The challenges facing evidence-based decision making in the initial response to COVID-19

Rubin, Olivier; Errett, Nicole A.; Upshur, Ross; Bækkeskov, Erik

doi:10.1177/1403494821997227

Cited by 18 publications

(9 citation statements)

References 37 publications

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“…Healing society should focus on people's dignity, rights, values, and humanity ( 370 ). Concurrently, it becomes imperative to use evidence-based policy and decision making ( 359 , 371 ) and reflexivity ( 13 ), as used in the EM process ( 363 ).…”

Section: Discussionmentioning

confidence: 99%

Aggressive measures, rising inequalities, and mass formation during the COVID-19 crisis: An overview and proposed way forward

Schippers

Ioannidis

Joffe

2022

Front. Public Health

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A series of aggressive restrictive measures were adopted around the world in 2020–2022 to attempt to prevent SARS-CoV-2 from spreading. However, it has become increasingly clear the most aggressive (lockdown) response strategies may involve negative side-effects such as a steep increase in poverty, hunger, and inequalities. Several economic, educational, and health repercussions have fallen disproportionately on children, students, young workers, and especially on groups with pre-existing inequalities such as low-income families, ethnic minorities, and women. This has led to a vicious cycle of rising inequalities and health issues. For example, educational and financial security decreased along with rising unemployment and loss of life purpose. Domestic violence surged due to dysfunctional families being forced to spend more time with each other. In the current narrative and scoping review, we describe macro-dynamics that are taking place because of aggressive public health policies and psychological tactics to influence public behavior, such as mass formation and crowd behavior. Coupled with the effect of inequalities, we describe how these factors can interact toward aggravating ripple effects. In light of evidence regarding the health, economic and social costs, that likely far outweigh potential benefits, the authors suggest that, first, where applicable, aggressive lockdown policies should be reversed and their re-adoption in the future should be avoided. If measures are needed, these should be non-disruptive. Second, it is important to assess dispassionately the damage done by aggressive measures and offer ways to alleviate the burden and long-term effects. Third, the structures in place that have led to counterproductive policies should be assessed and ways should be sought to optimize decision-making, such as counteracting groupthink and increasing the level of reflexivity. Finally, a package of scalable positive psychology interventions is suggested to counteract the damage done and improve humanity's prospects.

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Section: Discussionmentioning

confidence: 99%

Aggressive measures, rising inequalities, and mass formation during the COVID-19 crisis: An overview and proposed way forward

Schippers

Ioannidis

Joffe

2022

Front. Public Health

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“…Our interviewees, particularly those from LMICs, emphasised challenges associated with accessing and assessing evidence itself, the foundation of EIDM. An emphasis on science and evidence translation, while important, should shift to include how experts process, understand and synthesise evidence for decision-making in a high uncertainty and evolving public health policy environment 6 19 20. For example, interviewees expressed challenges with conflicting evidence, including inability to compare or weight studies that came to disparate conclusions using incongruent approaches or in different contexts, that lacked scientific rigour or integrity, or that were released without standard quality control processes (eg, peer review).…”

Section: Discussionmentioning

confidence: 99%

“…In the context of pandemics, rapidly evolving research environments, as well as the at times contentious sociopolitical context in which public health policy decisions must be made, create unique challenges for EIDM processes 5 6. Recent research and discussion specific to COVID-19 pandemic decision-making highlight concerns associated with the timing of response decisions, confusion and missed opportunities regarding levels of government responsible for and involved in decision-making, capacity to respond, communication around COVID-19-related guidance, and the use of discourse among authority figures to justify singular COVID-19 response options without attention to alternative policies 7–10.…”

Section: Introductionmentioning

confidence: 99%

Challenges to evidence-informed decision-making in the context of pandemics: qualitative study of COVID-19 policy advisor perspectives

et al. 2022

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IntroductionThe exceptional production of research evidence during the COVID-19 pandemic required deployment of scientists to act in advisory roles to aid policy-makers in making evidence-informed decisions. The unprecedented breadth, scale and duration of the pandemic provides an opportunity to understand how science advisors experience and mitigate challenges associated with insufficient, evolving and/or conflicting evidence to inform public health decision-making.ObjectivesTo explore critically the challenges for advising evidence-informed decision-making (EIDM) in pandemic contexts, particularly around non-pharmaceutical control measures, from the perspective of experts advising policy-makers during COVID-19 globally.MethodsWe conducted in-depth qualitative interviews with 27 scientific experts and advisors who are/were engaged in COVID-19 EIDM representing four WHO regions and 11 countries (Australia, Canada, Colombia, Denmark, Ghana, Hong Kong, Nigeria, Sweden, Uganda, UK, USA) from December 2020 to May 2021. Participants informed decision-making at various and multiple levels of governance, including local/city (n=3), state/provincial (n=8), federal or national (n=20), regional or international (n=3) and university-level advising (n=3). Following each interview, we conducted member checks with participants and thematically analysed interview data using NVivo for Mac software.ResultsFindings from this study indicate multiple overarching challenges to pandemic EIDM specific to interpretation and translation of evidence, including the speed and influx of new, evolving, and conflicting evidence; concerns about scientific integrity and misinterpretation of evidence; the limited capacity to assess and produce evidence, and adapting evidence from other contexts; multiple forms of evidence and perspectives needed for EIDM; the need to make decisions quickly and under conditions of uncertainty; and a lack of transparency in how decisions are made and applied.ConclusionsFindings suggest the urgent need for global EIDM guidance that countries can adapt for in-country decisions as well as coordinated global response to future pandemics.

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“…Healing society should focus on people's dignity, rights, values, and humanity (Gupta et al, 2021). At the same time, it becomes imperative to use evidence-based policy and decision making (Eden & Wagstaff, 2021;Rubin et al, 2021), such as reflexivity (Schippers & Rus, 2021), as used in the emergency management process (Redman, 2021).…”

Section: Possible Ways Forwardmentioning

confidence: 99%

Aggressive Measures, Rising Inequalities and Mass Formation During the COVID-19 Crisis: An Overview and Proposed Way Forward

2022

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The challenges facing evidence-based decision making in the initial response to COVID-19

Cited by 18 publications

References 37 publications

Aggressive measures, rising inequalities, and mass formation during the COVID-19 crisis: An overview and proposed way forward

Aggressive measures, rising inequalities, and mass formation during the COVID-19 crisis: An overview and proposed way forward

Challenges to evidence-informed decision-making in the context of pandemics: qualitative study of COVID-19 policy advisor perspectives

Aggressive Measures, Rising Inequalities and Mass Formation During the COVID-19 Crisis: An Overview and Proposed Way Forward

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