Covid inquiry: The week that science became both bamboozling and a millstone

1. Gareth Iacobucci

1. The BMJ

PM was bamboozled and confused over science

Patrick Vallance, the UK government’s chief scientific adviser (CSA) during the pandemic, gave evidence to the inquiry on 20 November. He was asked about the then Prime Minister Boris Johnson’s understanding of scientific concepts. The inquiry was presented with several extracts1 from Vallance’s personal notebook which gave an illustration of his thoughts. One diary entry from May 2020 described Johnson as being “clearly bamboozled” by discussions about modelling on schools. Another extract from May 2020 said Johnson was “confused” about the different types of covid tests. And in June 2020 Vallance wrote, “Watching PM get his head around stats is awful. He finds relative and absolute risk almost impossible to understand.” Vallance told the inquiry, “I think he’d be the first to admit [science] wasn’t his forte and that he did struggle with some of the concepts and we did need to repeat them often.”2

Sunak spoke of controlling “scientists, not the virus”

The inquiry pressed Vallance on extracts from his diaries that suggested advice from the UK’s Scientific Advisory Group for Emergencies (SAGE) was sidelined by senior government ministers, and that ministers suggested that SAGE scientists needed to be handled in some way. One extract said, “In economics meeting earlier in the day they didn’t realise [chief medical officer (CMO) Chris Whitty] was there and [the chancellor] said, ‘It is all about handling the scientists, not handling the virus.’” Giving evidence Vallance said, “It definitely is the case that there were times when, because we were giving unpalatable evidence and advice, people would rather not hear it.”

Vallance also revealed that he and Whitty did not know about Sunak’s controversial Eat Out to Help Out scheme until it was announced. “Our advice would have been very clear on that,” Vallance said, pointing out that the policy “completely reversed” all prior public health advice given during the pandemic. Yet in his witness statement,3 Sunak had said he did “not recall any concerns about the scheme being expressed during ministerial discussions, including those with the CMO and CSA.”

“Following the science” became a millstone for advisers

Giving evidence on 21 November, Whitty said the government’s often repeated mantra during the pandemic that it was “following the science” became highly problematic. Whitty told the inquiry, “Both Patrick [Vallance] and I, when it initially happened—remembering that our job was to get science into government—thought, ‘Oh, this is a good thing, government is recognising that science is important.’ Very soon we realised it was a millstone around our necks and didn’t help government either.” The phrase “blurred the distinction between the very firm, clear demarcation that must and did exist between technical advice and political decision for which people are then answerable in the ballot box and in parliament,” Whitty said.

Whitty felt the “precautionary principle” was misunderstood

In response to a question about whether the UK failed to adhere to the precautionary principle in a pandemic that you “go early and you go hard,” Whitty argued that some witnesses to the inquiry had “quite profoundly” misunderstood the principle. He said the precautionary principle is useful if you’re dealing with something where there are no or very minimal downsides relevant to the advantages, such as advising people to wash their hands. “The more you get into things where there is significant cost—I do not mean that in an economic sense, I mean cost to individuals, cost to families, in terms of their health, mental health, and so on—the less you can say, ‘Well, it’s just a precautionary principle, I’m going to impose this on you just in case,’” he said. “That’s not an appropriate understanding of what precautionary principle is or should be.” 4

Advisers diverged but agreed that first lockdown was too late

In his diaries, Vallance branded Whitty “a delayer” in the context of the CMO’s reluctance to move early to impose lockdowns and other non-pharmaceutical interventions because of the indirect harms that may be caused such as loneliness, depression, and poverty. “He was definitely of the view that pulling the trigger too early could lead to adverse consequences,” said Vallance. “I was more on the side of ‘we need to move on this.’” In his evidence, Whitty acknowledged that he was concerned about the impact of lockdowns and closing schools, and of the balance between going too early as well as going too late. But he said overall there were “extremely small” differences between him and the CSA. “My view is, with the benefit of hindsight, we went a bit too late on the first wave,” Whitty said, but added that the government had “no good options” at the time.

Herd immunity was a “ridiculous” and “dangerous” goal

Whitty said any notion of the UK achieving herd immunity from covid was “a clearly ridiculous goal of policy and a very dangerous one.” He said there was “considerable confusion” around herd immunity stemming from public comments from people who “had at best half understood the issue.” He said that modellers were referring to herd immunity “in the sense of gradually increasing levels of immunity” in the population, and not the threshold at which further waves are unlikely. He noted that 80% of the population would have had to have been infected with covid to achieve herd immunity, but by the end of the first wave fewer than 20% had. “It would have been inconceivable that this should have been an actual goal of policy because it would have led to an extraordinarily high loss of life,” he said.

Herd immunity should only have been talked about in the context of vaccination, he added.5

Whitty felt the UK’s pandemic plans were “woefully deficient,” even for flu

During his evidence, Whitty said that after examining the UK’s pandemic plans drawn up before covid-19, he felt they would have been “woefully deficient” even for an influenza pandemic. He said it was clear in early 2020 that the plan was not going to be particularly helpful, as it was based on the H1N1 2009 pandemic, which had very low mortality.

“My view was we didn’t have a plan that was going to be useful from a prevention or management point of view,” Whitty said. “It had a large number of useful components within it, but the idea there was a respiratory pandemic plan for the kind of pandemic this was going to be, if it was going to be a problem, that we could just take off the shelf and follow the playbook, was optimistic at best.”

Senior advisers needed police protection during the pandemic

In his written statement to the inquiry6 Whitty said he and other scientific advisers “received substantial abuse and hostility from a minority” who objected to the advice they were giving.

“In my case, I was advised by the Home Office that the threat was sufficiently high that I had to have police close protection for nine months,” he wrote, adding that others had threats made to their families. Giving evidence to the inquiry after Whitty on 22 November, former deputy chief medical officer Jonathan Van-Tam said police advised his family to move out of their home at one stage during the pandemic because of a threat that they would have their throats cut. Van-Tam said he was worried that such incidents could put off others from doing jobs like his. “My family didn’t sign up for that,” he said, as there was no one available to look after their cat. But he admitted that the ordeal was “very stressful indeed.”