Professor Neil Ferguson interview: “There’s something very nice about pandemics”
Tom Whipple
The Times, UK
There was a time in a different world, a world that shook hands, met relatives and commuted to work, when none of this was obvious. When it wasn’t clear that the way to stop an infectious disease was to stop a society and the very idea was horrifying and unimaginable.
“Of course we knew it was possible that social distancing could control a respiratory virus,” says Neil Ferguson, the Imperial College professor whose maths is now for ever associated with the lockdown. “But there is an enormous cost associated with it.”
Back in 2019, about the time someone was getting infected by a bat, no European country’s pandemic plans seriously entertained the prospect of putting a country on pause.
Then, that’s what China did. “I think people’s sense of what is possible in terms of control changed quite dramatically between January and March,” Professor Ferguson says.
He is speaking in a short hiatus in another busy day. In the morning, he has spent two hours briefing a Commons select committee on the new Kent variant, which his calculations suggest spreads faster. In the afternoon, in part on the basis of those calculations, Matt Hancock, the health secretary, will put another swathe of the country into stricter restrictions. Just hearing that the professor’s maths is behind another lockdown this month will at this stage in a politicised pandemic provoke some to fury.
Professor Ferguson, 52, did not start as an epidemiologist. He studied for a PhD in physics at Oxford. There he saw a talk from Robert May, a mathematical biologist who went on to be a government chief scientific advisor. “I didn’t even do biology O-level. I’d never even thought about using mathematics to study biological systems. And there’s something very nice about pandemics in particular, the way they behave mathematically.”
There is a satisfying dance of the differential equations, as they spiral across a graph — their dynamics changing with the population dynamics — that has an allure for mathematicians. Individually, humans are messy and confusing. Collectively, they are statistics and can be modelled.
For Professor Ferguson, though, it was one of those messy human interactions that tipped him over into the subject. “The brother of a close friend of mine was very ill and later died from HIV. I remember talking through a scientific paper with him, which used modelling to understand how a new generation of antiviral drugs known as protease inhibitors were inhibiting the virus and people. Unfortunately, it was . . . just . . . yeah. If he had survived another year, he would have benefited from the triple therapy as it came to be known.”
He moved from Oxford to Imperial as part of the country’s leading infectious disease modelling group. They modelled the 2001 foot and mouth outbreak, as well as the 2009 swine flu outbreak, in which at one point, before better data came in, they estimated a “reasonable worst case scenario” of 65,000 deaths.
When he returned to advise the government once again, this projection, two orders of magnitude above the real total, was cited by his critics. So too was foot and mouth, where the cull of millions of cattle and sheep, partly on the basis of predictions about the disease, still causes deep bitterness among farmers.
In every crisis there is a turning point, that sets the path for what is to come. For Britain, now with one of the worst death rates in the developed world, that moment came eight months ago, in a fateful spring fortnight when the country debated whether or not to lock down, a fortnight of argument, dithering and sudden prominence of the epidemiological term “herd immunity”.
How does the man who, partly by chance, is now seen as the key scientist in that argument look back on 2020? What was going through his mind? And, the question history could well ask of Britain, why did we not lock down sooner?
It is possible now to retrace what was going on in those weeks, and the weeks before. In January, members of Sage, the government’s scientific advisory group, had watched as China enacted this innovative intervention in pandemic control that was also a medieval intervention. “They claimed to have flattened the curve. I was sceptical at first. I thought it was a massive cover-up by the Chinese. But as the data accrued it became clear it was an effective policy.”
Either way, the Chinese govt ordered one (mainly Hubei-specific) 2-month lockdown, declared its ‘success in containing the virus’, then let everyone return to normal life. The Western ‘central steering committee’ went way beyond that, and after it became clear that Sars-CoV-2 was nothing to worry about (from the point of view of causing levels of mortality that would even remotely ‘threaten civilization’).
Between the lines, Ferguson is saying that Western operators like him spied an opportunity to use the ‘Chinese model’ for their own political purposes. Nothing to do with the science of virus transmission; everything to do with the science of controlling (via conditioning) populations.
Then, as infections seeded across the world, springing up like angry boils on the map, Sage debated whether, nevertheless, it would be effective here. “It’s a communist one party state, we said. We couldn’t get away with it in Europe, we thought.” In February one of those boils raged just below the Alps. “And then Italy did it. And we realised we could.”
That realisation was a fulcrum in British history, and in the life of Professor Ferguson.
On March 16, he and his colleagues gave a press conference. On the same day, Boris Johnson would announce the shielding of the elderly and vulnerable and an end to mass gatherings in a “national fightback against the new coronavirus”. It was the professor who provided the stark number. “Britain in lockdown,” was the Times headline. “Change of plan to save 250,000 lives.”
In a short half hour he provided a window into the evidence that had led to the prime minister’s speech. If we continued as we were, he projected, a quarter of a million Britons would die. If we wanted to stop that, he also projected, it would require extreme social distancing measures until a vaccine arrived.
That was when he went from unknown epidemiologist to academic superstar. Or, for some, villain. Despite being one of many epidemiologists on one of many modelling groups, he became Professor Lockdown. He became, to some, the weather forecaster who was blamed for the storms to come. Others blamed him for the storms that didn’t come. “It’s bizarre,” he says. “Particularly given that I’ve never been a public servant. We volunteer for scientific committees, we don’t get paid anything.” He says he has not read most of the coverage, but can’t help hearing some of the criticism.
“Where it’s been disappointing is if people start out from a viewpoint that they don’t agree with lockdown, then try to undermine the science and scientists behind it. That hasn’t been a pleasant experience.”
During lockdown, in May, he was caught meeting his lover. He won’t talk about the specifics, or about his unusual marital arrangements — he has a wife and son. What he will say, is it’s not what a mathematical biologist expects to happen to him.
“I made some mistakes. I’ve been completely open in terms of saying they were mistakes. But, nevertheless, the fact that journalists were digging into my private life at that level of detail was not something I could ever imagine. That’s not something you want to be on the end of.
“My wife and son and my partner had journalists on the doorstep. I was actually in my flat in London, they didn’t know where I was. It was a very difficult time.” He and Sir Patrick Vallance, the present chief scientific adviser, agreed he should step back from Sage work.
But before his polyamory-induced hiatus from public life, came that fateful press conference.
By the end of February it had become increasingly clear that this was an emergency.
Then, as now, much of the work of Professor Ferguson’s team was trying to work out what the present situation was. On the basis of what we knew about deaths abroad, movements here, hospital admissions and cases, how did this virus behave? How long did we have? How stoppable was it?
Much of the work was informal and on the fly. “The Cabinet Office would be emailing, and we’d send scenarios back. We were working very, very long hours.” They had a Sunday afternoon meeting with the senior NHS staff. “We thrashed out, what is the worst case scenario? What would it look like in terms of hospitalisations and deaths?” There was scepticism, in particular about the fatality rate. Then three things happened. The projections showed that if the estimates were correct then even with shielding of the elderly the NHS would collapse. In Italy, the health service did collapse. And data started coming through of people arriving in London in hospital with Covid-19. We had, in early March, our first cases.
“That focused the minds of the NHS. It certainly made me a lot more concerned about how far into the epidemic we already were, and the sort of time frames over which we really had to finalise decision-making.” Yet, that concern about time frames did not seem to be shared by those making decisions?
“I think there were some people who felt it can’t possibly be that serious, that it wasn’t really going to happen here.”
Then on March 13, he, Sage and Sir Patrick decided that it was past time the public were brought into the debate properly. Over that weekend, he and his colleagues prepared a paper outlining their projections for the pandemic in different scenarios, and organised a press conference. They finished writing the paper an hour before they presented it.
These days, lockdown feels inevitable. It was, he reminds me, anything but. “If China had not done it,” he says, “the year would have been very different.”
When we talk, he has just finished a presentation to Greg Clark MP, chairman of the Commons science and technology committee, on the Kent variant. He has told the MPs that he and his colleagues estimate that the old variant was on the retreat during England’s second lockdown, while the new one kept growing. Reading between the lines, he strongly implies that schools will have to shut in January, and even then the virus might evade lockdown.
This is, I say, petrifying. It is also extremely interesting. Nowadays, it is orthodoxy that lockdown was right. In the next pandemic, we won’t hesitate to use it. But as this new variant shows, lockdown does not always work. It was never guaranteed that lockdown would crush the curve. He is all too aware of this. “During late March, early April, we kept looking at the data as it came in. Was there any sign of hospital admissions and deaths hitting a peak? It was a very, very anxious time.” We now know that when we got it to its lowest, R, the reproduction rate of the virus, hit 0.6. Lockdown worked. If the professor’s modelling of the new variant is correct, it won’t be so easy to control. In the same circumstances it could have a rate just over 1 and the pandemic would not have retreated.
If back in spring it hadn’t worked, then — weirdly — Professor Ferguson’s reputation might be better. Those terrifying death tolls he rolled out would never have been in doubt.
There is, now, something of an orthodoxy in sections of the right: Professor Ferguson got it wrong. He predicted apocalypse and apocalypse (at least at the time of writing) did not come. This is odd, he feels, because the prediction was a counterfactual. It was of what would happen if we took no action. But we did take action, so of course it did not come.
Where people did not change their behaviour it has not been pretty. In Manaus, Brazil, a city of 2.2 million people seems to have had at least 45 per cent infection, probably 70 per cent, and the results aren’t that far from the apocalypse of the March 16 paper. In April gravediggers had to work at night. Coffins ran out. Bodies were buried in trenches.
On the other hand, he could have been a lot more wrong. After lockdown, he predicted that 20,000 deaths would be a good result. Some of his strongest scientific critics, the signatories of the Great Barrington Declaration, believed that herd immunity had been reached by then and the pandemic was all but over.
He says he respects and likes Sunetra Gupta, his Oxford University nemesis, but “reality has tended to support the assumptions and then later, inferences we made from the data.” He need not add that over 60,000 deaths make a pretty strong case she is wrong too.
Not everyone will be convinced, he is resigned to that. “It’s clearly unfortunate that a minority of people almost don’t like the idea that you can just have random bad things happen in the world, and want to attribute it to some malign plan.”
In reality, he is part of the minority that believes in the pseudo-reality they have built in their minds. And such people will not rest ‘until all think and see as I do’…