Test covid-19 (La Presse)

What is SAGE and is it Responsible for the UK’s Failed Coronavirus Response? 

Most world leaders are not doctors and a majority do not even have medical or scientific backgrounds. Even Germany’s Angela Merkel who holds a doctorate degree, consistently defers to the expertise of industry professionals when it comes to medical advice that shapes policy impacting millions of citizens.

Delay Prompts Question About Secretive Group

The UK is no different. In the middle of the COVID-19 pandemic ⁠— and led by a survivor himself ⁠— Prime Minister Boris Johnson has declared his government is “guided by the science” when making decisions on the coronavirus. In the UK, however, the science is funneled to Number 10 by the Scientific Advisory Group for Emergencies (SAGE).

Little is known of the top secret group, as the New York Times reported. Few of its members are known publicly by name, and the contents of the group’s meetings are rarely disclosed. While SAGE managed to fly under the radar in the past, critics of Johnson’s handling of the crisis have begun to question SAGE’s role in the public health crisis.

Criticism of SAGE

In particular, opponents point to a delay in shutting down the UK. While the virus was public knowledge since mid-January, Johnson waited two months before implementing emergency procedures. The prime minister himself boasted about shaking hands with as many people as he could, two weeks before taking up residence in an intensive care unit.

Was the information SAGE delivered to the prime minister’s office a realistic portrayal of the pandemic or did it lean toward an optimistic view of the virus? Or did the group make the right recommendation, but Johnson overruled it?

Details are scant, but some revelations have worked their way out from the shadows. On March 9, SAGE advocated for weaker social-distancing measures. The information, shared in a government report on the effects of social-distancing, ran counter to the common sense policies of other European states. By March 9, the severity of the disease was well-known, yet SAGE members only considered the public risk as “moderate.”

SAGE Process Revealed

Ian Boyd, professor of biology at the University of St. Andrews, used to be a member of SAGE. He offered a look at the inner workings of the group and its need for secrecy in a piece for the Conversation.

After a crisis begins, a litany of government groups identified mostly by acronyms start to work. The Civil Contingencies Secretariat (CCS) initiates the Cabinet Office Briefing Rooms (COBR) and delivers a briefing called the Common Recognized Information Picture (CRIP). After a situational analysis, COBR may opt to establish SAGE, which is usually chaired by the government’s chief scientific advisor, Boyd wrote.

SAGE essentially evaluates all possible data points and research to deliver recommendations to COBR, which may weigh the scientific information alongside other factors such as economic and political. Medical experts from within the group and around the UK are called upon.

The job is demanding, Boyd said. 

“At present, the SAGE process has never been worked so hard. Those involved right now will be struggling to find time to sleep, let alone have a protracted public dialogue over social media, as suggested in a Nature editorial.”

The group is vital in emergencies, particularly in the beginning, Boyd argued. However, if the system is as great as he made it sound, why then did the UK government stumble in its coronavirus response? Some health experts believe the government may be scapegoating the group.

Hiding Behind Experts

“It has become a shield for them,” said Devi Sridhar, director of the global health governance program at Edinburgh University. “If things go off, you can always say, ‘Well, it was the experts who told us.’”

One SAGE member, Professor Neil Ferguson, an epidemiologist at Imperial College London, told the New York Times that internal discussions within the government and SAGE may have contributed to the delayed response. Some members, including Patrick Vallance, chief scientific adviser and SAGE chairman, supported trying the herd immunity theory. That is, until revised projections predicted a higher number of casualties. From that point on, the government an earnest suppression campaign.

If critics hope to have a glance at SAGE’s advice to the UK government, it will have to wait until after the COVID-19 crisis subsides. Patrick Vallance, the government’s chief scientific adviser, told MP Greg Clark “Once SAGE stops convening on this emergency the minutes of relevant SAGE meetings, supporting documents and the names of participants (with their permission) will be published.” 

Within those minutes, people skeptical of the government’s scientific data are keen to know how the group arrived at conclusions that resulted in a delayed response. Whether SAGE called it wrong or the government refused otherwise sound advice will be up for determination when the pandemic is reviewed at a later date. 

In the meantime, calls for more transparency continue to rise. 

“The idea that a small group of experts can never make a mistake or miss out on any information is never right,” said Sarah Wollaston, a former chairwoman of the House of Commons Health Select Committee. “But you can’t challenge the advice if other experts can’t see what they are looking at.”