The experts missing from the Covid conversation

by Danny Vadasz
CEO, Health Issues Centre

There is a group of experts who have conspicuously been left out of the conversations that frame our strategic response to COVID-19. Experts who have just as much wisdom and insight to contribute as epidemiologists, health economists, emergency response specialists, politicians and policy advisors.

Who are these highly qualified but unsung stakeholders? You!

What makes you so special? Quite simply, only you appreciate how well-intentioned public health policies work (or don’t) in the real world because that’s where you live. And that sets you apart.

Do health economists rent in high rise public housing? Have policy advisors ever toiled in abattoirs? Have epidemiologists ever moonlighted as casually employed security guards? Do politicians go home to unwind in residential age care facilities?

Of course not. That’s why what has seemed bleedingly obvious and inevitable to those who are familiar with those real-world environments has taken our leaders by surprise and found them abjectly underprepared.  (You would only call a high-rise public housing complex a vertical cruise ship if you’d never experienced their one star amenities.)

And for those who dismiss hindsight as feasting on the entrails of the unpredictable, we could have told you so months ago, if only you would have listened.

In fact, three months ago, in frustration at the total lack of community engagement since the initial emergency response to COVID-19, Health Issues Centre initiated a series of community forums to give consumers the opportunity to express their fears and offer their constructive  suggestions to help manage the unfolding pandemic.

Everything you told us (and which we tried to share with the relevant authorities) has come to pass.

You warned us that there is a difference between messaging and communicating and that directives delivered at staged media events do not amount to communication.

You told us that some of your communities wouldn’t understand information if it was provided in English or if it wasn’t culturally appropriate.

You told us that people were confused by the mixed messages you were getting, ranging from the case for school closures to why Chadstone Shopping Centre was an essential service.

You told us you couldn’t understand why authorities were so dismissive of face masks when governments around the world had made them a compulsory part of their PPE arsenal.

You told us that you were concerned about how difficult it would be to maintain social distancing as restrictions were eased because our urban planning and business models were designed to herd people together not keep them apart.

You told us that social restrictions invariably broke down at the front door of co-habited residences and that a policy vacuum on domestic protocols would lead to household transmission.

And you told us that the lack of nuance in public policy had left you relying on your own judgement to protect your own and your family’s wellbeing and to take ownership of the risk equilibrium between contagion and economic hardship.

Most of all you told us that being admonished for community infection not only added to your sense of guilt and helplessness but made you less inclined to comply with directives that seemed arbitrary, inequitable and fell from the sky without notice.

Would anything have been different if you had been listened to?

Absolutely.

We would not now see the erosion of the community’s trust of authority hard-earned in the first days of the crisis and wasted through hubris ever since.

We would have been better informed to predict likely environments for cluster outbreaks in time to implement precautionary measures rather than rely on crisis management. (If you want to know the likely next hot spots come and ask.)

We would not have needed to send virtual swat teams into public housing towers to remind people how much they feared and mistrusted the instruments of the state.

And hopefully, by enabling the community to participate in the design of appropriate prevention measures and develop a sense of shared ownership, fewer people would have been inclined to game the system.

We will never know because nobody felt the need to factor lived experience into expert reckoning.

So listen up experts because we can’t afford your indifference to the reasoned concerns and timely warnings of communities any longer.

If you want to attack the virus with foresight rather than hindsight; engage with the people who live with the consequences of your decisions and make them part of that decision-making process.

If you want shared responsibility; treat the community as partners in formulating solutions not just as drones complying with instructions.

If you want compliance; stop treating people as delinquent adolescents and start taking into account the logistical and functional barriers and competing tensions that subvert their best efforts to comply.

Shared responsibility happens when people work in common cause, pooling knowledge and wisdom, sharing authority and taking accountability. If this all sounds too difficult, be guided by the simple mantra that consumer advocates who struggle every day to have their voices heard intone to ease their exasperation … ”Nothing about us without us”.