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Thu 29 October 2020
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Nafeez Ahmed reveals how outside pressure weighed on SAGE to prioritise ‘supply chains’, the ‘wider economy’, ‘workforce’ and ‘business’

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Documents published by the UK Government’s Scientific Advisory Group on Emergencies (SAGE) throw light on how overarching concerns about the economy derailed efforts to suppress the Coronavirus, resulting in a worst-of-all-worlds scenario: maximum fatality rates combined with the worst economic performance. 

One of the most consistent themes that emerges from the minutes of SAGE meetings is how the Government repeatedly expected its scientists to account for the economic impact of lockdown restrictions – even though SAGE was not doing any economic modelling.

The minutes reveal that economic modelling of the potential consequences of social distancing measures was being conducted by other Government departments such as the Treasury and the Actuary’s Department.

This evidence emerges in the context of a Government decision, from the outset, to refuse to consider the goal of suppressing the Coronavirus as a viable option.


Avoiding the Inevitable

The SAGE minutes confirm that the Government at no time considered attempting to prevent the Coronavirus from becoming endemic in the UK. They also show how social distancing measures were constantly and repeatedly pitted against economic considerations. 

In fact, on 3 February, the main concern was protecting UK “supply chains” rather than enforcing early restrictions that could have helped to prevent the virus from entering the country.

The SAGE minutes at the time said that preventing “imported infections” would have required “draconian and coordinated measures” at the border and that “stopping travel would also have other impacts, including on supply chains”.

Almost all social distancing measures that were later adopted were dismissed out of hand.

The minutes show that SAGE had assumed that reducing imported infections by more than 95% would only delay the onset of the epidemic in the UK by about a month, rather than preventing the bulk of it. But this assumption was false and at odds with progress being made elsewhere.

While the UK was refusing to close borders over fears about “supply chains”, other countries such as New Zealand, South Korea and Singapore were doing the opposite and successfully managed to suppress the virus within a shorter time-frame.

The next day, the Government’s scientific advisors seemed to agree that the spread of COVID-19 in the UK would be inevitable and that the focus was not to prevent this spread, but to merely “delay” it in order to improve “NHS readiness and ability to handle cases”. 

Meanwhile, almost all social distancing measures that were later adopted were dismissed out of hand. School closures, the banning of public gatherings, shutting down public transport and other measures were described as “probably relatively ineffective”.

But the SAGE documents suggest that this dismissal was less the result of science and more from being compelled by the Government to consider economic factors. 


No Social Distancing Modelling

Earlier released SAGE documents relating to school closures showed that SAGE had put forward ample evidence of their effectiveness based on preliminary literature reviews of existing scientific literature.

Early action, it was acknowledged, could potentially reduce an epidemic by as much as 60%. But, somehow, this data ended up being filtered out of SAGE’s final recommendations to the Government.

The SAGE minutes suggest that this was because of the constant insistence from the Government that the “economic consequences” of such social distancing measures needed to be accounted for. SAGE had also never been requested by the Government to do specific modelling of social distancing measures until much later.

Given the Government’s reliance on modelling to formulate its strategy, the failure to have detailed modelling in place for social distancing strategies three months into the crisis is damning and suggests that such preventive measures had not been given serious consideration.

As the journalist Stefan Simonowitz has observed, “the failure to do epidemiological modelling for lockdown until mid-March” meant that the Government had guaranteed it would not receive “any alternative ‘design options’”.

Meanwhile several other SAGE documents prior to March made explicit reference to how social distancing measures would have negative impacts on the economy.

By 11 February, SAGE attendees made clear that they expected “widespread transmission” in the UK and that the virus would peak two to three months after this.

However, at this time, the Government was already planning to put an end to contact tracing. The minutes show that Public Health England (PHE) would work with a SAGE sub-group, the infection modelling team (SPI-M), to “develop criteria for when contact tracing is no longer worthwhile”.

The same document shows SAGE advising that the Government “should plan for impacts on the NHS and also on the wider UK workforce”. The Government was, in other words, weighing up public health against wider economic concerns.


Blaming the Lockdown for Deaths

Two days later, the SAGE minutes were even more explicit about the role of economic considerations in Government reluctance to implement early social distancing.

Following a discussion of why there was no point in attempting to prevent transmission of the virus across the UK, the document referred to the option of school closures to delay either the first wave of the epidemic or its peak. It then added: “Either would have impacts on schools, other services and the wider economy.”

The minutes went on to call for SAGE to revisit the effects of school closures at the next meeting, including on “workforce consequences”. Notably, the Prime Minister’s chief advisor Dominic Cummings’ top advisor in Downing Street, Ben Warner, attended this SAGE meeting.

Such concerns were reiterated on 23 March, the SAGE minutes for which revealed that analysis of the “economic consequences” of social and behavioural interventions was to become a separate Government research programme in itself. “Given the clear links between poverty and long-term ill health, health impacts associated with the economic consequences of interventions also need to be investigated,” the SAGE minutes recorded. 

The Government was keen to find evidence that the lockdown itself would be a major cause of death. In a section titled ‘Excess Deaths Planning’, the SAGE minutes state: “Actuarial analysis is required to estimate the number of deaths caused indirectly, including those caused by the social interventions… In due course, analysis of the effects of the interventions on other causes of death should be undertaken.”

Towards the end of the month, this goal was reiterated even as SAGE was already under pressure to explore how to lift the restrictions just put in place. 

On 26 March – three days after the lockdown began – SAGE was tasked with shifting attention to “future phases of the epidemic” during which the Government would “release current measures safely and advise on long-term issues”. 

The SAGE document dated 31 March further confirms that economic modelling was feeding into Government decisions and scenario planning – and would continue to do so.

Discussing future SAGE research priorities, the minutes recorded that “[The Treasury] provided an update on economic work being considered elsewhere”. The minutes also noted that among further questions to be studied by SAGE was the issue of “long-term impacts of interventions on health, including socio-economic effects on health”. 

Attempting to model the deleterious economic impacts of the social distancing measures appears again and again over the ensuing weeks. 

On 2 April, even as SAGE warned the Government in no uncertain terms of “a danger that lifting measures too early could cause a second wave of exponential epidemic growth”, the minutes refer to an ongoing programme of Government economic modelling that was being conducted separately to SAGE.

The integration of such modelling appears to have been discussed at this meeting. The minutes record the results of that discussion: “SAGE agreed it is not advisable to combine epidemiological and economic or secondary health effect analysis in a single model.”


Vote Leave Economic Modelling

To their credit, the SAGE scientists had resisted the idea proposed at the meeting that the Government should be making its public health decisions using a single model that would combine public health issues with economic modelling. 

Nevertheless, that modelling was still going to continue elsewhere, including with support from the Actuary’s Department: “A group led by Ian Diamond and John Aston – and including NHS, HO [Home Office], Government Actuary’s Department – is considering longer-term impacts on overall health from the interventions as part of its work on excess deaths.” 

Formerly part of the Vote Leave campaign’s data science team, Ben Warner had attended both this and previous meetings where this economic dimension was mentioned explicitly. In the last meeting, Warner had been joined by another senior Government official Vanessa MacDougall from the Treasury. 

MacDougall is Director for Economics and Deputy Chief Economic Advisor at the Treasury, advising ministers on “the outlook for the UK economy and the evidence base for macroeconomic and microeconomic policy development to support UK growth and productivity”.

Less than a week later, SAGE was again asked to “consider direct and indirect health impacts of measures, both on COVID-19 cases and more widely (e.g. postponement of other NHS care, and socioeconomic effects).” Consistent with previous minutes, this work would not be done by SAGE, but by a “subset of SAGE participants and other experts”.

To date, the Government has not published these economic models. But it seems difficult to avoid the conclusion that they played a key role in its COVID-19 strategy.

The SAGE minutes confirm that the Government did not ‘follow the science’. Neither social distancing nor test and trace were modelled for their public health ramifications by SAGE until mid-March. Data on NHS capacity, too, only hit the Government’s radar around this time. Why was this scientific research hamstrung for months as the Government watched COVID-19 sweep through the country?

Read Parts Two and Three of this investigation below


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