COVID-19: A vital lesson in the importance of science in decision-making

Len Cook
Member with Delegated Authority FOR WHAT?

Len Cook
Transparency International Member with Delegated Authority

The recognition by Ministers in New Zealand of the vital importance of our epidemiologists in tracking and modelling the path of COVID -19 has put a powerful spotlight on the cost of scientific ignorance in government decision-making around the world.

Science can be ignored even in scientifically powerful nations. The initial COVID-19 responses of the authoritarian China, the theocratic state of Iran, or the populist leadership of Donald Trump are life threatening examples.

In the face of this, New Zealand’s epidemiologists have been one of the mainstays of Ministerial decision-making, to the great credit of both. Public trust here appears to be very high causing strong compliance with the directions of the government.

Statistical Science is needed to connect COVID-19 experiences to the population at large

Currently, people typically only present themselves to the health services through showing signs of a relevant condition for COVID-19 (e.g. respiratory illness) or have been traced as a contact by someone who has tested positive with the virus. The prevalence of COVID -19 in the population is not measured by these processes. An unknown number of people will have COVID -19 but not be visible to those making policy.

This is complicated by reports that a significant portion of those who have or catch COVID -19 will be asymptomatic yet may still infect others

From what we measure now, we can validate for New Zealand the knowledge from other countries about the impact on different age groups. This includes the affected share that is likely to be asymptomatic, virus transmission rates and the duration of infectiousness.

If we could measure the prevalence in the population at large at different points of time we would have more confidence in the systemic approaches needed allowing for policy change without risk of going backwards.

What we have through epidemiology is an excellent compass, but we need a sextant – our population sampling expertise – to tell us where we are at. Without this, we are uncertain about our starting point or where we will end up. Leading epidemiologists have been calling for this for several days, and we need to recognise the risks we are running through incomplete information that is obtainable if we were to seek it. Indeed, implicit in current policy settings there is an assumption of the prevalence of COVID -19 in the population at large that we appear not have attempted to assess. And yet statistical techniques provide the means to validate.

A public health blog recently released today (Testing for COVID-19 in NZ to Achieve the Elimination Goal) which I  co-authored, notes “Closer to the point of elimination of COVID-19, a phased removal of restrictions on economic activity will start, a process that may last many months.  It will be essential during that period to have in place the means to provide public confidence in government’s capacity to ensure that isolated cases as they arise are not a reversal of elimination. Managing the oversight of COVID-19 risk as well as the public’s welfare during the very essential recovery brings difficult political choices, and building confidence in these needs to be founded on trustworthy statistics based on measurement processes that have to be more frequent and timely than we are used to.” 

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