By July of 2020, the U.K. had recorded 654 COVID-deaths per million inhabitants. This is more than ten times the number of Norway, which recorded 46 deaths per million.
What accounts for this enormous difference? In a paper published in December last year, I and Kevin Pollock from the UK Emergency Planning College compare how Norwegian and British authorities handled the initial outbreak.
Both countries have adopted a so-called Total Defence approach. The purpose is to ensure all government organizations from health services to the military work together seamlessly to achieve the best possible outcome.
Our investigation shows both countries were inadequately prepared for the pandemic, despite warnings from simulation exercises and risk assessments.
In the U.K. a 2016 pandemic influenza exercise identified serious shortcomings in response capacity. Despite several media requests, the full report from this exercise went unpublished until it was leaked to the Guardian in 2020. This undermined trust in the Government’s ability to deal effectively with a pandemic.
In Norway, the Directorate for Public Safety and Emergency Planning (DSB) repeatedly identified a global pandemic as a probable and serious risk. Most recently in a 2019 report. The warnings went unheeded.
Once the pandemic situation became clear, Norway not only responded quicker than the U.K., but adopted a more effective monitoring and leadership approach.
Norwegian Prime Minister Erna Solberg acted decisively and imposed a strict lockdown on 12 March, the day the global pandemic was declared. The Government instituted an effective and centralized approach, with a single lead ministry and coordinating agency (DSB). Solberg advocated collaboration, stating:
“when you are in a crisis, you manage it and you do it jointly with others”.
British Prime Minister Boris Johnson continued downplaying the situation and did not impose a lockdown until 23 March. On 6 April he contracted the disease himself and had to be admitted to hospital because he became seriously ill.
On the UK PMs return, instead of bringing people together and organizing resources, most decisions were taken by himself and a small trusted group. Excluding most of the U.K. Government. The devolved nations of Scotland, Wales and Northern Ireland were also excluded from policy decisions.
Consequently, a YouGov poll found that most Britons thought the Government were doing a ‘bad job’ in handling the crisis. In Norway the PM and ruling party received public support and increased in the polls for their effective crisis management.
In both countries the Armed Forces are obliged to collaborate with civil authorities. In the U.K. 4 000 military personnel were deployed daily to help build temporary hospitals, deliver personal protective equipment (PPE) to hospitals and Local Resilience Forums, evacuate patients from across the country and set up Mobile Testing Units. The coordination of military resources was vital to the British response.
In Norway, the military supported hospital construction, provided medical facilities and assisted in ensuring airport operations. The Home Guard aided the police with enhanced border patrols. The Norwegian Defence Research Establishment (FFI) supported the development a new emergency ventilator which increased the ventilator capacity of Norwegian hospitals.
While the Armed Forces in both countries have clear command and control structures, the national health services are delivered at a more local level. Both Norway and the U.K. have similar coordination structures, and both struggled with problems related to demarcation between different levels of government. In Norway, between national, municipal and county levels, and in the U.K. between the national Government and the devolved nations.
Despite similarities in structure, Norway achieved markedly better health outcomes in terms of both number of infections and fatalities. One possible explanation is the effectiveness of the coordination structure in practice.
In Norway, DSB functioned as the single coordinating agency for COVID response. In the U.K. response was based on ministerial responsibility. This requires coordination of resources across sectors with potential uncertainty about the responsibility and authorities. Such uncertainty hampers cooperation.
To alleviate these uncertainties, roles and responsibilities are clearly detailed in guiding principles and protocols. However, it was reported that fatigue and strain were affecting the response and that those at the top of the U.K. civil service were exhausted and lacking in appropriate capacity.
One government minister described the situation as “a mess”, and a senior official stated “the system simply wasn’t ready to deal with what we have got.”
Finally, there were significant differences between Norway and the U.K. on crisis communication. Communication is an essential part of crisis management and has a direct effect on public support for how the crisis is managed and trust of public authorities.
In the U.K. there were very public disputes between groups of scientists concerning the efficacy of the advice provided. Moreover, one of the Government’s scientific advisors criticized the PM publicly for not taking COVID-19 seriously and causing a delay which cost thousands of lives.
The breakdown in trust became apparent when politicians and scientists began blaming and scapegoating each other. Public trust was further eroded when the media reported on several lockdown breaches. Seeing figures of authority not following their own rules and advice, the public began flouting lockdowns and social distancing.
In contrast, Norway’s crisis communicators demonstrated consistent respect for scientific advice. For example, the Norwegian PM made a clear point in a CNN interview of letting scientists, not politicians, make critical decisions regarding medication against COVID-19.
Norwegian leaders were also more open and transparent in their communication with the public. This type of behavior led to more supportive and trusting feedback from the media about political leaders.
Published 29. January 2021