Health
The private notes and secret documents that tell the inside story of the UK’s Covid response
The Covid inquiry is poised to release its second batch of conclusions, which will delve into the significant political decisions made during 2020.
The COVID-19 pandemic marked a pivotal moment in UK history, rivaling the significance of World War Two. As the virus spread, the government instructed millions to stay at home, while investing billions of pounds to stabilize the economy.

The COVID-19 inquiry is set to release its second set of findings on Thursday, examining the major political decisions made during this period, including the implementation of lockdowns, business and school closures, and the introduction of unprecedented social restrictions.
The lead counsel for the inquiry posed a critical question in 2023: "Did the government effectively serve the people, or did it fail them?" Since then, over 7,000 documents from the time have been made public, including WhatsApp messages, emails, private diaries, and confidential files.
BBC News has identified key messages and notes that shed light on the decision-making process behind critical choices made in 2020.
On January 2, 2020, a health alert was issued on ProMed, a platform used by healthcare professionals to track emerging diseases.
The alert stated that the World Health Organization was in contact with Beijing regarding a mysterious outbreak of viral pneumonia.
At the time, 27 people, mostly vendors at the Huanan Seafood Wholesale Market, were being treated in hospital.
The following day, England's deputy chief medical officer, Jonathan Van Tam, forwarded the alert to Professor Peter Horby, chair of Nervtag, a group that advises the government on new viral threats.
By the end of January, it was clear that health authorities in Wuhan were facing a significant challenge.

The deputy ambassador to China, Christina Scott, sent a sensitive cable to London, drawing parallels between the situation and the 2003 SARS outbreak.
The cable noted that Hubei province was under lockdown, with multiple cities imposing transport restrictions, and that the memory of the SARS cover-up had created lingering distrust of the government's response.
The cable also stated that the authorities would take all necessary measures to control the outbreak, but acknowledged the substantial challenges involved.
The virus soon spread to Thailand, South Korea, Iran, and northern Italy.
On Saturday, March 7, the UK's then-prime minister, Boris Johnson, exchanged WhatsApp messages with his health secretary, Matt Hancock, ahead of the England vs Wales game at Twickenham.
In the days that followed, the Cheltenham horse racing festival took place, and Atletico Madrid fans were allowed to travel from Spain to Liverpool for a Champions League match.

The government's strategy, supported by its scientific advisers, was to contain early outbreaks through isolation and contact tracing.
The plan was to transition to a "delay phase" as community transmission increased, using measures such as home isolation advice to slow the spread of the virus and prevent hospitals from becoming overwhelmed.
However, the virus was spreading faster than expected, and some scientists began to realize that more drastic action was necessary.

On Friday, March 13, two senior No 10 officials attended a key meeting of scientific advisers in Whitehall.
One of the officials wrote "WE ARE NOT READY" in capital letters in their notepad, before another official crossed out "NOT READY" and replaced it with an expletive.
That weekend, the prime minister's chief adviser, Dominic Cummings, held a series of meetings with Johnson and a small group of staff to develop a new strategy.
Smartphone images show whiteboards in No 10 filled with hand-drawn charts and scribbled notes.

One graph suggested that, without restrictions, over 100,000 people could die in hospital corridors during the impending wave.
On Sunday, March 15, Cummings sent a WhatsApp message to Johnson.

The message stated that Chief Scientific Adviser Patrick Vallance supported a plan that would not be publicly discussed.
The plan involved escalating measures to prevent NHS collapse and buy time to increase capacity.
Over the next week, COVID-19 rules across the UK were tightened.
People were advised to avoid non-essential contact and work from home, and schools, pubs, restaurants, gyms, and cinemas were subsequently closed.
However, concerns persisted that these measures were insufficient. On Sunday, March 22, London's mayor, Sadiq Khan, wrote a private letter to Johnson.
The following evening, in a televised address watched by 27 million people, Johnson announced the first national lockdown, instructing the public to stay at home.

The inquiry will now assess whether implementing the lockdown earlier could have saved lives and reduced the duration of the lockdown.
Over the next month, some hospitals faced significant pressure, with intensive care units overflowing into corridors and side rooms, but the NHS did not turn away emergency patients.
COVID-19 infections, hospitalizations, and deaths began to decline.
However, the lockdown had significant costs, including disrupted education, increased loneliness and mental health issues, and economic impacts on jobs and businesses.
On May 22, Johnson wrote a handwritten note to his officials, requesting a plan to "start operation BOUNCEBACK".
That month, some restrictions were lifted, allowing groups of six to meet outdoors and schools to begin phased reopenings.

In the summer, then-chancellor Rishi Sunak introduced the Eat Out to Help Out scheme, offering 50% off food and drinks for three days a week in August.
While the scheme was well-received by the hospitality industry, concerns were raised about its potential health impact.
In a WhatsApp message, Hancock warned Simon Case, the most senior civil servant in Downing Street, that the scheme was causing problems in areas with high infection rates.
In his evidence to the inquiry, Sunak downplayed the link between the scheme and the spread of the virus, noting that a second wave occurred in every other European country.

As autumn progresses, the challenge of balancing Covid-19 control measures with economic protection becomes increasingly daunting.
Scientists advising the government are advocating for stricter regulations, including a brief "circuit breaker" lockdown aimed at reducing infection rates.
The prime minister's stance on restrictions appears to shift, with some documents suggesting support for tougher measures, while others indicate a strong reluctance to impose another nationwide lockdown.
On WhatsApp, the prime minister's closest aides express frustration with his decision-making, using an emoji of a broken trolley to describe his seeming inconsistency in policy positions.

In a message dated 14 October, Case, the newly appointed cabinet secretary, writes to Cummings and Lee Cain, expressing concerns that the government lacks credibility to impose new restrictions just days after deciding against them.
Case's message continues, stating that the situation has become a "terrible, tragic joke" and that a decision to take harsher action should have been made weeks earlier, as the current approach is unbearable.
During his testimony to the inquiry, Case later expresses regret over his initial frustration with the prime minister, acknowledging that he barely knew Johnson at the time and was simply expressing his immediate concerns.
In his evidence, Johnson explains that his leadership style involves adapting to new scientific evidence and often adopting certain positions to hear counterarguments.
As autumn advances, it becomes clear that existing measures in England, including the 10pm curfew and tiered system of local controls, are insufficient to control the spread of the virus.
By the end of October, the prime minister's frustration is evident in a lengthy note appended to a Covid briefing document marked OFFICIAL/SENSITIVE.
The note, spanning two A4 pages, contains 22 detailed points written in tightly spaced handwriting.

Johnson expresses support for strengthening local restrictions but laments the significant cost and questions the duration of such measures.
He also inquires about the effectiveness of the NHS test and trace system, asking if it is "actually achieving ANYTHING."
On 5 November 2020, England enters its second national lockdown, lasting four weeks, with most schools remaining open.

By this point, the four nations of the UK are making decisions independently, with Wales and Northern Ireland implementing circuit breaker lockdowns, and Scotland imposing stricter rules in the central belt.
The plan remains to allow families and friends to gather during Christmas.
However, by mid-December, a new, more infectious variant of the virus is spreading, and millions in the south-east of England are informed at short notice that Christmas gatherings will be cancelled.
In January 2021, a third and final full national lockdown is implemented across the UK, coinciding with the peak of the winter wave and the rollout of millions of doses of the first Covid vaccines.
Five years after the pandemic, the inquiry's findings are highly anticipated, particularly by the 235,000 families who lost loved ones during that time.
The messages and documents presented here provide a glimpse into the events of that period, with the full report expected to span around 800 pages.
The report will delve deeper into key questions, including the timing of lockdowns, the impact of restrictions on vulnerable populations, and public confidence in the rules amid reports of rule-breaking in Downing Street.
Groups representing thousands of bereaved families are seeking accountability from individuals in government at the time for any pandemic-related failings.
Above all, these groups want the government to learn from past mistakes and be better prepared to respond to future unknown viruses.
Some documents referenced in this article have been recreated, with all containing the original texts, including spelling mistakes and typographical errors.
Additional reporting for this article was provided by Pilar Tomas and Ely Justiniani of the BBC Visual Journalism Unit.
The top image is credited to Getty/BBC.
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Health
Study Explores if Brain Stimulation Can Reduce Selfish Behavior
Researchers have found a way to temporarily and marginally decrease self-centered behavior in individuals by activating two specific regions of the brain.
Researchers have made a groundbreaking discovery, finding that temporary reductions in selfish behavior can be achieved by stimulating specific areas of the brain.

A recent study conducted at the University of Zurich involved 44 participants who were tasked with dividing a sum of money between themselves and an anonymous partner, allowing scientists to observe their decision-making processes.
The experiment utilized electrical current to stimulate the frontal and parietal regions of the brain, located at the front and rear of the skull, respectively. When these areas were stimulated simultaneously, participants exhibited a greater willingness to share their funds.
According to Prof Christian Ruff, a lead author of the study, the observed effects were consistent, albeit modest in scale.
Statistical analysis revealed a notable increase in participants' willingness to allocate funds to others, indicating a shift in their behavior.
The findings not only provide insight into the neural mechanisms underlying fundamental human behavior but may also have implications for the treatment of certain brain disorders characterized by impaired social behavior.
Prof Ruff noted that some individuals struggle with profound social difficulties due to an inability to consider others' perspectives, leading to consistently selfish behavior, and suggested that this discovery could potentially be used to address such issues.
However, the effects of the brain stimulation were found to be short-lived, suggesting that repeated application may be necessary to achieve lasting changes.
Prof Ruff likened the potential effects of repeated stimulation to the benefits of regular exercise, stating that consistent application over a prolonged period could lead to significant changes in behavior, much like the physical adaptations that occur with regular gym attendance.
This latest discovery builds upon a previous study in which researchers monitored brain activity while participants engaged in a similar money-sharing game, providing a foundation for the current findings.

The earlier study identified two brain regions that appeared to be synchronized, with neural activity occurring at the same frequency, when participants made more generous decisions.
These brain areas are known to play a crucial role in decision-making and empathy, enabling individuals to distinguish between their own feelings and those of others.
When participants made selfless decisions, the regions responsible for empathy and decision-making were found to be communicating with each other.
The researchers sought to investigate whether electrical stimulation could be used to influence this communication and promote more selfless decision-making.
One participant who underwent the brain stimulation test described the experience as a gentle, soothing sensation, comparable to a warm shower or light rain on the scalp.
The participant reported making decisions while receiving the stimulation without feeling any external influence on their choices.
The discovery of a consistent neural pattern associated with selfless decision-making across multiple individuals suggests that altruism may be an innate, evolutionarily conserved trait that enables humans to care for one another.
Prof Ruff emphasized the clinical significance of this finding, highlighting the potential to modify and influence this neural mechanism.
Dr Jie Hu, a co-author of the study, noted that the research provides evidence of a causal relationship between brain activity and decision-making, demonstrating that targeted stimulation can alter an individual's sharing behavior.
By manipulating communication within a specific brain network using non-invasive stimulation, the researchers observed a shift in participants' decisions, influencing the balance between self-interest and altruism.
Addressing concerns about the potential implications of this research, Prof Ruff assured that the experiment was conducted with strict adherence to medical regulations and ethical guidelines, ensuring the well-being and informed consent of all participants.
The neuroscientist drew a distinction between the controlled, medically regulated nature of the experiment and the often-subliminal influences of social media and advertising, which can affect behavior without explicit consent.
Prof Ruff suggested that, in contrast to the experiment, the impacts of social media and advertising on brain function and behavior are often unforeseen and uncontrolled, highlighting the importance of careful consideration and regulation in such contexts.
Health
NHS Workers to Receive 3.3% Pay Increase
Labor unions have expressed displeasure, yet the government maintains that its actions showcase a dedication to its workforce.
The government has confirmed that NHS staff in England will receive a 3.3% pay increase in the upcoming financial year.

This pay award applies to approximately 1.4 million health workers, including nurses, midwives, physiotherapists, and porters, but excludes doctors, dentists, and senior management.
Although the Department of Health and Social Care initially proposed a lower figure, it has accepted the recommendation of the independent pay review body to demonstrate its commitment to NHS staff, resulting in a higher pay rise than initially suggested.
However, several health unions have expressed disappointment with the announced pay award.
Prof Nicola Ranger, general secretary of the Royal College of Nursing (RCN), noted that the 3.3% increase falls short of the current consumer price index (CPI) inflation rate of 3.4%, which measures the rise in prices over the past year.
Prof Ranger stated, "A pay award that is lower than the current inflation rate is unacceptable, and unless inflation decreases, the government will be imposing a real pay cut on NHS workers."
She criticized the government's approach, saying, "This strategy of making last-minute decisions is not an appropriate way to treat individuals who are essential to a system in crisis."
Prof Ranger indicated that she would wait to see the pay awards for the rest of the public sector and doctors before deciding on a course of action.
The RCN had previously reacted strongly to the 5.4% pay increase received by resident doctors last year, compared to the 3.6% increase received by nurses, which they described as "grotesque".
Prof Ranger emphasized, "Nursing staff will not accept being treated with disrespect, as has happened in the past when they were given lower pay awards than other groups."
Helga Pile, head of health at Unison, the largest health union, commented, "NHS staff who are already under financial pressure will be outraged by another pay award that fails to keep up with inflation."
"Once again, they are expected to deliver more while their pay effectively decreases, as it falls behind the rising cost of living," she added.
In response, the government argued that the pay award is actually above the forecasted inflation rate for the coming year, which is around 2%.
A spokesperson for the Department of Health and Social Care stated, "This government greatly values the outstanding work of NHS staff and is committed to supporting them."
The pay increase is expected to be implemented by the start of April.
However, the government did not provide a timeline for the announcement on doctors' pay, as the pay review body responsible for making recommendations on their pay has yet to submit its report to ministers.
The government is currently engaged in negotiations with the British Medical Association regarding the pay of resident doctors, previously known as junior doctors.
Members of the BMA recently voted in favor of strike action, granting them a six-month mandate for walkouts, and there have been 14 strikes so far in the ongoing dispute.
Health
NHS Waiting List Hits Three-Year Low
In England, the backlog has fallen below 7.3 million for the first time since 2023, yet worries persist regarding prolonged waiting times in accident and emergency departments.
England's hospital waiting list has reached its lowest point in almost three years, marking a significant milestone in the country's healthcare system.

As of December 2025, the number of patients awaiting treatment, including knee and hip operations, stood at 7.29 million, the lowest figure recorded since February 2023.
However, the latest monthly update from NHS England reveals that long wait times persist in Accident and Emergency departments, with a record number of patients experiencing 12-hour trolley waits.
In January 2026, over 71,500 patients spent more than 12 hours waiting for a hospital bed after being assessed by A&E staff, the highest number tracked since 2010.
This translates to nearly one in five patients admitted after visiting A&E waiting for an extended period.
According to Health Secretary Wes Streeting, while progress has been made, significant challenges still need to be addressed.
Streeting acknowledged that "there is much more to do" and emphasized the need to accelerate progress, but expressed optimism that the NHS is on the path to recovery.
Dr. Vicky Price, representing the Society for Acute Medicine, noted that hospitals are operating beyond safe capacity in terms of emergency care.
Dr. Price highlighted the vulnerability of patients who require admission, often elderly and frail individuals with complex needs, who are at greater risk of harm when care is delivered in corridors and hospitals exceed safe limits.
Duncan Burton, Chief Nursing Officer for England, commended the progress made in reducing wait times, achieved despite the challenges posed by strikes by resident doctors.
Burton attributed this progress to the hard work and dedication of NHS staff, describing it as a "triumph".
Although the waiting list decreased, performance against the 18-week target slightly declined, with 61.5% of patients waiting less than 18 weeks, compared to 61.8% in November, and still short of the 92% target set to be met by 2029.
Rory Deighton of the NHS Confederation, which represents hospitals, welcomed the progress but cautioned that it obscures significant regional variations.
A recent BBC report revealed that nearly a quarter of hospital trusts experienced worsening wait times over the past year.
Deighton emphasized that the NHS is composed of numerous separate organizations, each with unique financial and operational challenges, making it more difficult to address care backlogs in some areas.
According to Deighton, this means that tackling care backlogs will be more challenging in certain parts of the country due to these distinct regional challenges.
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