Equality bodies had no role in pandemic planning, UK Covid inquiry hears

Key official bodies set up to tackle race, gender and other inequalities had no involvement in pandemic planning before Covid hit, government insiders have told the UK Covid-19 public inquiry.

There was “inadequate consideration” of the risk of different groups heading into a health crisis not on a level footing, and the government’s race disparity and disability units “had no involvement in pre-pandemic preparedness within government”, the opening module investigating the UK’s preparedness heard.

Amid “shocking” evidence that the virus took a greater toll on black and minority ethnic communities, and disabled and elderly people, Marcus Bell, the director of the equality hub in the Cabinet Office, was asked if pandemic preparedness was on his radar, and replied: “It wasn’t.”

Melanie Field, the chief strategy and policy officer at the Equality and Human Rights Commission, a statutory body, also told the inquiry “there was an inadequate consideration both of the existing health and other inequalities that might mean that people going into an emergency situation would not be on a level footing and … that they might need different responses in order to come out to have equal outcomes.”

The inquiry has already heard from lawyers for the bereaved that “shockingly, mortality was 2.6 times higher in the most deprived than the least deprived tenth of areas”.

Mortality was highest in people from the Bangladeshi, Pakistani and Black Caribbean communities, and mortality rates were higher among people with a disability.

Last month, Pete Weatherby KC, on behalf of Covid-19 Bereaved Families for Justice UK, said therefore that the “big question for module 1 is to what extent were those terrible outcomes either foreseen or capable of mitigation?”

On Thursday, Field also said the EHRC had no contact from the government to provide assistance in terms of pandemic planning and emergency preparedness.

“I am surprised,” Field said. “The issue was not on the commission’s radar either … our strategic priorities did not include a focus on health and social care.”

Dr Richard Horton, the editor in chief of the Lancet, told the inquiry: “This was not an equal opportunity virus.”

He said: “In the specific realm of pandemic prevention, we should be giving greater attention to those who are living with chronic disease and to those who are living in more deprived communities.”

Horton, who has written a book called The Covid-19 Catastrophe, also addressed the conundrum of why ministers and officials had felt the UK was well prepared for a pandemic.

Both the Global Health Security Index by Johns Hopkins University and the World Heath Organization rated UK preparedness highly. But Horton said those assessments didn’t account for “how our political leaders or health leaders frame the threat, how we assess the threat and how we respond”.

Critically, the index didn’t measure a population’s level of trust in the government or trust between people. These factors were “crucial in the influence of infection and mortality rates”.

He said there had been a “fair warning” in the form of the 2003 Sars coronavirus outbreak in Asia.

The global scientific community was aware that it needed to “really put coronaviruses on the map as a serious human threat”, he said. Yet it wasn’t elevated on the UK’s national risk register.

“We were publishing papers that were talking almost only about influenza as a threat,” he said. “I think this was a western groupthink, and certainly colleagues I have in China were very well aware the coronaviruses were a major threat.”

He described inaction after 2016’s Exercise Cygnus modelled a UK response to a flu pandemic. This, he said, exposed weakness around “surge capacity, triage management, regional and local planning, social care, and even schools, all areas that of course subsequently became major concerns during Covid”. But “we did not take note of those vulnerabilities and act on those,” he said. “There’s not much point in doing the simulation if you’re not acting on it.”

The inquiry continues.