The COVID-19 crisis has been an extreme stress test for governments around the world, with widely varying performance so far. I’ve already described some of the early lessons and the possible implications for government in the future.
Here I address a broader question: how governments should in general handle risks, crises and disasters like COVID-19. This is a question I found myself heavily involved in twenty years ago.
In the year 2000, a strike by fuel drivers almost brought the UK to a standstill. It turned out that in the age of just-in-time production stocks of fuel would barely last a couple of days. Food deliveries and hospitals would quickly grind to a halt. Luckily the strike was quickly settled. Then, less than a year later, the UK faced a severe outbreak of foot and mouth disease which brought the countryside to a standstill. In the end some 6 million cows and sheep were slaughtered to stop the disease.
Both crises showed up the weaknesses of government’s systems for handling risk. I was then running the government Strategy Unit and we were given the task of looking in a fresh way at how risks of all kinds were handled, a question that I am sure will return to the top of government’s agenda once the immediate COVID-19 crisis is under control.
Back then we examined how big companies and other governments handled things and made recommendations. None of the conclusions were earth-shattering - but they did lead to significant change. The main message was that inevitably, organisations that focused on the present tended to ignore potentially harmful risks, and that it was vital to pay attention to risks, which meant institutionalising it. We then helped put in place pretty comprehensive machineries within departments for:
- Scanning for potentially high impact if low probability events – from pandemics to financial crises, attacks on critical infrastructure to extreme weather events.
- Preparing decision-makers – through simulations, scenarios and models.
- Creating a central Civil Contingencies Unit, networked into local government, that could be quickly mobilised in a crisis.
- Ensuring budget allocations to deal with some of the obvious growing threats, such as increased flooding.
One main conclusion was that although essential to think about risks all the time, you could never expect to predict which ones would hit or the shape they would take. So the key was to build in resilience and adaptability so that when the crises hit you could respond fast and flexibly.
Another related conclusion was that it was vital to put senior decision makers, including politicians, through emotionally compelling simulations where they would act out how they might respond in the heat of a crisis.
Finally, we tried to ensure there was good independent advice on a proportionate response to uncertain risks - so that ministers wouldn’t be punished for taking risks seriously (like the French minister who spent heavily in response to H1N1 in 2009 and was then punished for wasteful overreaction).
In the five years after these measures were introduced in the UK there were no major crises. The measures proposed were dull, but effective, and for most of the last two decades the UK system was fairly well prepared for shocks. For most of that time pandemics were the top-rated risk (a Level 5 threat), alongside nuclear attack, but deemed much more likely. As a result there were regular exercises to model how the health service would cope with a surge of infections, and studies to examine, for example, the ethical dilemmas that would be faced by hospitals.
So what went wrong? When the COVID-19 crisis hit the government seemed unsteady rather than prepared. The east Asian countries that had dealt with SARS and MERS were much more nimble, far quicker to test, and far better at mobilising data. The UK switched strategy rapidly – from a mitigation strategy which assumed that the virus would spread and kill many, to a suppression strategy that involved forced isolation - under pressure from public opinion. I suspect it’s highly unlikely that any of the senior decision makers took part in any serious simulation exercises on pandemics over the last five years. If they had, they would have quickly discovered that the strategy produced by the experts was not politically viable. The communications people – and politicians – would have seen that it was impossible for a Prime Minister to appear to accept such high levels of mortality.
The programmes have also looked unsteady, with some of the policies apparently decided in a hurry and quickly unravelling. Again there didn’t appear to have been much preparation. This is even more true at the operational level where supplies of ventilators and protective equipment have become under intense scrutiny. These failings were in part the result of austerity (which led to the closure of the pandemics preparation unit) and the distractions of Brexit. In respect of the long-term, the government had taken its eye off the ball.
It’s easy to criticise, especially from outside, and I don’t envy those stuck at the heart of government during the crisis, some of whom have done extraordinary work. But pandemics were the most likely shock of all, and government should have done more to prepare.
Preparing for risks is costly. It takes people and resources away from immediate priorities. But ultimately protecting people from risk is the heart of what government is for and it’s become dramatically more visible once again this year.