What could virologists do better in the future?
>> To say it right from the start: Virology and disease control are like ringing a bell and riding a bicycle: The former is necessary, but not sufficient. And to stay with the analogy: just because you can ring a bell doesn't mean you can ride a bicycle or build a building.
Therefore, the first part of the short answer is: Next time, stick to your last. Virologists are more concerned with viruses than with applied infectiology. In this respect, however, many of the prominent virologists are no different from their colleagues in other highly specialized medical disciplines: Only a few in Germany have practical knowledge and experience in epidemic control in general (and even fewer in pandemic control specifically). Nevertheless, many of those approached by politicians had an answer to (almost) every question on the broad spectrum of epidemic control, no matter how far removed from their own core competence. Most astonishing, however, was that the majority of existing knowledge on pandemic control, and even the German government's own pandemic plan, was simply ignored or, in the worse case, not even known.
The second part of the short answer actually applies to all medical disciplines: Only advise politicians with a transparent, structured process for knowledge acquisition and strategy development. Based on a clear objective, several alternative control options should be advocated for interdisciplinary political decision-making, with identified advantages and disadvantages that take social, medical, and civil rights concerns into account. Use the spotlight on yourself and your discipline to demand scientific discourse and the structures and processes for interdisciplinary collaboration.
The second part is much more important in determining future success: In a robust crisis management system, there is less likelihood of a dominance of individual experts who are often not experts in the field, of advice without clear objectives, of a lack of discourse, of recommendations without alternatives, of a lack of analysis of advantages and disadvantages and of collusion between
Politics and science. How to structure national management in crises can be found in textbooks.
Here is another example specifically for Covid-19
from March 2020, which I can really recommend from my own experience; also for the federal structures in Germany: “Covid-19: Crisis Management Structures” (1).
The informed reader remains embarrassed to compare the situation created by politicians in Germany with this structure. What becomes clear here, among other things, is that expert advice for a government in crisis is not a hobby, but a 24/7 business, and the crisis management team should not necessarily be headed by a medical professional.
In my view, virologists, just like some modelers, physicists, and other basic scientists, are not the reason for the ignorance, incompetence, intolerance, and refusal to engage in discourse that initially led to one-sided policy advice and subsequently to a perceived media channeling. Rather, the fish starts to smell at the head here, too, due to suboptimal processes and structures of policy advice at best. Can virologists or other scientists, some of whom are not specialists in their field, be accused of having too little knowledge of political decision-making and the fundamentals of scientific advice and of allowing themselves to be co-opted by politics? Most likely not at the beginning, but after a university degree, the tools should be in place to at least become clear, after a few weeks, about the extent of the need for interdisciplinary work and the existing knowledge on the topic: in other words, to know what one doesn't know. This should then lead to a demand for politicians to establish appropriate structures and processes for advice.
In one area, virology, together with other infectious disease disciplines, must contribute far more next time and assume a leading position: in the development of a national research concept. Of course, this would also have to initiate political crisis management. Ultimately, evaluating the control status and progress is an essential component of national pandemic response and part of "good public health practice" to safeguard public health. Furthermore, a national research catalog on epidemiology and control is needed, which, updated throughout the phases of the pandemic, prioritizes the most pressing issues in practical disease control. This catalog provides the basis for the allocation of funds for applied research and the national coordination of pandemic-related research. Germany provided the knowledge on which receptors SARS-CoV-2 viruses primarily bind to, and England provided the information on new virus variants and their epidemiological properties, which is important for control. If politicians again fail to demand anything here, scientific medical societies can significantly improve the data basis for policy advice by taking more initiative.
However, I believe that in the next pandemic, most countries will again, as the Swedish perspective puts it, “participate in a risky, unprecedented experiment” (2), by relying on science to overturn established knowledge, following political instinct, and making crisis decisions at enormous cost to taxpayers based on maintaining political power.