If predictions of panic buying, school closures and mass self-isolation do come to pass here in the UK, we better hope we can buck the trend of disconnected policy networks that struggle to combine social and medical crisis management.
The policy response to COVID-19 across the world is unprecedented. There are many reasons for this, not least because this is no longer perceived by powerful nations as one of those epidemics that mostly affects “the other” far away, poor who are unlike “us”. This othering of victims and their governments becomes harder once your own government, school and workplace start seriously mobilising in response. ‘Super spreaders’ can no longer be portrayed as invisible people with strange customs, corrupt governments and broken health systems. The potential super spreaders are now Italian families, British MPs and students in your local University. They are us.
Can we learn lessons from the Chinese?
The irony of all this has not escaped development studies scholars and the European and US media have relatively quickly picked up on this reversal of fortunes. The Chinese response was initially criticised by some and there continues to be concern about the heavy-handed tactics of an authoritarian state. However, just over a month since the WHO declared a Public Health Emergency of International Concern (PHEIC), the debate has shifted dramatically. Now Western governments and multilaterals are increasingly asking what we can learn from the Chinese response. Despite the Italian’s quarantine of entire towns also getting labelled as “draconian,” our public health officials and media are openly discussing the possibility of future large-scale quarantine here in the UK.
A social response to COVID-19
As COVID-19 has spread the Western news coverage of evacuations, travel restrictions and the quarantine of cruise ship passengers has declined. It is being replaced with discussion about the social consequences of limiting public gatherings, the closure of schools and offices and growing hysteria. Social scientists have already been engaged by the WHO and the UK Government and set out some clear areas of concern. Many of these focus on the potentially devastating impact on low-income countries with weak health systems. However, some issues are relevant regardless of geography. These range from looking at the history of mass quarantine, focusing on the prejudice and social exclusion that results from containment measures to the need to combat misinformation and rumours.
Despite the strong interest in the social implications of COVID-19, we should not be complacent about our ability to connect expertise in this field with the clinical response. My own empirical study of the UK policy network that emerged in response to Ebola in Sierra Leone suggests that policy networks are driven by the tendency of like to attract like and protect the dominant viewpoints of their more powerful members. Despite everyone’s best efforts, the UK biomedical community never really integrated their expertise with social scientists specialised in zoonotic disease. Far from being one cohesive group, the network was divided into three distinct sub-networks, that competed to influence UK policy. For the most part, it was the epidemiologists and virologists, already well embedded in government, that got their own way.
Overcoming networked behaviour
One could argue that this is different. Ebola affected the other, was far away and required an international response. COVID-19 is on our doorstep, it requires a domestic political response that can draw upon our homegrown expertise, whatever their discipline. There are a couple of problems with this. Firstly, how likely is it that our policy makers, officials and practitioners in Public Health England, the NHS and the Cabinet Office Briefing Room A (COBRA) will really take into account the learning from other contexts such as China and West Africa? In a world in which northern expertise is still often perceived as superior, it will be hard to get some of our UK responders to sit in a room with people who are best known for their work in low and middle-income countries.
Secondly, sociological network properties are hard to overcome. Birds of a feather will flock together, (otherwise known as network homophily) and people who can broker connections between different groups tend to be few in number and unable to significantly improve network interconnectedness (homogeneity). Just because there appears to be widespread international concern with COVID-19 as a social crisis, as well as a medical one, does not mean it will be easy to create a truly interdisciplinary response. Nonetheless, whether in China or Italy, the UK or West Africa we have to try.