Anger over the forgotten exercise intended to prepare NHS Wales for epidemic

Martin Shipton

An overlooked report written 17 years before the Covid-19 outbreak shows that Welsh health officials participated in an exercise aimed at drawing lessons for the future handling of an airborne pandemic.

Now angry relatives of those who died of Covid want the Welsh Government to explain why recommendations from the exercise were not acted upon.

Anna-Louise Marsh-Rees, group lead of Covid-19 Bereaved Families for Justice Cymru, said: “On August 18 2023, a month after Module 1 of the UK Covid Inquiry had finished, a document was disclosed to us containing the recommendations of Exercise Shipshape. Under the rules of the Inquiry, we have previously been unable to discuss it.

“Undertaken in June 2003, this exercise tested the response by the health community to an outbreak of SARS in South West England and Wales. While pandemic prep exercises for influenza and MERS [Middle East Respiratory Syndrome] were covered by the UK Covid Inquiry in detail, not once was an exercise for SARS (now known as SARS1) mentioned in the hearing on the preparedness for SARS2 .

“As core participants in the Inquiry, we are deeply disappointed and saddened that a recommendations report on a highly transmissible airborne virus was not disclosed to them until after the hearing. It’s ironic that we are waiting for an Inquiry recommendations report on how the UK should have prepared for a coronavirus pandemic when one from 2003 already exists.

“This report covers everything from infection control, test and trace, resource – people, beds, treatment and PPE – structures, processes and communications for SARS.

“David Goulding, Emergency Planning Adviser to what is now the Welsh Government, who was awarded an MBE for his work during the pandemic; Dr Roland Salmon, epidemiologist; and colleagues from Gwent NHS Trust all attended. What action did they and the Welsh Government take following this report?”

Recommendations

Ms Marsh-Rees drew attention to a number of recommendations made in the report, asking what steps had been taken in preparation for a pandemic affecting Wales:

* “There was confusion during the exercise caused by Wales closing and the South West not closing hospitals. This looked bad in the media. There should be a cross-border strategy.” Was one put into place?

* “Should we identify one hospital as an infectious diseases receiving hospital? Should we gear up now?” What was the response to this?

* “South West Region should write a care homes strategy.” Where is this strategy?

* “Wales – it’s hard to take the temperatures of large numbers of people — nobody has thermometers these days.”

* “Have you learned anything from the exercise? Yes there are difficulties with Wales.” What exactly were these difficulties and what was done to remedy them?

Evidence

Ms Marsh-Rees said: “Had we as a group known about this report prior to the hearing, we would have asked those from the Welsh Government giving evidence why, when this report existed, they had only considered then failed to prepare for an influenza pandemic.

“We will want to know in the UK Inquiry Healthcare module starting in September why these many recommendations were ignored.

“Many Welsh witnesses, including Welsh Government Ministers at the UK Covid Inquiry when it sat in Cardiff in March, blamed communications with Westminster for their shoddy performance during the pandemic. And yet with Exercise Shipshape we had an opportunity almost two decades ago to be in a better position in Wales for a Covid outbreak. We suspect that, as with other pandemic planning exercises, the Welsh Government did not implement any of the recommendations.

“Shipshape is of nautical origin, based on the obligation of a sailor to keep his quarters neat and orderly. It is infuriating that the Welsh Government did not have the same obligation. They may as well have called it Operation Shitshape for the benefit that it provided to emergency planning in the Welsh Government.

“The absence of this document and the fact that only seven witnesses were called – who talked for only nine hours – is a gaping hole in the scrutiny of Wales in Module 1 of the Covid Inquiry. The Senedd Committee looking for gaps should have stumbled across this already.

“Welsh families bereaved by Covid will now have an unsettling sense of ‘what if’. What if the Welsh Government and Public Health Wales had implemented these recommendations? What if Jane Hutt, the Health Minister at the time, had acted on the recommendations? What if all the successive Health Ministers had made emergency planning for an airborne, asymptomatic virus a priority?

“The final nail in the proverbial coffin is that not only did the Welsh Government not do anything – they didn’t even disclose this exercise in their evidence to the UK Covid Inquiry.”

A Welsh Government spokesperson responded: “Ministers and government officials have given detailed evidence to the Inquiry and await the publication of its first report. We have made it clear that we continue to engage fully with the inquiry to ensure all actions and decisions are fully and properly scrutinised.”