following day.83 INQ000089020_0009
¶5.37. The Northern Ireland Executive Committee considered the review on 15 April 2020.84 INQ000048455 A paper submitted by Mr Swann confirmed that case numbers were rising in Northern Ireland. It said that it could be safely assumed that the true number of cases was significantly higher than the number of confirmed cases.85 INQ000065643_0003 para 10 The Executive Committee concluded that restrictions should not be lifted at that time.86 INQ000048455
¶5.38. Internal Welsh Government legal advice on 11 April 2020 stated that ministers' reasons for ending lockdown would "need to be firmly rooted in public health considerations" and that other considerations such as the economy "should not be the primary focus".87 INQ000349314_0002 para 9 The advice said:
" There is merit in Ministers therefore seeking to ensure that in so far as is possible the approach to exit is similar (even if not identical) to that in England in particular to avoid unintended consequences for public health in Wales that could be impacted by a different approach to relaxation."88 INQ000349314_0003 para 13
¶On 14 April 2020, the Welsh Government received advice supported by Dr (later Sir)
¶Frank Atherton, Chief Medical Officer for Wales from August 2016, which recommended retention of the full package of requirements.89 INQ000145553 On 16 April, following discussions with ministers in the morning, Mr Drakeford confirmed that the restrictions would remain in force with some minor amendments in Wales.90 INQ000389184_0040-0041 paras 138-140; INQ000023238; INQ000361513
¶5.39. Subsequently, at a COBR meeting on 16 April 2020 chaired by Mr Raab, it was agreed that the lockdown should continue across the four nations for at least a further three weeks, until 7 May 2020.91 INQ000083827_0006, 0008-0009 Mr Raab announced this in a 10 Downing Street press conference later that day and set out five tests to be met before restrictions would be eased in England.92 'Foreign Secretary's statement on coronavirus (COVID-19): 16 April 2020', Foreign and Commonwealth Office, Prime Minister's Office and Dominic Raab, 16 April 2020 (https://www.gov.uk/government/speeches/foreign-secretarys-statement-on-coronavirus- covid-19-16-april-2020; INQ000086576_0004)
226¶Figure 15: Five tests for adjusting the lockdown, 16 April 2020
¶Source: INQ000651575
¶5.40. Professor Vallance told the Inquiry that SAGE was not asked to comment on the five tests set out by Mr Raab. However, the tests did reflect the issues SAGE had discussed and on which he and Professor Whitty had provided advice.93 INQ000238826_0105-0106 para 321
¶5.41. These tests did identify the broad direction of travel needed before restrictions could be eased. However, their lack of specificity – for example, "manageable levels" of infection rates were not defined – meant that it remained unclear how each of the tests would be measured.94 INQ000651575_0001
¶5.42. There had been concerns about supplies for the health services, in particular in relation to testing, bed and staff capacity, ventilators and personal protective equipment (PPE) since late March 2020.95 INQ000183916_0001; INQ000255836_0081 para 305; INQ000411550_0112 para 341 By mid-April 2020, Wales was at risk of running out of some items of PPE within two to four weeks.96 INQ000216598_0001 PPE shortages also continued in England throughout April.97 INQ000232194_0086 para 356; see also INQ000182367_0001 para 2 Mr Johnson subsequently appointed Paul Deighton, Lord Deighton, as 'PPE tsar', responsible for coordinating a "resilient PPE industry in the UK".98 'Olympics chief brought in to boost PPE production', Department of Health and Social Care and Matt Hancock, 19 April 2020 (https://www.gov.uk/government/news/olympics-chief-brought-in-to-boost-ppe-production; INQ000198247); INQ000232194_0086 para 357 The issue of the lack of PPE in hospitals and around the UK is being further explored in detail in Module 3: Impact of the Covid-19 pandemic on healthcare systems in the four nations of the UK and Module 5: Procurement.
227¶5.43. On 16 April 2020, SAGE agreed to produce revised advice on face coverings so they could be considered as a measure to be implemented as part of the easing of the lockdown.99 INQ000075780_0002-0003 paras 2, 23 It advised that evidence of their effectiveness beyond healthcare settings was weak but "marginally positive" and highlighted the risk of community use of face coverings threatening stocks for healthcare settings.100 INQ000075780_0003 para 24 On the same day, there was discussion in a WhatsApp group that included Mr Hancock and Professors Vallance and Whitty about requiring members of the public to wear a face covering, following public comments made by the Mayor of London. Mr Hancock said:
" WE DO NOT HAVE ENOUGH MASKS TO SAY THESE THINGS. Talking about this before we are ready risks taking masks from nurses and social care workers who really need them … we must hold the line on masks – or they will go like loo roll."101 INQ000102697_0033
Preparing for the second review
¶5.44. On 20 April 2020, Mr Drakeford wrote to Mr Gove stating that, depending upon scientific and medical advice, there might be an opportunity to consider easing restrictions at the next review point. He said:
" [ W]e should endeavour to work even more closely together to agree a common approach where that is possible and to assist appreciation of difference where that is necessary."102 INQ000216489_0001
¶Mr Drakeford also called for a "regular rhythm" of intergovernmental meetings, in which officials met early in the week, devolved administrations and the Mayor of
¶London met with Mr Gove in the middle of the week, and there was a COBR meeting at the end of the week.103 INQ000216489_0001 The issue of the intergovernmental relationships between the UK government and devolved administrations is addressed in detail in
¶Chapter 14: Intergovernmental working, in Volume II.
¶5.45. On 21 April 2020, SAGE advised that there was evidence to support the wearing of face coverings as a precautionary measure in higher-risk settings such as shops and transport where social distancing was not possible. Any decision to require members of the public to wear face coverings should not jeopardise the availability of masks for use in healthcare settings.104 INQ000061535_0004 paras 12, 14 It stated that the effect of wearing a face covering was "small but not zero".105 INQ000061535_0004 para 11
228¶5.46. On 22 April 2020, the UK government Quad discussed a draft strategy for the next phase of the Covid-19 response.106 INQ000182349; INQ000182350; INQ000182351 A few days earlier, Dominic Cummings, Adviser to the Prime Minister from July 2019 to November 2020, had sent an email to Cabinet Office officials informing them that Mr Johnson wanted Mr Raab to take the Quad through an "Escape Plan paper".107 INQ000048313_0018 para 3 Drafting was to be worked up that week which Mr Johnson would subsequently review.108 INQ000048313_0018 para 3 This resulted in proposals, developed by the Cabinet Office C19 Strategy Unit, to moderate lockdown restrictions, including prioritising getting people back to work and reopening schools and non-essential retail when easing the lockdown.109 INQ000182353 The Quad approved the advice.110 INQ000182367_0001 para 1
¶5.47. Mr Johnson was still recovering from Covid-19 and did not attend the Quad meeting.111 INQ000249543 However, Sir Mark Sedwill sent the papers considered by the Quad to Mr Johnson as he had requested. He also sent an advice note to Mr Johnson in which he detailed that the papers set out strategic choices for the easing of the lockdown and that they had been reviewed and approved by Mr Raab and "key senior ministers".112 INQ000250229_0033 para 124; INQ000182367 New operating models were being developed for workplaces, schools, transport, and public and recreational spaces.113 INQ000182367_0002 para 6 Sir Mark Sedwill identified schools as "the trickiest issue", with the key question being "whether to re-open (some) schools after Whitsun half-term or keep them all closed until September" – SAGE having advised that "full re-opening would likely tip R back above 1".114 INQ000182367_0002 para 8 One significant question posed was whether, in easing the lockdown restrictions, the UK government should:
" target low general incidence, which requires R to stay well below 1, or low serious incidence, i.e. minimise the number of those who have a dangerous not just unpleasant bout [of Covid-19]".115 INQ000182367_0002 para 5
¶Sir Mark Sedwill advised that making a choice about the level of incidence might affect decisions about the speed and prioritisation of easing the lockdown restrictions.116 INQ000182367_0002 para 5
¶5.48. On 23 April 2020, testing was extended to all essential workers in England and members of their households showing symptoms.117 'Coronavirus testing extended to all essential workers in England who have symptoms', Department of Health and Social Care, 23 April 2020 (https://www.gov.uk/government/news/coronavirus-testing-extended-to-all-essential-workers-in-england-who-have- symptoms; INQ000497452)
229¶5.49. On 23 April 2020, the Scottish Government published COVID-19 – A Framework for Decision Making.118 COVID-19 – A Framework for Decision Making, Scottish Government, 23 April 2020 (https://www.gov.scot/publications/coronavirus-covid-19-framework-decision-making; INQ000369689) This framework recognised four harms that emanated from the virus:
-
¶
- Harm 1: Direct harm to health as a result of Covid-19.
- Harm 2: The wider impact on health and social care services – including how people used the services – and the postponement of other care and treatment in mobilising the health and social care services in response to Covid-19.
- Harm 3: Societal harm and harm to a broader way of living.
- Harm 4: Economic harm.119 COVID-19 – A Framework for Decision Making, Scottish Government, 23 April 2020 (https://www.gov.scot/publications/coronavirus-covid-19-framework-decision-making; INQ000369689)
¶This framework was intended to be integral to the Scottish Government's decisionmaking through the pandemic. On the same day, Ms Sturgeon also said that the lifting of restrictions in Scotland was "likely to be phased", with some measures remaining in place until 2021 "or beyond".120 'Lifting of Scottish coronavirus lockdown "likely to be phased"', BBC News, 23 April 2020 (https://www.bbc.co.uk/news/uk- scotland-52394685; INQ000357796); 'Looking beyond lockdown', Scottish Government, 23 April 2020 (https://www.gov.scot/news/looking-beyond-lockdown; INQ000369715)
¶5.50. The Welsh Government published Leading Wales out of the Coronavirus Pandemic: A Framework for Recovery on 24 April 2020.121 Leading Wales out of the Coronavirus Pandemic: A Framework for Recovery, Welsh Government, April 2020 (https://www.gov.wales/sites/default/files/publications/2020-04/leading-wales-out-of-the-coronavirus-pandemic.pdf; INQ000349353) Work had commenced on the framework in early April.122 INQ000215197; INQ000215196 Mr Drakeford said that this framework "formed the basis for the 21-day reviews that were carried out by Cabinet from 7 May onwards".123 INQ000371209_0047-0048 para 154 It summarised the Welsh Government's approach to lifting restrictions in line with three pillars: (i) how the government would judge the current infection level and transmission rates; (ii) the seven principles that would guide the easing of restrictions (including whether the measure had a "high positive equality impact"); and (iii) how its public health surveillance and response systems would be enhanced to "closely track the virus as restrictions are eased".124 Leading Wales out of the Coronavirus Pandemic: A Framework for Recovery, Welsh Government, April 2020, p7 (https://www.gov.wales/sites/default/files/publications/2020-04/leading-wales-out-of-the-coronavirus-pandemic.pdf; INQ000349353) It outlined the four ways in which the Welsh Government understood that harms could be caused by the virus. These were: (i) direct harm from infection; (ii) harm caused if services, including the NHS, became overwhelmed; (iii) harms from non-Covid-19 illness; and (iv) socio-economic and other societal harms.
¶5.51. Having been informed that the peak of deaths per day had occurred on 15 April 2020 and that deaths were starting to decrease, the Northern Ireland Executive agreed on 24 April to permit the first easing of restrictions to allow access to burial grounds for purposes other than funerals.125 INQ000065751_0016-0021; INQ000048459 A few days earlier, officials had discussed seeking agreement "on a series of tests or principles which will need to apply before any relaxation can begin".126 INQ000317372_0001
230¶5.52. On 27 April 2020, Professor Ian Young, Chief Scientific Adviser to the Department of Health (Northern Ireland) from November 2015, established the Strategic Intelligence Group. This group was to synthesise information from SAGE and produce regular analysis specific to Northern Ireland.127 Ian Young 7 May 2024 132/11-133/20; INQ000409589_0016-0017 para 47
¶5.53. In a bilateral meeting with the Secretary of State for Northern Ireland on 28 April 2020, it was recorded that Michelle O'Neill MLA, deputy First Minister of Northern Ireland from January 2020 to February 2022:
" updated that the NI Executive was beginning to consider post-COVID environment with a focus on recovery planning".128 INQ000232549_0002
¶Arlene Foster MLA (later Baroness Foster of Aghadrumsee), First Minister of
¶Northern Ireland from January 2016 to January 2017 and from January 2020 to June
¶2021, is recorded as having:
" noted that other devolved regions had issued recovery plans but NI has yet to do so, reinforcing the importance of regular early engagement and advance warning of HMG [the UK government] direction of travel".129 INQ000232549_0002
¶5.54. In Northern Ireland, more than 1,000 tests were carried out on 23 April 2020.130 INQ000273024_0002 para 2 The Scottish Government's target was 3,500 daily tests by the end of April and, by 28 April, it was considered that the target was on course to be met.131 INQ000214575_0003 para 10 On 21 March 2020, Wales had set a target of 9,000 tests a day by the end of April. However, this was abandoned on 20 April.132 INQ000391237_0122-0123 para 469 By 23 April, Wales had the capacity for only 1,800 tests a day.133 INQ000222807_0001 Mr Hancock had set a target of scaling up testing to 100,000 tests a day in England by the end of April. While Module 7: Test, trace and isolate is exploring whether this target was met, it is clear that testing capacity was significantly expanded during April.134 INQ000283921_0005
¶5.55. A meeting of the Covid-19 Strategy Ministerial Group on 30 April 2020 discussed the UK government's plans to scale up test and trace through the use of an app. Mr Hancock explained that the app would work best when "the overall number of cases was relatively small".135 INQ000088694_0007
231¶5.56. Despite the acknowledgement that incidence needed to be low for test and trace to work effectively, the UK government did not explicitly make a decision about whether to ease restrictions in a low-incidence or high-incidence scenario. The consequence was that the government ultimately eased restrictions without defining a level of Covid-19 deaths that it was prepared to tolerate to enable restrictions to be eased without access to a vaccine or medical treatments.
¶5.57. Professor McLean explained that the SAGE working group's "general consensus was that low incidence was preferable" when easing restrictions and implementing an effective test and trace system, given immunity might not be long lasting and to avoid test and trace systems being overwhelmed by new cases.136 INQ000309529_0040 para 135; INQ000061546_0002, 0003, 0006 paras 3, 21, 31 She further explained:
" [T]he strategy that the [UK] government in fact adopted post lockdown was to keep R below 1, without taking a view about how many infections were tolerable … Without a commitment to a target level of infections, the aim of keeping below 1 [was] only half a strategy."137 INQ000309529_0041 para 136
¶She said it was only "half a strategy" because setting a target for R was not the only relevant strategic consideration. Identifying a level of infections that the UK government did not wish to be exceeded when restrictions were eased was also a critical strategic consideration. This is due to the fact that the higher the number of infections in the population, the higher the number of deaths – even if R remains below 1. For example, the number of deaths would be much higher if the number of infections in the population was 1 million as opposed to 100, even where R is below 1 in both scenarios.
¶5.58. On 27 April 2020, Mr Johnson returned to work fully. The next day, Mr Drakeford wrote to him outlining that the Welsh Government had now published Leading Wales out of the Coronavirus Pandemic: A Framework for Recovery and stated his preference that the steps taken to ease elements of the lockdown would be agreed together and implemented in line with a "common timetable".138 Leading Wales out of the Coronavirus Pandemic: A Framework for Recovery, Welsh Government, April 2020 (https://www.gov. wales/sites/default/files/publications/2020-04/leading-wales-out-of-the-coronavirus-pandemic.pdf; INQ000349353); INQ000256845_0001; see also INQ000255836_0092, 0097 paras 345, 362 This reflected the Welsh Government's framework, which stated:
" The whole of the UK entered 'lockdown' in the same ways and at the same time, and our preference as a government would be that all four nations retain a common approach to lifting the restrictions."139 Leading Wales out of the Coronavirus Pandemic: A Framework for Recovery, Welsh Government, April 2020, p3 (https://www.gov.wales/sites/default/files/publications/2020-04/leading-wales-out-of-the-coronavirus-pandemic.pdf; INQ000349353)
¶5.59. Mr Johnson subsequently announced on 30 April 2020 that there would be a comprehensive plan set out the following week to restart the economy, reopen schools and for travel to work in England.140 'Coronavirus: Boris Johnson says UK is past the peak of outbreak', BBC News, 30 April 2020 (https://www.bbc.co.uk/news/uk-52493500; INQ000573837) Mr Drakeford said this was "without consultation with the Welsh Government".141 INQ000273747_0026-0027 para 82
232The risk of an exit wave
¶5.60. Each government was advised about the risk of an exit wave occurring once the lockdown restrictions were lifted, particularly if they were lifted too quickly and at a point at which cases were too high to be controlled by test, trace and isolate capacity. Any exit strategy was obliged to take account of this risk.
¶5.61. A Cabinet Secretariat briefing for COBR dated 6 March 2020 had advised that an exit wave was likely to occur if stringent restrictions were implemented and then lifted.142 INQ000151558_0003 SAGE had provided advice about the risk of an exit wave on 13 March 2020 and Professor Vallance had raised this directly with Mr Johnson on 14 March.143 INQ000236391_0002 para 24; INQ000048399_0003 Indeed, the risk of an exit wave occurring after stringent restrictions were lifted was a critical factor in the reluctance to impose a lockdown in the first place (see Chapter 3: The first 12 days of March 2020, in this volume). Scientific advisers continued to voice these concerns in the context of easing the first UK-wide lockdown restrictions. A few days later, on 2 April 2020, SAGE advised:
" There is a danger that lifting measures too early could cause a second wave of exponential epidemic growth — requiring measures to be re-imposed."144 INQ000120503_0002 para 4
¶5.62. On 6 April 2020, in Scotland, a briefing paper prepared for the deep dive meeting into social distancing measures recommended:
" Work on post-peak choices is needed to influence that debate away from simplistic 'exit' solutions that risk a massive second peak."145 INQ000233375_0006
¶5.63. Scottish Cabinet minutes dated 14 April 2020 recorded:
" Any move away from the current 'lockdown' regime, even partial, should be introduced with great caution. A gradual and systematic relaxation of social distancing would need to go hand-in-hand with a rigorous 'track, trace, and isolate' model, whenever new cases were identified, so as to guard against a new 'second wave' of infection spreading back into the community."146 INQ000214644_0003 para 7(a)
¶5.64. In Wales, the Technical Advisory Cell's Chief Medical Officer briefing on 31 March 2020 advised that a "second wave is likely if controls are relaxed too early, SAGE will now focus on this".147 INQ000299989_0003 The Welsh Government's framework specifically addressed the risk of a second wave, stating:
233" We will not do anything without being as sure as we possibly can be that we do not risk a second significant wave of infection, and therefore have to reintroduce some restrictions."148 Leading Wales out of the Coronavirus Pandemic: A Framework for Recovery, Welsh Government, April 2020, p2 (https://www.gov.wales/sites/default/files/publications/2020-04/leading-wales-out-of-the-coronavirus-pandemic.pdf; INQ000349353)
¶5.65. At the time of the initial relaxation of restrictions in Northern Ireland, the Northern Ireland Executive Committee did not yet have an overarching strategy for its decision-making. The decision to relax restrictions relating to burial grounds appears to have been triggered at the request of individual ministers, rather than as the result of a strategic approach. Nevertheless, it is clear that, in considering that decision, the Executive Committee did take into consideration the potential impact upon transmission and the possibility of a second wave of infections in the autumn.149 INQ000065751_0005-0009 Professor Young advised in his first modelling paper dated 1 April 2020 that there would be an exit wave when restrictions were relaxed.150 INQ000137369; Ian Young 7 May 2024 160/15-23 The Executive Committee was also advised on 15 April that it would be necessary:
" to plan for a potential second wave of Covid-19 cases later in the year, and possibly further waves, once restrictions are eased or lifted and normal life gradually resumes".151 INQ000065643_0003 para 12
¶At the Executive Committee meeting of 24 April, Professor (later Sir) Michael
¶McBride, Chief Medical Officer for Northern Ireland from September 2006, commented that tracking and testing would be "crucially important" in order to avoid a second wave.152 INQ000065751_0009
Developments in surveillance data
234" only country in the world that had a robust estimate of the number of infections at any point in time".155 INQ000269182_0047 para 174; see also INQ000147810_0029-0030 para 90.
¶From May 2020, the Real-time Assessment of Community Transmission (REACT) study measured the prevalence of Covid-19 in different areas of England – including in people who did not have any symptoms – and provided consistent, representative data on Covid-19 positivity in the community.156 Technical Report on the COVID-19 Pandemic in the UK, Department of Health and Social Care, 1 December 2022, p126, p159 point 4 (https://www.gov.uk/government/publications/technical-report-on-the-covid-19-pandemic-in-the-uk; INQ000101642) While both the Coronavirus (Covid-19) Infection Survey and REACT captured useful data for use in the pandemic, they started too late.157 The critical role of surveillance studies, including the Coronavirus (Covid-19) Infection Survey and REACT, was emphasised in the Technical Report on the Covid-19 Pandemic in the UK, Department of Health and Social Care, 1 December 2022, p87 (https://www.gov.uk/government/publications/technical-report-on-the-covid-19-pandemic-in-the-uk; INQ000101642).