Saturday 17 October 2020

Eighty-six sages

This article is about SAGE. That is, the UK’s “Scientific Advisory Group for Emergencies.” Its self-stated remit is that it: “provides scientific and technical advice to support government decision makers during emergencies.” And it has been front and centre in recent spats about COVID-19 [[1]].

The list of SAGE participants can be found at [[2]]. That list, dated 17th July, shows 86 members, of whom up to about 20 may be involved in any one meeting or topic.

SAGE recently released the minutes of one of its meetings from last month. This was an immediate response to Boris Johnson’s newly announced tiered COVID lockdown system. The Guardian [[3]] titled the release: “SAGE documents show how scientists felt sidelined by economic considerations.” The experts, they said, wanted a dramatic increase in restrictions across the country to check the alarming rise in infections. To include a “circuit-breaker” lockdown of a couple of weeks, and “closure of all bars, cafes, restaurants, indoor gyms and personal services such as hairdressers.”

Let’s review how we got to this pass. The UK government’s handling of the COVID-19 epidemic has been, in one word, atrocious. The Cygnus report was shelved. Preparation for the virus seemed all but non-existent. Health workers were under-protected. People were sent back into care homes after discharge from hospital, without being tested for the virus. Patients were put on ventilators, when less invasive treatments would have been more appropriate. In May, health secretary Matt Hancock was caught misleading the public about testing data by Sir David Norgrove, chief of the UK Statistics Authority [[4]]. As one who has been analyzing the data over several months, I know that the UK in early June wiped out and re-wrote all its past testing data; then it later did the same thing with new cases. In July, Leicester City Council had no warning at all that they were about to be ordered to implement a lockdown, because they had not been given the correct numbers of tests and new cases. Moreover, as of the latest date I have looked at (October 6th), among major European countries the UK was third worst, behind only Portugal and Italy, in deaths per case (offset by 21 days). And according to the Blavatnik School of Government’s stringency index, the UK has been continuously the heaviest locked down among those major countries since the beginning of August.

Then, four weeks ago, there was talk of a “second national lockdown.” This caused a considerable number of people, including me, to write to their MPs strongly urging that this must not be allowed to happen. Remarkably, for the first time in years or even decades, the government – prompted, perhaps, by Tory backbenchers nervous about their own positions – actually bothered to listen to the people they are supposed to be serving. The result was the “tiered” system, which has just recently come into effect.

This new system seems to me, at first glance at least, to be along the right lines. Epidemic control, by the nature of disease transmission, must be a local matter. And to push out powers and responsibilities, as far as possible, to the health people “on the ground,” who are best aware of the situation in their own areas, makes a lot of sense. There will, no doubt, be many matters that need resolution – most of which, at the moment, seem to be about money hand-outs, not medical issues. But it’s a start.

Crucially, the new system avoids ridiculae like confining people in Cornwall to their homes when the nearest major outbreak is in Bristol more than a hundred miles away. The “circuit-breaker” proposal, in contrast, would do precisely that, for no gain at all to anyone.

Even better, the new system provides a framework within which the effects of different policies can be objectively evaluated. If for a month, say, City A closes the pubs, City B closes public transport, and City C closes the schools, would that not help to clarify the picture of what works against the virus, and what doesn’t?

And yet, SAGE are opposed to this new system. Now, it seems strange to me that a group, whose supposed remit is to provide scientific and technical advice, is in effect issuing policy demands. That sounds like tail wagging dog. Another odd thing, to me, is their pooh-poohing of “economic considerations.” Of course, these are members of a privileged class, high in the favours of the state, and many of them very comfortably rewarded by it. If the economy goes belly up because of policies they favour, they won’t be the ones suffering. Nor, under today’s political system, will they be held personally responsible for their share of the harms those policies cause. Even so, are they not short-sighted and heartless, if they disdain the economic needs and desires of the “little people” who are forced to pay for the “work” they do?

Here are a few recent statements from SAGE members and associates. Let’s start at the top. Chief scientific advisor Sir Patrick Vallance’s September 22nd predictions of case numbers continuing to double every week have proved to be grossly exaggerated [[5]]. We also get pessimism from Professor Chris Whitty, chief medical officer [[6]]. “The highest level of restrictions in England’s new three-tier local lockdown system ‘will not be sufficient’ to slow COVID-19 infections alone.”

Then there is Professor Susan Michie, director of the “Centre for Behaviour Change” at University College London and (according to Wikipedia) a leading member of the British communist party [[7]]. “At this critical moment the gulf between the scientific advice from SAGE and from @IndependentSage and the political decisions made by government has been laid bare.” Michie also relayed a tweet from Professor Stephen Reicher, who is on the SAGE-associated “Scientific Pandemic Influenza Group on Behaviours” [[8]]. “Johnson has ignored the science and blown our chance to stop a second wave.”

And a somewhat more refined tweet along the same lines, from Professor Michael Parker, director of the “Ethox Centre” at the University of Oxford [[9]]. “Ministers are rightly free not to follow scientific advice but when they do so they have an obligation to provide a clear and reasoned public justification for this and a coherent plan of action for if the scientific projections start to look right.” On the other hand, they might just as well formulate action plans for the, far more likely, situation where the scientists turn out to have been wrong!

Next, I’ll look in more detail at the composition of SAGE. The first distinction I chose to make was between “advisors” and “clients.” Advisors are the people, whose skills and knowledge should enable them to offer scientific advice on the matter under discussion. Clients, on the other hand, represent some other part of government, not directly involved with the virus. Their main interest is in the effects of the deliberations on their particular departments. A few of them, though, happen also to have skills appropriate to advisors. My count divided the 86 SAGE members into 64 advisors and 22 clients.

Within the advisor group, I divided the personnel into three subgroups. First, those whose backgrounds and skills are clearly appropriate to make them advisors in this case. Second, those who might, or might not, be able to bring something useful to the party. And third, those whose membership appears to be incompatible with a body whose remit is to provide scientific and technical advice on a virus epidemic.

Among the skilled advisors, we have three biochemists – including Sir Patrick Vallance himself, and Nobel Prize winner Professor Venki Ramakrishnan. Three tropical medicine specialists, including Professor Whitty. Three I would surmise are general clinicians, though it’s not clear just how much field experience they gained before they became academics. There are six immunologists, three virologists, two statisticians, five epidemiologists, a mathematical biologist, two microbiologists, a child health expert and an adolescent health expert. There are also the Welsh and Scottish chief medical officers; one of whom, would you believe, is also a general practitioner! The team is certainly heavyweight, if nothing else.

And then, there’s Professor Neil Ferguson. I already counted him under the heading of “epidemiologist.” But there’s more to be said. I’m not actually sure whether or not he is still part of SAGE; although he officially left in May, it seems he is still involved. And his name is still on the list, too. It’s interesting to review some of his past statements. “The British response [the first lockdown], Ferguson said on March 25th, makes him ‘reasonably confident’ that total deaths in the United Kingdom will be held below 20,000.” [[10]]. October 15th, cumulative deaths: 43,293 and counting. On August 17th, he was “‘optimistic’ Europe won't see very large numbers of new COVID-19 cases this year.” [[11]]. October 15th, daily new case count: 18,980. That’s 2.4 times the peak of 7,860 on April 10th. Then, on September 22nd, we had this headline in the Sun [[12]]: “Professor Lockdown doubles down on 500k UK coronavirus deaths forecast [from March] – and claims it was ‘underestimate’.” Ho hum.

Passing to the not-sures, I see an educationalist, a professor of intelligent transport systems, a zoologist, a materials scientist, a “safety” expert, a mathematical modeller, an entrepreneur and general bright guy, an “environmental engineer,” and a representative apparently from the World Health Organization. There are also seven “public health” people; several of whom, I suspect, are more political operators than they are scientists. And no less than five in a field called “data research” or “data science,” four of them from a start-up outfit called “Health Data Research.” Oh, and then there’s Baroness Dido Harding. Who gets a lot of flak from all around; but, I suspect, as much for who she is as for what she does.

And then, the oughtn’ts. In addition to a behavioural scientist and a psychologist, no less than five SAGE members work in the fields of “social intervention” and “behaviour change.” These include Dr Michie above, and Professor Theresa Marteau from Cambridge. Four years ago, I had occasion to write an April 1st spoof of an article by Professor Marteau in the Cambridge alumni magazine [[13]]. But I wonder, why would a government, if it is genuinely trying to serve the people rather than to control them, feel a need to employ such “nudgers?”

There is also a professor of “EU law and social justice.” And the aforementioned Professor Parker, who seems to have so many different hats that it’s difficult to work out what he actually does for his living.

Conspicuous by its absence from the SAGE list, to me at least, is the name of Professor Carl Heneghan of the Centre for Evidence Based Medicine at the University of Oxford. The group he leads belongs to the Nuffield Department of Primary Care Health Sciences, which ought to make him extremely well qualified for SAGE. And his reaction to the current controversies was typically forthright [[14]]. “There is no good evidence for a circuit-breaker lockdown. We urgently need to address the lack of credible research into which interventions work and which don’t.” That second sentence is even more key than the first; which is key enough!

Among the clients from other parts of government, there are: A statistician, two mathematical biologists and an epidemiologist. An engineer, a geochemist, a “digital initiatives” person, a vet, two astronomers, a professor of “architectura and urban computing,” an ecologist, a computer scientist, an educationalist and a former senior corporate executive. And seven more, whose relevant skills I haven’t been able to find.

Other common themes run through the SAGE personnel, too. No less than 14 of its members have, now or in the past, a connection with University College London. UCL today describes itself as “London’s Global University.” It orients itself around six “Grand Challenges” [[15]]: Global Health, Sustainable Cities, Cultural Understanding, Human Wellbeing, Justice & Equality, Transformative Technology. All very “modern,” and with a strong and not very pleasant whiff of political correctness.

There are also eight SAGE members connected with Oxford University, and seven with Imperial College London. And five of its members have connections with the Wellcome Trust, the fourth wealthiest charitable foundation in the world. These include both the current and previous Directors of the Trust. In general, it’s fair to say that the senior members of SAGE are extremely well connected in government, academe, and in many cases commerce.

It’s hard to quantify, but some SAGE members, like far too many of today’s academics, seem to have views one might describe as “woke.” There is a mathematical modeller with an interest in “global inequalities.” A director of “a network which campaigns for the need and importance of better inclusion of all backgrounds, skillsets and disciplines in health technology.” A director of a government project on “Transforming food systems for UK human health and environmental health.” And the woman Neil Ferguson invited across London during lockdown [[16]], according to the Sun, works for US-based online network Avaaz, which “promotes global activism on issues such as climate change.”

Such “woke” views go hand in hand with hostility towards Western civilization, earned prosperity and individual freedom. That the SAGE group is infected by such views, may go some way towards explaining why their advice to government seems so often to be to hit the “little people” as hard as possible.

Boris Johnson and his aides deserve a (weak) cheer for – this once – actually listening to ordinary people, and trying to avoid unnecessary and harmful policies like locking down people in areas not seriously affected by the virus. But they need to do a lot more than just that. First and most obviously, they must resist the temptation to compromise with those, in SAGE and elsewhere, that do not wish well to the ordinary people of the UK. Having broken with the habits of decades by listening, however briefly, to the people they are supposed to serve, they must continue to listen. And they must make far more explicit their commitment to serve us, instead of ruling over us. That said, I confess I don’t have much hope that Boris the Bullingdon Boy will ever succeed in reforming himself. And as to Labour, forget it.

Beyond all that, the mechanics and culture of “scientific” advice to government needs to be re-examined and, very probably, re-booted. SAGE is as good a place to start as any. And cleaning out the Sagean stables, to use a phrase, will be good practice for the tougher tasks ahead, like neutralizing and overcoming the anti-scientific deep green mythmakers.


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2 comments:

Opher Goodwin said...

Hi Neil, a very detailed and interesting read.
I think you are right about local action and the tier system - with two provisos - firstly that the tier system was stringent enough to be effective (I don't think it is - far too cosmetic) and secondly that those shut down, who can no longer work, are fully compensated.
I would have reblogged this on my site but I can't from your site.

17 October 2020 at 15:02
Neil said...

Yes Opher, it isn't absolutely clear that "Tier Three" restrictions are enough to keep the cases down. Mr Whitty thinks not, but we'll have to see. However, I don't see that the system precludes a "Tier Four" in the future, which could be a full lockdown if it proved to be absolutely necessary. It's better to lock down just Liverpool (say) to the level of April, than to repeat that for the whole country. Also, I think there would be a lot more pressure - from local people - to release local lockdowns than could be mustered to release a national one.

As to compensation, that's a minefield. The problem is that, however much money gets handed out by government, people will have to pay for it all in the end. Either in taxes direct or indirect, or in loss of purchasing power of savings due to inflation. That, in its turn, depends on the approach they decide to take to re-constructing the economy. If it is government-driven, it will be doomed to fail, and we'll be on the path to revolution. The best thing, in my opinion, would be for government to stand aside, and let people re-build the economy from the bottom up. Something like what the Germans did after WWII.

18 October 2020 at 10:04

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