Public health decisions in the COVID-19 pandemic require more than ‘follow the science’

Abstract

Although empirical evidence may provide a much desired sense of certainty amidst a pandemic characterised by uncertainty, the vast gamut of available COVID-19 data, including misinformation, has instead increased confusion and distrust in authorities’ decisions. One key lesson we have been gradually learning from the COVID-19 pandemic is that the availability of empirical data and scientific evidence alone do not automatically lead to good decisions. Good decision-making in public health policy, this paper argues, does depend on the availability of reliable data and rigorous analyses, but depends above all on sound ethical reasoning that ascribes value and normative judgement to empirical facts.

Vaccination Is Not Enough: Understanding the Increase in Cases of COVID-19 in Chile despite a High Vaccination Rate

“…The establishment of a constitutional state of emergency for public health purposes only a year after similar measures had been taken for social unrest further deepened the preexisting inequalities. The most vulnerable, i.e., those experiencing poverty, overcrowded living conditions and malnutrition and relying on informal sector jobs were the hardest hit by the pandemic, a reality that reflected the wider debate in Chile about the country's inequalities [18,19]. Despite Chile having relatively low levels of informal labour (30%) compared to Latin America (53%), many women and men could not stay at home since they need to earn an income to feed themselves and their families, as most of them cannot rely on income replacement or savings [20].…”

New Frontiers in Biosafety and Biosecurity

“…It implies that “correct” decisions are reached solely by rigorous scientific analysis and reliable data. However, good decision-making “depends above all on sound ethical reasoning that ascribes value and normative judgement to empirical facts” ( Cristina de Campos-Rudinsky and Undurraga, 2021 ). Data on the reliability of tests for a virus and the efficacy and safety of a vaccine alone cannot determine whether particular people ought be tested or vaccinated.…”

Post-COVID-19 WHO Reform: Ethical Considerations

“…In other words, the shifting scientific evidence grounded the changing guidance in COVID-19 policies. The problem, however, was that this communication process between the scientific community and policymakers was not always accurately shared with (i.e., contextualized and explained to) all other stakeholders, including the public, and this led to the erosion of public trust in health authorities like the WHO ( de Campos-Rudinsky and Undurraga, 2021 ; Veit et al , 2021 ). A similar pattern of inconsistent recommendation and shifting messages was also observed in relation to travel bans: while not instructing countries against quarantines, WHO advised countries against travel bans pursuant to IHR.…”