I know a little bit about football. I’m by no means an expert, and would certainly perform worse than any of the 92 managers of Football League teams were I to take their jobs. But I know a little bit. For instance, if a football manager announced his intention to play without a goalkeeper, then that would strike me as being a terrible idea on a very basic level.
On 11th March Downing Street published an interview between Boris Johnson and Deputy Chief Medical Officer Dr Jenny Harries, in which they discussed the Cheltenham Festival, scheduled to take place between 16th and 19th March. Harries’ advice was that “in general, those sorts of events and big gatherings are not seen to be something which is going to have a big effect.” Two days later Sir Patrick Vallance played down the significance of canceling large gatherings, describing them as “a small way to stop it”.
Again, I’m no expert on medicine, immunology or public health, but this seems to me to be wrong on a basic level. I can picture in my mind a scene from an epidemic movie in which a hand touches on a shoulder leaving behind a CGI stain to represent the spread of germs; germs being left on a plastic cup by a customer, picked up by bar staff, and then passed on to the next customer; and of course the slow-motion flying projectiles accompanying a loud cough.
My gut feeling is backed by World Health Organisation advice – on 14th February the WHO published guidance that “there is ample evidence that mass gatherings can amplify the spread of infectious diseases. The transmission of respiratory infections, including influenza, has been frequently associated with mass gatherings.” This week it’s emerged that the areas around the Cheltenham racecourse had a spike in covid-19 cases.
On a similar theme, the announcement of a policy of ‘herd immunity’ immediately struck me as dangerous. It’s a term I’m familiar with because of the anti-vaccination movement – some people have immune systems that are too weak to fight and learn from even a weakened form of the relevant disease being injected into their bodies, and as a result can’t safely receive vaccinations. However, if a large amount of the population have received the relevant vaccination, the disease will die off before it reaches them. The big difference between a typical disease and Covid-19 is that there isn’t a vaccine available for the latter – a pretty huge part of the process.
Even relying on the assumption that those who are infected will develop immunity – which evidence from China suggest might not be the case – UK government estimates suggested that 60% of the population would need to become infected with a disease that has a 1% mortality rate for the herd immunity plan to work. That would result in the deaths of 0.6% of the population of the UK – around 400,000 people. Dr William Hanage, a professor of infectious disease at Harvard, has said that his colleagues assumed the policy was satire when they first heard about it.
In addition to her comments on Cheltenham, Dr Harries has also said “there comes a point in a pandemic where that [testing] is not an appropriate intervention”, and that “I think the actual mechanism between the two [Germany’s high test rate and low death rate] is still not clear.” This goes against basic common sense. On an individual level it’d be helpful to know if I have a mild case of covid-19 and should isolate, or just a bad cold. On a national level it’d be helpful to be able to organise regional lockdowns and reallocate resources before people start dying in large numbers.
Now of course I’m not claiming that I understand the science better than Harries and Vallance. But in a representative democracy the people’s role is to inform ourselves, ask tough questions, and use our voices in a way that pressurises for the best possible outcomes. What appears to be happening is that the government have either made decisions that are different to other countries, or have had difficulties with the logistics (tests and PPE). Either way it appears that our government is putting the scientists up-front to disguise the political nature of these choices or failings.
While I’ve been writing this blogpost news has emerged that Johnson’s chief advisor Dominic Cummings and a data analyst from the Vote Leave campaign have been taking part in meetings of the Scientific Advisory Group for Emergencies, helping shape the scientific advice to government. This story is hugely scandalous, but not remotely surprising – it explains why the ‘advice’ has contradicted most outside experts but aligned with what the government wanted to hear.
Anthony Costello, a former director of the WHO, has said “SAGE: 13 out of 23 are paid government advisors so not independent when in a room with D Cummings”. Sir David King, the Chief Scientific Advisor to the government between 2000 and 2008, has said that the presence of political ‘Special Advisors’ at SAGE meetings is “simply inappropriate and wrong”. Richard Horton, editor-in-chief of The Lancet, has said that “If it is true that Dominic Cummings attended meetings of SAGE, then every scientist of integrity on SAGE should resign immediately”.
Politics is always about choices. Devi Sridhar of Edinburgh University has said that there needs to be more people explaining that “These are possible routes & these are the trade-offs with each.” This is what I had assumed that SAGE had been doing in private – explaining the options available to the government, and the potential benefits and risks of each. Should the UK try and emulate Germany’s strategy of large-scale testing, though we might not have the scientific infrastructure to make such a policy work? Should we follow South Korea’s policy of using tests and software to keep track of everyone who might be infected, and can the relevant systems be put together in time? I’m not saying that the choices are easy, and I’m glad that I’m not the person making life and death choices that will result in or prevent thousands of deaths. But governments make choices. Pretending otherwise is scientism – appealing to the idea of science as an all-knowing deity offering objective truths that are clear and indisputable. Real life is messier than that.
On 3rd February Boris Johnson gave a speech in which, speaking about Covid-19 he pitched the UK as “the super-charged champion of the rights of populations of the Earth to buy and sell freely among each other”. It’s very convenient for him that the ‘scientific’ advice he’s received has been exactly what he wanted to hear. But the nature of that advice – both the contradictions to WHO advice and the reported presence of political non-scientists in the scientific advisory group – raises serious questions about whether our government has been following the science, or just putting scientific window dressing on the decisions they always would have made.
The Financial Times puts the UK death toll at the second worst behind USA, while Sky News puts the deaths per capita at third worst behind Spain and Italy – only slightly behind Italy despite having an extra two weeks to prepare and learn from their mistakes. Political decisions led us to this point, and it’s misleading to pretend otherwise.
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Was Dr Harries correct in saying that “those sorts of events and big gatherings [Cheltenham Festival] are not seen to be something which is going to have a big effect”?
Was the WHO wrong to say that “The transmission of respiratory infections, including influenza, has been frequently associated with mass gatherings”?
Why did Dr Harries’ advice contradict WHO guidance but align with Boris Johnson’s stated aims from 3rd February?
Is the government trying to hide behind the idea of science to evade responsibility for their choices?
Building Order from Chaos 
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