Boris is right not to be ruled by SAGE
It emerged last night that Boris Johnson ignored advice from the government’s committee of scientific advisers, the SAGE group, to institute a package of national measures, including a “circuit-breaker” lockdown, closure of hospitality and any mixing between households.
The various measures in documents released by SAGE are justified supposedly by their impact on the national R number. A circuit-breaker was credited with “reducing Rt to below 1.” As the virologist Professor Hugh Pennington told me recently, a national “R number” has “the ring of science” and not much else. SARS-Cov-2 is cluster-driven – it exhibits exponential growth only in limited circumstances. It is also an “overdispersed” virus – one case does not necessarily lead to another.
The R number may be a useful measure of the virus’s spread in a care home, a hospital, a prison or a ship, or a tower block – but it is useless and counter-productive as a guide to the complex interactions between shifting social networks, the “over-dispersed” character of the virus itself and the vast difference in susceptibility to severe disease between the old and the young.
We know where the problems are and the virus is still relatively localised. University cities and towns have seen vast increases in case numbers in the last two weeks. It is not difficult to see why. Mass testing of students is the norm at several universities. Students live in cramped halls of residence, share single kitchens and bathrooms between several people.
Strict measures should be targeted to those environments in which transmission is more even and the likelihood of death or serious illness is vastly greater. Closed off “eco-systems” like a hospital, or care homes are the easiest places to enforce control measures which have some of the least extreme knock-on effects. New data shows that up to a fifth of new coronavirus cases are acquired in hospitals, cases that are likely to be found in already vulnerable people.
And yet, stopping all social life is considered a “high impact” measure by SAGE – “high impact” indeed, if the goal is merely to delay transmission to some point in the future. How about a national action plan on high hospital standards enforced as a minimum both in the care sector and across the NHS?
Rather than fussing over the minutiae of social life, the “science” should be relentlessly focussed on the specific character of the virus, its risks to the vulnerable and the heterogeneity of its transmission dynamics.
Indeed, I think it is now appropriate to go further in criticism of the supposedly sacrosanct image we hold of the “scientific advice”. SAGE is actually engaged in a project of scientism – a curiously Western phenomenon that derives from the after-shock of the “Enlightenment” and its culture. They have been unwittingly captured by a set of beliefs fashionable in the 19th century: that the tools developed in the newly confident field of the “natural sciences” could transform social and political life for the better, if applied with sufficient wisdom.
In its extreme forms, it is a project that has often, in its many applications in the 20th century, inflicted terrible costs. In our own time, our strategy of “suppression” of a virus, through an aggressive series of restrictions on the general course of social life guided by “the science”, is mutating into a wholesale assault on human dignity, channelled, along the axes of age (the young, who are denied the experience of the essential evanescence of youth as well as an education), and class (the working class are forced to take the greatest risk in exposing themselves to the virus).
Boris is right to reject this kind of thinking – for it is rooted in a potent illusion, the illusion proudly exhibited by Goethe’s Faust, that in getting “to the root of those secret powers, which hold together this world of ours,” we might “better mankind and turn their hearts.”
Boris is right to not be ruled by SAGE.