Initial messaging around shielding at the height of the Covid-19 pandemic could have been more nuanced, Northern Ireland’s chief medical officer has said.

Close to the start of the outbreak of the pandemic in the UK in March 2020, scores of people who were considered to be clinically extremely vulnerable were advised to remain at home to protect themselves from the virus.

Sir Michael McBride, who still serves as Northern Ireland’s chief medical officer (CMO), was speaking as he gave evidence to the UK Covid-19 Inquiry.

Northern Ireland chief medical officer Sir Michael McBride gives evidence to the UK Covid-19 Inquiry. (Covid-19Inquiry/PA)

During a full-day appearance, Sir Michael was asked with the benefit of hindsight whether he felt he had got all the decisions right.

He responded saying ultimately that would be for the inquiry to determine.

“I think there were some issues because of the pace of events, I think there were certainly some issues in relation to communications, for instance to those shielding in terms of how we conveyed information, how we conveyed information in a balanced way which allowed people to make choices about what was important to them, to empower them,” he said.

“It became very difficult later on when the harm-and-benefit analysis changed to provide them with assurance, to the population of people who had been shielding who were clinically extremely vulnerable and looking back, I think some of the initial messaging around that could have been more nuanced.

“That was something which I was concerned about and was concerned really from May 2020 when I had commissioned some research to seek the views of people who had been shielding in terms of the impact it was having on them.”

Sir Michael said in the early stages of the pandemic with a new pathogen, no existing immunity, no treatment and no vaccines with uncertain timelines, it was felt it was the only course of action.

“I think we were all aware of the significant negative impacts of it (shielding) … I recall saying during some of the media briefing at the time, this was about protecting the vulnerable from the virus but it was not about removing the vulnerable from society,” he said.

“It was a very very difficult judgment in terms of trying to strike that right balance but the consequences with no immunity and a new virus that was clearly causing very severe disease in some people, it was the only course of action that was available to us at that time.

“But clearly the best approach to protecting those who are clinically extremely vulnerable is to suppress the transmission of the virus in the community, and we had that two-headed approach.”

Asked in terms of lessons learned, Sir Michael said: “While we endeavoured to ensure that we communicated the advice clearly, as honestly as we could based on the information that we had, and tried to keep that updated in a variety of ways, I think the net result of the advice on shielding was we engendered a significant degree of fear in those who were shielding, fear and anxiety.

“I think the population also communicated in that survey that at times they felt ignored and they asked for clearer guidance on a more regular basis and a clear rationale for why the guidance was being provided.

“I think that given the profound consequences that shielding had, I think the primary approach to future pandemics should be … suppressing the transmission of the virus and only keeping shielding in reserve if indeed it is necessary and, if it is necessary, then, for as short a time as is possible.

“I think the approach that was taken in good faith, initially, did not fully think through the loss of agency and loss of control that people would experience, and the real fear that people had about re-entering society.”

Sir Michael also said the health service “must do better” in terms of bereavement care and support.

He said they went on to establish a bereavement network and, later, the Northern Ireland Bereavement Network.

“I think that was a direct consequence of some of the experiences in the pandemic and the fact that we need to enhance arrangements in that area,” he said.

Sir Michael, along with some of Northern Ireland’s past and present leaders and ministers, previously gave evidence to the last module of the inquiry looking at governance.

The inquiry is currently examining the impact of the pandemic on the health and social care system in Northern Ireland as well as the NHS in Great Britain.