Science and policymaking
Pp:
Science and policymaking
Pielke- honest broker, different roles science plays
What role can it play? Constraints on it (Kourany- breast cancer screening policy)
Think more widely about difficulties of science influencing public policy, whether we have absolute
evidence that more attention in science brings improvement in public policy (contemporary, corona!
Science in public policy)
Essay plan:
“It is almost impossible for science to have a meaningful impact on policymaking”. Discuss.
Science can easily have an impact on policy making esp. when there is policy consensus-
current situation, there is demand for the science, strong insistence they are “following the
science”, efficiency/division of labour and experience arguments, scientists think their
advice is followed more than half the time
Whether it is “meaningful” is less clear, for the following three reasons:
-Scientific dissensus, politicians may not accept something until experts are agreed,
“Practical problems” in Kourany and Pinto
-Or artificial consensus because only listening to a subset of experts, structural problems,
bias and lack of diversity in scientific community and who the government listens to, current
spotlight on epidemiologists, intra-UK experts, PHE. “Social problems” in Kourany and Pinto,
“exclusionary structures” (though they mainly apply this to women, minorities and lower
classes. Also commercial interests etc.)
-Which science they follow depends on government values- ‘evidence-based policy’, yes
idea of herd immunity was represented in SAGE and the scientific community (see below)
but also divergent views as mentioned above e.g. international scientists/European (even
though say they are following WHO and European guidance large divergence in policy) govt
chose the former as worried about economy, choosing between those trade-offs themselves
and scientists are being scapegoated (they just present the evidence), also about
appearance- Brexit shouldn’t have even come into equation. Government also following
public opinion- assumption that politicians are vote seeking, if populace listens or does not
to science politicians should do the same. Science never dictates a course of policy- should
be neutral evidence presenters, fact that independent scientist and researches are being
presented as advocates (Pielke) could be damaging for public opinion of science in the long
run, scathing pieces on Imperial scientist. “Epistemic problems” in Kourany and Pinto,
science not value free, one set of scientists most concerned about overtreatment found
mammography to do more harm than good, others found lack of diagnosis more
problematic and found mammography to be a good thing
News:
, Read the new Imperial college London report on COVID, they were the one
advising the Government to build herd immunity; they redid the maths and
they’re basically admitting fault. 250k could die if suppressing measures not
taken
16 March 2020 Imperial College COVID-19 Response Team
We do not consider the ethical or economic implications of either strategy here, except to note that
there is no easy policy decision to be made. Suppression, while successful to date in China and South
Korea, carries with it enormous social and economic costs which may themselves have significant
impact on health and well-being in the short and longer-term. Mitigation will never be able to
completely protect those at risk from severe disease or death and the resulting mortality may
therefore still be high. Instead we focus on feasibility, with a specific focus on what the likely
healthcare system impact of the two approaches would be. We present results for Great Britain (GB)
and the United States (US), but they are equally applicable to most high-income countries.
Once interventions are relaxed (in the example in Figure 3, from September onwards), infections
begin to rise, resulting in a predicted peak epidemic later in the year. The more successful a strategy
is at temporary suppression, the larger the later epidemic is predicted to be in the absence of
vaccination, due to lesser build-up of herd immunity.
On Monday night, that theory collided with the facts. A new analysis by immunologists at
Imperial College London and the London School of Hygiene and Tropical Medicine of the
impact of the coronavirus in Italy suggested that up to 30 percent of patients hospitalized
with the virus would require intensive care treatment. Those numbers, if repeated in the
U.K., would quickly overwhelm Britain’s state-run National Health Service.
Within hours of the report, U.K. Prime Minister Boris Johnson appeared at a daily briefing at
No. 10 Downing St. to reverse the herd immunity policy. Announced lockdown on 23rd
March.
Instead, Johnson said that the government was giving “very strong advice
that public venues such as theaters should no longer be visited” but added,
“I don’t believe it will be necessary to use” enforcement powers.
Dr Nisreen Alwan: If you’re a public health expert, epidemiologist, scientist in
a relevant field or healthcare professional & would like to endorse our letter
in the Times today on the UK’s #COVID19 public health response, please add
your signature using this link: docs.google.com/forms/d/e/1FAI
https:// … pQLSfNRhGJEdcB SLvwe6T8MxZl48IcX 1dh9LThmw_aXijx3jVkOg/viewform