Case for transparency over Sage has never been clearer | Science

As the coronavirus epidemic spilled out of China and seeded outbreaks around the world, the British government looked to its Scientific Advisory Group for Emergencies (Sage) for guidance on how best to handle the crisis.

The of wise academics that wait in their offices for the hotline to ring. The makeup of the group depends on the emergency at hand and is put together at the request of the Cabinet Office. At its best, it gives ministers direct access to the finest minds in the country as it navigates an unfolding emergency.

Sage comprises two dozen or so experts. Today, two-thirds are men. Some members are there to share advice from more specialised sub-groups. During the coronavirus pandemic they include the Scientific Pandemic Influenza Group on Modelling, or SPI-M, made up of outbreak modellers from Imperial, Edinburgh and the London School of Hygiene and Tropic Medicine among others.

Then there are the behavioural scientists who feed into Sage via the Scientific Pandemic Influenza Group on Behavioural Science, or SPI-B. Another group that has a representative on Sage is the New and Emerging Respiratory Virus Threats Advisory Group, or Nervtag, home to the virologists and respiratory disease specialists who study the pathogens and their effects on the body.

The combined expertise, with senior medics, social scientists and outbreak specialists, is intended to ensure that all aspects of the unfolding pandemic, from the nature of the virus, to how people will react, are covered. Yet while Sage covers the academic bases, it is unclear whether it has the breadth of voices it needs. Could there have been more in the room, for example, who knew an emergency when they saw one?

More than a month ago, Michael Ryan, the World Health Organization’s head of emergencies, made it abundantly clear that governments had to act fast to beat the virus. “The virus will always get you if you don’t move quickly and you need to be prepared,” he said. Speaking from experience with Ebola outbreaks, Ryan went on to add: “Anyone who’s involved in emergency response will know this.”

Britain did not move fast and was not prepared. As Jeremy Farrar, director of the Wellcome Trust, one of the few members of Sage who is open about his membership, has warned, Britain could have Europe’s worst death toll.

Jeremy Farrar

Jeremy Farrar, director of the Wellcome Trust and a member of Sage Photograph: Dave Guttridge/The Francis Crick Institute

It is hard to look at the list and not feel it needs more mathematical modellers or more statisticians. Those disciplines are crucial for pulling in data and working out how the virus is spreading, who it is killing and in what numbers.

They are crucial too for cautiously predicting the future course of the disease, which in turn is needed to work out plausible exit strategies and give early warning of a second peak.

But what mattered at the start of the epidemic was to move fast, not wait until models revealed the spectacular death toll the country faced if sat on its hands.

It is not the only area where expertise appears to be lacking. Sage is not responsible for all of the government’s advice: it goes to Cobra where ministers weigh it up against other considers.

But beyond the clear failure to act fast, two areas that have defined Britain’s ham-fisted response to the coronavirus pandemic are the inability to test at scale and devastating shortcomings in supplies of personal protective equipment (PPE).

Where are the experts that could have organised companies to ramp up testing sooner, as is only now coming online? And who would have looked at the PPE stockpile and where the equipment had to go and seen a thorny problem that needed swift and decisive action?

The members of Sage are impressive individuals. But with the government insisting it is following the science, as if science offers only one route through this, the case for transparency has never been clearer.

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