There is little doubt that we have found ourselves in the midst of an historical event –the likes of which humans have not experienced for at least a century. The last time the human race experienced a pandemic of global proportions was back in 1918, when the Spanish flu caused huge devastation in a population that was already reeling from the unimaginable devastation brought forth by World War 1. Millions of lives were lost with a death toll estimated between 50 to 100 million: several times more than the lives lost during World War 1 or World War 2 and at least 25 times more than previous flu pandemics known to humankind.
The Spanish flu left in its wake a substantial change in how healthcare was perceived, delivered and consumed. It was in the aftermath of the Spanish flu that the collective consciousness of the world realized the importance of protecting the health of the masses, or ‘public health’. The elite could not remain protected if the masses were contagious. The emergence of socialized medicine, healthcare for all, was one by-product of the Spanish flu, initiated by Russia, then the Soviet Union, and subsequently adopted by many Western European countries. Employer-supported health care insurance schemes were another byproduct of the pandemic, adopted by countries like the United States.
The concept of preventative medicine also took root in the wake of the Spanish Flu. The powerful idea behind the concept is simple: What if measures are taken to prevent the onset of the disease before it becomes a pandemic? The push for prevention became the foundation for the field of epidemiology: the study of patterns, causes and effects in disease. The devastation brought by the Spanish flu highlighted the importance of tracking and measuring disease onsets and spread like never before. Departments of epidemiology popped up in most reputable academic institutions all across the globe. Several countries saw restructuring of health ministries and the establishment of public health departments within government machinery that relied heavily on the epidemiological studies to develop robust health care policies. National health surveys became a key method to systematically collect ‘baseline’ health datasets. The field of epidemiology highlighted that healthcare is not just about treating biological symptoms post disease onset, it is also about elevating social and occupational conditions to prevent illnesses. Talk about nipping in the bud!
If history is any indication, it would be reasonable to expect big changes coming our way post COVID-19 pandemic. Already, topics such as inequitable access to health care, health inequity within populations and across genders, coordination gaps between various levels of health care systems and lack of appropriate infrastructure for dealing with health crises at places like long-term care facilities are being heavily discussed and debated at various forums. There is also a greater recognition of mental health issues.
Simultaneously, serious reflections around how we live our lives are also taking place – most of which define the very fabric of our society. Our economic system, transportation system, schooling systems, governance systems, rural and urban planning, and our relationships with climate and food all require a reexamination. No topic is left untouched, including those related to behavioral and social norms such as work-life balance, working from home, home schooling, domestic violence, and childcare.
These are complex and highly intertwined topics. That such topics are under discussion at all levels of the society indicate that how we perceive health care is about to take another overhaul!
If we are to learn from the devastation brought by COVID-19 and if we are serious about building resilience in our infrastructures to deal with future crises, governments will need to create effective policy interventions that reconcile the scientific evidence with evolving societal values, beliefs, and priorities. Dr. Theresa Tam, Chief Public Health Officer, has already indicated: "The new normal, when we get there, is one that is not the same as before. It's one that might see our society function in different ways." It is clear that things will not return to normal for normal, had serious inadequacies.
The new normal will require serious policy interventions informed by scientific evidence and balanced with societal values, norms, priorities to buy the willingness of the public to comply. This is where science policy can help because it is at the juncture of science and its application in society (as policies) where science policy resides.
The process has already begun. Currently, almost all of the virus spread control and health care provision strategies adopted by governments around the world are informed, one way or the other, by those at the juncture of science and government policy-making. From policy measures around physical distancing to advice around wearing masks in public settings, it is scientific evidence, grounded in the knowledge of societal beliefs and priorities, that has fueled unprecedented policy recommendations – some of which will have lasting consequences on the economy and societal norms. One reason is simply because there is no vaccine for the disease available as of yet, implying that there is no shortcut to solving the crisis. The only option, then, is to navigate through the complex scientific evidence and balance it with what the masses are willing to implement collectively.
How quickly a country has contained the crisis is directly correlated to how closely the governments have listened to the scientific advice and applied it to their society’s norms, values, and priorities to come up with innovative policy interventions. The disease spread trends and evidence backs this idea. In this respect, science policy advisors have truly emerged as trusted allies in informing the government on policy solutions by balancing the dynamic relationships between complex science and the values, beliefs, and priorities of its citizenry.
As we move towards the reconstruction and recovery phase, even bolder policy interventions will be required almost certainly affecting the whole of the society. To support those bold policy interventions, established bodies and strong pools of science policy practitioners will be required at all levels of the government to contribute to the policy-making machinery. They will be essential in synthesizing the evidence from a multitude of scientific fields and in reconciling that knowledge with collective societal values, sensibilities, and priorities. The process will result in fruitful cooperation between scientists, policymakers, and the society, and will, inevitably, change the course of the society.
Intersectionality is an irreversible trend. Just as epidemiology became a recognized field of science after the Spanish flu, we will see science policy truly embedded in universities and government departments in the years to come.
It is time that science policy takes the driving seat. Make way.
1. Spinney, Laura , 27 September 2017. How the 1918 Flu Pandemic Revolutionized Public Health. Published in Smithsonianmag.com Retrieved on 28 April 2020.
2. Johnson, NPAS., Mueller, J. (2002). Updating the accounts: global mortality of the 1918–1920 "Spanish" influenza pandemic. Bulletin of the History of Medicine , 76: 105–15. DOI:.
3. Taubenberger, JK., & Morens, DM. (2006). 1918 Influenza: the Mother of All Pandemics. Emerging Infectious Diseases , 12(1), 15-22.
4. CBC News, 28 April 2020. Tam says the pandemic will bring a 'new normal' to workplaces, defends WHO's performance , Retrieved on April 30th 2020.
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