48 hours in September when ministers and scientists split over Covid lockdown
[...] Professor John Edmunds, of the London School of Hygiene and Tropical Medicine, presented the view of the government’s Sage advisory group, which wanted a two week circuit-breaker lockdown. [...]
But his firm view on the necessity for an immediate lockdown was clear in a paper he co-authored with other Sage members that weekend. “Not acting now to reduce cases will result in a very large epidemic with catastrophic consequences in terms of direct Covid-related deaths and the ability of the health service to meet needs,” they wrote.
[...] in the summer, the prime minister began relaxing social-distancing measures when the number of infections was higher than they had been in other European countries when they lifted their lockdowns.
[...] After the Sunday evening meeting in Downing Street,
Johnson continued with a series of weaker measures to contain the virus for six more weeks until — as the scientists predicted — the number of infections rose so high that his hand was finally forced into bringing in a national lockdown because the NHS was again in danger of being overrun.
As a result, more than 1.3 million extra infections are estimated to have spread across the country.
[...]
Sage had advised the government on June 23 to relax the strictest measures incrementally so that it could gauge the effect each one had on infection rates and prevent infections from “accelerating”. The rush to open everything up, therefore, meant the scientists were unable to read which of the measures caused the spike that began in July.
[...] the chancellor cheerfully served tables in a branch of Wagamama to advertise one of his new big initiatives: Eat Out to Help Out. [...]
The initiative was never put before the scientific advisers on Sage. Nor were members of Sage consulted on a sudden reversal of a key policy to control the virus announced by the prime minister in an online forum with the public two days later. He said it was time to replace the “stay at home if you can” with “go back to work if you can”’
[...]
But it was too good, according to researchers from Warwick University, who
found that the [Eat Out to Help Out] initiative may have been responsible for between 8% and 17% of new Covid-19 clusters in August and early September. Encouraging many different households to share enclosed indoor spaces, regardless of “Covid-secure” measures, had allowed the virus to proliferate dangerously fast.
The report’s author, Professor Thiemo Fetzer, concluded: “Eat Out to Help Out may in the end have been a false economy: one that subsidised the spread of the pandemic into autumn and contributed to the start of the second wave.”
They were strong words, but he was not alone in taking that position. “If you look at the use of restaurants in July, it’s pretty low,” the Sage source explained. “It took a bribe from the chancellor to make us go. It wasn’t about support for restaurants — otherwise, it would have counted for takeaways. It was to break our fear, and it worked.”
[...]
As part of the drive to return life to normal, international travel was opened up on the same day as Johnson’s online forum. A new “traffic light” system of “travel corridors” was introduced that
allowed people to travel to 59 countries with no requirement to quarantine for 14 days on return to England.
The policy was questionable, given that British tourists were travelling to countries such as Spain with higher rates of infection. In the penultimate week of July, when the air travel corridor was still open, Britain had 6.8 cases per 100,000 people, whereas Spain had 25.9 cases per 100,000. Many people brought the virus back into Britain from their travels.
This would later show up in research on the second wave of the virus.
A study from Basel University in Switzerland shows a new variant of the virus appears to have emerged in Spain in early summer and then spread to the UK by the middle of July. Remarkably, by September the variant was estimated to be responsible for 50% of virus cases in England and 80% of those in Wales and Scotland.
[...]
As September approached, the government was imploring people to return to working life after the school holidays.
[...]
According to Google tracking data — a source used by the government — the number of people attending workplaces was now just 35% below normal levels, whereas it had been down 70% during the first lockdown. [...]
[...]
Sage committee minutes show that it was recognised at the end of July that infections may no longer be below the crucial “one” threshold for R and by early August the scientists were advising that “strong measures introduced early for short periods are likely to be more effective in reducing transmission than less stringent measures which would need to be implemented for longer”.
[...]
Many scientists also favoured a strategy that was aimed at cutting infection to near zero. Professor Steven Riley, a member of the government’s scientific pandemic influenza group on modelling (SPI-M), which reports to Sage, said the UK must adopt such an approach if the country faced the same situation again. “From the experience of this pandemic, some countries have had much, much better outcomes by pursuing that [approach]. Even if we didn’t achieve it, we should have it as an objective,” he said. “I don’t think that will be controversial. In fact, it’s almost silly to suggest otherwise.”
Indeed, in May, economists at the World Bank had published a report entitled “The Sooner, the Better”, which concluded that countries in Europe and central Asia that had acted earlier to stem the virus’s spread had suffered less damage to their economies and fewer deaths. Locking down early was a win-win strategy. It was advice that many scientists believed should be applied to avoid further economic damage from a second wave.
[...]
The effects of the government’s strategy were becoming increasingly evident in the figures for new infections. By September 1, the average daily figures over a week had passed 2,000 for the first time since the first wave. They had almost quadrupled since Super Saturday.
The largest Covid-19 testing study of virus infection, undertaken by Imperial College London, has shown that between August 22 and September 7, the R number was estimated to be 1.7. In other words, it had hit the benchmark for the “worst-case scenario” the government’s scientists had set six weeks earlier.
[...]
The new “rule of six” came as a surprise to some of the government’s own scientists. Assistant professor Nicholas Davies, who sits on the government’s SPI-M committee, said his colleagues
had not been consulted. “They seemed to be making decisions, and it wasn’t really clear what the rationale for them was,” he said. That day
his modelling committee informed the government that the “the current situation is in line with the latest reasonable worst-case scenario”. But another week went by.
[...]
... on Wednesday, September 16, with infections rising to more than 4,000,
Johnson was still firmly against tougher measures. “I don’t want a second national lockdown,” he told a parliamentary committee. “I think it would be completely wrong for this country, and we are going to do everything in our power to prevent it.”
[...]
Hospital admissions for Covid-19 had doubled since the beginning of the month, they said, and the country was on track for 200 to 500 deaths a day by early November. The two experts urged the prime minister to impose a two-week circuit-breaker lockdown to bring the R number back under control.
Johnson is said to have initially sided with the two scientists. “There’s no question,” he said as he toured a new vaccine factory two days later on Friday, September 18, in his hard hat, “[we] are now seeing a second wave coming in”.
The proposal for the two-week lockdown went before the Cabinet Office’s Covid-19 operation committee, where it is said to have been accepted by Hancock and Gove. Plans were started to announce the circuit-breaker.
However, Sunak was the dissenting voice. On Friday evening, the chancellor met Johnson to express his concern about how damaging the quick lockdown could be to the economy.
The meeting resulted in invitations being sent out to the four academics — Gupta, Heneghan, Edmunds and Tegnell — to speak at Downing Street on Sunday, September 20. The presence of Tegnell, Sweden’s leading epidemiologist, was particularly controversial because his country had suffered a high death rate during the first wave. To date, Sweden has suffered 7,354 deaths from the virus compared with 442 and 918 in neighbouring Finland and Denmark respectively.
Many thought then his policies might have achieved some herd immunity, but infections would begin to rocket upwards again not long after he spoke at No 10. Tegnell now says a herd immunity approach is “highly unethical”.
The meeting seemed to convince Johnson. Afterwards, he called in his team and ruled out a lockdown. In doing so, he
dismissed the arguments of Sage expert Edmunds, who was warning of a “catastrophe” if it was not introduced.
The split with his chief scientific advisers had never been more apparent.
[...]
But Vallance and Whitty had lost the battle over the circuit-breaker lockdown and they were publicly at odds with their political masters. That day, the Sage meeting — which they jointly chair — endorsed the alarming report from Edmunds and his colleagues that warned of dire consequences if the government failed to act quickly. “The more rapidly these interventions are put in place the greater the reduction in Covid-related deaths and the quicker they can be eased,” the report stated.
Johnson, however, was not swayed. The next day, Tuesday, September 22, he announced minor extensions to the rules banning more than six people from meeting and a new 10pm curfew on pubs and restaurants. There was also a request that people work from home if they could. That was it.
The new curfew turned out to be a symbolic gesture and Google tracking data shows that the number of people attending workplaces continued to rise.
The Sage member says
the announcement ignored advice that a tougher package of interventions was needed. “Just picking one [intervention] and saying we’re going to try and get people to work from home a bit in some half-hearted way isn’t going to be enough,” he said.
Thomas House, a SPI-M member from Manchester University, recalled his reaction to Johnson’s decision. “It was a bit like, ‘Oh God, haven’t we learnt the message of March?’, which is that, when this starts, you want to act early,” he said. “By September, we’d had months and months of accumulated evidence.”
[...]
The academics in the study concluded: “The argument is strong for countries adopting a so-called zero-Covid strategy, which aims to eliminate domestic transmission.” There was still hope that Europe could regain some control over the virus. “It is not too late for the ... lessons to be learnt and applied now.”
[...]
In the middle of September, hundreds of thousands of students criss-crossed Britain to start the new term at universities and colleges. It was another step too far for the government’s scientific advisers.
“We were concerned that, in particular with the opening of the universities, things could escalate very, very rapidly,” said Professor Daniela De Angelis, a SPI-M committee member. Her fellow SPI-M member House describes the “remixing” of households at universities as a “high risk” to take. “I just thought, ‘Why didn’t we try and get the first semester online?” he said.
[...]
As the days passed, it was becoming obvious that
Johnson’s control measures were having little effect. On October 8, Sage received evidence that infections and hospital admissions were exceeding the reasonable worst-case scenario.
[...] the prime minister announced that he was “simplifying” and “standardising” local rules that had been used in England to damp down infections in towns and cities by introducing three tiers of restrictions.
It was the moment when the rift between the politicians and their scientists became public. [...]
The scientists say they were not consulted. Davies, the SPI-M member, describes the tiers decision as a “a moment of increasing concern and worry for a lot of us because it just felt like
the decision making was disconnected from the science.”
[...] Sunak hit back, accusing Labour of being “detached from reality” and being irresponsible for not acknowledging “the economic cost of a blunt national lockdown”. This was little more than two weeks before the government would perform a U-turn and announce a lockdown.
[...]
Assistant professor Davies says he felt scared that
Johnson appeared to be falling into the same delay pattern that had been so disastrous in the first wave. “It seemed like a repeat of the situation in March,” he said.
[...]
On Wednesday, October 28, with reported deaths at more than 300 a day, the scientists on the SPI-M committee made a final appeal. It produced a report setting out the consequences of continued inaction. As if to emphasise the point, the front-page prominently featured a line stating “not government policy” in large red capital letters.
While the committee had previously avoided making economic projections, now the gloves were off. The scientists wanted to show that the delays were killing people and would ultimately do more damage to the economy.
They argued for a “rapid and decisive” lockdown to control infections at much lower levels which could more effectively be tackled with the test and trace system. This would allow more of the economy to safely open up.
That day both Germany and France announced national lockdowns to curb their own second waves of the virus.
The pressure on the government was becoming too much. On Friday, October 30, health officials delivered a presentation to the Downing Street operation committee with an unequivocal message: hospitals would be overrun in every part of England within weeks if nothing was done to stem the rate of infections.
The prime minister had no choice. After making clear for months that he would not countenance a lockdown, he caved in.
[...]
The government’s delay had a human cost. According to estimates from Imperial College London, 2.5 million people were infected between the day the prime minister ignored his expert calls for the circuit breaker on September 22 and the end of the lockdown on December 1.
The figures suggest that if Johnson had brought in measures to hold daily infections level, 1.3 million fewer people would have been infected. With the virus’s death rate typically estimated at between 0.5% and 1%, it suggests that between 7,000 and 13,000 people
might not have died if stricter measures had been introduced earlier.