Hugh Lauder is Professor of Education and Political Economy in the Department of Education at the University of Bath
Much has been said about the importance of data in developing policies to mitigate the COVID-19 pandemic. But just as at the heart of a noir, in which detectives use theories to track down the murderer, theories as well as evidence lie at the heart of policymaking.
In the case of COVID-19 theories have been drawn from different disciplines - epidemiological, medical, behavioural and economic. Added to this intra-disciplinary cocktail are the vital questions of ethics, and trade-offs between apparently competing ‘imperatives’ of economic and medical interests and the risks involved.
It is important to stress that these ‘imperatives’ are only apparent because of the particular theories that are juxtaposed. Data is interpreted and risks are assessed according to theories held by the country’s leading policymakers, but the best theories available from each discipline should be held side by side. It is when they are not that we are likely to see policy failure. It is here that the question of wicked theories enters.
Theories are wicked when they are both complex and not the best available, and yet are chosen to guide policy. Policymaking is difficult enough in normal times when competing interests have to be reconciled within a framework of ethics and risk.
During a global pandemic we need to systematically assess theories before they are seriously entertained. Ideally, we should be in a position where interdisciplinary theories are developed within a common causal framework, so that we can identify the relative strength of causal tendencies in the relevant spheres of life, and how they may be directed, changed or extinguished. Such an approach is not part of current policy thinking.
We can put these considerations to work to illustrate why wicked theories can dominate the matrix of policymaking, in relation to what has become the most discussed theory in the early phases of the response to the outbreak in Britain – herd immunity. Here it is important to note that with the exception, briefly, of Holland, no other country had considered such a policy response. The majority have followed World Health Organisation (WHO) guidelines, and the examples of the South East Asian states - Republic of Korea, Taiwan - and Europe, Germany and New Zealand have conformed to the recommendation of lockdown and testing to identify the infected. The cost in mortality of espousing the anomalous herd immunity theory and the delay it caused in moving to a lockdown remains to be assessed.
The wicked theories that led to the policy of herd immunity
The intuition underlying herd immunity is that if sufficient numbers of a population are immune, normally through inoculation, as in the case of measles, then that insulates all the population from contagion.
In the case of COVID-19 the theory was that if a sufficient proportion of the population was infected, they would become immune. In the case of widespread infection, this would render the whole population immune. While there have been denials that the government entertained herd immunity, there is sufficient evidence that indeed it was considered as a candidate theory for guiding the policy response.
We do not need the benefit of hindsight to ask why sharp questions were not asked at the time as to whether a rigorous appraisal was undertaken of the theory. What was required at the time was an element of foresight that engaged with the assumptions underlying the theory.
Two assumptions stand out and have subsequently been the focus of research. Does suffering from the virus render victims immune, and in which case for how long? How many people have been infected by the virus and how many people need to be infected in order to gain herd immunity?
The further question on the effects of the policy, that Neil Ferguson at Imperial College addressed, was that of how many people would die in order for herd immunity to, in some notional sense, be effective. The major contribution that he has made, lies not in the detail of his modelling - all modelling will have more or less questionable assumptions - but that he was able to convince policymakers that their wicked theory would have highly destructive, ethical, medical and economic consequences.
At this stage the media has been looking for culprits, as in a noir, but that is to miss key steps in understanding how the problem to which herd immunity was seen as an answer was constructed.
Here we need to examine the economic and behavioural theories that were influential at the time. It is clear that even the Chief Medical Officer, Professor Chris Witty, was concerned with the economic effects of a lockdown and saw a trade-off between medical and economic interests. How, then should we understand the macroeconomic theorising that led to the construction of such a trade-off?
At its root, we need to return to Margaret Thatcher’s elision of micro and macro-economics in which she viewed the government’s finances as being analogous to those of the household. Households should not be in debt and nor should governments. Of course, the idea that all economics should be based on micro foundations was popular at the time and it led, after the 2008 crash, to austerity.
If the same approach was initially adopted by the country’s leading policymakers, we can see how the problem of COVID-19 was framed, pointing in the direction of herd immunity. The government would have understood that another prolonged bout of austerity would not have been acceptable to the country, hence the idea that if life continued as normal many would suffer temporary bouts of discomfort but the economy could continue.
It seems that once a policy of lockdown was decided upon, it was necessary to change the macro economic theory that had guided policy in the past decade. Austerity, in the extreme form in which it was implemented, did great damage to the network of institutions that is required to address the problem we now confront. We are now at a point where it is clear that government financing is not like that of the home and discussion centres on the various borrowing instruments that can be developed, so the economic cost of the pandemic is paid off in the long term, as it has been on other occasions in this country’s history.
This will be a difficult lesson for the government to learn because it will raise very sharp questions about why in 2010 the country needed such a severe form of austerity. But we should also recognise the courage and innovation of the Chancellor of the Exchequer, Rishi Sunak, in an extraordinary volte face he has changed British political economy from that similar to the United States to something akin to Northern Europe. Some in the Tory party may want to return to the mantra of low taxes and small states, but the consequences of such an approach in the 21st century are there for all to see.
Alongside changes in the economic, epidemiological and medical theories, there was also a change in the behavioural theory of the crowd response to, in the first instance, rejecting a lockdown and then endorsing the policy and hoping for the best. The theories that were entertained have not been canvassed and remain unclear. Certainly there were off the cuff remarks by David Halpern, head of No.10s Nudge Unit, on influencing behaviour but no systematic evidence was presented. Perhaps it was just a question of the Prime Minister’s personal view that as a matter of character and ethics, people should not be stopped from their freeborn right to go to the pub.
The point is made in this way because it is clear that underlying the government’s theory choice was a cultural view about English exceptionalism. It was clear in the Brexit debate, and evident in the early response to the COVID-19 crisis.
If we consider the ‘flow’ of policy decisions we can provide an account such as that given by the New Statesman, The Guardian and Time as how herd immunity theory was chosen. Here it seems the government assumed COVID-19 would be like a flu pandemic, and their strategy was based on those developed for flu viruses in the early 21st century – where herd immunity could be achieved once the outbreak had become established.
Possibly related to this was a concern that if a sufficient number of people did not catch the virus the first-time round, there would be a second wave in which it was assumed that catching the virus would ensure immunity. When a stop to testing was announced on the 12 March, it was because there was insufficient capability to test at that time. So, considerations of this kind lend to the idea of an alternative exceptional strategy for Britain, and we can begin to expose the thinking behind the choice of herd immunity. It is clear, however, that this ‘flow’ in policymaking needed to be interrupted and an appraisal of the plausibility of the theory made. This leads to consideration of the lessons that can be learned from this debacle.
Lessons to learn
Several points emerge. We need experts in the relevant forms of theory appraisal who are independent of government, as in the case of the Office for National Statistics (ONS). Whether herd immunity was entertained as a form of group thinking between experts and politicians remains to be seen but the lesson is clear, expertise needs to be seen to be at arm’s length from political influence, if trust in both groups is to be sustained. As Sophia Rosenfeld has argued in Democracy and Truth, with fake news being peddled, trust in our experts and politicians is essential if democracy is to survive.
It has been revealed that Dominic Cummings was present at SAGE meetings of the experts that inform policy, and is reported to have been influential in their discussions. Given the widespread accounts that he was in favour of herd immunity, these reports are troubling.
We also need theoreticians that can engage in interdisciplinary work. There are now suggestions as to how this can be done. While it is not an easy task, especially at a time of crisis, we need to consider how a standing unit, similar to the Nudge unit, can be established.
In the wake of the pandemic, there is also research in political economy to be undertaken in explaining the links between the different types of economy, forms of scientific knowledge, and the state in different countries' responses. This will inform a key element in how the state responds to future challenges.
This is a government that appears loathe to learn from the examples of other countries. Senior scientific and medical advisors have at different times dismissed the idea that we have anything to learn from Germany or the Republic of Korea, complex as such comparisons are. But what we have to learn is not just about how we can deal more effectively with COVID-19 and viruses like it, but how politicians can choose the best theories and strategies in responding to crises - a question of how to improve government decision-making.
Addressing fundamental policy problems requires high quality data and high quality theorising. If we are to learn anything from this crisis, these must be seen as essential.
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All articles posted on this blog give the views of the author(s), and not the position of the IPR, nor of the University of Bath.