On December 31, 2020 the four UK Chief Medical Officers (CMOs) published a statement announcing changes to the dosing schedule for the second dose of the Pfizer/BioNTech and University of Oxford/AstraZeneca vaccines. It stated that the interval between the first and second dose should be extended from 3–4 weeks to up to 12 weeks. This rapid response examines the evidence behind this decision.
- Over 1,100 experts have shared with us their concerns about COVID-19 and COVID-impacted areas in the immediate and longer term future.
- This report includes data or information experts would like to see the Government release in order to understand the decisions that underpin its approach to the COVID-19 outbreak.
- Generally, experts have highlighted five key areas of concern in the way the UK Government has released information. These include:
- Transparency of decision-making mechanisms.
- The quality, quantity and range of types of evidence used.
- The justification of the Government’s decisions.
- The need for accessible and understandable information.
- And the need to publish data as soon as its available.
- Experts have also called for additional information to be released by the Government including:
- Academic studies, models and Government data sets used to make decisions.
- All data being collected during the COVID-19 outbreak.
- Government guidance to departments, public bodies and public services.
- And recovery strategies from the Government and other public bodies.
- You can find all our horizon scanning work on COVID-19 here.
Our survey of over 1,100 experts asked them about their most important concerns relating to the COVID-19 outbreak. Their responses were analysed and synthesised into 15 reports in different areas. Our survey also asked experts what data or information they would like to see the Government release in order to understand the decisions that underpin its approach to the COVID-19 outbreak. There were 672 responses to this question (submitted between 3 and 30 April). These have been analysed and synthesised in this report. The first section of this report details the general principles that experts suggest the Government should follow when using data/information for making decisions and explaining these decisions to the country. The second section lists the specific data and information that experts want the UK Government to release in 13 different policy areas.
Over 120 responses focus on general principles for how the UK Government should release data and information relating to the COVID-19 outbreak. Experts suggest that these principles have not been routinely followed and this makes scrutinising the evidence base behind Government decisions more difficult. Experts’ responses centred on five main principles:
Experts emphasise the need to be transparent about what data/information is being collected during the COVID-19 outbreak and what data/information the Government is using when making decisions. Some experts also suggest that the full list of members of the Scientific Advisory Group for Emergencies (SAGE) and related subgroups should be public. Others suggest that minutes from SAGE, the Civil Contingencies Committee (COBR) and any other relevant meetings should be released.
Type of evidence
Experts raise concerns about the quality, quantity and range of data/information used by the Government to make decisions. They suggest that some publications released by the Government contain very few academic studies, considering the scale of the decisions being made. Other experts express concern that there has been an overreliance on a small number of studies and experts. Some suggest that the Government should consult experts from a wide range of institutions and disciplines to ensure they are using the maximum amount of information in their decision-making. There are a variety of concerns around the use of computational modelling in Government decisions. These include that Government decisions did not account for the uncertainty in the models and that important information about the models was not available publicly. Experts suggest that if models are used in Government decisions then their full code should be published alongside the data used for the model. They also suggest there should be a clear explanation about the assumptions made and the level of uncertainty in the output. Experts note that this allows others to replicate and test the models, permitting better scrutiny and potential improvements to the models.
Experts suggest that the Government should publish all the data/information they have consulted along with clear justifications for why decisions have been made, on what evidence these decisions were based and what are the contingencies if the decisions do not have the intended results. They also suggest that other policy opinions that were considered and rejected should be made public, along with the reasons they were not taken. Experts also want the UK Government to publish an overall strategy so the reasons for decisions are clearer to the general public and can be scrutinised.
Experts note that UK citizens may feel they have a right to know about what data/information the UK Government is consulting and what data/information they are collecting. They suggest that this information should be easily accessible and understandable for the public. Experts provide a number of ways this could be improved. They suggest that publications should be accessibly written so that anyone (not just experts) can understand the data/information and decisions made. For example, they note that better use of graphics could help to explain key concepts. They also suggest that studies used in decisions should be made open access (not behind a pay wall) so that anyone can read them. Some suggest that all the data/information about the COVID-19 outbreak should be published in one easily searchable place on the Government website.
Experts suggest that the UK Government should publish data/information as soon as it is available. They note that there have been delays in publishing decisions and strategies relating to the COVID-19 outbreak, which has reduced potential scrutiny. Experts also suggest that data/information should be regularly updated and decisions should be amended to include emerging evidence. They also suggest that detailed data/information should be systematically collected during the COVID-19 outbreak to allow for future scrutiny and learning. In particular, experts want to see more data disaggregated by protected characteristics (such as sex or ethnic background), region, occupation, and income level.
Example of a typical response in this area: The government need to be clear about what scientific evidence they have been using – not just via this [gov.uk] website but it also needs to be represented clearly on news programmes or other easily accessible formats to help gain trust and improve public understanding of what decisions have been made and why.
Information wanted in different areas
Nearly 550 responses focus on the data/information that experts want the Government to release across 13 different policy areas. Across all the policy areas, experts want the Government to release four types of information publicly:
- The data/information being used to make decisions during the COVID-19 outbreak, including academic studies, models and Government data sets.
- The data being collected during the COVID-19 outbreak in a format that allows easy analysis by others (such as in a raw form in spreadsheets) and includes the maximum amount of detail possible (such as geographical granularity).
- The guidance that has been given by the Government to departments, public bodies, public services and others relating to the COVID-19 outbreak.
- The strategies being drawn up by Government departments and other public bodies for how the UK will recover after the COVID-19 outbreak.
Economy and finance
Nearly 40 responses focus on the data/information experts want the Government to release about economy and finance. In particular, experts want to see any models that assessed the economic impact of different responses to the COVID-19 outbreak. For example, they want to know what assumptions were made about how lockdown would affect productivity and long-term health costs, including how excess deaths from non-COVID-19 causes were factored in. Experts also want to know what the Government’s long-term economic predictions are and its strategy for reviving the economy after the COVID-19 outbreak eases. Other experts suggest that the data and information that were used to decide the economic rescue plan for businesses should be released. For example, they want to know what data were used to set the rate of pay for furloughed workers and how many businesses were predicted to apply for Government support. Additionally, they want to know what the strategy is for financing this economic support, including any long-term plans for taxation or borrowing.
Example of a typical response in this area: I would like to see more information about the estimated short, medium and long-term likely economic and financial costs of current policy and alternative approaches.
Business and trade
Nearly 40 responses focus on the data/information experts want the Government to release about business and trade. Experts want more data on supply chains and how imports/exports are being affected by the COVID-19 outbreak. They also want data released on the number of businesses that have applied for Government funding and the number of business going into receivership during this period. Other information they suggest should be public include details of the contracts granted to companies by the Government to make vital equipment (such as ventilators). Some experts suggest that there should be data released regularly on productivity and manufacturing output during the outbreak. There are also calls for data on how the current situation has affected foreign investment in the UK. Experts also suggest that the UK Government could liaise more with private companies to collect industry data that may help track the effects of the outbreak. For example, data collected by supermarkets, delivery companies or search engines may provide insights into the stages of the outbreak.
Example of a typical response in this area: I would like to see an analysis of the UK’s food security based on an analysis of short, medium and long-term impacts of the pandemic.
Work and employment
Over ten responses focus on the data/information experts want the Government to release about work and employment. Experts want data to be released more regularly on unemployment figures during the outbreak and the number of people claiming benefits. They also want the Government to publish a strategy on how they will support employment in the long-term.
Example of a typical response in this area: To understand the consequences of this, it is important to have data that can be used to track the changing demographics of economic vulnerability.
Research and innovation
Over 80 responses focus on the data/information experts want the Government to release about research and innovation. Most responses in this area are experts requesting the Government to release all the research evidence that they consulted in their decisions during the COVID-19 outbreak. This includes the evidence used to decide when the UK went into lockdown, why face masks were not initially recommended, how to operate testing, how to develop and use contact tracing phone apps, and which indicators should inform an exit strategy from lockdown. Eight experts want the UK Government to address why their recommendations and strategy differ from advice given by the World Health Organization (WHO) and what research evidence supports the UK Government’s different approach. Some experts also want regular updates from the Government about financial investment and progress in research for new treatments, tests and vaccines for COVID-19.
Example of a typical response in this area: A key element for an effective response and monitoring of the illness was the testing capabilities available to track contact with the virus: There is still a lack of information on what methodology, tests and data analysis they are using to track people who have antibodies and are potentially immune for future outbreaks.
Health and social care system
Nearly 40 responses focus on the data/information experts want the Government to release about the health and social care system. Experts want various data relating to the health system to be made available, including the current NHS budgets and level of spending related to COVID-19 by local area, the types of treatments currently being used in hospitals for COVID-19 and the patient outcomes, the stock levels of personal protective equipment (PPE) and other equipment for COVID-19 by local area, patient figures for non-COVID-19-related services compared to figures in the same period in previous years, and NHS workforce figures (such as current staffing capacity, number of staff on sick leave, and the number of staff who have tested positive for COVID-19). Experts also want various data relating to the social care system to be made available, including figures on the number of referrals to social care services during this period and the number of people who have tested positive for COVID-19 in the social care system (particularly staff and residents in care homes). Other information that experts want published in this area includes all Government guidance given to hospitals, GPs and care homes relating to COVID-19 and the long-term strategy for how the health and social care system will manage ongoing COVID-19 cases.
Example of a typical response in this area: Location, quantity, quality and accessibility of the resources required to implement different elements of the response.
Over 150 responses focus on the data/information experts want the Government to release about public health. The majority of these responses urge the Government to release daily data on the number of people tested, the number of confirmed COVID-19 cases in hospitals and the community, figures on many people are in hospital with COVID-19 and how many are in intensive care, the number of deaths from COVID-19, and the number of deaths from other conditions. Experts particularly express the need for these data to be in a format allowing easy analysis (such as being published in a spreadsheet) and to be as detailed as possible. They suggest that the data should contain as much detail on cases as possible, including protected characteristics (such as sex and ethnic background), income level, occupation, other health conditions, and specific region (ideally at postcode-level rather than by local authority). Experts also want to know what information the UK Government is currently collecting on the mental health and well-being of the population and want this to be published publicly.
Experts want the Government to publish all of the research evidence and data used to plan its exit strategy along with any strategies it has for the long-term effects of the outbreak. They also urge the Government to publish all the emergency planning, protocols and policies that were in place before the COVID-19 outbreak. They also want full details of all previous pandemic planning exercises and strategies. In addition, they suggest the Government should publish a report on what lessons have been learned during the current outbreak and how this will change emergency planning for the future.
Example of a typical response in this area: Accurate statistics on infection levels, death rates, recovery rates, IC [intensive care] capacity, tests carried out, arranged by geography, occupation, age and setting (hospital/community/family/workplace).
Nearly 40 responses focus on the data/information experts want the Government to release about international affairs. The majority of these responses focus on cooperation and information sharing between the UK and other nations. Experts want the Government to publish a summary of the data and information that they received from other countries and justify why this was or was not used to inform UK strategies. They also want to know how countries are coordinating data collection so that it is globally comparable. Other experts want the Government to publish what the UK’s strategy is for supporting international development during the COVID-19 outbreak. Some experts want to see the research evidence used to decide that airports in the UK should remain open and that there would not be international travel restrictions.
Example of a typical response in this area: An analysis of the procedures adopted from other countries could help in decision making for Government and in the evaluation of the most effective approaches.
Law and human rights
There are ten responses focusing on the data/information experts want the Government to release on law and human rights. Experts want the Government to publish its human rights and equality impact assessments for the responses to the COVID-19 outbreak (including for lockdown, designations of ‘key workers’ and schools closing/reopening). They also want to know what legal advice the Government received on human rights and discrimination when making decisions. Some experts want regular updates on the number of employment tribunals throughout the course of the outbreak. Other experts want to know what guidance has been given to prisons for managing the outbreak and how many prisoners and prison workers have been infected.
Example of a typical response in this area: The legal advice for the measures which have had the most impact on a range of European Convention rights of the UK public.
Society and community
Over 30 responses focus on the data/information experts want the Government to release about society and community. The majority of these responses concern the collection and publication of data relating to inequalities. Experts want to know what data are being collected by the Government to measure how responses to the COVID-19 outbreak affect different groups. They want to know how potential social, economic and health inequalities are being measured. They note that detailed data should be collected to see what effect protected characteristics, vulnerabilities and other factors have on people’s experiences of the COVID-19 outbreak. Experts also want more data published on individuals living in detention centres and those classified as homeless (including how and where local authorities have housed these individuals). Experts also want information about how voluntary organisations have assisted during the outbreak, such as what roles volunteer groups have taken on and how many people have been volunteering.
Example of a typical response in this area: Data, where appropriate, needs to take into account the impact of Covid-19 in relation to the protected characteristics included in the Equality Act.
Media and communications
Over 40 responses focus on the data/information experts want the Government to release about media and communications. Experts want to know what research evidence and data were used to create the Government communications strategy. They also want to know what data are being collected to assess how well the public understands the policies in place and how much they are adhering to any restrictions. Experts also want to know if the Government is tracking misinformation about COVID-19 and want publications debunking false claims and guidance about how to deal with misinformation. In general, experts suggest that the public need more guidance written in a clearer way and covering a wider variety of topics.
Example of a typical response in this area: Data related to the behaviour of society in terms of adhering to government advice / regulations, and public information search / seeking (e.g. online).
Crime, justice and policing
Nearly 20 responses focus on the data/information experts want the Government to release about crime, justice and policing. Experts want data to be released regularly about arrests and fines relating to COVID-19. They also want data on the level of other crimes during this period, especially domestic abuse, public disorder and cyber crime. Some experts also want the Government to release all guidance given to police forces relating to COVID-19, especially any that outlines how they may use new powers.
Example of a typical response in this area: Data on alternative powers used to enforce the regulations should also be published, with a marker placed on all coronavirus-related out of court disposals, arrests and prosecutions whether under the regulations or other powers (e.g. Public Order Act) so that these can be subsequently analysed.
Over 20 responses focus on the data/information experts want the Government to release about education. Experts want data published on how the predicted grades being received by students this year compare to the actual grades achieved in previous years. They also want data on whether some groups (such as young people from Black and Minority Ethnic backgrounds) have fared worse than usual. Experts also want data on how many schools are providing online education, how they are providing it, and how many children and young people do not have the technology required to access online education. Some experts want the Government to publish any safeguarding guidance given to educational organisations relating to managing the COVID-19 outbreak.
Experts want to know what data are being collected to measure the impact of educational disruption on children and young people. Experts also want to know what the long-term strategy is for supporting services like the National Careers Service, as young people are likely to graduate into a difficult employment market. Experts also want data released on the number of nurseries and childcare services that have shut down during the COVID-19 outbreak. Some experts suggest that figures about the number of university applications as well as number of students who have deferred should be published publicly.
Experts also urge the Government to publish any research evidence or data on how the virus spreads in schools and how risks can be best managed.
Example of a typical response in this area: How the qualifications that pupils have been given this year based on teacher assessment have been received by the pupils, higher education and industry.
Over ten responses focus on the data/information experts want the Government to release about infrastructure. The majority of these responses are about transport. Specifically, experts want regular data published on the use of public transport and road traffic during the outbreak. They also want the Government to publish the research evidence and data they have consulted about how the virus spreads in public transport. Experts also want the Government to publish data on telecoms usage during the outbreak. Some experts want data to be released on how infrastructure has been maintained during this period and about the current state of key UK infrastructure.
Example of a typical response in this area: Impact of public transport on the spread of the virus.
You can find rapid response content from POST on COVID-19 here.
The body of research investigating the effects of Coronavirus infection on pregnancy is growing. What is the available evidence? How does COVID-19 affect pregnant women and their babies? Is the virus transmitted between mothers and babies? Are some women and babies at greater risk than others?
COVID-19 vaccine roll-out started in the UK on 8 December 2020. Results from Phase 3 clinical trials have been published for all the vaccines approved for use in the UK. But how does the performance of vaccines under real world conditions differ from clinical trial results? When will we able to observe the impacts of the COVID-19 vaccination programme?