The report's findings are based on its first 10 oral evidence hearings from July to October 2020. The APPG heard from 41 different individual or institutional spokespersons, ranging from Royal Societies to City Mayors.
Chapter 2: Lockdown and Exit Strategy
- Lockdowns are a means of slowing down the incidence of the pandemic when all other means to control the virus have broken down.
- The UK government’s centralised test and trace system is not working.
- The failure to provide sufficient financial support to those in self isolation is a barrier to compliance.
- Public messaging is unclear, and the reasons for the application of NPIs are ill-defined.
- There needs to be greater coordination between all stakeholders involved in the Coronavirus response.
- Relaxing lockdown restrictions too early, without sufficient suppression, can cause more economic damage in the long term. ‘Balancing health versus wealth’ is a false dichotomy.
- There is no such thing as Herd Immunity to Covid-19 in the absence of an effective vaccine.
- A future vaccine should not be relied upon as a ‘silver bullet’ to solve the pandemic.
- The UK government must remain focussed on NHS staff recruitment, retention and support.
Chapter 3: The Impact of Covid-19
- The UK government did not adequately prepare in terms of stockpiling sufficient and adequate Personal Protection Equipment (PPE). The procurement, supply and distribution of PPE to the NHS and social care sector was delayed and poorly coordinated, with ineffective oversight.
- There are significant staff shortages in both the NHS and social care sector. Covid-19 has had a considerable impact on the health, safety and well-being of the workforce.
- The social care sector has been severely impacted by the pandemic. There was insufficient coordination of supply and distribution to the social care sector which led to significant problems with access to PPE. The quarantine arrangements for those coming into the social care sector from hospitals were inadequate.
- In the first wave of the pandemic, there was a considerable resource shift in the NHS to managing patients with Covid-19. This has led to a considerable backlog of care.
- The centralised Test and Trace system is not working.
- Covid-19 has not impacted society equally.
- Communication between the UK government and local systems of healthcare provision needs to be improved.
Chapter 4: Long Covid and Bereaved Families
- The UK government is not counting the number of individuals who are left with long-lasting effects of Covid-19 as a measure of the severity and impact of the pandemic.
- As a medical condition, Long Covid has not yet received full recognition, sufficient research funding or adequate rehabilitation support.
- There are very few guidelines for employers or for GPs on recognising and managing Long Covid.
- There must be a judge led inquiry into the UK government’s handling of the pandemic.
- UK government was too slow to lockdown during the first wave of the pandemic.
- The advice given by the NHS 111 service may have resulted in people who were experiencing severe symptoms being advised against seeking medical advice.
- Hospital admissions may have led to increased incidence of Covid-19 in the first wave.
- Shielding guidance from the UK government was unclear.
- There is a lack of support for bereaved families as the normal support systems (family, friends, mental health support) are not accessible while Covid-19 restrictions are in place.
Chapter 5: The Impact on Social Care
- There has been a failure of those in social care. The social care sector has been failed during this pandemic. This failure has brought into sharp relief the urgent reforms required for social care, with centralised oversight, funding and support.
- The impact of complex bereavement, anxiety and depression on people in later life as exacerbated by the pandemic needs better recognition and support. Blanket lockdowns for long periods have had a severe impact on the mental health of residents and those who care for them.
- The guidance on visiting care homes has been unclear.
- The initial failure by UK government to include known mortality figures of those in the social care sector and reports of the use of blanket ‘Do Not Resuscitate’ Orders has created the impression that those in the social care sector are less valued.
- Covid-19 has had a disproportionate impact on the health of those from Black, Asian and Minority Ethnic (BAME) backgrounds.
- Social Care is addressed in chapters 3, 5, 6, 7, 8 and 9.5.6 The charitable sector has seen an unprecedented need for its support services. At the same time, the financial viability of the charitable sector is at risk. Government financial support had not been distributed in a transparent or timely way.
- Supermarkets need to increase the availability of slots for older and more vulnerable people and coordinate better with each other in their local communities
Chapter 6: Test and Trace
- Investment in the fields of virology and microbiology is needed urgently.
- The UK government has not invested sufficiently in the UK’s laboratory capability.
- Arbitrary testing targets have been prioritised over a coordinated testing strategy.
- There has been a lack of coordination between Pillar 1 and Pillar 2 laboratories.
- Information flow between Pillar 2 laboratories and the NHS has not worked well.
- The UK government’s decision to abandon test and trace in March the virus to take hold in England and the UK unchecked.
- The centralised test and trace system is not working.
- Regular and accessible staff testing is critical to enable the NHS and social care sector to provide care.
- Turnaround time of tests is not always meeting the required maximum 24-hour target.
- For effective pandemic management, the NHS and Social Care sector responses need to be coordinated.
- There has been no effective oversight of the social care sector since March.
- Isolation is having a devastating impact on those in social care.
- The cost of testing is a significant challenge for the social care sector.
- Local authorities do not currently have a sufficient role in the organisation and oversight of testing for the social care sector.
Chapter 7: Local Authority Response and Reorganisation of Public Health England
- The inability for local authorities to access the precise real-time data has significantly impaired their ability to work effectively at a local level to contain outbreaks.
- The Covid-19 crisis has demonstrated the vital and reciprocal relationship between the NHS and social care.
- Local authorities need enhanced powers and support.
- Reorganisation of PHE should be delayed until after the pandemic.
- Independent and trusted public health advice is critically important for a strong response to future threats.
- Public health resilience has been impacted by reduced spending over the last decade.
- In any reorganisation of PHE, all the functions of PHE should be read across and strengthened.
- The public health system requires joined-up local, regional and national functions, that are responsive to the needs of local communities.
Chapter 8: The Impact on Frontline Workers
- From the outset of the pandemic, frontline workers had inadequate access to personal protective equipment.
- The pandemic is having a clear impact on the mental health of frontline health and care workers. Many are experiencing stress, depression and burnout.
- Access to testing for frontline workers has been unsatisfactory.
- The social care workforce must have the same level of PPE and access to Statutory Sick Pay (SSP) as NHS staff. Greater guidance is needed for the sector.
- Workers from Black, Asian and Minority Ethnic (BAME) backgrounds have been disproportionately impacted by the pandemic.
- Doctors are particularly concerned about preparedness for winter and the ability of the NHS to face the elective backlog.
Chapter 9: The Impact on Mental Health
- Covid-19 has had profound consequences for individuals’ mental health.
- Those with pre-existing mental health conditions have seen their mental health decline further throughout the pandemic.
- Many individuals are experiencing mental health problems for the first time as a result of complex grief.
- Throughout the pandemic there has been a reduced access to services and support as a result of Covid restrictions. The impact of this has meant more people are suffering without having access to support and thus causing their condition to worsen.
- The reduction in normal activity and increased isolation has caused many to experience mental health problems for the first time.
- There is specific concern for the mental health of key workers. Key workers urgently need support now and as we move into the next phase of the pandemic.
- Those from BAME backgrounds have felt higher levels of depression and anxiety across the pandemic.
Chapter 10: International Comparisons
- The UK government failed to learn from other countries in their handling of the pandemic.
- Find Test Trace Isolate and Support is most effective when run at a local or regional level.
- Countries with experience of tackling SARS and MERS have dealt with the virus most effectively such as South Korea, Taiwan and Singapore. Those that implemented widespread testing at an early stage with effective contact tracing, cancelling major public events early on, using masks and social distancing measures had better outcomes. Countries which imposed testing and quarantining measures at their ports of entry also had a better rate of success, such as New Zealand.
- Communication, clarity, trust and risk perception are essential for compliance.
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