arlier this month in the Guardian, the Lancet editor, Richard Horton, suggested that “coronavirus is the greatest global science policy failure in a generation”. He recalled the many experts who have been predicting such a pandemic, some for decades, and argued that in the UK, “the experts – scientists who have modelled and simulated our possible futures – made assumptions that turned out to be mistaken.” If he is right, and I think he is, then we should ask, why? I’ve been researching the control of infectious diseases for 30 years, and I believe that an earlier debacle – one perhaps forgotten by many – offers insights. In 1976, fearful that an outbreak of swine influenza at Fort Dix army camp in New Jersey was the centre of an influenza pandemic on a scale potentially similar to the 1918 Spanish flu, the US Centers for Disease Control and Prevention (CDC) advised President Gerald Ford of the urgent need for a mass immunisation programme. The similarity between this swine influenza and the 1918 pandemic was overstated. But in the meantime, 40 million Americans were vaccinated. And the vaccine was associated with cases of Guillain-Barré syndrome, some fatal. In the immediate aftermath, the affair was seen as a fiasco. In their remarkable study of the event, Richard Neustadt and Harvey Fineberg set out the lessons learned. Their report, The Swine Flu Affair: Decision-Making on a Slippery Disease, is unlike almost every other report I have ever read. It is a candid, unsanitised analysis that aims to determine the managerial errors made and draw lessons so that they would not be repeated. The report was commissioned by Joseph Califano, Ford’s secretary of health, education and welfare: “Lessons were what he wanted,” wrote the report’s authors, “not a history; finger-pointing did not interest him in terms of last time; his concern was with next time.” What lessons from that report should we reflect on now? Two, I think, are especially important. First, we should be cautious that experts may be overconfident in theories that are “spun from meagre evidence”. Second, we should question “scientific logic and implementation prospects”. The key issue the authors identified was that groupthink led to misjudgments of the evidence, and failed to question assumptions; and voices that opposed were silenced, excluded or denied entry. “Collegial relations” in key advisory committees were too close, many members worked “with mutual confidence”. They “would talk it out together before writing memoranda to each other”. In a critical passage, the report states: “Panels tend toward ‘group think’ and over-selling, tendencies nurtured by long-standing interchanges and intimacy, as in the influenza fraternity. Other competent scientists, who do not share their group identity or vested interests, should be able to appraise the scientific logic applied to available evidence.” I know many of the current members of the UK’s key government committees. The membership of the New and Emerging Respiratory Virus Threats Advisory Group (Nervtag) is publicly available. The membership of the more important committee, the Scientific Advisory Group for Emergencies (Sage), which is responsible for scientific advice to the Cabinet Office briefing room, was revealed on Friday after a list was leaked. I like all the people I know on these committees. They are extremely bright. And I believe their values and motivations are “good”. But I worry that their intimacy, their familiarity, lends itself to groupthink. Are there sufficient contrarian views? Are critically important assumptions subjected to sufficient critique? Is groupthink acknowledged as a risk, and if so, how is it addressed? The roles taken on by the members are enormously important. The decision-making process is challenging, but must be scrutinised. Jeremy Farrar, director of the Wellcome Trust and self-identified member of Sage, has talked of receiving personal abuse because of his position on Sage. But the deliberations and minutes and, in my view, the academic disciplines of the members should be made public, if not members’ names. Transparency and scrutiny are critically important if groupthink is to be avoided. The revelation that Dominic Cummings, the prime minister’s adviser, has been attending Sage meetings, adds urgency to this demand. Without this, the integrity, impartiality, and independence of the committee and its members will continue to be regarded as suspect. When political influence is added to groupthink among scientists – should it have occurred – then the result can only be a diminution of the committee’s authority and the advice it gives. In their report, Neustadt and Fineberg wrote: “Policy decisions regarding influenza rest on judgments about the behaviour of the virus, the impact of the disease and our ability to interdict its course. But the virus is capricious, the disease elusive, and our remedies imperfect.” All of us involved in attempting to control Covid-19, which means all of us, should reflect with humility, embrace those who challenge our assumptions, and draw on these lessons. • Richard Coker is emeritus professor of public health at the London School of Hygiene and Tropical Medicine