UK Covid-19 Inquiry, Modules 2, 2A, 2B, 2C: Core decision-making and political governance, Volume I · 2025
Omicron: November and December 2021
Omicron: November and December 2021
¶8.98. As the UK moved into the winter period, the situation in the UK was one of high but stable prevalence.252 INQ000233716 It was in this context that the Omicron variant emerged. It was to fuel exponential growth in cases across the four nations.
¶Figure 33: Estimated percentage of the population testing positive for Covid-19 from 31 October to 31 December 2021 across the UK
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- 02 02 — 22
¶r2 r2 be be ary m m Ja ve ce nu No De
409¶Figure 34: Daily deaths per 100,000 population by date of death from 31 October to 31 December 2021 across the UK
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0 0 — 21
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02 02 — 20
r2 r2 y be be ar m m nu ve ce Ja No De
¶Source: UK Health Security Agency Covid-19 data dashboard archive (https://ukhsa-dashboard.data.gov.uk/covid-19-archive-data-download)
¶8.99. The Omicron variant was reported to the World Health Organization on 24 November 2021 after detection in South Africa. It was highly transmissible, with an alarming growth rate – it doubled every two to three days.253 INQ000120655_0001 para 4; INQ000120658_0001 para 1 This meant that it could – and did – lead to a significant number of cases in a short period of time.
¶8.100. The Omicron variant spread across several countries quickly. The first two cases in the UK were identified within days in England on 27 November 2021.254 'First UK cases of Omicron variant identified', Department of Health and Social Care, 27 November 2021 (https://www.gov.uk/government/news/first-uk-cases-of-omicron-variant-identified; INQ000237598) Six of the first eleven cases were found in Scotland.255 'Covid-19: Boosters advised for all adults and masks back in shops', BBC News, 29 November 2021 (https://www.bbc.co.uk/news/uk-59465127; INQ000357726_0003) The first cases in Wales and Northern Ireland were reported on 3 December and 7 December respectively.256 INQ000421714_0002 para 10; INQ000371645_0042 para 158 The wave peaked on 4 January 2022, with 275,647 confirmed cases and an estimated 5 million people infected across the UK.257 INQ000283367_0006 It led to further large peaks in hospitalised patients across the UK, reaching a high of 20,176 on 6 April, although far fewer needed admission to an intensive care unit or died of Covid-19 than in the initial waves.258 INQ000283367_0003 Ultimately, although the Omicron variant caused less severe illness (especially in a vaccinated population), the sheer volume of infections led to 30,000 people dying with Covid-19 in the UK between November 2021 and June 2022.259 See UK Health Security Agency Covid-19 data dashboard archive (https://ukhsa-dashboard.data.gov.uk/covid-19-archive-data-download).
410¶8.101. The sense of alarm was apparent within the scientific community. The New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG) convened an extraordinary meeting on 25 November 2021.260 INQ000119424; INQ000074374 Professor Vallance recorded in his evening notes that Professor Van-Tam (observing) had never "seen NERVTAG so rattled".261 INQ000273901_0529 The R number for the Omicron variant was estimated to be 1.9 against a backdrop of high levels of immunity (following the Delta variant and immunisation) in South Africa. It noted that, while there was "substantial current uncertainty" about the characteristics of the Omicron variant, there were "sufficiently worrying signals".262 INQ000119424 NERVTAG advised that it could not rule out a large wave of infections, accompanied by a wave of severe cases, which could be sufficient to overwhelm the NHS.263 INQ000119424_0006 para 18 The introduction of the Omicron variant "into the UK might have very serious consequences and, therefore, early and aggressive actions to prevent introduction and onward transmission" were warranted.264 INQ000119424; INQ000074374. Other actions included early detection, containment measures, acceleration of the booster vaccination campaign, antivirals, more work on understanding the characteristics and preparation of countermeasures (vaccines and antibodies).
¶8.102. Covid-O also met on 25 November 2021. No cases of the Omicron variant had yet been detected in the UK but they had been detected in South Africa, Botswana and Hong Kong – the latter relating to travel from South Africa.265 INQ000092222_0005 Professor Whitty warned that the new variant had a worrying number of mutations and was spreading very quickly in a highly immune population. He advised a cautious approach.266 INQ000092222_0006 Immediate actions, including the temporary suspension of flights from southern Africa, the addition of a number of southern African countries to the 'red list' (countries posing a high public health risk to the UK) and polymerase chain reaction (or PCR) testing for recent arrivals, were agreed.267 INQ000092222_0010 Tensions about the approach to be taken were once again apparent. Mr Javid described the relationship as "testy" because of the Omicron variant.268 Sajid Javid 29 November 2023 146/19-23 Professor Vallance recorded in his evening notes:
" Afterwards, No 10 says they are at war with No 11 + that anything Javid says they assume is wrong. They say they are missing Gove."269 INQ000273901_0529
¶8.103. A number of meetings were held on 27 November 2021 to consider the response in England.270 INQ000092196_0001-0003; INQ000185095 At Covid-O, in addition to the earlier measures, it was decided that arrivals into the UK would have to self-isolate and undertake a PCR test on the second day of their arrival, with a negative test result allowing them to end their self-isolation.271 'PM opening statement at COVID-19 press conference: 27 November 2021', Prime Minister's Office and Boris Johnson, 27 November 2021 (https://www.gov.uk/government/speeches/pm-opening-statement-at-covid-19-press-conference-27- november-2021; INQ000055627) Mr Javid had sought to extend the measures to a period of 10-day self-isolation, with testing at days 2 and 8. However, this was rejected on the basis of economic concerns and the risk of undermining the benefits of vaccination.272 INQ000092196_0004-0005 Covid-O further agreed that contacts of a suspected Omicron variant case would be required to self-isolate for 10 days, face masks would be required in shops and on public transport (but not in hospitality settings) and that the booster vaccination programme would be expedited, with Mr Javid having asked the Joint Committee on Vaccination and Immunisation to look at reducing the time between the second dose and the booster.273 INQ000092196_0007; 'PM opening statement at COVID-19 press conference: 27 November 2021', Prime Minister's Office and Boris Johnson, 27 November 2021 (https://www.gov.uk/government/speeches/pm-opening-statement-at-covid-19-press-conference- 27-november-2021; INQ000055627_0003) The Cabinet was updated.274 INQ000185095 The Covid-19 Taskforce was to coordinate a review of all measures by 17 December.
411¶8.104. Mr Johnson informed the public of the new variant and the temporary measures to be implemented in a press conference on 27 November 2021.275 'PM opening statement at COVID-19 press conference: 27 November 2021', Prime Minister's Office and Boris Johnson, 27 November 2021 (https://www.gov.uk/government/speeches/pm-opening-statement-at-covid-19-press-conference-27- november-2021; INQ000055627)
¶8.105. Ms Sturgeon and Mr Yousaf preferred a different approach, requiring all travellers to self-isolate for 10 days, even as a short-term measure. In a WhatsApp exchange with Ms Sturgeon, Mr Yousaf noted that the UK government wanted to stick to a PCR test on day two of self-isolation and that "[i]t is very clear they are going against the public health advice they've received".276 INQ000334923_0027 Ms Sturgeon noted that:
¶" If we go to 10 days we'll be back in position of people just flying into England.
¶So we don't get health benefit but we cripple our airports."277 INQ000334923_0027
¶Ms Sturgeon and Mr Yousaf concluded that they would be "reluctantly aligning" with the UK government measures due to the practical difficulties of taking a different approach.278 INQ000334923_0027 Ms Sturgeon requested that the Four Harms Group start work on possible scaling up of protections, such as social distancing and working from home.279 INQ000249371
¶8.106. At its meeting on 29 November 2021, SAGE was concerned about the likely increased transmissibility as well as the potential that the Omicron variant could escape from natural or vaccine-induced immunity, given the manner in which it had spread in South Africa and the potential consequent impacts on severity.280 INQ000064245; INQ000230814; INQ000230792; INQ000230793 SAGE noted that, even with good protection against serious disease from vaccination:
412" [A]ny significant reduction in protection against infection could still result in a very large wave of infections. This would in turn lead to potentially high numbers of hospitalisations even with protection against severe disease being less affected. The size of this wave remains highly uncertain but may be of a scale that requires very stringent response measures to avoid unsustainable pressure on the NHS. If vaccine efficacy is substantially reduced, then a wave of severe disease should be expected."281 INQ000061605_0003 para 12
¶SAGE emphasised the need to act ahead of the data being available and warned about a quickly developing situation and the importance of being prepared "for a potentially very significant wave of infections with associated hospitalisations now".282 INQ000061605_0003 para 14 As previously, SAGE advised that border measures could not completely prevent the introduction of variants into the country but could be effective in delaying the subsequent wave to allow time for further preparations – for example, increasing vaccination coverage.283 INQ000061605_0003 para 15
¶8.107. On 29 November 2021, the Welsh Cabinet was advised that the Omicron variant was more transmissible than the Delta variant, but it was not known whether it was more harmful or if it had the potential for vaccine escape.284 INQ000130006 The same day, the Joint Committee on Vaccination and Immunisation recommended that boosters should be offered to everyone aged over 18, and that the minimum gap between the second dose and the booster be halved to three months.285 'PM opening statement at COVID-19 press conference: 30 November 2021', Prime Minister's Office and Boris Johnson, 30 November 2021 (https://www.gov.uk/government/speeches/pm-opening-statement-at-covid-19-press-conference-30- november-2021; INQ000086803)
¶8.108. The UK Cabinet met on 30 November 2021.286 INQ000089099_0001 Cases of the Omicron variant remained low, with 5 confirmed and 10 highly probable. There were, however, more than 100 suspected cases. Mr Javid advised that the UK government should be prepared for a rise in case numbers. In England, all cases were linked to travel. However, in Scotland, there was the possibility of transmission in the community. The expedited booster vaccination programme had a target of immunising those eligible by the end of January 2022. Mr Johnson stated that it was important to take urgent steps to slow down the Omicron variant and especially to limit travel.287 INQ000089099_0008 If the variant did evade vaccine immunity, there would be a "big problem. However, it was also important not to overreact."288 INQ000089099_0008 This was, in his view, a proportionate response.289 INQ000089099_0008 That same day, the press reported details of alleged rule-breaking in 10 Downing Street, which became known as 'partygate'.290 'Exclusive: Boris Johnson "broke Covid lockdown rules" with Downing Street parties at Xmas', The Mirror, 30 November 2021 (https://www.mirror.co.uk/news/politics/boris-johnson-broke-covid-lockdown-25585238; INQ000548386) This is discussed further in Chapter 11:
413¶Government decision-making, in Volume II.
¶8.109. On 30 November 2021, the Scottish Cabinet agreed to consider the response to the Omicron variant on a weekly basis.291 INQ000214473_0004 para 13 Ms Sturgeon confirmed that all nine cases of the Omicron variant found in Scotland were linked to a single event on 20 November. She suggested that this meant that there was "limited" but not "sustained or widespread" community transmission of the Omicron variant in Scotland.292 'Coronavirus (COVID-19) update: First Minister's statement – 30 November 2021', Scottish Government, 30 November 2021 (https://www.gov.scot/publications/coronavirus-covid-19-update-first-ministers-statement-30-november-2021; INQ000353733_0004- 0005); 'Omicron variant', Scottish Government, 29 November 2021 (https://www.gov.scot/news/omicron-variant; INQ000584994) An emergency meeting of the Scottish Government Covid-19 Advisory Group took place on 2 December. It recognised:
" [ W]e don't have enough information but by the time we get it the need to act could well be acute. Intervening early could mean not needing to intervene more drastically."293 INQ000218226_0002
¶8.110. Also on 2 December 2021, the Northern Ireland Executive decided that current restrictions remained appropriate and it scheduled a further review for 13 January 2022.294 INQ000236761_0004
¶8.111. On 4 December 2021, Covid-O considered further travel and border restrictions.295 INQ000092227_0001-0004 The Covid-19 Taskforce was tasked to provide analysis on an exit strategy.296 INQ000092192_0002 By 6 December, there were 197 confirmed Omicron variant cases in England (in six of the nine regions), 48 in Scotland and 1 in Wales. The UK had the second highest number of reported, confirmed Omicron variant cases internationally. The numbers were expected to rise.297 INQ000088914_0002
¶8.112. SAGE convened again on 7 December 2021.298 INQ000120655 The Omicron variant was increasing rapidly, and daily infections were thought likely to be in the thousands.299 INQ000120655_0002 para 3 Preliminary modelling suggested that, without changes to the measures in place:
414" [T]he number of hospitalisations from Omicron may reach 1,000 per day or higher in England by the end of the year (and still be increasing at that point)."300 INQ000120655_0001 para 9
¶SAGE advised:
" [D]ecision makers will need to consider response measures urgently to reduce transmission if the aim is to reduce the likelihood of unsustainable pressure on the NHS."301 INQ000120655_0002 para 1
¶8.113. The Scottish Cabinet agreed on 7 December 2021 that it did not yet appear to be proportionate to introduce further protective measures, although further measures might be required in the near future.302 INQ000214474_0008-0009 para 29 Later that day, Ms Sturgeon announced plans to review Covid-19 protections on a daily basis.303 'Coronavirus (COVID-19) update: First Minister's statement – 7 December 2021', Scottish Government, 7 December 2021 (https://www.gov.scot/publications/coronavirus-covid-19-update-first-ministers-statement-7-december-2021; INQ000353736)
¶8.114. On 7 December 2021, the Covid-19 Taskforce presented Mr Johnson with a number of options.304 INQ000217015 The objective remained to avoid unsustainable pressure on the NHS. At that point, NHS England had about 97,000 beds – of which, 91,000 were occupied and 6,000 were Covid-19 patients. In the first and second waves, the NHS dealt with about 19,000 and 34,000 Covid-19 patients, respectively.305 INQ000217015_0003
¶8.115. Early case growth in the UK was consistent with that seen in South Africa, which had experienced "extraordinary case growth", at a rate steeper than for any other variant.306 INQ000217015_0018-0019, 0023 A number of European countries had imposed more stringent measures in response to the Delta and Omicron variants – Germany was in lockdown.307 INQ000217015_0025-0026
¶8.116. There were three options: stick with Plan A (and warn the public about the Omicron variant), move to Plan B (with the option to strengthen, with Plan B+ involving expanded mandatory vaccine, test or immunity certification – to include entertainment and hospitality with mandatory check-in at such venues) or "go harder" with Plan C and revert to Step 2 of the COVID-19 Response – Spring 2021 roadmap.308 INQ000217015_0004 It does not appear that actual plans were developed for steps akin to Plan C or Step 2.309 Sajid Javid 29 November 2023 150/20-151/20 It was acknowledged by the Covid-19 Taskforce that Plan B was "unlikely to bring Omicron sustainably under control if highly transmissible and/or vaccine escaping" and that further escalation might be required.310 INQ000217015_0008 Lateral flow testing capacity would also be strained.311 INQ000217015_0009 The taskforce advised that Plan C would "rapidly bring down Delta transmission and hospitalisations" – freeing up capacity for a possible Omicron variant wave – slow the Omicron variant and have the benefit of acting early if it escaped vaccine immunity.312 INQ000217015_0011 The taskforce recognised that the measures could be in place for a significant period of time and recognised the impact this would have on the economy and on mental health.313 INQ000217015_0011
415¶8.117. That same day, Mr Johnson told the Cabinet:
¶" [A]ny disease, however mild, that replicated that quickly and affected large
numbers of people, would inevitably put pressure on the health system. This posed a significant problem."314 INQ000185093_0003
¶The solution, in his view, was the booster vaccination programme.315 INQ000185093_0006 Mr Javid explained that it would be impossible to administer boosters to everyone within two weeks.316 INQ000185093_0006 Professor Whitty urged the UK government to "consider acting now".317 INQ000185093_0006 The Omicron variant was doubling roughly every three days, which would lead "to big numbers fast".318 INQ000185093_0006 The severity of illness was unclear, but it:
¶" was clear from the modelling that it would have to be very substantially less severe than Delta to avoid unmanageable pressures on the NHS".319 INQ000185093_0006
¶Professor Vallance concurred: "[A]ny gains from lower severity would quickly be overtaken by rapid exponential growth."320 INQ000185093_0006
¶8.118. On 8 December 2021, Mr Johnson chaired Covid-O. Previously, Covid-O had been chaired by Mr Gove as Chancellor of the Duchy of Lancaster. The data suggested community transmission, with rapid growth in the Omicron variant (particularly in London) and in hospitalisations.321 INQ000092202_0005 Mr Johnson considered that there "seemed little option than to implement Plan B. The reality was that they were running out of road," echoing sentiments expressed in the winter of 2020.322 INQ000092202_0006 Professor Whitty advised there was a strong case for acting earlier. Due to the booster vaccination programme targeting the vulnerable groups first and the quick doubling times, "buying time at the start of the variant spreading had a disproportionately positive impact".323 INQ000092202_0012 Summing up, Mr Johnson stated that the "country was facing a nightmare situation again".324 INQ000092202_0012-0013 Plan B was approved. These were temporary measures to be reviewed in advance of 5 January 2022.325 INQ000092194
¶8.119. That same day, in a UK Cabinet update call, Mr Johnson described the Covid-19 situation as "infuriating".326 INQ000088915 He noted that some would consider Plan B an "overreaction"
416¶– his view was that it was "moderate, proportionate and precautionary".327 INQ000088915 Professor Vallance described the effect of Plan B as a "behavioural change that would slow the spread … and buy time for the booster programme".328 INQ000088915 Once again, tensions had arisen between the Department of Health and Social Care and the Treasury, with Mr Javid unsuccessfully supporting measures in excess of Plan B, including legal requirements for check-in in settings such as hospitality venues.329 INQ000092202_0006-0007 Mr Gove was recorded, by Professor Vallance in his evening notes, as asserting that Plan B was not enough, but was said to have concluded that it was "pointless, no one is listening".330 INQ000273901_0540 Professor Vallance described it as feeling "like March 2020 all over again".331 INQ000273901_0540
¶8.120. Plan B was announced on 8 December 2021, to commence in England on 10 December.332 'Prime Minister confirms move to Plan B in England', Prime Minister's Office and Boris Johnson, 8 December 2021 (https://www.gov.uk/government/news/prime-minister-confirms-move-to-plan-b-in-england; INQ000049258) Face coverings were required in indoor venues, working from home was encouraged from 13 December and the NHS COVID Pass (which allowed for the sharing of Covid-19 vaccination status) became mandatory for nightclubs and large gatherings from 15 December.333 'Prime Minister confirms move to Plan B in England', Prime Minister's Office and Boris Johnson, 8 December 2021 (https://www.gov.uk/government/news/prime-minister-confirms-move-to-plan-b-in-england; INQ000049258_0002) These were similar to the restrictions already in place in Wales.334 INQ000271796_0006 para 1.1
¶Figure 35: Plan B measures announced on 8 December 2021
¶Source: 'Covid: New Plan B rules on working from home and masks announced for England', BBC News, 8 December 2021 (https://www.bbc.co.uk/news/uk-59585307; INQ000548020)
417¶8.121. The Welsh Government held Cabinet meetings to discuss the Omicron variant on 2, 6, 8 and 9 December 2021.335 Eluned Morgan 12 March 2024 42/23-24 On 2 December, Dr Atherton confirmed that the Delta wave "appeared to be plateauing".336 INQ000271796_0002 para 1.5 It was hoped that Test, Trace, Protect and new self-isolation requirements would help slow transmission.337 INQ000271796_0002 para 1.6. Test, Trace, Protect was the Welsh Government's service to track and prevent Covid-19, primarily through testing and contact tracing. Nonetheless, recognising the developing situation, the Welsh Cabinet agreed that restrictions should be reviewed weekly and it considered planning for a Covid Urgent scenario:
" [I]f there was a risk the NHS could become overwhelmed by COVID cases, Alert Level 4 should be the basis for the Government's response."338 INQ000271796_0004 para 3.11
¶It was, however, concerned that, without financial support from the UK government,
¶"the economic harms from moving to Alert Level 4 would be much greater than in previous waves".339 INQ000271796_0004 para 3.10; INQ000057958_0004 para 11
¶8.122. On 8 December 2021, there were three cases of the Omicron variant in Northern Ireland and the hospital system continued to operate at over 100% of bed capacity.340 INQ000269147_0001; INQ000421704_0229 para 495 Professor Young advised the Northern Ireland Executive Committee on 9 December that the Omicron variant was likely to result in a steep rise in infections, although more data were required to determine the potential increase in hospital admissions and the efficacy of booster vaccines. He said that it was unlikely that Omicron could be prevented from becoming the dominant variant but that its spread could be delayed.341 INQ000207229_0002
¶8.123. Also on 9 December 2021, Public Health Scotland urged people to cancel Christmas parties on the basis that some Omicron variant cases were linked to such parties.342 'Public Health Scotland urges public to defer Christmas parties', Public Health Scotland, 9 December 2021 (https:// publichealthscotland.scot/news/2021/december/public-health-scotland-urges-public-to-defer-christmas-parties; INQ000274186) Ms Sturgeon indicated that Scotland faced a "tsunami" of Omicron variant cases.343 'Coronavirus (COVID-19) update: First Minister's statement – 10 December 2021', Scottish Government, 10 December 2021 (https://www.gov.scot/publications/coronavirus-covid-19-update-first-ministers-speech-10-december-2021; INQ000353715) She warned the public that "once again we face a situation that frankly has no easy options".344 'Coronavirus (COVID-19) update: First Minister's statement – 10 December 2021', Scottish Government, 10 December 2021 (https://www.gov.scot/publications/coronavirus-covid-19-update-first-ministers-speech-10-december-2021; INQ000353715) Ms Sturgeon also announced that she would be pressing the UK government for financial support and announced changes to self-isolation rules.345 'Coronavirus (COVID-19) update: First Minister's statement – 10 December 2021', Scottish Government, 10 December 2021 (https://www.gov.scot/publications/coronavirus-covid-19-update-first-ministers-speech-10-december-2021; INQ000353715)
¶8.124. A COBR meeting attended by the devolved administrations took place on 10 December 2021, chaired by Mr Gove. This was convened following a request to Mr Johnson from the Scottish and Welsh governments on 29 November for a meeting to discuss a four-nations approach.346 INQ000256922; INQ000256925; Sajid Javid 29 November 2023 103/24-104/18 Professor Whitty stated that "infections [from the Omicron variant] were likely even for those who had two vaccines", with doubling times between two and three days, and closer to two in parts of Scotland.347 INQ000083854_0003 paras 2-3, 5 Scotland was seeing a "rapidly deteriorating situation".348 INQ000083854_0003 para 5 Both Wales and Northern Ireland had a small number of identified cases of the Omicron variant.349 INQ000083854_0003-0004 paras 5-7
418¶8.125. The same day, Mark Drakeford MS (First Minister of Wales from December 2018 to March 2024) stated that if Wales saw a situation:
" coming at us because of what we see happening elsewhere, that tells us that action needs to be taken, difficult as it is and upsetting as it can be".350 INQ000090717
¶This gave some expectation to the public that further measures might be necessary.
¶Dr Atherton noted that Wales would "likely move to [Alert Level 4] prior to Xmas".351 INQ000327548_0079
¶8.126. On 12 December 2021, the Chief Medical Officers for the four nations and the NHS England National Medical Director advised that the UK coronavirus (Covid-19) alert level should be increased from Level 3 to Level 4.352 'UK coronavirus (COVID-19) alert level increased from Level 3 to Level 4', Department of Health and Social Care, 12 December 2021 (https://www.gov.uk/government/news/uk-coronavirus-covid-19-alert-level-increased-from-level-3-to-level-4; INQ000237425)
¶8.127. That day, Mr Johnson chaired a UK Cabinet call.353 INQ000088916 He noted that there were 3,127 confirmed cases of the Omicron variant in the UK, up by 1,239 on the previous day.354 INQ000088916_0001 Severity remained uncertain. However, it was:
" increasingly clear that two doses of the AstraZeneca vaccine were not as effective at stopping Omicron transmission as they had been for Delta".355 INQ000088916_0001
¶8.128. Mr Johnson announced a UK-wide mission, 'Get Boosted Now', with every adult in England to be offered the vaccine by the end of December 2021.356 INQ000354766; INQ000089006_0004-0005; 'Urgent Omicron appeal: Get boosted now', Prime Minister's Office and Boris Johnson, 12 December 2021 (https://www.gov.uk/government/news/urgent-omicron-appeal-get-boosted-now; INQ000086635) The UK government would assist the devolved administrations in achieving the same acceleration. Mr Johnson considered that this approach "would not involve further restrictions and only minimal impact on the economy".357 INQ000088916_0001 He explicitly recognised that "taking this additional step might not be enough to deal with the variant", but considered "it was plainly right to pursue it".358 INQ000088916_0001 Communications to the public "needed to emphasise that the risk of Omicron causing significant pressure on the NHS and deaths was serious".359 INQ000088916_0001 Professor Vallance warned that the government needed to be "extremely wary" – the Omicron wave was going to come quickly.360 INQ000088916_0002
419¶8.129. The measures were to be reviewed in January 2022, by which point more data would be available.361 INQ000089006_0004-0005
¶8.130. By 14 December 2021, the UK had experienced the first confirmed death of an Omicron-positive patient. At a UK Cabinet meeting chaired by Mr Johnson, Mr Javid reiterated the scientific advice that "even with a low hospitalisation rate, the overall number of cases meant that the number of hospitalisations would be very high".362 INQ000089008_0008-0014 Professor Whitty warned of public debate being based on misunderstandings about the speed of spread and lack of severity. There was "no doubt that there would be a rapid rise in hospitalisations".363 INQ000089008_0010 Plan B "would slow [it] down, but only to some degree".364 INQ000089008_0010 He warned that, in the January 2021 peak of the second wave, NHS England:
¶" had coped but had been under severe pressure, and the decline in treatment of other conditions had led to excess mortality from other causes".365 INQ000089008_0010
¶There would also be a sharp rise in sickness, self-isolation and caring for others.366 INQ000089008_0010
¶8.131. It was noted in discussions that a package similar to Plan B had been in place in Scotland since October 2021 and had made no difference to the spread of the Omicron variant. Plan B was described as having "very minor restrictions, designed to keep the economy open".367 INQ000089008_0011 It was noted that "[b]oosters and Plan B might be sufficient to prevent the NHS being overwhelmed, but only with luck".368 INQ000089008_0012 The issue of consistency of messaging with the advice to continue with Christmas parties was raised.369 INQ000089008_0008-0014 Professor Vallance advised:
¶" The most important response was to reduce the number of social contacts and
make sure people self-isolated if they tested positive. It was certain that cases would go up: the situation was not looking good."370 INQ000089008_0013
¶At the Cabinet meeting, Mr Johnson concluded:
¶" The right response was to move to the Plan B package and roll out boosters rapidly. This would hopefully avoid the worst but it would be bumpy."371 INQ000089008_0013
¶8.132. An additional complicating factor was that Mr Johnson was facing significant internal political pressure not to impose further restrictions. On 14 December 2021, a number of Conservative MPs voted against Plan B measures – 98 voted against mandatory Covid-19 passes, 63 voted against mandatory vaccination for front-line NHS staff and
420¶38 voted against compulsory face coverings in most indoor spaces.372 INQ000255836_0184-0185 para 633; 'As it happened: Covid passes become law in England despite Tory rebellion', BBC News, 14 December 2021 (https://www.bbc.co.uk/news/live/uk-politics-59651187; INQ000548009) Reporting of
¶'partygate' resulted in some asserting that increased restrictions were intended to distract from the criticisms.373 'Covid: New Plan B rules on working from home and masks announced for England', BBC News, 8 December 2021 (https://www.bbc.co.uk/news/uk-59585307; INQ000548020); 'COVID-19 press conference (8 December 2021)', YouTube, 8 December 2021 (https://www.youtube.com/watch?v=87aIf4opgts; INQ000548291) That same day, the UK government announced additional Covid-19 funding for the devolved nations.374 'UK Government confirms £430 million funding for devolved administrations to tackle Covid', HM Treasury, 14 December 2021 (https://www.gov.uk/government/news/uk-government-to-confirm-extra-funding-for-devolved-administrations-to-tackle-covid; INQ000548036). For Scotland, this doubled to £440 million on 19 December (INQ000215484_0015-0016 para 53). For Wales, this doubled to £270 million on 20 December (INQ000321085_0001-0002 para 5). For Northern Ireland, this doubled to £150 million (INQ000304512_0002).
¶8.133. The following day at COBR, Mr Drakeford, Ms Sturgeon and Ms O'Neill raised concerns about funding arrangements. Simon Clarke MP, Chief Secretary to the Treasury from September 2021 to September 2022, confirmed that devolved administration "funding would be reviewed before Christmas and on a regular basis thereafter".375 INQ000083855_0004-0005 para 4 The following day, Mr Drakeford asked Mr Johnson to either reintroduce furlough for the UK or provide the devolved administrations with:
" access to the necessary Treasury funding so that we can ourselves consider the introduction of measures where these are necessary".376 INQ000228013_0002
¶8.134. On 15 December 2021, the highest daily number of Covid-19 cases (78,610) was recorded since the start of the pandemic. However, positively, around 24.6 million booster vaccines had been administered across the UK. In Scotland, there had been a "steep rise in COVID-19 cases".377 INQ000083855_0005 Wales was beginning to see a rise and Northern Ireland a "slight rise".378 INQ000083855_0004-0005
¶8.135. That same day, at a 10 Downing Street press conference, Professor Whitty warned that the Omicron variant posed "a really serious threat" and was "moving at an absolutely phenomenal pace".379 INQ000231045 When asked about the potential for overwhelming hospital capacity, Professor Whitty warned that there would be "substantial numbers" going into hospital and intensive care, which was likely to become apparent after Christmas.380 INQ000231045 He added that records would "be broken a lot".381 INQ000231045 Professor Whitty also advised members of the public to modify their behaviours and social mixing in the run-up to Christmas in order to protect and "prioritise what matters".382 INQ000231045 This did result in some behavioural change – for example, journeys on London Underground services on 16 December 2021 stood at only 31% of the previous week.383 INQ000104595_0004; INQ000120660_0001 para 6
421¶8.136. On 16 December 2021, Mr Drakeford confirmed that Alert Level 4 measures might be necessary in Wales from 27 December.384 INQ000228013_0002 The Technical Advisory Group advised that measures below this were "not likely to have significant enough effect on the peak of Omicron cases to prevent material harm to case services".385 INQ000057972 Waiting for further evidence on severity was "likely to involve going beyond the point where strong preventions would have a material impact on the immediate peak".386 INQ000057972 By 14 December, more than 1.1 million doses of the booster vaccine had been administered in Wales.387 INQ000548018 The advice reminded decision-makers to balance direct and indirect harms and advised that it would be "probably impossible" for the Welsh Government to provide comprehensive financial support without "large scale additional funding from the UK Government".388 INQ000057972_0008 It further advised that, if Alert Level 4 measures could not be introduced, then Alert Level 2 measures could reduce the size of the peak.389 INQ000057972_0012
¶8.137. In Northern Ireland, on 16 December 2021, the Executive Committee discussed the greater transmissibility of the Omicron variant – without further intervention, cases could rise to over 10,000 per day by the New Year. Professor McBride advised of the importance of introducing additional measures immediately after Christmas and noted that the health service was likely to come under severe pressure.390 INQ000048551_0003 para 9
¶8.138. That day, Ms Sturgeon wrote to Mr Johnson warning that further restrictions on "higher risk" sectors may now be unavoidable and that urgent financial help was needed to protect businesses from "economic shock".391 INQ000355166 The Scottish Government also issued new guidelines for hospitality and retail businesses, advising the return of social distancing and one-way systems for shops and supermarkets.392 'Limiting the spread of Omicron', Scottish Government, 16 December 2021 (https://www.gov.scot/news/limiting-the-spread-of-omicron; INQ000548023) Omicron had replaced Delta as the dominant variant in Scotland.393 'Coronavirus (COVID-19) update: First Minister's speech – 17 December 2021', Scottish Government, 17 December 2021 (https://www.gov.scot/publications/coronavirus-covid-19-update-first-ministers-speech-17-december-2021; INQ000353701_0003)
¶8.139. On the same day, Dr Atherton informed the Welsh Cabinet that there were "reports of reduced severity in symptoms but the large number of people expected to be infected would lead to substantial pressure on the NHS".394 INQ000057970_0002 para 1.6. Health boards were reporting a "relatively stable situation"; however, there were "850 more beds occupied at this stage than the same time the previous year" (INQ000057970_0003 para 1.10). The Cabinet agreed to a move to restrictions "at least at Alert level 2" after Christmas.395 INQ000057970_0004 para 1.16 Restrictions would include the reintroduction of two-metre social distancing. Regulations would be imminently changed to require people to work from home wherever possible.396 INQ000057970_0004 paras 1.20-1.21 Mr Drakeford reported that the Welsh Cabinet had to consider what actions to take in the context that Mr Clarke had "refused to provide financial support to the Devolved Governments, should they need to re-introduce restrictions independently".397 INQ000057970_0003 para 1.12 However, the Welsh Government had "up to £200m available until the end of the financial year" to provide support for businesses.398 INQ000057970_0003 para 1.13 On 17 December
422¶2021, it announced financial support of up to £60 million to support businesses affected by the new restrictions.399 'Written Statement: Review of the Health Protection (Coronavirus Restriction) (No. 5) (Wales) Regulations 2020', Mark Drakeford, First Minister, Welsh Government, 17 December 2021 (https://www.gov.wales/written-statement-review-health-protection-coronavirus- restrictions-no5-wales-regulations-2020; INQ000023305) By 20 December 2021, the UK government had provided an additional £270 million of funding for Wales.400 INQ000321085_0002 para 5
¶8.140. On 16 December 2021, SAGE noted that the number of Omicron variant infections had continued to increase rapidly, with the doubling time at around two days.401 INQ000120658 It was "almost certain" that there were hundreds of thousands of new daily Omicron variant infections.402 INQ000120658_0001 para 1 There was a data lag in hospitalisations, but SAGE expected hospital admissions to reach 1,000 to 2,000 per day by the end of the year.403 INQ000120658_0001 para 6 Scenarios from SPI-M-O suggested that measures equivalent to those in place after Step 1 or 2 of the COVID-19 Response – Spring 2021 roadmap could substantially reduce infections and hospitalisations if enacted before the end of the year.404 INQ000120658_0002 para 8
¶8.141. The following day, Mr Javid informed Mr Johnson by letter that he considered that the UK government should implement measures beyond Plan B and move quickly to implement measures that were in place at Step 2.405 INQ000251921
¶8.142. Covid-O also met on 17 December 2021.406 INQ000104595_0001 The Covid-19 Taskforce advised that there had been "rapid growth" in cases that week. The previous day, 88,000 cases had been reported. This was a "record figure and far exceeded the peak of the [second wave] when 68,000 positive cases were reported in one day".407 INQ000104595_0004 Far higher positive test numbers were expected, with the true number of infections potentially being 300,000 – the Omicron variant was estimated to account for the majority of cases in England. There was a significant impact on the working-age population.408 INQ000104595_0004 Professor Whitty advised that the booster vaccination programme was "key", but it had started at the top end of the age cohorts and was just starting to focus on those of working age.409 INQ000104595_0005 Mr Javid stated:
423" [M]illions of infections from the Omicron variant were expected, and the current doubling rate would mean that the 'pingdemic' seen earlier in the year would seem like a walk in the park."410 INQ000104595_0006
¶8.143. Mr Johnson concluded that the "booster programme and the implementation of Plan B measures were the right way forward to contain" the Omicron variant.411 INQ000104595_0009 From 17 December 2021, there were to be daily Covid-O meetings to consider contingency plans.412 INQ000104595_0005
¶8.144. At a meeting of the Scottish Gold Command on 19 December 2021, it was agreed that a paper would be prepared for the Scottish Cabinet to set out the full costs and requirements for a four-week circuit breaker lockdown.413 INQ000249362_0001
¶8.145. On 19 December 2021, at COBR, it was recorded that Scotland was monitoring the situation, considering it to be behind the wave in London. Wales was still experiencing high, but stable, community transmission of Delta variant cases, and Omicron variant cases were rising, but from a low baseline.414 INQ000083852_0005 Mr Johnson was not in attendance.415 INQ000083852_0001-0002
¶8.146. At this time, tensions in England over the way forward were becoming more acute. Mr Johnson was facing calls from Mr Javid to go further and to introduce a package of measures akin to the previous Step 2 of the COVID-19 Response – Spring 2021 roadmap (such as no indoor household mixing and the rule of six outdoors).416 INQ000251920; INQ000251921; INQ000255836_0185 para 636 Mr Sunak and Mr Johnson had a number of discussions between 16 and 19 December 2021. Mr Johnson recalled that Mr Sunak was "very concerned about restrictions and the impact that they would have on the economy".417 INQ000255836_0186 para 638 He did not recall receiving any analysis, modelling or forecasting concerning the economic impact.418 INQ000255836_0186 para 638 Mr Johnson was described as being "genuinely undecided" after a meeting with Mr Sunak on 18 December.419 INQ000184558_0001; INQ000263374_0141-0142 paras 526-528 Mr Sunak made it clear in a meeting on 19 December that he "remained sceptical of the case for further restrictions".420 INQ000263374_0142 para 529 In his evening notes, Professor Vallance recorded that Mr Sunak said he would "err on the side of waiting" as the evidence wasn't "compelling enough" and that in his view the model showed "herd immunity" being the way through.421 INQ000273901_0556
¶8.147. SAGE met on 20 December 2021. Infections and hospitalisations in South Africa appeared to be declining. The reasons for this were unclear and it could not be assumed that it would be sustained or that the wave in the UK would follow a similar pattern – given differing populations and epidemiological situations. SAGE noted the uncertainties, but "[p]olicy decisions (either to do nothing or something) need to be made sooner than these uncertainties can be resolved".422 INQ000120660_0001 para 6 The warnings were stark. SAGE reiterated its previous advice about early intervention and further advised that measures targeted at more at-risk groups only (eg shielding) were not an effective substitute for population-wide measures.423 INQ000120660_0002 para 11
424¶8.148. Mr Johnson chaired the UK Cabinet that day.424 INQ000217347_0001 The number of infections had hit the highest levels during the pandemic, with 93,000 on 16 December compared with a peak of 68,000 the previous winter. Footfall in city centres in England was 57% of pre-Covid-19 levels since Plan B. London Underground data indicated that, on 17 December, journeys were at 45% of pre-Covid-19 demand.425 INQ000088918_0015 A number of European countries had implemented stricter restrictions. Denmark had locked down.426 INQ000088918_0021 At Cabinet, Mr Johnson's view was to continue with Plan B. Mr Javid said:
¶" [T]he decision to not go further than Plan B was a significant one. It would mean that hospitalisations would increase with an uncertain peak."427 INQ000217347_0005
¶8.149. The discussion in the UK Cabinet focused on:
-
¶
- the potential for the outcome to be closer to the optimistic modelling;
- the UK's high levels of immunity;
- positive evidence of behavioural change;
- the possibility of shielding;
- the reported experience in South Africa of short hospital stays and potentially moving past the peak;
- other European countries' responses; and
- the advice of SAGE that early action would have the greatest benefit.
¶8.150. Professor Whitty provided unambiguous advice, explaining that he wanted to provide:
¶" his clear professional view on the discussion. It should not be assumed that
everything would follow the optimistic path. The balance of debate in Cabinet on the data was a long way from international consensus. There was going to be a wave of hospitalisations based on current infection rates. The question was going to be how big the wave was."428 INQ000217347_0007
¶He advised that it was difficult to make comparisons with South Africa, where it was summer, compared with the UK's winter, and where the demographic was different. The relative effectiveness of vaccination and the booster would be known within a week or two. Shielding of clinically vulnerable people would not make a significant impact on hospitalisation but there was evidence of negative mental health impacts.429 INQ000217347_0007 Professor Vallance also reiterated the SAGE advice – the longer it took to make decisions to introduce further measures, the higher the number of hospitalisations given current doubling rates. Modelling had included positive assumptions about severity, vaccine effectiveness and the booster uptake. He said that the "trajectory of Omicron infections and hospitalisations was clear".430 INQ000217347_0007
425¶8.151. Mr Johnson, noting that the UK Cabinet discussion was the "furthest it had been during the pandemic from the current scientific position", summed up with the decision not to introduce any further restrictions before the Christmas break:
¶" [ W]hile the data was uncertain, it was premature to reimpose restrictions. Given
the uncertainty of the data and the downsides of more stringent measures, it was right to proceed on the basis of: actively implementing Plan B, increasing capacity in the NHS (e.g. discharge); procuring antivirals; encouraging the public to exercise caution; making the proposed changes to self-isolation; and focussing on accelerating the booster campaign. There was an optimistic world where the Government may not need to act further."431 INQ000217347_0008
¶8.152. On 20 and 21 December 2021, to combat an expected increase in Omicron variant cases and consequent NHS pressures, the Welsh Cabinet agreed to move to Level 2 restrictions from 26 December, including reinstating two-metre social distancing, the rule of six and face coverings in hospitality settings. All indoor and outdoor events would be closed to spectators.432 INQ000057982; INQ000023306
¶8.153. The Scottish Cabinet met on 21 December 2021 to consider whether new restrictions would be required. Ministers were told they should take account of:
¶" the potential impact of a high number of cases on the wider provision of
essential services – even if, in health impact terms, Omicron was much less severe".433 INQ000214475_0004-0005 paras 23-24
¶The Cabinet agreed to introduce additional measures from 27 December 2021, including the reintroduction of one-metre physical distancing in all hospitality and indoor leisure settings and pausing large-scale events.434 INQ000214475_0008 para 34(d) The option of a circuit breaker lockdown was confirmed as the best means to tackle the viral spread, but ministers were told they could not take it due to the lack of commitment for financial support from the UK government.435 INQ000214475_0005 para 26 It was described as "extremely disappointing" that neither the Prime Minister nor the Chancellor of the Exchequer had attended COBR on 19 December.436 INQ000214475_0005 para 30
426¶8.154. That same day, Mr Johnson released a short video confirming that there would be no new restrictions imposed immediately in England for the Christmas period but that they could not be ruled out after Christmas – the situation was "finely balanced".437 INQ000257218
¶8.155. By 22 December 2021, the Omicron variant accounted for over 50% of new cases in Northern Ireland. Hospitals were operating at 103% bed capacity.438 INQ000207230_0002 para 2; INQ000421704_0231 para 500 Professors McBride and Young advised that this wave of infection would likely be "significantly larger" if current doubling rates continued, peaking in mid-January 2022 with a lag for any hospital pressures. They warned the Executive Committee that, without significant additional interventions, "it would be unwise to plan on the assumption that the wave would peak before we saw very large numbers" and observed that "earlier and stronger intervention" would be more effective in protecting hospital capacity.439 INQ000065662_0006-0007 paras 14, 19
¶8.156. The same day, the Northern Ireland Executive Committee agreed to impose a number of restrictions, including limits on mixing of households and in workplaces and a capacity cap for events, most of which took effect from 27 December.440 INQ000207230_0006-0007; INQ000065662_0002 para 7 Increased statutory requirements for wearing face coverings were introduced on 27 December, with a grace period to 7 January 2022. The Executive Office explained:
" There was little information available on the impact the Omicron variant would have. The scientific advice was, therefore, to implement precautionary measures to reduce its spread until more was known."441 INQ000438174_0180 para 684
¶8.157. On 23 December 2021, SAGE reported that the number of Omicron variant infections was still growing quickly, albeit rates were beginning to slow.442 INQ000120661_0001 para 1 Multiple analyses suggested (with medium confidence) that the Omicron variant was less severe than the Delta variant, although it remained unclear to what extent.443 INQ000120661_0001 para 5 The anticipated peak in hospital admissions was "highly uncertain", but even with:
" a reduction in severity may be comparable to, or higher than previous peaks in the absence of significant behaviour change or further interventions".444 INQ000120661_0002 para 13
¶SAGE advised that delaying interventions until after the anticipated wave of infections in older people was under way would be "too late to make a significant difference to the numbers of infections, hospitalisations or deaths".445 INQ000120661_0002 para 15
427¶8.158. By 30 December 2021, further data were available. Infection rates were "by far the highest levels seen yet in the pandemic" and admission data showed "rapidly growing pressure on the NHS" in England.446 INQ000074640_0001 The Omicron variant was considered to be around 50% to 70% less severe than the Delta variant in a population with high immunity and vaccine efficacy against severe disease, and hospitalisation was estimated at 90% after a booster.447 INQ000074640_0001 Professors Vallance and Whitty considered the updated data but advised that the issues and conclusions at the previous SAGE meeting remained appropriate.448 INQ000340401_0001 There was "rapidly growing pressure on the NHS" – the threat was no longer a theoretical modelled outcome but was based on admissions data.449 INQ000340401_0001 The encouraging severity and vaccine efficacy data were set against the increased proportion of the population infected. They advised 10 Downing Street, the Cabinet Office, the Department of Health and Social Care and the Covid-19 Taskforce that it would be unsafe to assume for planning purposes that the Omicron variant would peak early.450 INQ000340401_0001 They emphasised that any action would be useful in reducing the pressure on the NHS and probably in reducing deaths, and that, because the aim was no longer to reduce R to below 1 but instead to buy time for the booster vaccination programme, there would be no need for full lockdown measures akin to earlier in the pandemic.451 INQ000074640_0002
¶8.159. A smaller 'home team' meeting followed on 31 December 2021, foreshadowing the forthcoming review of Plan B. It was attended by the Prime Minister and representatives from the Cabinet Office and the Treasury.452 INQ000238826_0155 para 462 An email sent by Professor Vallance that day recorded that there was "huge resistance to any further measures" from Mr Johnson and Mr Sunak, with them not wanting to "move on anything more".453 INQ000064366 Mr Javid, who had previously argued for further restrictions, was not invited.454 Sajid Javid 29 November 2023 148/17-150/24; INQ000273901_0569, 0618; see, for example, INQ000251921. Mr Javid was also not invited to a meeting on 18 December 2021 (INQ000273901_0555). The briefing paper from Mr Ridley suggested that Mr Johnson consider further measures for a short period to reduce the peak. Mr Johnson told the Inquiry that he handwrote his scepticism of them: "bollocks".455 Boris Johnson 7 December 2023 69/13-25; INQ000251924_0007; INQ000255836_0187 para 641