Yesterday the “alternative Sage” said the Government needs to clarify whether its objective was to suppress or manage infections of Covid-19. Owl is concerned about one, little mentioned, aspect of the long term consequence of “managing within the capacity of our NHS” .
Owl hears a lot about NHS capacity being measured in terms of the supply of PPE, number of beds and ventilators etc, not much about the limits of human endurance. In a couple of articles Owl has posted recently, Max Hastings has drawn comparisons between this emergency and the way resources are, or have been, mobilised in war. One wartime experience is a recognition of “battle fatigue” and the need to manage this through “troop rotation” (either as individuals or as units) to maintain full efficiency. (Owl uses the recognised military terms to facilitate research searches.)
Frontline NHS staff have been working at full stretch in extremely stressful conditions. It is unlikely that this peak work rate could , or should, be sustained indefinitely.
Before coming to the article, Owl reports that there is now a substantial “fringe” scientific effort:
DELVE: Data Evaluation and Learning for Viral Epidemics is a multi-disciplinary group, convened by the Royal Society, to support a data-driven approach to learning from the different approaches countries are taking to managing the pandemic.
RAMP: The Royal Society is also convening the Rapid Assistance in Modelling the Pandemic (RAMP) initiative to support efforts to model the Coronavirus (COVID-19) pandemic. RAMP is bringing modelling expertise from areas other than pandemic modelling to support the pandemic modelling community already working on Coronavirus (COVID-19).
Nicola Davis www.theguardian.com
The government has fundamental questions to answer about its approach to tackling Covid-19, an independent body of experts have said.
The Independent Sage committee – a body of 12 scientists and experts set up in parallel to the government’s Scientific Advisory Group for Emergencies (Sage) – is chaired by the former UK government chief scientific adviser Sir David King, who has criticised the official body’s previous lack of transparency.
Its members said on Monday that the government needed to make clear whether its objective was to suppress or manage infections of Covid-19, saying the two required very different processes and it was unclear which the government is pursuing.
The team have also recommended that new health policies for ports are developed to prevent cases of Covid-19 being imported, particularly as and when restrictions are lifted, while they have stressed the need for better financial support for marginalised groups and the BAME community.
Among other recommendations, they also advise that the government needs to move towards a local approach to testing and tracing.
The group was set up by King and Professor Anthony Costello after concerns about the lack of transparency around the government’s current Sage participants, and the revelation that 16 of the 23 known members are employed by the government. While the official Sage group is known to include behavioural scientists, pandemic modelling experts and infectious disease specialists, Dominic Cummings, Boris Johnson’s chief political adviser, is also known to have attended meetings.
Holding their first meeting on Monday, the Independent Sage group discussed a number of points, including the need to avoid stoking social divisions as lockdown is eased.
“People were very surprised at how adherent the population has been and a lot of that is down to collective solidarity as people have been rising to the challenge,” said Prof Susan Michie, a behavioural psychologist at UCL. “Going forwards, in terms of lifting lockdown, it’s going to to be a very different situation. A lot of thought has to be given to how this will be managed. If it’s not handled well, it risks potential divisions between groups.”
Other topics included the potential benefits to harnessing the island status of the UK and Ireland, as countries such as New Zealand have done, and developing new port health policies.
Prof Gabriel Scally, president of the epidemiology and public health section of the Royal Society of Medicine, noted that unlike many countries, Britain and Ireland have maintained open borders in the face of Covid-19.
“That seems to me, as we go into a situation where we are thinking of lifting restrictions, places us in sudden jeopardy,” he said, adding that a key issue at present in countries including China is cases of coronavirus imported into the country, including from citizens who had returned from travelling abroad.
At a press conference, chaired by the MP David Davis, after the first meeting of the new group, King added that the government needs to manage the pandemic without banking on a vaccine, noting that it remains unclear at present how well the newly developed vaccines will work, while Prof Karl Friston, of University College London, cautioned against placing too great an emphasis on the “effective reproduction number”, or R, which is the average number of people that one infected individual will pass the virus on to and has been a recurring figure in the government’s daily press conferences.
“R in an of itself is not a cause of pathology, death, suffering or any other measurements of those things,” Friston said. Indeed R is not fixed, and is affected by a number of factors, including by policies such as social distancing.
Friston added that the current prevalence of the virus in the population is a more useful figure when it comes to making important policy decisions.
“R is post-hoc reflection, it is a nice statistic, it is easy to model,” he said. “However, it is not really the thing you should be aiming at.”