Hannah Baker

We are delighted to welcome Matthias Meller, Visiting student/researcher on the Expertise Under Pressure project (EuP), and asked about his hopes for his stay at the project. ​

Matthias is a Master’s candidate for the ‘Responsibility in Science, Engineering and Technology’ programme at the Technical University of Munich (TUM), Germany. He was Policy Intern at the Centre for Science and Policy (CSaP) in Easter Term 2021 and worked as a Policy Analyst intern at a German State Ministry for Digital Affairs. Before his graduate studies, Matthias was Entrepreneur in Residence at a financial technology start-up. Matthias holds a BA in Philosophy & Economics, having studied in Germany, Canada, and Italy, and was a fellow of the German Academic Scholarship Foundation.

Q: Matthias, which aspect of Expertise Under Pressure do you find most exciting?

I was particularly drawn by understanding more closely what makes expertise authoritative. During my time in the start-up ​industry, I found it fascinating to observe the weight that venture capitalists’ judgment carried for the trajectory of single companies and even ecosystems. This already hints that expertise does not need to come in strictly academic terms. The COVID-19 pandemic induced a change to our understanding of the role of experts in public. They always have and increasingly been present; however, now, their judgement has been sought to guide us through the uncertainties of everyday life and social order day-to-day (and sometimes even less than that). The pressing demand for immediate expert judgement in this emergency foregrounds what may make expertise authoritative and which claims are aimed to support such authority.

Q: How does your own area of interest relate to the project’s primary research questions?

While at CSaP, I worked alongside Hannah Baker and Emily So from the EuP project, Shauna Concannon from the Giving Voice for Digital Democracies project (also at CRASSH) and other CSaP interns on how the UK’s Scientific Advisory Group for Emergencies (SAGE) provided advice to government during the COVID-19 pandemic. Our research matured into a study of the evolving transparency and advice process, principally evidenced through the official minutes of SAGE meetings. I continued to be involved in the project beyond the internship and co-authored a paper we submitted at the end of 2021. My specific contributions included data acquisition and analysis, data visualisation and bringing in theory from my Science and Technology Studies (STS) background.

Additionally, for my graduate thesis supervised by Makoto Takahashi (Senior Researcher at TUM, Fulbright-Lloyd’s Fellow at Harvard), I am researching the public communication of SAGE experts and members of the group ‘Independent SAGE’ on Twitter. Independent SAGE, founded by the former Government Chief Scientific Adviser Sir David King, arose against calls for greater transparency of the scientific advisory process and has used the platform as a principal venue to engage with their audiences. Amid their early labelling as a ‘rival group’ to SAGE, I was intrigued to ask how Independent SAGE laid claims to expertise and authority and, judged by the extensive media coverage, continued to play a role in the public’s perception of the UK’s pandemic response until recently.

Q: What are your hopes for your stay at CRASSH?

Interdisciplinarity has been at the core of my academic education, yet, this project has allowed me to work alongside fantastic researchers on truly interdisciplinary and timely research, discovering computational social science methods along the way. I cherish the opportunity to meet so many faces I have seen and worked with only virtually now, finally in person. It is often the unintentional and undirected exchanges face-to-face that stipulate the most interesting and durable thoughts on how to make sense of social change.

During my visit, I hope to refine our research paper on SAGE during the COVID-19 pandemic for publication. Furthermore, the EuP team and I will jointly reflect on how the pressures on SAGE as the primary provider of scientific advice to government, including the emergence of Independent SAGE, may shape the public’s expectations in the UK of what makes expertise authoritative and credible in the future.

 

 

Decisions happening behind closed doors due to a lack of transparency of the scientific evidence has been a notable concern about the UK’s response to Covid-19. ^[1] The last of the BBC daily briefings was held on 24 June 2020. During these a Minister regularly stood in the middle of two senior members of the Scientific Advisory Group for Emergencies (SAGE). The job of SAGE is to pool together scientific experts and provide scientific advice to the Cabinet Office Briefing Room (COBR). Although decisions are made by the Government’s Ministers, not SAGE, the phrase ‘we are following the science’ was regularly used to justify decisions during these briefings.

Former Government Chief Scientific Advisor, Sir David King, established a separate group of experts called Independent SAGE in reaction to and part of this growing push for transparency. He warned the secrecy of the response could cause a loss of public trust in the science.^[2] Independent SAGE’s first meeting was on the 4 May 2020 and live streamed on YouTube. Their website is an obvious ‘dig’ at the Ministers’ rhetoric as it uses the tagline ‘Independent SAGE. Following the Science’. ^[3] 

Sir David King, Chair of Independent SAGE. Image source: Climaterepair via Wikimeida

Independent SAGE’s quest for transparency has not stopped since their inception. The latest change being live weekly meetings with their own scientific experts on their social media channels as a response to the end of the Government’s daily briefings, with the first of these being held on 26 June 2020. There are now over 10 meetings that the public can view on Independent SAGE’s YouTube channel. ^[4] Several reports and open letters are also available on Independent SAGE’s website. Topics include (but are not limited to) school openings, test and trace options and the impact of Covid-19 on Black and Minority Ethnic populations. 

This blog post uses media coverage to better understand these notions of transparency, the differences between SAGE and Independent SAGE and how SAGE has changed in the context of transparency over the duration of the pandemic. These sections consider whether a new standard of transparency has been set for SAGE but also highlights potential issues of having more than one scientific advisory group (albeit one not official) and the limitations of their outreach.

The origins of Independent SAGE and ongoing calls for transparency 

As soon as UK’s ministers claimed to follow the science, calls for transparency of the scientific evidence started gaining traction. As commented by James Wilsdon, a digital science professor of research policy at Sheffield University: ‘transparency must now become the default operating mode across the SAGE process…We’re in a situation of what some call ‘post-normal’ science, where the facts are uncertain, values are in dispute, stakes are high and decisions are urgent’ (4 May).^[5]

Although these calls for transparency were circulating since the beginning of the pandemic, a notable push to know the experts’ names came after a Guardian article on 24 April revealed that two political figures Dominic Cummings and Ben Warner had attended SAGE meetings. ^[6] Despite Downing Street reporting they did not participate, there was uneasiness in the media that the scientific advice was being politicised before it went up to COBR.^[7] Consequently, ‘concern over the secretary of SAGE’s membership reached a new pitch’. ^[8]  Shortly after this, Independent SAGE was established. However, in his recent interview with The Times, Sir David King indicates that ‘the seeds of Independent SAGE began to germinate’ in February when he had noticed the divergence of the UK’s approach to the rest of the world and the WHO’s advice to ‘test, test, test’. ^[9]

As part of their quest for transparency, Independent SAGE wanted to distinguish between the science and the politics. On 22 May, news broke in the Mirror and Guardian accusing Dominic Cummings of breaking lockdown rules. Despite a press conference in the rose garden of 10 Downing Street to explain his movements, there was an explosion of media coverage, including calls for his resignation. ^[10] Whether or not he broke the lockdown rules, articles emerged critiquing scientists for standing alongside ministers as they justified his decisions. The one article in The Guardian claimed the relationship between scientists and ministers had become ‘dangerously collusive’.^[11]

In Independent SAGE’s meeting on 28 May the panel was asked ‘Why do you think the Government is ignoring its own advice and why [have] Whitty and Vallance in particular stopped appearing?’. Although not explicitly mentioning Dominic Cummings, it is highly likely the ongoing media coverage of him in the previous week underpinned the question. Susan Michie, Professor of Health Psychology at UCL responded: “One thing I think that is very important going forward is that scientific trust isn’t dented at all… it would be extremely helpful if our chief medical advisor and chief scientific officer were to give direct press briefings and direct briefings to the public to report on the scientific thinking of SAGE.” ^{[12]: 47:20 – 48.17mins.}

Independent SAGE’s online discussions take the format that Susan Michie referred to: no ministers, just scientists. In some cases, a reporter may help facilitate the discussion by welcoming members of the public to ask a question or asking one on their behalf. The most appropriate expert is then chosen to answer and others may raise their hand to indicate they also have something to add. In some cases, the public’s questions are included in the report Independent SAGE send to the Government. An example being Section 7 in their report about schools: ‘School reopening: some of your questions answered’. ^[13]

If watching the live Independent SAGE’s discussion on YouTube, you can see the public’s comments. Some offering opinions about the topic being discussed, but the ones that stood out for me (obviously due my interest in transparency) are those thanking Independent SAGE for indeed that, their transparency, openness and honesty. On 27 June a Crowdfunding page was set up for Independent SAGE to continue their work. The comments here also provide interesting reading. For example, one states: ‘I donated because ISAGE are working for open/transparent and effective policies to deal with COVID19. I thank them all for working on behalf of all’. ^[14]

Since the setup of Independent SAGE, Sir David King and other members of Independent SAGE have become increasingly visible scrutinising the decisions that the Government has made. In one of his latest interviews (published 27 June), Sir David King comments that if members of SAGE were as visible “it would have changed this immensely”. He then reiterates the critique of the ongoing rhetoric mentioned earlier: “you can’t have a minister or prime minister saying we’re just following the science advice if the public doesn’t know what the science advice was”. ^[9]

Although Independent SAGE’s visibility has increased since their establishment and they are being referred to in more media headlines, there are limitations to their outreach and communication of the latest scientific thinking. Those aware of Independent SAGE are likely to be those actively seeking the discussion about the scientific evidence. At the time of writing (14 July 2020), Independent SAGE have 57.8k Twitter followers and 10.9k YouTube subscribers. ^[15, 16] The co-chairs of the official SAGE, Professor Chris Whitty and Sir Patrick Vallance (England’s Chief Medical Officer and the UK’s Chief Scientific Advisor) have their own Twitter pages with 256.9K and 137.6K followers respectively, SAGE itself does not have a page. ^[17, 18]   On the face of it, these numbers sound quite large. However political figures such as Boris Johnson and Donald Trump have 2.9M and 83.4M respectively, whilst to take an extreme example, celebrities such as Justin Bieber have 112.2M. ^{[19 ,20, 21]} Compared to these numbers, the outreach of Independent SAGE is small. 

Nonetheless, Independent SAGE was only established a few months ago and the 57.8K followers indicates there is a significant interest in them. Independent SAGE do not claim to be a communication platform for the guidelines but a platform for informed discussions which can be accessed by people if they so desire.

How is Independent SAGE different to SAGE?

Independent SAGE and SAGE are both made up of a body of experts from different disciplines. The official SAGE has 55 members listed as well as several sub-groups which focus on behavioural science, disease modelling, serology (scientific study or diagnostic examination of blood serum), clinical information, environmental modelling, transmission in children and hospital onset. ^[22] Independent SAGE originally comprised of the Chair, Sir David King, and 12 members. This has since been expanded to include a Behavioural Science Advisory Group, composed of 9 members. Some members of Independent SAGE or its sub-groups are part of SAGE or its sub-groups but the two bodies are different as Independent SAGE’s reports do not form part of the official government response.^[3]   

The two groups have been mixed up on more than one occasion. During news broadcasts, members of Independent SAGE (who are not also on SAGE) have accidently been referred to as members of the official SAGE by reporters and they have had to correct them. Another more specific example of this mix up happened on the 22 May when the deputy Labour Minister, Angela Rayner, accidently referred to SAGE after Independent SAGE had published a report advising against the reopening of schools on 1 June: ‘SAGE concludes June 1st “too soon” to open schools. Teacher unions have been absolutely correct in asking for safety measures to be in place before re-opening’.^[23]  She later tried to clarify that she meant Independent SAGE but subsequently both Tweets were deleted after she was accused of spreading misinformation.^[24]  Her statement has been fact checked on the website ‘full fact’.^[23]

In contrast to the two bodies being mixed up, several headlines have referred to Independent SAGE as a ‘rival’ group of experts.^{[25, 26, 27, 28]} In response to the use of the terminology ‘rivals’, Sir David King Tweeted ‘some have billed @IndependentSAGE as a ‘rival’ to the govts. To be absolutely clear that is not how we as a group see ourselves. Science is best when our community works together, on IndiSAGE we have a broad church of experts who are working hard to supplement existing advice’ (23 May).^[29]

The mix-up and perception of Independent SAGE as ‘rivals’ emphasises a potential problem with having two separate bodies. If they are seen to contradict one another, does that just add to confusion? Should there be just the one clear voice? Or is that simply the notion of science, there is not always consensus and that’s what is important for the public to see and understand? In another interview, Sir David King explains that scientists do not always agree and science is a discipline based on the peer review process where the evidence can be scrutinised, hence the objective of Independent SAGE is to offer this scrutiny and that is why it is vital that the science being referred to by decision makers is available.^[8]

A noticeable difference between SAGE and Independent SAGE is the visibility and direct communication with the experts in the public sphere. The public did have access to senior members of SAGE, such as Sir Patrick Vallance and Professor Chris Whitty during the daily briefings where a few questions were posed by the public. However, beyond this, as far as I’m aware, there haven’t been any conversations between just the scientists that are open to the general public to listen to and participate. This is the vision of Independent SAGE. As expressed by Karl Friston, a neuroscientist advising Independent SAGE: “I think of Independent Sage as the ultimate exercise in public engagement; what it would look like if you and I and everyone else were able to sit in on a real Sage meeting… In my view there can never be anything wrong with transparent, informed discussion.” ^[30]

Ascribing the virtue of public engagement to Independent SAGE should be carefully considered. In town planning policy, the terminology of public participation has many levels, from the consultation being tokenistic to the public having a significant impact on the design of a development. The channel that Independent SAGE has opened informs the public through a question and answer session, where some of those concerns are passed onto the government. They do not give access to the inner workings of writing the report. Nonetheless, access to a more in-depth question and answer session is an important quality and Whitty himself has noted that he has been much more shorthanded than he would have liked in the briefings when he was questioned about the changing guidelines of social distancing from 2m to 1m+ in the last daily briefing. ^{[31]: 40.46 – 41.00mins.}

There is a practical feasibility issue in having meetings like Independent SAGE, especially as the official SAGE includes more experts and sub-groups and all of those members will be under significant time-pressures (that’s not to say members of Independent SAGE are not busy as they are also volunteering their time whilst being in full time work). However, if some of the experts in the official SAGE, beyond those in senior roles, were able to factor in an hour of their time to answer some of the public’s concerns directly and in the format of a group discussion, it would be welcomed by members of the public seeking more detail about the scientific evidence. This question and answer format would help to balance the concerns about protecting national security and being open with the public as the public wouldn’t be listening into the actual deliberations but could still hear directly, and in more detail about what the science unpinning decisions is. Navigating through the evidence on the website for SAGE can quite easily become overwhelming. 

Another difference between SAGE and Independent SAGE is the perception that Independent SAGE is a left-wing body. An example of this is the Daily Mail headline: ‘Ex-science tsar Sir David King has built a Left-wing cabel to disperse virus health advice (but says ministers’ experts are too political to be trusted!’.^[32] In response to this criticism, Sir David King once again used Twitter as the communication channel and stated that political ideology is irrelevant and that the job of the scientific experts is to give scientific advice not political advice, and emphasised that it is up to the ministers to make the decisions.^[33] The very fact that he had to respond, shows that the perception is/was there, so much so he felt it needed addressing. 

The ‘boundary’ between science and politics has been an issue throughout the pandemic. How has the science been used within decisions which are inevitably political? Hence, the calls for transparency and concerns about trust. Scientists who are/were members of SAGE, such as Professor John Edmunds and Professor Neil Ferguson, have separately spoken out that lockdown did not happen soon enough and was being eased too quickly, whilst Melanie Smallman, a Lecturer in Science and Technology Studies at UCL, describes the terminology ‘Independent SAGE’ as an oxymoron arguing that that ‘the idea that government advisers can separate science and politics is bogus’. ^{[34, 35, 36]}

Has SAGE’s approach to transparency changed during the pandemic?

A short and simple answer to this question is yes. At the beginning of the pandemic, none of the evidence being referred to was available, the expert’s names were not released and the minutes of the meetings were not accessible. When there were the growing calls to release the names of the experts, Sir Patrick Vallance said the decision to not release them was due to concerns about safeguarding the individual’s personal security, based on advice from Centre for the Protection of National Infrastructure.^[37] However, pressure continued to mount and the experts were given an opt-out option and then the names were released on the 4 May. This was the same day as Independent SAGE’s first meeting, which Sir David King has commented he doesn’t think was a coincidence.^[38]

The Government Office for Science’s website for SAGE openly acknowledges that SAGE’s approach has changed during the course of the pandemic. The website says that in previous events the minutes and supporting documentation were not published until the conclusion of the relevant emergency in order to protect any national security and operational considerations and allow ministers to consider ‘free and frank advice’ from the experts. It also states ‘we have revisited this approach in light of the current exceptional circumstances, recognising the high level of public interest in the nature and content of SAGE advice’.^[39] Then it goes on to say, SAGE will now publish all past minutes and supporting documents and future minutes and documentations within one month of the meeting taking place. To overcome the concerns about protecting individuals and national security, in some cases information is redacted from these. When following the link to the minutes, the website user is taken to a page with the header ‘Transparency and freedom of information releases’ specific to SAGE. ^[40] In a comment in The Telegraph, Sir Patrick Vallance also acknowledges this change in SAGE saying ‘when it comes to this crisis it is clear we must get the information out as soon as possible, and in my opinion, as close to real time as is feasible and compatible with allowing ministers the time they need’. ^[41]

Obviously, the current approach is more transparent than it was at the start of the pandemic but as we are in such a fast-moving situation, to some, a one-month delay in the publication is not satisfactory, particularly for those that want to review and scrutinise the evidence before decisions are made, rather than just be informed what the evidence is when there are key policy changes. An example of evidence being released as policy changed is after an announcement on 23 June. In this announcement the public were told that from 4 July, the 2m social distancing rule could be reduced to 1m+ if social distancing was not possible. The + meaning with mitigation measures. A review of the 2 metre social distancing guidance was published by the Cabinet Office on the 24 June. ^[42] Within the text of this, a link is provided to a SAGE report from a meeting on the 4 June (published 12 June) entitled ‘Transmission of SARS-CoV2 and Mitigating Measures’.^[43]  In this, the executive summary states ‘Physical distancing is an important mitigation measure (high confidence). Where a situation means that 2m face-to-face distancing cannot be achieved it is strongly recommended that additional mitigation measures including (but not limited to) face coverings and minimising duration of exposure are adopted (medium confidence)’. 

In addition to the release of experts’ names and evidence, scientists have emphasised that SAGE’s job is to advise, not make decisions. A document published on 5 May explaining what SAGE is and its response to Covid-19 outlines that ‘The government is not beholden to what SAGE says, and the evidence SAGE puts forward forms just one part of what the government considers before adopting new policies and interventions during an emergency. In this current pandemic, the government also has to consider other factors’.^[44] Another example being, Sir Patrick Vallance describing what SAGE is and how the science is being used for decisions in his comment in The Telegraph on 30 May. He acknowledges that SAGE is not a group of people in consensus, that the science will not always be right and that it will change over time as we learn more. He also noted that science advice is just that, advice and the ‘Ministers must decide and have to take many other factors into consideration’.^[41] In the last daily briefing, Professor Chris Whitty made it clear that decisions on the easing of lockdown are a balance of risk. These are risks accepted by the Ministers to reduce the spread of the virus but also open up the economy. They are also risks accepted by individuals as they go about their everyday life. In order for individuals to make informed decisions, the pressure remains for the emerging scientific evidence to become available.

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It’s very easy to criticise in situations where you are not the decision maker, or even one of the main advisers, Sir David King himself says he’s glad he’s not currently in Sir Patrick Vallance’s position.^[9] However, it’s clear that if Ministers say they are ‘following the science’, they should recognise that many people want to know what this science is. Without that, trust can easily be lost. If trust is lost, this can impact whether or not people follow the guidelines. Although it will be impossible to pinpoint exactly what caused SAGE to make the changes that it did, such as the release of experts’ names, evidence and minutes, undoubtedly the fact this is an event affecting everyone’s daily life led to the growing calls for transparency. Independent SAGE have clearly made their point about what they think this transparency should look like. It is likely the group contributed to the growing pressure, particularly with their presence on Twitter, which then fed into members being contacted by news outlets and several articles referring to ‘Independent SAGE’s’ advice, particularly when that went against the latest government decisions.

An open letter to the leaders of the UK political parties published in the British Medical Journal was published on 24 June following the last daily briefing expressing concern over the preparedness for a second wave.^[45]  If there is a little ‘breathing room’ over the summer months, one part of this preparedness should be reflecting on the communication of the science and the evidence. SAGE should continue to release the minutes and update the evidence, but perhaps this could be taken a step further by applying some of the principles of Independent SAGE including hosting online discussions with only scientific experts and not ministers, as well as a more active presence on Twitter and other social media platforms to direct people towards these updates. Even if there is not a second wave, there will be future events that SAGE will be involved in and now there is this increased awareness of them, they will inevitable be under increased scrutiny – so the notion of transparency needs to continue wherever feasibly possible. 

However, it is important to note that one limitation of this blog post is that it has assumed transparency is a good virtue which should be strived towards. Before the pandemic (2017), Dr Stephen John, a Senior Lecturer at the University of Cambridge, argues that transparency is not always beneficial. One reason being, transparency can increase confusion as members of the public may expect consensus and that’s not what science always is.^[46] In the context of Covid-19 we have seen that if the evidence is not released, it gives the impression that the Government are hiding information from the public, however if released the public can pick and choose what they communicate on social media or to their peers. In the last few days, we have seen lots of mixed messages about face coverings, the Metro’s headline (13 July) being: ‘Call to clear up the mask muddle’.^[47] As the evidence for face coverings has changed over time, people arguing for and against them, are selecting the evidence which supports their viewpoint. If we assume transparency is a good virtue due to the provision of information for those that seek it, these problems of mixed messaging and misinformation need to be overcome. The Government need to carefully consider the communication channels that they use and how to extend their outreach. This communication needs to clearly explain what the guidelines are but also, as with the face mask debate, why they have changed. Clarity is key. 

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Text by Dr Hannah Baker 

Disclaimer: Published 14 July 2020. This article is based on media coverage and reports found online. Despite her best efforts to locate all relevant information, the author acknowledges there may be key pieces of information she would have missed. Members of Independent SAGE or SAGE have not been contacted for comment. 

Thumbnail image source: Climaterepair via Wikimeida

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References:

[1] https://www.nytimes.com/2020/04/23/world/europe/uk-coronavirus-sage-secret.html

[2] https://www.theguardian.com/world/2020/may/03/publics-trust-in-science-at-risk-warns-former-no-10-adviser

[3] https://www.independentsage.org/who-is-on-the-independent-sage/

[4] https://www.youtube.com/channel/UCqqwC56XTP8F9zeEUCOttPQ

[5] https://www.theguardian.com/politics/2020/may/04/no-10-facing-fresh-calls-for-transparency-over-sage-pandemic-advice

[6] https://www.theguardian.com/world/2020/apr/24/revealed-dominic-cummings-on-secret-scientific-advisory-group-for-covid-19

[7] https://theconversation.com/dominic-cummings-and-sage-advisory-groups-veil-of-secrecy-has-to-be-lifted-137228

[8] https://www.researchprofessionalnews.com/rr-news-uk-politics-2020-5-new-covid-19-science-advice-group-launched-to-rival-sage/

[9] https://www.thetimes.co.uk/article/sir-david-king-where-the-uk-has-gone-wrong-on-covid-19-and-what-we-should-do-now-nvhdxf7p9

[10] https://www.itv.com/news/2020-05-25/timeline-how-the-dominic-cummings-controversy-unfolded/

[13] https://www.independentsage.org/wp-content/uploads/2020/06/Independent-Sage-Brief-Report-on-Schools.pdf

[14] https://www.gofundme.com/f/indepdent-sage

[15] https://twitter.com/IndependentSage

[16] https://www.youtube.com/channel/UCqqwC56XTP8F9zeEUCOttPQ

[17] https://twitter.com/CMO_England

[18] https://twitter.com/uksciencechief

[19] https://twitter.com/BorisJohnson

[20] https://twitter.com/realDonaldTrump

[21] https://twitter.com/justinbieber

[22] https://www.gov.uk/government/publications/scientific-advisory-group-for-emergencies-sage-coronavirus-covid-19-response-membership/list-of-participants-of-sage-and-related-sub-groups

[23] https://fullfact.org/health/sage-did-not-advise-against-reopening-schools-1-june/

[24] https://www.spectator.co.uk/article/angela-rayner-s-sage-fake-news

[25] https://www.telegraph.co.uk/news/2020/05/05/three-scientific-unknowns-could-change-course-life-outside-lockdown/

[26] https://www.mirror.co.uk/news/politics/rival-coronavirus-science-advisors-urge-21973564

[27] https://www.theguardian.com/world/2020/may/04/rival-sage-group-covid-19-policy-clarified-david-king

[28] https://www.dailymail.co.uk/news/article-8281751/Former-chief-scientific-adviser-sets-rival-Sage.html?ito=amp_twitter_share-top

[29] https://twitter.com/Sir_David_King/status/1264105252233654272

[30] https://www.theguardian.com/world/2020/may/31/covid-19-expert-karl-friston-germany-may-have-more-immunological-dark-matter

[31] https://www.youtube.com/watch?v=QdakYCF1hXc

[32] https://www.dailymail.co.uk/news/article-8286797/GUY-ADAMS-Ex-science-tsar-Sir-David-King-told-switch-diesel.html

[33] https://twitter.com/Sir_David_King/status/1260557481715142656

[34] https://www.bbc.co.uk/news/health-52849691

[35] https://www.imperial.ac.uk/news/198155/neil-ferguson-talks-modelling-lockdown-scientific/

[36] https://www.researchprofessionalnews.com/rr-news-political-science-blog-2020-5-independent-sage-group-is-an-oxymoron/

[35] https://www.prospectmagazine.co.uk/science-and-technology/david-king-independent-sage-coronavirus-covid-19-government-transparency

[37] https://publications.parliament.uk/pa/cm5801/cmselect/cmsctech/correspondence/Patrick-Vallance-to-Greg-Clark-re-SAGE-composition.pdf

[38] https://www.researchprofessionalnews.com/rr-news-uk-politics-2020-5-independent-sage-group-is-making-government-more-open/

[39] https://www.gov.uk/government/groups/scientific-advisory-group-for-emergencies-sage-coronavirus-covid-19-response

[40] https://www.gov.uk/search/transparency-and-freedom-of-information-releases?organisations%5B%5D=scientific-advisory-group-for-emergencies&parent=scientific-advisory-group-for-emergencies

[41] https://www.telegraph.co.uk/news/2020/05/30/will-have-learned-lot-including-do-better-next-time-science/

[42] https://www.gov.uk/government/publications/review-of-two-metre-social-distancing-guidance

[43] https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/892043/S0484_Transmission_of_SARS-CoV-2_and_Mitigating_Measures.pdf

[44] https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/883104/sage-explainer-5-may-2020.pdf

[45] https://www.bmj.com/content/369/bmj.m2514

[46] https://www.tandfonline.com/doi/full/10.1080/02691728.2017.1410864

[47] https://www.metro.news/calls-to-clear-up-the-mask-muddle/2076904/

Text by EuP’s co-investigator Dr Emily So assisted by research associate Dr Hannah Baker.

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I was born and raised in Hong Kong. During the Covid-19 pandemic, my friends and family have told me that if you don’t wear a face mask/covering, you are the odd one out. Vending machines selling disposable face masks are common and the government has issued every resident with a reusable face mask. Many countries and cities around the world have followed suit.

There is a rich history of face masks and its origins. In Asian cultures, masks are respected as the social norm. You wear one when you are ill to keep your germs from passing onto others. Yet in the UK, where I now live, donning a face mask attracts public attention in the opposite way, that somehow the wearer has succumbed to fear and is wearing a mask to protect themselves. The debate over in western societies since the pandemic has revolved around the ability of masks to stop transmission of and protect the wearer from potentially viral airborne particles. 

By wearing a face mask, are we keeping the germs in or out?

In this short blog, I am not going to embark on a “to wear or not to wear” debate as I have no credentials to argue for either side and will leave Professor Patricia Greenhalgh and Professor Graham Martin to battle it out in the ring. What I am interested in is the timeline of advice on face masks in the UK and what has contributed to its current policy.

The World Health Organisation (WHO) declared Covid-19 a pandemic on the 11th March.  The first piece of advice I received about face masks from an expert on the BBC was on the 13th March where Dr Shunmay Yang from London School of Hygiene and Tropical Medicine explained if masks really protected people from contracting the virus. Her stance and the one of the UK government at the time was that face masks should be reserved for healthcare workers and those who are already infected. Looking back through the newspaper archives, when interviewed on the BBC the day before, Dr Jenny Harries, deputy chief medical officer, highlighted that risks of catching the infection could be increased due to the incorrect use and disposal of masks and

“because of these behavioural issues, people can adversely put themselves at more risk than less.”

Dr Jenny Harries, BBC interview, 12th March 2020

Tracking the pieces of advice since then from experts such as Dr Yang and the government, based on the science from Scientific Advisory Group for Emergencies (SAGE), we found the following:

Mid-March to end of March. Panic buying was rife  as rumours spread of an imminent national lockdown. Face masks were on the list of items in high demand and there were reports of opportunists taking advantage of the situation with fake Personal Protective Equipment (PPE) and other Covid-19 related supplies.  Worried about the scarcity of supplies to key healthcare workers, the Government reiterated their advice to the public and stressed that wearing a face mask is not recommended for people with no symptoms.

The UK was put under a strict lockdown on 23rd March.

Early April.  Professor Jonathan Van-Tam reiterated at the daily briefing (4th April) that wearing of face masks by healthy people is not recommended by the Government, he goes on to say that while the practice seemed “‘wired into’ some southeast Asian cultures, there was no evidence that general wearing of face masks by the public who are well affects the spread of the disease in our society” He added: “In terms of the hard evidence and what the UK Government recommends, we do not recommend face masks for general wearing by the public.” Social distancing remained the key mitigation strategy for Covid-19.

Echoing the Government’s messages are those from the WHO and experts from the UK, including Professor Bill Keevil, Professor of Environmental Health at the University of Southampton, who when interviewed by the Evening Standard on the 9th April was asked amongst other questions the following two: If I wanted to make my own, would you recommend it? Why are we seeing more people wearing masks? His answers being:

“No. It will not protect you.” (but in answer to the first question, there was no mention of whether it could protect others.)

“The US government is provoking this new interest in face masks because they have knee-jerked. That is because of the concept of symptomless carriers, who have the virus but do not show any signs of it. So what the US government has done is say: ‘People should wear masks.’ But if people are wearing inappropriate face masks, it is creating a false sense of security.” 

By Mid-April the mayor of London, Sadiq Kahn, was urging the Government to reconsider their advice on facemasks, he said that wearing non-medical facial masks, such as a bandana, scarf or reusable mask, would add “another layer of protection” to the public.  His letter to the Transport Secretary Grant Shapps says he is lobbying for masks to be worn in circumstances where people cannot keep two metres apart, such as on public transport or while shopping.  Mr Shapps however said it is “not the right moment” to encourage people to wear masks – adding that the Government needs to look at all the evidence.

21st April. SAGE met to discuss the advice on face masks.  The minutes to this meeting were published on the 29th May.

23rd April. SAGE submitted their review stating the evidence is weak.  At a daily briefing, Dr Jenny Harries, said the fact the issue was being debated means “the evidence either isn’t clear or is weak”.

She was also asked to comment on whether face coverings could have an effect on the London underground, where she said it was possible there could be “a very, very small potential beneficial effect in some enclosed environments” but no reference was given. Professor Martin Marshall, chairman of the Royal College of GPs, also echoed this and told BBC Radio 4’s Today programme: “there was no research to support wearing a mask if you were fit and well, and there was even a risk of picking up the infection if people were constantly adjusting it and touching their face.” He goes on to say that “I think the guidance that we’re expecting to hear is that the wearing of face masks is a voluntary activity, not mandated, and it certainly makes a lot of sense to focus limited resources that we have at the moment on those who have greatest need and that’s the health professionals.”

28th April. Michael Gove, the Cabinet Office Minister, confirmed that a “domestic effort“ has been launched to slow the spread of coronavirus by producing masks that “limit the droplets that each of us might be responsible for“. However, the Health Secretary Matt Hancock said, “On face masks, we are guided by the science and the UK Government position hasn’t changed, not least because the most important thing people can do is the social distancing… as opposed to the weak science on face masks, there is very clear science on social distancing. That is our absolute priority in terms of the message to the public.” 

Meanwhile, the First Minister of Scotland says Scots over the age of two should wear a cloth covering, such as a scarf or t-shirt, in “an enclosed space where you will come into contact with multiple people and safe social distancing is difficult – for example on public transport or in shops”.  The Scottish Government unveiled its own guidance on this issue, suggesting the voluntary wearing of coverings based on the same evidence and advice from SAGE. Downing Street said the Prime Minister wanted to maintain a UK-wide response to coronavirus as far as possible. 

30th April. Boris Johnson is back at Number 10 chairing the press conference following his stay in hospital and Chequers after contracting Covid- 19: “What I think SAGE is saying, and what I certainly agree with, is that as part of coming out of the lockdown, I do think that face coverings will be useful both for epidemiological reasons but also for giving people confidence they can go back to work” the PM said. The term ‘face coverings’ was used at the Downing Street daily briefings for the first time, a term which sets them apart from medical-quality masks. 

1st May. Ministers have yet to make a final decision on whether the public will be advised to wear face coverings, but the advice from science suggested that they have a weak but also positive effect in reducing transmission from asymptomatic people where physical distancing was not possible. 

4th May. Ministers confirm stockpiling of PPE equipment for healthcare workers and public use.

5th May. A day after PPE was announced, Sir Patrick Vallance told the parliament’s health and social care committee SAGE thinks the evidence on masks preventing the spread of infection from one person to another is “marginal but positive“. 

11th May. Two months after WHO declared a global pandemic, the UK public are urged to wear a face covering if social distancing is not possible. The government’s current (May 2020) guidelines include making a face covering out of an old t-shirt to provide some protection for others you come into close contact with.  

As I review this timeline, two things struck me. The timing of government advice which has been emphasised as “following the science” and the loose use of the word ‘evidence’.  Local Government Minister Simon Clarke told ITV News on the 20th April that the guidance around face masks “remains the same” until a “scientific steer” is given by SAGE. “At the moment this isn’t what is being recommended and therefore it isn’t government policy, we’re prioritising getting material to the frontline. If that advice changes then clearly that is something, we will work to accommodate over the weeks ahead.”  Should the two have been linked – the advice on whether face masks become mandatory of the public based on evidence from science and prioritisation of “getting material to the frontline”?  Does that imply the “scientific steer” is secondary to how much PPE the country can stockpile? 

Given the central role science has taken in this and all other strategic decisions the government has made, it is hard to not feel that the science is politicised and orchestrated at times. To understand why mask guidelines have been so varied, in the US National Public Radio (NPR) reached out to specialists in academia and in government. What they learned was that face mask guidelines are about science — but go beyond. The reasons for a policy may have to do with practical considerations like the national supply of masks but may also reflect cultural values and history.  In Eastern Asian countries, the attitude is perhaps one of “better safe than sorry”, particularly in countries where they had experienced SARS.  

Even though the central arguments and messaging have not changed – not mandatory to wear face masks or coverings in the UK and do not deplete our frontline healthcare workers of PPE, the difficulty in accessing the evidence informing the scientific advice has left me and perhaps many others confused and anxious. In the minutes of the 21st April SAGE meeting it states that evidence (point 10 in the minutes) that exists in marginally positive for the use of masks and RCT (Randomised Clinical Trails) evidence (point 11) is weak and that it would be unreasonable to claim large benefits from wearing a mask. Though evidence was been referred to, these minutes did not form part of the information pack to the public as they were only published on the 29th May.

The Expertise Under Pressure’s Rapid Decisions Under Risk case study spun out of frustration and confusion of where my own professional advice was heading in the field of estimating losses due to natural disasters. I was concerned about accountability but more importantly, I was worried about the impact of science-led advice on the public. By allowing the media to pick and choose what to present to the public, since the evidence used by SAGE has not always been made available, any scientific studies are up to public interpretation and can be taken out of context.  There are many to choose from. Scientific studies exploring the benefits of face coverings in a pandemic would vary in sample size, context and focus.  The phrases ‘randomised trials‘, under ‘medical conditions‘, ‘community settings‘, ‘observational evidence‘ comes to mind. As a member of the public, how do I decipher these terms and what do they mean?  Am I therefore comparing apples and oranges if I try to contrast the arguments based on studies designed with different parameters?

How does a study make the cut to become evidence examined by SAGE?

The image below is taken from a study (preprint) carried out by Aalto University, the Finnish Meteorological Institute, VTT Technical Research Centre of Finland and the University of Helsinki on a scenario where a person coughs in an aisle between shelves, like those found in supermarkets. This was picked up by most news platforms in the UK, including Sky News and the Daily Mail, and was making its rounds on Twitter and other social media outlets on the 10^th April, a month before the official advice on face coverings in public settings was given. Supermarkets in the UK have been urging customers to stay two metres apart while walking down aisles, with long queues seen in car parks around the country as staff limit the number of shoppers entering the store at any given time.  However, the finding from this study that “deadly coronavirus droplets can spread across two supermarket aisles and infect shoppers, with the bug hanging in the air for several minutes.” has never been addressed officially.

With reference to this issue on face coverings, what is the difference between weak and marginal but positive evidence, hence tipping the advice to the public from not wearing to wearing face coverings.  Was it more than just scientific evidence?

This pandemic will test the role of science and scientists in the management of a national and global challenge. There are growing concerns of the independence of advice and some scientists have broken rank and spoken out about the policies supposedly “following the science”. Given Covid-19 is a new virus and a highly contagious and mutating disease, one can be forgiven for being cautious, and a shifting policy based on changing data is expected.  However, the dithering and conflicting (with other countries and even with other nations in the United Kingdom) guidance on face coverings and other issues can only in my opinion harm the trust of the public in science and experts, if the cause of the shifts in strategies are not explained.  In early May, a survey conducted by the Open Knowledge Foundation  found that public trust in science has increased following the pandemic but that transparency is key. They found in the Survation (surveying the nation) poll that people are more likely to listen to expert advice from scientists and researchers, if data is openly available for checking and 97% believe it is important that Covid-19 data is openly available for people to check.

Constructive debate of risks and benefits is essential for any national intervention.  We all need to be prepared to modify our views.  However, open disputes can lead to public distrust and confusion.  We as scientists must think of the common good and duty of care to the audience, even though it is the responsibility of the politicians to make the final decisions. As remarked by Professor Trish Greenhalgh “I conclude by thanking my academic adversaries for the intellectual sparring match, but exhort them to remember our professional accountability to a society in crisis.”  The only way to be accountable is to be as transparent as possible, to offer and take time to explain the scientific evidence, the imperfect and ever-changing nature of evidence.  Perhaps the way to examine the guidance on “to mask or not” is one of precautionary science rather than absolute.

To conclude, there are three main arguments presented here. The first one is that the question about whether masks protect and who they protect is partly cultural because it relies on assumptions about people’s behaviour. The reticence of UK scientists seems to be driven by their sense of how we as a nation would behave with masks, and they will only consider their health effects after some assurance of compliance. But we have all had to change our behaviours for Covid-19, so why would this be one step too far?  The second is that the official advisors are not systematic in the sort of evidence they attend to, in particular they approach the question in an individualist way (will it save me?) instead of a broader communal way (would a community that wears masks be safer?). Lastly, my impression is that the scientific advisors are demanding much too high of a standard of evidence than is warranted by the current situation. The Precautionary Principle seems to argue that masks should be recommended even if the case for adopting them is not 100% watertight. Their cautious approach is also inconsistent since other highly uncertain strategies have been adopted, yet masks remain contentious.

I cannot help but wonder if face coverings would be more common and acceptable if the UK government had made it part of their public health requirement early on.  Afterall, this is a small behavioural change that at a communal level could have an impact on slowing the spread. I for one will be donning a mask to keep my own germs in.

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End note (added 18:30 4th June): Since the publication of this blog earlier today it has been announced that face coverings will be mandatory on public transport in England from the 15 June – showing a further development in the UK’s changing policy on this issue

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Thumbnail image source: Nickolay Romensky – https://www.flickr.com/photos/111977604@N05/49726977771

Disclaimer: Published 4th June 2020. Every effort has been made to scour through the numerous Government websites and reports, relevant papers and stories from the UK media about face coverings over the past two months by myself and my research associate Dr Hannah Baker. However, the author acknowledges there will be key pieces of information she would have missed. This blogpost are her own personal reflections and hers alone.

Public awareness in the Scientific Advisory Group for Emergencies (SAGE), or more specifically the scientists said to be guiding the Government’s COVID-19 decisions, is leading to increased scrutiny and calls for transparency. 

Thinking back to January 2020, in the days we as UK residents were living our ‘normal’ everyday lives, going to pubs, travelling abroad or even being within 2m of strangers and friends and/or family outside our household, very few people would have heard of Chris Whitty and Patrick Vallance who have now become ‘household names’ and even faces, with Professor Whitty, England’s Chief Medical Officer, appearing in TV advert breaks (shown in video below) from the Government urging us to ‘Stay Home, Protect the NHS, Save Lives’ and both regularly taking key roles in the BBC’s daily press briefing on COVID-19. In these briefings, the political figures, often situated at the middle podium, have frequently justified the decisions that have been made saying that they have been guided by ‘the science’.

Professor Chris Whitty, England’s Chief Medical Officer, appearing in Government advert urging the public to stay at home

Many people will now know that there is a group of scientific advisors, with some knowing that they are called the Scientific Advisory Group for Emergencies (SAGE). As defined by Government Office for Science, SAGE are ‘responsible for ensuring that timely and coordinated scientific advice is made available to decision makers to support UK cross-government decisions in the Cabinet Office Briefing Room (COBR)’.

SAGE has provided evidence for events since 2009 (and scientific evidence was also used in events preceding this such as the foot and mouth crisis). Events listed on SAGE’s website are: swine flu, volcanic ash emergency, Japan nuclear incident, winter flooding, Ebola outbreak, Nepal earthquake, Zika outbreak (precautionary), Toddbrook reservoir and of course, now COVID-19. 

The increase in media coverage and therefore public awareness of scientific advice and SAGE is undoubtedly because COVID-19 is an event affecting all UK resident’s lives (and of course lives throughout the world). Consequently, the situation previously described in January 2020 seems like a distant past time. This was spoken about by Sir Ian Boyd (former Chief Scientific Adviser at the Department for Environment, Food and Rural Affairs) in an interview with ITV news: “This is more than just an interesting thing going on, absolutely everybody in the country is affected by it….And therefore there’s a lot more interest in scrutiny in the underlying process.”

With this growing emphasis on SAGE in the media, we thought it would be useful to reflect on some of the questions Dr Emily So (Co-Investigator on Expertise Under Pressure project) had after being called upon as an expert herself in the 2015 Nepal Earthquake, which were posed in our previous blog summarising our ‘Disaster Response | Knowledge Domains and Information Flows’ workshop in February this year.  

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What is the process of turning this information into decisions and action?

The job of SAGE is to pool together scientific expertise to answer questions which are posed by COBR. It is at COBR that the scientific evidence is considered, as well as other advice including evidence from the ‘economic, security, administrative and political spheres’. An analysis of the minutes of previous SAGE events shows that the number of meetings, time frame and number of people involved varies from event to event. These figures are summarised in the first table below. For the Nepal earthquake, there was only one meeting, whilst for Swine Flu, a previous pandemic, there were 22 meetings spanning from May 2009 – November 2010. The number of people attending the meetings also varied and those involved differed depending on the expertise that was required at the time. On May 4th, a ‘list of participants of SAGE and related sub-groups’ for COVID-19 was released (a breakdown of the number of participants in each group is provided in the second table).

A  letter (dated 4 April 2020) from Sir Patrick Vallance, indicated that the frequency and timing of meetings was driven by current events and that “from 1 January to 31 March 2020 SAGE meetings were held on: • January: 28 • February: 3, 4, 6, 11, 13, 18, 20, 25, 27 • March: 3, 5, 10, 13, 16, 18, 23, 26, 29, 31. In addition, a precautionary SAGE meeting was held on 22 January 2020 to discuss scientific questions that were raised by COVID-19.”. During April, reports suggest SAGE met twice a week.

Data source: https://www.gov.uk/government/groups/scientific-advisory-group-for-emergencies-sage

A critique within the media is whether there is enough breadth in the expertise for the COVID-19 response with some feeling there is an over reliance on modelling the pandemic and a lack of public health experts. Another Guardian article suggests the Government have sent out requests to universities to expand the pool following this criticism. Putting that aside, as can be seen by the number of attendees and members of each group, many voices are put forward. However, these voices are not always in agreement and SAGE meetings can include ‘heated and prolonged’ discussions. 

A frustration that is becoming increasingly apparent in the media is questions over what is the science the politicians are referring to and how decisions are influenced by other considerations. In the Centre for Science and Policy’s (CSaP’s) podcast on ‘Science, Policy and Pandemics’ (episode 2), David Spiegelhalter says that we need to be clear the decisions are made by politicians taking into account the scientific advice. Another of many examples is when asked about his thoughts on the exit strategy during a BBC interview with Victoria Derbyshire (20/04/2020), former Prime Minister Tony Blair highlighted how the easing of the lock down will be based on scientific and medical advice but that in the end it is a political judgement.

The reason this overlap between science and politics is causing frustration is that SAGE is only one strand of information feeding into COBR. In an interview with Times Higher Education, Professor James Wilsdon, a professor in research policy at the University of Sheffield is quoted saying “It is problematic if political choices are being made and then the science advice system has to front them up. There needs to be a clearer sense of where science advice ends and political judgement begins − and at times that has been quite blurred”. 

Concerns about this blurring of boundaries between the scientific and political spheres were exacerbated further following The Guardian article revealing that Dominic Cummings and Ben Warner, both political figures, had attended SAGE meetings. In defense of this, a Downing Street advisor said that they were not members of SAGE and would only contribute if there were issues about Whitehall raised. However, their involvement has led to a flurry of reports questioning the independence of SAGE from politics, one example being Bloomberg alleging that Cummings was more than a bystander.

Chris Tyler, Associate Professor in Science Policy and Knowledge Infrastructure, UCL, discusses this further saying that it may be acceptable to let Cummings witness the debate as there are huge areas of uncertainty which need to be understood. However, if as the Guardian article suggests he is able to ask questions, this may risk politicising the scientific evidence before it goes up to COBR.

Whether or not Cummings did have a role in the SAGE meetings, the coverage of this in the media has clearly led to even more scrutiny of SAGE and pressure for transparency of where the boundary between the science and politics lies in the process of making decisions. 

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What happens to the gathered advice after it has been given or the event has taken place?

SAGE has been accused of keeping their advice behind closed doors, with the New York Times describing the operations as being within a ‘virtual black box’. I have briefly touched on the growing calls for transparency due to the increased public awareness and media interest in SAGE as well as the ongoing rhetoric by the politicians that decisions are following the science. Consequently, headlines such as ‘Case for transparency over SAGE has never been clearer’ have been circulated in the last few weeks.

As the pandemic has progressed the reasons for the calls for transparency have varied. In the initial stages, members of the public wanted to know why the UK was not in lock down when other European countries were and what the science, which was continuously being referred to, actually was. This led to the release of the scientific evidence on 16 March. This release, although criticised as being too late by some, was welcomed by several members of the scientific community as it was thought to be vital for building trust with the public.

However, the calls for transparency continued. The requests then became about understanding what the lock down exit strategy will be and who the experts actually are. In response to a request for these names by Rt Hon Greg Clark MP, Sir Patrick Vallance stated: ‘The decision to not disclose SAGE membership for the time being is based upon advice from the Centre for the Protection of National Infrastructure and is in line with the standard procedure for COBR meetings, to which SAGE gives advice. This contributes towards safeguarding individual members personal security and protects them from lobbying and other forms of unwanted influence which may hinder their ability to give impartial advice. Of course, we do not stop individuals from revealing that they have attended SAGE.’ (4 April 2020)

Since that response, the revelation that political figures had sat in on SAGE meetings increased the pressure from the media to identify the experts. Reports, including one from the New Scientist (27th April), indicated that Patrick Vallance had said the list of names would be released after the  experts had been given the option to opt-out of being identified. This list was released on 4th May, followed by an additional release of evidence on the 5th May.

Some calls for transparency are going even further with requests to release the minutes of SAGE meetings to understand why decisions were actually made. Sir David King, a former Chief Scientific Advisor, has also formed an ‘Independent SAGE’ with the first meeting (4th May) taking place via livestream on Youtube, this group was called ‘a rival panel of experts’ in the media.

Transparency is not a new concept and it is commonly referred to in the disaster management literature. Even in reference to SAGE, previous reports (pre COVID-19) have called for a more transparent process. Transparency is sought to develop trust with the public, as well as allowing the net of expertise to be cast further by giving other scientists and wider research community the opportunity to scrutinise the evidence before decisions are made, with the reason being that external scrutiny can help to avoid groupthink and identify blindspots. A counter argument here being that the decisions are being made in a time constrained environment and is there time to hear all these voices? Furthermore, there are concerns about how to ensure that those voices are from those with the relevant expertise: “The world wants to know what the science is behind the decisions, but there is great danger of misinformation when media interest is amplifying the voices of scientists, but not necessarily those most qualified to comment.”  (Gog, J. 2020).

It is abundantly clear from the newspaper headlines that there has been growing critiques of SAGE being ‘secret’ and the decisions happening behind closed doors. Consequently there have been calls for this evidence to be in the public sphere to allow for scrutiny but also build trust with the public. This pressure from the media and public appears to have led to the release of evidence and experts’ names, with the Government Office for Science recognising “In fast moving situations, transparency should be at the heart of what the government does”.

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What if the experts are wrong?

It is far too soon to know what was the right or wrong action to take and perhaps we will never know as there are so many parameters to consider, but when looking at this question there are a few things that I want to discuss: uncertainty, consensus and blame, which are not mutually exclusive from one another. 

After her own involvement in the Nepal earthquake’s SAGE meeting, Dr So posed this question ‘What if the experts are wrong?’ as she knows that there is uncertainty in the models that make casualty loss predictions for earthquakes. Obviously there is lots of uncertainty in this pandemic, be it the spread of infection, death rates or impact of interventions. To avoid being ‘wrong’ this uncertainty needs to be communicated to both the decision makers and the wider public. 

I have already referred to the heated discussions within SAGE. There have been reports, including one from Buzzfeed that there was no consensus as to when the lock down and social distancing should be implemented. With some scientists arguing that it needed to be introduced immediately to halt the spread of the virus and “pleaded with the government to change tack or face dire consequences”, whilst others felt that introducing social distancing measures at that point in time would be unsustainable and lead to a second wave of infection. Within this same article Vallance is reported to have said “If you think SAGE is a cosy consensus of agreeing, you’re very wrong indeed”. What is key here is that these areas of agreement and disagreement are passed up to COBR (as well as the uncertainty) in the evidence being presented.

The most concerning aspect related to whether or not experts are right or wrong is the ‘blame game’ as accusations have come out that Boris Johnson’s team are using the scientists as ‘human shields’. We are now seeing experts expressing concern with the politicians language which can be misinterpreted by the public that decisions have been made by the scientists. In his interview with ITV, Sir Ian Boyd states that he always told ministers it’s dangerous to say ‘I will follow the science’ as ‘essentially what they are doing is shifting the decision making role from them to the scientific advisors. And it would be better if they said ‘I will be strongly advised by the science’ or something like that’. Another issue with this phrase is that it doesn’t always acknowledge that ‘in reality the science of this crisis had been “riddled with doubt, uncertainty, and debate‘ (Professor Robert Dingwall, a member of the New and Emerging Respiratory Virus Threats Advisory Group).

Many feel that a judicial review is inevitable following COVID-19. To avoid a blame game of who was right or wrong, it is important in the coverage of SAGE and the evidence presented to acknowledge the uncertainty and that there is not always consensus. A previous post by EuP Research Associate Federico Brandmayr speaks more about these issues of responsibility by considering what COVID-19 could learn from the L’Aquila earthquake.

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It seems obvious that an increase in public awareness of scientific advice has led to increased scrutiny and calls for transparency of SAGE. By reflecting on the questions posed in our previous workshop, it has inevitably led to even more questions in relation to the use of scientific expertise in emergency response situations and I will now conclude by highlighting three of these:

• Decisions go beyond science. It needs to be clear where the boundary between the scientific, economic and political spheres lies rather than repeatedly saying that decisions are following the science. Where is this line drawn? Is there even a line?

• SAGE is receiving critique for being secretive which has led to numerous calls for transparency for both the scientific evidence and names of experts. This is considered important by many to develop and maintain trust with the public and also allow for the scrutiny of evidence by a ‘larger net of experts’. Delay in the release of names was due to concerns the experts may be put under undue influence. Perhaps a question for ‘next time’ is ‘How do we create an appropriate environment to allow for the open interrogation of evidence?’.

• To avoid experts ‘being wrong’, the communication of uncertainty is vital, as well as recognising that there might not actually be a right or wrong answer based on the evidence that experts have available at the time. In such an uncertain, time-pressured environment, disagreement is inevitable. These areas of consensus and disagreement need to be passed up to COBR to consider and also be communicated to the public for a truly transparent process. Has uncertainty been clearly communicated in the UK’s and worldwide response to COVID-19? If not, what should have been done differently?

Throughout the next few months, the EuP team will continue to reflect upon questions which COVID-19 has raised for our project through our series of blog posts with the overarching aim being to develop our understanding of the role of experts in bringing about social change.

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Text by Hannah Baker (published 5/05/2020)

Chris Whitty image source (thumbnail): Unknown photographer / OGL 3 (http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3)

As part of our new series on expertise and COVID-19, Mike Kenny and Anna Alexandrova interview Professor Erik Angner of Stockholm University. Erik is a philosopher and an economist writing on behavioral economics, economists as experts, measurement of happiness and wellbeing, Hayek, and the nature of preferences among other topics. Recently he has commented on the need for epistemic humility and the uniqueness of the Swedish response to the pandemic. In the podcast we discuss cultures of expertise, contestation, politics of behavioral science, and the relation of all three to the current crisis:

Listen to the segment on comparative cultures of expertise in Sweden and the UK, starting from 1:54

Responsibilisation of experts and disagreement between them, starting from 8:00

Who gets included in powerful expert groups, who gets sidelined and epidemiology as the current queen of sciences, starting from 16:11

Trust in epistocracies and its fragility, starting from 23:30

Value judgments in expert advice and how to make them responsibly, starting from 26:10

Discomfort of uncertainty, starting from 31:50

Behavioral science, nudge politics, absence of social science in all this, starting from 41:45

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Text by Anna Alexandrova (30/04/2020)

Dr Emma Doyle

Dr Emma Hudson-Doyle is based at the Joint Centre for Disaster Research at Massey University/GNS Science, Wellington, New Zealand. Her interests lie at the interface between physical science and critical decision makers, with a primary focus on the communication of science advice during natural hazard events. Current research focuses on the communication of forecast and model uncertainty. Other research areas and supervision topics include community resilience, social media in disasters, citizen science, aftershock forecasts, early warnings, motivations to prepare, communicating probabilities, low likelihood risk, and visual uncertainty, and exploring the use of science advice through table top emergency management exercises. 

We contacted Emma before our ‘Disaster Response | Knowledge Domains and Information Flows‘ workshop for her viewpoints on the questions that were being addressed throughout the day and to act as a foundation for conversation in the focus group discussions. We would like to take this opportunity to thank Emma for giving up her time to provide us with her answers, which can be seen below.

What type of knowledge is and should be used?

This depends upon the problems and issues you are trying to address. Adopting a problem/solution focus – rather than a ‘knowledge’ focus, and thinking about the needs and concerns of the communities, organisations, and others affected by a disaster will lead you to understand which knowledge is needed. We must move from a ‘deficit’ model of communication and knowledge sharing where we assume we know what others need, towards a two-way partnership model. Accordingly, scientific knowledge may then work in partnership with (for example) indigenous knowledge, complementing each other to address the issue at hand.

What constitutes as an expert?

Similar to above, there are many different experts. We need to move away from a generic label of “the expert” to more specific labels “the landslide expert”, “the psychology expert” etc. This respects more equally the different disciplines and epistemologies at the table, as it recognises each has expertise. Thus, with this in mind, I envision an expert as someone with extensive experience and training in a field or topic, able to make informed judgments by drawing on the evidence available. This training may not be formal/university, and thus an expert can include local community experts, etc.

How is and should uncertainty be factored into decisions and communicated?

There are a range of different academic views debated on this: On the one hand: people advocate for not communicating the uncertainty at all, as it can cause people to mistrust or deny the message, view the communicator as incompetent, allow people to interpret the information to one end member state of uncertainty, or even cause harm if the decision maker does not take a safety action because of uncertainty. On the other hand: people advocate for communicating all uncertainties as it is ethically and morally the correct action, the communicator is more honest and trustworthy, it enables decision makers to plan alternative courses of action, and is the true state of the knowledge. I think there is a happy medium somewhere in the middle: if we were to communicate all the uncertainties it would be overwhelming during short time, high pressure, decision-making situations. However, it is important to communicate them to enable decision makers to make the best decisions with alternative actions. In order to assess what to communicate, we must thus first identify the decision-makers’ needs – through relationship building activities so we can understand which uncertainties are relevant to them and their decisions, and which are not. Ideally this should be identified in pre-event planning, so that during an event, scientists and others provide a ‘targeted’ supply of information to meet the decision-makers’ needs, communicating only the decision-relevant uncertainties – communicating all uncertainties could overwhelm a decision-maker with information (causing cognitive overload). Please see the attached for more discussion of this… 

What happens to, and should happen to, knowledge after it is produced and the event has taken place?

This is a tricky one: it depends whose knowledge it is. If it is publicly funded, then it should be publicly available to aid other communities, and future resilience building. If it is privately funded, one would hope it could be publicly available, but there may be company rights that mean it can not be. If it is indigenous knowledge, then (depending on the customs of the indigenous people of the region), it is for the indigenous owners of that knowledge to decide. 

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Thank you again to Emma for these responses.

Responses received on the 6th February 2020.