There is a lot in Vivienne Allan's long and thoughtful letter that every reasonable person will agree with.

She does, however, make one big error when she asks rhetorically "How can one prepare for the unknown?" This is an idea that is creeping insidiously into the current debate.

In essence, the current pandemic was NOT "unknown". We have known for a long time that something like this was almost certain. The World Health Organisation lists in its advice to member states on how to maintain a state of readiness a number of possible sources of an epidemic or pandemic, including : "disease X...a serious international epidemic caused by a pathogen currently unknown".

As reminders, we have had five near-misses in this century alone: SARS-1 (2002/3); flu H5N1 (2005); flu H1N1 (2009); MERS (2012), and Ebola (2018-20). Any of these pathogens, with a minor genetic tweak, could have produced a major global disaster. After the SARS-1 scare, the Government reviewed preparations and embarked on a major programme of building up strategic reserves, a project that was accorded such importance that it continued up to 2010 in the aftermath of the international financial crash.

One problem was that some materials have a shelf-life, and there is a need for a continuous programme of replacement. DHSS accounts show that between 2013 and 2019 the value of the strategic reserve fell by 40%, representing withdrawal without full replacement.

"Exercise Cygnus" in 2016 played out a response to a hypothetical "swan fever". The report from that has never been published, but many who took part, such as Dr Philip Lee, have publicly revealed that the exercise showed a significant lack of suitable material for dealing with a pandemic which resulted in pneumonia-type symptoms. Even so, the value of the reserve continued to fall, and recent ministerial assurances have been couched in such vague terms as to be deliberately obfuscating.

The exercise also revealed that ministers were reluctant to act decisively, much the same as this time round in the early stages when the severity of what was coming was evidenced by the experience of other countries.

Vivienne Allan is absolutely right that we need to be caring and watchful for each other. We are where we are. But there must at some stage be a review of what went wrong, and for some things there will not be easy excuses.

Barry Tempest