Chris Whitty and Patrick Vallance must speak out against Dominic Cummings

When the coronavirus pandemic began to grip the UK in early March, I was not alone in taking heart at what seemed to be the quality of scientific advice that the government could expect to receive. It seemed fortunate happenstance that not only was the Chief Medical Officer (CMO) Chris Whitty a specialist in infectious diseases who had been active in the Ebola outbreak, but that the Government Chief Scientific Adviser (GCSA) Patrick Vallance had years of experience in public health as president of R&D at the pharmaceutical giant GlaxoSmithKline. I knew of Vallance’s reputation as a smart and eloquent spokesperson for scientific health management, and very early on in the crisis I was given a ringing endorsement of Whitty from a leading epidemiologist, who assured me that he was not the sort of person to yield to bluster from the likes of Boris Johnson or Dominic Cummings.

But serious questions about that are now being asked by some scientists, and the scandal around Cummings’s lockdown road trip may be seen as a crucial test of the credibility of the duo leading the effort to bring scientific rigour and probity to the government’s pandemic strategy. Johnson’s unwavering support for his adviser, who ignored lockdown rules by leaving his house and taking his wife Mary Wakefield and his child 260 miles to his parents’ farm estate in Durham while she had suspected Covid-19 symptoms, has elicited a breadth of condemnation unprecedented in recent times: not just from the usual suspects but from several Tory MPs (one of whom, Douglas Ross, has resigned his ministerial position in the Scotland Office in response), religious leaders, Piers Morgan and the Daily Mail. It looks as though Johnson has finally achieved his stated aim of unifying the country across the political spectrum, albeit with an act so egregious that it beggars belief.

But there has been not a word on the matter from the CMO or GCSA. You might want to say that this is a political matter on which it is not their role to comment. But that would be entirely wrong. The affair goes to the very heart of the government’s mantra of having been “led by the science”—by making a mockery of it. Nothing it has done has undermined its public-health efforts more than this—not even the pseudoscientific “alert level” equation or Johnson’s confusing “advice” about returning to work.

Police officers have attested that their authority to enforce whatever remains of lockdown has now evaporated; medical professionals have greeted the events with despair.

The outgoing president of the Royal Society, Nobel laureate Venki Ramakrishnan, has expressed the concern that scientists could be made the scapegoats for poor outcomes of the pandemic. So we should be very clear that at no stage were scientists dictating the policy decisions that have left the UK with the highest number of fatalities from Covid-19 in Europe. But the vast stock of goodwill towards the most senior scientists advising the government is being burned up fast, and the Cummings affair could exhaust the reserves, unless they act strongly and openly.

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These are unthinkably difficult times to be a GCSA or CMO, and we cannot expect them to execute their roles without missteps. All the same, some of these have been alarming. When Vallance defended the decision not to ban large public events such as the Cheltenham races and rock concerts in mid-March, he did so by explaining that you were more likely to infect close family members in your household than random people at a large gathering, because an infected person typically transmits the disease to just two to three others—as the “reproductive number” R indicates. (Vallance suggested that cancelling such events could even be “counterproductive.”) This causal reasoning did not make sense: there is no reason why a single person could not infect all those around him or her in a close-packed throng, just because the average transmission rate in the population is different. Bill Hanage, an associate professor at the T. H. Chan School of Public Health at Harvard, was moved to conclude that “it is pretty clear that Patrick Vallance has no idea what the reproductive number is.”

When Johnson infamously boasted that he had been at a hospital where there were people infected with Covid-19 and shaken hands “with everybody,” and turned to Vallance for support, the GCSA simply muttered that you should wash your hands afterwards. The obviously correct advice would have been, on the contrary, that one should absolutely not engage in any physical contact with someone who might have the virus unless absolutely necessary. It was a staggering dereliction of duty at a crucial stage in the outbreak.

Then there is the matter of herd immunity. It was staggering to hear Jeremy Farrar, director of the Wellcome Trust and a leading member of SAGE, admit in a recent interview with Alan Rusbridger that he does not know where the notion of “herd immunity” as a viable strategy for the pandemic came from, since in his view it was “an unacceptable way to think about public health” in a potentially fatal pandemic. Health Secretary Matt Hancock claimed that this was never a part of the plan anyway, but that clearly conflicts with the evidence—not least the statement made by Vallance on 13th March that “because the vast majority of people get a mild illness, [the aim is] to build up some kind of herd immunity, so more people are immune to this disease, and we reduce the transmission.”

It seems clear that this flawed notion, which horrified many scientists outside the UK, played a key part in delaying the government’s decision to go into lockdown, which it reversed only after modelling studies conducted by Neil Ferguson and his colleagues at Imperial College London predicted that a “herd immunity” approach could overwhelm the NHS and lead to a quarter of a million deaths. The consequences of the UK’s slow response are now terribly clear.

Under those circumstances, understanding where this idea came from is imperative. Farrar stated that he is not aware it was ever mentioned at SAGE meetings in his presence. So was it dreamed up by Vallance (very unlikely)? Was it one of Cummings’s fantasies about a complex-systems approach to “the science”? If someone like Farrar doesn’t know, we have little choice but to speculate in this way. But why does he not know, has not demanded to be told, and has apparently not been given an explanation by Vallance or Whitty?

The participation of Cummings and his Vote Leave modeller Ben Warner in SAGE meetings merely adds to suspicions. Farrar seemed relaxed about it, but the former GCSA David King was anything but, saying that “if you are giving science advice, your advice should be free of any political bias.” King was so alarmed that he convened an “independent SAGE” group to formulate its own scientific opinions and recommendations. Like SAGE, it is composed of top scientists, albeit with a broader range of expertise. Unlike SAGE, its membership and discussions are conducted with total transparency. Its report on schools reopening states clearly, in contradiction of the government’s intentions, that it is not yet safe to take this step.

The very existence of this group shows that “the science” is now in disarray, and that the SAGE process—though not its members—have lost the trust and goodwill of some of the scientific community. It has shown that the government cannot any longer even pretend to be “following the science,” but is merely doing what suits its own interests. Vallance and Whitty cannot easily prevent this, but neither do they need to accept it.

None of this is to deny that SAGE itself is composed of top-rate scientists determined to do their utmost to help steer us through this emergency. But they have sometimes been shown scant regard by the government. None of the scenarios for opening schools modelled by SAGE was adopted, and neither Vallance nor Whitty was asked to sign off the new nonsensical “Stay Alert” strategy. Psychologist Robert West has said that "those of us on Spi-B [SAGE’s behavioural sciences advisory group] have been increasingly concerned about the extent to which the government’s approach to the behavioural sciences and the messaging, particularly, has been at 180 degrees from the kind of advice that we have been sending into the Cabinet Office.”

So Vallance, Whitty and the scientists advising them absolutely must not be made to shoulder the blame for the mess we are now in. What’s more, some of them have made their views on the Cummings affair very plain. Social psychologist Stephen Reicher, a member of the behavioural sciences team on SAGE, has said that Johnson “trashed all the advice we have given on how to build trust and secure adherence to the measures necessary to control COVID-19.” It is, he says, “very hard to provide scientific advice to a government which doesn't want to listen to science.” West, meanwhile, tweeted that “The people of this country are being treated like idiots and I doubt that they will stand for it.” Another scientist advising the government, epidemiologist Adam Kucharski, has said that public compliance with the planned contact-tracing measures will be harder to ensure after this.

Meanwhile, one SAGE member, civil engineer Cath Noakes, took steps to distance herself from it on Sunday by tweeting “As a SAGE member I try to give impartial advice based on the best scientific evidence available to supposedly help government make appropriate decisions. It doesn’t mean that I in any way support or condone the actions of ministers or their advisors.”

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But the situation now needs more than these lone voices of unease, defiance and anger. That the prime minister has demonstrated a readiness to let Cummings wreck all the scientific public health advice he has received is shocking even for a government shamelessly willing to dissemble, distort and conceal. If people now decide they can do what they like, ignore all official advice, and travel or visit whom they wish—and who could blame them?—a second wave of infection and death is likely to be on its way.

Let’s assume that the flaws and inadequacies of Cummings’s story are as clear to Vallance and Whitty as they are to most people. After all, West has said “There are so many holes in his narrative that only the most desperate people who want to believe him could do so.” In which case, the GCSA and CMO should not stand silent; to do so will render their position and authority untenable. They will know full well that, even if one chooses to believe Cummings’s increasingly bizarre story, his decisions, and the government’s evasions about the details—such as its initial denial that Durham police had contacted the Cummingses, or its silence over the trip to Barnard Castle—undermine the spirit of everything the lockdown was trying to achieve.

Their situation is not like that of President Trump’s leading pandemic adviser Anthony Fauci, who has had to stand by and watch jaw-dropping idiocies come from the lips of his leader. Fauci knows that he will be instantly dismissed the moment he makes any explicit criticism of the president—the fate of everyone else who has tried it—and he calculates that on balance he can do more public good by biting his lip and dealing with the fallout behind the scenes.

This is not so for Vallance and Whitty. Were they to make statements that make it plain what was expected of individuals during lockdown, and what dangers the current confusion and anger create for compliance, Johnson could not sack them without exposing himself to (more) charges of hypocrisy and cavalier neglect of science. Advisers need to maintain a working relationship—but at what cost? To keep silent now about the almost surreal enormity of this insult to public health efforts, and indeed to the public, is to fail in the duty of a public servant. The jobs of CMO and GCSA are subject to the Nolan rules that should govern the ethics of public office holders: “selflessness, integrity, objectivity, accountability, openness, honesty and leadership.” Even if we know how much those principles have been traduced by politicians, they are also a fair summation of what is expected of any scientist.

Could they achieve more in private discussions? It would be naïve to think so. It took an avalanche of very public fury to wring Cummings’s convoluted tale out of him, and even that indicated a determination not to budge an inch. It is very hard to imagine that another former GCSA, the late Robert May, would have hesitated to make his views known in a situation like this. Not only was May an expert in epidemiological modelling (and much else), but he was intimidated by no one and was determined to make science heard and respected. It seems we have instead now reverted to the old Churchillian notion that scientists should be “on tap but not on top”: that they should know their place as a source of “impartial advice,” lacking any right to express views on how that advice is implemented.

Any therapist or business guru will tell you that when leaders and authority figures fail, it is common for everyone to start turning on each other. It would be tragic if scientists were to start blaming one another for the derelictions of government. But in this present crisis, in which the moral as well as pragmatic issues are crystal clear even to some of the government’s hitherto most ardent supporters, it would be gravely dangerous for scientists to neglect their social obligations, reinforcing a public suspicion that “the science” is an amoral endeavour that will not serve their best interests. It is time to speak out.

 

This piece was updated to clarify the author's intentions in relation to civil servants' obligations under the Civil Service Code