The UK’s Response to the COVID 19 pandemic Part 3 – Lessons learned?
Main Article Content
Abstract
There are crucially important lessons that can be learned from the UK's experience during the COVID-19 pandemic, but overall, the COVID-19 pandemic has highlighted the importance of being prepared, early intervention, clear communication, collaboration, equity, and the legitimate (truthful?) use of science to guide decision-making. So, this paper tries to understand the reasons for these revealed issues –
- Adequate Preparation
- Early Intervention
- Legitimate (truthful) use of the “Science” involved.
- Basis and quality of decisions taken.
- Perceived Equity and Trust
- Clear communication of messages
There seems to be an inevitable exponential progression of the impact of these successive factors. Apparent ignorance and inertia and the inability to grasp the scale of the projected health and economic impacts, seemed to lead to overcompensation and concern for political survival over societal safety. It’s also clear that the deaths in Italy, Britain and USA were heavily impacted by how we care for the elderly, and how we failed to protect them in care and nursing homes.
The paper attempts to better understand the reasons for this escalation by examining in detail each of these issues, so it can be avoided in future.
It is not clear that we have either understood or are prepared to undertake to implement the changes needed and suggested by this and most other independent analyses. The paper discusses and makes recommendations on how some of the underlying issues might be addressed.
- Recommendation 1 - We should look again at the design, effectiveness, and interactions of traditional Government Structures – particularly in the NHS.
- Recommendation 2 – The UK Government needs to rethink the status, roles and responsibilities of “Special” Advisers (SPAD’s) in managing independent advice to ministers.
- Recommendation 3 – As a basis for decisions and communication Governments need to be clearer about the difference between “Objective” and “Convenient” Truth.
- Recommendation 4 – We need the commitment of decision makers to accept responsibility for following, (or interpreting?), or not, (published?) advice.
- Recommendation 5 – The public needs best available information, and reasons for choice, not polarised opinions.
- Recommendation 6 – Governments should recognise, address and communicate the uncertainty, ambiguity, and complexity inherent in difficult decisions.
- Recommendation 7 – Governments should formally require a red teaming function in their planning and response organisations.
- Recommendation 8 – Governments should encourage a culture of challenge, and independent/ enlightened thinking.
- Recommendation 9 – In these kinds of pandemic challenges, Governments should adopt (sooner?) a more “military” versus “conventional / predictable” mindset / culture as they would in “wartime”.
Recommendation 10 – In these situations, Governments should consider a mandatory requirement for inclusivity, acceptability and competence in crisis management. (War cabinet?).
Keywords:
COVID 19, COVID 19 pandemic Part 3, The UK’s Response to the COVID 19 pandemic
Article Details
How to Cite
SLATER, David.
The UK’s Response to the COVID 19 pandemic Part 3 – Lessons learned?.
Medical Research Archives, [S.l.], v. 11, n. 7.1, july 2023.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/4000>. Date accessed: 15 may 2024.
doi: https://doi.org/10.18103/mra.v11i7.1.4000.
Section
Review Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
1. Scally (2020) The UK’s public health response to covid-19 Too little, too late, too flawed BMJ 2020;369:m1932 doi: 10.1136/bmj.m1932 (Published 15 May 2020)
2. The Kings Fund (2021) Assessing England’s response to Covid-19 - A framework - https://www.kingsfund.org.uk/publications/assessing-englands-response-covid-19-framework
3. Nelson F (2023)- Was Sweden right all along? The Telegraph, March 10.
4. SPI – M advice.
5. Jon Miltimore (2022) https://fee.org/articles/we-failed-danish-newspaper-apologizes-for-its-covid-coverage/
6. Seldon A. and Newell R. (2023) Johnson at 10: The Inside Story, to be published by Atlantic Books on May 4th.
7. Slater, D, Hollnagel, E, MacKinnon, R, Sujan M, Carson-Stevens A, Ross, Bowie P, (2022) A systems analysis of the COVID-19 pandemic response in the United Kingdom – Part 1 – The overall context Safety Science, Volume 146, 10552
8. UK Government, Policy Paper (2022) UK COVID Inquiry ; Terms of Reference www.gov.uk/government/publications/uk-covid-19-inquiry-terms-of-reference
9. Slater D. (2020) Why don’t we learn from disasters? –policy lessons from catastrophic events Bennett institute of Public Policy Report
10. House of Commons Select Committee Report (2022) Coronavirus: Lessons learned to date https://committees.parliament.uk/publications/7496/documents/78687/default/
11. The Government’s Response to the Health and Social Care Committee and Science and Technology Committee Joint Report: Coronavirus: Lessons Learned to Date ; https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1083412/government-response-to-the-hscc-and-science-and-technology-committee-joint-report-coronavirus-lessons-learned-to-date-print-ready.pdf
12. Slater, D (2019a) - Grenfell Tower - How could we have done the Risk Analysis Differently? DOI: 10.13140/RG.2.2.30762.72649 https://www.researchgate.net/publication/319183242_Grenfell_Tower_-_How_could_we_have_done_the_Risk_Analysis_Differently?channel=doi&linkId=59993be00f7e9b3edb1700c4&showFulltext=true
13. WHO - www.who.int/news-room/feature-stories/detail/a-guide-to-who-s-guidance
14. Slater D., (2022) A systems analysis of the COVID-19 pandemic response in the United Kingdom – Part 2 – Work as Done vs Work as Imagined Safety Science, Volume 146, 105526
15. Bell, Sir J. and King, Sir D. (2023)– The Independent - www.independent.co.uk/news/health/arcturus-new-covid-variant-uk-symptoms-b2321577.html
16. Decision making in a crisis: First responses to the coronavirus pandemic www.instituteforgovernment.org.uk/publication/report/decision-making-crisis
17. Thomas, A. and Clyne, R. (2021) Responding to shocks: 10 lessons for government Institute for Government www.instituteforgovernment.org.uk/publication/report/responding-shocks-10-lessons-government
18. Min J.Y. (2020) A Study on South Korea's emergency response to the MERS outbreak, using the Functional Resonance Analysis Method. Saf. Sci. 2020. [Google Scholar]
19. Carvalho. P.V.R. et al, Transformative dimensions of resilience and brittleness during health systems' collapse: a case study in Brazil using the Functional Resonance Analysis Method BMC Health Serv Res. 2023 Apr 10;23 (1):349. doi: 10.1186/s12913-023-09301-1.
20. Boschiero MN, Palamim CVC, Ortega MM, Mauch RM, Marson FAL. One Year of Coronavirus Disease 2019 (COVID-19) in Brazil: A Political and Social Overview. Ann Glob Health. 2021 May 18;87(1):44. doi: 10.5334/aogh.3182. PMID: 34046307; PMCID: PMC8139306
21. Slater D.H, and B.J.M. Ale. 2022. Organisations: Drifting or Dysfunctional? Proceedings of the 32nd European Safety and Reliability Conference (ESREL 2022) Edited by Maria Chiara Leva, Edoardo Patelli, Luca Podofillini, and Simon Wilson ©2022 ESREL2022 Organizers. Published by Research Publishing, Singapore. doi: 10.3850/978-981-18-5183-4_S32-02-197-cd
22. Bingham, K. and Hames, T, (2022)- The Long Shot: the inside story of the race to vaccinate Britain Oneworld Publications, London.
23. Nature (2020) “Governments cannot just ‘follow the science” on COVID-19 Human Behaviour | VOL 4 | 560 | www.nature.com/nathumbehaviour/
24. Ale, BJM (2005) Living with Risk: a management question, Reliability Engineering and System Safety, Reliability Engineering and System Safety, 90 (2005) 196-205
25. Ale BJM, Hartford DND, Slater DH (2021a), Living With Legacy Risk; the Limits of Practicalities? Sustainability 2021, 13(6), 3004; https://doi.org/10.3390/su13063004
26. Ale BJM, Hartford DND, Slater DH. Resilience or Faith, in Piero Baraldi, Francesco Di Maio and Enrico Zio (Eds) Proceedings of the 30th European Safety and Reliability Conference and the 15th Probabilistic Safety Assessment and Management Conference. Published by Research Publishing, Singapore 2020,; ISBN: 981-973-0000-00-0 : doi: 10.3850/981-973-0000-00-0.
27. Ale BJM, Hartford DND, Slater DH (2021), Prevention, precaution and resilience: Are they worth the cost? Safety Science 140 (2021) 105271.
28. Ale, B.J.M. (2003) Keynote Lecture: Living with Risk: a management question, in ESREL 2003, Safety and Reliability, - Bedford en van Gelder (eds), Swets en Zeitlinger, Lisse, ISBN 90 5809 551 7
29. Ale, B.J.M., D.H. Slater and D.N.D. Hartford. 2022. “The ethical dilemmas of risky decisions”. Risk Analysis 1–15. https://doi.org/10.1111/risa.13893
30. Ale, B.J.M., D.N.D. Hartford and D.H. Slater. 2021. “Justifying the basis of Risk Decisions in a Pandemic – framing the issues”. In Proceedings of the 31st European Safety and Reliability Conference Edited by Bruno Castanier, Marko Cepin, David Bigaud and Christophe Berenguer Copyright ©2021 by ESREL2021 Organizers. Published by Research Publishing, Singapore ISBN: 981-973-0000-00-0: Doi: 10.3850/981-973-0000-00-0 esrel2021-paper nr 298 pages 407-414
31. Ale, B.J.M., D.H. Slater and D.N.D. Hartford. 2021. “Vaccination with vector type vaccines – is it worth the risk?” Medical Research Archives 9 no 6. https://doi.org/10.18103/mra.v9i6.2478
32. Ale, B.J.M. (2023) – Third party risk policy in The Netherlands A historical sketch, Cambridge Scholars Publishing, Cambridge
33. Ferguson, N.M. et al, (2020) Report 9: Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand WHO Collaborating Centre for Infectious Disease Modelling, MRC Centre for Global Infectious Disease Analysis, Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London
34. Ale, BJM., Hartford, DND, Slater, DH (2020), Dragons, black swans and decisions; Environmental research 183 (2020) 109127
35. Ale, B.J.M., D.N.D. Hartford and D.H. Slater. 2020b. “Precaution, Resilience, Faith, and COVID-19” Medical Research Archives 8 no 8. https://doi.org/10.18103/mra.v8i8.2197
36. Slater, D. (2012) – “Risk Assessment from the Top”, The Chemical Engineer, February 2012 P.41
37. Slater, D. and Ale, B.J.M. (2017) Risk and Regulation - Risks we cannot afford? DOI: 10.13140/RG.2.2.31235.50728
38. Taleb, N.N. (2010) – The Black Swan: The impact of the highly improbable, Penguin Books
39. May, R. (2011) Science as organised scepticism – Phil. Trans. R. Soc. A (2011)369, 4685 – 4689
40. Carrel, S. et al – (2020) - www.theguardian.com/world/2020/apr/24/revealed-dominic-cummings-on-secret-scientific-advisory-group-for-covid-19
41. Andersen, K.G., Rambaut, A., Lipkin, W.I. et al. The proximal origin of SARS-CoV-2. Nat Med 26, 450–452 (2020). https://doi.org/10.1038/s41591-020-0820-9
42. Calisher, C. Carroll, D. Colwell, R. Corley, R.B. Daszak, P. Drosten C. et al. (2020), The Lancet, DOI: https://doi.org/10.1016/S0140-6736(20)30418-9
43. Thacker, P.D. (2021) The covid-19 lab leak hypothesis: did the media fall victim to a misinformation campaign? BMJ 2021;374: n1656.
44. Li, H., Yuan, K., Sun, YK. et al. Efficacy and practice of facemask use in general population: a systematic review and meta-analysis. Transl Psychiatry 12, 49 (2022). https://doi.org/10.1038/s41398-022-01814-3
45. Herd immunity critique HOC.
46. “Unimaginable” cost of Test & Trace failed to deliver central promise of averting another lockdown www.committees.parliament.uk/committee/127/public-accounts-committee/news/150988/unimaginable-cost-of-test-trace-failed-to-deliver-central-promise-of-averting-another-lockdown/
47. Susskind, L. (2010). Dealing with an angry public: The mutual gains approach to resolving disputes. Free Press.
48. The Cummings effect: politics, trust, and behaviours during the COVID-19 pandemic www.thelancet.com Vol 396 August 15, 2020
49. Slater, D. “Systemic Factors in Organisational Failures: A Review of some recent high-profile cases” in Medical Research Archives, [S.l.], v. 10, n. 12, dec. 2022.
50. Perrow, C. (1999) Normal Accidents – Living with High-Risk Technologies – Princeton paperbacks.
51. Hopkins, A. (2009) Learning from High Reliability Organisations CCH Ausdtralia Ltd.
52. LeCoze, J.C. (2022) Post Normal Accident: Revisiting Perrow’s Classics.
53. Peter, L.J and Hull, A. (2020) The Peter Principle: Why Things Always Go Wrong Profile Books Ltd. London.
54. Stanley, M. (2021) – Speaking Truth to Power – Richborne Publishing, London.
55. Slater, D, et al, (2000) Policy, Risk and Science: securing and using scientific advice, Report and recommendations submitted by OXERA to the Health and Safety Executive; the Cabinet Office (Regulatory Impact Unit); the Department of the Environment, Transport and the Regions; the Department of Health; the Environment Agency; the Food Standards Agency; the Office of Science and Technology; and the Scottish Executive.
56. Slater, D. and Ale, B.J.M. (2022) The Scientific Advisor in a Politicized World January 2022 Medical Research Archives 10(5) DOI:10.18103/mra.v10i5.2799
57. Ackoff, R.L. (1971) Towards a system of systems concept, Management Science Vol 17, No. 11
58. Nomoto H, Slater D (2017) Decision Making Under Uncertainty –The Brain as a System Model, https://www.researchgate.net/profile/David-Slater/publication/324910984_An_Internet_of_Functions_The_Brain_as_a_System_Model/links/5aeafab70f7e9b837d3c4e0f/An-Internet-of-Functions-The-Brain-as-a-System-Model.pdf
59. Lord Reith - https://www.bbc.com/historyofthebbc/research/john-reith/
60. Gore, A"An Inconvenient Truth (U)". British Board of Film Classification. May 18, 2006. Retrieved December 9, 2016.
61. Rutherford Aris, Neal R. Amundson, An analysis of chemical reactor stability and control—I: The possibility of local control, with perfect or imperfect control mechanisms, Chemical Engineering Science, Volume 7, Issue 3, 1958, Pages 121-131, ISSN 0009-2509, https://doi.org/10.1016/0009-2509(58)80019-6.
62. Slater, D. Burnap (2010) Managing Risk in Complex, Interacting Systems. Final Report –Technology Strategy Board: Network Security: Information infrastructure Protection – Fast Track Project: BK106A August 2010
63. Ale, B.J.M. (1976) Analysis of the operating stability of a caprolactam reactor (Symp. Loss Prevention, Basel). Loss Prevention and Safety Promotion 3, vol. 4, p. 1541
64. Royal Academy of Engineering, (2022) Engineering X - Safer Complex Systems, https://engineeringx.raeng.org.uk/programmes/pandemic-preparedness
65. Ministry of Defence (2021) Red Teaming Handbook: 3rd Edition, Crown Copyright.
66. Rossine, F.W. et al (2020) Eco-evolutionary significance of “loners” https://doi.org/10.1371/journal.pbio.3000642
67. La Guerre Bent, Samuel Arthur (1887). Familiar Short Sayings of Great Men. bartleby.com. Boston: Ticknor and Co. Retrieved May 7, 2016.
68. Churchill, Sir W. (1948) In a Speech to UK Parliament, Hansard.
69. Lovelock, J. (227) – The Revenge of Gaia, Penguin Books.
70. Gutenschwager, G. (2021). Ambiguity, Misinformation and the Coronavirus. Academia Letters, Article 1395. https://doi.org/10.20935/AL1395. 4
71. Capra, F. (1982) The Turning Point: Science, Society, and the Rising Culture. Simon and Schuster, New York.
72. Lancet – (2023) Comment | volume 401, issue 10385, p1324 DOI: https://doi.org/10.1016/S0140-6736(23)00804-8
2. The Kings Fund (2021) Assessing England’s response to Covid-19 - A framework - https://www.kingsfund.org.uk/publications/assessing-englands-response-covid-19-framework
3. Nelson F (2023)- Was Sweden right all along? The Telegraph, March 10.
4. SPI – M advice.
5. Jon Miltimore (2022) https://fee.org/articles/we-failed-danish-newspaper-apologizes-for-its-covid-coverage/
6. Seldon A. and Newell R. (2023) Johnson at 10: The Inside Story, to be published by Atlantic Books on May 4th.
7. Slater, D, Hollnagel, E, MacKinnon, R, Sujan M, Carson-Stevens A, Ross, Bowie P, (2022) A systems analysis of the COVID-19 pandemic response in the United Kingdom – Part 1 – The overall context Safety Science, Volume 146, 10552
8. UK Government, Policy Paper (2022) UK COVID Inquiry ; Terms of Reference www.gov.uk/government/publications/uk-covid-19-inquiry-terms-of-reference
9. Slater D. (2020) Why don’t we learn from disasters? –policy lessons from catastrophic events Bennett institute of Public Policy Report
10. House of Commons Select Committee Report (2022) Coronavirus: Lessons learned to date https://committees.parliament.uk/publications/7496/documents/78687/default/
11. The Government’s Response to the Health and Social Care Committee and Science and Technology Committee Joint Report: Coronavirus: Lessons Learned to Date ; https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1083412/government-response-to-the-hscc-and-science-and-technology-committee-joint-report-coronavirus-lessons-learned-to-date-print-ready.pdf
12. Slater, D (2019a) - Grenfell Tower - How could we have done the Risk Analysis Differently? DOI: 10.13140/RG.2.2.30762.72649 https://www.researchgate.net/publication/319183242_Grenfell_Tower_-_How_could_we_have_done_the_Risk_Analysis_Differently?channel=doi&linkId=59993be00f7e9b3edb1700c4&showFulltext=true
13. WHO - www.who.int/news-room/feature-stories/detail/a-guide-to-who-s-guidance
14. Slater D., (2022) A systems analysis of the COVID-19 pandemic response in the United Kingdom – Part 2 – Work as Done vs Work as Imagined Safety Science, Volume 146, 105526
15. Bell, Sir J. and King, Sir D. (2023)– The Independent - www.independent.co.uk/news/health/arcturus-new-covid-variant-uk-symptoms-b2321577.html
16. Decision making in a crisis: First responses to the coronavirus pandemic www.instituteforgovernment.org.uk/publication/report/decision-making-crisis
17. Thomas, A. and Clyne, R. (2021) Responding to shocks: 10 lessons for government Institute for Government www.instituteforgovernment.org.uk/publication/report/responding-shocks-10-lessons-government
18. Min J.Y. (2020) A Study on South Korea's emergency response to the MERS outbreak, using the Functional Resonance Analysis Method. Saf. Sci. 2020. [Google Scholar]
19. Carvalho. P.V.R. et al, Transformative dimensions of resilience and brittleness during health systems' collapse: a case study in Brazil using the Functional Resonance Analysis Method BMC Health Serv Res. 2023 Apr 10;23 (1):349. doi: 10.1186/s12913-023-09301-1.
20. Boschiero MN, Palamim CVC, Ortega MM, Mauch RM, Marson FAL. One Year of Coronavirus Disease 2019 (COVID-19) in Brazil: A Political and Social Overview. Ann Glob Health. 2021 May 18;87(1):44. doi: 10.5334/aogh.3182. PMID: 34046307; PMCID: PMC8139306
21. Slater D.H, and B.J.M. Ale. 2022. Organisations: Drifting or Dysfunctional? Proceedings of the 32nd European Safety and Reliability Conference (ESREL 2022) Edited by Maria Chiara Leva, Edoardo Patelli, Luca Podofillini, and Simon Wilson ©2022 ESREL2022 Organizers. Published by Research Publishing, Singapore. doi: 10.3850/978-981-18-5183-4_S32-02-197-cd
22. Bingham, K. and Hames, T, (2022)- The Long Shot: the inside story of the race to vaccinate Britain Oneworld Publications, London.
23. Nature (2020) “Governments cannot just ‘follow the science” on COVID-19 Human Behaviour | VOL 4 | 560 | www.nature.com/nathumbehaviour/
24. Ale, BJM (2005) Living with Risk: a management question, Reliability Engineering and System Safety, Reliability Engineering and System Safety, 90 (2005) 196-205
25. Ale BJM, Hartford DND, Slater DH (2021a), Living With Legacy Risk; the Limits of Practicalities? Sustainability 2021, 13(6), 3004; https://doi.org/10.3390/su13063004
26. Ale BJM, Hartford DND, Slater DH. Resilience or Faith, in Piero Baraldi, Francesco Di Maio and Enrico Zio (Eds) Proceedings of the 30th European Safety and Reliability Conference and the 15th Probabilistic Safety Assessment and Management Conference. Published by Research Publishing, Singapore 2020,; ISBN: 981-973-0000-00-0 : doi: 10.3850/981-973-0000-00-0.
27. Ale BJM, Hartford DND, Slater DH (2021), Prevention, precaution and resilience: Are they worth the cost? Safety Science 140 (2021) 105271.
28. Ale, B.J.M. (2003) Keynote Lecture: Living with Risk: a management question, in ESREL 2003, Safety and Reliability, - Bedford en van Gelder (eds), Swets en Zeitlinger, Lisse, ISBN 90 5809 551 7
29. Ale, B.J.M., D.H. Slater and D.N.D. Hartford. 2022. “The ethical dilemmas of risky decisions”. Risk Analysis 1–15. https://doi.org/10.1111/risa.13893
30. Ale, B.J.M., D.N.D. Hartford and D.H. Slater. 2021. “Justifying the basis of Risk Decisions in a Pandemic – framing the issues”. In Proceedings of the 31st European Safety and Reliability Conference Edited by Bruno Castanier, Marko Cepin, David Bigaud and Christophe Berenguer Copyright ©2021 by ESREL2021 Organizers. Published by Research Publishing, Singapore ISBN: 981-973-0000-00-0: Doi: 10.3850/981-973-0000-00-0 esrel2021-paper nr 298 pages 407-414
31. Ale, B.J.M., D.H. Slater and D.N.D. Hartford. 2021. “Vaccination with vector type vaccines – is it worth the risk?” Medical Research Archives 9 no 6. https://doi.org/10.18103/mra.v9i6.2478
32. Ale, B.J.M. (2023) – Third party risk policy in The Netherlands A historical sketch, Cambridge Scholars Publishing, Cambridge
33. Ferguson, N.M. et al, (2020) Report 9: Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand WHO Collaborating Centre for Infectious Disease Modelling, MRC Centre for Global Infectious Disease Analysis, Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London
34. Ale, BJM., Hartford, DND, Slater, DH (2020), Dragons, black swans and decisions; Environmental research 183 (2020) 109127
35. Ale, B.J.M., D.N.D. Hartford and D.H. Slater. 2020b. “Precaution, Resilience, Faith, and COVID-19” Medical Research Archives 8 no 8. https://doi.org/10.18103/mra.v8i8.2197
36. Slater, D. (2012) – “Risk Assessment from the Top”, The Chemical Engineer, February 2012 P.41
37. Slater, D. and Ale, B.J.M. (2017) Risk and Regulation - Risks we cannot afford? DOI: 10.13140/RG.2.2.31235.50728
38. Taleb, N.N. (2010) – The Black Swan: The impact of the highly improbable, Penguin Books
39. May, R. (2011) Science as organised scepticism – Phil. Trans. R. Soc. A (2011)369, 4685 – 4689
40. Carrel, S. et al – (2020) - www.theguardian.com/world/2020/apr/24/revealed-dominic-cummings-on-secret-scientific-advisory-group-for-covid-19
41. Andersen, K.G., Rambaut, A., Lipkin, W.I. et al. The proximal origin of SARS-CoV-2. Nat Med 26, 450–452 (2020). https://doi.org/10.1038/s41591-020-0820-9
42. Calisher, C. Carroll, D. Colwell, R. Corley, R.B. Daszak, P. Drosten C. et al. (2020), The Lancet, DOI: https://doi.org/10.1016/S0140-6736(20)30418-9
43. Thacker, P.D. (2021) The covid-19 lab leak hypothesis: did the media fall victim to a misinformation campaign? BMJ 2021;374: n1656.
44. Li, H., Yuan, K., Sun, YK. et al. Efficacy and practice of facemask use in general population: a systematic review and meta-analysis. Transl Psychiatry 12, 49 (2022). https://doi.org/10.1038/s41398-022-01814-3
45. Herd immunity critique HOC.
46. “Unimaginable” cost of Test & Trace failed to deliver central promise of averting another lockdown www.committees.parliament.uk/committee/127/public-accounts-committee/news/150988/unimaginable-cost-of-test-trace-failed-to-deliver-central-promise-of-averting-another-lockdown/
47. Susskind, L. (2010). Dealing with an angry public: The mutual gains approach to resolving disputes. Free Press.
48. The Cummings effect: politics, trust, and behaviours during the COVID-19 pandemic www.thelancet.com Vol 396 August 15, 2020
49. Slater, D. “Systemic Factors in Organisational Failures: A Review of some recent high-profile cases” in Medical Research Archives, [S.l.], v. 10, n. 12, dec. 2022.
50. Perrow, C. (1999) Normal Accidents – Living with High-Risk Technologies – Princeton paperbacks.
51. Hopkins, A. (2009) Learning from High Reliability Organisations CCH Ausdtralia Ltd.
52. LeCoze, J.C. (2022) Post Normal Accident: Revisiting Perrow’s Classics.
53. Peter, L.J and Hull, A. (2020) The Peter Principle: Why Things Always Go Wrong Profile Books Ltd. London.
54. Stanley, M. (2021) – Speaking Truth to Power – Richborne Publishing, London.
55. Slater, D, et al, (2000) Policy, Risk and Science: securing and using scientific advice, Report and recommendations submitted by OXERA to the Health and Safety Executive; the Cabinet Office (Regulatory Impact Unit); the Department of the Environment, Transport and the Regions; the Department of Health; the Environment Agency; the Food Standards Agency; the Office of Science and Technology; and the Scottish Executive.
56. Slater, D. and Ale, B.J.M. (2022) The Scientific Advisor in a Politicized World January 2022 Medical Research Archives 10(5) DOI:10.18103/mra.v10i5.2799
57. Ackoff, R.L. (1971) Towards a system of systems concept, Management Science Vol 17, No. 11
58. Nomoto H, Slater D (2017) Decision Making Under Uncertainty –The Brain as a System Model, https://www.researchgate.net/profile/David-Slater/publication/324910984_An_Internet_of_Functions_The_Brain_as_a_System_Model/links/5aeafab70f7e9b837d3c4e0f/An-Internet-of-Functions-The-Brain-as-a-System-Model.pdf
59. Lord Reith - https://www.bbc.com/historyofthebbc/research/john-reith/
60. Gore, A"An Inconvenient Truth (U)". British Board of Film Classification. May 18, 2006. Retrieved December 9, 2016.
61. Rutherford Aris, Neal R. Amundson, An analysis of chemical reactor stability and control—I: The possibility of local control, with perfect or imperfect control mechanisms, Chemical Engineering Science, Volume 7, Issue 3, 1958, Pages 121-131, ISSN 0009-2509, https://doi.org/10.1016/0009-2509(58)80019-6.
62. Slater, D. Burnap (2010) Managing Risk in Complex, Interacting Systems. Final Report –Technology Strategy Board: Network Security: Information infrastructure Protection – Fast Track Project: BK106A August 2010
63. Ale, B.J.M. (1976) Analysis of the operating stability of a caprolactam reactor (Symp. Loss Prevention, Basel). Loss Prevention and Safety Promotion 3, vol. 4, p. 1541
64. Royal Academy of Engineering, (2022) Engineering X - Safer Complex Systems, https://engineeringx.raeng.org.uk/programmes/pandemic-preparedness
65. Ministry of Defence (2021) Red Teaming Handbook: 3rd Edition, Crown Copyright.
66. Rossine, F.W. et al (2020) Eco-evolutionary significance of “loners” https://doi.org/10.1371/journal.pbio.3000642
67. La Guerre Bent, Samuel Arthur (1887). Familiar Short Sayings of Great Men. bartleby.com. Boston: Ticknor and Co. Retrieved May 7, 2016.
68. Churchill, Sir W. (1948) In a Speech to UK Parliament, Hansard.
69. Lovelock, J. (227) – The Revenge of Gaia, Penguin Books.
70. Gutenschwager, G. (2021). Ambiguity, Misinformation and the Coronavirus. Academia Letters, Article 1395. https://doi.org/10.20935/AL1395. 4
71. Capra, F. (1982) The Turning Point: Science, Society, and the Rising Culture. Simon and Schuster, New York.
72. Lancet – (2023) Comment | volume 401, issue 10385, p1324 DOI: https://doi.org/10.1016/S0140-6736(23)00804-8