September 2020
¶6.50. The situation continued to worsen in September 2020. In Northern Ireland, on 1 September, R was noted to be "steady at 1.3", but there was an increase in intensive care and hospital admissions. Certain council areas had concerning case numbers.127 INQ000304290_0001 As explained in Chapter 5: Exit from lockdown, in this volume, Professor Young had said that Northern Ireland could just about cope with R of 1.2, but not with anything higher.128 INQ000065729_0003
¶6.51. At a UK Cabinet meeting on 1 September 2020, Professor Whitty repeated his earlier advice, while Professor Vallance pointed to France, where younger people were transmitting the virus to the older population, resulting in increasing hospitalisation rates.129 INQ000088930_0008. See also the minutes from a meeting of Covid-S on 16 July 2020 (INQ000088249_0005). Mr Johnson acknowledged that increasing case rates in France and Spain served as a "warning" to the UK, with "no room for complacency". He was clear, however, that "a national lockdown should not be reimposed and schools would not be instructed to close again". Mr Johnson's preference was to focus on building an effective test and trace system, combined with "strong local lockdowns" as and when required.130 INQ000088930_0007
¶6.52. On 3 September 2020, Professor Whitty emailed Mr Case. While acknowledging Mr Johnson's "strong desire to avoid a national lockdown", Professor Whitty advised that a scenario in which this intervention was needed should be considered "quite seriously". He suggested that a "2-3 week partial or full lockdown" would act as a "fire break" and a "return from a doubling to a halving of the virus".131 INQ000070554_0001 Two days later, Professor Whitty emailed Mr Case again, cautioning that the growing test positivity rates were a "depressingly reliable early indicator of trouble … this is not yet trouble, but is heading for trouble".132 INQ000070569_0001 At this point, the death rate in the UK remained low.133 SAGE estimated R for the UK to be between 0.9 and 1.1 (INQ000061563_0002 para 1). However, as Professor Whitty explained:
" [T]here was a lag time between infections and deaths … if the Government waited for deaths to increase before it took action, that would inevitably result in a substantial number of deaths."134 INQ000088964_0005
¶6.53. Rising case rates were also being seen in Wales.135 INQ000320919 On 8 September 2020, Caerphilly was designated as the first 'local health protection area' in Wales, and saw the implementation of targeted local restrictions.136 The Health Protection (Coronavirus Restrictions) (No. 2) (Wales) (Amendment) (No. 8) (Caerphilly) Regulations 2020 (https://www.legislation.gov.uk/wsi/2020/961/made) That same day, it was noted that a number of other local authorities were at the "cusp of reaching threshold" for consideration of more stringent measures.137 INQ000220655_0004 Dr Sandifer had earlier outlined his concerns about the likelihood of increasing demands on the NHS, due to a
282¶"significant risk of exponential spread of the virus", and about the ability to control infection rates through Test, Trace, Protect (the Welsh Government's system of testing and contact tracing).138 INQ000385533_0003 He had again raised the need for urgent work on strengthening the local prevention and response plans.139 Dr Sandifer had previously raised this on 24 August 2020 (Quentin Sandifer 6 March 2024 64/2-65/11).
¶6.54. In Scotland, the Scottish Government Covid-19 Advisory Group raised concerns with Professor (later Sir) Gregor Smith (Interim Chief Medical Officer for Scotland from April to December 2020 and Chief Medical Officer for Scotland from December 2020) in mid-September 2020 that the pandemic was "[c]urrently heading fast in wrong direction" and that a second peak would happen in November 2020.140 INQ000217906 Ms Sturgeon concluded, on the advice of Professor Smith, that it would be "vital to go as far as possible" in reducing the R number.141 INQ000214448_0010 para 40 The Scottish Government would take action across a similar range of areas as the rest of the UK, but with proposed changes to "reflect the Scottish Government's existing precautionary approach". This was noted by Ms Sturgeon to be stricter than the approach adopted by the UK government.142 INQ000214448_0010, 0014-0015 paras 41, 57(a), 57(b)
¶6.55. The UK appeared to be following a similar trajectory to its European neighbours. At a UK Cabinet meeting on 8 September 2020, Mr Hancock noted that the death rate in France had just doubled over a three-week period.143 INQ000088964_0005 Data from the Joint Biosecurity Centre showed that the evolution of the case rate was consistent with that in France and Spain, which were four weeks ahead of the UK in terms of resurgence.144 INQ000088262_0006 This was an ominous forecast of what lay ahead. Mr Johnson told the Cabinet on 8 September:
" [T]he trend was clear … The Government would take action now so that the UK would not suffer the same consequences as those countries."145 INQ000088964_0004
The rule of six
¶6.56. That action was discussed in a meeting of Covid-S the same day, chaired by Mr Johnson. It noted that proposals would be developed to increase compliance with self-isolation, standardise local interventions into tiers and strengthen border control policies.146 INQ000088297_0003 para 8
283¶6.57. In terms of the strategic approach, the Covid-19 Taskforce advised that there were two choices in the short term:
-
¶
- "go harder now, with a greater degree of disruption"; or
- " adopt a softer approach, buying time to see whether the response is effective, while accepting that this might necessitate a more onerous response in the future".147 INQ000088297_0001-0002 paras 1, 3
¶The taskforce's recommendation was to "double down on the current strategy" (the softer approach) with "more forceful communications, tighter social contact and tougher enforcement". This included changing the guidance for indoor mixing from a maximum of two households to a "fixed number", which "may be easier to understand, comply with and enforce".148 INQ000088297_0003-0004 para 8 A fixed number of six or eight was raised by Simon Ridley (Director General for Policy and Strategy on the Covid-19 Taskforce from May 2020 to July 2021) and discussed.149 INQ000088263_0004-0005 This was to develop into the 'rule of six'.
¶6.58. Professor Vallance advised:
" [I]t was not possible to quantify the impact of a social contact limit of eight as opposed to six, although the lower the number the better from a transmission perspective."150 INQ000088263_0008
¶He suggested that the UK's response should be "quick and hard".151 INQ000088263_0008 Professor Whitty warned:
" [T]he more steps taken to make it easier to bring households together, the more likely that the brakes would need to be slammed on hard later."152 INQ000088263_0008
¶6.59. Despite this, Mr Johnson agreed to set a single numerical limit of "6 people in all settings including private homes", without any limit on the number of households.153 INQ000233982_0001; INQ000088263_0009; INQ000088297_0004 This "would be simple and enable tough enforcement". Any social gathering of more than six people would be against the law, unless it fell within a limited number of exemptions.154 INQ000086845_0004; The Health Protection (Coronavirus, Restrictions) (No. 2) (England) (Amendment) (No. 4) Regulations 2020 (https://www.legislation.gov.uk/uksi/2020/986/contents) Mr Gove relayed the UK government's intentions to the leaders of the devolved nations on 9 September 2020.155 INQ000361620
284¶6.60. The rule of six was implemented in England on 14 September 2020, five days after its announcement.156 'Rule of six comes into effect to tackle coronavirus', Home Office and Priti Patel, 14 September 2020 (https://www.gov.uk/government/news/rule-of-six-comes-into-effect-to-tackle-coronavirus; INQ000212110); INQ000086845 During that time, the number of infections had continued to grow.157 INQ000049748_0020; INQ000061565_0002 paras 1-5; INQ000120554_0001 para 1 In his contemporaneous evening notes from September 2020, Professor Vallance recorded that it felt:
" like Feb/March … strikes me that the delay in introducing the new rules until Monday is exactly what they did in March. Why delay??"158 INQ000273901_0176
¶6.61. SAGE had provided "no specific advice" on the rule of six.159 INQ000238826_0118 para 354 It ought to have been consulted by the UK government. Neither Professors Vallance nor Whitty believed that this measure alone could reduce R below 1. Professor Vallance told the Inquiry that he was "confident" he had communicated this advice to Mr Johnson.160 INQ000238826_0118 para 355; INQ000251645_0136 para 8.48 Their views were reflected in the subsequent SAGE minutes of 10 September 2020, which stated:
" It is highly likely that further national and local measures will be needed to bring R back below 1 in addition to those already announced. An early and comprehensive response would mean that measures have more effect and may be needed for a shorter duration."161 INQ000120554_0001 para 3
¶6.62. More significantly, far from the recommended "tighter social contact", the rule of six in England in fact represented a loosening of the guidance.162 INQ000233982_0001; INQ000088297_0003 para 8 Instead of the previous two-household limit indoors, the new measure permitted mixing across as many as six households, so long as the total number of people meeting did not exceed six. Although the rule of six changed over time, the initial guidance applying the same limits in all settings failed to distinguish between the relatively higher risk of transmission indoors compared with outdoors. Professor Whitty warned Covid-O that "the number of households meeting was one of the biggest determinants of spread".163 INQ000251645_0136 para 8.48 Dominic Cummings, Adviser to the Prime Minister from July 2019 to November 2020, described the rule of six as "a bad decision made under the influence of communication concerns".164 INQ000273872_0093 para 468
¶6.63. Fewer households were able to meet under the rule of six in Scotland, Wales and Northern Ireland, although younger children were exempted from the six-person limit.165 INQ000023258; INQ000048489_0004 paras 13-14; 'Coronavirus: Maximum size of gatherings in Scotland cut to six', BBC News, 10 September 2020 (https://www.bbc.co.uk/news/uk-scotland-54093110; INQ000357427)
285¶Table 3: The rule of six by nation, September 2020
¶Nation Implemented Household limits Position of children England 14 September 2020 None Included Scotland 14 September 2020 No more than two Under 12s excluded Wales 14 September 2020 Four households per Under 11s excluded one exclusive 'bubble' Northern 25 August 2020 No more than two Under 12s excluded from Ireland 17 September 2020
¶6.64. The Northern Ireland Executive had previously restricted indoor gatherings in private
dwellings to six people from no more than two households from 25 August 2020, in response to rising infection rates.166 INQ000065565_0002 para 4; INQ000048486_0005 para 18(iii); INQ000425623_0003-0004 para 12; INQ000421704_0177 para 389 On 17 September 2020, this was extended to hospitality settings.167 INQ000048489_0004 para 13 Scotland, similarly, limited the six people to two households.168 'Coronavirus: Maximum size of gatherings in Scotland cut to six', BBC News, 10 September 2020 (https://www.bbc.co.uk/news/uk-scotland-54093110; INQ000357427)
¶6.65. The Welsh Government had already agreed to impose restrictions on the number
of households that could meet at its review on 18 August 2020, and agreed on 8 September 2020 that those limits should remain in force.169 INQ000048867_0003 para 2.1; INQ000048862_0003 para 2.1 On 11 September, Mark Drakeford MS, First Minister of Wales from December 2018 to March 2024, announced the introduction of the rule of six from 14 September 2020. A total of six people from one extended household (comprising a maximum of four households) could meet indoors.170 INQ000023258; The Health Protection (Coronavirus Restrictions) (No. 2) (Wales) (Amendment) (No. 9) Regulations 2020 (https://www.legislation.gov.uk/wsi/2020/985/contents/made) Mr Drakeford confirmed that Wales had adopted the same number "because of simplicity of messaging".171 INQ000090607_0001; INQ000349851_0001; INQ000145504_0008 para 44; INQ000361620
¶6.66. The rule of six was accompanied by an announcement of, in Mr Johnson's words:
" an alternative plan which could allow life to return closer to normality. And that plan is based on mass testing."172 INQ000086845_0005
286This was the Moonshot programme: testing was to be used to identify people who were Covid-19 negative to allow them to return to normal life. The Moonshot programme was distinct from test and trace initiatives. Scientific advice provided in August 2020, prior to the announcement of the policy, was that such mass testing would have minimal effect on the strategic aim to reduce R.173 INQ000371699 Furthermore, the effectiveness of mass testing would:
" depend on several factors including the proportion of the population tested; the frequency of testing; the ability of a test to identify true positives and negatives; the speed of results; and adherence to isolation".174 INQ000061561_0002 para 2
¶6.67. Concerns were raised about the potential negative impact on resourcing NHS Test and Trace, with advice that it needed to be "optimised" and remain a "priority".175 INQ000120552_0001 para 5 This was reiterated in advice from Professor Whitty in November 2020, who explained that the evidence that mass testing would have a useful impact was "weak" and that there were "clear and major opportunity costs".176 INQ000071531 Diversions and delays in testing time turnaround "would definitely lead to a net loss for public health".177 INQ000071531
¶6.68. The rule of six was also undertaken alongside other measures across the devolved nations. Each nation was facing an acceleration of Covid-19 cases. The Scottish Government had been considering whether it needed to "put the brakes on" the further lifting of lockdown measures.178 'Coronavirus (COVID-19) update: First Minister's speech 7 September 2020', Scottish Government, 7 September 2020 (https://www.gov.scot/publications/coronavirus-covid-19-update-first-ministers-speech-7-september-2020; INQ000354272_0005) Planned relaxations to some restrictions, scheduled for 14 September 2020, were delayed until 5 October 2020 and amendments were made to face covering requirements.179 'Coronavirus: Maximum size of gatherings in Scotland cut to six', BBC News, 10 September 2020 (https://www.bbc.co.uk/news/uk-scotland-54093110; INQ000357427) The Northern Ireland Executive also deferred proposed hospitality openings.180 INQ000048489_0004 para 13
¶6.69. Covid-19 infections in Wales had tripled in the four days preceding 8 September 2020, representing "the largest number of daily infections since May".181 INQ000048867_0002 para 1.4 Professor Christopher Jones, Deputy Chief Medical Officer for Wales from June 2010, provided advice on 10 September that supported mandatory face coverings and further restrictions on household gatherings.182 INQ000281839
¶6.70. On 10 September 2020, the Northern Ireland Executive agreed to introduce localised restrictions in Greater Belfast, Ballymena and three other postcode areas for an initial period of two weeks (subject to weekly monitoring and review).183 INQ000048488_0004 para 11; INQ000208760_0002, 0004-0005 paras 6, 12, 13 Reflecting the urgency of the situation, Professor McBride said that he was "profoundly concerned" and urged ministers "to take affirmative action … soon. Don't have days to wait."184 INQ000065769_0017
¶6.71. Professor Young explained to the Inquiry that, while the impact of localised restrictions in the context of rising transmission rates was uncertain, and it was recognised that the impact was likely to be transient, they were worth trying in an effort to reduce transmission.185 Ian Young 7 May 2024 169/1-5 Professor McBride described localised restrictions as the "least worst option" when they were considered by the Northern Ireland Executive in September 2020.186 INQ000065769_0017
287¶6.72. SAGE and Wales's Technical Advisory Cell both observed on 10 and 11 September 2020 that the situation in the UK was similar to the one in early February 2020 and that early action was required to stall the increase in cases.187 INQ000120554_0001 para 1; INQ000066383_0002
¶6.73. There had been a particularly steep rise in case rates across the north-east of England, West Yorkshire, the Midlands and parts of north-west England. On 18 September 2020, these areas were made subject to local restrictions.188 INQ000090165; INQ000233995_0001
Face coverings
¶6.74. The Welsh Government was the last of the four nations to mandate the wearing of face coverings in shops and supermarkets, on 14 September 2020. It had also been the last to mandate their use on public transport, on 27 July 2020.189 INQ000391115_0025-0026 paras 103, 106 Dr (later Sir) Frank Atherton, Chief Medical Officer for Wales from August 2016, told the Inquiry that he felt he had been "putting ministers in actually quite a difficult position" by taking a different position from the Chief Medical Officers for the other three nations, but he was:
¶" trying to make sure that ministers understood that this was their decision but my advice was that the evidence was not robust".190 Frank Atherton 4 March 2024 48/18-50/8
¶6.75. Mr Drakeford explained that the Welsh Government did not mandate face coverings sooner because:
¶" While the Chief Medical Officer for Wales's advice remained explicitly against
making them mandatory, I felt it important to support that position. Not to have done so would have eroded trust between decision-makers and advisers and, more importantly, would have eroded trust amongst the public that the Welsh Government was committed to following best advice, even when that advice was controversial."191 INQ000371209_0065 para 209
¶Mr Drakeford did, however, "absolutely agree" that the Welsh Government had had the choice to go against that advice.192 Mark Drakeford 13 March 2024 137/12-138/3
¶6.76. Looking back, Sir Frank Atherton said that it "would have been better to align" with the position on face coverings in England.193 Frank Atherton 4 March 2024 53/11-19 Mr Drakeford told the Inquiry that, by the time the Welsh Government changed its advice on face coverings, Dr Atherton had "moved away from the argument that [they] would do more harm than good".194 Mark Drakeford 13 March 2024 140/5-17
288¶6.77. The concerns raised by Dr Atherton regarding the supply of masks to the NHS, the adoption of risky behaviours and the potential for discrimination could have been addressed through clear communication and guidance in a similar way to the UK government's advice about the use of face coverings in its May 2020 Roadmap.195 See INQ000349411_0002; INQ000391115_0024-0025 paras 99, 102; Our Plan to Rebuild: The UK Government's COVID-19 Recovery Strategy, HM Government, May 2020, pp31, 54 (https://www.gov.uk/government/publications/our-plan-to-rebuild-the-uk- governments-covid-19-recovery-strategy; INQ000198892)
¶6.78. The experience of the Covid-19 pandemic has shown that wearing a face covering has minimal disadvantage for the majority of the population. In any future pandemic where airborne transmission is a risk, the UK government and devolved administrations should give real consideration to mandating face coverings for the public in closed settings. At the very least, they should strongly advise that face coverings are worn by those who are able to do so in settings such as public transport, supermarkets, and health and social care settings. Further, it would be beneficial for governments to align their positions to avoid confusion, particularly if they are in receipt of the same or similar expert advice (such as from SAGE, the New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG) or the World Health Organization).
Consideration of a circuit breaker in England
¶6.79. By mid-September 2020, the situation in England was approaching crisis point. Despite uncertainties in the data, the Operational sub-group of SPI-M (SPI-M-O) stated that there was "complete consensus that the epidemic situation is very serious" and warned:
" [T]he epidemic is close to breaching the agreed Reasonable Worst Case Scenario on which NHS, DHSC [Department of Health and Social Care] and HMG [UK government] contingency plans are based."196 INQ000213284_0001 para 2; INQ000223534
¶6.80. On 17 September 2020, SAGE advised that a "'circuit-breaker' type of approach" with "a 2-week period of restrictions similar to those in force in late May" could have a "significant impact on transmission" and could delay "the epidemic by approximately 4 weeks". Individual interventions were "highly unlikely" to bring R below 1, and SAGE emphasised that effective operational response measures were "absolutely critical, particularly in care homes, hospitals, workplaces and Test, Trace and Isolate (TTI) systems".197 INQ000061565_0002-0004 paras 1-5, 15, 17, 23
289¶6.81. R was estimated to be between 1.2 and 1.4 in England, with the caveat that it was believed to be higher given the "recent changes from the last 2 to 3 weeks such as the reopening of schools in England".198 INQ000061565_0002-0003 paras 10, 17 Critically, SAGE estimated that the growth rate equated to:
" a doubling time for new infections of 10 to 20 days, though currently this doubling time could be as short as 7 days nationally and even shorter in some areas".199 INQ000061565_0002-0003 para 10
¶SAGE therefore agreed to prepare an updated paper for the Cabinet Office by
¶21 September 2020, noting that "speed of response is key".200 INQ000061565_0004
¶6.82. SPI-M-O advised that a 'circuit breaker' (a short-term set of restrictions of pre- determined length) would be most effective when growth of the epidemic was relatively low (ie with R at or below 1.2).201 INQ000213284_0001 para 6 Professor Graham Medley (Professor of Infectious Disease Modelling at the London School of Hygiene & Tropical Medicine and Co-Chair of SPI-M-O from January 2020 to February 2022) explained that a circuit breaker aims to:
" keep prevalence low whilst it is low, in contrast to emergency breaks which aim to reduce prevalence once it becomes high".202 INQ000260643_0062 para 6.29
¶6.83. R in England had already exceeded 1.2. The UK government's daily cross-departmental Covid-19 Dashboard set out data from the Coronavirus (Covid-19) Infection Survey that showed cases were growing rapidly.203 INQ000283722_0004 The conditions in which SPI-M-O considered a circuit breaker would be most effective were already at risk.
¶6.84. Following the SAGE meeting, Mr Cummings encouraged Mr Johnson to adopt the approach put forward by SAGE, noting that the "[l]esson of first wave was earlier better when dealing with exponentials".204 INQ000102265_0002 Professor Vallance reiterated the point he had made earlier in September 2020 that the "lesson is go fast, go a bit harder than you think you need, go a bit wider in geography".205 INQ000102265_0002
¶6.85. On 18 September 2020, Mr Case (by now Cabinet Secretary and Head of the Civil Service) told Mr Hancock that "the fire-break idea is gaining traction" with the Prime Minister.206 INQ000129483 Later that day, however, he advised:
290" PM [Prime Minister] wants to double down on present strategy for now – tougher local lockdown/enforcement, warning messages about what happens if people don't follow the rules."207 INQ000129483
¶6.86. Sadiq Khan (later Sir Sadiq Khan), Mayor of London from May 2016, wrote to Mr Johnson expressing his:
" firm view that we should not wait for this virus to again spiral out of control before taking action and the best thing for both public health and the economy is new restrictions imposed early, rather than a full lockdown when it's too late".208 INQ000118973
¶6.87. On 19 September 2020, Professor Vallance recorded in his evening notes:
" He [Mr Johnson] is all over the place and completely inconsistent. You can see why it was so difficult to get agreement to lockdown 1st time."209 INQ000273901_0188
¶6.88. That day, the Covid-19 Taskforce produced its 'COVID-19: Winter strategy'.210 INQ000137293 This presented a stark reality. The seven-day average of confirmed cases had more than tripled from mid-August 2020 and was "on a sharply upward trajectory". This had translated into a doubling of hospitalisations within the fortnight and the potential for NHS overwhelm within six weeks. SAGE modelling suggested that the first wave's peak of infections could be surpassed by mid-October 2020, and hospitalisations and deaths by early November 2020.211 INQ000137293_0001 paras 1, 3
¶6.89. However, the Covid-19 Taskforce asked Mr Johnson to consider three potential 'packages' of interventions: A, B and C. Package A contained the least stringent measures and Package C the most stringent, including a circuit breaker.212 INQ000137293_0003-0006 Within Package C – essentially a lockdown but lighter than the lockdown beginning in March 2020 – non-essential retail, universities and schools would nonetheless remain open. The taskforce recommended Package A, which included a national address by Mr Johnson, a return to guidance that people work from home where they could, and "a codification of our local interventions into tiers, as agreed at the COVID-Ops Committee [Covid-O]".213 INQ000137293_0003 para 6 It observed:
291" Package A is designed to change behaviour while minimising economic harm. UK GDP is still 11.7% below February levels, after a record fall of 20.4% in Q2 [April to June] 2020. There is a risk that interventions may have a more significant impact than in March, given the weakened position of many firms and individuals, and would compound existing inequalities."214 INQ000137293_0004 para 10
¶However, it also noted:
" It is the view of the CMO [Chief Medical Officer] and GCSA [Government Chief Scientific Adviser] that, unless it prompts a significant behavioural response, Package A is very unlikely to drive R below 1."215 INQ000137293_0003 para 7
¶The taskforce further advised that there was a risk that even a combination of
¶Packages A and B, or Package C, would "fail to bend the curve, leaving R above 1".216 INQ000137293_0003, 0006 paras 7, 18
¶6.90. Although both Professors Whitty and Vallance recommended a circuit breaker, this was not the Covid-19 Taskforce's unequivocal recommendation – hence Mr Johnson's observation that a circuit breaker had not been pressed hard on him.217 INQ000273872_0095-0096 para 486; INQ000255836_0133-0134 para 476
¶6.91. On 20 September 2020, Mr Johnson held a "challenge session" over Zoom to hear arguments from a range of scientists, including "some highly-qualified critics of the Government's approach to date".218 INQ000255836_0129-0130 paras 460-461; see also INQ000183965; INQ000238826_0125 para 372 Mr Sunak and Professors Whitty and Vallance were invited but Mr Hancock and Mr Gove were not. Mr Johnson said that he was aware of their views and "wanted time to quiz the experts myself".219 INQ000255836_0129 para 460 He said that he considered it "important to hear some alternative views".220 INQ000255836_0128 para 457 Mr Hancock, however, was "astonished that No10 [10 Downing Street] could organise such a meeting without inviting the Health Secretary".221 INQ000232194_0132 para 523
¶6.92. Professor John Edmunds (Professor of Infectious Disease Modelling at the London School of Hygiene & Tropical Medicine) advised Mr Johnson that the UK's response needed to be "fast and large".222 INQ000146605 He recommended the imposition of "an immediate circuit breaker (two-week lockdown)", urging that the UK "should not make the same mistake" as it did in March 2020.223 INQ000146605 He reminded the meeting that the "key factor for the large number of deaths in the UK was the lateness of our response".224 INQ000146605 Professor McLean cautioned that test and trace would not function effectively in a large second wave.225 INQ000146609 She advocated "decisive action" with a circuit breaker, but with schools remaining open.226 INQ000309529_0043 para 143
¶6.93. Dr Anders Tegnell, Swedish state epidemiologist, was also in favour of further action by the UK government. He told the meeting that "the myth that Sweden did nothing during the pandemic is false".227 INQ000146608_0001 Sweden is frequently cited as a country that did not implement a lockdown but that successfully brought the virus under control. It is true that, rather than imposing mandatory measures, the government issued guidelines recommending social distancing, the avoidance of non-essential travel and working from home where possible. Businesses and primary schools largely remained open.
292¶Gatherings of more than 50 people were, however, banned and secondary schools and universities switched to remote learning.228 INQ000249526_0090 para 274
¶6.94. In a study that Imperial College London undertook comparing the first wave of the pandemic in the UK, Denmark and Sweden, it found that Sweden achieved almost the same level of reduction in contact rates (as reflected in workplace mobility changes and the proportion of people avoiding public spaces) as many other European countries. These included its neighbour, Denmark, which instituted a suite of mandatory policies. However, Swedish control measures took longer to reduce R below 1 than did the measures adopted by both the UK and Denmark, and achieved a lower overall reduction in R.
¶6.95. By contrast, Professor Sunetra Gupta (Professor of Theoretical Epidemiology) and Professor Carl Heneghan (Professor of Evidence-Based Medicine), both at the University of Oxford, rejected the concept of a national lockdown.229 Professor Gupta was among the signatories to the Great Barrington Declaration, which called for the lifting of lockdown restrictions (and is discussed further below). Both Professors Gupta and Heneghan were on the scientific advisory board of 'Collateral Global', which campaigns against the imposition of mandated interventions. They proposed an alternative approach: "focused protection" of those who were most vulnerable to severe disease and death, while allowing the unrestricted spread of infection in the non-vulnerable population.230 INQ000248853_0093-0094 para 6.24; INQ000146606; INQ000146607 This had parallels with Mr Johnson's interest in population segmentation. Professor Gupta highlighted the social, economic, psychological and developmental harms caused by lockdowns. She asserted that focused protection was "the only humanitarian route out of the crisis".231 INQ000252725_0008-0009 para 30 Professor Heneghan argued that the UK government's response to the crisis was:
" out of proportion to the threat … underpinned by a lack of understanding of the data, the role of community pathogens and an overreliance on predictive modelling".232 INQ000146607
¶He also said that "there will be more deaths, but there needs to be context … deaths are lower than influenza/pneumonia".233 INQ000146607
¶6.96. There was considerable criticism of the approach advocated by Professors Gupta and Heneghan. Mr Hancock described them as "discredited anti-lockdown proponents" who "did not represent credible scientific thinking".234 INQ000232194_0132 para 523 Mr Johnson told the Inquiry that he was "certainly willing to be persuaded" by the views of Professors Gupta and Heneghan. He recalled, however, that they were in fact "reluctant to argue any such case, or not very hard".235 INQ000255836_0131 para 464
293¶6.97. Professor McLean told the Inquiry:
¶" Among the more important inaccurate assertions made by Professors Gupta and Heneghan were that: most of the population were immune ('dark immunity'), we could not measure immunity, we should let everyone acquire immunity by allowing a huge second wave because we could fully shield all the vulnerable, and that Covid-19 was less dangerous than influenza."236 INQ000309529_0044 para 145
¶6.98. In advance of an upcoming Covid-S meeting and having considered the Covid-19 Taskforce's 'COVID-19: Winter strategy', Mr Johnson's view on the evening of 20 September 2020 was to "pursue all of Package A nationally, and some measures from Package B" (greater restrictions, including a curfew for hospitality and weddings).237 INQ000215035_0031 para 119
¶6.99. On 21 September 2020, Mr Cummings chaired a "hypothetical future meeting" with Mr Johnson and 10 Downing Street officials. He hoped to push Mr Johnson:
¶" into the mental state the data suggested he would be in at the end of October, and make him realise what he would then do".238 INQ000273872_0096-0097 paras 490, 492; INQ000146611_0002
¶This followed supplemental advice and projections about infections and deaths from the Covid-19 Taskforce provided on 20 September. Notwithstanding its recommendation of the least restrictive Package A measures the day before, Mr Ridley said that the presentation aimed to "prompt action".239 Simon Ridley 7 November 2023 83/8-12, 84/4
¶6.100. Mr Cain recalled that the evidence in favour of a circuit breaker at this meeting was:
¶" overwhelming, with the data and overwhelming expert opinion being that if the Government did not take action in the form of a circuit breaker, Covid would once again spread rampantly across the UK and leave no other option than a longer and more restrictive lockdown in the months ahead.
¶The PM remained unconvinced, believing it would be better to 'keep the beaches open' (a reference to the film Jaws) and not to close down the economy for a second time."240 INQ000252711_0029 paras 127-128
294¶Without a circuit breaker, Covid-19 would:
" leave no other option than a longer and more restrictive lockdown in the months ahead … The Downing Street team believed it would be better for the economy and for the health of the nation to implement a circuit breaker as this would mean spending less time in lockdown."241 INQ000252711_0029 paras 127-128
¶Mr Johnson was "not persuaded" that a circuit breaker was a "good idea".242 INQ000255836_0132 para 470
¶6.101. On 21 September 2020, SAGE repeated its earlier advice "with more urgency". A package of interventions was needed to reverse the exponential rise in cases. A shortlist of measures "should be considered for immediate introduction".243 INQ000238826_0119-0120 para 359 These included: a circuit breaker lockdown; working from home; closure of hospitality settings and personal services; a move to online learning for college and university students; and a ban on socialising with people from outside the household in the home.244 INQ000061566_0002 para 2 Mr Johnson said that this advice, as well as subsequent advice up to 22 October 2020, was "never … pushed on me very hard".245 INQ000255836_0133-0134 para 476
¶6.102. SAGE noted that each intervention had "associated costs in terms of health and wellbeing and many interventions will affect the poorest members of society to a greater extent". However:
" The more rapidly interventions are put in place, and the more stringent they are, the faster the reduction in incidence and prevalence, and the greater the reduction in COVID-related deaths (high confidence). Both local and national measures are needed; measures should not be applied in too specific a geographical area."246 INQ000061566_0002 para 6
¶6.103. In a briefing for Mr Sunak in advance of a meeting of Covid-S on 21 September 2020, the Treasury stated:
" We are reaching the limits of what we can do economically, with further measures likely to be catastrophic. We need a strategy that works over the winter period, rather than tinkering with restrictions week to week."247 INQ000184589_0001
¶The briefing advised Mr Sunak to "push back strongly on the circuit breaker proposal", on the basis that its "economic impacts would be severe, making firm failures and redundancies far likelier".248 INQ000184589_0002 In a briefing to the Cabinet and COBR on 22 September, the Treasury emphasised that the UK:
295" must avoid at all costs returning to national economic restrictions that will devastate sectors that are already extremely vulnerable".249 INQ000232100_0001
¶6.104. Mr Sunak told the Inquiry that he had not supported the use of a circuit breaker in England.250 Rishi Sunak 11 December 2023 156/13-18 Mr Johnson feared that the UK would "unlock and then lock down again as the cases rose" after a circuit breaker lockdown, which "might cause even worse disruption to people's lives and businesses".251 INQ000255836_0134 para 478 Mr Hancock expressed similar concerns.252 INQ000232194_0131 para 519 Both Professors Whitty and Vallance acknowledged that this was likely and that a circuit breaker alone would not avoid a second wave of infections. However, both considered that interventions were needed and would result in shorter, less stringent restrictions later.253 INQ000238826_0119 para 358; INQ000251645_0140 para 8.52
¶6.105. At Covid-S, more stringent measures were rejected in favour of a combination of Package A and some additional measures, including extensions of mandatory requirements for face coverings, restrictions on household mixing and curfews in the hospitality sector.254 INQ000088271_0005-0009; INQ000232194_0133-0134 paras 525-526 Mr Johnson noted that a failure by the public to adhere to the restrictions would result in further action that would be "disruptive".255 INQ000088299_0002 para 4; INQ000088271_006; see also INQ000065358
¶6.106. On 22 September 2020, the UK government and devolved administrations discussed and endorsed the measures proposed at COBR, but noted that there would be some variation in the measures put in place in each nation to reflect "local circumstances".256 INQ000091388_0001; INQ000083849 The Scottish Government noted media speculation about the circuit breaker lockdown at a Scottish Cabinet meeting that day, but had not formally considered whether such a measure should be implemented.257 INQ000214448_0011 para 51
¶6.107. Measures were subsequently imposed to take effect in Scotland on 23 September 2020 and in England and Wales on 24 September.258 INQ000232100_0001; INQ000065358; INQ000023259 In a statement to the UK Parliament on 22 September, Mr Johnson set out new restrictions to take effect in England, including: working from home where possible; table service only in pubs, bars and restaurants; closure of hospitality venues at 22:00; extended requirements on face coverings; a maximum of 15 people at wedding ceremonies and receptions; and the rule of six extended to all adult indoor team sports. The 22:00 curfew had been considered by SAGE on 21 September to be "likely to have a marginal impact. Low confidence."
¶6.108. On 22 September 2020, four more local authorities in Wales were designated as local health protection areas.259 The Health Protection (Coronavirus Restrictions) (No. 2) (Wales) (Amendment) (No. 11) (Blaenau Gwent, Bridgend, Merthyr Tydfil and Newport etc.) Regulations 2020 (https://www.legislation.gov.uk/wsi/2020/1022/contents) Having met the day prior to consider the need for urgent restrictions in additional areas, due to a "substantial increase in Covid-19" infections, on 22 September the Northern Ireland Executive agreed to extend the current restrictions on household mixing to the whole of Northern Ireland, along with further restrictions on hospitality.260 INQ000213664_0001 para 1; INQ000022457_0001-0002 paras 1, 3
296¶6.109. The rejection of a circuit breaker by the UK government (including COBR and Covid-S) went directly against the clear advice of SAGE. The UK government chose to implement a selection of measures that it had been warned were unlikely to be effective.261 INQ000137293_0003-0004; INQ000251645_0141 para 8.54 The damaging economic and societal consequences of a circuit breaker were obvious. However, by rejecting harsher restrictions in favour of a 'softer' approach, the UK government failed to take the steps necessary to prevent the virus from continuing to spread at pace. This failure paved the way, in turn, for the inevitable outcome: a more deadly spreading of the virus and a lengthier, later lockdown, with greater economic impacts.
¶6.110. Mr Johnson told the Inquiry that the scientific advice on this intervention "was not clear".262 Boris Johnson 7 December 2023 30/12-13; INQ000255836_0133-0134 para 476 This is incorrect. SAGE delivered robust and forceful expert scientific advice on the merits of a circuit breaker. The advice was unequivocal that, the more stringent the measures taken and the sooner they were implemented, the faster the epidemic would shrink and the shorter the period interventions would need to be in place. As Professor McLean pointed out, a short, intermittent circuit breaker would be less detrimental than allowing infections to "grow until you're just about to break the NHS, and then you bring in a massive, massive lockdown".263 Angela McLean 23 November 2023 80/20-81/1
¶6.111. It is correct that the scientific advisers "did not believe it [a circuit breaker] was in any sense a silver bullet".264 INQ000255836_0133-0134 para 476 However, SAGE made it plain that a circuit breaker was a vital element of a wider package.265 INQ000238826_0124 para 370; INQ000061565_0002 para 2; INQ000061566_0002 para 2 Other scientific experts agreed. Professor Neil Ferguson, Mathematical Epidemiologist at Imperial College London, observed:
" [ W]hile the measures announced were certainly better than taking no action, they did not reach the level recommended by SAGE the previous day and would at best slow the rate of growth of the epidemic."266 INQ000249526_0101 para 312; see also INQ000309529_0043 para 143
¶6.112. Similar scientific advice was provided to the Welsh and Scottish governments and the Northern Ireland Executive at this time. It noted that further measures might be needed if R did not fall below 1, and that such measures would have a greater impact the earlier they were introduced.267 INQ000066391; INQ000233568; INQ000022457; INQ000065777
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