Scientists proposed ‘cocooning’ carers to protect elderly from Covid, inquiry hears

Top UK government scientists overlooked a proposal to ‘cocoon’ vulnerable elderly people and their carers during the first year of the pandemic, the Covid-19 inquiry has heard.

Epidemiologist Mark Woolhouse said cocooning, in which you “protect the people around the people you’re trying to protect”, was suggested by the Scientific Advisory Group for Emergencies’ pandemic-modelling sub-group (SPI-M-O) in the early months of the pandemic.

By then, Woolhouse said, the government’s initial plan to ‘shield’ elderly people had already proved unsuccessful, with over-75s accounting for the majority of Covid-19-related deaths.

He believes that, despite this, SAGE did not properly consider cocooning, which would have involved taking further steps to protect the vulnerable and their families and carers while avoiding lockdowns for others.

Giving evidence, Woolhouse, a professor of infectious disease epidemiology at the University of Edinburgh, said: “[Shielding] came to be seen as enforced self-isolation by the elderly. [It was] very unpopular and very, very difficult to manage. That turned out not to be a very successful policy.

“We [SPI-M-O] decided that we needed to go further and identified that many of these people cannot reduce their contacts to zero because they need care [...] how do we protect them best? By protecting their carers. This idea is known as ‘cocooning’.”

Woolhouse believes SAGE was “caught up in their eagerness to disprove the Great Barrington Declaration – an open letter from an international team of scientists that suggested governments should end lockdowns to pursue herd immunity.

“[SAGE] looked at [the Great Barrington Declaration’s] caricature version of [our proposal], which I already knew wouldn’t work, and they confirmed it wouldn’t work, but our baby got thrown out with that bathwater,” said Woolhouse. “Something I believe would have worked was never considered.”

Woolhouse said it was necessary to propose more tailored protective measures for elderly populations because over-75s were 10,000 times wmore likely to die of a Covid-19 infection than 15-year-olds.

He said: “We knew from very early on in the pandemic that there was a relatively small subset of the population that were at tremendously enhanced risk: the elderly, the infirm and the frail.”

Modelling didn’t take care homes into consideration

Woolhouse confirmed when questioned by a lawyer for Covid Bereaved Families for Justice UK that care homes and hospitals were not explicitly represented in SPI-M-O’s models for how the virus would spread.

Hospitals and care homes have “their own dynamics” that general health modelling might not take into account, he said. Lockdowns, for example, weren’t effective at reducing cases in care homes and hospitals because they had to “carry on” at odds with the wider community.

I wanted to see mass testing on the scale of millions a day. I was told that this was not a realistic option

The models being used may not have included care homes and hospitals explicitly because they were adapted from existing influenza models, which place emphasis on locations such as schools, said Woolhouse.

It is possible to model for those settings but would have been challenging at the beginning of the pandemic as the necessary data wasn’t available, such as transmission rates for Covid-19 in care homes. “But my understanding is the structures weren’t even there to attempt it,” he added.

‘100,000 tests per day’

In his evidence, Woolhouse said he told the Scottish government’s Covid-19 advisory group that testing would prove vital to controlling the spread of infection in early 2020.

He said he was disappointed by an announcement in April 2020 from the UK government that it would carry out 100,000 Covid-19 tests a day, which he described as “so inadequate”.

“A hundred thousand wasn’t even close,” said Woolhouse. “I wanted to see mass testing on the scale of millions a day. I was told when I first proposed it that my advice was not serious, that this was not a realistic option.”

By December 2021, tens of millions of people were self-testing every day – but this was far too slow, he said. “There was absolutely no realisation of what needed to be done in that first year and even then we were so slow to roll out the self-testing. That was a tremendously effective intervention but we didn’t get it until [the Omicron variant].”

The inquiry continues.