Standing Committee on Pandemic Preparedness minutes: 29 April 2022

Attendees and apologies

Chair 

• Professor Andrew Morris

Attendees  

• Professor Linda Bauld
• Dr Ian Cambell
• Professor Tom Evans
• Richard Foggo
• Professor Massimo Palmarini
• Professor Nick Phin
• Professor Stephen Reicher
• Professor Aziz Sheikh
• Professor Emma Thomson
• Professor Matthew Williams
• Professor Mark Woolhouse

Observers

• Daniel Kleinberg
• Dr Jim McMenamin
• [REDACTED]
• Dr Arlene Reynolds

Apologies   

• Professor David Crossman
• Professor Julie Fitzpatrick
• Dr Graham Foster
• Dr Audrey MacDougall
• Professor Sir Gregor Smith
• Professor Devi Sridhar

Secretariat

• [REDACTED]

Items and actions

Introduction

The Chair welcomed members to the third meeting of the Standing Committee on Pandemic Preparedness (the Committee) and noted apologies. The first in person meeting of the committee was a notable development and there was a brief tour de table for members to introduce themselves.

Review of actions from previous meeting

The comments made at the previous meeting had been considered and the terms of reference had been adjusted to take them into account. The Chair confirmed that the Committee’s remit extended to social care.

The mapping exercise regarding other Scottish and UK Government groups was underway and would follow on from the work done for this meeting on the learning from pre-COVID exercises.

The secretariat had taken forward the requested actions and put in place arrangements for today’s meeting and consideration of workstreams.

Overview of evidence landscape

Richard Foggo opened the session with an overview of the Scottish Government’s perspective on some of the issues relating to pandemic planning. He thanked the Committee for their input to the recent deep dive with First Minister and noted the advice requested from the committee, as set out in their Commission. He concluded by stressing the value which Ministers placed on the independent, expert, advice provided over the last two years by the COVID-19 Advisory Group and which they now looked forward to receiving from the committee.

The Committee then received a presentation which provided an overview of the evidence from Exercises: Cygnus, Silver Swan, and Iris - the pre-COVID pandemic planning exercises in Scotland and the UK - which also summarised the Audit Scotland conclusions on these exercises.

Discussion followed, noting that it was important to learn from these exercises, avoid reinventing the wheel and avoid the trap of planning to respond to the last pandemic. However, the exercises focused mainly on operational preparedness and we also need to consider viral threat preparedness and what we need to do to get early warning signs of a new virus and track its development. It was also noted that contact tracing is very different now from four years ago with the development of real time genomic tracing.

A further element which could be developed was reports putting in place a research infrastructure and embedding data which would help researchers engage and respond to lessons learned. The new era we are in offers new e.g. vaccine solutions which requires a research response which should be at centre of the NHS and this could be improved. The potential for improvement through research goes wider than technology – the improvements in clinical treatment & epidemiology solutions before vaccines were available was crucial in responding to the demands of the pandemic.

It was noted that the conclusions drawn needed to be expanded to take account of experience with COVID-19– in particular the development of new technologies, especially vaccines, and the repurposing of existing therapeutics ahead of the development of new ones.

The close alignment of science and policy that underpinned our response to the COVID-19 pandemic was an important development which should be built on. It would also be important to reflect on the recommendations from the exercises in the light of our experience of COVID-19. Some of the assumptions made in the exercises may now be questionable – we now know a lot a lot more about public reactions for instance – though it was noted that exercises usually set out to test specific issues and don’t necessarily test others.

A feature of the exercises is that they focus on partnerships between agencies, with the public excluded, so there is limited learning on communication. We know from experience of the pandemic how important effective communication is - multiple publics behave in different ways and communication cannot be framed as top down. We need to understand the barriers to adherence and structure communication that will enable us to understand and respond to the different publics.

Potentially, the pandemic could be modelled digitally as a basis for future exercises. However, while there may be value in new exercises in line with international best practice, the priority should be on learning from our experience with Covid. This has been much more profound than any exercise and should consequently be more valuable in informing future pandemic planning. Scotland also has significant experience in responding to animal health outbreaks and there may be preparedness expertise in that area we can draw on.

The Committee then received a presentation which provided an overview of international and domestic reports on Future Pandemic Preparedness. The main themes of the reports to a large extent mirrored issues raised by Committee members in their conversations with the Chair, as summarised at the last meeting of the Committee.

In discussion it was noted that these reports would be helpful in considering the issues the Committee would address in their reports, with a number of members commenting positively on the approach taken in the Biden/Harris report. It would be important to consider preparedness structures as well as a preparedness plan and think about how we might leverage existing strengths in Scotland to make a contribution beyond Scotland as well as addressing our own needs. There was value in continuing the culture which had enabled a positive interface between science and policy makers. A consensus view on how to manage uncertainty and honesty about the degree of certainty in conclusions and recommendations would be important.

Discussion of problem statements – session 1

Discussion of problem statements – session 2

The Committee formed two separate discussion groups for these sessions, to discuss problem statements for the different workstreams. The groups also gave initial consideration to the key issues to be addressed in the Committee’s Interim Report.

Agreement of problem statements

The Chairs of the working groups spoke about discussions in their groups, summarising the problem statements they would focus on and key points for further discussion.

In discussion it was noted that the Committee as a whole would need to consider any overlap or gaps between workstreams to ensure coherence – the importance of research and data were common themes.

It was noted that future meetings of the Committee would be provided with information on work underway on pandemic recovery and planning within Scottish Government, the NHS and in social care which would enable the group to come to conclusions on priority issues for health and social care.

AOB

There was a consensus that meeting in person with the option of attending virtually had been a success. The Chair noted that the next meeting would be arranged on the same basis and the secretariat would be in touch with dates for future meetings in due cour