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“Following the science” is not enough in the event of a pandemic


As we approach the end of the second year of the coronavirus pandemic, it is time to reflect on how we have handled this emergency and what lessons we could learn from it. The phrase “we follow science” is heard frequently by politicians and others. While science has been invaluable in the fight against Covid-19, science alone is too narrow a platform to underpin overall government policy to deal with the pandemic.

When an issue like Covid-19 arises requiring expert scientific advice from government to help formulate national policy, it is tempting for politicians to enthusiastically declare that they are ‘following the science’. This lends an air of calm objectivity to government policies and offers the possibility of hiding behind the science. If government policy fails, politicians can still plead “the science was wrong”.

Claims by politicians that they “follow the science” are only partially true because their appeals to science are limited to traditional health fields, including immunology, virology, epidemiology, clinical medicine and medicine. public health. There is little evidence that advice has been sought in other relevant fields such as behavioral, sociological and economic sciences. This is reflected in the skill set of the National Public Health Emergency Team (Nphet) appointed in January 2020 to advise the government on how to negotiate a path through the pandemic.

Communication between science advisers and government must be effective but silent

The Covid-19 pandemic is primarily a physical health issue and detailed advice to government from health science advisers is essential, but certainly no justification for excluding other areas of expertise. For example, Nphet’s strong advice that those over 70 should ‘cocoon’ at home during the first nationwide lockdown was a mistake that surely would have been avoided had the advice of psychologists and sociologists been followed on how people react to isolation during lockdown. I have discussed aspects of collateral damage and Covid-19 previously in this column.

In order to conserve limited hospital resources to deal with the pandemic, the government has suspended or seriously reduced screening programs and other programs. Where was the analysis to ensure that the cancellation of medical screening and other restrictions would not kill more people than they saved lives affected by Covid-19?

The government has also borrowed huge sums of money to pay the wages of workers whose jobs have been suspended due to regulations designed to control the pandemic, for example in hospitality and entertainment. Where was the economic advice on how much borrowing the country could afford so that our economy was not crippled when the repayment deadline arrived?

When government needs to take scientific advice to help design national policy, the collaboration needs to be carefully tailored for effectiveness and for maintaining public confidence in both government and science. Communication between science advisers and government must be effective but silent.

Unclear policy

Clear public policy statements should emanate from government alone. But how many times have we seen the government and Nphet arguing in public over policy making? And most of the government press conferences held during this pandemic featured multiple scientists alongside the government minister.

Science must inform, not make policies. Policy making is the job of government

Moreover, science does not have all the answers. For example, at the start of this pandemic, the World Health Organization and Nphet reported that wearing face masks offered little or no protection. They reversed their position after several weeks. Nphet was also hesitant about the usefulness of Covid-19 antigen testing. And much of the science advice offered to government during the pandemic is based on modeling projections, but it’s not scientific findings in the conventional sense – it’s projections of what might happen under various scenarios. And as we know from weather forecasts, modeling is useful but far from foolproof.

Scientists can also disagree with each other. For example, the Independent Scientific Advisory Group, a group of professional scientists who publicly comment on how the pandemic should be handled, frequently disagrees with Nphet.

We are deeply indebted to science for the wonderful contributions it has made in the fight against this pandemic, especially the rapid development of effective vaccines. But, at the end of the day, developing policies to manage a pandemic is a complex issue often involving difficult ethical trade-offs, including assessing the collateral damage to the economy and to the physical and mental health of the public. Science must inform, not make policies. Policy making is the job of government.

William Reville is Emeritus Professor of Biochemistry at University College Cork