Learning the hard lessons of lockdowns must lead to four key changes in government decision-making

OVER THE PAST couple of months, there seems to have been a desire to believe that Covid isn’t over. That we can’t now live with Covid as we do with flu. 

We saw this during the winter with the arrival of the Omicron variant when modellers predicted several thousand deaths a day unless we were banned from mixing indoors, with a limit on social gatherings outdoors. They predicted even the Government’s short-lived Plan B measures would lead to disaster. In reality, Covid-19 deaths per day in England never peaked above 300 since the arrival of Omicron. 

It was only thanks to groups like Recovery outside of Parliament and groups like the Covid Recovery Group inside Parliament that we didn’t spend this past Christmas in lockdown. 

Now that all domestic Covid-19 rules have been scrapped, mass testing in our schools is ending and the legal requirement to self-isolate has been ended, we should both be glad that there is no “new normal” and reflect on the last two years. We ought to think why so many well-intentioned, intelligent people make mistakes; why they locked us all down when a more targeted approach was possible; why the models never matched the reality; why policies were often ill-thought-out; why there was a national debate about whether a Scotch Egg was a substantial meal.  

As we, both as an economy and a society, begin to live with Covid as we do with flu, we must look to the future and what reforms to our institutions are necessary to ensure that the mistakes of the last two years are not repeated. We must be under no illusion. Covid is a seasonal disease like flu. There will be bad Covid periods as there are bad flu periods. The calls for lockdown restrictions will return. Similarly, there will, eventually, be another pandemic. It could be in ten years, twenty years, fifty years… We must ensure that our institutions deciding policy, and ultimately deciding on our rights as citizens, are improved structurally to make better decisions. 

This starts with recognising that the pandemic has put a great burden on the shoulders of scientists, economists, policy makers and politicians. I sympathise with their positions. The philosopher and economist Friedrich Hayek always assumed that opponents of the open liberal society he championed were well-intended but misguided. We must assume the same. But this does not mean that decision-making cannot be improved. 

There are several reforms that would improve Government decision-making in pandemics. I have raised these reforms in the media, in Parliament and with Government. I will continue to work hard to press for them and I encourage campaign groups outside of Parliament like Recovery to do the same. I have worked on each reform with leading experts in the respective fields. 

1.            Reforms to how expert advice is provided to Government.

2.            Reforms to epidemiological modelling and a recognition of its limitations.

3.            The introduction of a new Public Health Act. 

4.            Reforms to how cost-benefit analyses are conducted.

How expert advice is provided to Government 

There is no doubt that we need experts and expertise, and that most experts act with good intentions. I believe those advocating for lockdown sincerely believed it was necessary. However, there is a structural problem rooted in the division of labour which, when combined with bad incentives, causes poor expert advice to Government. 

This does not arise from poor expertise or experts acting in bad faith, but we must recognise that scientists and public health experts are just like everyone else: they are human. They respond to incentives like everyone else. Even the most scientific and impartial experience pressure, especially during a pandemic when knowledge is incomplete and uncertain. Suppose an expert provides the Government with a low estimate of the number of deaths. As a result, there is no lockdown. Perhaps there are many more deaths than the expert predicted. They will be blamed and labelled a bad scientist. Suppose our expert provides a high estimate. As a result, there is lockdown. Even if many people die, it can always be said it would have been worse without a lockdown. A high prediction will always mean that the expert can be credited for saving lives. 

Furthermore, throughout the Covid-19 pandemic, it was forgotten that all experts only provide a partial perspective. Narrow expertise must be complemented. Where in SAGE were the GPs, mental health practitioners, economists, and cancer specialists?

In order to rectify these issues, we must simulate a market for expert advice using competing expert groups in the same field, bringing together complementary fields so the partial perspective of experts is corrected for. Finally, not only should Ministers ensure they receive competing expert opinions, but “red teams” should be deployed to challenge the advice Ministers receive.  

Reforms to epidemiological modelling and a recognition of its limitations 

Many Covid-19 public health decisions have been driven by epidemiological modelling. Yet, time and time again, these models have had their accuracy publicly questioned and it is worrying that their predictions have rarely been matched by the actual course of the pandemic. The modelling in relation to the Omicron variant is the most recent example of this, but we saw this during the second lockdown where the death projections presented to justify it were taken apart the next day by Prof. Carl Heneghan and his team at the University of Oxford. The models were shown to be using out-of-date data and weren’t even nearly accurate about the number of deaths on the day they were presented to the public.

In epidemiological modelling, models are often tested by whether they match the predictions of other models rather than real-life developments. This is one of the many problems that leads to epidemiological models being proved time and time again to be inaccurate. Similarly, we often see models produced with code that would hardly be fit for an undergraduate university course, researchers choosing data and assumptions that do not match reality, and only pessimistic scenarios being presented to Ministers.  

Alongside code quality controls and requiring all modelling that may impact public policy to demonstrate a rigorous cost-benefit analysis, we must set up a new Office of Research Integrity that pre-vets research before it is presented to Ministers or the wider civil service. It should seek out disagreement from both within and outside the academic community, be trained in how to critically review research papers using in-house statistical expertise and require all epidemiological models to validate their models against reality. This would prevent inaccurate models with wrong assumptions from scaring Ministers into bad decisions that impact all of us.

The introduction of a new Public Health Act

While these two reforms are vital, we cannot be said to be secure in our rights when by the stroke of a pen, ministers can shut down our ability to see loved ones, to socialise with friends, travel abroad, or to operate businesses and invest in our futures. That’s why we need a new Public Health Act.

This new Public Health Act would not be produced out of thin air; it would bring together and reform established law and practice. On numerous occasions, MPs have been side-lined in decision making and Parliament has only had a retrospective say after restrictions have already become law. It would ensure Parliament could vote in advance and regularly on any restrictions. This would both ensure that Ministers can justify their proportionality and that the details of the policies are well thought-through. It would also allow restrictions to be amended and debated in the usual way – this has not been the case over the past two years. It would also require Ministers to go through the cost-benefit analysis process, as with other policy proposals. At no point throughout the Covid-19 pandemic has the Government produced a serious “impact assessment” or “cost-benefit analysis” been produced that looked at non-Covid effects of restrictions. The Labour Party accepted this and voted with the Government regardless. There is no other policy area where this would be acceptable, let alone one that restricts our most basic civil liberties.

Government would still have the power to act decisively in emergency situations, but a new Public Health Act would ensure that they cannot do so with only retrospective scrutiny and oversight. Ministerial power during the pandemic has been far above my expectations and the scrutiny of it by Parliament far below: in a free society, draconian powers must be restrained.

Reforms to how cost-benefit analyses are conducted

Finally, regardless of our views about the response to Covid-19, we can all agree that there are response areas that can be improved for future crises and, indeed, for calmer times too. 

For effective policy making we should focus on how better to capture the full range of a policy’s effects on the distributions of wellbeing across society, capturing and quantifying all its possible short and long-term effects. Many of the problems we are responding to now, such as long NHS waiting times and children dropping off school registers, are the result of only judging policies by their initial effects. Professor Paul Dolan has led the field in this area. We need cost-benefit analyses to look to the long-term and to focus on wellbeing factors. A narrow, tunnel-vision focus on Covid ignores both the long-term impact of policies and the impact on wellbeing across all other areas of an individual’s life.

I am genuinely hopeful for the future but we cannot pretend the past two years did not happen or that the response could not have been less harmful and more justifiable. These reforms are essential to that end.

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Steve Baker MP FRSA is a Conservative Member of Parliament representing Wycombe in Buckinghamshire and Deputy Chair of the Covid Recovery Group.

For further information about these reforms:

1. Reforms to how expert advice is provided to Government: https://twitter.com/SteveBakerHW/status/1284378971099013121?s=20&t=KvVR3uVZlLRHyFydC3Qpvg

2. Reforms to epidemiological modelling and a recognition of its limitations: https://www.stevebaker.info/2020/11/summary-of-methodological-issues-in-epidemiology-mike-hearn/

3. The introduction of a new Public Health Act: https://twitter.com/SteveBakerHW/status/1361237773802471427?s=20&t=nYrAfZr-vaK9rCaR5Bm2TA

4. Reforms to how cost-benefit analyses are conducted: https://collateralglobal.org/authors/paul-dolan/

Photo of Covid-19 Press conference on 20 March 2020 with Boris Johnson, Rishi Sunak and Jenny Harries courtesy of 10 Downing Street, https://commons.wikimedia.org/w/index.php?curid=99547633