Why Covid-19 shows governments should work closer with experts in the social aspects of biomedicine
COVID-19 shows how governments need to work more closely with experts in the social aspects of biomedicine by Martyn Pickersgill, Associate Director of CBSS
Science, technology, and medicine are embedded in all aspects of society. They make and are made through social processes, including in times of catastrophe and crisis. Governments tend to see physical and biomedical scientists themselves as the most appropriate people to shape and direct societal endeavours in relation to STEM. Too often omitted from policymaking are the insights of experts in how scientific research, new technologies, and experiences of health interweave with and reciprocally shape societies.
In the case of COVID-19, there would have been benefits from embedding social science advice more deeply within policy around the management and mitigation of the pandemic. Social scientists in the UK have held major advisory roles and undertaken vital work, yet they have commonly sat within committees where biomedical and public health researchers predominate. This is despite the fact that COVID-19 is not solely an illness of the body, but is an issue built on, and requiring, social responses.
Illness itself is intrinsically social: the emergence and transmission of disease depend on social practices, relationships, and experiences. The pandemic also creates these, with new interactions and communities forming around perspectives on what COVID-19 is (a hoax, the worst threat to society we have ever seen, and everything in between), as well as around if and how it can be prevented and treated. Valuable research on these and other areas is being undertaken by social scientists across specialisms. This includes work on the role of the pandemic in exacerbating inequalities, reshaping international relations, perceptions of risk, and the rise of self-treatment. Such scholarship impinges on national and transnational policy across many dimensions. Politicians themselves, though, can appear reticent to seek out critical social scientific insights – or, it sometimes seems, even to acknowledge that these exist at all.
We know, for instance, that what people understand disease is will influence how they respond to measures introduced to stop its transmission, and what they will do if they fall ill. Perspectives on COVID-19, as with all illness, reflect personal and professional biographies, pre-existing patterns of communication and interaction, and trust in science, medicine, and the state. Yet, rhetoric can often reduce these complexities to simplistic characterisations of people as straightforwardly ‘misinformed’ about the pandemic, or simply ‘ignorant’.
Such caricatures can result in policy discourse that frames ‘the general public’ as a problem to be worked on. Instead, publics should be regarded as varied, knowledgeable collaborators in both setting and achieving health-related goals. Publics can also be all too readily conceived of as straightforwardly either ‘trusting’ or ‘mistrusting’ of interventions like vaccination. Trust, however, comes in many different forms and with a variety of caveats. It is also informed by prior experience. There are plenty of people around the world whose scepticism about biomedicine and politicians is entirely comprehensible.
Televised vaccinations and the trend for politicians to post ‘vaccine selfies’ on social media are an example of good intentions that take too atomised a view of trust. It’s feasible that an apparently trustworthy politician receiving a COVID-19 vaccine on TV might, perhaps, bode well for vaccine uptake among people with a particular disposition towards both vaccination and the politician themselves. However, when many viewers could well be experiencing structural discrimination at the hands of governments, we should hardly expect seismic shifts in perspective. Trustworthiness needs to be demonstrated beyond one-off messaging – and never merely asserted.
Central as health scientists and good policymakers obviously are to tackling the pandemic, neither are alone best placed to fully comprehend the extent and nature of the disruptions that COVID-19 has had on society. The management of the pandemic requires expertise in the social aspects of biomedicine, including medical anthropology and the sociology of health and illness. Social scientists can surface concerns and issues that might not be visible within a primarily biomedical or public health framing. They can provide valuable data and insight to shape decision-making about how to intervene in the pandemic. Just as importantly, they can also provide data and theory-derived analysis of what the consequences of different kinds of action might be. As concerns continue to grow in many nations that people are not taking up vaccines for COVID-19, for example, politicians and civil servants should be engaging very closely with social scientists who have extensively researched public perspectives around vaccination to inform roll-out. Such experts must have an institutional platform upon which to make themselves heard, and from where they have to be heeded.
Expertise from beyond biomedicine and public health needs to be leveraged to enhance the health of publics.