A future-proof Covid policy calls for action based on different scenarios

The cafés, bars and terraces filled with people may suggest otherwise, but coronavirus is still very much with us. Whether this means the pandemic will take hold again in the coming period remains to be seen. What we do know for sure is that we will have to learn to live with the virus. This means that the government, parliament and society are facing an uncertain, complex and long-term challenge. By thinking through various scenarios for the course of the pandemic, a large number of advisory bodies are offering collective guidance on this issue. The government bears an important  responsibility for this approach, which rests on two essential elements: (1) use the good times to plan for the bad times, and (2) take a broad societal approach when considering measures, without dodging the complex choices that need to be made in the process.

We will have to learn to live with COVID-19, but at the same time we do not know how the virus will develop. It is therefore important that both government and society are prepared for different scenarios for the future course of the pandemic. In the joint report [in Dutch] Thinking through COVID-19 Scenarios: A Guide to Necessary Choices, a number of advisory bodies examine the implications of five scenarios: (1) Common cold, (2) Flu+, (3) External threat, (4) Continuous struggle and (5) Worst case.

In order to help the Netherlands prepare as effectively as possible, these scenarios have been worked through in detail for various societal domains and policy questions, providing a broad overview for areas such as the economy, public administration, healthcare, education, culture, sports, law and international relations. The scenarios have also been thought through to assess the implications for the areas of science and technology, behaviour and communication, and human rights, as well as for vulnerable groups in society, including people who are medically vulnerable and those in juvenile care facilities and prisons. In developing these scenarios, the organisations make several domain-specific recommendations and draw some overarching lessons. In addition, the report highlights two key points for a future-proof COVID-19 policy.

Use good times to plan for the bad times

Now that the infection rate is relatively low and other crises are demanding attention, there is a risk that we will pay too little attention to the possible threat posed by COVID-19. But in times of relative calm, it is more important than ever to start preparing for an uncertain future. In doing so, at least two elements are important:

  1. Invest in agility. Assuming that COVID-19 will continue to affect society in the future, it is vital to be able to move quickly and smoothly in different domains. Future agility requires investment in the present, such as a robust digital infrastructure and sufficient opportunities for retraining and upskilling.
  2. Develop legal and administrative frameworks to address a range of possible developments in the pandemic. This ensures that, even in times when the pandemic leads to a crisis, decision-making will take place within existing democratic and legal structures. Design a toolbox of measures enshrined in law and administrative structures that are equipped to address the different scenarios. However, this toolbox should also have a proper lock and only be opened in line with pre-established procedures which safeguard democratic rights.

Ensure that policy takes into account broad societal considerations, and don't avoid the complex choices that need to be made in the process

The importance of taking into account not just medical, but broad societal interests is widely endorsed. Given the fact that the virus and measures to combat the virus affect everyone, it is crucial to factor this broad impact into policy-making. At the same time, it is important to have realistic expectations of such a wide-ranging approach. Clearly, there are a great many different societal interests and this makes it impossible to decide on an approach that will satisfy everyone. Broad societal consideration means making tough choices that are bound to have adverse effects for some. It is vital not to avoid these choices, but to discuss them in a timely and honest manner. One such tough choice is whether taking a broader view of the impact on society could lead us to hold back on taking restrictive measures in the knowledge that this will lead to more patients in need than the ICU can handle.

Enlarge image plaatje artikel over Coronavirus disease scenarios for a long-term strategy under fundamental uncertainty in blad Journal of Clinical Epidemiology 2022
Image: ©Journal of Clinical Epidemiology

Frans Brom, Josta de Hoog, J. André Knottnerus, Ruth Mampuys, Tanja van der Lippe, Coronavirus disease scenarios for a long-term strategy under fundamental uncertainty, Journal of Clinical Epidemiology 2022. ISSN 0895-4356, https://doi.org/10.1016/j.jclinepi.2022.02.012.