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UK covid response: If they were following the science...

The UK's response to Covid-19 is a national tragedy. It's not just a case of "bad luck": we had approx 2 weeks extra time than Italy in coming up with our response, and yet we somehow managed to achieve a higher number of Covid deaths, and even, a higher number of Covid deaths-per-million.

For me, it's the deaths-per-million that is the number to care about, since it adjusts for the big differences in numbers you would get simply from a country being large or small. For a long time we were tracking along with the same rates as France and the Netherlands, both countries that "got the virus" at about the same time as us. Then our stats pulled away, now being twice the (normalised) fatality rate as those countries. Twice.

You can also measure "excess deaths" which helps account for deaths not necessarily labelled as "covid deaths". As of May 15th, the FT lists us as having 59,500 excess deaths (+65%), versus Italy's 46,700 (+47%) and Spain's 43,500 (+62%). (Update: the FT has an article on 28th May analysing our higher death rate in more detail.)

The minor differences in how each country reports their data are insignificant here. They can't possibly explain away this tragedy. We had two extra weeks to get our preparations in place. And there are plenty of reasons the UK should have been one of the best-prepared countries in the world. This BMJ editorial gives a good overview of the UK's public health failures in handling the coronavirus. There were (probably) mistakes in the scientific advice, and these are mentioned in the article. But don't let that misguide you - there were big, very big errors of judgment at the political level too. And it is the government which has the responsibility for getting us through crises like this. Our numbers should not have been anywhere near as bad as Italy's or Spain's.

Politicians are dedicated experts at pinning the blame on anyone but themselves, though. The UK government are already trumpeting loudly the defence that they're "following the science", and surely they will use that defence when the public inquiry comes.

So. Putting aside many of the other uncertainties - if they were indeed following the science, then:

  • Why did Boris Johnson not turn up to any of the early Cobra meetings about Covid, to find out what the science was? (January, February - he missed all 5 of the Cobra Covid meetings, finally turning up to chair one on March 2nd.)

  • Why did Boris Johnson give a speech on 3rd Feb in which he enthusiastically promoted an idea of the UK as a small plucky country that would refuse to close its borders, all in service of the ideal of free trade?

  • Why were Dominic Cummings and other political advisors, able to be present at some SAGE meetings despite the strong risk of affecting the political neutrality (real or perceived) of the scientific advice?

  • Why did the government, at any time between 2016 and 2020, not make preparations in response to the critical warnings from the 2016 Exercise Cygnus (pandemic preparedness exercise)?

  • Why, when scientists advised that the public should not shake hands, did Boris Johnson announce gleefully that he had been shaking hands with everyone when he visited a hospital ward with Covid patients (March 3rd)?

  • Why did the UK government advise the public not to go to pubs, while also not mandating that pubs should close? (March 16th) (Anecdotally: I walked past a couple of pubs, and saw them packed full with people, presumably grabbing a last chance before any potential closure. The closure eventually happened on March 20th.)

  • Why were incoming flights still broadly permitted, without testing, even from highly-infected parts of the world, as late as April 16th?

  • Why did the UK Government claim in May that they had "brought in the lockdown in care homes ahead of the general lockdown", when there was no lockdown in care homes until the general lockdown? (There was non-mandatory guidance, on 13th March.)

  • Why did the UK Government redefine its "covid tests completed" statistic to include tests posted out to people, even if not returned or processed - creating obscurity about the true number of tests completed and thus the covid incidence rates? (The Chair of the UK Statistics Authority sent a strongly-worded rebuke to the UK Government (2nd June) about its test data reporting.)

  • Why, when the government introduced its "alert levels", did it clearly state that alert level 4 would mean restrictions remain in place (May 11th), but then later (the first week of June) eased lockdown restrictions while also keeping the alert level at 4?

  • Why, instead of maintaining clear public messaging about the safety rules, did 10 Downing Street and many cabinet ministers choose to leap to the defence of special advisor Dominic Cummings when he was revealed to have broken the guidance and potentially the law? (The government could perfectly well have declined to comment, citing it as a personal matter. I find it deeply troubling that they instead chose to risk the public trust in their messaging by linking it to Cummings' chosen behaviour.)

None of these are "science led" actions, even considering the differences in advice from different scientific advisors. I'm nervous that the scientists involved, who are presumably much less experienced at media and spin than the politicians, may end up scapegoated for mistakes and ambiguities which we can see in retrospect. One of the scariest implications of that would be the big disincentive for scientists to get involved with giving their expert advice to the UK government in future.

If you are involved in science: beware of framing your conversations around flaws/gaps in the scientists' advice - even though that can be an interesting discussion (particularly because it's more concrete than discussing politicians' ideologies). As the list above shows, the people in charge made lots of concrete statements and decisions that deserve clear scrutiny. Similarly, there's no point blaming politicians nor scientists for innocent mistakes. Instead, focus on clear deliberate actions such as listed above. So much of the UK's response was shaped strongly by political ideology and political allegiances. We need to investigate these.

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