Science and the coronavirus pandemic

Graham Room is a Professor of European Social Policy at the University of Bath. He is author, co-author or editor of thirteen books, the most recent being Agile Actors on Complex Terrains: Transformative Realism and Public Policy (Routledge, 2016). He was Director of the Institute for Policy Research (IPR) until December 2013.

Science-based policymaking

The UK Government has framed its policy on the Coronavirus pandemic having strict regard to the scientific advice it is receiving.  Its policy may seem to have shifted, but only as the science itself has shifted.   That, at least, is what we are being told.    

It was because of that advice, that the UK did not rush to follow WHO recommendations – and the experience of China, Singapore, Taiwan and Korea – with a strict regime of testing for the virus, following up the social contacts of those found to be positive and enforcing isolation of all those with any symptoms. Still less did it follow the examples of Wuhan and Italy, in imposing ‘lock-down’ on whole cities and regions, with little or no movement in and out. 

The UK science, it seemed, held two lessons, pointing in a quite different direction.  The first was that by encouraging hand washing and social distance, and discouraging large gatherings, the rate of infection could be sufficiently slowed, that the NHS would have time to adjust to the growing number of cases needing hospitalisation - a slowing that would take us into the summer months, when the virus would in any case lose much of its potency.  On the other hand, the numbers of people exposed to infection would by then have become quite considerable, and the UK population would be developing ‘herd immunity’.  We would, in other words find ourselves in sort of ‘Goldilocks zone’, with a virus of steadily declining potency and a population more resistant to infection.  Science - in particular, the scientific expertise of the UK epidemiologists - would have brought us to the least bad outcome available.   

As data on the spread of the virus have become more available however, on a global basis, and as other scientists and modellers entered the debate (notably Imperial College), the prognosis became less rosy. Now it seemed that in the UK up to 8 million could be expected to be hospitalised over the period until spring 2021, a number with which the over-stretched NHS would hardly cope.  It also seemed that maybe 80% of the population would need to be infected before ‘herd immunity’ was reached. That would likely involve up to 400,000 deaths.  Even then, there was little confidence that the Coronavirus would not mutate into new and more dangerous strains in the course of the coming winter.  The science at least had mutated; the precautionary principles underlying the WHO advice – informed by its unique vantage point on the Coronavirus worldwide - were after all not without value.  As the scientific facts changed, so did Government policy. 

It was however not only the science of UK epidemiologists that had swayed the Government. It was also behavioural science, the science that had underpinned much of policymaking from both sides of the UK political spectrum for two decades, most obviously in the form of ‘nudge’ (Thaler and Sunstein, 2009).  This seems to have played a key part in shaping the Government’s response to the Coronavirus[1].   Such behaviourist perspectives in some degree abandon orthodox models of rational behaviour, so dominant in much of social science, pointing instead to the biases and blunders and inertia that ordinary people display in many of their decisions.  If policymakers want to engage citizens in an assessment of the costs, benefits and consequences of a health emergency, they must also be ready to take into account this inertia and short-sightedness.  The mass of the population are set in their ways and – in a democratic society at least – they cannot for long be cajoled into actions that depart from what they are used to.  Overly stringent restrictions on normal everyday life will – if continued for too long – meet increasing resistance; better therefore to reserve such restrictions for those times and places when they can have the greatest positive effect.  It is on this science – as much as the epidemiological science – that the Government seems to have relied.

The limitations of behaviourist perspectives

It is good that the Government is placing such weight on scientific advice and that social science is playing a key role in shaping the destiny of the nation.  However, just as the initial epidemiological advice proved insufficient to the development of the pandemic, behaviourist perspectives may also have their limitations. They may then risk becoming a justification for policies that could be inappropriate or even damaging.

Much of the behaviourist literature has relied on experiments conducted with university students in classrooms. If we believe that human characteristics are largely fixed, spanning cultural, socio-economic and generational divides, this is not inappropriate (and certainly efficient in terms of research budgets).  From there, the exponents of behaviourism have gone on to study real world problems, such as the reluctance of ordinary citizens to invest in pension plans, even where these are self-evidently in their best interest.  The evidence suggests that individual citizens recognize the risks they are running, of suffering a major drop in their income when they retire; but they hesitate to make the choices and investments that would reduce this risk.  This suggests that they suffer from inertia, they are poor at assessing risks and they are unreasonably loss-averse (Thaler and Sunstein, 2009: Ch 1).  Government therefore has a duty to nudge them along the path of virtue. 

But what if the citizen, far from being lazy or short-sighted, simply has insufficient confidence that any pension arrangement will be sufficiently robust long-term, to justify investing a significant portion of their earnings here and now (Room, 2016)?  They may have insufficient trust in the various institutions involved – the Government, financial intermediaries and employers – and their readiness to ensure that robustness. They may want a guarantee of their future well-being and security, if they are to opt-in to any new pension regime, and make their own contributions. The slashing of other public provisions in an era of austerity has done little to build that confidence.

‘Nudge’ tends to ignore the active role of citizens, seeking to shape the society in which they live, albeit under circumstances not wholly of their own choosing.  If citizens seem to be characterised by inertia and blunders, this may attest not to their cognitive biases, but rather to the social, institutional and political obstacles that they face, in playing such a creative role.  This would suggest a very different policy stance by Government, as it addresses the present crisis: treating citizens not as set in their ways and reluctant to comply with stringent restrictions on their normal everyday freedoms, but as potentially eager partners in a deliberative conversation as to how the nation can cope. 

It is after all evident that in the new phase of community ‘lock-down’ that has been instituted over the past week, the bottom-up development of community self-help will be indispensable, if those living alone – especially the elderly – are to be supported.  Radio and television carry heart-warming stories of such initiatives springing up, led by local volunteers.  This is the antithesis of inertia and cognitive bias; it demonstrates untapped reserves of energy, caring and foresight; the good behaviour and inventiveness of ordinary local people.  To this the behaviourist literature is largely blind.

Government is already saluting such initiatives as evidence of the energy of local communities and their engagement in the national struggle for survival.  That could however too easily become an excuse for ignoring the very real needs that such communities face, after a decade of austerity-driven cuts to local council budgets, the failure to invest in local health and social services and the ‘hollowing out’ of government.  Local communities need rebuilding, as points where national policies can be connected up.  Local energy cannot make up for the voids that have opened up, except perhaps in affluent middle class neighbourhoods, where relatively few are in dire need.   

The alternative to behaviourism 

Behaviourism tells us that ordinary citizens are set in their ways.  In a democratic society they will not endure stringent restrictions on their normal everyday activities.  Better therefore to reserve such restrictions to times and places when they can have greatest positive effect.  Otherwise those restrictions will progressively lose their force.  Strong Government action will lose its credibility and traction and we will be worse off than before.   

The counter-view is that citizens can be treated as grown-ups, ready to work with their communities and with Government, in a collective effort to address the pandemic.  It is noteworthy that the scientific literature to which the Government’s behavioural science advisors pointed, when doubting the efficacy of long term restrictions on normal everyday life, itself makes clear that such efficacy depends crucially on people being given clear reasons for the restrictions and a sense of the larger purpose to which they will be contributing, rather than simply being thought of as unsophisticated and hidebound by their own inertia, as in the nudge narrative.

This must start with measures to guarantee the security of the mass of the population – in terms of food supply, income security, and a well-equipped health service. The economic package the Chancellor announced on 20 March, unprecedented in peacetime, is a good first step in this direction, but it should have been taken sooner.  Inertia until now characterised Government ministers far more than the common citizens: too little, too late.        

It may not be enough; and the patience of the public may be limited.  Their impatience may moreover be expressed more forcefully than simply returning to their established patterns of socialising. Supermarkets are having to employ more security staff to manage the race among shoppers to clear the shelves of food. The government itself is assessing the risks of civil disorder. Signs that wily entrepreneurs are looking out for the chance to make a quick buck could stoke further unrest. The Government is only too aware that its own position – whatever its handsome majority in Parliament – could be in peril, especially if a new leader of the Opposition breaks away from the current attempts at cross-party consensus.   

Indeed, those political dangers are inherent in the very policies that the Government has been rolling out.  For a decade, successive Conservative Chancellors have declared that there is no alternative policy to austerity and financial cut-backs in social expenditure, if the national finances are to be put in order and the economy re-built on a sound basis.  For a decade, Governments have declared that it is not for the public purse to come to the rescue of failing businesses; the Government has now come to the rescue of all businesses, lest they fail.   Theresa May, when Prime Minister, declared that there were no magic ‘money trees’ from which Government could pluck public largesse.   Now however it seems that whole forests are sprouting up everywhere.   

In a single week, Government has made evident by its actions that those nostrums of the past decade were based on a lie and that the refusal to act was rooted not in harsh economic reality but in political and economic power.  The genie is out of the bottle and it will be hard to put back.   

What is also now evident is that those lies coexisted with growing inequality to a quite remarkable degree, with the superrich getting richer while wages stagnated. Those inequalities also were attributed to the implacable laws of the market place.  Here again, it may be difficult for Government to go back to ‘business as usual’ with a deferential public. 

It is not surprising that many commentators have therefore seen in the present crisis a potential upside, as the prevailing political and economic order is put in question by a fearful public.  This is a fear that could on the one hand produce unrest in the supermarkets and on the streets; or could be channelled into a national deliberation about the public services on which we all depend - and the virus of private plunder which over recent decades has weakened their vitality. 

This will depend crucially on how far the political elites remain set in their ways, retaining the biases in their thinking that inhibit new and more appropriate social and economic strategies, and limited therefore to short-sighted blundering. The strictures of the nudge theorists about the styles of thinking of ordinary citizens are in many ways much more applicable to those elites: albeit their styles of thinking may be better explained in term of their own economic and political interests[2].   

Beyond these national debates, some have seen possibilities for new and more hopeful thinking about the wider global world in which we live – and a shared humanity to which governments must bend.  That then raises issues that go far beyond the battle against the Coronavirus. The bail-out of the financial system in 2008 was funded by cuts in public services during the ensuing decade; why should the investment in our collective public services now not be funded by wealth taxes on the superrich and the internet giants whose bestride the global order? That would of course require global agreement – but if that cannot be achieved now, in face of this shared epidemic, it is unlikely to be achieved ever.

Last but not least, beyond the science of the epidemiologists and the behavioural scientists is the highly relevant science of complex systems, concerned not so much with the behaviour of individuals as with that of interconnected social and biological systems (Room, 2011; 2016). The Coronavirus pandemic is stimulating wide-ranging debates among such researchers which, providing they are well-articulated with the social and power dimensions of our interconnected world, could provide key insights for policy. 

The author is grateful to Marlies Morsink for many helpful comments on earlier drafts of this paper.

References

Room, G. (2011). Complexity, Institutions and Public Policy: Agile Decision-Making in a Turbulent World. Cheltenham: Edward Elgar.

Room, G. (2016). Agile Actors on Complex Terrains: Transformative Realism and Public Policy. London: Routledge.

Room, G. (2016).'Nudge or Nuzzle?  Improving Decisions about Active Citizenship' Policy Studies, 37 (2): 113-128.

Thaler, R. H. and C. R. Sunstein (2009). Nudge: Improving Decisions about Health, Wealth, and Happiness (Revised edition). London: Penguin.

Endnotes

[1] For nudge thinking on the Coronavirus by the Behavioural Insights Unit see https://www.bi.team/our-work/covid-19/

[2] For an account of the resistance of these elites in Korea, notwithstanding the vigorous and widely praised efforts on its government, see http://phmovement.or.kr/phm-korea-statement-on-covid-19-outbreak-and-responses-in-south-korea/