Scientific Advisory Group for Emergencies

Did You Know?

• An April 2020 article in The Guardian cited SAGE as a potential example of 'scientific groupthink'.
• On 24 October 2020, The Spectator called for publication of the data used by SAGE, including NHS occupancy data.
• A group of scientists created Independent SAGE, chaired by Sir David Anthony King, in early May 2020.

History

SAGE emerged from guidelines developed after the UK BSE outbreak. The then Government Chief Scientific Adviser, Lord May, published Guidelines on the Use of Scientific Advice in Policy-Making, later revised, most recently in June 2010. The Government subsequently developed the Principles of Scientific Advice to Government, which set out rules of engagement between Government and independent scientific advisers. These principles were updated in May 2011 in the Code of Practice for Scientific Advisory Committees. In an emergency requiring scientific or technical advice, the Lead Government Department or the Cabinet Office, in consultation with the Government Office for Science, may decide to convene a SAGE. Each SAGE is emergency-specific. The swine flu pandemic was the first emergency where the SAGE mechanism was used, followed by volcanic ash. SAGE has since advised on events including the 2010 eruptions of Eyjafjallajökull, the 2011 Fukushima nuclear accident, the 2013–14 United Kingdom winter floods, the 2014 Ebola outbreak, the 2015 Nepal earthquake, the 2015–16 Zika virus epidemic, the 2018-9 Ebola outbreak, the potential catastrophic breach of Toddbrook Reservoir in 2019, and the COVID-19 pandemic.

Structure and function

SAGE was reported in July 2020 to consist of around 20 participants at any one time. Participants are drawn from academia and practice, selected by the British Government Chief Scientific Adviser and the Chief Medical Officer for England based on required expertise. They are not generally government employees and do not operate under government instruction. Officials from relevant government departments and arm's-length bodies, such as the UK Health Security Agency and departmental Chief Scientific Advisers, also attend. The government is not obliged to act on SAGE's conclusions, and other sources of scientific advice also inform decisions. Only the Chief Scientific Adviser and Chief Medical Officer may speak on behalf of SAGE. In 2020, the UK Government reviewed SAGE's structure in the context of the COVID-19 pandemic. SAGE can delegate sub-committees to study particular issues; during the COVID-19 pandemic these included the Scientific Pandemic Insights Group on Behaviours, the Scientific Pandemic Influenza Group on Modelling and its Operational sub-group, the PHE Serology Working Group, the COVID-19 Clinical Information Network, the Environmental Modelling Group, the Children’s Task and Finish Working Group, the Hospital Onset COVID-19 Working Group, the Ethnicity Subgroup, and the Social Care Working Group.

COVID-19

The 2020 COVID-19 pandemic saw an expanded role for and greater attention paid to SAGE. Until this pandemic, political advisors had not attended SAGE meetings in any capacity, nor was there evidence of 10 Downing Street officials attending. It was reported that Dominic Cummings and Ben Warner had attended COVID-19 meetings, drawing widespread criticism from other attendees who were shocked and concerned for the impartiality of advice. Early in the pandemic, in April 2020, SAGE was criticised for a lack of transparency. On advice from the Centre for the Protection of National Infrastructure, the list of current members was not disclosed for their security and safety, though members could reveal their own membership. Chris Whitty told the Health and Social Care Select Committee that SAGE was given clear advice from the Centre for the Protection of National Infrastructure because SAGE is a sub-committee of COBRA. Patrick Vallance argued in a letter to Parliament that anonymity protected scientists from lobbying and unwanted influence. Membership of SAGE and its subcommittees was published on 4 May 2020, and a register of participants' interests was first published in December 2020.

Participants

A report in The Guardian listed attendees at an April 2020 meeting, including senior advisers Sir Patrick Vallance (chair) and Professor Chris Whitty; medical and scientific experts such as Professor John Aston, Dr Meera Chand, Sir Ian Diamond, Professor John Edmunds, Sir Jeremy Farrar, Professor Neil Ferguson, Professor Peter Horby, Professor Angela McLean, Professor Graham Medley, Dr Edward Mullins, Professor Sharon Peacock, Professor Stephen Powis, Professor Andrew Rambaut, Emma Reed, Professor Brooke Rogers, Dr James Rubin, Professor Jonathan Van-Tam, Professor Charlotte Watts, and Professor Maria Zambon; and political advisers Dominic Cummings and Dr Ben Warner. Vallance wrote that SAGE includes scientists and experts from more than twenty separate institutions, and its four expert groups may each have as few as five and as many as over forty members. Dominic Cummings was confirmed by 10 Downing Street to have attended a 23 March meeting, but the government said he was not a member of SAGE. One participant considered that Cummings' interventions had sometimes inappropriately influenced the impartial scientific process; another expressed shock when Cummings began participating in SAGE discussions in February, viewing it as unwanted political influence.