Covid mistakes demand a swift, no-blame inquiryLondon School of Hygiene & Tropical Medicine https://lshtm.ac.uk/themes/custom/lshtm/images/lshtm-logo-black.png Thursday 20 August 2020
Many countries face the prospect of continued large-scale transmission of COVID-19 or its re-emergence as a second wave. Responses from governments and health systems have, unsurprisingly, been mixed: we’ve seen some innovative, effective measures but we got many things wrong. What matters now is that we have remarkable opportunities to learn from the first wave.
The expectation is that public inquiries will answer three questions: what happened, who is responsible and what can we learn? The middle question leads to an adversarial environment, which both detracts from learning processes and leads to inordinate length. When people have died, apportioning blame in a fair and just way is not something that can be done quickly. This means public inquiries are long — several years not being unusual.
There are many areas of the response to COVID-19 where Britain could have done better and there are lessons we can learn. We lacked crucial data on viral activity in the community. Not appreciating the speed of viral spread, we introduced lockdown weeks too late, increasing the size of the pandemic and leading to a large number of deaths. Rather than focusing on who to blame for this disastrous delay, we need to learn from our mistakes and ensure we have the data we need.
Another example is care homes: largely ignored until much too late, again resulting in large numbers of deaths. What were the strategies adopted by those homes that managed to protect their residents, and can these be more widely adopted? This isn’t about blaming specific homes; it is about learning to do things better. Even rapid action is useless when it is focused on blame rather than on learning, as shown by the recently announced overhaul of Public Health England.
A public inquiry that reports in a year or two will be too late: we will have missed this vital opportunity to learn. To achieve the necessary speed, we need an inquiry stripped of any function relating to blame. There are large numbers of grieving families and friends for whom I realise this will be unpalatable and indeed, on its own, unacceptable. But this is not a proposal to ignore issues of responsibility; it is separating out these issues so that they can be dealt with properly, at the pace they deserve.
We need a rapid inquiry where people provide full, open, honest evidence, without fear of retribution. The only way to do this is to put issues of culpability temporarily to one side — and to act now.
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