Hammer or nudge? Science based policy advice in the COVID-19 pandemic

As so many other researchers sitting home and watching the news on the onslaught of COVID-19 in Europe, I have been impressed with the way the scientific community of virologists, epidemiologists and other medical experts on infections and viruses, caught the listening ear of national policy makers, business leaders and the public at large. Suddenly, scientific facts and evidence could lavish themselves in the trust of public opinion and fake news became “fake” in the real sense of the word, unreliable: not to be trusted by anyone. Something climate experts have been dreaming of for decades, not to mention my own, down to earth economic pleas to public authorities to invest more in public research . But as time went by and the scientific comments and expertise given on television and radio in my two home countries, The Netherlands and Belgium, and neighbouring Germany and France, became dominated by each country’s own, national virology and epidemiological experts explaining how their country’s approach on “flattening the curve” and bringing down the reproduction rate was best, it became clear, even to a non-expert in the field like myself, that many of the science-based policies subscribed to contain COVID-19 were first and foremost based on ‘hypotheses’. With the exception of Germany, not really on facts. And as Anthony Fauci, the director of the US National Institute of Allergy and Infectious Disease, probably the world’s most respected virologist once put it: “Data is real. The model is hypothesis”. So at the risk of being an ultracrepidarian – an old word which has suddenly risen in popularity – it seemed appropriate to have a closer, more critical look at the science-based policy advice during this COVID-19 pandemic. For virologists and epidemiologists, the logical approach to a new, unknown but highly infectious virus such as SARS-CoV-2, spreading globally at pandemic speed, is ‘the hammer’: the tool to crush down quickly and radically through extreme measures (social distancing, confinement, lockdown, travel restrictions) the spread of the virus and get the transmission rate’s value as far as possible below 1. The stricter the confinement measures, the better. For a social scientist and social science-based policy adviser, a hammer represents anything but a useful tool to approach society or the economy with. Her or his preference will rather go to measures, such as ‘nudges’ which alter people's behavior in a predictable way without coercion. Actually, the first COVID-19 measure was based on a typical ‘nudge’: improving the hand hygiene among health care workers which was now been enlarged to the whole population. ‘Nudging’ in the face of a new virus such as SARS-CoV-2 will consist of making sure, incremental policy measures build up to a societal behavioural change, starting from hand hygiene, social distancing, to confinement and various forms of lockdown. It will be crucial to measure the additional, marginal impact of each measure in its contribution to the overall reduction in the transmission of the virus. Introducing all measures at once such as in the case of the ‘hammer’ strategy provides subsequently little useful information on the effectiveness of each measure, on the contrary. In a period of deconfinement, one now has little information on which measures are likely to be the most effective. From a nudging perspective, achieving a change in social behavior with respect to physical distancing: the so-called one-and-a-half meter society, will be an essential variable and measuring its impact on the spreading of the virus crucial. One of the reasons is that full adoption of such physical distancing automatically and without the need of coercion, will prevent the occurrence of large or smaller social gatherings without authorities having to specify the rules. This is implicit in the principle of nudging: it will be the providers, the entrepreneurs of personal service sectors which will have to come up with organisational innovations enabling physical distancing in the safe delivery of such services. But most noteworthy is the purely national setting within which most virology and epidemiological science-based policy advice is currently framed. This contrast sharply with the actual scientific research in the field which is today purely global, based on shared data and open access. For years now, epidemiological studies have taken individual countries as ‘containers’ for data collection and data analysis. It is also the national setting which provides the framework for estimating the capacity of medical facilities, especially the total number of available intensive care units needed to handle COVID-19 patients in each country. In the case of Europe and as a result, it has led to the reintroduction of internal borders which had ‘disappeared’ 25 years ago for fear of cross-border contamination. Doing so, COVID-19 has undermined the notion of European values.