In the third part of his investigation, Nafeez Ahmed reveals how laissez-faire attitudes have hampered a proper response to the Coronavirus pandemic in the UK.
Health Secretary Matt Hancock has denied that the Government ever adopted achieving ‘herd immunity’ as an official goal in tackling the Coronavirus outbreak. But new reports from sources who claim to have attended a private Government briefing in February say that they heard Prime Minister Boris Johnson’s chief advisor Dominic Cummings advocate a policy they described as amounting to “herd immunity, protect the economy and if that means some pensioners die, too bad”.
Downing Street has said that the claim is fabricated, yet official documents published on 20 March by the Government’s Scientific Advisory Group on Emergencies (SAGE) confirm that senior officials were discussing the idea of ‘herd immunity’ a week before the concept was publicised by Government advisors. They suggest that the nebulous outcome of ‘herd immunity’ was, if not a central goal of Government policy, certainly factored into its strategy.
Accepting the Epidemic
On 11 March, Dr David Halpern, a member of SAGE and chief executive of the UK Cabinet Office’s Behavioural Insights Team – otherwise known as ‘the nudge unit’ – told the BBC: “There’s going to be a point, assuming the epidemic flows and grows, as we think it probably will do, where you’ll want to cocoon, you’ll want to protect those at-risk groups so that they basically don’t catch the disease and by the time they come out of their cocooning, herd immunity’s been achieved in the rest of the population.”
Four days later, the Government’s chief scientific advisor Sir Patrick Vallance told Sky News that he expected some 60% of Britons would need to contract the Coronavirus in order for the population overall to develop “herd immunity” from future outbreaks.
Matt Hancock subsequently retracted these claims and denied that achieving herd immunity was ever a UK Government strategy.
But the SAGE corpus reveals that, a week before Halpern spoke publicly about herd immunity for the first time, the Government’s behavioural science advisors had secretly referred to the idea as a way of scientifically justifying the Government’s inaction to the British public.
They did not, however, marshal any actual scientific evidence for the notion. As we found in Parts One and Two of this investigation, the Government’s strategy was, until 16 March, alarmingly out of sync with a wealth of scientific data – and had, according to an Imperial College study, put at least 250,000 Britons at risk of death.
I asked Dr Jason Hickel, of the London School of Economics, why he thought that the Government had insisted on such a destructive course of action, oblivious to the emerging evidence of successful action in places such as Singapore and South Korea.
“I think it’s partly because they feared that rapid action would take a toll on the economy; they were literally weighing GDP and stocks against people’s lives,” he said. “It’s partly also because they were simply not paying attention to the evidence coming out of China; they had weeks to prepare and they blew it.”
Making Government Strategy ‘Acceptable’
An SPI-B document dated 4 March, which rejected the need for school closures, went on to refer to the medical concept of immunity. In a discussion about how the public might be confused about the disparity between the Government’s approach of “not applying widescale social isolation at the same time as recommending isolation to at-risk groups”, the document acknowledges disagreement within the SPI-B.
The document explains: “One view is that explaining that members of the community are building some immunity will make this acceptable. Another view is that recommending isolation to only one section of society risks causing discontent.”
The idea of immunity does not come up elsewhere in the SAGE corpus. But, Professor Chris Whitty, the Government’s Chief Medical Advisor, claimed that 20% of the population of Wuhan, China, had contracted the Coronavirus and acquired herd immunity. He believed that this explained why new cases had begun to fall in China.
This flatly contradicted data from China showing that, by end of January, after the crisis had peaked, just under 95% of the Wuhan population remained uninfected by the virus. This was, therefore, nothing to do with herd immunity, but a result of China’s emergency containment response.
The UK Government, it seemed, had made a gamble: one that Dr Brian Ferguson, Director of Immunology at Cambridge University, described as “not scientifically based and irresponsible” because typically “Coronaviruses don’t make long-lasting antibody responses”.
Whether or not it was a specific goal of the Government, its network of behavioural science advisors had fielded herd immunity as a way of justifying to the public why the Government was not taking early action – despite having no scientific evidence behind the idea.
Costs, Benefits and National Experiments
Indeed, the one thing that stands out across the SAGE corpus is that, until 16 March, there is never any specific, consistent advice to the Government demanding urgent action to slow or stop the spread of the virus.
David Halpern’s role as the first senior Government official to speak publicly about the herd immunity strategy puts this into context.
As a Number 10 advisor to the then Prime Minister David Cameron heading up the ‘nudge unit’, Halpern distinguished himself in 2012 by calling for the retirement age for elderly people to be lifted above the age of 70. He also blamed them for exacerbating the housing shortage by staying in large houses with empty rooms.
Halpern’s job is to harness behavioural science in Government to ‘nudge’ people into behaviours which save Government costs and drive up national GDP.
Writing in 2016 in the Behavioural Science & Policy journal, Halpern explained that “the aim” of the nudge approach is “to influence people’s choices through policies that offer the right incentive or hurdle so that people choose the more economically beneficial options”.
“Behaviorally inspired interventions can help Government agencies save hundreds of millions of dollars per year,” he added. “The UK Government’s Behavioral Insights Team is delivering monetary benefits in the region of hundreds of millions of dollars, if not billions.”
In 2018, the Cabinet Office explained – in response to a request under the Freedom of Information Act – that “the Behavioural Insights Team supported a range of Government policies ranging from tax collection, through to health, crime, education, employment, economic growth and international development”.
Under Boris Johnson’s premiership, Halpern received a promotion to the role of What Works National Advisor across the whole of Government. This role, according to a Government announcement about the appointment, “is to provide advice to ministers, the Cabinet Secretary and other leaders in Government on what evidence shows to be cost-effective in delivering policy outcomes”.
Apart from being concerned about cutting Government spending and lifting economic growth, Halpern’s nudge effort also frequently uses behavioural experiments to test and improve different approaches.
His approach “depends a lot on experimentation and the nudge unit has championed wider use of experiments in Government,” according to the Institute of Government, which Halpern founded. “The nudge unit is working closely with the Department of Health and Social Care in crafting the Government response. The most visible manifestation of its influence to date is in the communication around hand-washing and face touching.”
The less visible manifestation of the nudge unit’s influence, it seems, was promulgating the idea of herd immunity as a way to justify the Government’s inaction on COVID-19 for nearly two months.
Prior to the COVID-19 crisis, the ‘nudge unit’ was extending a pseudo-scientific “experimental” cost-benefit approach obsessed with economic metrics across the UK Government. While the approach may well have had some uses, it was fundamentally ill-suited to understanding and managing the impacts of a complex global public health emergency.
It is difficult to avoid the conclusion that the Government’s inability to respond properly to the crisis was rooted in the growing prominence of ‘nudge thinking’ across Boris Johnson’s Government.
According to LSE’s Dr Jason Hickel, the related prevalence of neoliberal ideology – which sees a diminished role for the state in an economy dominated by unregulated private power – played the key role in confusing the Government’s capability to respond decisively in the public interest.
“It’s partly because their minds are so strafed by neoliberalism that they cannot imagine how to function as an actual state,” he told me. “It’s all just ‘nudges’ and individual responsibility and laissez-faire.”
The evidence supports Hickel’s verdict. The interplay between the bad science on ‘herd immunity’, the questionable modelling, and the Government’s background obsession around ‘balancing’ COVID-19 responses against economic growth considerations, created a perfect storm of laissez-faire incompetence that ended up escalating the transmission of the virus.
And this, as The Lancet editor Dr Richard Horten has lamented, ramped up the scale of entirely preventable deaths – with the epidemic now overwhelming an underfunded and ill-equipped NHS. By allowing the crisis to escalate, and with its scientific advisory groups in disarray, the Government is being gradually pulled into increasingly dystopian, draconian actions as the crisis spirals out of control.