Amazon: Spike: The Virus vs. The People – the Inside Story. Jeremy Farrar with Anjana Ahuja

Spike: The Virus v the People review – Sage scientist’s revelatory Covid memoir – The Guardian

Jeremy Farrar’s account of the spread of the pandemic, in particular his view of government policy and fears about the virus’s origins, is genuinely shocking.

It cannot be easy keeping confidences when your whole scientific career has been predicated on the transparent sharing of data. But this is the bind that Jeremy Farrar, the director of the Wellcome Trust and a prominent government scientific adviser, found himself in on learning in January 2020 that Chinese scientists had isolated a novel coronavirus in Wuhan with an unusual constellation of genes.

Within days, Farrar, an infectious disease clinician by training, had obtained the virus’s genetic sequence and knew it was related to Sars, the cause of a major global outbreak in 2002-2003. And within weeks, Farrar knew it was being transmitted from person to person and had “the makings of a nightmare”. More concerning still, Sars-CoV-2, as the virus came to be known, “seemed almost designed to infect human cells”, raising the possibility it might have accidentally or deliberately escaped from a laboratory.

That revelation and the simultaneous realisation of its geopolitical implications thrusted Farrar into a twilight world of suspicion and moral conflict. “I would do things I had never done before: acquire a burner phone, hold clandestine meetings, keep difficult secrets… In hushed conversations, I sketched out the possibility of a looming global health crisis that had the potential to be read as bioterrorism.”

Thus begins Spike, Farrar’s riveting “inside story” of his efforts to warn the world of the looming pandemic and devise countermeasures, written with the help of the science journalist Anjana Ahuja. As the head of one of the world’s biggest philanthropic science funding bodies and a member of the government’s Scientific Advisory Group for Emergencies (Sage), Farrar – or Sir Jeremy as he has been known since his knighthood in 2019 – is uniquely placed to draw back the veil and take us into the Whitehall sanctums where doubts are discreetly aired by advisers and key decisions made.

 

Farrar doesn’t disappoint. Having spent the past 18 months keeping his counsel, Spike reads like a long-overdue political reckoning and settling of scientific scores. Appointing Dido Harding to run the UK’s test, trace and isolate system was a “grave error… I could not see what skills she brought to the role”, Farrar writes. On the question of who was responsible for the government’s initial, ill-conceived herd immunity strategy, he exonerates both Sage and Dominic Cummings, suggesting instead that the idea for Covid-style “chickenpox parties” came from within No 10 and the government’s behavioural insights team. Certainly, if chief scientific adviser Patrick Vallance, who floated the herd immunity strategy in an interview with the BBC on 13 March 2020, had come to Sage and said: “Our plan is to take it on the chin”, Farrar insists “I would have resigned”. He is similarly scathing about last summer’s “eat out to help out” scheme, describing it as “a tinderbox” that lit the deadly second wave. Ditto the Oxford scientist Sunetra Gupta and other signatories of the Great Barrington declaration, whose proposal to allow the virus to sweep through the population while shielding elderly people Farrar dismisses as “ideology masquerading as science”.

Nor does Farrar seek to evade his own blindspots. Though he was not present at the Sage meetings in February 2020 when Chinese-style lockdowns were first mooted, he acknowledges that the idea you could tell the citizens of mature European democracies not to leave their homes was met with “disbelief, including from me”.

Farrar is similarly honest about his other biases and in a reflective passage on his initial willingness to entertain the laboratory conspiracy theory, he admits: “I had put two and two together and made five.” But perhaps the bigger surprise, given the fact that in February 2020 Farrar had lent his name to a controversial letter in the Lancet “strongly” condemning speculation about Covid’s non-natural origins, is that he entertained the theory at all (in a rare oversight, Farrar and Ahuja fail to mention the Lancet letter).

I suspect these passages will prove the most controversial, particularly given the Biden administration’s recent decision to reopen the lab leak investigation and the recent publication of a follow-up Lancet letter in which Farrar and other prominent scientists reaffirm their view that the weight of “credible”, peer-reviewed scientific evidence points to a natural origin.

Certainly, as a long-time Farrar watcher (disclosure: some of my research has been supported by the Wellcome Trust and I’ve also interviewed Farrar for my podcast), I was astonished to learn that a month before the publication of the first Lancet letter Farrar had scheduled a confidential call with Anthony Fauci, the director of the US National Institute of Allergy and Infectious Diseases, to discuss the evidence for and against the lab leak theory, after which Farrar was still split 50-50. Equally astonishing is the revelation that he was so spooked by the possibility that the virus was human-made that he raised it with Eliza Manningham-Buller, the former head of M15 and a Wellcome trustee (it was Manningham-Buller who advised Farrar to get a burner phone and beef up his security). Indeed, the most compelling passages of Spike are where Farrar, skilfully aided by Ahuja, takes us through the complex scientific case for and against the lab leak theory, as he wrestles with his conscience and who he should let in on the secret lest something ill should befall him. John le Carré couldn’t have plotted it better.

Despite this, many readers may feel Farrar’s conclusion is a bit of a cop-out – without access to the laboratory records, he says, we may never be able to definitively rule out the lab leak theory “but the simplest explanation remains the likeliest: nature plus bad luck”. No less easy is the question whether Farrar would have done better to break ranks with Boris Johnson’s government earlier. “Does staying in an advisory role mean being complicit in the outcomes of bad decisions?” he asks at one point.

I believe Farrar when he says he still doesn’t know the answer, but after reading this searing indictment of the government’s serial failures to follow the science, I can’t be the only reader who wishes he’d written it sooner.

This scientist’s plague year journal gives fresh insight into the uneasy relationship between science and politics in the UK’s fight to constrain the pandemic – FT

The darkest moment of the pandemic for Jeremy Farrar came on September 21 last year. Incident cases of Covid-19 had been rising in England through the summer. Boris Johnson, prime minister, had urged the lifting of lockdown in May. Amid general optimism that the worst was over, pubs and restaurants opened their doors in July, then Rishi Sunak, the chancellor, launched his “Eat Out to Help Out” scheme, dubbed by some as “Eat Out to Help the Virus Out”.

There were simply no plans in place to meet the predicted autumn rise in cases. By the time of the Scientific Advisory Group for Emergencies meeting on September 21, infections were doubling about every week, even before the impact of school reopening. Sage was clear: “A package of interventions will be needed to reverse this exponential rise in cases.” The measures included a short lockdown, a circuit breaker. By their actions, the government was also clear: we won’t follow the scientific advice — we’ll say we will, but we won’t.

Farrar, who gives this account, asked himself why he should continue reviewing the evidence, serving on Sage, doing everything he could to reduce the toll of the pandemic, if the prime minister refused to act until far too late.

Farrar is in little doubt that government reluctance to act led to preventable deaths. “As the government remained rooted to the spot, transmission was already getting away from us. It was a catastrophe playing out in slow motion,” he writes.

Spike — a scientist’s version of Defoe’s A Journal of the Plague Year — is a necessary insider’s account of how the pandemic was, and should have been, handled. It is written in the first person as the voice of Farrar. It is, though, a collaboration with FT science writer Anjana Ahuja. Whether its fluency and clarity are a testament to one or the other does not matter. It is a pleasure to read.

My own approach to the pandemic was that it exposed and amplified inequalities in society: the greater the deprivation, the greater the loss of life from coronavirus. That leads to two approaches to reduce suffering: reduce inequalities — my Build Back Fairer reports — and control the pandemic, as laid out in Spike. Both are vital.

Farrar had good grounds for frustration that his advice was ignored. He is a global expert in infectious disease control, he directs the Wellcome Trust, one of the world’s largest medical research foundations, and is on first name terms with all the key players responding to the pandemic. His, and Sage’s, advice is not ignored because he is an outsider.

Jeremy Farrar in Vietnam when director of the Oxford University Clinical Research Unit in 2006 Jeremy Farrar in Vietnam when director of the Oxford University Clinical Research Unit in 2006 © Chau Doan/LightRocket via Getty Images

A first reason for the government’s failure to act at the beginning of the pandemic from January 2020 was lack of understanding of the urgency. With exponential growth of infection, the days, the hours, mattered. As early as January 23, Carter Mecher, an impressive US epidemiologist, said “we are not going to be able to outrun it” and advocated targeted layered containment.

If that meant, at the extreme, lockdown, Farrar along with most others close to decision-making thought that it might be acceptable in China, but it couldn’t be done in Europe. Then Italy did it. By March 10, Sage concluded the UK would have to follow Italy and lock down. Initially, the government refused.

A second reason was the prime minister’s libertarian instincts. On March 11 he said one strategy was “perhaps to take [the virus] on the chin, take it all in one go . . . ”, although he later went on to say that more had to be done. Farrar is scathing about the idea of taking it on the chin, or developing some form of herd immunity. Simple modelling by Imperial College suggested perhaps 510,000 deaths. Natural herd immunity as a strategy is scientifically and morally indefensible.

The idea of a trade-off between public health and the economy was simply contradicted by the evidence It is worth noting that on March 10 2020, when Sage was recommending urgent lockdown, there were 113,702 known global cases of Covid-19. On July 19, 2021, the day the prime minister labelled “freedom day” and lifted all remaining restrictions, there were about 45,000 new daily cases in England alone, though in the last week the daily rate has fallen. Yes, of course, a majority of adults have had at least one vaccination, but hospitalisations are rising, as will deaths, and there will be more cases of “long Covid”. It looks like herd immunity is back as a tactic.

A third reason against taking action to lock down was concern for the economy. Everyone shares that concern. But the idea of a trade-off between public health and the economy was simply contradicted by the evidence. The data are clear. Countries that better controlled the pandemic had a smaller economic hit.

There was scientific disagreement, too. Farrar dismisses the Great Barrington Declaration — written by three scientists from prestigious universities, which argued for a form of herd immunity — as “ideology parading as science and the science was still nonsense”.

Spike is a closely observed and deeply analysed case study of the intersection between science and politics. Beware of politicians claiming to be following the science. There are lessons to be learnt as to how to handle the next pandemic when it comes. Farrar lays them out. The world needs to take heed.

Spike: The Virus v The People — The Inside Story by Jeremy Farrar with Anjana Ahuja, Profile £14.99, 272 pages

Michael Marmot is the director of the Institute of Health Equity at University College London

Waterstones Says.

Spike: The Virus vs. The People – the Inside Story (Hardback)

In this major study of the scientific mission to combat the effects of the Covid-19 pandemic, leading scientist Farrar gives a compelling insight into the challenges of responding to an unprecedented medical emergency and how governments around the world reacted.

The Coronavirus pandemic has devastated lives and livelihoods around the world – and continues to do so. These personal tragedies will, and must, be told and heard. There is, however, also a truthful and objective scientific narrative to be written about how the virus played out and how the world set about dealing with it. Spike is that story – from the inside. Its author, Jeremy Farrar, is one of the UK’s leading scientists and a member of the SAGE emergency committee.

As head of the Wellcome Trust, and an expert in emerging infectious diseases, Jeremy Farrar was one of the first people in the world to hear about a mysterious new respiratory disease in China – and to learn that it could readily spread between people. Farrar describes how it feels as one of the key scientists at the sharp end of a fast-moving situation, when complex decisions must be made quickly amid great uncertainty. His book casts light on the UK government’s claims to be ‘following the science’ in its response to the virus, and is informed not just by Farrar’s views but by interviews with other top scientists and political figures.

Farrar, who has spent his career on the frontlines of epidemics including Nipah virus in Malaysia, bird flu in Vietnam and Ebola in West Africa, also reflects on the wider issues of Covid-19: the breath-taking scientific advances in creating tests, treatments and vaccines; the challenge to world leaders to respond for the global good and the need to address inequalities that hold back success against the virus. All these shape how the world ultimately fares not just against Covid-19, but against all the major he alth challenges we face globally.

A neon sign at the Wellcome Institute in London, February 2021. Photograph: Alastair Grant/AP

Reprinted for educational purposes and social benefit, not for profit.