Three Steps for an Expert Response to COVID-19

Sidney Shapiro
Liz Fisher

March 25, 2020

Whatever one's political views, the end goal regarding the coronavirus (COVID-19) is the same – to minimize the number of people dying and suffering from severe disease. As commentators have repeatedly noted, we need genuine expertise for that. Beyond involving scientists and physicians in decision-making, there are three steps in determining what that expertise should look like and how we tap into it most effectively.

First, the experts can inform decision-making, even if uncertainty will remain. While we can all agree on the end point – no one dying – how to get there is not clear, even to the experts. Rigorous expert judgment and a respect for science are therefore required. Expertise is developed not just from professional training, but from experience in using that training over and over, building up a store of experience that makes one a better expert.

Ultimately, however, the choices in uncertain situations are the province of democratically elected leaders. Much as a patient in a physician's office must choose a path of treatment based on the doctor's advice, elected leaders must make decisions affecting an entire population. These choices are ripe for controversy because there is no one obvious choice about how best to stop the spread of COVID-19 in a way that minimizes disruption of the economy and our daily lives.

But none of that obviates the needs for decision-making to be informed. Rather, decisions made on behalf of an entire population need to be even better informed. More than that, in a democracy, the public is entitled to transparency and to candor. The necessity of relying on expertise cannot be used as a justification for not explaining resulting policies.

Second, a broad range of expertise is needed. Policymakers need information and advice concerning how deadly the disease is, how it can be treated, and how its future trajectory is modelled. There must also be an understanding of how people are infected; what the best and safest ways to diagnose people are; and what measures are practically possible to limit the spread of the virus.

To generate this knowledge, the government needs to draw on a range of disciplines, experiences, and types of knowledge. Much of this already exists, and some of it is being assembled as quickly as possible. That might mean that expertise and knowledge required to make cogent policy choices change and evolve.

Finally, the expertise needed to develop the comprehensive response to COVID-19 cannot be siloed. The "best" response to COVID-19 will be a multifaceted approach that encompasses considerations of safety, fairness, the economy and much else besides. Various types of expertise need to be consulted and integrated. An institutional structure is needed to bring this expertise together for making practical, lifesaving decisions.

This process is challenging. It requires integrating models, statistics, economic analysis, and psychological insights. It also requires integrating information from a diverse range of international, national, and private institutions. That process needs to be quick, and it needs to be iterative. Mistakes will be made, so learning from mistakes is needed.

The good news is that such structures do exist. Integrating expertise for decision-making is at the heart and soul of the administrative state. True, President Trump has attempted to deconstruct that state, and is generally contemptuous of the notion that somebody else might know more about a topic than he does, but government's expert capacity and its architecture still exist. The government has built up its expertise over the last 200 years. It rests not just in particular expert staff members, but organizational structures, committee, structures, civil service professionalism, accountability processes, and much else besides.

To move ahead, it is not enough to say we need expertise. Elected leaders need to be informed by expert judgment, expert judgment should be based on the integration of available knowledge, and the choices that are made should be explained to the public. While none of this is easy, particularly under crisis conditions, it is what government has done in the past and what it can do now.

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