What does the leaked report tell us about the UK's pandemic preparations?

Careful analysis of the National Security Risk Assessment document illustrates how the Covid-19 pandemic represents a hybrid of two of the major threats to the UK anticipated by the British government.

The first, an influenza-type disease pandemic, predicts waves of a novel flu virus striking several months apart. This type of threat represents the basis of the UK government’s blueprint for how it would respond to a pandemic.

Britain’s preparations for a flu pandemic include stockpiles of millions of doses of antivirals, including the drugs Tamiflu and Relenza, as well as a digital distribution system called the National Flu Pandemic Service that would be deployed to coordinate the distribution of antivirals to people who were symptomatic.

Plans published in 2011 detail stocks of pre-specific vaccine that could be administered to healthcare workers in parallel alongside antivirals, so as to maintain the UK’s health workforce.

However, these preparations are contingent on the pandemic being a variation of influenza. Covid-19 is a coronavirus, not a strain of influenza, making some of those preparations less useful.

The document also contains a separate chapter anticipating non-flu-based “emerging infectious diseases”, even specifically citing the risk of a novel coronavirus arriving in the UK.

The risk model assumes that such a disease would be comparable to Sars (severe acute respiratory syndrome) or Mers (Middle East respiratory syndrome), outbreaks of which afflicted south-east Asia and the Middle East in recent years. Those viruses have case fatality rates of between 33% and 50%, making them far more lethal than Covid-19.

In some respects, the UK’s response necessarily has to begin from scratch because of the novel nature of the disease: treatments, vaccines and even the mode of transmission all have to be identified.

But the building blocks of responding to a pandemic are roughly the same, a source said: “We are not moving from a standing start. We should be building out from what we know – PPE [personal protective equipment], community disruption, supply line difficulties and public anxiety.

“Pandemic flu gives us the modelling to start from. It’s about building on what you have. What we had at the beginning had been depleted over the years and no one challenged the changes because [the feeling was] something like this would never happen.”

Containing any novel disease outbreak in the UK would require intensive measures to detect and limit its spread, the document states. “Sustained human-to-human transmission in emerging airborne diseases is possible,” it reads, “which is why infection control procedures are critical to the mitigation of this risk.”

The impacts of an emerging infectious disease anticipated by the risk assessment are vastly less severe than the havoc Covid-19 has wrought. A reasonable worst case scenario included 200 fatalities and an economic cost of £7.5bn, chiefly as a result of a drop in tourism.

This is, again, largely because the prediction is modelled upon Sars and Mers, which never achieved the same level of community transmission as Covid-19 has.

The coronavirus pandemic’s damage has instead been much more comparable to what the document anticipates for a flu pandemic: potentially hundreds of thousands of fatalities, as well as a total economic cost of over £2tn as a result of widespread and lasting disruption.

Alarmingly, the document notes that, although unpredictable, “the emergence of new infectious diseases … appears to have become more frequent”, possibly as a result of worsening global heating. “Climate change may result in conditions that may make the UK more hospitable for establishment of insect vectors of diseases currently not endemic in the country,” it warns.