With the Knowledge of the Future. Science Well Prepared for Pandemics

The Covid-19 pandemic showed how important science is, for example for developing medical treatments and vaccines and for advising policymakers on complex issues. The enormous scale and rapid escalation of the crisis called for the broad deployment of scientific knowledge from many different fields. The Royal Netherlands Academy of Arts and Sciences (KNAW) therefore established a committee charged with mapping out what the Dutch scientific community needs to prepare itself (and thus to be ready) for future major outbreaks of infectious diseases.
This advisory report is not an evaluation of the Covid-19 crisis, but an analysis of the pandemic preparedness of the Dutch scientific community, or, in other words, of the pandemic research preparedness of the Netherlands, based on the experience gained since the start of the Covid-19 pandemic in 2020. It answers the following question:

In the event of a pandemic, what does Dutch science need to be able to deliver effective and robust knowledge that will help control the outbreak, protect public health and prevent social harm?

To answer this question, the committee carried out a literature review and interviewed researchers who were involved in combating the pandemic or who advised policymakers during the crisis in the Netherlands. The report addresses three topics: (1) the preparedness of researchers in the Netherlands, (2) the preparedness of the Dutch data infrastructure, and (3) knowledge-exchange between scientists and policymakers.

With regard to researcher preparedness, when the crisis began in early 2020, scientists, advisors and policymakers were able to draw on expertise about infectious disease control acquired over many years of research. As the outbreak spread and its impact became clearer, a broader range of questions emerged and finding robust answers became more difficult. Researchers had to find their way through an ever-growing number of publications, and the fight against the pandemic turned out to require wide-ranging knowledge. To properly assess and synthesise this knowledge and to set up new studies therefore requires an understanding of and experience with interdisciplinary, multidisciplinary and transdisciplinary scientific cooperation.

In the case of data infrastructure preparedness, data on infections, vaccinations, hospitalisations and public support for government measures was indispensable to the pandemic response, but accessibility, interoperability and linkage issues limited the extent to which researchers could make use of this data. Medical and social science data was not always collected and connected in the most effective manner. Reluctance to share source data also prevented scientific scrutiny. Data-sharing was further limited by the decentralised nature of the public health care system. Another obstacle was that databases belonging to different parties are not linked, whereas in for instance Denmark, the United Kingdom and Ireland such linkages are possible.

Regarding knowledge-exchange between scientists and policymakers, the pandemic made clear that the current advisory structure is unable to accommodate all types of knowledge. Certainly at the onset of the crisis, the biomedical perspective and insights from secondary and tertiary care dominated. A more systematic use of knowledge from health care practice, especially from public and primary health care, provides a more nuanced view of the problems encountered in care and of the course of the pandemic. Evidence from the social sciences on human behaviour and social inequalities can also aid in developing and evaluating policy. The same applies to legal and ethical questions about the desirability and feasibility of interventions and restrictions. In addition, the technical and natural sciences can deliver valuable knowledge leading to innovations that may help to combat a pandemic. Finally, the systematic use of communication science expertise is important for both scientists and policymakers, because it can help them make information accessible and convey their messages effectively. Closer integration of these knowledge fields for scientific advising requires interdisciplinary cooperation.

Based on the above analysis of scientific preparedness, the performance of the data infrastructure and the incorporation of interdisciplinary expertise in policy advising during the Covid-19 crisis, the committee has several recommendations for improving pandemic research preparedness in the Netherlands. To accomplish such an improvement, scientists and decision makers must begin by adhering to the following general principles: preparations should commence now and not only when the next crisis hits; all relevant fields of knowledge should be brought into the crisis response from the outset; data should be shared according to the principles of Open Science; researchers should always be transparent about evidence, uncertainties and differences of opinion; and international cooperation and coordination are indispensable. Mindful of these principles, the committee recommends the following.

Parties united in the Knowledge Coalition* and researchers: 
Improve opportunities to develop and conduct pandemic research.

• Establish a digital network for the synthesis of knowledge from different disciplines and the assessment of its quality.
• Encourage research geared towards pandemic preparedness that emphasises multidisciplinarity, interdisciplinarity and transdisciplinarity.
• Identify obstacles to cooperation so that they can be removed quickly during a crisis.

Ministry of Education, Culture and Science and Ministry of Health, Welfare and Sport:
Strengthen the national data infrastructure in cooperation with the major scientific institutions and researchers.

• Set up a structure for running high-value data collections that can be scaled up and can deliver results promptly in emergencies.
• Establish rules and protocols allowing rapid access to and use of data concerning the surveillance and spread of the virus and treatment of the disease.
• Develop an information system in which different health databases can be linked to one another as well as to administrative records.

Government and scientific policy advisors:
Improve the broad knowledge-exchange between science and policy.

• Build an advisory structure that gives centre stage to interdisciplinary input, based on a constructive and continuous assessment of different types of knowledge.
• Welcome input from medical practice, the social sciences and humanities, the technical and natural sciences, and law and ethics.
• Make systemic use of input from communication science when announcing measures and developing a compliance strategy.

* The Knowledge Coalition is a consultative body consisting of Universities of The Netherlands (UNL), The Netherlands Association of Universities of Applied Sciences (VH), The University Medical Centers of the Netherlands (NFU), the Royal Netherlands Academy of Arts and Sciences (KNAW), The Dutch Research Council (NWO), The Confederation of Netherlands Industry and Employers (VNO-NCW), The Royal Dutch Association of Small and Medium-Sized Enterprises (MKB-Nederland) and the Cooperation Committee of Applied Research Institutes (TO2-federatie). See: Kenniscoalitie.nl (last visited March 30, 2022).