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The Scientific Advisory Group for Emergencies (SAGE) is a British Government body that advises central government in emergencies. It is usually chaired by the United Kingdom's Chief Scientific Adviser. Specialists from academia and industry, along with experts from within government, make up the participation, which will vary depending on the emergency. [1] SAGE gained public prominence for its role in the 2020 COVID-19 pandemic in the United Kingdom.
In the aftermath of the United Kingdom BSE outbreak, "the then Government Chief Scientific Adviser (Lord May) published Guidelines on the Use of Scientific Advice in Policy-Making; these have subsequently been revised, most recently in June 2010... The Government [later] developed the Principles of Scientific Advice to Government, [2] which 'set out the rules of engagement between Government and those who provide independent scientific and engineering advice.' The Principles apply to 'Ministers and Government departments, all members of Scientific Advisory Committees and Councils [...] and other independent scientific and engineering advice to Government.' They detail principles related to roles and responsibilities, independence and transparency and openness." [3] The May advice was updated in May 2011 in a document entitled Code of Practice for Scientific Advisory Committees (CoPSAC 2011). [4]
"In an emergency where scientific or technical advice is required to aid the emergency response, the Government may decide that a" SAGE "is required; this decision can either be made by the Lead Government Department (LGD) or the Cabinet Office in consultation with the Government Office for Science. SAGE is usually chaired by the Government Chief Scientific Adviser... Each SAGE is emergency-specific. The swine flu pandemic was the first emergency where the SAGE mechanism was used; volcanic ash was the second." [3]
SAGE has advised the government on a number of events, including: [5]
SAGE was reported in July 2020 to consist of around 20 participants at any one given time. [12] Participants are drawn from both academia and practice, and the participants of a particular meeting are decided upon by the British Government Chief Scientific Adviser and the Chief Medical Officer for England, depending on the expertise required. They are not generally employed by government. They do not operate under government instruction. In addition to these participants, SAGE is also attended by officials from relevant parts of government and arm's-length bodies who may contribute to discussions with relevant expertise, for instance, the UK Health Security Agency and the Chief Scientific Advisers to government departments. [12]
The government does not have to act upon the conclusions of SAGE, and other bodies, including other sources of scientific advice, feed in to government's decisions. [13] Only the Chief Scientific Adviser and Chief Medical Officer may speak on behalf of SAGE. [12]
In 2020, the UK Government carried out a review of SAGE's structure in the context of the COVID-19 pandemic. [12]
Sub-committees can be delegated by SAGE to study particular issues. During the COVID-19 pandemic, these were: [14]
The 2020 COVID-19 pandemic has seen an expanded role for and greater attention paid to SAGE.
Although not prohibited, until the 2020 COVID-19 pandemic, it is believed that political advisors had never attended SAGE meetings in any capacity nor is there evidence for 10 Downing Street officials attending these meetings too. [16] It was reported that Dominic Cummings and Ben Warner had attended COVID-19 meetings. Their attendance and participation was widely criticised, [17] in particular by other attendees "shocked, concerned and worried for the impartiality of advice". [18]
Early in the pandemic, in April 2020, SAGE was criticised for a lack of transparency. [19] For their security and safety, and on advice from the Centre for the Protection of National Infrastructure, the list of current members was not disclosed, although members could, and many did, reveal their own membership. [16] Chris Whitty, speaking to the Health and Social Care Select Committee regarding the COVID-19 meetings of SAGE and the anonymity of its members, said that SAGE was "given quite clear advice from the Centre for the Protection of National Infrastructure, basically based on the fact that SAGE is a sub-committee of COBRA". [20] Patrick Vallance argued in a letter to Parliament that scientists were protected by the anonymity from "lobbying and other forms of unwanted influence". [19]
Membership of SAGE and its subcommittees was published on 4 May 2020. [21] A register of participants' interests was first published in December 2020. [22]
A report in The Guardian stated that attendees at an April 2020 meeting of the group included: [23]
Senior advisers:
Medical and scientific experts:
Political advisers:
Vallance has written that SAGE includes scientists and experts from more than twenty separate institutions. SAGE also contains four expert groups which may each have as low as five and as many as over forty members. [19]
Dominic Cummings was confirmed by 10 Downing Street to have attended a 23 March meeting, but the government said Cummings was not a member of SAGE. [25] The attendance and participation by Prime Ministerial advisors caused much criticism. It was reported that one participant considered that Cummings' interventions had sometimes inappropriately influenced what is supposed to be an impartial scientific process; another expressed shock when Cummings first began participating in SAGE discussions, in February, viewing this as unwanted political influence on what should be "unadulterated scientific data". [18]
In May 2020, Professor Neil Ferguson resigned from SAGE after The Telegraph revealed he had violated lockdown rules to meet with a partner. [26] The same day of his resignation, a list of SAGE participants was published by the UK Government, 4 May 2020. [27] However, it notes that: "Permission to publish names was requested from all participants. Those who did not give permission have not been named." In addition: "These meetings are also regularly attended by officials from Her Majesty’s Government. These attendees have not been named." No reason for the secrecy is provided. Two attendees did not give permission to be named. Attendees as of May 2020 included: [23]
In July 2020, the participants list was updated to reflect recent meetings. Professor Neil Ferguson was featured on the list. As of 19 November, the list remains unchanged and includes: [28]
The following were included on the minutes of a 11 March meeting: [29]
Scientific experts:
Observers and government officials:
Secretariat:
The following were added to the list of participants: [22]
An April 2020 article in The Guardian written by Richard Coker cited SAGE as a potential example of "scientific groupthink" in which disagreement and/or conflicting views are minimised to reach a consensus. [30] Although disagreement is not preferable, this may ultimately lead to potentially irrational decision-making as counter views are not encouraged. [30]
On 24 October 2020, The Spectator , while noting that SAGE minutes are published, called for a publication of the data used by SAGE, including NHS occupancy data, that were employed by it to justify the decisions it made. The editors remarked how in France hospital occupancy data were indeed published daily, while they were told by the NHS to submit a Freedom of Information request, which can take up to 28 days. [31]
The questions raised about the transparency of SAGE [19] and possible political interference [24] [17] during the COVID-19 pandemic raised concerns about trust in public health messaging by opposition parties and others. As an alternative, a group of scientists created Independent SAGE, chaired by Sir David Anthony King, a former Government Chief Scientific Advisor, in early May 2020 to "provide a clear structure on which an effective policy should be based given the inevitability that the virus will continue to cross borders". [32] [33] Later that month, Independent SAGE warned against ending lock-down prematurely in places like schools. [33]
The UK Government Chief Scientific Adviser (GCSA) is the personal adviser on science and technology-related activities and policies to the Prime Minister and the Cabinet. They are also the head of the Government Office for Science.
Susan Fiona Dorinthea Michie is a British academic, clinical psychologist, and professor of health psychology, director of The Centre for Behaviour Change and head of The Health Psychology Research Group, all at University College London. She is also an advisor to the British Government via the SAGE advisory group on matters concerning behavioural compliance with government regulations during the COVID-19 pandemic. In 2022, she was appointed Chair of the World Health Organisation’s (WHO) Technical Advisory Group on Behavioural Insights and Sciences for Health.
Dame Angela Ruth McLean is professor of mathematical biology in the Department of Biology, University of Oxford, and Chief Scientific Adviser to the UK Government.
Dame Sally Claire Davies is a British physician. She was the Chief Medical Officer from 2010 to 2019 and Chief Scientific Adviser at the Department of Health from 2004 to 2016. She worked as a clinician specialising in the treatment of diseases of the blood and bone marrow. She is now Master of Trinity College, Cambridge, appointed on 8 February 2019, with effect from 8 October 2019. She is one of the founders of the National Institute for Health and Care Research.
Sir Mark Jeremy Walport is an English medical scientist and was the Government Chief Scientific Adviser in the United Kingdom from 2013 to 2017 and Chief Executive of UK Research and Innovation (UKRI) from 2017 to 2020. In 2023 he became the Foreign Secretary of The Royal Society.
Sir Jeremy James Farrar is a British medical researcher who has served as chief scientist at the World Health Organization since 2023. He was previously the director of the Wellcome Trust from 2013 to 2023 and a professor of tropical medicine at the University of Oxford.
Sir Patrick John Thompson Vallance is a British physician, scientist, and clinical pharmacologist who has worked in both academia and industry. He served as the Chief Scientific Adviser to the Government of the United Kingdom from 2018 to 2023.
Sir Christopher John MacRae Whitty is a British epidemiologist, serving as Chief Medical Officer for England and Chief Medical Adviser to the UK Government since 2019.
Dame Jennifer Margaret Harries is a British public health physician who has been the chief executive of the UK Health Security Agency (UKHSA) and head of NHS Test and Trace since May 2021. She was previously a regional director at Public Health England, and then Deputy Chief Medical Officer for England from June 2019 until her UKHSA appointment in 2021.
Devi Lalita Sridhar FRSE is an American public health researcher, who is both professor and chair of global public health at the University of Edinburgh, Scotland. Her research considers the effectiveness of public health interventions and how to improve developmental assistance for health. Sridhar directs the University of Edinburgh's Global Health Governance Programme which she established in 2014.
The New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG) is an advisory body that advises the United Kingdom Government's Chief Medical Advisor / Chief Medical Officer for England, who in turn advises the UK Department of Health and Social Care and relevant ministers regarding threats from viral respiratory tract infections. The body replaced the UK Scientific Pandemic Influenza Advisory Committee (SPI) as part of a move to expand the scope to cover the threat of other respiratory viruses, besides pandemic influenza. The inaugural meeting was held on 19 December 2014 where the terms of reference were agreed. The group has been advising the Department of Health for some years and minutes of meetings are now regularly published, backdated to 2014. As of 2020, the group has been advising specifically on the COVID-19 pandemic.
Professor Sir Jonathan Stafford Nguyen-Van-Tam is a British healthcare professional specialising in influenza, including its epidemiology, transmission, vaccinology, antiviral drugs and pandemic preparedness.
William John Edmunds is a British epidemiologist, and a professor in the Faculty of Epidemiology and Population Health at the London School of Hygiene & Tropical Medicine.
Sir Peter William Horby is a British physician, epidemiologist, Moh Family Foundation Professor of Emerging Infections and Global Health, and Director of the Pandemic Sciences Institute at the University of Oxford. He is the founder, and former director of the Oxford University Clinical Research Unit in Hanoi, Vietnam which was founded in 2006. In 2014, Horby established the Epidemic Research Group Oxford (ERGO). ERGO incorporates a number of international projects such as the European Commission funded PREPARE, the African coaLition for Epidemic Research, Response and Training (ALERRT), and the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC). Since 2016, Horby has been chair and executive director of ISARIC.
Russell Mardon Viner, FMedSci is an Australian-British paediatrician and policy researcher who is Chief Scientific Advisor at the Department for Education and Professor of Adolescent Health at the UCL Great Ormond Street Institute of Child Health. He is an expert on child and adolescent health in the UK and internationally. He was a member of the UK Government's Scientific Advisory Group for Emergencies (SAGE) during the COVID-19 pandemic and was President of the Royal College of Paediatrics and Child Health from 2018 to 2021. He remains clinically active, seeing young people with diabetes each week at UCL Hospitals. Viner is Vice-Chair of the NHS England Transformation Board for Children and Young People and Chair of the Stakeholder Council for the Board. He is a non-executive director (NED) at Great Ormond St. Hospital for Children NHS Foundation Trust, also sitting on the Trust's Finance & Investment and the Quality and Safety sub-committees.
The Independent Scientific Advisory Group for Emergencies, better known as Independent SAGE, is a group of scientists, unaffiliated to government, that publishes advice aimed toward the UK government regarding the COVID-19 pandemic. Its name is based on SAGE, the name of the government's official Scientific Advisory Group for Emergencies.
Operation Moonshot was a UK government programme to introduce same-day mass testing for COVID-19 in England as a way of enabling large gatherings of people to take place in that country while maintaining control over the virus. According to the British Medical Journal, the programme aimed to deliver 10 million tests per day by 2021.
Sir Andrew John Pollard is the Ashall Professor of Infection & Immunity at the University of Oxford and a Fellow of St Cross College, Oxford. He is an Honorary Consultant Paediatrician at John Radcliffe Hospital and the Director of the Oxford Vaccine Group. He is the Chief Investigator on the University of Oxford COVID-19 Vaccine trials and has led research on vaccines for many life-threatening infectious diseases including typhoid fever, Neisseria meningitidis, Haemophilus influenzae type b, streptococcus pneumoniae, pertussis, influenza, rabies, and Ebola.
Professor Julie Fitzpatrick OBE is a Scottish scientist and academic. She is the CEO of Moredun Research Institute and Scotland's part-time Chief Scientific Advisor. She attended Scientific Advisory Group for Emergencies meetings in that role.
Lucy Chappell is a British professor of obstetrics at King’s College London and the Chief Scientific Adviser (CSA) for the UK Department of Health and Social Care. As part of her CSA role, she oversees the National Institute for Health and Care Research (NIHR) as Chief Executive Officer. Her research areas include medical problems during pregnancy such as pre-eclampsia, and the safety of medicines in pregnancy.
Mr Cummings' attendance has been criticised, with many suggesting it could have politicised decision making.
I like all the people I know on these committees. They are extremely bright. And I believe their values and motivations are "good". But I worry that their intimacy, their familiarity, lends itself to groupthink. Are there sufficient contrarian views? Are critically important assumptions subjected to sufficient critique? Is groupthink acknowledged as a risk, and if so, how is it addressed?
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