Government warned of need for PPE stockpiles and contact tracing four years before pandemic

The Government modelled the impact of a coronavirus hitting England four years before the pandemic, with health officials warning of the need to stockpile protective equipment and develop a contact tracing tool, documents show.

Exercise Alice, carried out in February 2016, recommended 12 actions for the government to make the NHS ready to cope with an outbreak of Middle East Respiratory Syndrome (Mers) coronavirus.

The need for PPE and contact tracing

This included ensuring sufficient levels of Personal Protective Equipment (PPE) and producing a plan examining the evidence on quarantine and self-isolation requirements and recommending a “viable” approach.

The exercise was commissioned by the Department of Health and Social Care in response to concerns raised by the chief medical officer about the planning and resilience to respond to a Mers outbreak in England.

The resulting 23-page report says that PPE stockpiles were suggested “as a means to ensure sufficient quantities were available”, and a live, web-based contact tracing system was also recommended.

A key section reads:

There was a general consensus on the need to identify capacity and capability of assets within the health system.

Assets in this context would be all resources that would be required to effectively respond to a Mers-CoV outbreak such as trained personnel, appropriate PPE in sufficient quantities and the requisite beds with suitable clinical equipment.

It is one of seven reports on pandemic preparedness exercises between 2015 and 2018, first reported on by the Guardian, which came to light after Freedom of Information requests from Dr Moosa Qureshi.

Public Health England tried to block releasing the document

It was claimed that Public Health England had previously refused to release the document, saying it “could precipitate an unnecessary heightened public concern that could lead to loss of public confidence in the Government’s and the NHS’s Covid-19 response”.

But it was disclosed after Dr Qureshi said he would complain to the Information Commissioner’s Office (ICO).

Dr Qureshi said:

Disgracefully, the Government covered up Exercise Alice – a coronavirus exercise which predicted the importance of isolating patients, contact tracing, PPE provision, trained personnel and adequate NHS beds.

The fact that Covid-19 is a novel type of coronavirus is irrelevant – every pandemic is different, but the lessons of Exercise Alice were generally applicable to coronaviruses including Covid-19, they were agreed by general consensus, and both political leaders and NHS England executives failed to implement that consensus.

They failed to maintain contact tracing capacity and isolate patients, they failed to provide adequate PPE, and they cut NHS beds.”

Leigh Day partner Tessa Gregory added: “The public have a right to know why issues such as PPE supplies and developing a working contact tracing system, which were flagged in 2016 during Exercise Alice, had not been addressed by the Government when the Covid-19 pandemic hit in 2020.”

“Manipulated”

Lobby Akinnola, a spokesman for the Covid-19 Bereaved Families for Justice group, said members felt “manipulated”, adding:

For the tens of thousands of families that lost loved ones as a direct consequence of the lack of PPE, ineffectual contact tracing systems or the failures in screening for foreign travel, this news is extremely painful.

Our loved ones might still be with us today, if only the Government has followed their own recommendations.

The group repeated its calls for the promised public inquiry to start as soon as possible.

A government spokesperson said Exercise Alice had focused on a different virus to SARS-CoV-2, which causes Covid-19, and “was not a coronavirus pandemic preparedness exercise”.

She said: “Mers-CoV does not transmit as easily as SARS-CoV-2 between people, outbreak sizes are comparatively small and the risk to individuals in the UK remains very low.

“The results of Exercise Alice have been incorporated into ongoing planning work conducted by DHSC, UKHSA and the NHS to respond to potential outbreaks of high consequence infectious diseases like Mers-CoV.

“We have always been clear that there will be opportunities to look back, analyse and reflect on all aspects of Covid-19, and full statutory independent inquiry is due to begin in Spring 2022.”