The situation at the end of October 2021

The situation at the end of October 2021

¶8.90. Although the vaccine rollout was reducing rates of deaths and serious illness, the higher rates of transmission of the Delta variant meant the number of cases continued to climb. On 31 October 2021, Wales had the highest number of infections, with the infection rate being an estimated 81 cases per 100,000 people. The comparative figure was 60 for each of England and Northern Ireland and 48 for Scotland.²⁴²²⁴² 'UK: Daily new confirmed COVID-19 cases per 100,000, Oct 31, 2021', Our World in Data, 31 October 2021 (https://ourworldindata. org/grapher/uk-daily-covid-cases-7day-average?tab=discrete-bar&time=2021-10-31&country=Scotland~England~Wales~Northern+Irel and; INQ000548394) While the number of patients in hospital and intensive care and the deaths due to Covid-19 increased, these remained substantially lower than in previous waves.²⁴³²⁴³ INQ000396876_0008 Figure 1; INQ000022553_0002; INQ000249453_0011; INQ000048537_0002; 'UK: Daily new confirmed COVID-19 deaths', Our World in Data, 31 October 2021 (https://ourworldindata.org/grapher/uk-daily-covid-deaths?time=earliest..2021- 10-31&country=Northern+Irelan~Wales~England~Scotland~Northern+Ireland; INQ000548396); 'UK: Daily new confirmed COVID-19 cases per 100,000', Our World in Data, 1 August to 31 October 2021 (https://ourworldindata.org/grapher/uk-daily-covid-cases-7day-ave rage?time=2021-08-01..2021-10-31; INQ000548393)Show full note

¶8.91. Restrictions had, understandably, given way to efforts to balance and alleviate indirect harms, which in themselves were significant. In this respect, the UK government and devolved administrations relied heavily on the success of the vaccine rollout. By the end of October 2021, the percentage of adults aged 18 and over who had received two doses of the vaccine stood between 84% and 88% across the four nations.²⁴⁴²⁴⁴ INQ000065228_0048 Figure 15; INQ000065602_0007 para 21 However, the booster vaccination programme for vulnerable groups was only introduced in mid-September 2021, despite growing concerns about waning immunity.²⁴⁵²⁴⁵ INQ000370347_0057 para 117; 'Covid-19 booster vaccinations underway', Scottish Government, 20 September 2021 (https://www.gov.scot/news/covid-19-booster-vaccinations-underway; INQ000548017); 'Covid-19 vaccines for over-12s and boosters for over 50s', BBC News, 14 September 2021 (https://www.bbc.co.uk/news/uk-northern-ireland-58555665; INQ000548019); 'Covid Wales: Go-ahead for boosters and jabs for 12-15 year olds', BBC News, 14 September 2021 (https://www.bbc.co.uk/news/uk-wales- politics-58557120; INQ000548016); 'Covid booster vaccine rollout to begin across UK next week', BBC News, 14 September 2021 (https://www.bbc.co.uk/news/health-58550833; INQ000548014)Show full note

¶8.92. The period was marked by increasing pressure on health service capacity across the four nations.²⁴⁶²⁴⁶ INQ000092120_0004, 0006; INQ000421704_0228 para 493; Official Report: Meeting of the Parliament (Hybrid), The Scottish Parliament, 16 September 2021, Session 6 (https://www.parliament.scot/api/sitecore/CustomMedia/OfficialReport?meetingId=13300; INQ000548024); INQ000090707_0001 This underscored the importance of planning ahead for a difficult winter.

¶8.93. The aim in England was to manage surges alongside recovery and to live with Covid-19 without the need for increased interventions.²⁴⁷²⁴⁷ INQ000198208_0001 para 4 As such, there was to be no return to more stringent restrictions as implemented earlier in the pandemic. This was an optimistic approach, given the potential for variants of concern to emerge and the known seasonal issues. The better approach would have been for full contingency plans to have been drawn up to enable a swift and flexible response, if necessary. A more lethal and vaccine-evading variant was a realistic possibility and comprehensive plans should have been made accordingly.

¶8.94. In establishing Covid Urgent, the Welsh Government acknowledged that it might need to respond urgently to a new variant or waning vaccine immunity by the implementation of significantly more stringent measures to avoid unsustainable pressure on the NHS. This was useful as a communication tool to remind the public that the risks from Covid-19 were not yet over. The Welsh Government also confirmed publicly that, if the situation deteriorated, further restrictions could be needed.²⁴⁸²⁴⁸ 'Written Statement: Review of the Health Protection (Coronavirus Restriction) (No. 5) (Wales) Regulations 2020', Welsh Government, 29 October 2021 (https://www.gov.wales/written-statement-review-health-protection-coronavirus-restriction-no5-wales- regulations-2020-15; INQ000023302) However, the response under a Covid Urgent scenario did not envisage anything other than a return to the suite of restrictions that had been used to respond in other waves of the pandemic.

¶8.95. The approach of the Scottish Government over this period had changed from its position in the summer of 2020, when it had sought maximum suppression of the virus in Scotland. The greater focus on recovery and non-Covid-19 harms during this period meant that more stringent measures were not introduced.

¶8.96. The Northern Ireland Executive eased restrictions at a slower pace across this period. This was a comparatively cautious approach to that taken previously and was understandable in the context of uncertainty as to the potential impact of the Delta variant. The Executive Committee's Autumn/Winter COVID-19 Contingency Plan recognised the possibility that case numbers might rise sharply or that hospital pressures might become unsustainable.²⁴⁹²⁴⁹ NI Executive Autumn/Winter COVID-19 Contingency Plan, Northern Ireland Executive, October 2021 (https://www.executiveoffice-ni.gov.uk/sites/default/files/publications/execoffice/autumn-winter-covid-19-contingency-plan-2021.PDF; INQ000104468) While the plan set out potential contingency measures that could be used in those circumstances, these were limited and included only a bare reference to the possible "re-imposition of a legal requirement for minimum social distancing in prescribed settings".²⁵⁰²⁵⁰ NI Executive Autumn/Winter COVID-19 Contingency Plan, Northern Ireland Executive, October 2021 (https://www.executiveoffice-ni.gov.uk/sites/default/files/publications/execoffice/autumn-winter-covid-19-contingency-plan-2021.PDF; INQ000104468) Given the uncertainty at the time, detailed contingency plans were required.

¶8.97. Throughout this period, Delta had been the dominant variant, but concerns relating to potential new and evolved variants continued to feature heavily in scientific advice.²⁵¹²⁵¹ INQ000092856_0005 para 42