UK Covid-19 Inquiry finds early pandemic surveillance was weeks out of date

Lack of effective data flows and reduced scientific investment hampered response

During the early stages of the Covid-19 pandemic in the UK, it took up to three weeks for confirmed cases to be recorded on the health database used at the time.

The two-volume report into the second set of UK Covid-19 Inquiry hearings found that data collection for the systematic NHS surveillance of the virus became available around March 8, 2020.

Despite every positive case being indicative of the underlying epidemic, John Edmunds, professor of infectious disease modeling at the London School of Hygiene & Tropical Medicine, told the inquiry that the data was "very difficult to analyze."

"There were delays of five to seven days between onset of cases and 'confirmation and entry onto the database' – although 'some cases were taking up to three weeks to be recorded.' There were significant caveats to, and uncertainties in, the data available," the report said.

Edmunds told the inquiry: "New cases registered on a given day were actually reflecting infections that might have occurred two weeks earlier... We were estimating that there were hundreds or perhaps thousands of cases occurring every day."

In more than 750 pages, the second module of the inquiry report – there will be ten in total – details numerous failures in the government's response to the global pandemic.

Lack of functioning data systems was also evident in measures of the health service's capacity to deal with the number of Covid cases.

Although statistics on bed availability had been published since 2000, in England it was recorded on a weekly basis, rather than as real-time data. Lord Simon Stevens, NHS England chief executive during the pandemic, said that before the second half of March 2020, "it was not possible automatically to 'pipe' real-time information on patient case mix and capacity" because of the limitations of existing hospital records and systems.

He said that NHS England's proposals to invest in more modern systems had been "repeatedly rejected or scaled back" and the lack of immediate access to data therefore "should not have come as a surprise to ministers," according to the inquiry report.

The report also slams the lack of investment in public health and scientific research to deal with the impact of a pandemic.

It points out that funding constraints on Public Health England (PHE) affected its "ability to fulfill both its advisory and its operational functions."

"As was common across the four nations, there was, for example, no standing capacity for a scaled-up test and trace system. The resource constraints on Public Health England are illustrated by its £287 million budget for 2019/20, compared with the £37 billion allocated to NHS Test and Trace," the report said.

The Test and Trace program became heavily reliant on private sector consultants, with Deloitte, Serco, and IBM among the beneficiaries. According to a Parliamentary answer in 2021, the program hired more than 2,300 consultants and contractors working for 73 different suppliers at a total cost of approximately £375 million.

Professor Patrick Vallance, the government's chief scientific adviser at the time of the pandemic, told the inquiry: "The decisions taken over a number of years to reduce the science budget of PHE must have had an effect on its ability to perform at scale during the pandemic. The outsourcing of research to universities left PHE with restricted internal science and operational capability... It is important to view public health science funding as a resource that is required for the future, much in the same way as the army is required to be ready for action even when there is no war." ®