UK Covid-19 Inquiry, Modules 2, 2A, 2B, 2C: Core decision-making and political governance · 2025
Complexity and change
Complexity and change
¶12.42. Professor Halpern told the Inquiry that a study by the Behavioural Insights Team for the Department of Health and Social Care found that:
" The public were very confused. The rules were getting more complicated. They were struggling to remember what they were. They might not know which tier they're in, and so we would test this. We were testing it periodically and many of the public didn't really understand the rules, and this in some ways got worse and worse."79 David Halpern 1 November 2023 186/1-7; INQ000591905
¶12.43. A good example of this is demonstrated by the various systems of tiers, levels and alert levels, which operated differently in each nation and were subject to frequent change, as outlined in Chapter 6: The second wave, Chapter 7: Further lockdowns and Chapter 8: Learning to live with Covid-19, in Volume I. On 12 October 2020, the
171¶UK government announced a system of tiered restrictions.80 'Prime Minister announces new local COVID alert levels', Prime Minister's Office, 12 October 2020 (https://www.gov.uk/government/news/prime-minister-announces-new-local-covid-alert-levels; INQ000137280_0002-0007) By the end of 2020,
¶Scotland and Wales had their own similar systems (with different names: 'levels' in Scotland and 'alert levels' in Wales).81 A nationwide system of tiers or levels was not adopted in Northern Ireland. When the system was first introduced in England and Scotland, different tiers and levels were applied to targeted geographical areas depending on the stringency of the response in those areas.
¶In Wales, alert levels, when applied, covered the entirety of the nation.82 Coronavirus Control Plan: Alert Levels in Wales – A Guide to Restrictions, Welsh Government, December 2020, p4 (https://www.gov.wales/sites/default/files/publications/2020-12/coronavirus-control-plan-alert-levels-in-wales.pdf; INQ000227576); INQ000255836_0142-0143 paras 510-512 (tiers in local areas of England); INQ000339033_0124 para 347 (Scotland local levels)
¶12.44. Similarly, as set out in Chapter 6: The second wave, in Volume I, the 'rule of six' operated differently in each nation. The least stringent restriction was in England, where people were prohibited from meeting socially in groups of more than six.83 INQ000086845_0003 In Scotland and Wales, the differing restrictions were based upon the number of households, with younger children excluded.84 'Maximum gathering set at six people from two households', Scottish Government, 10 September 2020 (https://www.gov.scot/ news/maximum-gathering-set-at-six-people-from-two-households; INQ000651573); 'Written Statement: Review of the Health Protection (Coronavirus Restrictions) (No. 2) (Wales) Regulations 2020', Mark Drakeford, First Minister, Welsh Government, 11 September 2020 (https://www.gov.wales/written-statement-review-health-protection-coronavirus-restrictions-no-2-wales- regulations-2020-1; INQ000023258) These differing systems were complex to understand, and they posed particular problems for the many people in the UK who lived and worked across its internal borders.
¶12.45. In Professor Halpern's view, this complexity strengthened the case for communications that focused on underlying principles and risks – particularly when, as with the various systems of tiers, levels and alert levels, the "rules are likely to have to flex and change".85 INQ000188738_0049-0050 para 197
¶12.46. The Inquiry also heard evidence from Professor Ann John (Clinical Professor of Public Health and Psychiatry at Swansea University and Co-Chair of SPI-B) regarding the importance of communicating uncertainty in public health messaging. Professor John stated:
" In a pandemic, work is undertaken at a far more rapid pace, necessitated by the need for a rapid response. While it is better to communicate uncertainty in the evolving scientific position, because it avoids later claims of engaging in 'U-turns,' I can understand why politicians may want to communicate certainties in order to make people feel safe."86 INQ000286066_0038-0039 para 7.5
¶Professor John explained that perceptions of U-turns are significant because they can possibly lead to reduced adherence to any measures adopted. Providing explanations that are fully reasoned would avoid changes in response being viewed as U-turns.87 INQ000286066_0038 para 7.2
172¶12.47. Advisers to the Welsh Government appreciated the need to communicate clear expectations of behaviour to the public. In a Welsh Cabinet paper dated 19 November 2020, it was noted that the Keep Wales Safe (Diogelu Cymru) slogan was an "overarching simple, inclusive message that represents the collective effort of the people of Wales".88 INQ000048999_0005 However, the new Wales-wide rules introduced following the 'firebreak' lockdown in October and November 2020 were accompanied by a new "behaviour change campaign"89 INQ000048999_0005 and adopted a change in emphasis, which:
" asked the public to consider not just what they can and can't do, but to ask themselves what they should be doing".90 INQ000048999_0005
¶12.49. The Inquiry recognises the difficulties that existed in clearly communicating the uncertainty, and complexity, of the scientific information in such a fast-developing pandemic, with a novel virus. In such emergencies, it is inevitable that there will be changes in approach that will need to be communicated to the public. When doing so, such communications should be transparent as to the fact of the change and should include – together with the explanation of any new measures – an explanation of the rationale for the change.
¶12.50. For communications to be more effective, risks must be explained. However, these risks should be set in the context of the ways in which they can be mitigated. In future, the UK government and devolved administrations should provide simple, transparent messaging that communicates:
-
¶
- the risks that exist;
- the strategy for addressing those risks; and
- the behavioural changes that are required to pursue that strategy.
¶12.51. Whereas the UK government and devolved administrations largely adopted an 'authoritarian' approach – communicating highly specific rules, such as the rule of six – some other governments promoted 'authoritative' messages that set out key principles and risks without being overly prescriptive. In Japan's case, this authoritative approach was based around the 'Three Cs' of avoiding closed spaces, crowded places and close-contact settings, without strictly defining what would qualify as, for example, a 'crowded place'.92 INQ000188738_0046-0047 paras 188-189
173¶Figure 45: 'Avoid the Three Cs'
¶Source: Extract from 'Avoiding the Three Cs: A Key to Preventing the Spread of COVID-19', Government of Japan, Health and Welfare, 24 December 2020 (https://www.japan.go.jp/kizuna/2020/avoiding_the_three_cs.html; INQ000591892)
¶12.52. As Professor (later Sir) Jonathan Van-Tam (Deputy Chief Medical Officer for England from October 2017 to March 2022) suggested in mid-June 2020, when he forwarded examples to the Cabinet Office's COVID Communications Hub of how the Japanese government communicated its Three Cs:
" I really think people now need to be told that with our new found freedoms these (attached) are still the main risk factors. I think we should unashamedly copy the Japanese who have done very well."93 INQ000269203_0141 para 13.9
¶12.53. A principles-based approach, akin to the one used in Japan, would be an effective way to achieve this type of communication. However, this is only likely to be possible if the regulations and guidance are themselves simpler and (as far as possible) change less frequently than they did during the Covid-19 pandemic. The impact of the frequent changes to public health regulations is considered in Chapter 13: Legislation and enforcement, in this volume.
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