In May 2009, Alan Johnson, the then Labour health secretary, was questioned by the House of Lords science and technology committee. The committee was, in the midst of the 2009 swine flu outbreak, investigating the threat of pandemic influenza. Swine flu would infect 780,000 people in the UK in 2009, but only 203 died. The Lords committee was concerned about a far more lethal hypothetical threat – one such as Covid-19, which researchers from Imperial College London have estimated to be about 50 times deadlier than swine flu.
Four weeks before Alan Johnson responded to the committee, the health department had issued a 127-page document suggesting that the NHS could double critical care capacity during a lethal pandemic. Nevertheless, the document went on, at the peak of the outbreak, “there may be ten times as many patients requiring mechanical ventilatory support as the number of beds available”. Under a worst-case scenario, Johnson conceded in a letter to the committee that “intensive care capacity may well be inadequate”.
Johnson was not describing a black swan event. He was describing a threat that had, two years earlier, been classified as the number one national security risk to the United Kingdom. A pandemic as lethal as coronavirus has, for the past 13 years, been deemed a “level 5” threat. The only other level 5 threat has been large-scale biological or nuclear attack, but this was deemed to have a less than one-in-200 chance of happening in the next five years. The risk of a pandemic in that time was deemed to be between one-in-20 and one-in-two.