Transparency data

SAGE 52 minutes: Coronavirus (COVID-19) response, 20 August 2020

Updated 29 April 2022

Fifty-second SAGE meeting on COVID-19, 20 August 2020.

Held via Video Teleconference.

Summary

1. SAGE noted the recent increase in infection rates in Birmingham, predominately amongst the South Asian population, but with a growing proportion of the Black British and White British population affected. SAGE noted that the pattern of spread is rather wide and does not suggest a single point outbreak. SAGE reiterated previous advice that acting early to mitigate further spread is critical.

2. Considering all available data, it is likely that incidence may be increasing slowly, meaning R may be above 1 in England and across the UK.

3. Risk of transmission at any large venue or event will depend on several factors, including prevalence of infection at the time; the design of the venue; indoor environment; and the nature of the event and the audience. Risk assessments and mitigation plans should therefore be specific to each venue and event.

4. Larger gatherings and events, particularly those held indoors, typically pose higher risks of transmission due to increased proximity and mixing of people. The gathering of people on the way to and from events in transport and pubs poses a more significant risk.

5. SAGE noted risks in the timing of reopening large events and venues, particularly when incidence rates are increasing across Europe, and in some parts of North England, which could signal conflicting messages.

Situation update

6. SAGE noted the recent increase in infection rates in Birmingham, predominately amongst the South Asian population, but with a growing proportion of the Black British and White British population affected. SAGE noted that the pattern of spread is rather wide and does not suggest a single point outbreak. SAGE reiterated previous advice that acting early to mitigate further spread is critical.

7. SAGE thanked PHE for the hard work and support to date, on which it relies on for data and information. SAGE will continue to work closely with the new structure and organisation as it evolves.

8. SAGE approved R and growth rate estimates. The latest estimate of R for the UK is 0.9 to 1.1, while the daily growth rate estimate is -3% to +1% (90% confidence interval). As previously, these estimates mask wide regional variation across the country and should be treated as a guide to the general trend.

9. In England, R is estimated at 0.9 - 1.0, with a daily growth rate of -3% to 0%. However, these estimates of R rely on lagged data (for example number of deaths). SPI-M does not have confidence that R is currently below 1 in England.

10. Analysis of pillar 2 testing data suggests a daily growth rate of around +3% over the past 2 weeks in England (90% confidence interval). As previously, this should be treated with caution given changes in the population being tested, particularly in areas of local intervention where testing volumes have increased. Additionally, interpretation of pillar 2 data is difficult as only 11% of tests have a known reason for the test being requested.

11. As previously, SAGE does not have confidence that most regional R estimates are sufficiently robust to inform decisions, since they are based on low numbers and/or are dominated by clustered outbreaks.

12. Most recent ONS study data suggest a flat prevalence and incidence.

Actions:

• SPI-M to amend consensus statement to include context of latest ONS COVID-19 incident data by 21 August

13. SAGE discussed further analysis on testing strategies. Evidence suggests that testing could enable early release from self-isolation dependent on a negative test result, effectively reducing the 14-day self-isolation period. It was noted again that testing with earlier release would provide similar but not identical effects to 14 days self-isolation, and the overall effect will depend on adherence.

Actions:

• SAGE secretariat to ensure SPI-M advice on testing and release from self-isolation is being taken into account by DHSC by 21 August

14. As previously, SAGE noted some complicating factors, including prevalence of infection; test turnaround times; and public adherence to testing and self-isolation, which may be influenced by financial implications of self-isolation (and duration of isolation).

Actions:

• SPI-B to review existing evidence on self-isolation compliance in relation to loss of earnings and potential incentives by 27 August

15. A significant and growing proportion of the epidemic in much of England remains in the British and Asian Pakistani heritage population, particularly young males (17% to 20%), and British and Asian Indian population (8% to 11%).

Actions:

• SAGE secretariat to ensure PHE data on COVID-19 incidence and ethnicity is considered by the Ethnicity subgroup by 21 August

Opening large events and venues

16. SAGE endorsed the SPI-M and SPI-B papers — subject to amendments, and increased consistency between the papers.

17. Risk of transmission at any large gathering or event will depend on several behavioural and environmental factors, including the frequency of events and re-attendance of attendees; prevalence of infection at the time; design of the venue; indoors or outdoors; nature of the event; number and characteristics of attendees; distance travelled by attendees; and pre- or post-event activities.

18. Given the heterogeneity of events, risk assessments and mitigation plans should be specific to each venue and event, and co-produced with event organisers.

19. Consideration should also be given to risks associated with not holding or banning events.

20. Larger gatherings and events, particularly those held indoors, typically pose higher risks of transmission due to increased proximity and mixing of people. There may also be increased risk at different times of an event, for example during half time at a football match where greater numbers of people will congregate to access refreshments. In many situations, risks of crowding in indoor environments in transport and pubs associated with events may carry greater risks than the event itself and this should be taken into account in policy considerations.

21. Specific activities such as hugging and singing or cheering could also increase the risk of transmission, and may be enhanced by alcohol use. The difficulty in dealing with these issues in practice were highlighted.

22. SAGE reiterated the importance of improved ventilation at venues and highlighted issues of tracking and testing of attendees, before and after attending events.

23. Guidance and communication should be tailored to individual event organisers, and the public, to improve understanding of transmission risks and who is responsible for mitigating them, and to encourage adherence to measures.

24. SAGE agreed that pilots to reopen event venues should evaluate transmission risks and adherence to behaviours which reduce transmission, using observational and self-report data. There should also be careful design of indoor venue pilots.

25. SAGE noted risks in the timing of reopening large events and venues, particularly when incidence rates are increasing across Europe, and in some parts of North England, which could signal conflicting messages. This is a high-risk time to be restarting events, particularly indoor events.

26. Comms should consider how to communicate the issue of network re-connection rather than simply the risk to the individual.

Actions

• SPI-M and SPI-B to amend papers on reopening large events and venues, ensure consistency of language and include context of previous advice by 21 August; SAGE secretariat to send finalised papers to DCMS, DHSC and C19 Taskforce; the table in the SPI-M paper, and the principles identified were seen as particularly useful
• SAGE secretariat to identify possible presentation/seminar to policy leads and customers on SAGE advice on mass gatherings by 27 August

Opening Higher Education and Further Education settings in Autumn

27. SAGE reviewed the DfE HE and FE Sub-group Output, which will be subject to further amendments. The paper was a note of the output and is not a SAGE endorsed paper.

28. Considering ventilation in HE and FE settings will be important in controlling risks of transmission. Where possible, poorly ventilated spaces should be adapted to improve ventilation, or alternative options considered.

29. SAGE highlighted that HE and FE settings differ, with some FE systems more similar to schools for example with many students living at home rather on campus like HE settings. Variability between FE and HE settings is also greater than that for schools.

30. Consideration should be given to international travel, transport options and mixing of people in campus-based universities.

31. SAGE noted the risks of limiting face-to-face attendance at educational settings, particularly the long-term impacts of distance learning on socially deprived groups. This should be taken into account when considering policy options.

32. International comparators of outbreaks in universities and further education institutions should be considered in developing further advice for HE and FE settings.

33. Overarching principles should be designed to guide policy makers and universities and education settings to make individual, informed decisions. HE and FE re-opening plans should also be co-designed with students, the workforce and the wider community to ensure it is achievable and will be adhered to.

34.Re-opening will carry with it pressure on R and will create new network connections.

Actions:

• SAGE secretariat to support revisions of HE and FE paper, incorporating comments from SAGE and representatives from SAGE subgroups, aiming for an amended paper by 28 August

List of actions

• SPI-M to amend consensus statement to include context of latest ONS COVID-19 incident data by 21 August
• SAGE secretariat to ensure SPI-M advice on testing and release from self-isolation is being taken into account by DHSC by 21 August
• SPI-B to review existing evidence on self-isolation compliance in relation to loss of earnings and potential incentives by 27 August
• SAGE secretariat to ensure PHE data on COVID-19 incidence and ethnicity is considered by the Ethnicity subgroup by 21 August
• SPI-M and SPI-B to amend papers on reopening large events and venues, ensure consistency of language and include context of previous advice by 21 August; SAGE secretariat to send finalised papers to DCMS, DHSC and C19 Taskforce; the table in the SPI-M paper, and the principles identified were seen as particularly useful
• SAGE secretariat to identify possible presentation/seminar to policy leads and customers on SAGE advice on mass gatherings by 27 August
• SAGE secretariat to support revisions of HE and FE paper, incorporating comments from SAGE and representatives from SAGE subgroups, aiming for an amended paper by 28 August

Attendees

Scientific experts

• Patrick Vallance (GCSA)
• Chris Whitty (CMO)
• Andrew Curran (CSA HSE)
• Andrew Morris (Scottish COVID-19 Advisory Group)
• Angela McLean (CSA MoD)
• Carole Mundell (CSA FCO)
• Charlotte Watts (CSA DfID)
• Graham Medley (LSHTM)
• Ian Boyd (St Andrews)
• lan Diamond (ONS)
• Jenny Harries (dCMO)
• Lucy Yardley (Bristol/Southampton)
• Maria Zambon (PHE)
• Mark Walport (UKRI)
• Mark Wilcox (NHS)
• Michael Parker (Oxford)
• Nicola Steedman (dCMO Scotland)
• Osama Rahman (CSA DfE)
• Peter Horby (Oxford)
• Rob Orford (Health CSA Wales)
• Robin Grimes (CSA Nuclear)
• Sheila Rowan (CSA Scotland)
• Stephen Fowls (NHS)
• Yvonne Doyle (PHE)

Observers

• Rupert Shute (HO)
• Vanessa MacDougall (HMT)

Secretariat

• Simon Whitfield
• Stuart Wainwright,

Total: 51

11 observers and government officials and 12 Secretariat members redacted.