Two leading health experts with connections to Newcastle gave evidence during the first week the independent Covid-19 Inquiry - highlighting "quite a few flaws" in pandemic planning.
Professor Clare Bambra of Newcastle University and Professor Michael Marmot who is patron of Tyneside charity Healthworks prepared a joint statement and gave evidence before inquiry chair Baroness Hallett on Friday. Both professors work extensively on health inequalities.
At the Inquiry, both academics highlighted how they felt, especially when it comes to a lack of forethought about the impact of the pandemic on different socio-ethnic groups, emergency planning had been "lacking". They also said in future, at-risk groups should be prioritised for infectious disease testing and vaccinations.
During questions from the Inquiry counsel Kate Blackwell KC, Prof Marmot said "that the impact of the pandemic is very much influenced by pre-existing inequalities in society, including inequalities in health".
Reflecting on how the Government managed the pandemic, he said: "It's not just specific pandemic planning, it's not just whether there's a report somewhere in government about planning for a pandemic; you've got to plan for better health, and narrow health inequalities, and that will protect you from the pandemic."
The professors highlighted five ways in which existing health inequalities result in "higher mortality and morbidity from an infectious respiratory virus" such as Covid-19. These include that all of treatment, exposure, vulnerability, susceptibility and treatment are influenced by inequality across demographic groups.
Asked to consider in evidence whether the Government had appropriately prepared for this impact, the professors wrote: ""[The Government] knew from previous pandemics and research into lower respiratory tract infections that people from lower socio-economic backgrounds, people living in areas or regions with higher rates of deprivation, and people from minority ethnic groups and people with disabilities, are much more likely to be severely impacted by a respiratory pandemic.
"Lack of consideration of pre-existing social and ethnic inequalities in health in our pandemic plans may have meant that our responses were unable to mitigate the disproportionate impact experienced by minority ethnic, low socio-economic status and other socially excluded communities."
Both academics have written extensively on the impact of the pandemic on deprived communities, including in the North - with Prof Bambra having previously discussed how chronic health problems and child poverty make our region especially vulnerable to the impact of a pandemic.
Answering questions from Allison Munroe KC representing the Covid-19 Bereaved Families UK group, Prof Bambra said there were "quite a few flaws, in the planning that we've talked about today, with regard to health inequalities and groups not being considered within, for example, the risk register or the contingencies and civil emergency planning".
Looking ahead to recommendations the inquiry chair may make and lessons that should be learned from the pandemic, Profs Marmot and Bambra wrote: "Pandemic planning and preparation should integrate a health equity lens across all aspects of the process. It should consider if, in future pandemics, additional social groups should be added to those based on age or clinical risk.
"This could lead to prioritising access to testing, PPE, vaccines, and antiviral medications. Public communication messages about risk and mitigating actions should be both universal for the whole population and targeted to specific at-risk communities.
"Suitable PPE equipment should be stockpiled in advance and distributed according to relative occupational risk. Enhanced testing should be conducted within at risk communities. Inequalities between and within communities (eg Local Authorities, voluntary sector and NHS capacity) in terms of the ability and capacity to respond to pandemics needs to be addressed.
"A 'universal proportionalism' strategy should be applied in future pandemic planning so that mitigations are delivered for the whole population (universalism) but enhanced for those most in need (proportionalism)."
The Covid-19 Inquiry is expected to last for several years.
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