2. Submissions on Behalf of the Government Office for Science by Mr Sheldon KC

Mr Sheldon: My Lady, the Government Office for Science, which I represent, remains acutely conscious of its responsibilities to those affected by the Covid-19 pandemic, to those who will be affected by future pandemics when they inevitably occur, and to your Inquiry.

It has sought to discharge those responsibilities through the detailed and reflective evidence of Sir Patrick Vallance, Dame Angela McLean, And Dr Stuart Wainwright, as well as through the provision of a large volume of documentary material. We hope you have found that evidence helpful.

We intend to provide you with a set of written closing submissions which will address some of the detail of the evidence, and the brief observations I make this morning are intended to address in outline a handful of the key themes of the evidence most directly concerned with the provision of scientific advice to decision-makers.

As I observed in our opening submissions, and as I hope you have found, the task of identifying what scientific advice was given, when it was given, and the terms in which it was delivered, has been one of the easier tasks faced by this Inquiry. There is a clear, contemporaneous and publicly available record of that advice in the SAGE minutes and the papers discussed. That advice was distilled and communicated to ministers by the GCSA and the CMO, and there has been a striking consistency in the evidence of all ministers from whom you have heard that this was done accurately and it was done well. In any event, the minutes themselves were available to any minister who wished to refer to them from the outset.

It is the view of GO-Science, both the present and the former GCSAs, that it is important to maintain the transparency and the integrity of that approach. It was and should be clear what science advice is being given by SAGE, and clear what that science advice is based upon. Challenge and debate were and should be encouraged, and you have heard from a number of attendees how valuable they found that process to be.

Providing useful science advice to decision-makers is best achieved, we submit, by assembling scientists with relevant expertise, debating the issue and producing a consensus or central view of the state of current scientific understanding on that issue, including the level of certainty with which that understanding can be expressed and the understanding that advice will and should change as new data emerge.

To the extent that there was some misunderstanding as to what consensus means in that context, and whether it implies the suppression of dissent, we trust that that has been resolved by the evidence you’ve heard.

So, we would submit that the evidence shows that the structure for the provision of scientific advice during an emergency such as a pandemic is fundamentally sound. The model necessarily depends on eminent scientists being prepared to contribute time and personal resources to the process, but they did so, for the two years and 105 meetings that SAGE was in operation, for which we can all be grateful.

In particular, we would invite the Inquiry to treat with caution suggestions of changes to the approach to SAGE minutes, which were produced quickly and circulated widely, or to the composition of SAGE, or to the way in which its advice is communicated to central government.

SAGE evolved and improved its processes during the pandemic as lessons were learned through experience. The SAGE development programme has identified further areas for improvement, but the essential framework is sound. It is well respected internationally, and it showed itself capable of delivering large volumes of high quality scientific advice under intense time pressure throughout the pandemic.

There has been an intense focus on the timing of the first lockdown and the decision-making leading up to it. Witnesses have expressed the view that, in hindsight, it would have been better had the 23 March full lockdown commenced a week or so earlier. Sir Patrick was one of those witnesses, and we would commend that view to you.

We do not consider that the evidence supports the proposition that a lockdown at the very start of March was realistic, a time, you will recall, when the Prime Minister decided against advising people to stop shaking hands. And you will also be aware of the very limited data available at that stage to be deployed in support of such extreme action, as well, of course, as the reluctance to order a second lockdown in autumn 2020, even when the data, including the number of deaths, was far more compelling.

Nor does the evidence support, we would suggest, the viability of achieving the necessary 75% reduction in contacts through voluntary action alone.

In the event, the peak of the first wave occurred in April, and it was earlier and lower than it would have been if lockdown had been further delayed. Lockdown a week or so earlier is likely to have resulted in a somewhat earlier and lower peak than we in fact experienced, and it is on that basis that we consider that it would probably have been beneficial.

The ultimate lesson from the timing of the first lockdown is simply that, as Sir Patrick has put it to you, you have to go earlier than you would like, harder than you would like, and more geographically broad than you would like, with the necessary interventions. You cannot expect to be able to predict the right time with any real accuracy, and if you wait until the data has reached the point at which you are comfortable that the measure is obviously required, you have almost certainly waited too long, at least for this type of pandemic.

Now, that may seem obvious now, with the knowledge and experience of the whole pandemic, but it was far from obvious at the time to anyone seeking to take a balanced and objective view of the available information.

The data was sparse and inadequate, but it was difficult to assess how inadequate it was or how much reliance could be placed upon what was available. There was very little testing and tracing capacity, and it was simply not possible in the early part of 2020 to get an accurate picture of the prevalence of the virus across the country. Several independent scientists have told you that it was not until around 13 March that the data allowed for scientifically coherent advice that urgent and extensive action was required. When that picture became clear, that advice was given promptly.

It is also important to keep in mind, as we’re sure you will, my Lady, that a pandemic is not a single event requiring a single and immediate response. It runs a course. The question of whether to order a lockdown or any other significant non-pharmaceutical intervention inevitably incorporates the questions of: what damage will it do? And what happens next?

As I said, it is likely on balance that the first lockdown a week or so earlier would have had some long-term beneficial effects, but what the effects of a lockdown even earlier than that would have been is far less apparent, and would require those who propound that theory to grapple with the “What damage?” and “What next?” questions, which we would suggest have yet to be convincingly answered.

What can be said with confidence, though, is that in all eventualities a more scaled and effective test, trace and isolate system, available to be applied early, would have helped suppress the virus.

There has been some inaccurate and ill-informed suggestion that there was a significant divergence of view between the GCSA and the CMO as to the timing of the first lockdown. That is not so. The advice of SAGE, including its assessment of the progress of the pandemic and the effect of NPIs, is in the minutes and was communicated to decision-makers by the GCSA and the CMO as co-chairs of SAGE. That is all a matter of record.

However, Sir Chris, as the Chief Medical Officer for England with overall accountability for public health, had a responsibility to identify to ministers the wider health impacts of a measure as extreme as a lockdown: the deaths that would be caused by other agents than the virus; the conditions that would go untreated; the diagnoses that would be missed; the mental health impact on the vulnerable and the isolated. Discharging that responsibility did not put Sir Chris at odds with Sir Patrick in March 2020 or at any other point. On the contrary, it was essential that decision-makers were made aware of both strands of advice, and lest there be any doubt about it, Sir Patrick holds Sir Chris in the highest possible regard, as he did for the entirety of the time they worked together, day in and day out, throughout the pandemic.

Whilst on the subject of Sir Patrick’s personal views, can I deal briefly with what have been referred to as the evening notes.

Sir Patrick explained in both his written and oral evidence how those notes came to be written and how they were never intended to be read by anyone else for any purpose. It has been said that he provided them to the Inquiry willingly, and to the extent that it was not necessary for you, my Lady, to exercise your powers of compulsion to enforce the request that he submit all his written and electronic notes, that is of course true. But that does not mean, as you know, that he provided them enthusiastically. He hopes it is now clear to everyone that they reflected unedited thoughts scribbled down in the most challenging circumstances, and if anyone wishes to know his true and considered opinion about the decisions taken and those who made them, they are in his witness statement and in the transcript of his evidence to you.

The shorthand that has perhaps understandably crept into some of the questions to the effect that, by reference to his evening notes, “Sir Patrick said that” or “accused” someone of something, is therefore inaccurate and, we would respectfully suggest, unhelpful.

In general terms, and as reflected in his statement, Sir Patrick considers that those with the heavy responsibility of core decision-making during the pandemic took care to listen to and understand the scientific advice provided by SAGE. Everyone, particularly in the early months, was operating in the fog of war and under acute pressure of time, and it is inevitable that recollections on some matters vary and misunderstandings may have arisen. No criticism of anyone is intended by this short list of issues in respect there has been some variation in the evidence but where the contemporaneous documentation makes the position clear such that, we submit, the Inquiry can reach a confident conclusion.

First, SAGE began to consider and advise upon the need for and effectiveness of multiple NPIs from early February 2020, having convened for its first meeting on 22 January. The first paper on NPIs was produced on 3 February, and by SAGE 10, 25 February, a package of measures had been identified as representing a realistic means of reducing the spread of the virus. The specific phrase “lockdown” was not used at the outset, as you have seen, and it did not become part of the vernacular until some weeks later, but very significant, indeed unprecedented, restrictions were being expressly considered by SAGE and reflected in its advice throughout February, including the percentage reduction in contacts that would be needed to be effective.

It was of course for government departments and agencies to plan how such measures would be put into effect, and for ministers to decide which ones should be implemented and when, but the fact that these measures were being considered and advised upon by SAGE from a very early stage is clear, we submit.

Second, in the absence of any available alternatives, early references to the pandemic flu reasonable worst-case scenario of 800,000 deaths were useful in communicating the potential scale of the emergency and the need for action. The essential message, which is reflected in the COBR documentation from February 2020 onwards, was that there was a significant chance of a very bad outcome. It cannot realistically be suggested that references to this worst-case scenario were in any way reassuring to anybody, and the reduction in the RWCS to 525,000 deaths in late February 2020 plainly made no difference in that regard. Indeed, the fact that this figure was calculated with greater information about the nature of SARS-CoV-2 may have made it still more worrying.

The Inquiry has heard evidence on how the RWCS could be augmented and improved, and that must be considered carefully, of course, but it must be remembered that in early 2020 it was the established approach used by the Civil Contingencies Secretariat.

Third, the possibility of asymptomatic transmission, as distinct from asymptomatic infection, which, as you know, my Lady, is a different concept, was identified by SAGE at an early point. Sir Patrick noted that it appeared to be occurring in correspondence on 1 February. It was identified as a possibility by SAGE on 4 February, and it was referred to in the COBR documentation shortly thereafter, including an early COBR meeting chaired by the Secretary of State for Health.

Fourth, neither SAGE nor Sir Patrick ever advised the adoption of a strategy of pursuing herd immunity other than through vaccination. As the extent that the virus had become seeded in the population became clearer during March 2020, it was acknowledged that significant numbers of people would inevitably become infected and a degree of immunity would be generated as a result. This was a factor that needed to be taken into account when considering the future course of the pandemic and assessing the effect of different interventions. The evidence of the key witnesses has been clear on this point and we would submit there is no longer any doubt about it.

Fifth, the list of attendees and invitees to SAGE meetings is a matter of record, and the contemporaneous documentation demonstrates the extent to which the devolved administrations were engaged in the SAGE process. We’ll return to this issue in our written submissions, but in light of what was said yesterday, can I briefly deal with the position in respect of Northern Ireland, whose CMO was invited to SAGE from as early as 11 February 2020.

You may feel, my Lady, that it was for the Northern Ireland Executive and departments, in common with their colleagues from other devolved administrations, to decide how and when they chose to attend SAGE meetings to which they were most certainly invited.

Sixth, the contemporaneous documentation, including SAGE minutes, established that neither SAGE nor the GCSA was asked for advice on the impact of the Eat Out to Help Out policy. Whether they should have been, and whether there were good reasons for not doing so, are matters for you. But the factual position is clear. It is also clear that around that time the science advice was that more openings would be associated with higher infection rates. The merits of the policy, to the extent that they may be relevant, are for you and we take no position, nor have we ever suggested that the policy was responsible for the second wave.

Finally, my Lady, for the purposes of this list, the events of autumn 2020 and the advice given in the lead-up to the second lockdown. Here again, the contemporaneous documentation is clear. The science advice when lockdown measures were eased in May and June 2020 was that there was a significant risk of R going back above 1. It duly did so, in part as further measures were eased over the summer.

As we moved into the autumn, it was made equally clear that significant measures would be required to prevent the number of cases growing exponentially, and the SAGE minutes clearly record the measures that were discussed and the assessment of their likely effect. SAGE was not consulted on the three-tier approach that the government chose to adopt, and Sir Patrick made clear in correspondence with the Cabinet Secretary in early October 2020 that those measures would not be sufficient to keep R below 1. In the event, the policy decision was to proceed with the tiered approach in the first instance, just as the policy decision was taken to reduce the 2-metre rule to 1 metre, notwithstanding the scientific advice, again recorded in the SAGE minutes, that this would increase the risk of transmission.

But these are reflections of the different roles of scientific advisers and political decision-makers. It’s for elected decision-makers to take the difficult policy decisions, balancing the full range of relevant considerations. SAGE sometimes took the initiative to consider certain issues, but its essential function is to respond to requests for advice from decision-makers, and it is a matter for them to decide what issue they wish to be advised upon and how to act in light of the advice they receive.

It is also recognised that science cannot provide a clear answer to every question, and answers change over time as evidence changes.

By the time we get to the relaxing of the third lockdown, it is clear how better understanding of the virus, better data and a more developed test and trace capability enabled a far more informed approach to be taken. As the quality of the data improved, so did the precision of the science advice and the ability of decision-makers to take sophisticated decisions in light of that advice.

That is why, we would suggest, my Lady, the Module 2 evidence has been valuable in illustrating the importance of the potential recommendations discussed in Module 1 about preparedness for a future pandemic. More developed test and tracing capacity, improved diagnostics and therapeutics, more collaborative research, and greater vaccine manufacturing capabilities, will all contribute to better advice, a wider set of options beyond the inevitably crude tool of lockdown, and better, more informed decision-making.

So we anticipate, my Lady, that you will have well in mind the need to ensure that any assessment of the core decision-making in the pandemic takes account of the course of the pandemic as a whole, and that the successes of the later period are just as important in identifying valuable lessons for the future as any deficiencies you may identify in the early period.

My Lady, that concludes my submissions for today. The Government Office for Science looks forward to assisting you with future modules of your Inquiry.

Lady Hallett: Thank you very much indeed, Mr Sheldon.

Mr Block? Ah, right at the back.