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Science advice in times of COVID-19

| What’s at stake?

The important question for scientists and policy-makers is how they can most effectively work together to develop and implement policies that have the greatest likelihood of success in limiting mortality and severe socio-economic damage due to COVID-19, in a situation where much of the evidence is uncertain and rapidly evolving?

Moreover, no matter what the evidence base, the policies that are selected need to be understood and adopted by citizens, which means that those providing the evidence need to be trusted. Ultimately, it comes down to individual scientists to provide scientific advice to policy makers and communicate this advice to the public. The selection of these individuals is absolutely critical and is an area in which many countries appear to have made judicious choices in the COVID-19 context.

However, even the most outstanding individual scientists, with the most accomplished communication skills, cannot assure that the best evidence informed policies are adopted and implemented. They need to be supported by an effective national (and international) science advisory system that should comply with a number of basic principles, as shown in the figure (OECD, 2015). Attention to these principles will both enhance the efficiency and quality of the science advice that is provided and help ensure the necessary trust between scientists, policy-makers and the public.

 

| What’s the context?

Science is informing the policy response to the COVID-19 pandemic and it is science that provides the greatest hope of a long-term solution. Even in countries, where the role of experts has been questioned, policy-makers find themselves turning to experts for advice. In some countries the political leadership has even devolved much of the responsibility for communicating and explaining its policy choices to scientific experts.

Different countries have different systems for providing science advice to policy-makers in times of crisis. Whilst most countries have a crisis management system that is scalable, this is not the case in all countries, including many lesser-developed countries. In OECD countries, as the pandemic’s impacts have spread, the requirements for scientific advice are increasingly distributed across different government ministries, which presents a coordination challenge.

Scientific evidence that is informing the policy response to COVID-19 is incomplete and conditional – as more data is collected the scientific understanding of COVID-19 changes. In such a dynamic situation, when policy-makers and the public want assurance and certainty, there is a real challenge for the scientific community. Consensus is difficult to achieve and yet communication of uncertainties and alternative views can potentially undermine trust in scientific advice and related policies. Transparency and openness are important for maintaining trust.

Given the global nature of the COVID-19 pandemic, international cooperation on science advice is critical. However, no two countries are the same and this can create challenges for mutual understanding when it comes to international cooperation. Even where advice is based on the same evidence, countries make different science-based policy choices that are not always easy to explain and can create tension between governments and with international organisations.

| What needs to be done?

The OECD has identified five key areas that are particularly important in providing and using scientific advice in international crises like COVID-19 (read Scientific Advice during Crises: Facilitating Transnational Co-operation and Exchange of Information).

Read the OECD’s recommendations on providing and using scientific advice in international crises.

1. Fostering capacity to provide advice that fits the national context

There are differences between countries in the capacity and structures to develop and provide scientific evidence on COVID-19 and assess the likely effectiveness of different policy interventions. This may relate to access to knowledge (and people) with experience of dealing with related crises. The clinical research community (and physical sciences generally) do not always have effective links with social sciences and humanities, including those who have previous experience of assessing social (as opposed to clinical) interventions. Unless advisory systems are organised to bring these different perspectives together, then it is unlikely that all of the pertinent scientific evidence and opinions will be considered in developing policy. Certainly many OECD countries do have multi-disciplinary advisory mechanisms but it is not clear that all the potentially useful scientific knowledge is being integrated in all countries. This is likely to be more of an issue as the longer term effects of current policy actions, such as social distancing, become apparent.

2. International cooperation

The World Health Organisation (WHO) is the intergovernmental body that has the remit for monitoring and coordinating the response to global pandemics of infectious diseases. WHO has its own science advisory mechanisms and releases data and information and advice for all countries, which is made publically available and is updated on a daily basis. At the European level, the European Centre for Disease Prevention and Control (ECDPC) also plays a coordination role and supports countries with advice in responding to the epidemic. It was clear from the previous OECD work in 2018 that most OECD countries see the information that comes from these international bodies as an important supplement to their own national advisory mechanisms, but certainly did not feel limited or bound by this advice. For lesser developed economies, the situation is somewhat different. These countries are generally much more dependent on the advice coming from WHO – often in association with bilateral inputs from OECD countries. However, local cultural practices and norms are critical for developing effective mitigation strategies. Policy interventions that are applicable in one country will not necessarily be as directly applicable or effective in other countries. International cooperation around science advice is effective when there is trust between actors and the necessary mechanisms to translate international consensus into appropriate policies at the national or local level.

3. Promoting mutual understanding and trust: people and networks

Promoting trust between different advisors and users of scientific data, information and advice is a long-term challenge. It requires appropriate support, mandates and incentives at the national level and mechanisms for building mutual understanding at the international level. Openness and transparency with regards to the data and information that underpins the scientific advice that is given in different countries is critical. This in turn requires support for international scientific networks and infrastructures that can complement and implement formal international frameworks, including with specific regard to COVID-19, the WHO health regulations.

4. Being prepared: learning from past experience

Preparation for health pandemics ideally begins in times of calm, i.e. before crises occur, and most OECD countries do organise drills and exercises, involving their public health agencies and crisis management bodies, to rehearse what might happen during an actual crisis. Valuable as they are, such exercises may not always be given the priority they deserve and may not always engage all the necessary actors. They are more difficult to organise and more expensive at the international level, and unless led regularly, the turnover of individuals can mean that their value is reduced. Nevertheless, it is clear that many countries and organisations had carried out pandemic preparedness exercises prior to Covid-19 and these had identified many of the critical challenges that are now strikingly evident. Being prepared is not just about knowing what is likely to happen based on previous experience but also about taking the necessary mitigation measures before a crisis happens. Having clearly defined organisations with long-term responsibilities for crisis management and related science advisory processes is important for learning from the past to inform the present and future.

5. Communication with the public

No matter how good the scientific advice and how well it is integrated into crisis management and decision-making processes, the way that it is communicated to the public will have a major impact on its effectiveness. This is very clearly the case with regards to COVID-19, where the performance of different political, medical and scientific leaders has been closely scrutinised and variously criticised or complemented. It is striking that in many countries, scientific experts have become national spokespersons, who are expected not only to provide scientific evidence but also justify policy actions, which in many cases are not solely based on this evidence. The reality is that in times of crises, the distinction between advisor and policy-maker can sometimes be blurred, and there can be intense public debate about the scientific data and information that is accredited with determining policy. In this context, it is critical that the independence of science and autonomy of scientific institutions is respected and understood; science should inform policy but it is not the role of science to make policy.

 

Read more about Providing science advice to policy makers during COVID-19.

| What are countries doing?

The OECD is collecting information on the arrangements countries have in place to ensure scientific advice informs national policy and decision making in relation to COVID-19. The available information suggests OECD country governments are paying attention to the principles outlined above (see the infographic) in the way they are assessing and using science advice.

• However, the extent to which they are ensuring all of the conditions (i-l) that are identified for optimising their science advice seems to vary considerably.

• Issues such as clarification of advisory versus decision-making or communication roles and responsibilities (conditions a and b) vary across countries and over time and are not always transparent.

• The engagement of many disciplines and non-scientific experts in generating advice (conditions h and g) appears to be limited in some countries, although this may change as the public health imperative shifts to a fuller integration of socio-economic issues.

• Communication of uncertainties (condition j) also seems to vary across countries, although understandably so in a situation where the scientific evidence is conditional and changes over time as more data and information become available.  

| What’s the outlook?

Whether or not the policy actions that are currently being put in place in different countries to limit the effects of COVID-19 are ultimately judged to be optimal, it is critical that they are based on trust and reinforce trust across the science community, between scientists and policy-makers and in the public at large. 

Trust is critical for ensuring support and compliance with policy measures such as social isolation and in the longer term it will be important in ensuring solidarity and broad public support for interventions to ensure socio-economic recovery.

What we are learning from COVID-19, in the age of social media, is that openness and transparency are critical. Governments have been rapidly criticised for not providing rapid access to the primary scientific data and models that underpin their decision-making.

Careful communication of uncertainties and balanced presentation of potential scenarios – including worst case scenarios – appear to be broadly appreciated and understood by most of the public. We have also seen that the promise, and hype, associated with potential scientific or medical breakthroughs, such as reports of effective treatment with chloroquine, can also be managed with careful communication and explanation of scientific uncertainties by trusted experts.

 

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