In late 2019 in Wuhan, China, a new severe acute respiratory and multi-organ disease was identified named COVID-19, caused by the coronavirus SARS-CoV-2. The WHO declared the outbreak of a pandemic on 11 March, and called countries to take urgent and vigorous action. It is now a major public health crisis throughout the world, and is also predicted to have major impacts on European societies and economies.
The SARS-CoV-2 virus is a pathogen previously unknown to science and medicine. To date, there is still a dearth of information on the virus itself, the spread of the disease, and the causes of excess deaths. Looking beyond the chain of infection, there is limited understanding of how the measures that have been taken to fight the pandemic are disrupting health systems, businesses, trade chains, and society more generally, as well as how all of these interconnect with each other. Regarding the future, the possibility exists that societies will have to live long-term with COVID-19.
It will take time for scientific knowledge to be advanced to a level that will allow the disease to be kept under control. Nevertheless, evidence from science, which is often required at short notice, is crucial to help develop sound public policy. It raises the question of how scientific advice can be best given to European policy makers when knowledge is fast evolving, risks are large, and evidence is preliminary and limited. This question is particularly difficult because there are many uncertainties, outcomes and risks that need to be considered as well as at times limited scientific evidence, which means politicians have to face difficult trade-offs sometimes requiring controversial and unpopular decisions.
The COVID-19 pandemic has been with us for some months now, and the Group of Chief Scientific Advisors (GCSA) of the European Commission, who tend to work on long-term issues, has decided that it is now time to learn from experience to date, about giving scientific advice concerning this ongoing crisis. Giving scientific advice in complex and uncertain circumstances such as the current pandemic, was the subject of an Opinion “Scientific Advice to European Policy in a Complex World” prepared by the Group of Chief Scientific Advisors (GCSA) of the European Commission, published in September 2019. In the present Statement the GCSA draw on the principles generated in that Opinion with inputs from Peter Piot (special advisor to the European Commission’s President Ursula von der Leyen on the response to the coronavirus and COVID-19), and the European Group on Ethics in Science and Technologies draw on their Statement “European Solidarity and Protection of Fundamental Rights in the COVID-19 Pandemic”, to explain how science advice can be best provided to help policy makers cope with the COVID-19 crisis.
To help policy makers manage a viral epidemic such as COVID-19, scientific advice needs to address a number of crucial issues. First, there is a need to understand the SARS-CoV-2 virus and the disease that it causes: how does it infect; what is the way and the rate of transmission in populations; what are the severity and long-term health effects of the disease; how can the virus be detected; how does the virus evolve? Answers to these kinds of questions are required to properly model the pandemic so appropriate social measures can be recommended taking into account fundamental rights and freedoms to contain and flatten the curve of infection, to avoid overwhelming health care systems and to preserve lives.
However, when knowledge is only partial as it is at the beginning ofa pandemic, scientific understanding may be limited and modelling is imprecise with significant margins of error, and so advice may well change as knowledge improves. A second issue important for managing the pandemic is the development of treatments that can reduce or eliminate the virus, or can ameliorate symptoms of the disease. Because of the length of time it takes to develop drugs, the main option initially is re-purposing of pre-existing drugs. Subsequently, treatments can be designed that are more specific to the virus, but that is a longer term solution. Third, is the development of a vaccine, which depends on knowing how the immune system can mount a defence against the virus, and how that immune response can be best stimulated. Vaccines also take time to develop, to test, and to scale-up for use at the population level, and indeed may not be developed at all. Fourth, is understanding and advising on the impact the pandemic and the containment measures can have more generally on society, for example on other human health conditions and their treatment, on the quality of lives, on policies, economies, and fundamental rights and freedoms. A fifth issue is the need to use systems approaches to address the two way feedbacks and interactions between societies and the disease as societies respond to the threat of COVID-19. The pandemic itself is evolving, partly because of changes in the virus and the disease it causes, and partly because of the personal and societal measures put in place to control the infection.