Just as we were getting over the tyranny of distance, another has emerged to make life incredibly difficult for ordinary folk: the tyranny of experts.
When the pandemic first emerged, some high-profile journalists rejoiced that so-called experts were now in charge. At last, experts were dictating policy and this principle must be extended to climate change policy — we listened to the experts on coronavirus, it’s time we heard them on climate change.
But the so-called expert opinion when it comes to COVID-19 is just a motley mess of differing views often using inappropriate modelling and silly assumptions. The carry-on by local epidemiologists has made economists look good. And don’t forget that you can lay all the economists in the world head to toe and they still won’t reach a conclusion.
It’s not just the howlers, such as the Doherty Institute mixing up total number of hospitalisations with intensive care unit admissions and thereby frightening the pants off governments.
It turns out the figure of 36,000 was not the number of ICU beds required — there were only 4000 ICU beds at the time — but the maximum possible number of people with the virus requiring hospital care at any time.
It also is not just the fact many epidemiologists and, for that matter, state chief health officers have zero clinical experience, including in infectious disease management. For many it’s simply a mathematical game and cranking the handle of their preferred models. But the public exposure, if not adulation, is a plus many have enjoyed.
The tragedy is that our political leaders, particularly at state level, have insufficient nous to see through what is served up by “experts” while meekly claiming the “science” has made them impose the unbearable draconian restrictions, particularly where restrictions can be marketed in ways that make them politically attractive as well. The process may be coming to an end in Victoria, but there is no doubt Daniel Andrews initially found no problem wrapping up frightening “expert” opinion with the image of a strong leader solely concerned about the welfare of his people.
When it comes to the epidemiologists, there clearly are large divisions among them, particularly in relation to the elimination-versus-suppression strategy, the appropriate modelling approach and the need to take into account the wider effects of any measures imposed, including on other health outcomes and the economy.
There’s the sky-is-about-to-fall gang and the more measured group. University of Melbourne professor Tony Blakely, commissioned by the Victorian government to undertake the latest modelling underpinning the highly contested future road map, is in the first group. Australian National University professor Peter Collignon is much more measured, seeing the bigger picture.
Then there is Stephen Duckett of the Grattan Institute, who calls himself a health economist — he is definitely not an epidemiologist — who has argued for zero COVID-19 cases irrespective of the economic consequences. This is notwithstanding other Grattan staff arguing for even more government spending to counter the negative economic consequences of the restrictions. Go figure.
A key problem with the modelling exercises undertaken to justify harsh actions by governments is that underlying assumptions are unclear. There also seems to have been little learning from the course of the disease. Initially, it was fair enough to paint the worst-case scenario in which our hospital system might be overwhelmed and act to increase our ICU capacity, purchase personal protective equipment and other items, and ensure adequate staff.
We have learned much since. The virus is highly infectious though not very lethal, but it remains a problem for older people and those with certain comorbidities. This points to targeted, more nuanced approaches than those undertaken by state governments.
The modelling underpinning the Victorian government’s latest policy proposals is based on a core assumption not supported by the facts. As University of Toronto professor Josh Gans notes, the model assumes that everyone, directly or indirectly, eventually runs into everyone else. If we look at the geographical incidence of the virus and known patterns of movement by Victorians, this is just wrong. The alternative susceptible, infected and recovered individuals modelling approach would yield different policy implications, including the need for local hotspot identification and graduated local responses.
Not that the tyranny of experts is confined to Victoria. In Queensland, justification for closed state borders becomes more ridiculous as the weeks pass. But the “intimidated but I won’t be intimidated” Premier, Annastacia Palaszczuk, blames the Chief Health Officer. This person has no expertise in infectious diseases, almost no clinical experience and has been in the job almost two decades. Her capacity to justifiably demand state borders be closed to protect public safety must surely be open to question. And her excuse for allowing some into the state — AFL royalty, celebrities, the wealthy — is laughable. According to this faux economist: “We need every single dollar in our state.” The mind boggles — how many more dollars does she think have been forgone by the border closures?
What governments should have requested after the first phase of the pandemic, and when appropriate resources were in place, was analysis from epidemiologists and economists working together to manage the virus at the lowest cost. And note the economic damage wrought is already substantial, long-lasting and uneven in impact.
Instead of our governments managing the virus relatively well — with the exception of Victoria — at a high economic cost, there was an alternative of managing it at a much lower cost.
When a politician says experts are in charge or the “science” made them do it, be suspicious. These experts don’t speak with one voice and many are peddling values they hold dear; as true with COVID-19 as it is with climate change. Politicians are elected to govern us all; this requires judgment about the trade-offs that inevitably exist with all policy decisions. The tyranny of experts needs to resisted. They may have a role to play but not in an uncontested way. And when you hear the term “evidence-based policy”, bear in mind it’s generally policy-based evidence.
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