The Problem – ensuring, restoring and maintaining public trust in Government policy making
Although initially greeted with broad public approval, over the course of the pandemic public trust in the political and policy mantra of ‘follow the science’ has wavered. Which science ? Whose science ? Have become increasingly relevant questions, that threaten to destabilise the development of evidence-based public health policies.
Polar opposites : exemplars of divergent science advice from 2020 pandemic
‘Run riot’ or ‘Lockdown’.
Over summer 2020 opposing scientific camps either promoted fast severe lockdown or opposed such measures proposing instead that the virus should run free in less at-risk populations. Arguably this led to a delay in decision-making on lockdown policy prior to the second wave and importantly exacerbated distrust in governments and public policy. There was a perception of delay and indecision, inevitably disrupting confidence in government policy and worse still risking non-compliance with future policy rollouts.
The ‘Little ships’ or ‘Mega labs’
Early in the epidemic when a novel virus meant de novo development of specific and sensitive diagnostics test for SARS COVID19 , there was a fierce debate in the public arena, as to the merits of the ‘little ships’ model of many small labs in research institutes and hospitals developing and running tests, or, the perhaps slower but ultimately larger capability and capacity of developing mega Lighthouse labs. There was a heated debate featuring eminent scientists and bioscience leaders, played out across the media. This wrangle engendered public sentiments of distrust and even anger towards government. The debate in and of itself threatened the successful development and implementation of a testing system.
Disadvantages of current scientific advice set up:
– In non pandemic times scientific debate between experts, professional rivalries, factional groupings and so on are part of the general lively development of scientific principles and procedures. In pandemic times, this adversarial ’normal’ way of generating consensus works against the Government getting the best scientific advice which is trusted by the public.
– SAGE and its subcommittees are comprised of a small number of scientific experts in comparison to the large scale of national and global expertise available. A number of eminent scientists inevitably feel overlooked and seek to find an input, which can be disruptive, a distraction and can be to the detriment of making good policy.
– A relatively small number of scientific ‘Talking Heads’ on media airing their perspectives through a range of communications channels over-emphasises individual and singular views.
– The public feels excluded
Tackling the problem
Let’s create a new path for capturing the breadth and depth of scientific opinion: crowd-generated scientific advice as a primary step to policy-making. Clearly development of policy cannot be made ‘en masse’ but the primary feed in needs to capture shades of expert opinion, bring in the breadth and depth of scientific opinion, and engage the wider public in the process and its culmination. The aim being to engender a sense of ownership by the public critical to future compliance with government policy.
HOW : ‘Open Mic Research Days’ on specific research topics
– An Open Mic Research Day is independent, inclusive, exploratory, open, original, inventive.
– An Open Mic Research Day could be used for any type of science.
What an Open Mic Research Day would look like: An on-line event hosted in turn by independent research-focused organisations eg Wellcome Trust, Health Foundation, CASE, Nuffield, appropriate to the science area of the day. In post pandemic times, an in-person conference meeting would work .
Examples of research topics that could have been used for Open Mic Research Days to develop consensus relevant to COVID:
‘Developing the best diagnostic tests’
‘Problems and solutions in vaccine development’
‘Managing severe respiratory illness’
‘Modelling pandemics- lessons to be learned’
Making an Open Mic Research Day happen:
1.Select participants – Invitation to all scientists with significant research funding in the area (criteria for inclusion such as: holding a 5 year programme grant fund currently or within 10 years, or holder of a senior fellowship) – the ‘Expert Group’ add in Policy experts – Funders – Comms experts – Media
2. Develop questionnaire to members of Expert Group prior to Open Mic Day to elicit :
– Key research questions in the field directly relevant to the selected topics: now, next 5 years, next 20 years – Most important recent developments, searching out about the latest ideas
– Pit falls in the field- where not to go
– What are the barriers to progress?
– Where should science developments feed into policy?
Analyse responses and pre-circulate as a discussion document.
3. Structure day around presentations and discussion on these topics informed by survey For the topic areas, aim to produce options for the way forward, scenarios dependent on adopting different strategies, and evaluations of how the evidence could inform or develop policy
4. Members of public can sign up to listen to discussions and send in their questions and suggestions online for Q&A
5. Synthesise outcomes – Identify where the science can shape and inform policy – Put confidence limits about what is known / not known/ will never be known – Share where there are divergences of opinion and why, and the consequence of choosing different paths
6. Share the thinking. The key target audiences for the thinking developed from Open Mic Days are the Departmental Government Science Advisory teams, Government Office for Science, the Cabinet Office and parliamentarians and funders. Dissemination of the thinking, options, strengths and weaknesses of the science should also be shared widely in the public arena. Ensure proceedings available for all online, use comms experts and creative innovators to share outcomes with scientific community, the public and media.
There should be a new way to generate scientific opinion: inclusive, integrated and relatable – at a stage before government-selected advisory committees shape ideas to form policy. The concept of crowd sourcing scientific advice through ‘Open Mic Research Days’ is proposed as a way to do this.