Science and politics: a complicated formula


Richard Horton is correct to highlight the vital need for medical leadership during the Covid-19 pandemic (How can any scientists stand by this government now?, 27 May)(. Unsurprisingly, medical leadership is not only about critiquing the government’s actions during this extraordinary situation. It’s also about questioning and working collaboratively to proactively deliver effective and timely solutions to challenges.

The Royal College of Anaesthetists (RCoA), which represents the largest single hospital-based medical specialty, continuously engages and communicates with senior political and healthcare leaders on behalf of its anaesthetist members on issues such as personal protective equipment stocks, testing, the wellbeing of healthcare workers and drug supplies. As with other medical royal colleges, the RCoA has communicated the first-hand experiences of medical staff on the Covid-19 frontline so that decision-makers can learn from their insights.

Much of this engagement is not in the public domain, so not everyone will be aware that these efforts are taking place. But, rest assured, they are – and the RCoA will continue to challenge politicians on issues of importance to anaesthetists and our patients throughout the pandemic and beyond. The RCoA has called for a public inquiry that should not be an exercise to allocate blame, but on how to be better prepared when another such health crisis emerges.
Prof Ravi Mahajan
President, Royal College of Anaesthetists

• Richard Horton rightly condemns the government’s chief scientific and medical advisers, but his call for them to “disengage” misconstrues their status. In over 40 years of occupying and observing such advisory roles, it is obvious that, in taking them on, you must cease to be an independent scientist. Whatever you may think or say in private, you have to toe the party line in public. If you dissent too many times in private you will be sidelined. Various rationales will be advanced for staying in place, usually with a large dose of self-deception, but the pretence of scientific independence cannot pass close scrutiny. That is why the independent Sage group led by David King is such a vital corrective to what is often government propaganda dressed up as science.
Alan Walker
Professor of social policy and social gerontology, University of Sheffield

• The Home Office has defended its economically damaging plan to quarantine visitors to the UK by saying that decisions have “got to be led by the science”. They are simultaneously disregarding a stark warning by the Association of Directors of Public Health that the new rules on social interaction are “not supported by the science” (Health officials make last-minute plea to stop lockdown easing in England, 31 May) . They express increasing concern that “the government is misjudging the balance of risk between more social interaction and the risk of a resurgence of the virus, and is easing too many restrictions too quickly”.

It explicitly advises postponement “until more is known about the infection rate, the test-and-trace system is better established and public resolve to maintain physical distancing can be reinforced”. Why are we being led by the science while simultaneously disregarding it? Government interaction with “the science” appears dangerously incoherent; a secondary spike now seems all but certain.
Philip Barber
Consultant respiratory physician, Manchester

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