The UK’s response to COVID-19 was likely slowed or hampered by the inability to get access to useful data during the early days of the pandemic, according to evidence heard by the House of Commons Science and Technology Committee.
In its latest report, which examines how the government has received scientific advice during the pandemic, the Committee notes that it is “regrettable that poor data flows, delays in data-sharing agreements and a general lack of structuring and data integration across both the health and social care sectors have throttled timely data sharing and analysis”.
The report follows the director of a leading UK health data organisation, which is advising the government’s Scientific Advisory Group for Emergencies (SAGE) on the public response to the COVID-19 pandemic, saying that the lack of data and intelligence in social care has been a “catastrophe” and that there are still a number of unknowns for this “significant community”.
The UK has one of the highest infection rates of COVID-19 in the world and now has more COVID cases per capita than any other country globally. All countries in the UK are currently in lockdown and the government is working to avoid the NHS becoming overwhelmed, as patients with the novel Coronavirus soar.
The government’s Chief Scientific Adviser, Sir Patrick Vallance, gave evidence to the Committee and said:
One lesson that is very important to learn from this pandemic, and for emergencies in general, is that data flows and data systems are incredibly important. You need the information in order to be able to make the decisions. Therefore, for any emergency situation those data systems need to be in place up front to be able to give the information to make the analysis and make the decisions.
He added that this should include basic information flows around patients in hospital, rates of admission and rates of movement. However, Sir Patrick explained that access to such data at the beginning of the pandemic was difficult to get hold of.
The situation has now improved, but he highlighted that the NHS does not have centralised data flows on everything scientists and the government need.
Commenting on the findings in the report, Chair of the Science and Technology Committee, Rt Hon Greg Clark MP, said:
This pandemic has been the greatest test of the way in which the UK Government takes, and acts on, scientific advice in living memory.
We believe that the Government has been serious in its intention to obtain and act on rigorous scientific advice, and that scientists – led by the Chief Scientific Adviser and Chief Medical Officer – have given outstanding service in providing analysis and explaining it to the public.
SAGE began with too little transparency and has improved by publishing its membership, minutes and papers. Similar openness should apply to new bodies like the Joint Biosecurity Centre. There is nothing to fear from openness. The more transparent data, analysis and conclusions drawn are, the better it is for policy making and for public confidence.
Sir Patrick later provided more detail to the Committee, where he explained that:
It took until mid-February for the relevant data sharing agreements to be signed by modelling groups, with the first detailed Public Health England line list data being provided to modellers on 6 March.
Initially “not all SPI-M modelling groups were able to access” data from NHS England and that early data “lacked granular detail, such as how many patients were new covid-19 admissions, versus potential re-admissions”.
Comprehensive data on COVID-19 in care homes was not available to the government.
At a SAGE meeting on the 15 March, just before the UK went into its first lockdown, it was highlighted that there was a 5-7 day lag in data provision for modelling, which means SAGE now believes that there were more cases in the UK than previously expected at the time.
The Science and Technology Committee also received written evidence from experts that claim:
Problems occur at every level, from data collection, curation, storage in accessible sharing formats, and a lack of competence.
There is a fragmentation of health data across various organisations, such as NHS Digital, NHS England and Public Health England.
The fragmented and devolved nature of the NHS has made it difficult to combine datasets and carry out UK-wide analysis.
Conclusions and recommendations
In response to its report, the Science and Technology Committee is urging the Department of Health and Social Care to set out an action plan that describes what efforts have been made, and will be made during the pandemic, to address the poor data access issues raised by the scientific community. This should include considerations of:
Agreements and incentives for data sharing
Integration of data flows across the health and social care sectors, including public health bodies at the national and local levels
Integration of data flows across the health and social care systems of the four UK nations
The Committee concludes by stating:
Given the UK’s strengths in statistical analysis and data science, it is regrettable that poor data flows, delays in data-sharing agreements and a general lack of structuring and data integration across both the health and social care sectors have throttled timely data sharing and analysis.
For example, it is unacceptable that detailed public health data was only made available to modellers from March. The potential consequences of this will undoubtedly include slower and less effective decision-making. The establishment of the Joint Biosecurity Centre as an effort to centralise data flows to manage the pandemic gives some hope, although it is unfortunate that no central mechanism to coordinate data was in place at the start of the pandemic.
However it will only be successful in this mission if it learns from the issues encountered in the early stages of the pandemic, such as those raised to us by SAGE, representatives of the health and social care sector and the academic and research community.