Dismore condemns Government lack of preparedness for Covid 19 in light of Operation Cygnus recommendations

At today’s Mayor’s Question Time, Andrew Dismore AM, Labour London Assembly member for Barnet and Camden questioned Mayor Sadiq Khan over the Government lack of preparedness for the Covid 19 outbreak in light of Operation Cygnus recommendations.
Exercise Cygnus was a pandemic preparedness exercise carried out in October 2016 that revealed a variety of problems with the UK’s response. The Guardian published a leaked redacted version of the report.

Mr Dismore put to the Mayor:

‘What role did you and the GLA family of services play in Exercise Cygnus; and what were the lessons from the exercise; and do you agree that the conclusions and findings of the exercise ought to be made public?

‘Would you agree that Exercise Cygnus revealed a whole host of shortcomings with the Government’s response which were not acted on?.
‘For example, it found that residential care homes were noted as sites of high risk for virus spread and lethality and that the impact in care homes would be catastrophic unless new measures were put in place. However, no specific guidance for care homes was included in the Government’s strategy.
‘So untested patients including those previously suffering from the virus, were bussed from hospitals to care homes, without information about the patient being passed on or the provision of the PPE needed; and unbelievably, untested agency workers, often on zero hours contracts, moved freely within and between different care homes to cover for other staff who were self isolating. It’s the case, isn’t it, that highly vulnerable people and staff were exposed to infection and indeed many died as a result.
‘London’s pandemic response strategy is reliant on PPE stocks held by the Government. But 45% of boxes of PPE held in the national government stockpile were out of date when the pandemic hit, according to revelations on Channel 4. This includes nearly 80% of the stock of respirators. What is the point of local resilience work if the national Government is so slapdash it allows failings like this?’
The Mayor said that he agreed absolutely. The Cygnus report should be published. It was a scandal that the Government was so ill prepared when they had weeks’ notice from elsewhere to prepare. We need an independent public inquiry to learn the lessons. London’s Strategic Coordination Group was doing a great job but they are ‘firefighting’ without the necessary equipment. There needs to be trust and confidence in the Government which is lacking put in place.

Notes for editors:
Learning from Exercise Cygnus
Exercise Cygnus was a pandemic preparedness exercise carried out in October 2016 that revealed a variety of problems with the UK’s response. The leaked report on the exercise published by the Guardian reveals several matters of note:
– “the UK’s preparedness and response, in terms of its plans, policies and capability, is currently not sufficient to cope with the extreme demands of a severe pandemic that will have a nationwide impact across all sectors” p.6

High excess deaths
– “the lack of centrally produced advice to local authorities on excess deaths and body management was considered a major issue” p.12
– “It is believed, following the exercise, that LRFs would have difficulty operating their plans and capabilities at this scale” p.26
– London LRF commented: “[There is a] lack of required knowledge in excess deaths for their SCG, highlighted that it’s very in depth and complex issue” p.26

Social care
– “LRFs reported it was not possible to collate an accurate picture of social care capacity because much of that capacity lies with private providers” p.24
– The Exercise flagged the need for a rapid discharge protocol for sending people home or into residential care from hospitals to free up space
– The need for accessible funds and distribution routes for care providers to purchase PPE from existing stockpiles was also raised (p.15, 25)
– Following the report, the Association of Directors of Adult Social Services (ADASS) told the Government they needed advice on controlling cross infection and warned demand for PPE “could rapidly outstrip supply”.

London’s flu pandemic strategy
Residential care homes were noted as a site of high risk for virus spread and lethality. However, no specific guidance for care homes was included in the strategy, which instead pointed to national government guidance on controlling infection spread in health and care settings.
London’s pandemic strategy (last updated in May 2018) noted that central government maintained appropriate quantities of PPE.
Distribution arrangements would be finalised as needed, but expected to be direct from the national stockpile to the NHS, or through local hubs to social care providers.
45% of boxes of PPE held in the national government stockpile were out of date when the pandemic hit, according to Channel 4. That includes nearly 80% of the stock of respirators.
By January 2020, the national stockpile held 10% fewer respirators and 19% fewer surgical masks than recommended when it was set up in 2009.
Testing capacity in London
The SCG do not know how many tests are or can be carried out in London each day. The Testing Coordination Group is working on an answer to this.
There are six drive through testing sites in London, and nine testing vans, directed by a cell operating under the SCG. Plans to open more testing centres are in the hands of DHSC.
On 7 May, the Government wrote to local public health directors asking them to take charge of testing in care homes. It is difficult to understand how this can be done without understanding capacity, control of future growth, and a strategy for deployment of assets.
Revealed: the secret report that gave ministers warning of care home coronavirus crisis, the Guardian, 7 May 2020 https://www.theguardian.com/world/2020/may/07/revealed-the-secret-report-that-gave-ministers-warning-of-care-home-coronavirus-crisis
2 Ministers were warned two years ago of care homes’ exposure to pandemic, the Guardian, 13 May 2020 https://www.theguardian.com/society/2020/may/13/ministers-were-warned-two-years-ago-of-care-homes-exposure-to-pandemics
3 Pandemic influenza framework, LRF, May 2018 https://www.london.gov.uk/sites/default/files/london_pan_flu_framework_v7_may_2018_0.pdf
4 PPE stockpile was out of date when coronavirus hit UK, Channel 4, 7 May 2020 https://www.channel4.com/news/revealed-ppe-stockpile-was-out-of-date-when-coronavirus-hit-uk
5 Public health directors in England are asked to take charge of covid-19 testing, the Guardian, 8 May 2020 https://www.theguardian.com/world/2020/may/08/public-health-directors-take-charge-covid-19-testing-care-homes