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In the media: Differences of opinion essential in critical decision-making

Vicki Thomson – The Australian – 25 March 2020

No one would want to be in the shoes of our Chief Medical Officer or members of the national cabinet as they work to steer us, as a nation, through this crisis in the safest way possible.

They seek to save us as individuals and also ­to preserve the productivity and wealth of our future economy.

To do this, they need help. They need the best medical and economic advice available, and they know that it is there for them, night or day, from our universities for as long as they need it.

This means considering the latest available data — rigorously and critically debated — and covering the range of elements that will allow governments to make informed and balanced decisions.

These expert views are not always in agreement, and the advice that is offered up to governments is sometimes a consensus but not unanimous. That should not be seen by the community as a negative. Rather, it should be seen that governments are making these complex decisions based on the very latest information — despite it being of a complex nature and changing daily.

It is government’s responsibility, through the national cabinet, to weigh up all the advice it receives and make the decisions it believes will give us the best chance of the best outcome. And we have to remember that, in the grave situation we face, there is no perfect outcome.

As governments seek all the advice they can get, the community should see differing expert views as a welcome sign that every evidence-based detail, cause, effect and unintended consequence is being debated forensically and fearlessly. Because to progress to the delivery of an advisory document to government in any other way would be unprofessional, deficient and, in the case of COVID-19, outright dangerous.

It was a throwaway line on radio early this week by one of the nation’s best-recognised medical communicators, a man of enviably simple language, Norman Swan, that caused me concern as chief executive of Australia’s leading research-intensive universities, the Group of Eight.

The radio “grab” in isolation said nothing wrong. It simply referred, as an aside, to work that the nation’s leading experts on epidemics and related disciplines had been doing — something they had given their undivided attention to for the whole of that weekend and the Friday before it.

This work had been directly requested by the Chief Medical Officer and involved very difficult questions — questions that no one around the world has yet been able to answer definitively: what level of community shutdown is required, to what extent and for how long?

There are many factors involved in these deceptively simple questions.

A “go now, go hard, go smart” approach is probably the best way of suppressing the spread of the virus, but this will result in a range of social and economic consequences that will not be trivial.

It is therefore hardly surprising that the advice provided by the Go8 universities’ expert group was not a 100 per cent definitive view.

Those who argued for a more nuanced approach came at it not as epidemiologists and public health experts fearing an Italian situation but as social scientists deeply concerned about the financially and mentally vulnerable, the lonely, and those about to ­become much lonelier as the restrictions and lockdowns become speedier and more severe.

But a throwaway radio comment that even eminent researchers could not agree with can too easily create unnecessary fear for many in the listening community.

“If they can’t agree, what hope is there for us?” is an understandable reaction. But we need to get better at letting a potentially ­nervous public know that the best minds are there to offer advice, not solutions.

The public also needs to know that by experts, we mean people who have vast knowledge of what has and has not worked in previous epidemics, such as the Ebola and severe acute respiratory syndrome outbreaks. They have seen the effect that policies have on real people in real circumstances.

But their role is to give the best available advice, not to tell governments what to do.

At this moment, our leaders do not need to be lectured or hectored by us. Advice is advice, no more, no less. There was disagreement between our experts, yes, but this was mainly to do with how to manage the impacts of a move to a full lockdown — which is also vital information for the community to know.

For governments, the choices are no less than a policy hell.

What the public deserves to know is that highly qualified experts are giving our leaders the best possible advice. And they need to know that a range of ­expert opinions from different ­angles of an issue are necessary to give our decision-makers the full picture of a complex ­situation.