COVID inquiry reveals lack of governmental science knowledge

the Covid inquiry here in the UK has been hearing in recent days from some of the country’s most respected scientists - including Sir Patrick Vallance who served as the government’s chief scientific adviser during the pandemic.

Sir Patrick told the inquiry that top scientists were often excluded from crucial meetings as the virus took hold, not listened to on key policy decisions on lockdowns and that leaders across Europe - including the then UK prime minister Boris Johnson - often had only a rudimentary grasp of science:

Patrick - I think I'm right in saying that the prime minister at the time gave up science when he was 15. And I think he'd be the first to admit it wasn't his forte and that he did struggle with some of the concepts and we did need to repeat them often. I would also say that a meeting that sticks in my mind was with fellow science advisors from across Europe when one of them, and I won't say which country, declared that the leader of that country had enormous problems with exponential curves and the entire phone call burst into laughter because it was true in every country. So I do not think that there was necessarily a unique inability to grasp some of these concepts with the Prime Minister at the time, but it was hard work sometimes.

Sir Patrick Vallance.

To explore this further is Dr Julian Huppert, a chemist and former Member of Parliament for Cambridge, and Charlotte Summers, professor of intensive care medicine at the University of Cambridge. Both were key actors in various ways during the pandemic, and Charlotte’s also scheduled to give evidence to the Covid inquiry in due course. The first point of discussion was this issue of scientific literacy raised by Patrick Vallance…

Julian - We don't need civil servants or politicians or any other group like that to be expert scientists necessarily. We need them to be able to understand science, how to use it, what it can do, what it can't do, and what use that will be. And so there are people who are non-STEM graduates who I would not fault at all for their ability to think about science. But there is also a large set who really don't understand it. And for some of them they might even be sort of quite anti-science. Boris in some ways I think was a bit like that at times. But there's also a set who almost over deify science, who think that they don't understand science but it can do magic things. Though they're not interested in understanding the uncertainties that come with science, the trade-offs and, again, what science can do and what science can't do. And also more porosity where more people from a scientific or medical background spend time in government and then move back out. So there is more mutual understanding because equally some scientists don't understand the constraints of government decision making.

Chris - Why do you think there is a paucity of science and the representation of people from a science background like you? Why were you so much in the minority when you were in parliament?

Julian - Yeah, so it depends how you define it, but there were two of us with science PhDs in the Commons. I think it's partly because the way people think about politics, and what people believe politics is, puts a lot of people off who come from a STEM background. And it's definitely a problem. But there's a lovely line from the West Wing - 'decisions are made by those who show up.' And the problem is that if people who care about evidence, who care about science, who care about research, don't go into politics, don't go into government. By definition, it's the other people who get there. My own work, which I think was quite good about fascinating four stranded DNA structures. It wasn't that that I needed, it was the mindset of what science can and can't do.

Chris - In some respects then, what Rishi Sunak is trying to do, where he's trying to push maths further for longer for everyone, that's sort of founded on that principle then, isn't it?

Julian - Oh absolutely. And there are many countries, Australia for example, where they've had that for a very long time. I don't think he's wrong to try to encourage that. I think we overspecialise too early. The idea that at 15 you say 'I will do science or I will not do science' strikes me as absurd.

Chris - So what's your view of the COVID inquiry? Do you think this is a massive waste of money or do you think, and have you heard so far, things which you think are useful and pertinent, notwithstanding the fact that your co-contribution Charlotte Summers will be herself giving evidence in one of the future modules?

Julian - Well, I mean that will obviously be the thing to buy tickets for, absolutely. Look, it's important that we do an inquiry, we do it properly. I think there is an over legalistic approach to it, which I worry drags it out and we can't learn all the lessons as quickly as possible. I'm pleased we're doing it. I think there's a lot of things that we should look into about how early decisions were made. Not always with perfect hindsight, but to understand what we learn for the future. So to me it should be principally about lessons not about blame.

Chris - Would you share that sentiment Charlotte?

Charlotte - I would. I am on record as having written in the national press that I am somewhat dubious about whether the history of national inquiries into all sorts of things has led to fundamental changes and how we would deal with similar events going forwards. I think one of the things that has been highlighted this last week that's come out of the inquiry that feeds on from Julian's talking about people participating in public life from science backgrounds. I've been really struck by evidence from both Chris Whitty and Jonathan Van-Tam about the downsides of them being public scientists. Always shocked to hear Professor Whitty say that actually he had to have close protection for nine months because of the response to him being involved. The concern is, in the future, people may choose not to contribute to public life because of the cost. And I think we have to find ways to improve that because otherwise whatever the next crisis, if people hesitate to come forward and provide their expertise, we're going to have a significant problem.

Chris - Julian?

Julian - I think that's absolutely right and those stories were absolutely terrifying. Actually, I was really concerned at the time by some of the excessive focus that Boris Johnson put on 'we will do what the science says.' And I think that's part of the thing is it's an unfair burden to put on scientists because there are some questions which science can answer. If we do this, what happens? What's the likely effect on spread if we do this to schools, what's the likely effect on a child's education, et cetera. But science can never tell you which policy decision is the correct one to take. So I think it's really important throughout, with the pandemic but with all sorts of other advice, what can evidence tell you and what is value judgments and the proper domain of politics and policy.

Chris - Indeed because Chris Whitty put it very well because to quote him, he said, 'you end up with spurious numbers informing more spurious numbers.' Did you find, Charlotte, that the fact that people really do struggle to understand and comprehend risk was a problem in trying to balance how you delivered the service that you had to deliver during COVID

Charlotte - Risk, and there's been huge amounts of work in all kinds of domains, is something that people struggle to understand every single day. When they're going to have a surgery, they are told there's an X percentage risk of this outcome or this outcome. And those risks don't necessarily mean anything in a way that's comprehendible. However, if you are one of the people who gets that particular complication, the risk feels very different to you on an individual basis because you've got a hundred percent of that bad outcome. Whereas the other, if it's a 1% risk, 99% of people didn't get it. It Is very hard to communicate risk and I think the other issue was that there was the idea that we were following 'the science' as though science is a single immutable thing that is in some way fixed. But of course the way science works isn't like that. Science is somewhere where we generate a hypothesis. We then try to prove that hypothesis wrong. And when we do prove it wrong with data and evidence, we make a new hypothesis and we keep going round this process because that's how science evolves over time. It is not an actual thing. You can't follow it anywhere other than it leads, but it doesn't stand still and nor do we expect it to. So sometimes those kinds of changes in the evidence base were perceived as u-turns or people not having known what they were talking about for the first time and having changed their mind, as opposed to the data just having shown us something else. So I think the whole idea of following science was really quite challenging.

Chris - Yeah, it led to a toxic U-turn situation, didn't it, Julian? Because the one thing you'd never do in politics is apparently U-turn and it was trying to get across to people that in fact this is a very valid change of direction in reaction to a change in the facts.

Julian - Absolutely. And it's a real problem with the way science is understood because changing your conclusion based on different data, new evidence is of course the right thing to do. But we have this idea that a U-turn is a bad thing that changing your mind means you are wrong. I think there's a fundamental problem that we have to address about the language that we use. We talk in a scientific community about risk, about uncertainty, about errors. In general colloquial parlance, those suggest you don't know what you're talking about. If you say I'm uncertain about the result, that's technically right. But it projects this idea of I don't know what I'm doing. I think the issue about U-turns generally is a big problem because we do penalise leaders who change their minds. I'd love to see us much more generally separated between saying, 'my values have stayed the same, but now I know more things.' The way to optimise my values is different from how I've changed my values.

Chris - So let's finish by asking both of you what you hope will change next time. What you think you've learned personally and what you think the country as a whole has, has learned so that next time this happens, we're in better shape. Let's start with Charlotte. What's on your wishlist?

Charlotte - The public communication of science and the setting in which this outbreak happened in the world of social media, real time news. It's very different handling things and one story that would start somewhere and one part of the globe had rapidly transmitted to another part and often misinformation and disinformation made large aspects of handling the pandemic much harder than they had been previously. And so I think what I would like to see is that, actually as scientists, we have an obligation to communicate better about what we do. It's really, really important that we explain science in a way that is meaningful for people so that we can ensure that the impact of this and misinformation is less substantial next time.

Chris - Julian?

Julian - We didn't have any spare capacity. We said as long as nothing changes, we can just about cope. And obviously one of the problems then was that as soon as you have a little bit more demand, things start to fall apart. We have massively under invested for a long time in prevention and public health. At the beginning of the pandemic, Public Health England had a budget that was I think a bit less than a third of what it was supposed to have when it was set up. And it's perhaps not a surprise that when we haven't invested in public health, we don't have such good health in the public, when something goes wrong. There's a biological weapons venture which is aimed at preventing bioweapons from being developed. It's internationally funded, but has less money and fewer staff than a typical McDonald's franchise. Now that's fine as long as nothing goes wrong. But if we start to have a problem, we massively regret not having spent money in the past on this. It's about having spare capacity so we're not right at the edges. We can cope when things happen that we didn't expect. Investing much more in prevention of public health and things like the social determinants of health so that we're in a much better place when inevitably some bad happens.