UK Inquiry Module 2: Decision-making & political governance

[elbows]

Stay at home orders are then discussed, mostly obvious stuff, and then on page 124:

Q: One of the more important points in this chapter concerns the recognition of the effectiveness of social distancing and the importance of social distancing in care homes --
A: Yes.
Q: -- because some of the research showed, quite plainly, that the strict cohorting of staff alongside residents, and restrictions on visitors, was associated with significantly reduced transmission, again unsurprisingly?
A: Yes. I think that's exactly right. I think that none of this is surprising when you think about the first principles of stopping an infected person infecting an uninfected person. But that is absolutely right: in care homes, if you could restrict the movement of care workers, for example, between different care homes or between different populations, that reduces the chance of anyone infected, in this case an infected care worker, infecting large numbers of people. So that's important.
Equally, if you have got people in a care home who are infected, then keeping the staff that look after them separate from uninfected people is important.

Then test, trace and isolate, and mention of the test app on the Isle of Wight, and by pages 126-127 we have:

A: The evidence overall is strong that if test, trace and isolate is applied early, and effectively, then it's actually quite a powerful measure, and we may come back to it when it comes to the discussion of Korea.
But almost all of these interventions -- the other thing we haven't specifically talked about is sort of the force of transmission. In other words, when there are a very large number of cases in a community, so the exposure goes up. And in the case of test, trace and isolate, when you've got very many cases then it's very difficult to apply it at a national level. So with all of this, early application is important.
Q: That's a point, if I may suggest, of enormous importance in the case of the United Kingdom, because the position was, wasn't it -- and it's well established -- that there was no significant or comprehensive test, trace, isolate system in the United Kingdom in the early days?
A: Yes.

Q: What the evidence from South Korea, along with New Zealand, Australia and a number of other countries shows, that if there is in place such a system, it becomes possible for the government to be able to control the spread of the virus before it runs away?
A: Yes. I think that is correct. It is, of course, difficult to extrapolate between different countries, because of course the application of all of these non-pharmaceutical interventions depends on all sorts of social and cultural issues as well.
Q: Of course.
A: Korea was very well prepared because it had had the outbreak of MERS in 2015, and I think it's fair to say that not only the government was more prepared but the community was aware of what happens when you have a dangerous virus in your country, and so they were able to adopt -- so testing on its own with sort of voluntary isolation doesn't work nearly as well as if you've got very systematic testing, coupled with the tracing and the isolation. Those are the key other elements.

Pages 128-129:

Q: If the level of incidence is too high, no system of test and trace, however sophisticated, could get on top of the problem?
A: When the level is very high, then, you know, essentially you end up testing, tracing and isolating the whole country, which is where you need -- you get to lockdown measures. So it is exactly as you describe, it's when you have geographically limited and low levels that you can remain able to test at sufficient scale and bring it under control without locking down everyone.

Q: We may never know what the effect would have been had the United Kingdom had a comprehensive scaled-up test and trace, isolate system at the beginning, but is there anything that can be said about the levels of incidence, the incidence -- the level of spread of the virus, in the early days in the United Kingdom?
A: Well, the one thing we do know is that in February of 2020 there were about 1,500 independent importation of cases which was across the whole nation from people who'd been away during the half term school holidays in Italy, Spain and Switzerland, who had been on skiing holidays, and because they were a young and fairly fit population, they managed -- the sort of severe morbidity wasn't really seen in that population. So the UK was hit in a very widespread way very early. We didn't have tests nearly as early at scale as Korea did. So a lot of this comes back to the evidence I gave actually in Module 1, which is: the real challenge for nations is to be prepared.

Q: Of course. And were genomic studies in fact subsequently carried out, in particular a main study in the summer of 2020, which was able to trace back the genetic origin of a large number of infections --
A: Yes.
Q: -- in the United Kingdom to viral infections in France, Spain, and Italy?
A: Yes. That is correct. And as a result of that we knew that these were independent introductions.

 

[elbows]

Skipping some of the stuff on border controls, that points ends with this on pages 132-134:

A: ...But I think the real point about the travel measures is that, again, you have to implement a comprehensive package for them to be effective. And I think New Zealand is quite an interesting example we'll come to, where they have the advantage that they're geographically isolated -- I mean, basically you get there by plane or occasionally by boat, ship -- but they found, even with the most stringent application of border controls, there would still be influx into the country. So, for example, at the border it may be that a border official or someone supervising a quarantine facility could become infected and carry the infection into the country. So border controls are only effective in the context of other stringent measures as well.
Q: So that we may be clear, in those small number of countries where rigorous border closures enabled those countries to keep a tight grip on the virus and, by and large, thereafter to avoid long, stringent --
A: Yes.
Q: -- national lockdowns, for example, those border closures were coupled with other NPIs, but in particular TTI, test and trace?
A: Absolutely, it was test, trace and isolate coupled with border controls, and of course it was found that long periods of quarantine were more effective than short, that compulsory quarantine was more effective than voluntary quarantine, and later on in the pandemic it was found that you could probably reduce quarantine times if you did daily testing. But effective quarantine, if you're trying to keep your border as a barrier, is -- was an essential feature as well.

They then discuss the dissapointment that they didnt manage to get anything but weak experimental evidence of the effectiveness of environmental measures (eg ventilation) but that absense of such evidence doesnt mean there isnt an effect from such things.

Then a discussion about communication and its role, including on page 136:

Q: I in fact was reading out the words of the report itself, Sir Mark:
A: "Trust was the most common factor impacting communication effectively."
Q: Yes. Absolutely.

Page 137:

Q: Secondly, could you just elaborate, please, on the importance of knowledgeable and trusted local groups and leaders as communicators? So in the particular context of members of ethnic minorities, how important is the existence of knowledgeable and trusted local leaders in the communication of NPIs and the promotion of trust?
A: I think one can extrapolate from advice, say, on vaccines to NPIs, because I think there is a sort of common denominator; and certainly when it comes to improving uptake of vaccines, then there's pretty good evidence that people trust people who they feel are like them, in similar cultures, more. So it is important to have that communication distributed and reflecting the diverse nature of a community.

Q: Firstly, how important in the development of trust and promulgation of effective communication is the need of consistent messaging and the absence of conflicting or changing messages?
A: I think that there is little doubt that consistent messaging is extremely important, and that then takes us to how uncertainty is communicated as well. And uncertainty is sometimes communicated as: X has one opinion and Y has a completely opposite one, and that then sends very confusing messages.

Pages 138-139:

Q: Because you were looking technically at research emanating from the United Kingdom, was one of the findings of the report that government guidance in the United Kingdom -- which had, as we know, changed multiple times, and of course changed across devolved administrations as opposed to the United Kingdom -- led to the potential for non-compliance, simply because people became either confused or desensitised?
A: Yes. I'm not sure that the evidence is that rigorous on that, but I think it's a reasonable interpretation of what happened.

Q: Thirdly, to what extent is an absence of scientific certainty damaging to the efficiency or efficacy of communication? So, putting it bluntly, to what extent does a population need to know the scientific basis for what it's being told in order to make it comply?
A: Well, but that's an interesting question, but it goes back to the start of the pandemic and even at the end there were huge numbers of things we didn't know, and actually an important part of the communication is to communicate what is not known as well as what is known.
So, whilst everyone would like perfect answers as soon as possible, we started with hardly any specific answers, we had generic answers, and so that I think is a sort of more general issue of communication of uncertainty and the communication of science in general. It's the whole nature of science to be sceptical, actually, to want further evidence. And I think the evidence is actually that the public, and there isn't one public, but public audiences did accept and understand the fact that there are things which were not known.

 

[elbows]

Then they discuss comparisons to other countries and how the previous witnesses report covers a lot of that stuff and is very useful. Skipping over some of. what they mention here, a point about New Zealand is reiterated on page 144:

Q: Therefore although there was a one-month strict lockdown and a whole series of local lockdowns, so attempts to suppress local outbreaks, and a fairly low level of domestic NPIs imposed, New Zealand remained mostly transmission free until late 2021?
A: Yes, that's correct. I think New Zealand provides a very clear illustration of what is needed to make border controls work, because we do have very good data, and what they found was that in spite of having rigorous quarantine there were still cases that were brought into the community by probably people working in and around the borders, and by using testing, tracing and isolation they were able to keep those under control, but from time to time there were then episodes that suggested there was domestic transmission occurring, so you wouldn't have been able to do contact tracing right back to the border, and under those circumstances they imposed quite strong localised lockdowns.
So I think it's an extremely good example of how, if you're going to make border closures work, you have to do a whole lot of other things as well.

South Korea is then discussed, including how much tracking of the population they had, and how fast they scaled up their testing capacity. I usually end up thinking that when discussing these successes and preparedness in countries like South Korea, its a shame more attention isnt paid to their ability to control the spread of infections in hospitals too. I think I remember seeing photos which demonstrated what sort of extreme forms of protection they were using on healthcare workers who attended to known/suspected covid cases early on, but I dont see those sorts of dots getting joined up to that extent, including in this inquiry so far.

This witnesses evidence session then concludes with various points about the importance of evidence, of collecting it in between pandemics too, the effect they might hope it has on policy etc. And at the end, pages 155-156 we have:

LADY HALLETT: Can I just ask one question, and this positively is the last.
Given the importance you place or the study -- your report places on having a scalable system of test, trace and isolate --
A: Yes.
LADY HALLETT: -- have you got any estimation of what our position is like today here in the UK?
A: I think it is not as strong as we would like it to be. But that is a judgement, and I should probably resist it.
LADY HALLETT: And I didn't give you notice of the question, but I thought I'd just --
A: I think there is much more to do, and we talked in my last appearance about the work of Dr Kirchhelle, who is one of your advisers, on the history of public health, and I think that the disinvestment in public health, not just in the UK but in the richer countries of the world, needs to be tackled. But that is a personal opinion rather than the sort of -- yes. It goes beyond this report, that's for sure.

 

[elbows]

Last Thursdays transcript: https://covid19.public-inquiry.uk/w...2858/2023-10-12-Module-2-Day-8-Transcript.pdf

The first witness is a civil servant, head of GO-Science, and was on the Civil Contingencies Secretariat in the past too (though not during the pandemic). GO-Science is a small department thats there to support the Chief Scientific Officer.

A lot of the evidence was pretty dull structures of government stuff, eg what is SAGE, how they had to scale SAGE up to deal with this pandemic, how hard everyone in it ended up working, gaps elsewhere that it ended up having to fill. And the modelling subgroup of SAGE, and the behaviours subgroup, and what NERVTAG is.

He was asked whether the SAGE subgroup on ethnicity should have been setup sooner than it was, and about there being no Long Covid subgroup. The answers werent very illuminating.

They were also asked whether there was any resistance within government to publishing the SAGE minutes etc. They didnt give a useful answer to that but they did highlight three challenges that resulted from the decision to publish:

Pages 38-39:

I think there were three problems with publishing, though, we were worried about, all of which came to pass, all of which relate to: if you only publish the SAGE minutes and not anything else within government.

So the first is that we were concerned that it would lead to greater abuse of the scientists who were supporting us. And it did. So we had to put in place a lot of mechanisms to support them. The second challenge, in our mind, which I think also came to pass, is that it would lead to an unbalanced understanding, and debate, in Parliament and the media. They were only seeing one form of advice -- they were not seeing economics or operational or policy advice, they were only seeing one form of advice. And I think that did have a negative impact.
The third reason is that it reduced the amount of time that policy and decision-makers had to make decisions. Now, they managed that, but at times that felt -- I imagine that felt challenging for them.

Q: So it was transparency but at a cost?
A: Yes, but it was the right thing to do, but there should have been more transparency on other forms of advice.

There was quite a lot of discussion about SAGE members being abused.

And some talk about other organisations that helped sometimes, such as the Academy of Medicall Sciences who were commissioned to produce reports looking ahead to winter challenges, for two years running. And then some stuff about the Devolved Administrations having access to SAGE.

Then a discussion about an Institute for Government report "Science advice in a crisis" from December 2020, and some of its findings.

eg on pages 50-51:

"Nevertheless, our research has identified some clear problems: while there are improvements those providing scientific advice should reflect on, the biggest concerns are the way the government used this advice and the way it communicated it."

"Decision making at the centre of government was too often chaotic and ministers failed to clearly communicate their priorities to science advisers. This was most acute in the initial months but a lack of clarity about objectives persisted through the release of the first lockdown to recent decisions over the second lockdown and regional tiers."

On pages 53-54:

"SAGE members told us that in the autumn they were still unclear about the government's thinking, despite the new Covid cabinet committees having been created in June with the aim of clarifying decision making. One interviewee described the conversation between ministers and SAGE as circular: 'Ministers said: "What should we do?" and scientists said: "Well, what do you want to achieve?"' Some back and forth is necessary to refine questions, but scientists said minsters' objectives remained unclear throughout the crisis."

He tended to agree with much of that and some similar comments from other sources, but said there were periods when things got a bit better. Plucking a few more bits they quoted from that report, on pages 54-55:

"At times the process of commissioning advice -- COBR asking questions for SAGE to answer -- did not work well, with advisers' ability to provide useful answers hampered by poorly formulated questions (though [your point] this improved as the crisis went on)."
Q: Is that correct, that there was, especially at the outset, poorly formulated questions in terms of seeking advice?
A: I think that's right. I actually think it wasn't so bad very early on, although it -- I think the scale of what people had to contend with meant that it was hard to formulate the question.
So early on, as you discovered in Module 1, you know, there weren't sufficient plans for things like non-pharmaceutical interventions in place, and I agree with the analysis of many people in Module 1 that PHE did not go in with sufficient capacity into this.

In that context, to shift from a position whereI think no one ever believed sort of a lockdown could happen in a society like ours to it happening, you had to overcome a lot of public health and policy and political beliefs and dogma. That was hard, and I think needed to involve scientists, policy officials, politicians engaging closely.
But the commissioning of advice did get quite chaotic and poorly formulated from March through into the summer and then got better again in the autumn.

 

[elbows]

And more from that report and stuff that flows from it, on pages 56-57:

Q: "The government was also slow to seek advice from SAGE on issues where it was evident some time in advance that difficult policy decisions would have to be made."
It gives an example about return of students to universities and how SAGE was not commissioned to look at this until it was almost too late.
"Members told us that, since they were not asked for advice on some key issues, they started to set some of their own research questions based on what they thought would be useful to policymakers."
So two questions flow from that. Firstly, was that right, in your view, that the government was on occasion slow to seek advice from SAGE on issues?

A: I think it's a bit more nuanced than that. I think by this point -- we talked about the lack of capacity of PHE and others going into this situation, and SAGE had to grow into something that it was never meant to be, to fill some of the gaps that were just not there going into the pandemic. We didn't have a lot of standing public health capacity on the scale that we needed it going into the pandemic, so a mixture of academic volunteers and a small number of officials filled that gap. I mean, this is the kind of example when you might want a SAGE view, but you might just want -- in a better situation, you might want to draw on your public health experts within your public health agency. So maybe they were slow to seek scientific advice but whether SAGE advice was needed I think isa question.

Q: Let's examine that for a moment. SAGE grew into something it wasn't ever meant to be. Was it the case that there was a vacuum which SAGE had to fill because other departments were unable or perceived to be unable to fill that?
A: I think I mostly agree with that. I suppose the feeling for us through late February and into March was a feeling of other parts of government either not being there or not being allowed to be there, in some cases, and -- but science, technical advice, public health advice was needed and we had to grow our structures to be able to provide that. That wasn't out of design, certainly not by desire, but I think it was out of necessity.
Q: You've hinted at it, but was PHE one of those organisations which you would have thought would have been asked to do some of the work which SAGE undertook?
A: That's correct.

Theres then a bunch more discussion about how SAGE ended up doing stuff it wasnt designed to do, and for longer than normal, which then circled back around to Public Health England again, eg this on page 61:

Q: From your dealings, bearing in mind you had to scale up SAGE, were you aware of concerns regarding the lack of capability or confidence in PHE to deal with this crisis?
A: Yes, I think I was aware of the lack of sort of capacity and capability in PHE. Even from previous roles I'd seen -- they have some wonderful people in PHE but they always seem very thin on what was available. The issue of trust others will have to comment on that but my perception in February and March is that gradually the centre began to trust what GO-Science and SAGE were doing, and possibly not other parts, but I don't know the reasons for that.

Then a discussion stemming from part of the report that said there had been some criticism of SAGE for not building more challenge built into the scientific advice process. And that too narrow a range of experts were drawn upon at the expense of others such as external public health experts. Leading to this on pages 62-63:

A: So, first of all, do I think SAGE had challenge within it? Absolutely. I mean, the way that it worked, the individual academic groups would be challenging themselves and each other, they'd bring things to subgroups and challenge each other there, and bring it to SAGE and challenge each other more. And we drew on more and more experts -- you know, almost 200 for SAGE alone over time. But I think, as we've said already, that as SAGE was so prominent and maybe leaned on more than it should have been, it meant that some of the areas where you might have had -- drawn on more experts on public health, within PHE structures -- we've given SAGE more of an ability to challenge those, which might be a better system -- I think that is something to reflect on.
So I think a lot of challenge happened within SAGE in the system, but I think given so much focus on using SAGE, I think you reduced its role to sort of challenge other parts of the system where other forms of advice might have been brought to bear much more.

Later another topic, pages 65-66:

Q: It's a phrase which we're all very familiar with, about "following the science" and the opinion of the authors that ministers and systems -- that they were "following the science" was inaccurate and damaging. And that may be questions for politicians and not to you as a civil servant, but I want to draw out some of the issues in relation to this, and whether these are matters that you raised as a problem with government during your time as chief executive.
So in relation to that phrase, it says in the second paragraph or third paragraph:
"The phrase blurred the line between the scientific advice and policy decisions."
Do you agree, first of all, with that proposition, that the phrase blurred the line between the scientific advice and decision-making?
A: I do.

Q: And the next paragraph, in the same theme:
"The difference between being led by the science and being informed by the science may seem subtle, but it is important."
And again that this is something which is not new and had been raised before in previous inquiries.
A: I agree. In a situation like this, there's no easy decisions, and it's right that -- ministers -- we live in a democracy and ministers are the elected representatives of our people, and in a situation like this, it's right that they have to balance up different factors and forms of advice, science, public health, economic, operational, policy, and it's the understanding of all of those that should inform their decision, not one form of evidence.

After some more discussion of this and the erosion of the protective space the scientific advisors could operate in, we get to this on pages 67-68:

Q: (still quoting from the report) "Many scientists including members of the SAGE went as far as to say that they felt they were being set up as scapegoats, with politicians hiding behind a cloak of science."
In relation to that, was that a concern which was expressed to you, perhaps informally, by members of SAGE?
A: I don't -- I don't recall.
Q: Have you raised with government the concern, when you were chief executive of GO-Science, about the usage of the term "following the science"?
A: Yes, I recall doing so.
Q: What was the response?
A: Our counterparts in Cabinet Office understood, and gradually, I can't remember how long it took, but gradually that term did stop being used.

Thats pretty much it for this witness, I'm not going to go as far as to quote the three big areas he thought SAGE did well in that he was given the opportunity to mention at the end.

 

[elbows]

I wanted to get that witness done this evening because after him we are now mostly getting deeper into a batch of modellers, pandemic and public/international health experts, epidemiologists etc etc. Certainly the remaining two witnesses last Thursday were modelling group people, and the new week that has begun is mostly full of such witnesses. I'll start digging into these witnesses tomorrow.

However last Fridays witnesses dont fit those themes so I think I will come back to that days transcript some other time - I think there are no sessions next week so I should get a chance to catch up with those then.

 

[elbows]

Whats emerging today is that Neil Ferguson was not some modelling hero who pushed for lockdown etc in a timely way - rather for a crucial period he was one of those who was pushing back against people within the modelling group even submitting papers that looked properly at those sort of options, because there was no appetite for such things in policy circles. He probably only changed his tune once the politics of the situation had changed, although we havent heard that bit of the evidence yet and we havent heard from Ferguson himself at all yet.

Steven Riley is currently giving evidence and he was a key modelling person who was pushing for action to be taken in a more timely manner.

 

[elbows]

The evidence has continued in that direction, until plan A went in the bin at a higher government level, Ferguson wasnt 'Mr Lockdown', he was Mr Mitigation. With all the shit arguments that entailed. Happily Steven Riley actually paid attention to evidence, lack of evidence, logic and rationale, and noted all sorts of unsourced assumptions that were used to defend the original plan.

 

[elbows]

The inquiry noted that when Ferguson changed his tune and published their (famous) report that said there was no alternative to stringent NPI's (on 16th March once plan A was already dead in government circles), the following excuse for not coming to that conclusion sooner was in the report:



They asked Riley (who was also listed as one of the authors of this report) whether he agreed with that excuse. No, he did not. Which is not surprising given that his own view was that we should have locked down by around March 9th.

So if key parts of the UK establishment had been in tune with the likes of Riley, we would have taken strong action two weeks earlier than we actually did. There is evidence that when it came to the public, they were right in the middle of these alternative timings, they started to change their behaviours a lot by March 16th.

 

[elbows]

I'll be going back and formally quoting from all the relevant parts of todays proceedings later, along with other modellers and epidemiologists etc of recent days, but I wanted to get the gist of todays revelations out there as soon as I heard them. I'll be interested whether the press notice and report on this stuff later today.

 

[elbows]

Ferguson was up next.

It appears that he has complex attitudes towards what should be said via official channels, and also has views that scientists providing advice shouldnt use their public platform to advocate for particular policies.

In contrast, the inquiry lead counsel suggested that via private communications he was sometimes more critical of strength and timing of response, and government priorities, but they havent actually shown us any email etc examples of this yet. (they are on a lunch break at the moment and his evidence continues this afternoon with no further witnesses to follow today).

When it came to his direct discussions with people like Riley, Ferguson often started wanking on about economic issues, and was the sort of person who would try to characterise others opposing stances as being 'advocacy' and his own as being 'evidence based'.

So at least on certain fronts he came across during that critical period in the first half of March as a bit of a gatekeeper, a dont rock the boat, 'be realistic' merchant, someone who didnt want official stuff that he was a part of to contradict official policy. Hopefully later we will get to see whether there is evidence of a somewhat different picture, eg signs that he was more critical via direct private channels that werent part of the tidy official record or reports that his university group were prepared to publish.

One of the themes here ties into some evidence from the modelling group chair the other day. There was quite a discussion then about whether it was actually clear to that group by some time in February that hospitals would be overwhelmed, given that such a stark picture was not apparent when reading the official SAGE minutes. I havent quoted all that witnesses remarks yet, its still on my todo list, but I did quote the parts relevant to this point in some detail a post on the UK forum thread about this: The Covid Inquiry

I note that Ferguson also shares my own opinion that the published 'SAGE minutes' arent actually proper detailed minutes at all, they are mostly high level summaries that tend to reflect the central stance rather than individual views.

I should also point out that Ferguson and Riley were from the same university modelling group, they werent competitors on that front.

 

[elbows]

This afternoons evidence further confirmed that he was very much part of the old orthodox approach up until some point in March.

He was one of the sources of advice that stopping mass gatherings would have limited impact, for example.

Some of the more interesting detail to emerge involved the timing of when their estimates of things like infection fatality ratio and hospitalisation ratio firmed up. We heard a depressing story of how many weeks were wasted by the likes of SAGE waiting for further confirmation of such estimates, and how Ferguson started to get frustrated with those delays.

We then heard about a March 1st 2020 meeting in his office where NHS officials were involved with working out what such figures meant for NHS operational capacity.

He was absolutely grilled about this stuff and why SAGE wasnt sounding the alarm to the rest of government by that stage. And then some more excuses about some of those estimates firming up firther in the subsequent weeks.

That sort of thing and some other stuff I wont quote till another day makes it seems reasonable to conclude that perceptions about what policies the government wanted, combined with the traditional orthodox approach, and some data failings, were driving things, rather than some mythical form of pure science driving the agenda. Only once the old orthodox approach was dying (eg via strong measures in other countries including Italy) was the penny allowed to fully drop across the establishment in regards the implications of the scale of the horror that awaited if they stuck to plan A. And only then were the likes of the SAGE modelling group encouraged to produce stuff which modelled alternative approaches properly, and provided justification for suddenly changing the whole plan. There was a period leading up to this where the likes of Ferguson were becoming more concerned, so I dont want to mischaracterise his stance, but Riley was much better sooner than Ferguson from the evidence we heard today.

Once the old orthodox plan was dead his thinking became much more to my taste, and so later in his statement he is critical of lessons that werent learnt properly, eg the inexcusable ones that caused a 'catastrophic second wave'.

There have been a few hints from a few sources so far that part of that sorry picture that allowed the old orthodox approach to persist for so long, was that the amount of death and hospitalisation it entailed would be tolerated. I'm not sure we will get to the bottom of that, but I'll be sure to include those quotes from various peoples evidence when I get round to those people. Other themes that we heard about at the time, such as concerns by the likes of Whitty about a suppression strategy leading to a 2nd wave in autumn, and some 'get it out of the way in one go' excuses including herd immunity are also present.

I'm knackered. I'll take a break, and probably wont watch the next 2 days worth of hearings this week. Instead I'll do my usual quoting stuff for my backlogged bunch of witnesses at some point in the coming days, then take another break, and then clear the rest of the backlog by the end of next week (as I think there are no hearings next week).

 

[elbows]

Please post if you see any of this Ferguson or Riley stuff covered by the press. Or the likes of Woolhouse yesterday that I havent had the chance to report on properly yet but did watch on the livestream at the time.

 

[elbows]

OK here is a BBC piece about it.

What they are missing is the Riley stuff, but they do a better job than me of describing Fergusons stance by March 10th when he started trying to warn government about how many deaths there would be per day. (I was already knackered by that part of the evidence and didnt do a good job of writing an overview of it here at all).

Combine these things and some other variations in emphasis and you'd be forgiven for thinking me and the BBC were describing completely different stories.

Lack of urgency in government as Covid spread, inquiry told

Prof Neil Ferguson denies he "stepped over the line" as a government adviser on Covid.

www.bbc.co.uk

By 10 March he said he was "extremely concerned" about the latest data. He told the inquiry he had been "frustrated" that some government officials had not "comprehended the figures".

"There was a lack of urgency, let's put it that way," he said.

He emailed Ben Warner, a data scientist brought in to Downing Street by Dominic Cummings, asking him to make sure the prime minister was shown graphs with projections of between 4,000 and 6,000 deaths a day "under the strategies being considered".

"This event is in the natural-disaster category, and the cure (eg massive social distancing, shutdowns) could be worse than the disease," he said in the email.

Asked why he sent the message, Prof Ferguson said: "It felt uncomfortable, but at the time it felt like it needed to be said. I was increasingly concerned about this disconnect between the numbers we were actually presenting, and the reality of what that would actually look like."

One of the frustrating things about todays evidence and therefore the way its written about in the media was the use of the term containment to describe a phase in the original response that was not actually a sincere attempt at containment in the first place. This was one of the issues I was aware of long before this pandemic since its long been a feature of UK flu plans, and indeed the independent report into the swine flu pandemic had this issue as one of its findings:

In particular, ‘containment’ was used to describe a strategy which was not intended to contain the disease but to slow the spread.

(from page 15 of the swine flu review https://assets.publishing.service.g...422068a10/the2009influenzapandemic-review.pdf )

I'm sure the current inquiry has covered this issue in the past, but they dont necessarily pick up on it every time these plans and language are referred to by witnesses. This matters because the likes of the BBC ended up writing the following:

Giving evidence to the inquiry on Tuesday, he said he realised by late January 2020 that the government's early policy of trying to contain the virus would not be possible with the limited border checks and other measures in place at the time.

'Contain' was the name of the phase the official plan of the time placed us in, but no, we did not have a genuine policy of trying to contain the virus. I spent plenty of February 2020 trying to explain this to people, with some success, especially once people saw the details, the extreme limitations, the lack of sincere effort at actual containment, and what the next crappy stage of the original plan was.

 

[elbows]

In an attempt to explain whats missing from the BBC article when I mentioned it on the UK forum Inquiry thread, I've ended up posting some email screenshots there. I will put more of that evidence in this thread when its published and I get round to sifting through it, but if you want to see some in the meantime then look here: The Covid Inquiry

 

[elbows]

Some explosive evidence today. I wont be reporting on it all properly for some time but I have covered some relating to a 'Dr Death the Chancellor' whatsapp remark from a notorious September 2020 meeting over on the UK forum thread from the following post onwards: The Covid Inquiry

 

[elbows]

The evidence session with Carl Heneghan was quite entertaining, they knew exactly who they were dealing with. Spent a while pointing out what his areas of expertise actually were, had to resort to getting him to give yes or no answers in order to bypass his slippery shit, made him look as unimpressive as he really is.

They played some of the let it rip brigade off against eachother too, and relied on the fact that even some of those whose instincts did not favour lockdown, were not actually willing as to go as far as to sign the fucking Great Barrington Declaration. Even Heneghan didnt sign it and was made to explain why, lol.

On a related note, they made use of Woolhouse, because although Woolhouse was not exactly a massive fan of lockdowns, he does at least have a clue what he is talking about (eg knew there was no choice but to lockdown by the time a new plan was required in March 2020, because of all the earlier opportunities that were squandered). And Woolhouse understood that if you are going to call for a policy of segregating and cocooning the most vulnerable, you actually need a plan to make that achievable in practice. So they used some of Woolhouses evidence to pin down Heneghans beliefs.

Earlier in the day some whatsapp evidence suggests someone had privately said 'who is this fuckwitt?' when forced to listen to Heneghan in a notorious September 2020 meeting with the PM.

And there was also a funny moment where, to somewhat paraphrase, Heneghan said in front of the inquiry that 'even my opinion exists as evidence' to which the inquiry chair responded 'not in my world it doesnt!'. At the end they asked him what he thought about that.

Hahahahahaha, this session was therapy for me. Although the earlier session was depressing as it was going through in more detail various failings and the growing sense of alarm in March 2020. And at least one of the SAGE modelling people seemed to be of the opinion, during that most crucial time in March 2020, that Chris Whitty was part of the problem because he didnt fully believe that things could turn out as badly as their modelling and figures suggested.

 

[two sheds]

Science adviser referred to Rishi Sunak as ‘Dr Death’, Covid inquiry hears

Comment by Dame Angela McLean in message during meeting was apparently in reference to ‘eat out to help out’ scheme

www.theguardian.com

The government’s chief scientific adviser sent a secret message calling Rishi Sunak “Dr Death the chancellor” during a meeting attended by both in the Covid crisis, the official inquiry into the pandemic has been told.

Prof Dame Angela McLean, who at the time was the chief scientific adviser to the Ministry of Defence, made the comment in a WhatsApp message to another leading scientist in apparent reference to Sunak’s “eat out to help out” scheme that ran during the summer of 2020.

Was McLean?

On 20 September, Vallance asked Edmunds to join a meeting at which Boris Johnson and Sunak were to hear views from scientists – “mainly from the ‘let it rip’ brigade”, Vallance told Edmunds in the email.

McLean and Edmunds exchanged messages as the meeting heard from anti-lockdown voices, with McLean making reference to “Dr Death the chancellor”. Asked if this was a reference to “eat out to help out”, Edmunds replied: “It’s so long ago I don’t know. But it could well be.”

At another point, McLean asked: “Who is this fuckwit?” to which Edmunds replied: “Every statistic is wrong.”

 

[elbows]

It was probably a reference to other shit Sunak was promoting in that meeting too, but they didnt actually ask witnesses so far to describe what Sunak said in the meeting, and we havent heard from either McLean or Sunak yet. It was Edmunds we heard from today that prompted that evidence to appear.

McLean now has Vallances old job, she has been chief government scientific advisor since this February!

 

[elbows]

BBC reports it too:

Covid inquiry: Sunak called Dr Death by top scientist

The comment was made in a WhatsApp exchange after the public had been encouraged to "eat out" to help the economy.

www.bbc.co.uk

The government's new chief scientific adviser described Rishi Sunak as "Dr Death, the Chancellor" in private messages sent during a crucial pandemic meeting, the Covid inquiry has heard.

Prof Dame Angela McLean made the comment in a WhatsApp exchange in September 2020.

The government's Eat Out to Help Out scheme had been running that summer.

At the time, there was fierce debate about the need for social-distancing measures to control the virus.

On Sunday 20 September 2020, then Prime Minister Boris Johnson called a Zoom meeting of scientists to discuss the government's response to sharply rising Covid infections.

Dame Angela, then chief scientific adviser to the Ministry of Defence, who co-chaired the influential SPI-M modelling group during the pandemic, was one of the attendees, along with her colleague Prof John Edmunds, from the London School of Hygiene and Tropical Medicine (LSHTM).

Also note Edmunds attitude towards Eat Out To Help Out:

But in earlier testimony to the inquiry, he said he was "still angry" about the policy.

"It was one thing to take your foot off the brake - but to put your foot on the accelerator," he told the inquiry.

 

[elbows]

The BBC version of that latter quote left bits out that the Guardian did cover:

“To be honest it made me angry, and I’m still angry about it,” he said. “It was one thing taking your foot off the brake, which is what we’d been doing by easing the restrictions, but to put the foot on the accelerator seemed to me perverse.

“And to spend public money to do that – 45,000 people had just died. I don’t want to blame eat out to help out for the second wave, because that’s not the case. But just the optics of it were terrible.”

He added: “My feeling was, yes, the pub and restaurant sector really needed support, I wasn’t against that at all. But this was not really just supporting them. They could have just given them money. This was a scheme to encourage people to take an epidemiological risk.”

 

[elbows]

During this week off I havent really managed to catch up with all the evidence I didnt quote from last week. WIll try to do a few bits and bobs at some point in the coming days but I'll just have to leave a lot of it out for now.

There was a preliminary hearing for the Scottish version of this module, which I did not see, but it made the news:

Scottish government accused of withholding Covid WhatsApps

A lawyer for the UK Covid Inquiry says it is surprising that so many messages have been deleted.

www.bbc.co.uk

When the hearings return next week, those giving evidence will be Lee Cain on Monday afternoon, and Dominic Cummings on Tuesday morning. Also a bunch of fairly high ranking civil servants, Simon Stevens the former chief executive of NHS England, and David Halpern the head of the Behavioural Insights Team.

 

[Thesaint]

thought I would listen to the full session of Profs Heneghan and Edmunds give evidence as they are names I remember from the day. Perceptions of subtle bias can always subjective in the eye of the beholder way but this session was blatent :-(

The two Profs have different views and backgrounds, but the inquiry treated them very differently. As soon as Prof H sat down he had to explain and justify his background, yet prof E's qualifications were reeled off.

Whenever Prof H tried to answer he was more interrupted and challenged, yet prof E was allowed to tell his 'tale of woe' more freely.

If anything Prof E should have been subjected to more detailed scrutiny, if only because his organisation had more influence.

The worst example was the judge consoled Prof E at the end with comforting "you did your best" etc which itself demonstrate a lack of neutral professionalism by the judge and underlying bias.

Its tempting to consider this a victory for one side of the debate, but this session maybe the one that renders the whole inquiry void and a waste of stretched public money.

 

[elbows]

Heneghan is a pandemic shithead and was treated exactly as he deserved to be by a serious inquiry that has a grasp on pandemic wave dynamics. They called the fucking idiot out for trying to describe the virus as endemic in September 2020, and he squirmed around in a pathetic way in response to that line of questioning, demonstrating why his evidence should be treated with contempt. During some other parts of his questioning, they had to resort to getting him to answer certain questions with a simple yes or no, to try to bypass the wriggling.

The inquiry isnt void just because it doesnt share your idiotic attitude.

 

[elbows]

The transcript from that day: https://covid19.public-inquiry.uk/w...334/2023-10-19-Module-2-Day-13-Transcript.pdf

Pages 188-190

Q: I would like to ask you if I may about a line towards the top of the paper. Sorry, we'll need to go back. So at the very top after the title there's a bit in italics about terminology, and then immediately underneath that it says this:
"The current strategy requires acknowledging the virus is endemic and the need to learn to live with Covid."
Now, Professor, I want to ask you about your description of the virus as endemic at that point.
Tell me if I'm wrong, but there is a distinction, isn't there, between a virus or a disease which is at a stage of being an epidemic, where it spreads quickly, unexpectedly and unpredictably -- it becomes a pandemic if it acts in that way across a very large area, across nations -- but that's on the one hand; on the other hand, an endemic disease is one that is consistently present in a region or population and where its prevalence remains stable and its spread fairly predictable?
Now, that's what I understand by those terms, but are you saying -- or were you saying there -- that Covid, in September 2020, was a disease that was stable and predictable?

A: No, because there's nothing predictable about acute respiratory infections per se. Across the whole of my 20 years -- apart from broad areas, for instance a seasonal effect, which you can understand -- they're highly unpredictable agents, and therefore the point being made is that where we were at, if -- and I have to elaborate here, if you don't mind -- we'd gone from March/April to flattening the curve, two weeks to protect the NHS, to an area now where we were talking about zero Covid and suppression. The policy on the table was to reduce infections below 1,000 and then keep Test and Trace to keep it below that level.
What had happened over the summer is, remember, we're scaling up testing and there was a misperception that actually out there was far less cases. The only cases were the ones that were being detected. Well, actually there's pre-symptomatic phases, asymptomatic phases, there are also people who don't turn up for testing.
My experience throughout the whole summer was telling me, right back to March 15th, that there was much wider circulation than this virus is being understood if you're just looking at the case numbers.

In this initial response to that question he tries to muddy the waters about the definition of endemic. And then makes it obvious that his motive for talking shit was because he perceived there to be a zero covid policy that he didnt like. And then he talked absolute shit about the number of cases over the summer - it is true that we werent testing everyone, but actually we could tell that there was a period with vastly less cases because there were vastly less hospitalisations and deaths during that period! Everyone understood that at the time, that we werent managing to record anything remotely close to every case, but that we could still see the trends, and that some of those trends were dramatic in both directions, when going up and when going down, and then when going up again.

Pages 190-192

Q: Thank you, Professor, but I do just want to press you on this sentence here which you put in the note, albeit drafted in a bit of a rush, for the Prime Minister. You are a scientist, and you used that word "endemic" deliberately, and it does mean, doesn't it, a disease that is stable and predictable?
A: Well, not in all -- it's not a clear definition thatI would agree with. What it means --
Q: Well, I'm going to interrupt you a moment.
Let's just look, if we may, at a graph just to get the context here. It's INQ000283367. We can see there's a date there of 1 October. So we see if we look just to the left, obviously, that's 20 September of that year. There was nothing stable or predictable, as it turned out, about Covid at that date, was there, Professor?

A: Well, in terms of the seasonal effect, there are predictable natures to January. The second week of January, about seven of the last ten years you will see the highest number of deaths from acute respiratory infections. Most of that occurs in the over 80s.
So within -- if you notice my plan is that actually there is a seasonal effect, but actually what's more so is unpredictable is the fact you've got the sharp rise in April/May. I'd say that's more unpredictable.
There is a generalised predictability to the seasonal effect that starts in about 1 December and goes into January/February --

Q: I just want to press you though, Professor, because you used that word "endemic", didn't you, to suggest it's no longer an epidemic, it's no longer unpredictable, growing exponentially; it's endemic, it's stable in the community, it's predictable? And if we look at that graph, you were wrong to use that word, weren't you?
A: No. So, you're using interchangeable terms all the time, which is difficult to follow. Epidemic --
Q: Just, sorry to interrupt you. "Epidemic" and "endemic" are not interchangeable terms, are they?
A: Well, "epidemic" and "pandemic" are.
Q: I wasn't asking you about "epidemic" and "pandemic", I was asking you about "epidemic" and "endemic".
A: So what in terms of endemic is there's widespread global circulation of the pathogen that's gone beyond low level circulation. No acute respiratory infection is predictable or stable, so I would contest what you're looking at is not my interpretation of the word "endemic", and I would have had the opportunity at the meeting to explain all of the nuances around those issues of what I meant.
Within the problem of, remember, throughout summer you were scaling up the testing, we were scaling up the testing, so our actual understanding of what was going on was fairly limited until we scaled up the testing.

Stupid slippery fucker. He used the word endemic quite deliberately in his September 2020 paper, in order to suggest that there was no big risk of a huge second wave. But he wont give a straight answer about that, and so is quite rightly grilled and exposed.

I wont be quoting anything else from the transcript of that witnesses evidence session. The only people that respect his pandemic stance are those who didnt like certain policies and wanted someone to fight for their cause, no matter how ineptly. He has fuck all credibility when it comes to epidemiology.

 

[elbows]

Well maybe one more quote, a comedy moment:

Pages 195-196:

Q: Yes. Now, Professor, in the course of his evidence earlier today, Professor Edmunds made various statements about you and about the contribution that you made to the meeting, and I'd like to give you a chance to respond to them. There were three points.
First of all, we looked at an email between him and Dame Angela McLean where they described the approach that you and, I think, Professor Gupta were taking at the meeting as "half-baked nonsense"; we looked at a WhatsApp message sent by Dame Angela McLean during the meeting where there was a reference to a "fuckwitt", and Professor Edmunds I think inferred that that was probably a reference to you; and he also said today that he thought you didn't understand basic epidemiology.
What are your reflections on that evidence that the Inquiry has heard?

A: I would never in a professional capacity use such language about other individuals.
It is not unusual to find yourself in disagreement and a position of disagreement. We call it uncertainty.
And the job of an evidence-based approach is to try to reduce uncertainties so that you can make an informed decision.
The very fact that you have opposing views shows that you there is a problem within the interpretation and the understanding of the evidence, but it also shows me a position of: that sort of language would mean
I would become resistant to any other's viewpoint or discussion. And I think that's unhelpful. And it goes back to why we were brought in in the first place, is to try to propose a viewpoint that obviously was not being aired in SAGE, was not being aired at any point of the government advice.
Despite the fact I'd been working for the World Health Organisation, I'd given evidence to the Irish Parliament, I spoke to a number of MPs outside of the Cabinet Office -- and I said did the work for the World Health Organisation. So to be clarified as classed at that, you know, just goes to probably the heart of the problem here, because one should always have an open viewpoint about alternative views.
It is -- you know, the idea that a statement could provide all of the answers is not something that you would recognise, but what it was proposing was an alternative view, how you might look at the issues,
how you might develop an evidence base and test some things you have to, just as we were doing with drugs, and in doing so come to a difference of what the current strategy was.
In the round, I think it's fair to say that everything that we were proposing and the way we were looking at the epidemiology, remembering up to that point we'd established clearly that many faults in the data, as an epidemiological team, we also would be, and I would be very ... the idea we would -- so one of the evidence-based approaches, we would be looking at the data trying to understand what was happening.
What I found very difficult was a modelling approach which kept looking into the future and saying "This is what we now predict", with some certainty. And what comes with certainty is a reluctance to engage in the discussion, in the debate.

There are some reasonable concepts in there but that isnt what he was actually doing at all, he and the likes of Gupta were full of absolute shit and had a really crude anti-lockdown agenda that was incompatible with basic epidemiology.

 

[elbows]

We should also consider what Johnson claims in his written evidence, were his impressions of that meeting:

Pages 193-194:

He records, about halfway down the paragraph, Professor Edmunds's advice, which of course we've heard evidence about this afternoon, and Mr Johnson states at the bottom of this page:
"I greatly respected [Professor Edmunds'] views, but had always put him at the gloomier end of the spectrum. I wanted to give the Rule of 6 a chance to work, and to hear some alternative views."
And of course one of those alternative views was yours.

And if we look at the next paragraph, Mr Johnson says that he thought "we put all the scientists through their paces". He says that by this point he had a much better understanding of the data and evidence, and he certainly thinks that he was able to probe the different points of view that were being presented. And he says he was willing to be persuaded by the lockdown sceptics. But then this, he says he:
"... found that in reality they [that is you] were reluctant to argue any such case, or not very hard. When pressed, the so-called dissenters actually seemed to agree with SAGE's position and did not present anything compelling to make me think it was sensible to change [his] approach."

 

[elbows]

Went through my notes and I've got no chance of quoting all the interesting stuff from the witnesses that I havent covered yet. I'll have to resort to extreme cherrypicking for now, and there will still be loads.

Going back to the start of that last session, the link to the transcript of which I already posted earlier today, we have Catherine Noakes who was brought in to look at environmental transmission, and became co-chair of a SAGE subgroup looking at that stuff.

Page 4:

Q: Now, just dealing with the remit of EMG, in a nutshell, how would you describe it?
A: So I would describe it as we focused on how the virus transmits from person to person and the role that the environment plays in that, and then we also focused on the mitigations we could apply. But we focused more on the local mitigations, things like face masks, distancing, ventilation, hand hygiene, rather than the big ticket items like lockdowns or work from home.

Her evidence was good stuff, but I will only pick a couple of themes right now:

Page 12:

Q: Were you concerned that the airborne transmission routes in terms of aerosols were being overlooked to some extent?
A: Yes, I was.

Page 14-18:

Q: On 29 March of 2020 the World Health Organisation published a tweet stating that Covid-19 was not airborne. Did that cause concern?
A: I think it did. I was concerned by it, and I'm aware that other people were concerned by that as well.
Q: Indeed, in your statement, you explain that that prompted the formation of a group that came to be known as Group 36, and that's 36 experts in transmission, essentially?
A: Yes, so these were 36 scientists from all around the world who had expertise and had worked in this area prior to the pandemic.

Q: Indeed, you and those individuals signed a petition that was then sent to the World Health Organisation very quickly thereafter, on 2 April --
A: Yes.
Q: -- 2020. If you forgive me just for summarising, you followed that up with a letter when it was --
effectively fell on deaf ears, initially; is that right?
A: Yes, that's correct.
Q: And, following on from that, articles. And as you explain at paragraph 10.8, that prompted both media attention and started to change the discussion that took place around airborne transmission; is that right?
A: Yes, that's correct.

Why do you think there was a reluctance to acknowledge the potential for airborne transmission?
So it is hard to be sure, but my personal opinions are there may be a number of reasons. So I think it's -- there's something about changing an accepted paradigm, if -- you know, traditionally respiratory diseases have often been categorised as droplet, and to change what people's accepted views are is -- can be difficult, especially if they feel that that challenge is coming from a different -- different field, a different area, aspect of it.
I think mitigating airborne transmission is more challenging, because it involves dealing with the environment, every environment's different, and it's not as easy to put a simple rule like washing your hands.
It also takes the responsibility from the individual to the organisation, because it's the organisation that tends to deal with the environment whereas it's the individual who perhaps washes their hands.
And I think I note in my statement as well that it's possible there may be a fear aspect to it, and you can see this in movies and things where it goes airborne, it promotes a fear. Now, I don't know whether that really was the case, did happen, but I think that may possibly play into it as well.

Q: You also touch upon implications for hospital infection control. What implications would those be?
A: Yes, so in hospital infection control, you know -- which is a very good field and there are a lot of really expert people who do hospital infection control, but conventionally if something is deemed droplet transmission, then you have relatively simple precautions: you perhaps put somebody in a side room, you maintain a distance, and you would wear relatively straightforward PPE, a simple surgical mask, maybe a visor.
If something is deemed airborne, then, providing you've got the capacity to do it, ideally you put that person into a negative pressure isolation room and you wear full respiratory protective equipment to manage that person.

Q: Certainly at the very outset of the pandemic, we'll all recall those images of people in --
A: Yeah.
Q: -- those sorts of mitigating outfits and so on.
In terms of EMG, it was obviously not established until April 2020, but in your view, was there an evidence base sufficient to operate on the precautionary principle through January through to March of 2020?
A: I think there was, and I believe that, prior to my involvement in SAGE, that NERVTAG had indicated the potential for airborne transmission.

Q: To your knowledge were there any reasons not to take steps to guard against airborne transmission?
A: I don't see that there were, no. I think there was -- although the evidence at the outset was weak, in truth it was weak for all transmission routes. I think there was just a tendency to assume the other transmission routes, and then require the evidence for airborne transmission. So I think from a precautionary basis, it would have been appropriate to indicate that aspects like ventilation mattered, early on, and as that evidence base built, it was important that that -- those mitigations were more readily applied and people became more -- should have been made more aware of them.

This was a big issue. I think its the case that authorities didnt want to acknowledge it because it had implications. The witness is being kind and gentle about this stuff. As for the questioner mentioning 'images of people in those sorts of mitigating outfits and so on', we really didnt see enough of that in this country, it was associated more with the likes of South Korea and is likely one of the reasons they maintained a reasonable grip on the virus during certain critical periods, especially when it came to spread in healthcare settings. And that topic is on the list of things I go on about a lot, hence me quoting this part of the evidence session.

 

[elbows]

Pages 18-20:

Q: Now, come autumn 2020, did you still have concerns in terms of airborne transmission being taken seriously, or did you consider that enough was being done?
A: Yes, I did, and one of the concerns which I think you will have identified that I raised in my statement was that the publicly available information that's on the websites of the Public Health England, as it was then, and the NHS, for members of the public who maybe are trying to find information about how to manage the illness if, you know, they have a case in their home, that all still focused on droplets and surfaces and didn't mention airborne. So I emailed Patrick Vallance and Chris Whitty in September to say:I'm concerned that this information, that we -- you know, the evidence base that we've been collecting and discussing and agreeing is not feeding in to this guidelines.

Q: Did you get a positive response?
A: So in one sense, yes: I believe Chris Whitty sent the emails on to Public Health England, they actually responded very quickly, they changed the information on their website, and indeed they -- in the process of doing that, they shared it with me, and we -- I helped them put some forms of words together to describe what we knew about transmission.
The NHS, on the other hand, nothing changed, and I believe I raised it in February, and then again at a SAGE meeting in June 2021, and finally, a few weeks after that, their webpages were changed.
Q: So quite some time later?
A: Quite some time later, yes.

Q: Now, you describe that period of autumn of 2020 as being the most frustrating period and -- for you, during the pandemic. Why was that?
A: I think it was because we could see cases were rising. We could see there was a desire to try to get back to normal, which is understandable, we can't stay in a lockdown forever, and that's totally inappropriate.But I think it was that -- seeing cases rising and not very much being really done to try to mitigate them, even when people were interacting together.
Q: Now, your frustrations were such that you spoke to the press, is that right?
A: Yes. So I spoke to the press on many occasions through the pandemic, almost all of them were to talk about the science of transmission. On that one occasion I expressed a frustration with feeling that the mitigations that were being put in place, Q: I think it was a curfew at 10 o'clock in a pub, that it was not going to make any difference.
Indeed. And that was an article in the -- there was an article in The Financial Times in that respect --
A: That's correct, yes.

 

[elbows]

The modellers are the hardest to quote to the proper extent so far, because I could almost end up quoting their entire evidence sessions. Having to go for extreme cherrypicking.

John Edmunds from the same session already linked to earlier today:

Pages 43-44:

Q: But the basic information about the threat of this virus and its potential fatal impact and the impact upon the healthcare systems of this country were known, was known, relatively early on?
A: Correct, yes.
Q: It was known, putting together the reproduction number, the infection fatality rate, the knowledge of the sizeof the population in this country, the knowledge of --
A: Demography, yes.
Q: --how big the NHS is--
A: Yeah.

Q: -- that was all apparent to those in the know, to the experts, certainly by the end of February?
A: Oh, yeah. I mean, earlier than that, really.
Q: When earlier than that, do you assess?
A: Sort of mid-February, I think, where we had probably a pretty good -- pretty good idea. You get an initial sketch even earlier than that, perhaps, but then -- which might give you, you know, an initial impression, but of course then you improve on that and then you understand some of the nuances, like the -- how risk varies with age and how risk varies perhaps with other -- with other sorts of variables, ethnicity -- obviously those sorts of things came later.

Page 50:

Q: And when you say "we would face a very, very major pandemic", you mean, so that we are clear?
A: Something like 1918. That was always -- you know, that would have been -- and of course that's the great -- it was the great influenza pandemic of more than 100 years ago. You know, it's sort of etched in people's -- especially my field, of course, the sort of collective memory has been a horrendous event, and this looked, there was -- it was, you know, every time a new bit of data came in they just sort of confirmed that this was going to be something like that, you know, a once in a hundred years event, horrific.

Page 51:

So by late January, early -- late January, let's say early February, we knew something about the characteristics, you quite rightly say, so there was quite a long period between infection and you becoming ill of sort of five or six days, which is very different to flu, which is sort of one or two days, and so there was a possibility that gave you a bit more time, if you were trying to contact trace -- I mean, if you're trying to contact trace, it gave you a bit more time to be able to do it.

Pages 55-57:

Q: What I'm asking you, though, is why was that terrible conclusion, that dawning realisation that the virus was coming, it was a fatal pathogenic disease, and there was in practice, you understood, not much more than a hope that it could be controlled, why was that warning, why was that realisation not made more apparent to government in the middle of February, to the public --
A: Yeah.
Q: -- to the United Kingdom --
A: Yeah.
Q: -- that this pathogenic tsunami was coming?

A: So I distinctly remember my feeling at the time. I assumed that the government did know all of this. I mean, you know, I can't believe that they didn't, quite honestly. I still can't believe that they didn't.
So I assumed that they did know all of this, and that actions were being taken.
I -- the messaging at the time was very reassuring, and I assumed that there was a plan: let's not concern people and bother people now, because we'll have to -- we'll have to get people prepared, and do it in the right way. That was my assumption at the time.
Afterwards, I look back on it and think: actually, really, you know, was there a plan? I'm not sure. But I'd assumed that there was. I assumed that the messaging being quite reassuring was there for a reason.

Q: I'm not asking you to speak for the government, and we'll come later to how much the government responded to the advice you actually did give. I'm asking you and, through you, vicariously SAGE and SPI-M-O and SPI-B and all the august, brilliant advisory committees, the epidemiologists, the modellers, the virologists, why was that warning not being shouted out from all of you --
A: Yeah.
Q: -- from mid-February?
A: Yeah. So I didn't think we had to shout it. You know, in terms of the government, I -- you know, something of this magnitude you'd have thought the government should have all its attention paid to it, you'd think. So there's that.

Secondly, yeah, I kind of just assumed that there was some reason for not shouting it out. I remember quite distinctly -- I remember Neil Ferguson gave a --did say something on Radio 4 and I remember Chris Whitty also saying something. There was this kind of funny period where people would talk about, as you're talking about, the -- you know, the reproduction number and the implications that would mean for how many people might get infected in an unmitigated wave, and there was talk about the infection fatality rate, and so, you know, you could easily just multiply those two numbers together and get a very big number for deaths. But people didn't. I was ... you know, people avoided multiplying, you know, in public utterances.
And I felt that -- I honestly thought -- I mean, it sounds really naive and silly, I think, but I honestly thought there was a plan. I didn't want to be the person who multiplied those two numbers together and -- I thought that should come from someone central in a kind of organised -- in an organised comms plan way to prepare the country for what was going to happen. And I didn't want to get -- I didn't want to mess that up in any way.