Lifting lockdown measures is ultimately a political decision, the government's chief scientific adviser has said, amid a controversial move to ease the restrictions on gatherings and reopen businesses.
Changes to the lockdown measures coming into effect today mean schools have reopened for young children and up to six people from different households can now meet outside, provided they follow social distancing measures. Non-essential retail businesses will begin to open in a staggered fashion in the coming weeks.
The changes have prompted criticism from health experts, including members of the Scientific Advisory Group for Emergencies, which is advising government on its approch to tacking the pandemic.
Among those calling for caution was Jeremy Farrar, head of the health research funding charity the Wellcome Trust, who said over the weekend that coronavirus was "spreading too fast to lift lockdown in England".
Writing in the Telegraph on Saturday, Sir Patrick Vallance, who chairs SAGE as the government's top scientist, said "ministers must decide" what approach to take.
"Perhaps now is a good time to clarify exactly what SAGE is, and what it is not," he wrote.
He said SAGE's responsibility is to present evidence that politicians then use to make informed decisions.
"Science advice to COBRA and to ministers needs to be direct and given without fear or favour. But it is advice," he wrote. "Ministers must decide and have to take many other factors into consideration. In a democracy, that is the only way it should be. The science advice needs to be independent of politics."
Ministers have repeatedly said the government's approach to tackling the coronavirus pandemic has been "led by the science" and that government has been "following the science".
But Vallance told MPs last month that this was not an accurate way to explain how decisions were being made.
"We give science advice and then ministers have to make their decisions. All I can say is that the advice that we have given has been heard and has been taken by the government," he told the Health and Social Care Select Committee.
"Clearly, what we do not give advice on is absolutely precise policy decisions or absolute timings on things. Those are decisions that ministers must take on the basis of the science. The correct way of saying it is that the decisions are informed by science. They are not led by science [as the MP asking the question had said]."
In the same evidence session, Vallance told the committee the government's planned "test, track and trace" system would help to present a second peak of the virus as lockdown measures are eased.
But the track and trace system is not yet fully up and running, prompting concern from health experts.
The Association of Directors of Public Health, which represents senior public health officials, said it was “increasingly concerned” that the government was lifting “too many restrictions, too quickly”.
The group said it was “not yet confident” that there was a “sufficiently effective” test, track and system in place to map a resurgence of the virus.
Farrar, a world-renowned medical researcher, said "TTI [test-track-isolate] has to be in place, fully working, capable dealing any surge immediately" before it is safe to lift lockdown measures.
He was backing comments by John Edmunds, a professor of infectious disease modelling at the London School of Hygiene and Tropical Medicine, who also attends SAGE meetings.
"Many of us would prefer to see the incidence driven down to lower levels because that then means that we have fewer cases occurring before we relax the measures," Edmunds said.
“I think at the moment, with relatively high incidence and relaxing the measures and also with an untested track and trace system... we are taking some risk here.”
Covid-19 spreading too fast to lift lockdown in England. Agree with John & clear science advice. TTI has to be in place, fully working, capable dealing any surge immediately, locally responsive, rapid results & infection rates have to be lower. And trusted https://t.co/ZmYKs4Go3W
— Jeremy Farrar (@JeremyFarrar) May 29, 2020Fa
In his Telegraph article, which has also been published on GOV.UK, Vallance said it is important that the government is transparent about the science behind its decisions to enable "challenge".
"Good science involves sharing findings and interpretations for others to challenge, build on and replicate. Scientists publish their models, methods and results and subject them to review by their peers, for critique and reuse by others. If you sign up to science, you sign up to the idea that others should review your work. We learn from each other and we learn from mistakes," he said.
"Clearly it is right that ministers see the advice first and that they have a chance to consider it as part of their overall decision making, but I believe it is also right that the evidence base should become open for others to see too, so they can provide challenge and form new and important observations."
Vallance said he wanted papers to be published "as soon as possible and... as close to real time as is feasible and compatible with allowing ministers the time they need". In previous crises, the evidence from SAGE has been published after the crisis has ended.
The papers being presented to the advisers have so far been published in batches a few weeks apart, with SAGE drawing criticism for the infrequent publishing schedule.
Last month Vallance defended the Government Office for Science, which is responsible for publishing the papers, and which he described as a "rather small organisation and they are working flat out and trying to get papers published and ensuring that they have been appropriately cleared".
But he said he wanted there to be a "much more regular rhythm of getting those papers out".
'Herd immunity through transmission was never the aim'
In his column, Vallance also said it was never the government's goal to allow large numbers of people to catch Covid-19 to create widespread immunity to the disease.
Before the UK went into lockdown to try and minimise the spread of the novel coronavirus, it was widely reported that the government was following a "herd immunity" strategy by allowing the virus to spread, on the advice of the Scientific Advisory Group for Emergencies.
The theory was partly attributed to Vallance's comments in an interview in March, when he said that if the government's efforts to “broaden and flatten” the peak of the outbreak were successful, “you should anticipate that more people will get immunity to this and that in itself becomes a protective part of this process”.
But appearing before the health select committee last month, he acknowledged his comments may not have been clear and that he had never advocated for a herd immunity strategy.
"My points about immunity were not actually about getting immunity through that route. My point has been clear from the outset that we need to suppress the peak, and keep the peak down flat below the level at which the NHS can cope, to protect the NHS and to make sure that we reduce deaths," he said.
He told the MPs that it was not yet known whether people who have contracted Covid-19 in the past develop immunity to the virus, saying only that it was likely to provide "some degree of protection".
And in Saturday's Telegraph article, Vallance said: "Allowing many people to catch Covid to create widespread immunity was never an aim and never could have been with a committee comprised of many doctors who have spent their lives dedicated to improving health.
"Immunity on the other hand is something that prevents transmission and we all hope that a vaccine to induce immunity will become available."