The Independent Scientific Advisory Group for Emergencies (Sage) has warned the UK faces “inevitable” future lockdowns if the government implements its “potentially dangerous” coronavirus strategy.
The committee was formed to provide a “constructive” alternative to the official Sage team, which has come under fire for a lack of transparency over the advice it gives Number 10.
Chaired by the former chief scientific adviser, the 13-strong independent group has argued the government’s approach of “managing” the outbreak rather than “suppressing” it risks the “rapid return of localised epidemics”.
Boris Johnson has set out plans for England’s return to a “new normal”. This includes primary-school children going back as soon as June and outdoor pub areas potentially being opened in early July.
Independent Sage has argued the “R number”, which officials are using to track the rate of infection and assess restrictions, is three to four weeks out of date.
Coronavirus: Government approach ‘counter-productive’
In a report released on Tuesday, Independent Sage stated: “We detect ambivalence in the government’s strategic response, with some advisers promoting the idea of simply ‘flattening the curve’ or ensuring the NHS is not overwhelmed.
“We find this attitude counter-productive and potentially dangerous.
“Without suppression, we shall inevitably see a more rapid return of local epidemics and face the prospect of further partial or national lockdowns.”
Latest coronavirus news, updates and advice
Many have accused the prime minister of setting out a confusing action plan on how the government will ease its extreme restrictions.
The decision to change the advice in England from “stay at home” to the somewhat-muddled “stay alert” has inspired countless internet memes.
Independent Sage wants the recommendations to be “advice closely linked to action”.
Speaking at a press briefing, Independent Sage member Professor Susan Michie, from University College London, said: “The concern with the slogan of ‘stay alert’ is it’s not very obvious what this means.
“The public wants really clear, behaviour-specific advice about who should be doing what and where”.
According to The Guardian, the UK’s chief scientific adviser Sir Patrick Vallance and chief medical officer Professor Chris Whitty were not asked to sign off the “stay alert” message before Johnson announced it on 10 May.
Speaking of the Independent Sage report, its chair Sir David King said: “Since the start of the COVID-19 epidemic the government has told us they are ‘following the science’, however, in the weeks and months that have followed it has become increasingly apparent that this is simply not the case.”
COVID-19 is the name of the respiratory disease that can be triggered by the coronavirus.
During the daily Downing Street press briefings, officials often talk about the importance of bringing the R number to below one.
The R, or the basic reproduction number, is the number of people a patient statistically goes on to infect.
With no restrictions in place, the coronavirus’ R number is thought to be three, which would cause the outbreak to grow exponentially.
Keeping the R below one means an outbreak eventually dies out.
Contact tracing and community quarantining ‘crucial’
Independent Sage has claimed the government is basing its decisions on R numbers with a three to four week lag time, when it should be using “real-time” models.
At the heart of the report, the committee set out proposals to address the government’s failure to implement a policy of testing, tracing and isolating cases.
The UK stopped routinely testing non-hospitalised patients on 12 March.
Sir Vallance said this would “allow the epidemic to spread and build herd immunity” the following day.
Independent Sage argued contact tracing and community quarantining is “critical” to stop further waves of the epidemic.
Independent Sage has also criticised the “inaccurate, incomplete and selective data” presented by government officials during the press briefings.
For example, statistician Sir Professor David Spiegelhalter, from the University of Cambridge, previously claimed country-to-country death rate comparisons are “deeply unreliable”.
A chart presented on 29 April showed the number of COVID-19 fatalities per million people, with the UK appearing to be in a less severe situation than Belgium, Spain or Italy.
The UK figures, however, only included deaths where the patient tested positive for COVID-19. The Belgian statistics were made up of all suspected cases, regardless of whether they had been swabbed.
It is only since 29 April that England’s figures have included deaths outside the hospital setting, like in care homes.
Care home deaths made up 40% of all COVID-19 fatalities in England and Wales in the week ending 1 May.
Independent Sage has called for the Office for Statistics Regulation to assess the data presented so far.
To improve tracing and tracking of community cases, the committee has urged for GPs and other primary care teams to be involved rather than “outsourcing” patient monitoring to “private contractors”.
The committee called primary-care medics “central to the success of virus control”.
“Contact tracing is the bread and butter of public health,” said Professor Allyson Pollock, from Newcastle University.
“It it needs to be done in local communities [where primary care staff] understand the extent [residents] can comply with isolation.
“If you want to put out a fire in Blackpool, you don’t call a fire engine in London”.
Independent Sage also believes anyone who develops the coronavirus’ tell-tale fever or cough should self-isolate entirely at home for 14 days, in line with the World Health Organization’s advice.
Britons have been told to isolate for seven days if they develop signs of the infection, while other members of their household should do so for two weeks.
While the race is on the develop a vaccine, which has been hailed the way out of lockdown, Independent Sage has warned it is “foolish” to bank on a jab being available soon.
Ethicists have previously said “crises are not an excuse to lower standards” when it comes to vaccine development.
The government must instead prepare for “recurrent local outbreaks” for at least the next year by investing in local healthcare, said Independent Sage.
Statistics have also revealed coronavirus-related deaths in England are twice as high in deprived areas as well-off regions.
Many front-line positions – like social care staff and delivery drivers – are poorly paid, with these workers being forced to work in the midst of the outbreak
Independent Sage said “poorer people [are] expected to risk their lives to get the economy going whilst wealthier people stay in the safety of their homes”.
Johnson recently announced people who cannot work from home, like builders, should be encouraged to go back to the site.
‘Poorer people’ more likely to risk their lives, says group
“‘Staying alert’ does not protect vulnerable groups who have been forced to go out to work,” said Dr Zubaida Haque, deputy director of the Runnymede Trust think-tank.
“When you have a choice between working in an unsafe environment and feeding your family, you work in an unsafe environment.
“We know [the] ‘stay at home’ [message] has been very effective at protecting vulnerable communities.
“This [stay alert] is a reckless message; [it] puts the onus of responsibility on individuals who may not have all the information to protect themselves”.
Independent Sage claimed the government should continue its furlough scheme until staff are guaranteed of a safe working environment, which includes public transport.
The Coronavirus Job Retention Scheme, which supports 7.5 million jobs, has been extended to the end of October, chancellor Rishi Sunak told parliament on Tuesday.
Sunak added that he would allow firms to reintroduce workers on furlough leave on a part-time basis from July to help them recover.
Staff will continue to receive pay subsidies at 80% of average pay up to £2,500 ($3,082) a month, rather than a cut to 60%, as some had anticipated.
His statement said the costs would be “shared” from July by the government and employers however, with further details on the hit employers will have to take expected by the end of the month.
The Independent Sage report will be sent to Sir Vallance; number 10 Downing Street; the first ministers in Wales, Scotland and Northern Ireland; and Jeremy Hunt, the chair of the Health Select Committee.
“It is vital the best possible science advice is not only being received by the government, but also by the public”, said Sir David.
“Following our Independent Sage meeting last week, we have produced this rapid response report with actionable recommendations that we firmly believe if adopted will help the UK bring this pandemic to an end as quickly as possible with the fewest fatalities, something that surely must be the government’s primary goal.”
Fiona Godlee, editor in chief of the BMJ, added: “The committee's report is welcome, not only for its wide ranging recommendations but for the refreshing openness about uncertainties, disagreements and debate on key issues.
“I hope the government will take note not only of the content but the manner of its creation and dissemination.”
What is the coronavirus?
The coronavirus is one of seven strains of a virus class that are known to infect humans.
Others cause everything from the common cold to severe acute respiratory syndrome (Sars), which killed 774 people during its 2002/3 outbreak.
Since the coronavirus outbreak was identified, more than 4.2 million cases have been confirmed worldwide, according to Johns Hopkins University.
Of these cases, over 1.4 million are known to have “recovered”.
Globally, the death toll has exceeded 286,600.
The coronavirus mainly spreads face to face via infected droplets expelled in a cough or sneeze.
Symptoms include fever, cough and slight breathlessness.
The coronavirus has no “set” treatment, with most patients naturally fighting off the infection.
Those requiring hospitalisation are given “supportive care”, like ventilation, while their immune system gets to work.