Ebola outbreak exposed major weakness in UK handling of health emergencies
BMJ 2016; 352 doi: https://doi.org/10.1136/bmj.i455 (Published 25 January 2016) Cite this as: BMJ 2016;352:i455The United Kingdom has “serious weaknesses” in its ability to handle and respond to infectious disease emergencies, MPs have warned.
Slowness to respond, poor coordination among various expert bodies, delays in organising research, and a lack of speed in manufacturing vaccines were all exposed by the recent outbreak of Ebola virus disease in west Africa, says a report by the House of Commons Science and Technology Committee.1
The committee praised the government for its “leading contribution” to the fight against the disease in west Africa and for the practical support it provided in building and staffing treatment centres and deploying troops, helicopters, and an aviation support ship.
The west African outbreak, which began in late 2013 but was first reported in March 2014, led to the deaths of more than 11 000 people in Guinea, Liberia, and Sierra Leone.
Despite their praise, MPs said that the epidemic exposed the UK’s lack of readiness for such an infectious disease emergency. There were systemic delays at every stage of the government’s response to the Ebola outbreak, from escalating Public Health England’s disease surveillance data to convening the Scientific Advisory Group for Emergencies (SAGE), the main mechanism for channelling scientific advice to the government in an emergency.
The advisory group was not convened until October 2014, three months after the first meeting of Cobra, the government’s emergency response committee. The MPs recommended that in future the formation of SAGE should be triggered by a recommendation of the chief scientist.
Neither the UK nor the international community was “research ready” at the beginning of the outbreak, even though trials of vaccines and drug treatments often need to be conducted during a disease outbreak. There was also a lack of capacity to manufacture vaccines quickly. Such a lack would place the UK in a vulnerable position in future epidemics, warned the MPs.
They called on the government and the chief medical officer to embed research into future emergency responses and ensure that agreements were in place with vaccine manufacturers to ensure that capabilities could be called on quickly in an emergency.
The committee’s chair, Nicola Blackwood, the Conservative MP for Oxford West and Abingdon, said, “Universities, regulatory bodies, and pharmaceutical companies launched clinical trials for Ebola vaccines and treatments in record time. These efforts are to be commended, but it is also clear that the capacity to conduct research during an outbreak was not embedded in the UK’s emergency response.”
The report praised the Public Health England and NHS staff, including GPs, nurses, clinicians, psychiatrists, and consultants in emergency medicine, who volunteered to help in Sierra Leone at the height of the Ebola outbreak. By November 2014 more than 1000 NHS staff and 185 staff from Public Health England had put their names forward to volunteer.
Blackwood said, “Scientists, health workers, and agencies did a heroic job working around the clock to confront the Ebola outbreak, sometimes at risk to their own lives.
“But the UK response to Ebola—like the international one—was undermined by systematic delay. The government’s emergency response procedures were triggered far too late in the day, Ebola test kits were developed and trialled but not deployed, and the initial response was ad hoc and uncoordinated.
“A combination of hard work and chance prevented Ebola spreading further than it did, but a future epidemic may be less containable and spread within the UK as well as overseas. We must take the opportunity now to ensure that the UK is not caught unprepared when the next disease emergency strikes.”
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Cite this as: BMJ 2016;352:i455