SAGE conflicts of interest

Introduction

Imagine that a new disease emerged. It presented less risk of death than a lightning strike for school-age children (Ref i), but it was particularly nasty for the elderly and those with pre-existing conditions. A committee decided that draconian measures – the likes of which had never been experienced or studied – should be imposed on the entire population until a drug to ease the disease outcome arrived. If you then discovered that the majority of the committee members had financial interests in the drug being developed, how would you feel?

Background

The conflicts that I am going to go through in this note are primarily related to vaccines, but this is a note about conflicts and not vaccines. The background to the issues is as follows…

On March 11th, 2020, UK Prime Minister Boris Johnson, and the Deputy Chief Medical Officer, Dr Jenny Harries, held at briefing at Downing Street. A five minute video summarised the evidence and advice to the British people (Ref ii). The advice was stay home if you’re sick, wash your hands, protect the vulnerable, most people will have a mild illness, wearing face masks is “usually quite a bad idea“, and “big gatherings don’t have a big effect so we don’t want to disrupt people’s lives.” Dr Harries summed up the UK position by saying, “so, as a professional, I am absolutely delighted that we are following the science and the evidence.” The science has not changed, but the advice has.

On March 16th, Neil Ferguson/Imperial College published a non-peer-reviewed paper which said that unless a suppression strategy were adopted “we would predict approximately 510,000 deaths in GB and 2.2 million in the US not accounting for the potential negative effects of health systems being overwhelmed on mortality” (Ref iii). Prime Minister Johnson announced stricter measures that day and then, a week later, on March 23rd, he announced that the UK would be put into lockdown for three weeks “to avoid the NHS being overwhelmed.

Professor Johan Giesecke is an infectious disease specialist and advisor to the Swedish government. He was the World Health Organization (WHO) leader of the revision of the International Health Regulations and he was the first Chief Scientist of the European Centre for Disease Prevention and Control (ECDC) a post he held between 2005-2014 (Ref iv). Just before five minutes into this interview (Ref v), Professor Giesecke explained the Sweden coronavirus strategy: “Herd immunity isn’t the strategy; it’s a by-product of the strategy. The strategy is to protect the old and the frail.” Giesecke summarised the policies introduced in Sweden as: there’s no lockdown. People are free to go out. There’s no police to stop you in the street. People are asked to stay inside but there’s no reinforcement. We have a rule that a crowd cannot be bigger than 50 people. The upper schools are closed. Schools up to the age of 15-16 are open. Nursing homes are closed to visitors. Sweden didn’t do nothing; therefore, but Sweden did treat their grown-ups like grown-ups. Giesecke then described the Sweden strategy as “It’s very similar to the one the UK had before there was a famous paper by the Imperial College by the modellers, that came out and the day after you made a U-Turn in England.”

Giesecke said of the Ferguson/Imperial paper: “I don’t think any other scientific endeavour has made such an impression on the world as that rather [pause] debatable paper.” “It was very much so overly pessimistic.”

In this context, there are two fundamental issues with the committee making decisions about lockdowns having vaccine conflicts:

1) Organisations invested in vaccines make money from vaccines. If people acquire natural immunity, they have reduced or no need for a vaccine and thus the potential gain for the vaccine company is reduced.

2) Locking people in their homes and other lockdown measures will reduce the number of people who acquire natural immunity.

It’s that simple.

As Giesecke explained, the Ferguson/Imperial paper had global impact, since its dire warnings were heeded around the world. Ferguson’s history of abysmally inaccurate models must be noted upfront. As just one example, in 2005, Ferguson predicted that up to 150 million people could be killed from bird flu. In fact, 282 people died worldwide from the disease between 2003 and 2009 (Ref vi). When challenged about his March 2020 Covid-19 model, Ferguson admitted that it was based on undocumented, 13-year-old, computer code that was intended to be used for a influenza pandemic, rather than a coronavirus. Ferguson refused to release his original code so that other scientists could check his results. When software engineers finally got hold of some of the code, they tore it apart in hours (Ref vii).

In this context, let’s examine the key influencers who managed to get the UK into lockdown 1 and who have just succeeded in returning the UK to lockdown 2.

Method

The minutes from the SAGE committee meetings are available thanks to the efforts of businessman Simon Dolan. He has fought in the courts to ensure that the minutes are openly available, as part of his ongoing legal action that the measures imposed on the UK have been illegal and disproportionate (Ref viii). The minutes were finally published on Friday 29th May (Ref ix).

I have gone through the minutes to get the list of attendees and then assessed the key influencers on the committee. This was done by attendance and importance. I examined the first 30 minutes, from meeting 1 on January 22nd, 2020 to meeting 30 on April 30th, 2020 (Ref x). This covered the important period from early discussions about the virus situation in China… to the Downing Street Briefings on 16th March and then the UK lockdown announcement on 23rd March… to the point where Johnson declared, in a briefing on 30th April, “we are past the peak of this disease” (Ref xi).

There were 25 people who attended 5 meetings or fewer – 10 attending just 1 meeting during that 3-month period – whose influence would have been minimal. The key influencers were the 20 people who attended at least half (15 or more) of the 30 meetings I examined. I checked to see if these were still the key attendees in the more recent minutes (meeting 55, 3rd September and meeting 61, 8th October as examples) and they essentially were. The notable exception was that Ferguson resigned from the SAGE committee when it became known (on 5th May) that he had broken lockdown rules (Ref xii). He had attended every one of the first 30 meetings. The only other person with that 100% attendance record was Sir Patrick Vallance. Ferguson’s influence has not gone, however. He is a member of NERVTAG (The New and Emerging Respiratory Virus Threats Advisory Group), as are many members of SAGE (which means that the main committee is largely using a subset of that committee to advise itself). Additionally, Ferguson is still given airtime by the media to continue to issue his apocalyptic predictions.

The details of the conflicts of these key influencers are below.

The 20 key influencers

In what follows: GCSA = Government Chief Scientific Advisor, CSA = Chief Scientific Advisor, CMO = Chief Medical Officer and LSHTM = London School of Hygiene and Tropical Medicine. Please note that the references for the table are reported separately at the end of this note.

Examination of the 20 key influencers on SAGE reveals the following:

1) 11 out of 20 work for the government (some hold government roles in addition to other roles).

2) 12 out of 20 work for/have received funding from organisations involved in the Covid-19 vaccine. Those 12 don’t include Vallance with personal pharmaceutical conflicts or Whitty with historical funding from the Gates foundation. Three work for Imperial College and two work for Oxford University – the two forerunners in the Covid-19 vaccine race in the UK – each receiving millions of pounds from government(s) (Ref xiii). Three more work for the London School of Hygiene and Tropical Medicine with its own vaccine centre (working on Covid-19 among other vaccines). One works for UCL, which is working with Imperial on its vaccine. Two work for Wellcome/the Wellcome Sanger Institute and one has received funding from the latter. Two members have double conflicts – Peter Horby with Oxford University and Wellcome and Wendy Barclay with Imperial College and Wellcome.

3) Taking the major role only (to keep this totalling 20), 5 are Chief Scientific Advisors in government (2 of these are modellers/statisticians); 4 more are modellers/statisticians, 2 are experts in how to manipulate human behaviour, 3 are medical officers/directors, 3 hold senior roles in the 2 universities leading the vaccine race, and 3 work for/have been funded by Wellcome (as above, 2 of the university members also have conflicts with Wellcome.)

4) There are no immunologists among the key influencers on the SAGE committee. There are two virologists. Wendy Barclay has particular expertise in flu and works for Imperial College and her laboratory is funded by Wellcome. The other, Maria Zambon, also works for Imperial and has “specific interest in RNA viruses, antivirals and vaccines.” Zambon and Ferguson were named in a 2010 article exposing the fact that: “A third of the experts advising the World Health Organisation about the swine flu pandemic had ties to drugs firms, it has emerged.”

Zambon and Ferguson are not the only SAGE members to have history of working together. As another example, Whitty, Ferguson, Farrar, and Edmunds collaborated on an Ebola paper entitled “Infectious disease: Tough choices to reduce Ebola transmission” (Ref xiv). The two behaviour experts among the key influencers have also collaborated on this controversial paper (Ref xv). The following extract from the paper has been widely cited as evidence to show how fear has been used to coerce UK citizens: “A substantial number of people still do not feel sufficiently personally threatened… The perceived level of personal threat needs to be increased among those who are complacent, using hardhitting emotional messaging based on accurate information about risk.” The paper has sections on coercion, compulsion and how to harness “social disapproval” to coerce people into doing what government wants them to do.

Given that the media was interested 10 years ago when one third of the experts advising the WHO on swine flu had drug conflicts, the media should surely be interested now that 12-14 out of 20 have such conflicts (Ref xvi). It doesn’t matter if a drug is good or bad. It matters that those who have a financial interest in that drug are conflicted if they give advice that protects the financial interest in that drug.

The advice emanating from SAGE is currently under scrutiny as never before. The Centre for Evidence Based Medicine, which has been an exemplar of rigour during the Covid-19 period, has highlighted the inaccuracies in the recent forecasts that have resulted in Lockdown 2 (Ref xvii). Slides broadcast on national TV on 31st October were revised downwards by the time the slides were published on line. The two main drivers of SAGE – Vallance and Whitty – were summoned to appear before the Science and Technology Committee on 3rd November where Vallance expressed regret for frightening people. But SAGE knows that people need to be frightened into compliance for their strategy to work, as the SAGE behaviour advisors documented in their academic paper. I wonder if that fear might turn to anger if people realise that the committee may not be the independent body that it has been assumed to be.

Summary 

* As late as March 11th, 2020, the UK government and medical officers issued practical and minimally disruptive advice to combat the spread of the novel coronavirus.

* On March 16th, the now infamous Neil Ferguson/Imperial College paper was published predicting over 500,000 deaths in the UK and 2.2 million in the US if suppression measures were not introduced.

* Stricter measures were announced on the day that paper was published, and the first UK lockdown was announced a week later, on March 23rd. US states variously followed suit.

* The committee that has been advising the government throughout this period is called the Scientific Advisory Group for Emergencies (SAGE). Ferguson was a member of this committee until he resigned in May for having broken lockdown rules.

* This week’s note examines the key influencers on SAGE and their conflicts of interest:

– Organisations invested in vaccines make money from vaccines. People who acquire natural immunity have less/no need for a vaccine. If people are locked in their homes, they have less chance of acquiring natural immunity.

– Twelve out of 20 key influencers work for/have received funding from organisations involved in the Covid-19 vaccine.

– There are four times more modellers/statisticians and experts in behaviour manipulation on the committee than there are virologists. There are no immunologists.

* It doesn’t matter if a drug is good or bad. It matters that those who have a financial interest in that drug are conflicted if they give advice that protects the financial interest in that drug.

References

Ref i) https://www.bmj.com/content/370/bmj.m3259
https://www.telegraph.co.uk/politics/2020/06/09/school-age-children-likely-hit-lightning-die-coronavirus-oxbridge/
Ref ii) https://www.facebook.com/watch/?v=227850301597915
Ref iii) https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf
Ref iv) https://www.who.int/emergencies/diseases/strategic-and-technical-advisory-group-for-infectious-hazards/members/biographies/en/index2.html
Rev v) https://unherd.com/thepost/coming-up-epidemiologist-prof-johan-giesecke-shares-lessons-from-sweden/
Ref vi) https://statmodeling.stat.columbia.edu/2020/05/08/so-the-real-scandal-is-why-did-anyone-ever-listen-to-this-guy/
Ref vii) https://lockdownsceptics.org/code-review-of-fergusons-model/
Rev viii) https://www.theguardian.com/law/2020/may/16/government-legal-action-refusal-to-publish-sage-minutes-lockdown
Ref ix) https://www.gov.uk/government/news/government-publishes-sage-minutes
Ref x) The meeting minutes ceased being searchable from meeting 18 on the 23rd March, which made analysis more difficult.
Ref xi) https://www.gov.uk/government/news/prime-ministers-statement-on-coronavirus-covid-19-30-april-2020
Ref xii) https://www.telegraph.co.uk/news/2020/05/05/exclusive-government-scientist-neil-ferguson-resigns-breaking/
Ref xiii) 17 May “So far the government has invested £47 million in the Oxford and Imperial vaccine programmes. But today I can announce an additional £84 million of new government funding to help accelerate their work… I can also confirm that with government support, Oxford University has finalised a global licensing agreement with AstraZeneca for the commercialisation and manufacturing of the Oxford vaccine.” https://www.gov.uk/government/speeches/business-secretarys-statement-on-coronavirus-covid-19-17-may-2020
Ref xiv) https://www.nature.com/news/infectious-disease-tough-choices-to-reduce-ebola-transmission-1.16298
Ref xv) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7276722/
Ref xvi) https://www.dailymail.co.uk/health/article-1302505/WHO-swine-flu-advisers-ties-drug-firms-Experts-linked-vaccine-producers.html
Ref xvii) https://www.cebm.net/covid-19/the-innacuracoes-in-the-sage-models/

References for the table

Ref 1 : https://www.gov.uk/government/people/patrick-vallance
Ref 2: https://www.telegraph.co.uk/news/2020/09/23/revealed-sir-patrick-vallance-has-600000-shareholding-firm-contracted/
Ref 3: https://www.imperial.ac.uk/people/neil.ferguson
Ref 4: https://www.gov.uk/government/speeches/business-secretarys-statement-on-coronavirus-covid-19-17-may-2020
17 May “So far the government has invested £47 million in the Oxford and Imperial vaccine programmes. But today I can announce an additional £84 million of new government funding to help accelerate their work… I can also confirm that with government support, Oxford University has finalised a global licensing agreement with AstraZeneca for the commercialisation and manufacturing of the Oxford vaccine.”
Ref 5: https://www.gov.uk/government/people/christopher-whitty
Ref 6: https://www.eurekalert.org/pub_releases/2008-03/lsoh-lso030408.php
Ref 7: https://www.gov.uk/government/people/charlotte-watts
Ref 8: http://strive.lshtm.ac.uk/people/charlotte-watts
Ref 9: https://www.lshtm.ac.uk/research/centres/vaccine-centre/covid-19
Ref 10: https://www.lshtm.ac.uk/research/research-action/features/maths-maps-modellers-tackling-covid-19
Ref 11: https://blogs.bmj.com/bmj/2015/03/26/clare-wenham-and-john-edmunds-how-effective-is-this-years-flu-vaccine/
Ref 12: https://www.gov.uk/government/people/jonathan-van-tam
Ref 13: https://www.kcl.ac.uk/people/james-rubin
Ref 14: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7276722/ “A substantial number of people still do not feel sufficiently personally threatened… The perceived level of personal threat needs to be increased among those who are complacent, using hard‐hitting emotional messaging based on accurate information about risk”
Ref 15: https://www.gov.uk/government/people/john-aston and http://www.csap.cam.ac.uk/network/john-aston/
Ref 16: https://www.isirv.org/site/index.php/council-members/11-antiviral-group/165-maria-zambon
Ref 17: https://www.imperial.ac.uk/medicine/nihr-hpru-respiratory-infections/people/ and https://www.imperial.ac.uk/medicine/nihr-hpru-respiratory-infections/research-themes/influenza/
Ref 18: https://www.who.int/ihr/procedures/emerg_comm_members_20140616/en/
Ref 19: https://www.dailymail.co.uk/health/article-1302505/WHO-swine-flu-advisers-ties-drug-firms-Experts-linked-vaccine-producers.html
Ref 20: https://www.gov.uk/government/people/angela-mclean
Ref 21: https://www.kcl.ac.uk/people/brooke-rogers
Ref 22: https://www.ndm.ox.ac.uk/team/peter-horby
Ref 23: https://www.england.nhs.uk/author/professor-stephen-h-powis/ and https://www.ucl.ac.uk/news/headlines/2020/apr/profile-professor-stephen-powis
Ref 24: https://www.ucl.ac.uk/news/2020/jul/covid-19-vaccine-trialled-healthy-volunteers
Ref 25: https://www.sanger.ac.uk/external_person/peacock-sharon/
Ref 26: https://www.astrazeneca.com/media-centre/press-releases/2016/AstraZeneca-launches-integrated-genomics-approach-to-transform-drug-discovery-and-development-22042016.html#!
Ref 27: https://www.gov.uk/government/people/carole-mundell
Ref 28: https://wellcome.org/about-us/executive-leadership-team
Ref 29: https://wellcome.org/about-us/teams/vaccines-team
Ref 30: https://www.imperial.ac.uk/people/w.barclay
Ref 31: https://www.ed.ac.uk/edinburgh-infectious-diseases/research/themes/disease-dynamics/andrew-rambaut
Ref 32: https://twitter.com/arambaut/status/1254827417761431555?lang=en and https://www.cogconsortium.uk/about/
Ref 33: https://www.gov.uk/government/people/ian-diamond

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