Response to Channel 4 Dispatches

This evening, Channel 4's Dispatches will air claims about the government's response to coronavirus.

At every stage, we've been guided by the advice of experts from SAGE. You can read their advice here.

The Department of Health and Social Care responses to the various claims can be found below.

A Government spokesperson said:

''This is an unprecedented global pandemic and we have taken the right steps at the right time to combat it.

"At every stage, the government has been guided by the advice of experts from SAGE and its sub-committees - advice which has now been published on gov.uk. The Government has been very clear that herd immunity has never been our policy or goal.

''Our response has ensured that the NHS has capacity for everyone who needs it and that it can provide the best possible care for people who become ill. Instead of accepting the claims of a rushed documentary which set out to find failings rather than to inform, we advise viewers to read the published evidence themselves."

Claim - SPI-M committee of modellers had concluded a reasonable worst-case scenario of 500,000 deaths without mitigation. By March 3rd, SPI-M had concluded that even closing schools together with measures like working from home and shielding the elderly could still leave 200,000 dead.

• The Government needs scenarios of the future progression of the epidemic to allow for short, medium, and longer-term planning. This evidence was often compiled very rapidly during a fast-moving response and should be viewed in this context.
• It is impossible to model the reasonable worst case scenario with any degree of precision - it will be highly dependent on the timing and nature of policy decisions that are taken and the behaviour of individuals over the time range considered.
• As SPI-M has made clear, these scenarios are not forecasts or predictions. No likelihood is attached to any of these scenarios.

Claim - Given such mitigation measures were not enough to stop the NHS being overwhelmed, there was frustration among the modellers that there was a lack of clarity from the government over what government strategy was to deal with the epidemic.

• Our approach has meant the NHS has never been overwhelmed with COVID-19 patients, and is able to carry on treating other patients who require critical care.
• The Government's strategy has been very clear and has always been informed by evidence-based scientific advice.
• On 3 March, the Government launched a comprehensive Action Plan which set out measures to respond to the outbreak. The action plan included information on the government's 4-stage strategy: contain, delay, research, mitigate. It set out advice for how the public should respond in each stage, including what to expect as the outbreak advances.
• By March 9 the modellers also realised the epidemic was at a more advanced stage than previously realised.
• Advice that was given to the government always reflected the latest picture when it came to the spread of the disease in the UK and this advice was given without hesitation.
• New data was constantly emerging on the disease and SAGE always formulated advice based on the latest information. Modelling was continually updated based on the latest evidence.
• As the minutes of the SAGE meeting of the 13 March detail, SAGE was aware of the lag in data provision for modelling, meaning that there may have been more cases in the UK than SAGE previously expected at this point, but it assessed that the UK remained on broadly the same epidemic trajectory.

Claim - From late February modellers took it on themselves to model more radical measures and realised that these might keep the epidemic at a level that might not overwhelm the NHS. By March 11 there was unanimity that keeping people in their homes was the best way forward.

• As the minutes from the 13 March SAGE meeting show, SAGE was at this point "considering further social distancing interventions - that may best be applied intermittently, nationally or regionally, and potentially more than once - to reduce demand below NHS capacity to respond". To suggest that there was unanimity that keeping people in their homes was the best way forward is wrong.
• Advice from SAGE has always been that it is not just about what you do, but when you do it that has the greatest impact. If the interventions are made too early, they could potentially have a severe impact on people's wellbeing, either directly or indirectly, and it's important this is taken into account; it was about balancing risks at a point we had much less information than we have now. The CMO has spoken publicly about this on a number of occasions.
• SAGE advice has consistently reflected the opinions of its participants who bring an enormous range of expertise and diversity of views and backgrounds from across the scientific spectrum. SAGE has always been clear that its advice on interventions, like lockdowns, would be given at the right time, based on the latest information.

Claim - These findings were passed in a timely manner to SAGE. As well as other officials from across government, the SAGE meetings of March 3 and March 10 were attended by Dominic Cummings. The findings were known throughout the government.

• SAGE's role is to provide consensus advice on all the key issues, based on the body of scientific evidence presented by its expert participants. This informed advice is then passed onto Government ministers and decision makers to help inform the Government response to COVID-19.

Claim - Expert and reviewed modelling conducted for this programme suggests had Britain locked down on March 12th nearly two thirds of hospital deaths at the end of April could have been avoided, some 13,000 lives. A lockdown on the 16th could have prevented 8,000 hospital deaths.

• As we have made clear, we have always taken the right steps at the right time, guided by expert scientific advice. The minutes of the SAGE meeting of the 18 March make this abundantly clear, with the recommendation that schools are closed and that the measures already announced should have a significant effect provided compliance rates are good.
• We published the Government's Action Plan on the 3 March which set out measures to respond to the outbreak. We then rapidly drafted and passed into law essential emergency legislation.
• The WHO determined that COVID-19 was a global pandemic over a week later, on 11 March.
• We introduced a number of measures ahead of the lockdown to minimise the impact of this virus including; requiring individuals to self isolate for 7 days from the point of experiencing symptoms, or 14 days if someone else in the house is symptomatic, social distancing, an end to mass gatherings, closure of schools, bars and restaurants and shielding the clinically extremely vulnerable.
• On 16 March we also published guidance on social distancing for everyone in the UK, including children, and protecting older people and vulnerable people.
• Delay and 'lockdown' were part of potential measures set out in our action plan from the start. The timing and implementation of these measures was based on scientific advice.

Claim - Cheltenham Festival and a Liverpool Champion's League fixture with Atletico Madrid were allowed to go ahead. Scientists had advised the government that shutting sporting events would have little effect on their own, but note those same scientists had by then submitted evidence that only lockdown measures would avoid a huge death toll.

• It is our absolute priority to protect people's health and our advice on coronavirus is the result of direct, continuous consultation with medical experts. These events took place within clear government guidance at the time - the SPI-M statement of the 11 March states clearly that the direct impact of stopping large public events on the spread of the epidemic is low.
• The decision to go ahead with the festival was taken by the racecourse and was operating within clear public health guidance at the time. In view of the decision to proceed, The Director of Public Health at Gloucestershire County Council and her team provided advice to the racecourse in relation to additional hygiene measures that they could put in place for racegoers and staff.
• There are many factors that could influence the number of cases in a particular area, including population density, age and health profile and the position of an area on the pandemic curve.

Claim - On March 13 there was a phone conversation between the Prime Minister and Italian Prime Minister Giuseppe Conte which discussed the UK strategy. Italy was then in lockdown, with Spain and France about to follow. Italy's health minister says after this call he was told by Prime Minister Conte that 'He told me that he wants herd immunity'.

• The Government has been very clear that herd immunity has never been our policy or goal.
• Other major European countries implemented lockdown measures at a similar point in the curve of the epidemic to the UK.

Claim - Testing and tracing in the community was abandoned on March 12th. There were concerns that prior to abandonment, contact tracing was too slow and that PHE had limited capacity to do tests and too few contact tracers for England.

• Contact tracing has never been abandoned and has been used throughout the COVID19 response.
• At the start of the outbreak, tracing the contacts of every case helped to delay community transmission and bought time for the NHS and country to prepare, ultimately helping save lives.
• When we moved from the initial containment phase, the focus switched to using stay at home measures for everyone other than essential workers to stop the spread of the virus. Contact tracing did not stop, but it focused on specific settings such as care homes or prisons where there was greatest risk of local outbreaks. As SAGE set out in the minutes of its 13 March meeting "this will increase the pace of testing (and delivery of results) for intensive care units, hospital admissions, targeted contact tracing for suspected clusters of cases and healthcare workers".
• As we move into the next phase of our response, where incidence of the virus is lower and lockdown measures start to be eased, it now needs to play a much greater role. We have successfully launched NHS Test and Trace, a service to help identify, contain and control coronavirus, reduce the spread of the virus and save lives. Backed by the rapid expansion of testing across the country and 25,000 dedicated contact tracers, we are now able to offer anyone with symptoms of the virus a test, and trace the contacts of those testing positive to prevent further transmission. Those with symptoms and their close contacts must follow advice to self-isolate, to protect others from the virus and to allow the safe and gradual lifting of lockdown.
• Social distancing has helped us to reduce the reproduction rate of the virus (R), meaning it is now possible to test every suspected case and, if they test positive, trace any close recent contacts they have to stop the spread of the virus further.
• In the early stages we rightly prioritised those with a medical need and healthcare workers. From the outset, we have acknowledged the need to increase our testing capacity, having started from a low base and we have done so reaching over 200,000 tests per day by the end of May. Our approach has meant that everyone with symptoms now has access to rapid, free testing.

Claim - Manufacturers were only asked to build ventilators as late as March 16.

• Everyone who has needed a ventilator during this unprecedented pandemic has had access to one.
• The Ventilator Challenge was rapidly established to increase ventilator capacity. Since we launched the Ventilator Challenge, we exceeded the target of producing 18,000 more ventilators and ventilator bed capacity was never overwhelmed. The Ventilator Challenge has manufactured over 3000 ventilators, increasing the numbers available to the NHS front line.
• We have also purchased thousands of ventilators from established manufacturers and started contacting suppliers in the beginning of march with the first deliveries arriving later that month.

Claim - Professor Matthew Freeman and Sir Paul Nurse contacted the government to offer help with testing but feel they got no meaningful reply.

• We are very grateful for all offers of support to increase our capacity. The approach we took in building an integrated network of lighthouse and other labs enabled us to rapidly increase our capacity to meet the immediate challenge of this pandemic.
• The scale and speed at which we have increased our testing capacity and rolled out mass testing is unprecedented and a real success.
• We have rapidly built the largest diagnostic testing industry in British history from scratch in response to an unprecedented global pandemic. This includes 50 regional test sites, more than 100 mobile testing units and 3 mega Lighthouse laboratories.

Claim - Professor Gabriel Scally says that he was amazed there wasn't more discussion about measures to prevent the importation of the virus. He comments, 'Not putting good public health checks in place at your ports and airports is a serious breach of good public health practice in containing major epidemic problems.'

• At the start of the outbreak, we used enhanced monitoring at the border to identify symptomatic travellers from high risk areas early and safely triage them into the health system.
• This was applied to those returning from Wuhan on 22 January and broadened to the whole of China on 25 January; Japan on 8 February, Iran on 25 February, Northern Italy on 4 March and the whole of Italy on 5 March.
• Once there was significant transmission within the UK, the scientific advice was that border restrictions would have a very marginal impact on the number of cases of coronavirus within the UK, as at that point they contributed a tiny proportion of the number of new infections.
• In the minutes of the SAGE meeting of the 23 March, SAGE reiterates its previous advice that closing borders would have a negligible effect on the spread of the virus.
• Imported cases matter most when the UK has a low level of infection. When domestic transmission is high, imported cases represent a small amount of the total and make no significant difference to the epidemic. As the UK moves to a situation where domestic transmission is much lower, imported cases could become a higher proportion of the overall number of infections. Requiring arrivals to the UK to self-isolate for 14 days will reduce the risk of transmission from this group.
• Now that domestic transmission is decreasing, it is the right time to prepare new measures at the border to protect us from imported cases and the risk of a second wave of infections from those arriving here. As the Prime Minister has set out, those arriving in the UK from overseas will be required to self-isolate.

Jonathan Calvert of the Sunday Times comments on his piece, particularly on the period when the Prime Minister was at Chevening in February.

• The Sunday Times article contained a series of falsehoods and errors and actively misrepresented the enormous amount of work which was going on in government at the earliest stages of the outbreak.
• The Prime Minister has been at the forefront of the response, providing leadership and direction during a hugely challenging period for the country. Our full response to the Sunday Times can be found here.

Claim - Members of the SPI-B committee of behavioural scientists were astonished to see the Prime Minister shaking hands on television and talking about shaking hands when the advice to the government was to avoid such greetings.

• The Prime Minister set out on many occasions that he made the decision at the time as a general principle to continue shaking hands with additional precautions including frequent hand washing. He also frequently used social media to urge the public to follow guidance on measures to reduce the spread.

Claim - Members of that committee tell us that they did not advise the government that behavioural fatigue would occur if lockdown was initiated earlier than it was.

• SAGE's role is to provide consensus advice on all the key issues, based on the body of scientific evidence presented by its expert participants.
• The consensus advice from SAGE was that if the interventions are made too early, they could potentially have a severe impact on people's wellbeing, either directly or indirectly. The Chief Medical Officer has spoken publicly about this on a number of occasions.
• As detailed in the minutes of the meeting on the 14 March, SAGE agreed that a balance needs to be struck between interventions that theoretically have significant impacts and interventions which the public can feasibly and safely adopt in sufficient numbers over long periods.
• Therefore, it was absolutely crucial our policies to protect the public could be realistically implemented and followed for a long period of time, while minimising the impact on the public.