November and early December 2020

November and early December 2020

¶6.238. Three of the four nations were in a form of lockdown in early November 2020. Unlike the rest of the UK, Scotland did not have a lockdown or other circuit breaker during this period. Although the test positivity rate and the number of deaths rose in Scotland, it did so at a more gradual rate than in England and Wales. The number of cases in Scotland never reached the peaks experienced in the rest of the UK around this time. Scotland continued to rely on local restrictions through the five-levels system.

¶6.239. On 17 November 2020, Ms Sturgeon announced Level 4 restrictions in 11 local authorities in Central Scotland and the West of Scotland, to give the "best possible chance" of being able to ease the restrictions for all of Scotland over the Christmas season.⁵²⁶⁵²⁶ 'Coronavirus (COVID-19) update: First Minister's statement Tuesday 17 November 2020', Scottish Government, 17 November 2020 (https://www.gov.scot/publications/coronavirus-covid-19-update-first-ministers-statement-tuesday-17-november-2020; INQ000354350); 'Covid in Scotland: Level 4 move "could help ease rules at Christmas"', BBC News, 16 November 2020 (https://www.bbc.co.uk/news/uk-scotland-54960028; INQ000357587)Show full note Some 2.3 million people were placed under the highest level of restrictions, under which non-essential shops, pubs and restaurants would close, but schools would remain open. People were not permitted to meet indoors, but up to six people from two households could still meet outdoors.⁵²⁷⁵²⁷ COVID-19: Scotland's Strategic Framework, Scottish Government, October 2020, pp58-69 (https://www.gov.scot/publications/covid-19-scotlands-strategic-framework; INQ000245551) These restrictions came into force on 20 November, creating a public expectation that the stringent measures would result in fewer restrictions over the Christmas period. A few days later, East Lothian and Midlothian moved from Level 3 to Level 2 restrictions.⁵²⁸⁵²⁸ INQ000214796_0007 The Scottish Government also announced travel regulations preventing people who lived in a Level 3 or Level 4 area from travelling outside their local authority area, except for an essential purpose.⁵²⁹⁵²⁹ 'Updated COVID-19 protection levels supported', Scottish Government, 19 November 2020 (https://www.gov.scot/news/updated-covid-19-protection-levels-supported; INQ000369748)

¶6.240. This targeted approach appears to have successfully avoided the need for a second nationwide lockdown in Scotland at this time for a number of reasons. These included: the NHS in Scotland having "sufficient reserve capacity";⁵³⁰⁵³⁰ INQ000078524_0004, 0012, 0013 para 15 the restrictions in October 2020 leading to a more gradual increase in cases than in England and Wales; strict Level 4 restrictions being implemented in good time and targeted to respond to local areas of significant concern; and the Level 4 restrictions covering a significant proportion of Scotland's population.

The rollout of the vaccine and mass testing

¶6.241. It was at this point that there was transformative news concerning the development of a vaccine. On 9 November 2020, Pfizer and BioNTech announced that their vaccine appeared to be over 90% effective at preventing infection with Covid-19.⁵³¹⁵³¹ 'Pfizer and BioNTech announce vaccine candidate against COVID-19 achieved success in first interim analysis from Phase 3 study', Pfizer, 9 November 2020 (https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-announce- vaccine-candidate-against; INQ000421407) The following day, Mr Johnson told the UK Cabinet that the UK had secured 40 million doses of the Pfizer/BioNTech vaccine.⁵³²⁵³² INQ000088986_0005-0006 By early December 2020, temporary authorisation had been granted by the Medicines and Healthcare products Regulatory Agency.⁵³³⁵³³ 'COVID-19 vaccine authorised by medicines regulator', Department of Health and Social Care, Department for Business, Energy and Industrial Strategy and Alok Sharma, 2 December 2020 (https://www.gov.uk/government/news/covid-19-vaccine- authorised-by-medicines-regulator; INQ000479077) Rollout commenced shortly afterwards and authorisation for the Oxford/AstraZeneca and the Moderna vaccines followed in late December 2020 and early January 2021 respectively.⁵³⁴⁵³⁴ 'Landmark moment as first NHS patient receives COVID-19 vaccination', NHS England, 8 December 2020 (https://www.england.nhs.uk/2020/12/landmark-moment-as-first-nhs-patient-receives-covid-19-vaccination; INQ000237370)

¶6.242. SAGE noted in mid-December 2020 that emerging data showed the vaccines could offer good protection against the disease, but the degree of protection conferred against infection and potential infectiousness remained unknown. It was:

" critical to get extremely high vaccine coverage in the most vulnerable groups … in order to limit the number of hospitalisations and deaths".⁵³⁵⁵³⁵ INQ000120576_0003 para 21

¶6.243. In the event that the vaccines were not highly effective against infection and transmission, "the epidemic would continue to spread".⁵³⁶⁵³⁶ INQ000061580 The advice of SAGE was that vaccines would:

" prevent more COVID-19 deaths if prevalence [was] kept low until a late stage of the vaccine rollout through maintenance of and adherence to NPIs [non‑pharmaceutical interventions]".⁵³⁷⁵³⁷ INQ000061580

¶6.244. In Liverpool, the first mass testing pilot (part of the Moonshot programme) was rolled out in November.⁵³⁸⁵³⁸ INQ000251645_0194 para 10.6; INQ000088986_0005-0006; 'Liverpool to be regularly tested for coronavirus in first whole city testing pilot', Department of Health and Social Care, 3 November 2020 (https://www.gov.uk/government/news/liverpool-to-be- regularly-tested-for-coronavirus-in-first-whole-city-testing-pilot; INQ000086810) On 30 November 2020, mass testing was also announced for Scotland's university students and residents of five areas of Scotland, including Glasgow, Ayrshire, Clackmannanshire and Renfrewshire.⁵³⁹⁵³⁹ 'Covid in Scotland: Students and "hotspot" areas targeted in testing', BBC News, 30 November 2020 (https://www.bbc.co.uk/news/uk-scotland-55101155; INQ000357678)

¶6.245. Mr Johnson was optimistic that these developments would allow life to return to normal, telling the Cabinet in mid-November 2020 that "the cavalry was coming over the hill in the form of mass testing and vaccines".⁵⁴⁰⁵⁴⁰ INQ000089030_0005; see also INQ000280061_0242 There was, however, concern about the weight that was being placed on mass testing and vaccines by the UK government. Professor Whitty warned Mr Ridley in mid-November that he did not expect the vaccine to have "any measurable effect" until January 2021, and that any effect before April 2021 would be "modest". He also cautioned against:

" stoking an excessive belief that testing alone, even if done well, is our salvation. It is not. It is a helpful adjunct, if it leads to isolation."⁵⁴¹⁵⁴¹ INQ000236416_0001

¶Professors Whitty and Vallance both considered that mass testing would not enable the widespread relaxation of measures, unless it was repeated frequently over time.⁵⁴²⁵⁴² INQ000251645_0195 para 10.8; Patrick Vallance 20 November 2023 135/1-13 Professor Whitty explained that mass testing:

" would not identify those who might have been exposed prior to this point who would test negative but then go on to develop the disease in the following days. Nor could mass testing feasibly identify everyone with Covid-19 on that date, on the basis that some sections of the population would not come forward to be tested and of those who did, there would be a portion of false negative results."⁵⁴³⁵⁴³ INQ000251645_0195 para 10.7

¶6.246. These limitations were reflected in the pilots. As Professor Whitty explained:

" [M]ass testing resulted in us identifying more of those who were positive (a good thing). There was however limited evidence that it had in and of itself contributed to a sustained slowing in rates of transmission."⁵⁴⁴⁵⁴⁴ INQ000251645_0195 para 10.9; INQ000071945

¶6.247. As predicted, implementation was also difficult.⁵⁴⁵⁵⁴⁵ INQ000238826_0165-0166 para 501 Professor Whitty considered the hope expressed by some that mass testing could be used to control the pandemic as "optimistic".⁵⁴⁶⁵⁴⁶ INQ000251645_0195 para 10.7

The challenges ahead

¶6.248. The second wave was far from over. As Professor Whitty said: "The end was in sight but it was still quite a long way off."⁵⁴⁷⁵⁴⁷ INQ000088967_0005 The experience in the USA following social mixing at Thanksgiving (a shorter holiday period than Christmas) was cautionary, with Professor Whitty warning:

" The situation could still go badly wrong between now and the start of March, despite the fact that this was predictable, preventable and the end was in sight."⁵⁴⁸⁵⁴⁸ INQ000072078_0001

¶6.249. In addition, although unknown at that time, the significantly more transmissible Alpha variant was well established in Kent by December 2020. It could not be restrained by the measures that were in place in England. Even without the Alpha variant, the situation was, in Professor Whitty's view, "problematic: the emergence of Alpha made a subsequent lockdown virtually inevitable".⁵⁴⁹⁵⁴⁹ INQ000251645_0156-0157 para 8.98

¶6.250. Had lessons been learned from the first wave and timely and effective action taken to respond to the virus, a subsequent lockdown might have been avoided.