Standing Committee on Pandemic Preparedness minutes: August 2021

Attendees and apologies

Chair:

• Professor Linda Bauld, Interim Chair

Attendees:  

• Dr Ian Campbell 
• Professor David Crossman
• Professor Julie Fitzpatrick
• Richard Foggo
• Dr Graham Foster
• Professor Andrew Morris
• Professor Massimo Palmarini
• Professor Nick Phin
• Professor Stephen Reicher
• Professor Aziz Sheikh
• Dr Gregor Smith
• Professor Devi Sridhar
• Professor Emma Thomson

Observers:

• Daniel Kleinberg

Apologies:

• Dr Audrey MacDougall 
• Professor Andrew Millar
• Professor Mark Woolhouse 

Secretariat:  

• [REDACTED S.38 (1)(b)]

Items and actions

Welcome and introductions 

The chair welcomed members to the first meeting of the Standing Committee on Pandemics (the Committee) and noted apologies. The first session would focus on discussion of the remit for and commission to the group. The aim is to provide advice to Ministers to enable Scotland to be as prepared as possible for future pandemics. 

Committee remit

The chair introduced the Committee’s terms of reference and invited comments.

It was suggested that the current remit and draft commission may need a broader focus, as the current focus is biomedical only. A greater focus on wider scientific advice would be helpful, as would a consideration of the impact of pandemics beyond science and medicine. Too narrow a biomedical focus would insufficiently respond to the wider, 4 harms dimensions of pandemics. This may include considerations of workforce preparedness, including whether it might be more flexible or different. These comments were acknowledged, noting that there may be other locations within the Scottish Government and wider advisory network that are better suited to consider the wider dimensions of pandemic preparedness which would fall under the current 4 harms approach. 

Understanding better how to prepare for and mitigate the impacts of mental health and inequalities in future pandemics would be important. Other areas that were noted include the role of communications, test, trace and isolation, surveillance, borders, schools, and the introduction of new protocols in healthcare settings. There may need to be a role for the Committee in advising on where gaps needed to be filled in research and advisory structures. It would also be important to attend to wider capability and infrastructure questions, in particular in support of diagnosis and testing. It was noted that the diagnosis and surveillance work should include zoonotic surveillance and the identification of risky interactions between humans and animals.  

The Chief Medical Officer commented that there ought to be a relationship with operational components but the primary role of the group is to support pandemic preparedness policy for the future, not management of actual pandemics across the range of their impacts. The Committee is an advisory body. In addition, the remit and commission needed to be mindful of the changes coming with the formation of the UK Health Security Agency (UKHSA) and other developments in UK and international structures. There is a need to ensure that Scotland and Scottish institutions are able to access opportunities and funding that new developments at UK level are creating, such as those that may arise from the UKHSA. 

It was noted that the draft terms of reference only use the term preparedness and strongly suggested that it should explicitly refer to consideration of prevention. The Committee should explore the range of things that we could begin to change or prepare that might reduce the potential for epidemics to become pandemics. This includes issues like building regulations around ventilation and 'clean air'. There are also wider considerations about keeping ourselves safe, such as the provision of sick pay, so people can afford not to go to work when sick.

It was observed that key lessons of Covid had been how to make the most of global capability to identify and assess a new pathogen, and at national level how to buy sufficient time to allow for the development and deployment of vaccines, for example. There was discussion in the group as to how long that time might be. RNA and viral-vectored vaccines are a step change for technology and safety remains at all times an overriding consideration. 

It was suggested that it would be important to consider and advise on the steps that should be in place/taken in the early days of a new epidemic or pandemic as well as saying what needs to be put in place now that would enable a swift and effective response to the next pandemic.

It was observed that previous pandemic planning had identified many issues and Disease X models have been useful. It is critical how quickly one identifies and acts on the emergence of a pathogen. One of the challenges is how to reduce the time taken/needed to confirm a pandemic event so that delay doesn’t impact on the course of events. Vaccine infrastructure and manufacture is not easy, for example, and science has to be the primary focus before considering policy options.  

The importance of an explicit consideration of the opportunities, alongside the legal and ethical dimensions, around data sharing and infrastructure was highlighted in discussion as a very important issue for development of advice. Data and potentially AI will be at the heart of future approaches. This would need to take account of the changing landscape, with SPI-M linked into JBC for example, which is now part of the UKHSA. 

It was agreed that policymaking needed to – and had been – attentive to the science but equally clear that neither scientists nor policymakers should act in isolation – there needs to be a team approach to the consideration of options and appropriate actions. There is a need to have conversations with different groups across the population as part of designing how future communications would work, and ensuring that the social sciences play their full part in informing recommendations and action.  

Action:

• Secretariat to review the terms of reference in the light of the discussion and provide a draft for consideration by the chair and vice-chairs ahead of the next meeting

Committee membership 

The chair opened the discussion by noting the five broad areas listed in the agenda where expert advice might be useful:

• surveillance, testing and diagnostics
• zoonotics and ‘spillover’
• bacteriology, virus and treatments (vaccines, therapeutics)
• social and behavioural science
• system response and pandemic partnerships

The Committee agreed with the five areas proposed. The Committee spoke about the value of explicitly advising on links to industry, suggesting that bullet 5 could read ‘System response, infrastructure and pandemic partnerships’. The Committee also emphasised the importance of adding data and analytics to the list of areas. Where required the Committee may also support the creation of subgroups or short life working groups to support detailed work on specific topics. 

Intensive Treatment Unit (ITU) surveillance systems are likely to be critical as the most likely early warning of any developing future pandemic. Representation from that area and engagement with industry would benefit the Committee. Another area that may require more specific consideration would be supply chains and consumables.

The Committee also noted the importance of being outward looking and connecting into work at UK and international level, with membership to support this.

Action:

• Secretariat to collate suggestions aired, including international expertise, for the chair and vice chairs to consider ahead of the next meeting

 Committee workplan

The chair introduced the discussion and asked if the group had views on how quickly they would wish to prepare advice. Changes at UK level won’t be clarified until autumn and there is a value in taking early opportunities to enable Scotland to adapt and benefit from those changes. 

A number of members spoke of the value of a swift (3-6 months) piece of work scanning the landscape and identifying early areas for action. There’s already much in place internationally – such as pathogen lists – the question is what is Scotland specific. 

The value of an early scoping report would include transparency and the ability to showcase Scotland’s place in the evolving international pandemic response landscape. This might usefully be presented at Scottish, UK and International levels, with what can be done, when and where at each level. 

A more comprehensive analysis would require further supporting evidence and would  take longer – but may also benefit from access to further learning. 

A number of members noted the importance of the Committee being supported by the necessary resources to provide informed advice on pandemic preparedness and any other work to be undertaken by the Committee. Support may include access to legal and other specialised advice. In discussion, parallels were drawn with the support provided to SAGE and the resources available through GO-Science. Effective support would be particularly important if the Committee were to be asked to provide early advice.

Action:

Secretariat to ensure that Ministers are aware of the Committee’s views when commissioning advice

Scottish Government update and administrative arrangements

Daniel Kleinberg spoke briefly about the Committee’s administrative arrangements, noting that any questions should be referred to the secretariat. 

AOB

There being no other business, the chair thanked members for the very active and productive contributions to the discussions and closed the meeting.