The UK did "not have the ability to scale up" quickly to deal with the COVID-19 pandemic in areas such as testing, England's Chief Medical Officer told the UK COVID-19 Inquiry.
Professor Sir Chris Whitty told the public inquiry that the "hazards and threats" from a pandemic are "going to be completely different every time", and what is needed are "multiple capabilities that can be flexed to almost any emergency" rather than having a plan for one particular scenario.
He also said one weakness in the system was a lack of "radicalism" in thinking, adding there should have been "a more imaginative approach to how we would respond to a major pandemic".
Sir Chris addressed bereaved families at the start of his evidence on Thursday, saying he had first-hand experience of being on the front line when he was on NHS wards for 12 weeks.
"I can say to the families who are here I saw the extraordinary impact and devastation for individuals and the families," he said.
Module 1 of the inquiry, which is set to run until mid-July, is looking at the UK’s preparedness for pandemics in the time before COVID struck.
'Insufficient Thought' Given To a Possible Pandemic
Under questioning from Hugo Keith KC, lead counsel to the inquiry, Sir Chris admitted that insufficient thought had been given to how a pandemic like COVID could be stopped in its tracks.
Asked about written evidence from former health secretary Matt Hancock and whether there was a focus on worst-case scenarios, he said: "I certainly agree that we did not give sufficient thought to what we could do to stop, in its tracks, a pandemic on the scale of COVID, or indeed any other pathogen that could realistically go there.
"Where I would completely agree, is that we do need to actually start off – and I think this is brought out in Mr [Jeremy] Hunt's evidence yesterday and also Mr [Oliver] Letwin's – all of them essentially said we saw this huge problem and we didn’t say to the system, 'how are we going to stop it?’"
Sir Chris told the inquiry that non-pharmaceutical interventions (NPIs) used during the COVID pandemic – social measures such as quarantine, individual isolation, closing schools – were not new and some went back to the Middle Ages.
"However, the very big new idea was the idea of a lockdown," he said. "I'm talking here very, very specifically about the state saying people have to go home and stay at home, except under very limited circumstances – a very radical thing to do."
He added that it would have been "very surprising – without this being requested by a senior politician or similar" that a scientific committee would have planned for lockdowns with their "huge economic and social impact ramifications" in advance.
A Plan for Every Eventuality
Sir Chris was asked by Mr Keith about the fact there appeared to have been no extensive discussions about issues such as speed of transmission or asymptomatic infection in Government documents pre-COVID.
He replied: "I think this illustrates a failure in the way we generally operate in government to deal with emergencies, which is to say, 'we need to have a plan for every eventuality and if you can just pull off the plan and you can tick off all the things you want to do that’s going to work'.
"Actually what nature is going to give you…the hazards and threats…is going to be completely different every time," he said. "So what you need to have is building blocks of lots of different capabilities and you need to say, 'actually, we don’t know what problem we’re going to face but what we do know is we've got the capabilities to face a whole range of different possible outcomes'."
Later, he also said: "I think, in a sense, the danger in government is that people feel the document is written, and therefore the problem is solved, and I absolutely do not think that’s the case."
On the issue of scaling up, Sir Chris said one issue "we really absolutely should have taken much more seriously, was the capability to scale up".
He added: "In every pandemic, every epidemic, the ability to diagnose, for example, is essential, and we had a very good capacity to do a very small amount of diagnoses really quickly and we did not have the ability to scale up, and I could repeat that across multiple other domains."
He also suggested that within the Government, there is sometimes a lack of understanding of science between emergencies, saying: "In an emergency, everyone is clamouring for scientific advice… they are desperate to get scientists in the room. Between emergencies, you have to kind of elbow your way in."
He continued: "So, it’s the ability to actually engage all the way through the system between emergencies – that I think is the big risk."
'Paucity' of Data in Earliest Stages of Pandemic
Earlier, Sir Chris was asked about the level of abuse experienced by some scientists involved in the COVID outbreak, which he called "extremely concerning".
Meanwhile, Sir Patrick Vallance, former chief scientific adviser, later told the inquiry there was a "paucity" of data in the earliest stages of the pandemic which meant he and others were flying more "blind" than they would have liked.
He also pointed to an "inherent reluctance" to spend public money on endeavours that might fail, adding: "I think we need to be much more explicit about why spending public money is important for certain things, even if nothing turns out not to be what's needed or used."
He further said that the lack of an industrial vaccine base in the UK when the pandemic struck was "benign neglect".
Former health secretary Mr Hancock, ex-Scottish first minister Nicola Sturgeon and the chief executive of the UK Health Security Agency, Dame Jenny Harries, will give evidence to the inquiry next week.