The weekend of 21 and 22 March 2020

¶4.140. Over the weekend of 21 and 22 March 2020, concerns escalated about the sufficiency of existing measures to avoid the collapse of the NHS in England. The virus was spreading exponentially. The NHS Covid SitRep for 21 March indicated that there were 2,428 Covid-19 patients in hospitals across England.³⁴⁵³⁴⁵ INQ000049748_0012 As Professor Ferguson explained:

" This 700-fold increase in hospitalised cases in over just two weeks partly reflects the approximately 4 doublings (16-fold) increase in the size of the epidemic, but also indicates the degree to which hospitalised cases were under-ascertained (i.e. missed) prior to full establishment of the NHS COVID Sitrep system."³⁴⁶³⁴⁶ INQ000249526_0084 para 260

¶4.141. On 20 March 2020, England had 3,384 confirmed cases of Covid-19, while Scotland had 322, Wales had 191 and Northern Ireland had 86.³⁴⁷³⁴⁷ INQ000056076_0002

¶4.142. At the Covid-19 Strategy Ministerial Group meeting on 21 March 2020, Mr Johnson said that the UK was heading for an "Italy-style situation" unless the country could turn around the current situation. He suggested that the public "did not yet grasp this from the Government's messaging".³⁴⁸³⁴⁸ INQ000056263_0002 He explained that he wanted to discuss whether the restrictions implemented the previous day were sufficient in light of data being presented or "whether prohibitions needed to be put in place that day".³⁴⁹³⁴⁹ INQ000056263_0002

192

¶4.143. Professor Whitty advised:

" [T]here was some risk of ITUs [intensive treatment units] being overtopped if the Government did not do more, but there were also risks associated with further action."³⁵⁰³⁵⁰ INQ000056263_0002

¶4.144. Sir Simon Stevens advised that the NHS was aiming to increase bed capacity.³⁵¹³⁵¹ INQ000056263_0003 Professor Vallance explained that measures to increase NHS England capacity should mean it would not be overwhelmed.³⁵²³⁵² INQ000056263_0003-0004 The worst-case scenario was that intensive care capacity in London would be overwhelmed in 9 days' time, but the projection was that this would happen in 15 days' time.³⁵³³⁵³ INQ000056263_0003

¶4.145. Mr Johnson concluded that "the situation remained dire and was getting worse".³⁵⁴³⁵⁴ INQ000056263_0004-0005 It was agreed that a further discussion on bed capacity would take place at the Covid-19 Strategy Ministerial Group meeting on 23 March 2020.³⁵⁵³⁵⁵ INQ000056073

¶4.146. Concerns about public compliance with social distancing continued over the weekend. Mr Shafi observed that 21 March 2020 was Snowdonia National Park's "busiest visitor day in living memory".³⁵⁶³⁵⁶ INQ000215035_0019 para 76 Similarly, on 22 March, Eluned Morgan MS (Baroness Morgan of Ely), Minister for International Relations and the Welsh Language from December 2018 to October 2020, noted to Mr Drakeford that the Welsh seaside town of Tenby was "full of visitors" and "the Daily Mail is recommending the Welsh wilderness as a place to escape".³⁵⁷³⁵⁷ INQ000376650

¶4.147. In an email to Professors Vallance and Whitty sent on the evening of 21 March 2020, Professor Ferguson said he was "unconvinced we're really seeing a 75% drop in contacts outside the household, at least this weekend".³⁵⁸³⁵⁸ INQ000228862 He advised that it could be necessary to "consider some degree of enforcement of 'stay at home' recommendations".³⁵⁹³⁵⁹ INQ000228862

¶4.148. On 22 March 2020, a Covid-19 Strategy Ministerial Group meeting took place at 15:00. The Covid-19 Dashboard, updated at 14:00, was presented at this meeting. That day, for the first time, the Dashboard contained data on intensive care unit capacity in England (but not in Scotland, Wales or Northern Ireland).³⁶⁰³⁶⁰ INQ000056076_0016 It outlined that occupancy had reached 80% of capacity in Greater London. It explained that "social distancing is happening but very likely not enough to prevent the virus growing".³⁶¹³⁶¹ INQ000056078_0005 Mr Hancock told the Inquiry that the data about intensive care unit capacity:

193

supported the need for a legal lockdown rather than the advisory approach that had previously been taken".³⁶²³⁶² INQ000232194_0076 para 319

¶Professor Whitty advised the meeting:

¶" [I]t was unclear how people had responded to social distancing measures so far

… 45% of people had changed their behaviour and … this needed to increase to 75% to be effective."³⁶³³⁶³ INQ000056266_0004

¶Mr Johnson stated that it was clear that "dramatic action to flatten the infection curve" was needed.³⁶⁴³⁶⁴ INQ000056266_0006 It was agreed that messaging would be worked up for 24 March which emphasised that "people should not leave their homes unless absolutely necessary".³⁶⁵³⁶⁵ INQ000056085

¶4.149. A further meeting of the Covid-19 Strategy Ministerial Group was held at 17:30. A paper drafted by Professor Whitty presented at the meeting explained that, in addition to direct deaths from Covid-19, excess mortality would arise from Covid-19 in a number of ways:

If the NHS was overwhelmed, deaths would result because otherwise treatable conditions, including Covid-19, would not be treated.
Deaths would result from conditions for which procedures had been delayed as a result of the NHS needing to reprioritise its resources.
Deaths would result from an increase in poverty due to measures taken by the UK government to reduce the spread of Covid-19.³⁶⁶³⁶⁶ INQ000203890_0001 para 1

¶4.150. At the meeting, Mr Johnson was provided with a draft version of the Department of Health and Social Care's COVID-19 Response – health & social care 3 month battleplan to tackle the virus and protect life.³⁶⁷³⁶⁷ INQ000106286 This estimated that between 12,500 and 15,000 hospital beds across England could be freed by postponing non-urgent elective operations and that, potentially, 15,000 acute beds could also be freed up.³⁶⁸³⁶⁸ INQ000106286_0006; INQ000255836_0087-0088 para 330 It was agreed that the Department of Health and Social Care should clarify that non-elective surgery would stop in England in mid-April 2020.³⁶⁹³⁶⁹ INQ000056094

194