UK Inquiry Says Government Did ‘Too Little, Too Late,’ in Response to COVID-19 Pandemic
The four governments of the United Kingdom responded during the COVID-19 pandemic. But they did “too little, too late,” to effectively stop the virus from spreading during a critical moment in time, according to a national inquiry published this week.
“This lack of urgency and the huge rise in infections made a mandatory lockdown inevitable,” the inquiry report explained. “It should have been introduced one week earlier. Modelling shows that in England alone there would have been approximately 23,000 fewer deaths in the first wave up until 1 July 2020.”
As the pandemic continued, indecisiveness and a false sense of security continued to plague decision-makers across England, Northern England, Scotland, and Wales.
“All four governments failed to appreciate the scale of the threat or the urgency of the response it demanded in the early part of 2020, relying in part on misleading assurances that the UK was properly prepared for a pandemic,” said UK COVID-19 Inquiry Chair The Rt Hon Baroness Heather Carol Hallett in a statement.
The UK COVID-19 Inquiry was established under former UK Prime Minister Boris Johnson to assess the UK’s response to the COVID-19 pandemic. It published its first report—on resilience—in July 2024 and released its second report this week on the core decision-making and political governance in the UK during the pandemic.
The new 760-page volume rigorously reviewed all actions that the governments of each nation of the UK made during the global crisis and found that their inaction and inability to properly assess the risk of the virus—especially during the first quarter of 2020—contributed to the calamity that ultimately unfolded, which killed more than 232,000 people.
“The tempo of the response should have been increased. It was not. February 2020 was a lost month,” Hallett explained. “There was a serious failure by all four governments to appreciate the level of risk and the calamity that the UK faced, and the need to inject urgency into the response. The obviously escalating crisis required leadership from the very top.”
Yet that leadership was slow to emerge. The report details that the UK government’s crisis coordination committee did not meet in mid-February 2020, despite cases being regularly reported in the UK at that time, and Johnson was not made chair of the committee until 2 March 2020. The inquiry faulted Johnson for not appreciating sooner that the pandemic was an emergency that required his leadership for an urgent response.
“Mr. Johnson’s own failure to appreciate the urgency of the situation was due to his optimism that it would amount to nothing, his skepticism arising from earlier UK experiences of infectious diseases, and, inevitably, his attention being on other government priorities,” according to the report. “This was compounded by the misleading assurances he received from the Cabinet Office and the Department of Health and Social Care that pandemic planning was robust, as well as the widely held view that the UK was well prepared for a pandemic.”
The lack of urgency from the UK leadership was especially problematic since the other nations were relying on the UK government to lead the response to the pandemic. Officials in Wales, Northern Ireland, and Scotland all waited to discuss pandemic actions until the end of February 2020, despite the inquiry assessing that it was the most pressing issue facing their governments at the time.
“Ministers and officials in the UK government had been given clear advice that, in the reasonable worst-case scenario, up to 80 percent of the population would be affected—with a very significant loss of life—but did not appreciate the increasing likelihood of this scenario materializing,” the report said. “At the same time, it was clear that the test and trace system was inadequate for a pandemic. The lack of urgency on the part of all four governments, and the failure to take more immediate emergency steps, are inexcusable.”
The lagging response meant that COVID-19 case numbers were much higher than estimates and risked overwhelming healthcare systems in March 2020. To prevent that from happening, governments responded by releasing advisory restrictions on social contact on 16 March—self-isolation, household quarantine, and social distancing. The UK government then rolled out a mandatory lockdown on 23 March.
The inquiry assessed that initiating that lockdown was the right decision, but it could have been avoided entirely if decision-makers had acted sooner to mitigate the spread of the disease.
“Restricting people’s liberty in such a draconian fashion, with all the devastating consequences, should be avoided, if at all possible,” Hallet said. “But to avoid them, governments must take timely and decisive action to control a spreading virus. The four governments of the UK did not.”
Former Florida surgeon general Dr. Scott Rivkees says that one of the problems with the early response to COVID-19—a new virus—was the failure to understand the biology of the virus associated with presymptomatic spread. This misunderstanding meant that medical and public health organizations were at a disadvantage in issuing prompt and meaningful recommendations, adds Rivkees, now associate dean for education in the School of Public Health at Brown University.
“Going forward, we need to develop better—and a wide range of models—for how respiratory and non-respiratory viruses spread, along with potential response strategies,” he says. “Without this type of information, it is difficult for governments to act swiftly and do the right thing.”
It’s also critical for infection control measures to be balanced with the needs of society to continue to function.
“It is clear that the public has limited tolerance for social, economic, and educational disruption, and preplanning how we balance infection control practices with normal societal function is needed,” Rivkees says.
The inquiry was also critical of decision-makers’ lack of consideration for how COVID-19 would affect the most vulnerable people in the UK—older people, disabled people, and some ethnic minority groups that faced a higher risk of dying from the virus. Decision-makers also failed to assess how restrictions to control the virus would affect vulnerable groups, such as children. When schools were shutdown, it impacted their educational, physical, and mental health.
“Despite this harm being foreseeable, the impact on vulnerable groups had not been adequately considered in pandemic planning and the existing mechanisms for assessing the impact of decisions were largely applied retrospectively,” the report said. “Decision-makers consequently had little understanding of the impact of restrictions on vulnerable groups.”
During pandemic response measure considerations in Florida, which has a very large population over the age of 65, Rivkees says they made it a priority to identify who the most vulnerable to the virus were and put measures in place to protect this group. Florida’s responders knew, based on data from China as early as January 2020, that “this virus heaped its fury on the elderly,” he adds.
“We also had examples of severe outcomes when COVID-19 got into nursing homes and assisted living facilities,” he continues. “During the early part of the pandemic in the United States, it was pretty clear that states that protected the elderly and those in assisted living facilities, and promoted early broad vaccination of this group, had much lower mortality rates than the states that were less aggressive.
“Thus the take-home message is that during pandemics and other widespread infectious outbreaks, we need to identify who are the most vulnerable groups early on and be aggressive in protecting these individuals,” he says.
The inquiry also faulted how pandemic response and restrictions were communicated with the public, whose cooperation was critical to slowing the spread of the virus. The simplicity of the UK government’s “Stay Home” campaign was effective for compliance for the first lockdown, but it also left many people with a poor understanding of how and if they could seek medical help.
As national and local governments introduced their own pandemic restriction measures, the public became increasingly confused about what the rules were and how they applied to them. Some of these restrictions were also not communicated in language that the public could understand, such as the lack of British Sign Language interpretation for press conferences or key guidance in alternative formats.
“These are not secondary considerations,” the inquiry assessed. “Everyone should be able to understand the action their government is asking them to take, and improvements made later in the pandemic serve to highlight the difference that proper and timely consideration of accessibility issues can make.”
Additionally, public messaging campaigns did not always reflect the actual laws in place for issuing pandemic restrictions. The confusion this created undermined public trust and compliance with virus containment measures, according to the report.
“We need to recognize how communication has changed dramatically over the past decade with social media in many forms, along with the role of influencers supplanting traditional media and the voice of scientific experts,” Rivkees adds. “We need to recognize society polarization and the politicization of responses to any form of emergency puts us all on our back feet when developing effective communication strategies. More modern strategies and approaches to build community trust are clearly needed in our rapidly evolving era of new communication.”
Next Steps
The inquiry produced 19 recommendations for the UK government to improve its pandemic response and preparedness in the future. They include reforming and clarifying the structures for decision-making during emergencies in each nation, ensuring that decisions and their implications are better communicated to the public, enabling greater parliamentary scrutiny of the use of emergency powers, improving communication of rules to the public, and establishing structures to improve communication between the four governments during an emergency.
These recommendations were made based off the inquiry’s lessons learned throughout its assessment.
“Unless the lessons are learned and fundamental change is implemented, the human and financial cost and sacrifice of the COVID-19 pandemic will have been in vain,” Hallet said.
Those lessons include the need for decision-makers to use multiple scenario planning to consider the short-term and long-term ramifications of those plans. No plan is comprehensive, but the inquiry stressed that reviewing more potential scenarios will make decision-makers better prepared to act quickly and decisively during an emergency.
The inquiry also said there needs to be an unambiguous strategy with clear objectives and a framework to guide how decisions during an emergency will be considered, and, in emergencies involving a virus with the potential for exponential growth, interventions need to be imposed more quickly and more harshly than might be considered ideal.
“Even where the available evidence is sub-optimal, decisions still need to be made—putting off decisions until later is in itself a decision not to intervene,” the report said.
The inquiry also stressed that leaders must work constructively within their own governments and across the four nations of the UK, discarding their political differences and accepting responsibility for their decisions.
“Finally, as part of pandemic preparedness, governments must understand what data they are likely to need during a pandemic and identify how these will be collected,” the report said. “The limitations of data should be understood and clearly explained to decision-makers, and consideration should be given to how front-line experiences can sit alongside quantitative data.”
The COVID-19 pandemic, which may have killed more than 20 million people around the globe, taught us many things, Rivkees says. For one, pandemics usually end when enough of the population has developed immunity—such as through the use of vaccines that saved tens of millions of lives.
“Second, further investment in public health preparedness is critical to help us understand the biology of looming pathogens and how to respond in such a way that we protect those who are must vulnerable, while allowing society and the economy to function as we deal with infectious responses,” he continues. “Third, we need to recognize the response to pandemics in infectious outbreaks as being shaped by politics and how responses are becoming political issues, showing how public health needs to continue to adapt to a rapidly changing society.”
The inquiry is continuing to research the UK's response to the COVID-19 pandemic and will release additional reports on various aspects of the response. Upcoming reports will include emphasis on the impact of the pandemic on healthcare systems, vaccines and therapeutics, procurement, care sector, children and young people, testing and isolation, economic response, and the impact on society.
For more on pandemic preparedness and response, revisit our series on Pandemic Readiness and Biosecurity.
