Nullius in verba - take no-one’s word for it
Nullius in verba - take no-one’s word for it
Nullius in verba is the motto of the Royal Society, yet during the pandemic we were frequently asked to do exactly that - unquestioningly take someone else's word for it.
This week saw Patrick Vallance give evidence at the Covid Inquiry. The headline grabbing story was probably his testimony that SAGE were not consulted about the, now infamous, Eat Out to Help Out scheme (more of which in this excellent substack by
).There were a range of other fascinating insights offered by his testimony and perhaps most tellingly his diary entries. These include suggestions that Number 10 wanted science “altered”, that Rishi Sunak (then chancellor of the Exchequer) suggested “It is all about handling the scientists, not handling the virus” and that Boris Johnson described the covid graphs as a “mirage” suggesting, in direct contradiction of evidence to the contrary, that "the curves just follow natural patterns despite what you do."
In less reported parts of his testimony, Vallance was asked about members of SPI-B (the behavioural committee of SAGE) joining Independent SAGE. He replied “I'm second to none in my belief in academic freedom, but if you join a government committee it’s slightly odd to the be on a committee that’s set up to challenge the government committee.”
This completely misunderstands the reasons for the formation and the purpose of Independent SAGE. Independent SAGE was not set up to challenge SAGE advice, but rather to communicate science transparently and directly. Indeed, our advice was largely in line with SAGE and we drew frequently on the advice and evidence of the excellent scientists working for SAGE. Primarily, for my part, I wanted transparency in communication, which I felt was not being offered by the official government committee.
Transparency is a vital part science - and this is especially true for science which has such significant ramifications. If you are going to ask people to undergo restrictions on their liberties and livelihoods based on scientific advice, scientists owe it to the public to explain the science and the modelling behind those decisions. It doesn’t have to be the scientists doing the work who share it with the public - understandably many scientists working on the UK’s pandemic response already felt overwhelmed - but someone capable should be keeping the public up to date. Too often science was either communicated poorly or left entirely uncommunicated, which left a vacuum for potential bad actors to step in an manipulate the situation.
Transparency
In his testimony Vallance went on to describe “a chilling effect, where people didn’t want to bring things to either SAGE or subcommittees as a result of either this [members of SPI-B joining Independent SAGE] or indeed the transparency of publishing all of our minutes.”
Understandably some of the documents discussed at SAGE meetings may have been sensitive or confidential, but the logical consequence of that sensitivity is not that all SAGE minutes should be secret. It makes sense that there should be a mechanism which allows classified documents to remain as such. What doesn’t seem to follow is that being transparent about memberships and minutes jeopardises that. This is especially true given that the type of “minutes” that SAGE was publishing were more akin to a high-level “consensus statement” than a detailed transcription of everything that was said during meetings. If anything I would have liked to have seen more detailed minutes that captured the nuances of the debates that were had during SAGE meetings.
Another important benefit of increased transparency is that is also leads to increased accountability. Being able to scrutinise the minutes of scientific committees such as SAGE means that outsiders can verify the assertions and check the results for themselves. Reproducibility and replicability through transparency lies at the heart of science and it should be no different in the case of emergencies.
Indeed, early on in the pandemic, there were scientific mistakes in the SAGE minutes – for example the doubling time of the pandemic was overestimated. The scientific advice which stemmed from this mistake potentially led to the UK thinking it was further behind Italy’s pandemic trajectory. This misunderstanding potentially induced the UK to pursue a mitigation strategy ( as opposed to a suppression strategy) for too long at the cost of many lives. If these minutes had been available to scrutiny then no doubt interested non-SAGE scientists would have been able to highlight the mistake – although whether they would be listened to is a different matter.
The motto of the Royal Society is “Nullius in verba” – take no-one’s word for it. What we were asked to do all too often in the acute phase of the pandemic is exactly that - to accept the government’s interpretation of the scientific evidence with which they were being supplied, without the ability to subject it to scrutiny. In my opinion that is not a model for good science.
Thanks. Just shared FWIW on my hardly followed twitter account, thanks Kit. Rory Stewart got it. I remember phone call from niece / senior nurse / policy Australia who was losing sleep trying to prepare family back here in UK. We both knew where we were on the graph respectively. Where I lived lockdown luckily came just in time to save local care homes. Disastrously late eleswhere in more populated parts.
Vallance?
My twitter comment: "Ok this is Covid early 2020; our youngest back from lockdown Italy & doing voluntary self-isolation in unaware UK. Incredible Vallance did not explain/insist on doubling times maths."
Regarding Chris Whitty’s evidence, which generally I found very honest and self-effacing, the one amazing admission when asked why he did not chose to include infection control and expertise other than academics, he failed to acknowledge its importance and relevance to his previous evidence about his focus on reducing R below 1 and using models.
As was obvious from the outset and Far East countries other than China repeatedly demonstrated in the earliest stages of 2020, basic Infection Control - masks, atmospheric and other disinfection and detailed practical advice to every family and section of the community (what to do, where, when, how and why) - could have had a major impact on transmission and therefore R number without the need for the more draconian measures that Ferguson and his simplistic models were advocating. The process of transmission is far more complex and there are many ways to reduce it that cannot be adequately modelled, most of them equally effective irrespective of whether it might be by surface, droplet or aerosol but few of which were ever considered by SAGE, let alone deployed.
By the end of 2020 Taiwan and Vietnam only had 11 and 27 deaths respectively and Hong Kong in particular had managed to suppress several outbreaks, despite airline pilots repeatedly bringing in new infections every day. They free issued a custom developed 99% efficient mask to every citizen within weeks.
Similarly, the head of IC in Japan said very early on that the West “could not see the wood for the trees”. They were using visualisations and animation to educate the public in how to avoid transmitting Covid whilst still going about their normal day.
In short, whilst Western Academics focused on understanding the “problem” i.e. the nature of Covid, in the FE Engineers, Public Health Officers, local disaster relief agencies and others with practical experience of IC focused on rapid implementation of all measures that might help to stop it getting from person to person. To most it was just another pollution or contamination incident for which there were many proven solutions that could have been implemented in early 2020 “for the avoidance of doubt”. Irrespective of the obvious lack of “evidence”, since the adverse impacts were negligible in comparison to a pandemic and the economic & social impact of Lockdowns, Bubbles and other draconian but modellable measures, the demand by Academics that evidence-based medicine principles should be applied was entirely inappropriate and, as Johns Hopkins widely accepted world mortality data (still available) showed in Jan2021, the average death rate of principal western countries over 2020 was 4000 times higher than the average of key countries in the FE, excluding China, who like the western world failed to act quickly enough to suppress first outbreaks and let it escape.
As the Engineers’s Covid Task Force, we had IC and pollution/ contamination experts, people with in-depth understanding of aerosol dynamic, surface and atmospheric chemistry and droplet capture, filtration and separation , mask design and optimisation, atmospheric and surface sanitisation, hospital, operating theatre, laboratory, food processing and hygiene design on trains, planes supermarkets, workplaces and in public spaces, all of which was ignored despite approaches in early 2020 to Vallance and SAGE and, I have to say, Indi-Sage.
Nabarro of the WHO was the first to recognise that what we saying (to Leicester PH the morning news of their second wave broke) had merit. We agreed that by reducing the dosage from one infected individual to another, below the threshold of infection, transmission might be prevented. The simplest way to do that was to get all to wear a surgical mask (by then available on internet and later tested to be 98% efficient and particularly effective at capturing finest aerosols) and put it under a snood or home made mask to reduce leakage. With such relatively low levels of infection, the greatest danger was being alongside the same infected person for long enough to get infected, so if both were wearing masks and keeping moving, rather than staying indoors, the chance of receiving sufficient dosage to become infected would be radically reduced, the local R number would be reduced to well below 1. Leicester’s outbreak and similar ones elsewhere might have been suppressed or contained without loss of life until vaccines became available.
Since then we have done nothing to augment our capability for emergency IC. By now we could have developed a mask specifically to capture finest liquid aerosols with far lower leakage.They would cost pence and we could have stock piled them with the equipment to produce more. Even current UK made SMs are now 600 times better than the UK/EU standardfor “face coverings” which was 15 times lower than those already being manufactured at the time and should never been issued, yet it has still not been updated or withdrawn.
In building and enclosed spaces rather than relying on filtration and standard alone units we should be developing ventilation systems that reduce airflow between people, sanitise the air and use heat recovery units to introduce fresh air whilst reducing heat loss to tackle CC&IC simultaneously. Hong Kong retrofitted sanitisation systems on the HKMTR within weeks.
As we said in March 2020 “If Scientists and Academics can outline the problem i.e. the mechanism of infection, sufficiently, Engineers, professional and practicing, can provide the solutions.
We could have developedYouTube videos animations and visualisation and other guidance available for the general public, not only for hospitals but care homes, schools, workplaces, restaurants, public spaces etc so everyone would know how to avoid infection. (Taiwan reckoned they had most families trained within a couple weeks but in the UK most people instinctively knew far better what to do and found much of the simplistic guidance inadequate, counter intuitive and wrong, like being told to follow the same arrow or stand on the same dot as the person in front of you.)
We would welcome Indi Sage comments and suggestions as to how we should prepare for the next pandemic, to suppress outbreaks and prevent spread, whilst vaccines are being developed or perhaps render that unnecessary. Whitty said he and Fergusson gave up on “containment” in mid March too early and it seemed wrong as intensive IC would have been far less disruptive,could still have suppressed local outbreaks and transmission saving many thousand of lives, as we suggested at the outset but Taiwan and Vietnam in particular later proved
Peter Hebard
Chair of Engineers’ Covid Task Force
peterh@realisations-uk.co.uk
07764170439/01590622517