Scientific advice and COVID-19 policy making in the UK: an oral history study

BACKGROUND: The COVID-19 pandemic has posed severe challenges to policy makers in all countries: these include uncertainty about the science of the disease, its epidemiology, and public behaviour, coupled with the need to act fast. This real-time study was undertaken to capture UK Government scientific advisers' perceptions of how scientific advice worked and to learn lessons about what works best in a fast-moving response to a novel epidemic. METHODS: Regular semi-structured calls were recorded with ten prominent scientific advisers to elicit their roles in, and reactions to, the UK's COVID-19 response. Interviewees were recruited using the existing networks of the NIHR Health Protection Research Unit for Emerging and Zoonotic Infections. They were active in fields including biomedical research, modelling, and global health, and they included members of the Scientific Advisory Group for Emergencies (SAGE). In pandemic conditions interviewing was opportunistic: one participant spoke to us almost every 1–2 weeks, others at longer intervals. Interviews were transcribed and coded using a published analytical framework for the study of policy decision-making. FINDINGS: 93 interviews were conducted between Feb 17, 2020, and July 22, 2021. We report interviewees' perceptions that scientific advice had not led to sufficiently rapid policy decisions, and that a lack of transparency was sapping public trust. Interviewees also drew attention to policy makers' failure in the early months of the pandemic to frame a policy goal, and the problems this posed for giving scientific advice. It also became clear that scientific advisers and policy makers operated in different intellectual worlds, and that useful advice was most likely to be given when individuals could span this gap and understand the agendas of each group. INTERPRETATION: These findings provide empirical information about how science advice has worked, uncovering power dynamics and business processes that are not otherwise well understood. We argue that politicians abdicated responsibility by their early “follow the science” rhetoric, later renegotiated. The study would be strengthened if the perceptions of policy makers were also included. We requested interviews with eight policy makers, who declined due to unavailability. FUNDING: UK Research and Innovation—National Institute for Health Research.