Government’s pandemic modellers ‘weren’t given key policy information’

The UK government withheld key information on health policy from the scientists tasked with modelling the pandemic during 2020, the Covid-19 inquiry was told today.

Giving evidence to the second module of the inquiry, Graham Medley – a professor of infectious disease modelling at the London School of Hygiene and Tropical Medicine – claimed the government had failed to share details of its own policies for managing the pandemic, or to tell scientists what it considered a successful (or “less worse”) outcome. In his written evidence to the inquiry, he said this prevented the group from helping the government as much as it could.

During the pandemic, Medley was chair of a sub-group of the government’s Scientific Advisory Group for Emergencies (SAGE) that advised the government on Covid-19 based on infectious disease modelling and epidemiology. The sub-group is known as SPI-M-O (Scientific Pandemic Influenza Group on Modelling, Operational sub-group).

“Modelling has a particular problem with the lack of discussion and lack of understanding [of] what the policies might be, because we cannot make a policy-neutral model,” he said. “If we don’t know what the government might do when or why they might do it, then we have to second guess. We have to make it up. We can’t put ‘nothing’ into the model.”

‘On the hoof’ strategy

Medley said the UK’s pre-pandemic strategy for dealing with epidemics was to “have the epidemic in one wave”.

“There were no other strategies. That changed as soon as the epidemic [developed] and the strategies were much more short-term,” he said.

In his written statement to the inquiry, he added that between February and March 2020 there was a sense that government strategy was being created “on the hoof”.

“It wasn’t clear what the plan was going to be,” he said when questioned about this description.

Finally in January 2021, the Cabinet Office started sending people to SPI-M-O meetings, the inquiry heard, enabling the group to better understand government policy concerns at the time.

“It wasn’t until early 2021 that there was a good dialogue between policymakers and the scientists,” said witness and epidemiologist Matt Keeling, a SAGE member and professor, speaking later in the afternoon session. He said it was “really the first time that there was a marriage between science and policy and we could generate policy-ready answers on a timescale that was important”.

The group gathered that a successful outcome would be the avoidance of a major surge in Covid infections in the following six months, said Medley. This resulted in a shift in the government’s approach to managing the pandemic to follow ‘data not dates’.

“In which case we can say: ‘Do it slowly. Don’t rush to open up immediately,’” he explained. “‘Remove restrictions slowly and remove them in an ordered way so that the data analysis on the modelling could inform you what the impact of the previous decision was.’”

NHS overwhelm

Medley’s written statement to the inquiry said it had become increasingly clear to SPI-M-O during February 2020 that NHS capacity would be overwhelmed by Covid.

Asked by inquiry counsel Andrew O’Connor KC to confirm this, he said: “By the end of February it was clear that the NHS would be overwhelmed and I don’t think that was being kept secret.”

He said that in February 2020 the sub-group had established the proportion of people who would die from infection. To model hospitalisation rates, a meeting with the NHS and clinical colleagues was needed. A need for such a working group was raised and recorded in a SAGE meeting on 27 February 2020.

Medley said the group was clear at this point that the NHS would be overwhelmed, but needed clinical input to understand the extent to which it would be overrun.

He was pushed by O’Connor on whether SAGE and SPI-M-O should have raised the alarm in February 2020.

“If you and your colleagues had already realised during February that the NHS was going to be overwhelmed by the pandemic that was developing, why didn’t you just say so?” asked O’Connor. “The minutes [of the 25 February 2020 SAGE meeting] record simply that there needs to be some reasonable worst-case planning for the NHS.”

Medley said the writers of these minutes needed to be questioned on this.