F&D: There Must be
a Proper Inquiry

Prof Bob Michell, BVetMed BSc PhD DSc MRCVS
Former President of the RCVS

Veterinary Times, 9th July 2001
Copyright 2001 The Veterinary Times (due acknowledgements made).

There has to be a powerful independent inquiry into all aspects of FMD 2001; there is no reasonable alternative.

Too many people, too many animals, have suffered both directly and in directly; and the lessons have to be drawn with total objectivity: faced with the same situation again, what would we repeat, and what would we do differently ?

The Council of the RCVS has supported, unanimously, the need for such an inquiry once the outbreak is over, based on the principle of the Northumberland Report on the 1967-68 outbreak. 
 
The profession should rally behind this lead and urge others to do the same. Some might feel it unnecessary, might take it for granted, but it is vital that we secure such an inquiry. 

There are already indications in the media that the Government, including the Prime Minister, are not enamoured of the prospect. This should arouse deep misgivings if it is true. Any attempt to evade such an inquiry - or to attenuate its powers - would arouse grave suspicions that there may be truths too unsavoury to be redeemed, even by the most beguiling exponents of spin.

Precedent Such pessimism ought to be misplaced. The precedent from 1967-68 is clear, indeed it seems that some of the lessons of the Northumberland Report may have been neglected or forgotten; though others may have been overtaken by progress. 
 
We ought to have every confidence that the Prime Minister could have no conceivable reason to avoid a similar inquiry. He came to power to eliminate sleaze and secrecy and it replace it with integrity and openness. But there is more to openness than a relaxed shirt and a choirboy smile, and while there has been no more consistent advocate of openness, transparency and accountability, the refusal of such an inquiry would be a dereliction of all three. Above all, since the Prime Minister took personal charge of the crisis, he would be using his powers to prevent scrutiny of his actions. That would to repeat the Nixon gambit, which became a prelude to ignominious checkmate. 
Indeed, in the improbable event that he were to block the calls for a powerful independent inquiry into all aspects of the current FMD outbreak, it would be so far out of proclaimed character that the assertion that two and two were four would be universally mistrusted, should it subsequently fall from his lips.

Responsibilities of the profession In times of national epizootics, the veterinary profession has four main responsibilities:
• to control the outbreak;

• in doing so, to cull the essential minimum number of animals;

• to minimise the impact on animal welfare, even and especially at slaughter - the farmer and his family, in their ultimate despair, rely on the veterinary surgeon to safeguard the welfare of their animals in their last moments, however difficult that maybe;

• to facilitate the recovery of farm animal agriculture, locally and nationally. 

These responsibilities include a duty to ensure that the lessons are learned to improve the management of any future outbreak.

Certainly the Northumberland Report swiftly, concisely and accurately identified important lessons from the 1967-6B outbreak. It took 12 months to report on the most pressing issues and a further six months to complete its analysis, Neither volume exceeded 100 pages. The precedent which it set was of a powerfully constituted inquiry, fully independent, free to follow wherever the evidence might lead. Nothing less, will suffice now.

It has been suggested, for example, that a purely scientific inquiry, led perhaps by the Royal Society, would be appropriate. Inevitably that would risk excessive preoccupation with the scientific aspects, important though they are. Certainly the Royal Society could contribute valuable evidence to a Northumberland-style inquiry, but the scope of the inquiry would need to include not only issues of science, but of implementation and of politics, both national and party political.

The impact of a particular disease control strategy on our international trade or on our non-agricultural industries is legitimate national politics. But securing the timing of an early general election is not, it is a matter of party politics, as was the attempt in 1972 to extract information from the Democratic Party headquarters in the Watergate Building, Washington DC. 

Early this year, before the foot-and-mouth look hold, political commentators had identified the likelihood of a deterioration of economic indices and industrial relations in the second half of the year and the consequent importance of a general election in the early summer. Just a few weeks after 7th June, those predictions are gathering authenticity. It looks as if control of the epidemic "entered the home straight" only just in. time. Not a re-run of 1967-68 
 
Some of the problems highlighted.in this outbreak have been:
· the extreme difficulty of diagnosing the disease by clinical examination;
· the rapidity of the early spread, as a result of patterns of animal movement unknown in the 1960s;
· conflict of interest between halting the spread of the epidemic and crippling other aspects of the rural economy.

Even if the outbreak had repeated precisely the events of 1967, it would have been perceived almost exactly as it has been recently. Longer TV news programmes rely on extended picture sequences to support their lead story; they dwell on disturbing images, in full colour, rather than arguments and issues; when issues are addressed it tends to be to generate an exciting adver-
sarial fracas, to get a good sound-byte, rather than to promote insight. To remember the grainy, black and white images of 1968, you probably need to be over 40.
Then the pictures were familiar and unsensational - because FMD epidemics (and those of swine fever and fowl pest) were fairly regular, and British people were still familiar with dangerous human epidemics, such as smallpox, polio and scarlet fever, which brought fear to parents and children alike.

In 2001 we have not sufficiently emphasised, because it is so obvious to us, that in most farm animal disease outbreaks, it is the group at identical risk, not simply the individual, which is "the patient". But we should beware of the argument that farm animals are mostly destined for slaughter anyway. The reasons matter and the circumstances are intensely important.

Remarkable
What seems remarkable in this outbreak is the number of animals that have been destroyed, even excluding the welfare cull. By the end of May there were 1,661 confirmed infection sites yet over three million animals had been culled.
Even that number - and it may well now be far greater - is over six times as many as in 1967-68 , when there were 2,364 outbreaks on 2,346 farms (i.e, 18 were infected twice). It might have been because FMD 2001 was a more dispersed epidemic when first detected; or because it spread among sheep, rather than cattle - both differences from 1967 - and because much larger herds are more usual. But it also appears to have resulted from the culling of animals in possible contact with possible-outbreaks, slaughtered ahead of confirmation.

In particular, contiguous culling appears to have been based on geographical proximity rather than informed, local assessment of probable risk. Substantial numbers of animals appear to have been killed which never were at risk. Each farm family so affected has suffered a blight on its future amid a horror in recollecting the days before the buildings and fields fell silent, which demands that their experiences are never repeated unless they are truly essential to disease control.

Questions needing answers:
One effect of overkill is to ensure that animals do not get the disease and add to the figures. That produces satisfying downturns in graphs, but in terms of economic loss and suffering of both farmers and animals, the impact is as great as if they had contracted the disease. If the screening test is clinical examination, it demands a high index of suspicion (sensitivity) to avoid false negatives: but that implies an obligation in all possible circumstances to await confirmatory tests with sufficient specificity to avoid false positives.

Which brings us to some of the most important questions for the inquiry:

· How much anticipatory culling, i.e. in the absence of confirmation, is inescapably necessary in controlling an outbreak and what, in terms of real risk, defines contiguous herds or flocks ?
Apart from the humanitarian and welfare problems, and the financial waste, "overcull" saturates vital resources - for example, for rapid disposal. The claim that the extended cull caused the downturn in the epidemic, rather than coincidentally preceding it, requires strong scrutiny, region-by-region, allowing for incubation periods. 
The decline of the epidemic in 2001, halving from peak in two weeks and halving again in another two looks very similar to the pattern established in 1967.

· Is the criterion of successful control {a) the fastest possible control, at all costs, with many animals culled because they might theoretically get the disease, or (b) control with least cost - to farmers, to the Exchequer and to animal welfare: that might imply greater willingness to await confirmatory tests - slower control but fewer animals killed?
And if, in 2001. we opted for maximum speed, why did it relate - like many of the official predictions - to 7th June, a date irrelevant to agriculture or disease control ?

· What is the potential for modern vaccines, combined with modem methods of antigen detection, either as an alternative to eradication or as an adjunct to control of an epidemic ?
This was examined in the Northumberland Report, and subsequently, but it is a question to be asked again in the light of new technologies. These are big strategic questions directly affecting how we would react in the future, facing a similar problem. There will also be questions of detail - errors made, gaps between intention and outcome; and these, need to be analysed as evidence of systems failure, not a hunt for culprits. 

One of the most important points in the Northumberland Report was this: 
granted that slaughter was the best method of eradicating the disease, reliance on a slaughter policy alone demanded a complete ban on imports, or at least the exclusion of dangerous components of meat from countries or areas where FMD is endemic.
Granted that such a policy worked for 34 years - i.e. FMD was controlled at almost zero cost - a key question is why it broke down.
The earlier swine fever outbreak highlighted the risks associated with ineffective regulation of illicit meat imports and the likelihood that this was not simply "family smuggling” but a thriving covert industry. 

Excuses and evasions are unacceptable. Some have said we cannot have an inquiry like the Phillips BSE Report, either in cost or duration. Fortunately that is not what we need. BSC/CJD involved a frightening potential zoonotic risk; unique diseases with much of basic biology awaiting discovery; and an extended and complicated history of events. 
But none of these apply to FMD, The Northumberland Report provides an excellent example of independence, thoroughness , swiftness and conciseness - fewer pages than the first James Herriot book. It provides both the precedent and the model.

The issues to be addressed in 2001 will fall under the headings of scientific knowledge, implementation and resource costs, animal and human welfare, politics.
That is why we must have a powerful independent inquiry, unfettered by a restrictive remit, free to follow wherever the evidence may lead. We need it in the interests of openness and accountability, in the interests of our rural communities and our taxpayers. We need it, above all, in the interests of animal welfare and of truth. 

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