Learning from a crisis

‘The more complete the picture, the better you can fight a crisis.’[1] With these words, the cabinet in the Netherlands acknowledged the need for more complete advice during pandemics. The Cabinet’s statement was a response to the first report of the Dutch Safety Board (Onderzoeksraad voor Veiligheid / OVV), which regarded the dominant perspective of infectious disease control at the beginning of the corona pandemic.[2] Despite the establishment of the Social Impact Team (MIT), the current advisory structure is not optimally organised. The MIT, Outbreak Management Team (OMT) and other advisory bodies advise almost exclusively from their own areas of expertise. This prevents considered advice that integrates different perspectives. As a result, the risk of a dominant perspective is still present.

The report Learning from a Crisis and the white paper Contours of Integrated Pandemic Advice describe the path and obstacles to integrated advice. Integral counselling has important advantages, including:

It can reveal the interaction between parameters from different domains. For instance, economic contraction may be exacerbated by fear of a virus. Or, reduced support for measures can increase infection spread.
It provides insight into necessary flanking policies to mitigate negative consequences of measures.
It creates the possibility of drawing up broad scenarios for the long term.
It can make social trade-offs between measures more explicit by estimating effects of measures on different collective values.

Exploiting these benefits is possible, but requires new policy and research. A cross-domain organisation for advising and knowledge infrastructure across domains is lacking. Think of a broad cohort to gain both biomedical and social as well as economic knowledge during a crisis. The report also contains a pandemic knowledge agenda with the research questions yet to be answered. This knowledge agenda identifies questions that should lead to better integrated advice and higher pandemic preparedness.

The report and white paper are an initiative of the Pandemic and Disaster Preparedness Center, The Social and Cultural Planning Office, the Council for Public Health and Society, UMC Utrecht and TU Delft. The publications are the result of extensive desk research, interviews with leading experts and working sessions with scientists from different fields.

The main lessons are as follows:

Lesson 1: Integrated advice does not occur automatically: it requires action and investment from scientists and policymakers
• Lesson 2: A joint framework for weighting advice from different scientific disciplines is feasible and can provide general guidance, also when the disciplines also continue to issue advice independently
• Lesson 3: There are still unanswered questions concerning the different facets of integrated advice and how those come together in a broadly supported, integrated decision-making framework

For the report and white paper, see the download links below.

Questions about this research and the report? Mail to Anja Schreijer, pdpc@erasmusmc.nl.

[1] Parliamentary paper 25 295, no. 1827

[2] Approach to corona crisis Part 1: until September 2020, OVV: https://www.onderzoeksraad.nl/nl/page/16666/aanpak-coronacrisis-%E2%80%93-deel-1-tot-september-2020