The Welsh health system was “not adequately prepared” to deal with high consequence infectious diseases (HCIDs) prior to pandemic, the Covid inquiry heard today.

Frank Atherton, the chief medical officer (CMO) for Wales, admitted the country had no specialist units capable of treating patients with diseases such as Mpox, Ebola and Covid-19.

Atherton noted that arrangements were in place to transfer patients to Newcastle and London, where these units existed, but signalled his concern at this state of affairs.

“We were not geared up to provide all the facilities needed,” he said, “all the staffing, all the arrangements to provide treatment for a high-consequence infectious disease in Wales, and I felt that was a gap in our armour which we should improve.”

Hugo Keith KC, counsel to the inquiry, put to Atherton that this was a “yawning chasm in terms of preparedness” and noted that the Welsh NHS had lacked the facilities in 2019 to treat a patient who contracted Mpox and two individuals who had been in contact with them.

The inquiry also saw emails from an official within Public Health Wales the same year that said there was “urgent work to be done” to ensure NHS Wales could respond to “cases of high-consequence infectious disease anywhere in the country”.

And participants were shown the readout from a workshop with Welsh health trusts and boards in May 2019 – run by Atherton and Wales’s then chief nursing officer Jean White – that called the country’s diagnosis and testing services “fragile”. The report said participants felt health services were “struggling to deliver on a day-to-day basis the prevention, early diagnosis and frontline support that professionals and the public require”.

Atherton, who became the Welsh CMO in 2016, agreed that there was “fragility” with regards to diagnostic testing but said he had made moves to address the issue in 2019, prior to the onset of the pandemic.

He said “significant work was going on around preparedness” and that he, and other officials working in civil contingency, had identified the need for further resources to be devoted to pandemic planning.

The inquiry continues.