The government’s two most senior advisers in the pandemic will turn their attention to health inequalities, the state of the UK’s air and emerging technologies following the milestone decision to end all legal Covid restrictions in England this week.
While the pandemic is far from over, Boris Johnson’s announcement on Monday of the “living with Covid” plan is expected to be the last time Sir Patrick Vallance, the chief scientific adviser, and Sir Chris Whitty, England’s chief medical officer, will flank the prime minister to explain the UK’s response.
As the country moves beyond the emergency phase of the crisis, Vallance and Whitty are expected to slip out of the spotlight and make headway with other projects.
“We are not witnessing the end of Covid, but we are probably witnessing the end of the Chris and Patrick show,” said Prof Jack Stilgoe, a specialist on the governance of emerging technologies at University College London. “It is easy to forget how strange it is to have senior scientists showing powerpoint slides on the nightly news.”
Not that the Covid work is going away. Vallance and Whitty will continue to follow the data on infections, hospitalisations and deaths, the effectiveness of vaccines, and whether further doses or different shots are needed. With the end of free tests for the general public, the GP-led surveillance system for “influenza-like illness” is being adapted to detect new variants of Covid.
Prof David Heymann, the former chair of the Health Protection Agency, said Whitty and Vallance will probably focus on three key areas. First, strong public health capabilities are needed to identify, investigate and close down future outbreaks – with precision lockdowns if needed. Second, the NHS needs beefing up to withstand a surge in admissions alongside routine patient loads in the event of a future pandemic. Third, more must be done to make the population more resilient, through promotion of healthier lifestyles and perhaps tobacco-like taxes on unhealthy products, Heymann said.
Whitty already has work under way on health inequalities, tragically exposed in the pandemic, and will look in particular at problems in coastal towns. A report on air quality is also in the pipeline – an issue that overlaps with health inequality and the underlying issues of deprivation, housing, lifestyle and employment.
As the chief scientific adviser, Vallance has a wider role and in recent months has taken on the title of national technology adviser and set up two new government bodies, the National Science and Technology Council and the Office for Science and Technology Strategy. The aim is to help ministers understand, and know how to exploit, emerging science and technology to help achieve net zero emissions, improve public health and strengthen national security. As Prof James Wilsdon, an expert in research policy at the University of Sheffield, points out, “it will take time and effort to make them work effectively”.
With a public inquiry into the Covid response looming, Wilsdon believes Vallance will want to lead a “root and branch review” of the UK’s science advisory system and the lessons to be drawn, good and bad. According to Stilgoe, that inquiry will want to apportion blame and with politicians normally better at playing the blame game than scientists, he warned: “Science will need defending from politicians who will claim they were just doing what the scientists told them.”
Several experts believe Whitty is well placed to help the NHS clear its backlogs and recover from the carnage of the pandemic, but it is unclear how much influence he will have on this. “The biggest challenge for Chris will be to have a role in the priorities for clearing health backlogs,” said Prof David Salisbury, former head of immunisations at the Home Office. “Although superficially the work of NHS England, the prioritisation of tasks and capacity to respond become public health issues as well as just capacity topics.”
England’s deputy chief medical officer, Prof Sir Jonathan Van-Tam, will stand down at the end of March, but it is unclear how long Vallance and Whitty will remain in their posts. Wilson speculates that Vallance could take over from Sir Jeremy Farrar as director of the Wellcome Trust next year, or become president of the Royal Society in 2025. “Whitty is harder to predict,” he said, and may continue as CMO for “some years to come”, or step back into a chief scientific adviser role in a government department.
While Vallance and Whitty will welcome stepping out of the spotlight, Heymann believes neither should disappear from public view. “It would be good for them to appear periodically to remind people what needs to be done, both to prepare for the next pandemic should it occur and also what needs to be done with other problems,” he said. “They’ve got the trust of the population and they should use that.”
