Five years on from first Covid lockdown, how prepared is the UK to react to another pandemic?

Five years on from the first Covid lockdown, The Sunday Post asks how prepared we really are for the next pandemic.

As we approach that milestone on March 23, scientists agree it is a matter of when, not if, the worst will happen again.

No one can predict the exact date of the next outbreak or how severe it will be. It could be five years away or 50 – and that makes planning extremely difficult.

Hard-won progress in vaccine science provided an escape from the daily misery and isolation that many felt during Covid, and scientists believe the same technology could grant humans a head start against any nasty new bug.

However, our investigation has revealed that vital progress risks being undermined by the stark challenges crippling our health service.

That includes having among the lowest rate of hospital beds per person anywhere in Europe – a key metric for how well the country would be able to absorb the punch of a deadly new pandemic.

Speaking in Glasgow last year, Dr Tedros Adhanom Ghebreyesus, the Director General of the World Health Organisation, had a stark warning for governments.

He said: “As the generation that lived through Covid-19, we have a collective responsibility to protect future generations from the suffering we endured. We must not be taken by surprise next time. And to not be surprised, we need to be prepared.”

So how prepared are we?

Vaccines

The route out of the pandemic was a range of new mRNA vaccines produced using technology that dates back to the 1960s but which saw huge amounts of research and development during the Covid outbreak.

This type of vaccine effectively teaches the immune system how to fight off the virus by using parts of the virus itself.

Experts planning for the next outbreak believe it is those breakthroughs that offer the world the best chance against any new virus.

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Professor Roy Soiza, an expert in elderly health care and vaccinations at Aberdeen University, said progress made during Covid will make it easier to produce a vaccine quickly in any future pandemic.

He said: “I think there was a lot of learning during Covid, particularly around the public health messaging and hygiene precautions, along with the need for testing and a vaccine that was effective much earlier on.

“There is better infrastructure now to develop that faster and much more effectively.”

The UK’s lack of vaccine manufacturing capacity was one of its major weaknesses leading up to Covid.

There was just one plant in Liverpool making seasonal flu jabs and another in Scotland making a niche product, Japanese encephalitis vaccine.

To tackle that, the UK Government has since announced a 10-year strategic partnership with pharmaceutical giant Moderna.

Construction has been completed at the Moderna Innovation and Technology Centre in Oxfordshire, and it is expected to be fully operational later this year.

The facility will have capacity to produce up to 150 million vaccine doses per year and a minimum of 250m vaccine doses per year in the event of a pandemic.

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The scale of the project, which will give the UK access to domestically-produced mRNA vaccines for Covid-19 for the first time, demonstrates how significant a role officials believe the technology could play in fighting future pandemics.

However, there was disappointment in January after it was confirmed another firm, AstraZeneca, had scrapped plans for a £450 million expansion of its own vaccine plant in Liverpool.

The company blamed a cut in promised funding from the UK Government for the change of direction.

Soiza, who led research into the new RSV vaccine which showed it could prevent thousands of deaths among elderly Scots, described the news as a “blow”.

He warned health chiefs must not lose ground as the memory of Covid grows more distant in people’s minds. Asked if he believes pandemic preparedness remains a top priority, Soiza said: “If you’d asked me a couple of years ago, I would have said definitely yes.

“My worry is that over time, memory fades and that this might once again become de-prioritised, especially because the financial situation for the country isn’t very good. When you’re preparing for something that may or may not happen soon, it’s very tempting to save money by disinvesting from that. I think that’s what happened before.”

Hospital beds

A lack of hospital capacity was in part responsible for one of the most disastrous decisions made during the Covid pandemic – to send contagious individuals into care homes full of frail and elderly residents.

While the number of Scottish beds is now slightly higher than it was at the start of lockdown, we continue to have among the fewest beds in proportion to our population in Europe. Even if politicians learn from that mistake, freeing up hospital beds will remain a key challenge during any future pandemic until an effective vaccine can be developed.

According to a report published by the Standing Committee on Pandemic Preparedness in November, “stark challenges” facing the health and social care system present a major risk to Scotland’s ability to respond effectively to a new virus.

A Royal College of Nursing report earlier this year warned medical staff are already delivering care in overcrowded and unsuitable places such as corridors, converted cupboards and even car parks.

Official figures show there are 2.54 hospital beds for every 1,000 people in Scotland, slightly higher than the UK average but around half of the European average and considerably less than the 5.8 in France, 7.2 in Austria and 7.9 in Germany.

The number of beds overall dropped by around 1,200 in the decade up to the outbreak of Covid in 2020, falling to 13,156. The same year, the vice-president of the Royal College of Emergency Medicine in Scotland warned a further 1,000 beds were needed.

By the end of the last financial year, the number of beds increased to 13,755 but that remains well short of the number health experts say is required.

PPE and safety equipment

Another major flaw revealed during Covid was the difficulty in sourcing relevant safety equipment – known as PPE.

Our investigation found health chiefs are aware of how important this equipment is but individual NHS boards told us they have no record of how much PPE they currently hold.

The Scottish Government no longer tracks how many items of PPE are available across the country but is currently consulting on how best to manage rolling stock in the event of a pandemic.

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Dr Jim McMenamin is head of the infections service at Public Health Scotland and was the strategic incident director for Covid-19.

He believes we are in a stronger position now than in 2020 but warned constant improvements are needed to ensure Scotland remains on a firm footing. That includes working on key measures that can quickly be scaled up in the event of a major outbreak.

“I can only tell you from my own organisation’s perspective,” McMenamin said. “Is it as important today as it was at the height of the pandemic or in the intervening period? Yes, it remains really of critical importance for us.

“Of course there are competing demands and we need to get back on an even keel for many other things but it’s something where there’s an art to balancing what we need to do.”