{"id":49288,"date":"2020-12-23T18:02:13","date_gmt":"2020-12-23T17:02:13","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=49288"},"modified":"2021-01-05T15:21:41","modified_gmt":"2021-01-05T14:21:41","slug":"as-covid-19-has-progressed-ministers-have-gone-from-hiding-behind-the-science-to-hiding-from-the-science","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2020\/12\/23\/as-covid-19-has-progressed-ministers-have-gone-from-hiding-behind-the-science-to-hiding-from-the-science\/","title":{"rendered":"As covid-19 has progressed, ministers have gone from hiding behind the science to hiding from the science"},"content":{"rendered":"

Ministers have lacked the confidence to draw together scientific and other forms of evidence to form a clear strategy and make decisions, says Tom Sasse<\/span><\/p>\n

<\/p>\n

When Boris Johnson cancelled Christmas for millions on Saturday evening, he was only half-justified in saying \u201cwhen the facts change, you change your mind.\u201d The discovery of a much more transmissible variant of covid-19 rampaging through Kent, made as a result of the UK\u2019s leading genomic surveillance, caught most by surprise\u2014and pointed yet again to the capricious nature of the crisis countries around the world have faced this year.\u00a0<\/span><\/p>\n

Yet, the truth is the facts had already changed weeks earlier, and the prime minister did not change his mind until the very last minute. The government announced its plan to \u201csave Christmas\u201d in November. Rather than saying the situation was uncertain and waiting for data on the impact of the November lockdown, it raised hopes and expectations\u2014in keeping with Johnson\u2019s optimism throughout the crisis. Back in July, he promised a return to normality by Christmas\u2014a pledge Chris Whitty conspicuously failed to endorse.<\/span><\/p>\n

Throughout December, before any whisper of a \u201cmutant strain,\u201d data on transmission grew ever grimmer. Doctors warned of the need to rethink. Britain\u2019s <\/span>leading medical journals<\/span><\/a>, including The BMJ<\/em>,<\/span> called for an urgent change of tack. SAGE minutes have not yet been published, but when they are, they will surely show alarm bells ringing. But having over-promised, the prime minister refused to budge, insisting people could enjoy a \u201cmerry little Christmas\u201d until no other options remained. With many people\u2019s plans already formed, the timing led to a last-minute exodus from London that is already seeding the virus across the country.\u00a0<\/span><\/p>\n

As an example of how, in a crisis, to take uncertain evidence and knowledge into political action, this leaves much to be desired. Yet it bore all the trademarks of mistakes ministers, especially the prime minister, have made throughout the crisis in using scientific advice to inform their decisions and public communication, which we outline in a new <\/span>Institute for Government report<\/span><\/a>.<\/span><\/p>\n

At the outset, Johnson and his cabinet colleagues insisted they were \u201cfollowing the science\u201d, repeating it so often that it became a mantra. Scientists hated the phrase, which gave the impression that they could offer advice that could simply be \u201cfollowed\u201d, rather than used alongside other forms of evidence and information to make judgements (the way the <\/span>other<\/span><\/a> leaders<\/span><\/a> explained it). They felt they were being set up as scapegoats.<\/span><\/p>\n

This confusion lay behind the delay to the spring lockdown, which scientists believe cost thousands of lives. UK scientists have admitted they were <\/span>too cautious<\/span><\/a> in making recommendations based on uncertain evidence, including pre-prints produced abroad. But politicians in countries that locked down sooner proved willing to act pre-emptively.<\/span><\/p>\n

As the crisis progressed, ministers went from hiding behind the science to hiding from the science. From early summer, the government repeatedly sided with the Treasury and resisted scientists\u2019 warnings until the last possible moment.\u00a0<\/span><\/p>\n

The way the government lifted the first lockdown\u2014after months of sacrifice\u2014may prove its biggest mistake of the crisis. Rather than make changes incrementally to test their impact, it encouraged people to return to work, gather indoors in restaurants, and travel abroad. Its scientific experts were not consulted on these policies and thought them epidemiologically illiterate.\u00a0<\/span><\/p>\n

The lesson of the first lockdown had been to act early, but the delay was repeated with the second\u2014ultimately implemented on 2 November, six weeks after SAGE called for it (and two weeks after the prime minister had pledged not to).\u00a0<\/span><\/p>\n

The pattern of over-promising, losing control, and being forced to U-turn has made for very confusing communications. Consistency of messaging is critical in a crisis determined by public\u2019s willingness to make unfamiliar sacrifices to reduce contact. In the initial months, the government achieved hard-won cut through\u2014witness the public\u2019s (well-placed) hesitancy about the government\u2019s invitations to mix again in early summer.\u00a0<\/span><\/p>\n

But since May, ministers have switched back and forth between alarm and reassurance. Rather than explaining<\/span> risks\u2014<\/span><\/i>like <\/span>Japan\u2019s exemplary three C\u2019s\u2014<\/span><\/a>they have focussed on adherence to (often confusing and frequently changing) <\/span>rules<\/span><\/i>. Their authority in insisting the public should not break these was shattered by their weak response when Dominic Cummings, the prime minister\u2019s then chief adviser, did just that. Meanwhile, key messages\u2014that the virus is airborne and transmits best in poorly ventilated spaces\u2014have been lost.<\/span><\/p>\n

Even as ministers diverged more from their scientific advisers, they have still deferred to them when it comes to explanation and persuasion. Watch back the Saturday evening press conference on 31 October, when the November lockdown was announced, and notice the prime minister\u2019s astonishingly brief introduction, apologising only for interrupting people\u2019s evenings and leaving it to the scientists\u2019 slides to explain (<\/span>not all that clearly<\/span><\/a>) why the restrictions he had promised to avoid were, alas, needed.\u00a0<\/span><\/p>\n

Throughout the crisis, ministers have lacked the confidence to draw together scientific and other forms of evidence to form a clear strategy and make decisions\u2014and then front up those decisions and explain honestly and consistently the trade-offs they are making and the guidance the public needs to follow. As we wait for the vaccine rollout to bail us out, that is what really needs to change.<\/span><\/p>\n

Tom Sasse<\/strong> is an associate director at the Institute for Government and an author of <\/span>Science advice in a crisis<\/span><\/a><\/em><\/p>\n

Competing interests<\/strong>: none declared.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

Ministers have lacked the confidence to draw together scientific and other forms of evidence to form a clear strategy and make decisions, says Tom Sasse […]<\/p>\n

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