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Tuesday, Mar 09, 2021

We deserve to know what Sage is saying

We deserve to know what Sage is saying

At the beginning of the Covid-19 crisis it was easy to see why the Prime Minister was so keen to be seen to ‘follow the science’. He had a pandemic plan, designed by past governments, to be guided by the medical facts and expert judgment. There was to be no role for politics.
He held press briefings at which he was flanked by the chief medical officer and chief scientific officer, armed with charts and graphs, making it known that everything he did hinged on their advice.

At first, we were not even allowed to know the identity of the 50 men and women who sit on the Scientific Advisory Group for Emergencies (Sage). Now they have become the most influential group of people in the country, whose decisions shape the lives of millions.

Yet their deliberations are often a mystery even to cabinet members. In emergencies, this makes sense, but as a day-to-day model of government, it’s deeply problematic. We end up with London telling Manchester to enter the highest tier of restrictions for reasons no one is able to explain properly.

Millions of people are having their liberty curtailed and their human rights abridged on the strength of evidence that is not made public - and on data that may well be corrupt, as previous SAGE data has been shown to be.

The Tier-3 restrictions are being justified on the idea that hospitals in Manchester and Liverpool would otherwise be overrun. But on what evidence? No. 10 says cases may double in a week.

Why so? We’re not told. Sir Richard Vallance, the chief scientific officer, offered an insight into SAGE thinking when he outlined a scenario that Covid cases could rise to 50,000 by mid-October. In the event, they were barely at a third of this level.

So might northern cities be locked down on the basis of 'worse-case' assumptions like the above? And how sure are we about hospital capacity? The most important metric is NHS intensive care occupancy rates: the data is collected daily, but not made public. This creates space for panic and scare stories. Every day in France figures are published for the use of intensive care units in hospitals in each of its regions.

When The Spectator contacted the NHS to investigate reports that intensive care units were full, we were told to submit a Freedom of Information request which may or may not be answered in 28 days. The secrecy would be excusable if the information was not gathered. But there is an NHS Covid dashboard, with all kinds of relevant information, updated hourly and accessible to those who have the login. The government chooses not to share it, so the public are left in the dark.

The men and women of Sage cannot be blamed for this. They are asked for their advice and they give it. The original problem was that they disagreed among themselves, so it was hard to produce a consensus. In April, a political whispering campaign blamed Sage for the country going into lockdown too late, at the cost of tens of thousands of lives.

We then saw the advisers fight among themselves: Sir Patrick Vallance, the chief scientific officer, said he had wanted an early lockdown but was opposed by Professor Chris Whitty, the chief medical officer.

This time, Sage members are taking the politically safe route. As we now know, on 21 September, they advised the government to call an immediate two-week ‘circuit--breaker’, rather than pursuing the existing strategy of localised and targeted restrictions on civilian life. But a close reading of the Sage advice shows why the Prime Minister took the decision he did.

The minutes admit that a two-week lockdown would merely delay the progress of the epidemic by 28 days. Impose one now - as the Welsh government did this week - and by mid-November we would be back to where we are now, except with billions more added to borrowing and many more businesses driven to the wall.

Minutes from SAGE meetings are released - but belatedly and often devoid of context, or the data used to make the decisions. Britain has no equivalent of Germany's Robert Koch Institute or Spain's Carlos III Health Institute, no dependable independent organisation to ensure the most important facts are made public.

Public Health England is a quango so unfit for purpose that it being abolished. But for now, there is a vacuum. The result: confusion, rancour and division at a time when the government ought to be bringing people together. It's no way to handle a pandemic.

We’re now back to the slogan ‘Protect the NHS’ - which annoys doctors, who quite rightly argue that the NHS is there to protect the public and not vice versa. Worse, if No. 10 asks people to ‘protect’ the NHS by not using it, fewer people will come forward to receive the help they need. They are less likely to seek help for a suspicious lump or a chest pain if they hear politicians talking about the NHS being ‘overwhelmed’.

This is not a theoretical risk. A study this week concluded that we can expect an excess 1,500 deaths from colorectal cancer, 1,300 from lung cancer and 300 from oesophageal cancer. Other studies have estimated that, compared with the five-year average, there have been 2,000 excess deaths so far this year from heart disease and stroke.

It has been clear for months that the messaging during the spring lockdown of dissuading people from seeking medical help had a fatal side-effect, and yet the government this week has again been accused of exaggerating the pressure on intensive care units. This is certain to add to the problem.

As late as mid-March, Sage was still advocating a policy of shielding the elderly rather than placing restrictions on everyone. In recent weeks, Professor Graham Medley of the London School of Hygiene and Tropical Medicine has called for another lockdown, co-writing a paper claiming it could save 8,000 lives before Christmas.

Yet on 13 March, the day after the first of the Prime Minister’s daily press briefings, he said that, ‘We’re going to have to generate what we call herd immunity… the only way to generate that, in the absence of a vaccine, is for the majority of the population to become infected’.

Given how quickly expert opinion changes, it’s past time to open up the decision-making process. If Covid data is obscured, policies will never be properly scrutinised, leaving potential for big mistakes. No. 10 should order Sage to publish all of the studies that are behind UK government policy.

The NHS daily dashboard showing hospital capacity should be made public to stop the scare stories. We are told that these restrictions are necessary, but never really told why. About half the country is now living under Tier 2 or Tier 3 restrictions, with their liberty and in many cases their livelihoods curtailed. They deserve a much better explanation.

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