In Science We Trust? Science Advice and the COVID-19 response in the Philippines

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19th June 2020

Kristoffer B. Berse

University of the Philippines

Kris is an Associate Professor at the University of the Philippines-National College of Public Administration and Governance (UP-NCPAG) and concurrent Director for Research and Creative Work of the UP Resilience Institute (UPRI).

In many parts of the world, science has guided governmental response to the ongoing COVID-19 pandemic. The United Kingdom, for example, has activated its Scientific Advisory Group for Emergencies (SAGE), albeit not without issues, to inform decisions of the Cabinet Office Briefing Room (COBR). Elsewhere, scientists have taken center stage in the fight against COVID-19, from Beijing and Berlin to Singapore and Seoul to Washington and Wellington.

The same is true in the Philippines, even if its approach has been observed to be largely military-oriented. No less than Pres. Rodrigo Roa Duterte himself has said that the government’s decisions with respect to the enforcement of community quarantine protocols will be guided by science, a point that has been reiterated by members of his Cabinet.

The country’s ad-hoc policymaking body, the Inter-Agency Task Force for Emerging Infectious Diseases (IATF-EID), is headed by the Secretary of the Department of Health (DoH)—who is a medical doctor by profession—and aided by a group of scientists from the government, academe and private sector in analyzing epidemiological data. The DoH has publicly acknowledged these entities, which officially comprise the IATF’s Sub-Technical Working Group (Sub-TWG) on Data Analytics, in its press release dated 7 April 2020.

Data analytics as science advice

In the Philippines, government science advice to inform COVID-19 response falls primarily on the lap of the aforementioned Sub-TWG. Members of the Sub-TWG operate independently, but they supposedly coordinate among themselves to enrich each other’s work. In the words of DoH Sec. Francisco Duque III, “each group worked on their different models using technologies available to them… [resulting in] increased rigor for each team’s output.”

The set-up, however, did not seem to work right away as early projections of the groups differed substantially. One group estimated that as much as 1.5 million people in metropolitan Manila could be infected by the time the epidemic reaches its peak around mid-May, if no interventions were made to control the transmission of the disease. This number, which accounts for about 10 percent of the metropolis’ estimated daytime population, includes those who might not be detected for one reason or another.  Another group yielded a much higher estimate of 4 million cases at peak day, which could happen around first week of June 2020.

These COVID-19 projections for the National Capital Region (NCR) were starkly higher than the results from other models outside the Sub-TWG. For example, three independent groups from the University of the Philippines (UP) projected a much lower peak size for Metro Manila at 120,000-550,000 cases sometime between April and June.

At the national level, a third group from the Sub-TWG estimated that as much as 23-29 million could get infected at peak day, which could happen from August to September 2020. This is approximately one-fourth of the country’s total population. The same group, headed by a government think tank, would later adjust the projections at around 18.9 million, with the peak expected to occur in the month of August 2020.

The appropriation of scientific analysis for decision-making raised another red flag when the government decided to place some areas under Enhanced Community Quarantine (ECQ) without any evidence of increasing community transmission. The IATF supposedly adopted a decision matrix developed by a private contractor that belongs to the Sub-TWG, but other factors seem to come into play, given the inclusion of low-risk provinces under the ECQ. The soundness of using case doubling time as one of the parameters in the decision matrix was also questioned by some quarters.

Over the course of three months since the government confirmed community transmission, data-related issues have surfaced, seeding doubts on the accuracy and truthfulness of evidence being provided by the government. The opprobrium reached its peak when the DoH started selling the narrative that the Philippines is already in the so-called second wave. The public, independent experts, and even other high-ranking members of the IATF quickly rebutted this assertion, pointing to the factual impossibility of three imported cases in January constituting an epidemic wave. In response, the DoH and its allied experts attempted to insist on their storyline by conjuring alternative scenarios and terms that further fanned public’s distrust in the government’s overall management of the crisis.

Perils of an exclusivist structure

At the outset, the convergence of epidemiological models is important to lend credence to the science that should guide the decisions of the government. In crisis management, this first step is critical in order to establish a Common Operating Picture (COP) against which all response actions should be based from. Without a clear and unified picture of what lies ahead, the government may run blind after an invisible enemy, completely unsure of its directions.

The structure of the Sub-TWG is partly to blame. While its members were supposedly volunteer groups, no other entities were allowed to join up to now. Most members are also bound by non-disclosure agreements that preclude the possibility of sharing data and methodologies. And until recently, it has not been flexible and transparent enough to accommodate peer review from other stakeholders. The seemingly highly exclusive and closely guarded membership of the Sub-TWG makes it somewhat similar to UK’s SAGE except that it does not have a physical structure and has been non-existent until COVID-19 happened.  

The need for an open system is critical in a fast-evolving, yet likely protracted, crisis like the COVID-19 pandemic. It allows for quicker analyses and cross-validation of findings thereby improving quality of science advice and ultimately facilitating faster relay of scientific insights to decision-makers.  The equation is simple enough: more brains means more insights and fewer errors.

Yet even in the face of mistakes, science advice is not infallible. Science, after all, is provisional. Findings are not etched in stone as these are only as good as the best available data around. This means that it is acceptable for science to admit mistakes in light of new or more compelling evidence. Doing otherwise will not only be detrimental to the integrity of science advice provided to the government, but will also jeopardize the legitimacy of government actions following such advice. This is what happened in the Philippines when government-affiliated experts defended an erroneous declaration of DoH, rather than admitting a mistake and making the needed correction.

Post-normal science in a new-normal world

The COVID-19 crisis has popularized a term that disaster and climate change scholars have been tossing around for quite some time now: the new normal. It refers to new conditions, usually brought about by intensifying climate-related extreme and slow onset events, that require us to adjust our approaches, sometimes drastically, in managing disaster risks. In the larger scheme of things, the US military had popularized a nice term for it: VUCA, a world that is characterized by volatility, uncertainty, complexity, and ambiguity.

What SARS-COV-2 has brought upon us is even more far-ranging. It strikes at the heart of how our societies are built: social interaction. In order to contain the spread of the virus, we have been taught to curb that very foundation of our cities and communities through a plethora of terms: social/physical distancing, lockdown, community quarantine, herd immunity, isolation, mass testing, and contact tracing, to name some. Unlike the coronavirus, most of these concepts are not novel in certain professional and academic domains, but it is only now that they have entered public consciousness.

One fairly old idea that has yet to gain currency in public discourses is post-normal science. Funtowicz and Ravetz introduced it in 1993 to refer to the kind of science needed when factual uncertainties and societal implications of scientific findings are high. Under such an environment, contestations of evidence due to differences in values and norms are par for the course, if not a sine qua non, to inform policy decisions within a short timeframe.  In response to a post-normal pandemic like COVID-19, a group of scientists has already pushed the idea of an extended peer community, wherein experts of various scientific disciplines, mass media, and the community at large are given a say under the rubric of deliberative democracy.

The need for transdisciplinary collaboration to guide COVID-19 responses is important. The ongoing pandemic is a public health issue that has short- and long-term spillover effects on the economic and social well-being of modern societies. Tackling it requires multiple expertise closely working together from epidemiology, emergency medicine, economics, public policy, communication, social work, psychology, public safety, mathematics, statistics, and disaster science, among others. The challenge then is how to make this collaboration happen under a high-stress environment that requires quick analysis and advice to inform decision-making.  

Transdisciplinary platform for expert advice

To deal with future perturbations, we need to institutionalize a platform that would allow experts from different disciplines to collectively and independently assess the situation and determine possible solutions. Correcting for the shortcomings of the current IATF Sub-TWG set-up, this mechanism can be activated in times of compound disasters and other complex emergencies like COVID-19. The current pandemic is not just an ordinary biological disaster, it is a complex crisis that affects various aspects of society at all tiers of governance, from national down to the lowest political unit. 

The UK’s SAGE can be one model, as previously proposed by a group of UP professors. However, lessons from institutional transplantation have taught us to be extra cautious in adopting external structures. For one, the British model assumes an embedded science advisor at the highest political office and similar positions at the ministerial level, features that are absent in the current Philippine administrative system.  

It does not help that SAGE itself is fraught with issues as of late, such as lack of transparency and accusations of political interference. These structural problems are the very same concerns that the UP COVID-19 Pandemic Response Team, a group of volunteer faculty, students and alumni, have alluded to when they identified prevailing data issues that hamper the Philippines’ response to the pandemic.

There are various models for government science advice that we can further explore to suit the unique institutional structures and cultures of the Philippines’ separate but closely related disaster risk reduction and crisis management systems. Truth is, we may not need to look overseas for exemplars as we have existing systems in place to mainstream science advice in disaster policy- and decision-making. For example, tweaking the National Disaster Risk Reduction and Management Council structure, which has a seat for an academic representative, might do the trick. This national set-up is replicated by law at the provincial, city and municipal levels.

The experience of the Philippines in fighting the COVID-19 pandemic points to the inadequacies of an ad hoc and closed government science advice structure. In crisis situations where competing values are prevalent and time is a luxury, the “paradox of scientific authority” can only be minimized if the mechanism for government science advice is transdisciplinary, transparent, and independent.  Science loses its legitimacy the moment it forms a protective, exclusivist silo and becomes subservient to a political objective.

 

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Kris is an Associate Professor at the University of the Philippines-National College of Public Administration and Governance (UP-NCPAG) and concurrent Director for Research and Creative Work of the UP Resilience Institute (UPRI). He is an IRDR Young Scientist and was one of the inaugural Research Associates of the International Network for Government Science Advice (INGSA) in 2018-2019. He is a member of the UP COVID-19 Pandemic Response Team.

The author is grateful to the comments of Grant Mills and Dr. Jomar Rabajante in improving this article. However, the views and opinions expressed here, including errors, are his alone and do not necessarily reflect the official policy or position of his organizational affiliations. This thinkpiece is part of a larger ongoing study by the author on the subject.