numb to covid

How Behavioral Science Can Inform A Post-COVID World: Susan Michie

PodcastFebruary 20th, 2021

“I just hope that people will have the resilience to, after this pandemic, collectively work together to think about, first of all, the best way forward. What have we got wrong? What should we do differently? But also, exercising muscle. How can people on the ground exercise muscle to governments, and say, ‘You know what? We want something different.’”

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Intro

Since the beginning of 2020, COVID-19 has changed virtually everything about our lives, from how we work to how we care for one another, and even how we spend our time and money. Behavioral science is keeping up. In this episode of The Decision Corner, we sit down with British psychologist and behavioral science advisor Susan Michie to tear apart some of the most complex causes and effects of the COVID-19 pandemic. Michie shows us how increased public engagement in behavioral science and health research can help us imagine a post-COVID world that is more equitable, environmental, and convenient than the one we left behind. Read more about her research, including the development of the behavior change wheel, here. Some topics that we discuss include:

  • The operation of British scientific advisory group in emergencies (SAGE)
  • The gap between scientific research and public policy—are governments really “following the science?”
  • How a psychological look at problem framing can help change the way we talk about the pandemic
  • Contributors to the pandemic, including weakening global ties and environmental degradation
  • The need for increased public engagement in behavioral science research
  • How behavioral science can inform a better future

Key Quotes

Policymakers don’t follow the science

“Anybody who’s worked with policy makers knows that policy makers don’t follow the science, we hope they’re informed by the science, we hope that science is a really important part of what feeds into decision making. So it’s very odd, this determination to keep saying, ‘follow the science, follow the science.’ And myself and many colleagues began to get a bit suspicious. Is this setting science up to be blamed if and when things go wrong?”

Science is always social

“The whole process of decision making is the stuff of social science. It’s not that science is divorced from society. If you’re a social or behavioral scientist, it is part of society. And indeed, for all sciences, there’s a question of, what questions do you ask? What methods do you use to address those questions? How do you interpret those findings? These are all shaped by people’s experiences of society. And people’s experiences of society engender certain values in them.”

Problem framing in health crises

“As often as not, as the strategy for addressing the problem begins to be played out, so they and you learn more about the nature of the problem. And so, often, it’s very explicit that this is part of the process, that as you try things out in real life, you learn, you’re collecting data, whether it’s formally or informally, and using that data to update your understanding of yourself, of the situation around you, the interaction between you and the situation. And so problems don’t stand still.”

Learning our lesson

“People also talk about going back to normal. And I’m not the first to say it’s normal that got us into this situation. Because there’s increasing environmental degradation, where animals and humans are coming into contact with each other in ways they never have previously, as we’ve always said, it’s not if the next pandemic comes, it’s when. What it’s looking like is that they will be much more frequent than previously. So really, governments need to take a real long, hard look, and societies need to have long, hard looks at themselves.”

A global community

“No individual is an island, no community is an island, no country is an island, we are totally interconnected. And so we do need to think much more globally. Over the last few decades, for many reasons, important global bodies tset up after the Second World War have been undermined, and weakened in various ways. I think it’s imperative that they regain the necessary resources, the support and the recognition – without these bodies, we’re going to be in a mess.”

People need to see the science for themselves

“Everybody thinks they know about behavior, because we all behave, we see other people behaving. But when people are able to engage with the evidence, the theories that we have, and see the complexity of behavior, then I think it gives a whole new respect and interest and engagement with behavioral science.”

Bringing in the public

“I think another thing going forward is we need to break down barriers between science and research and the public. There’s not always barriers. I think the public is really interested in finding out about behavioral science, and how we can think about behavior… And what does being a researcher mean? So we just need much, much more engagement.”

Transcript

The wisdom of SAGE

 

Brooke: Hello, everyone, and welcome to the podcast of The Decision Lab, a socially conscious applied research firm using behavioral science to improve outcomes for all of society. My name is Brooke Struck, research director at TDL, and I’ll be your host for the discussion. My guest today is Susan Michie, Director of the Center for Behavior Change at University College London. In today’s episode, we’ll be talking about how behavioral science has been impacted by COVID-19, which has profoundly reshaped the boundaries of the field. Susan, thanks for joining us.

Susan: Pleasure. Good to be here.

Brooke: Before we jump in too deep into the meat of today’s conversation, can you please tell us a little bit about the center as well as the work that you’ve been doing to support the fight against COVID?

 

Susan: Absolutely. So I set up the Center of Behavior Change at University College London about seven years ago, and it was supported by one of the university’s grand challenges. These are streams of money to address the globe’s big challenges, and there are six of them. And we actually got funded through the grand challenge for human wellbeing. And there are two main purposes at the center.

One is to bring together all the different disciplines that have got something to say about behavior change, on the basis that no one discipline, even my own psychology, has all the answers to behavior change. And the second mission, I suppose at the center, is to translate academic expertise from universities to the outside world that can benefit from it, whether it’s planners, policymakers, practitioners, or the public.

In terms of my role within this latest COVID-19 pandemic, it really stems from my role in the 2009 H1N1 pandemic, where I was the only social and behavioral scientist that was part of our cross government scientific advisory group in emergencies, also known as SAGE. And I convinced them that they actually needed the whole behavioral and communications subgroup to advise them. So they agreed to this, and I set up and chaired the behavioral and communications subgroup of SAGE.

And then when this pandemic came along, it was very gratifying, because the researcher who came to work with me on research projects to do with pandemic flu communication was asked to chair the new behavioral science advisory group for SAGE because he’s stayed really within that area of research, and invited me to be part of it. So I’ve been delighted to be part of participating in SAGE and this behavioral science advisory group.

And I was also invited to be part of what’s called Independent SAGE. And this was set up a couple of months into the pandemic by Sir David King, who’s an ex chief scientific adviser for the government, as he was very concerned that the deliberations of SAGE were being conducted in secret the membership, their papers, their meetings and also that there wasn’t sufficient public health expertise, and especially the public health of pandemics on SAGE.

So he brought together a group of 13 scientists from many different disciplines and backgrounds to form Independent SAGE to produce multidisciplinary, public health-based scientific advice to governments, and also directly to the public. He was a strong believer of that, and had done that when he was chief scientific adviser to the government, and so that’s what we’ve done. And we hadn’t envisaged being active for many months, but we’re still very active. And when our government in the UK stopped its regular briefings to the press, we started regular weekly press and public briefings. So members of the press and the public are able to come and ask questions. And we also regularly publish papers often consultative, to begin with, and get feedback from the public and various professional scientific organizations, and then produce a final version. So those are all on the website of Independent SAGE.

 

Brooke: That’s wonderful. It’s a very interesting background, and I think it launches us very nicely into this first topic that I wanted to address with you. So I mentioned that I want to talk about how the boundaries are being reshaped. The first type of boundary that I want to talk about with you is institutional boundaries. So it seems like, actually, the institutional boundaries being reshaped by COVID, in fact, began more than a decade earlier with the previous H1N1 outbreak.

Can you tell us a little bit more about how this change has continued now in COVID-19, and there are two topics in particular that I’m hoping you can help us to unpack. The first is around proactive versus reactive stances of researchers vis-a-vis policy discussions, and perhaps also vis-a-vis public discussions, not just about the decisions that governments make, but about individuals.

Susan: Yes. Well, interestingly, the government’s SAGE works very differently than independent SAGE. So the behavioral science advisory group of SAGE isn’t in a position to proactively say these are the topics that we think we have expertise, or that we think need to be addressed right now. We wait for what are called commissions to come to us. So those can come through a variety of routes. And they’re fed through, it’s called Go Science, which is part of the business part of the UK Government. And so we’re asked to address particular questions, which we do. We are a very large group now, I’d say more than 40, from many, many different backgrounds, very talented researchers and scientists.

And we discuss issues, we commission rapid reviews, occasionally do some rapid experimental work, for example, on different types of communication. And then try and come up with a sort of expert consensus, and then work very effectively. So a small group drafts a paper that is then commented on by the larger group, and then it goes to SAGE for discussion. And then from SAGE on to wherever governments, but we don’t get very much direct feedback as to what actually happens from the many papers that we put forward.

And these are, in the end, now published on the website. So it’s very difficult for government websites to manage and I rarely manage to track down the papers through there , but they are there somewhere. And now, independent SAGE is completely different. It’s a small, very agile group. And we meet every week on a Thursday evening to prepare for the Friday lunchtime press conference that’s happening the day after, but also to prepare more long term about different issues that we think are very topical. And those issues will be ones that people may have brought to us, or ones that we just as researchers and scientists think are really key.

We also set up a behavioral advisory group to independent SAGE. So this is a group I think of eight people. And that’s led by professor Steve Russia, who’s also on the government’s SAGE behavioral group. And in fact, several of them are in both groups. And we’ve been also very active in presenting papers on a myriad of different subjects, to the main group, and then onto the website and fed into being presented at the weekly meetings.

So it’s very intuitive, it’s very agile, it’s very two way, it’s very transparent, we put all our minutes on the website, and people contact us frequently to ask for advice or ask us to discuss things. So the proactive could only really be done easily, probably with a smaller group. So that’s actually been very interesting to be in two such different groups. One that’s very small, very proactive, very agile, can really respond to things very quickly. And also, is able to say yes or no to engagement with a whole range of different organizations who ask us to participate in various ways,whereas the other is part of an absolutely enormous structure. I’ve never seen it written down,but I think the main SAGE group has had more than 100 of us participate at some point or another. And its meetings tend to be extremely large, and attended by not just scientists, but many people from Public Health England, from government departments, from the Cabinet Office. And so it’s a very, very large, complex structure. There are two co-chairs, and that’s Professor Chris Whitty, who’s Chief Medical Officer. And then we also have Sir Patrick Vallance who’s our Chief Scientific Adviser. And they together will represent SAGE to the government. So they are the two people who will routinely speak directly to the government.

So it’s a very one way, we feed in our expertise that goes into the sausage machine and comes out somewhere in some form, hopefully, but I think it’d be fascinating. And I hope next time there’ll be such a need for a scientific advisory group in emergencies. There’ll be more actual in time, real time evaluation of what’s going on. Where does all this science go? How is it brought together? How is it used or not? So fascinating. I think there’s no easy answers as to how to combine the best of all these worlds. And I think there’ll be a lot of lessons to learn in due course as to how to do this better next time.

Problem framing to the public

 

Brooke: One of the things you mentioned about the independent SAGE is that it’s highly iterative. And in my own experience, working in those iterative contexts, one of the things that I’ve seen is that those rapid cycles allow for problem framing to evolve very quickly. So you mentioned with the main SAGE group, the downstream impacts of the sides, how it’s taken up, what decisions are made on that basis, et cetera,. is a bit opaque and it’s hard to see how things are flowing through the system.

What about further upstream? Do you feel that there’s opportunity for the main SAGE group to actually engage in discussions around problem framing? Or is it very much kind of that a formal request comes in and the problem is already cut up for you, and you must remain within the boundaries of that box?

Susan: That’s an interesting question. And no, I think what you’re alluding to is right, that we are able to shape up the question. So the question may come in a form that doesn’t really make sense to us, or that we think could be improved on. And so that’s really a negotiation to say, I think what you mean to ask us or I think what would be more useful for us to address is this. And so that is the first bit of work, is actually translating what comes to us into something that we think would be addressable and useful within that arena.

Brooke: That touches so nicely on the second dimension that I’d like to explore, kind of the institutional changes that COVID-19 is bringing about. Maybe the easiest way to sum that up is around this value free ideal that all that the researchers are doing is feeding evidence into the system, it’s not politicized, there’s no kind of bleed of politics or ideology into research, it remains pure and kind of on its own on one side. And on the other side, you have policy and political discussions. And those two things are supposed to remain somehow separate and unique with this extremely thick frontier between them, with all of the research going on in academia, and no discussions of values or ideology.

And on the other side, you’ve got this extremely naked power discussion, which is going on in the political and policy realm. How do you see that kind of ideal, which of course is not real to begin with, right, it’s a caricature, even to start. But how do you see it breaking down even further now in the COVID situation?

Susan: I think this is a really interesting question. And it’s a question that I’ve been thinking long and hard during this last year. And my final views: I don’t have final views. I want to be involved in all discussions about this. It’s a very complex and a very important question. What I do think is the mantras that are being used are too simplistic. So on the one hand, we’ve had the UK government, the Prime Minister, Boris Johnson, repeatedly saying, “We follow the science, we follow the science.”

And it almost became a repetitive mantra, people saying, “What’s going on here?” I mean, I’ve worked with policymakers in government for many decades. And anybody who’s worked with policy makers knows that policy makers don’t follow the science, we hope they’re informed by the science, we hope that science is a really important part of what feeds into decision making. So it’s very odd, this determination to keep saying, “follow the science, follow the science.”

And myself and many colleagues began to get a bit suspicious. Is this setting science up to be blamed if and when things go wrong? So there’s really quite a concern about that. And also, what became evident was that there was a mismatch between what was being said and what was being done. So, for example, the methods for communication, the methods for optimizing adherence to the population that has come through our committee were not being followed. We advocated consultation and engagement of communities, working with communities in a co-production co-creation kind of way. That’s not happened.

We’ve advocated all the way along about support and enablement for those communities who find it most challenging to adhere. But instead, there’s been much more of a blame and punishment culture. So it’s been very obvious that there’s a big chasm in many cases between the behavioral and social science that was being advised via SAGE and what we saw happening with the government.

And then there were some very blatant occasions where this wasn’t true. So for example, we, like several other countries, had a rule about keeping two meters apart, in order to reduce the droplet transmission of COVID. And that was instituted in organizations, in public spaces, all very well, using markings on pavements, et cetera.

And then I think it appeared that this was getting in the way of short term profitability. And so I think it was quite a business lobby to drop it. And SAGE didn’t shift its advice, because the scientific advice is very clear: two meters is much, much safer than people staying one meter apart. I mean, you just need to look at trajectories when people cough or sneeze or shout or laugh, to know that, it’s not up to interpretation.

And so what then happened was the Prime Minister set up his own Downing Street Review by a body he called of scientists and economists to give him different advice. And that advice was what ended up as ‘one meter plus,’ which actually ended up as one meter, which is actually the space that is a normal social space between people who aren’t intimate with each other. So basically, the whole idea of distancing just went.

And now, this group, the membership was never published, the deliberations were never published, the science on which the ‘one meter plus’ was based was never published. So, that’s an example of how following the science kind of idea was, I think, being politically used. However, that’s a different question than the more interesting one you raise about what should be the relationship between scientists and policymakers, those who make policy decisions?

And there are a group of scientists who very much say, “scientists advise, policymakers decide.” Try and make use of hermeneutically sealed two boxes. And this is kind of a one way trip. Now, my experience working effectively with policymakers and governments, is that you make relationships with people, and they trust you. And there’s a lot of joint discussion. And yes, at the end of the day, you’re not making the policy. But you’re involved in a lot of discussion about the science, its interpretation, and also its implementation.

Because you have scientific advice, but it has to be implemented into the real world. And that itself is a subject of scientific inquiry. I was one of the founding editors of a journal called Implementation Science. So there’s a whole pathway from science coming together, multidisciplinary science, different kinds of advice. And then how is that communicated? And not just communicated, but how is it translated so that it is maximally implementable?

Because, from my perspective, science needs to be useful and usable. And that means not just saying, “I’m a pure scientist out here. I will publish my papers, I will tell you about my findings. End of story.” It’s about being involved in relationships, we are part of society. And to think about the whole translational pathway, it’s not just science, and then there’s a bridge, and then you’ve got policy. There’s a much more nuanced, much more iterative type of relationship and pathway that I think should be understood.

And the whole process of decision making, again, is the stuff of social science. It’s not that science is divorced from society. If you’re a social or behavioral scientist, it is part of society. And indeed, for all sciences, there’s a question of, what questions do you ask? What methods do you use to address those questions? How do you interpret those findings? These are all shaped by people’s experiences of society. And people’s experiences of society engender certain values in them.

So for example, many scientists, many social behavioral scientists, now think and probably this wasn’t so explicit a few decades ago that working towards a more equal society is a good thing. For many, many reasons, we could have a whole hour on that, that’s the value. And there are other values too. And I think the important thing is to be explicit about what the values you’re drawing on are. And that should be true of everyone. That when you discuss things, there are frameworks in which you’re thinking about things. And I would say that’s very different from the government SAGE body from independent SAGE, because independent SAGE is much more upfront that we do have beliefs about the kind of society that we think there should be.

Now we can say, “this is for public health, for physical and mental public health, this is the kind of society.” And a vision of that, quite explicitly, would drive up what we are saying and doing. So I think there’s not such a demarcation between, ‘we are the scientists, we will advise you, the policymakers.’ And this is why we have this very much consultation documents, we have our weekly press and public conferences, not just to talk and to answer questions, but to listen, and to learn. So a two way nuanced process.

But as I say, I think this is a really fundamental, a very deep, a very complex question. And I would love to be part of future discussions. I’m sure it will be because I think there’ll be many discussions about quite what’s the best way to think about this in order to make the process as transparent, and also as effective as possible.

Brooke: I like that, that we need to have our priorities kind of clear and upfront, not just about the types of solutions that we would propose as a government science advice body, but also about the purpose of government science advice, it’s to help the government to find that meeting point of being a policy solution that is both good management and good leadership. We think it will effectively get us going in the direction we want to be headed. And a lot of that comes down to problem framing. And I really like the way that these two examples, the kind of contrast classes of the main SAGE and the independent SAGE really illustrate two very different approaches to that.

And I’m, on a personal note, very glad to hear that the kind of early stage work with SAGE is really a good chunk of mileage on problem framing, because that can so often be the place where science advice falls down. That the way that a problem is communicated from a government body has a bunch of assumptions implicitly baked into it. And those get stripped out when a group of researchers who have kind of decided that they will put themselves behind a wall, read a question and interpret it in a very, very different way than it was intended. And at the end of a very long, arduous process, they come back with something that ultimately is not answering the right question, and therefore it doesn’t have the kind of impact that we hoped it would have.

Susan: Absolutely, I totally agree. I mean, in science and in life, you get the question right, and you’re halfway there to solving it. You get the question wrong, and you can’t solve it. Having said that, I do think there is a very dialectical process of formulating the question in the best possible way to begin with, but also, as one begins to address it, as one begins to gather the evidence to address it, as one begins to interact and talk with people from other disciplines, other perspectives, other experiences to address it, that formulation of the problem can change.

Just as I said, it’s not necessarily that science is a static thing that is plonked onto the desk of the politician. So we don’t have a problem as a static thing, that then has a solution plunked on the desk of whoever wants the problem solved. And I really learned this in my many years working as a clinical psychologist. Because there, somebody comes to you, in distress with a problem to solve and a huge bit of that work is helping them and jointly formulating the problem.

But as often as not, as the strategy for addressing the problem begins to be played out, so they and you learn more about the nature of the problem. And so, often, it’s very explicit that this is part of the process, that as you try things out in real life, you learn, you’re collecting data, whether it’s formally or informally, and using that data to update your understanding of yourself, of the situation around you, the interaction between you and the situation. And so problems don’t stand still.

And as often as not, the problem that we end up working with is actually not the one that the person comes when they come to see. Now, obviously, clinical psychology and advising policymakers are two very different processes. But I just use this as an example of the fact that, I mean, it’s very much in line with Bayes’ thinking, that you come with your priors based on what you know, but then as you go forward, those are continually being updated. That’s what we’re doing the whole time in our lives as we go on with our lives. It’s not explicit, it’s so automatic, that we’re not aware of it. And I think one of the arts of that whole science policy communication is the ability to do that in a constructive and alternate partnership way.

Interlude

 

Welcome back to The Decision Corner. If you’re joining us now, please welcome Susan Michie, behavioral science health expert who is joining us from the UK today to discuss how the field of behavioral science is both shaping and shaped by the current COVID-19 pandemic. In our last segment, we’ve discussed how the gaps between research and public policy create confusion and inconsistent outcomes among the public. Moving forward, we’ll be talking about how we got in this mess in the first place, what we can do to get out, and what a better post-pandemic world might look like. Stay with us.

Beyond disciplinary boundaries

 

Brooke: I want to come back to something you said earlier, it kind of echoed faintly in the mention that you made of Boris Johnson forming this kind of Downing Street Group to provide advice. And you talked about the disciplinary composition of that group being done too clear. And the efforts within SAGE, both the main SAGE and the independent SAGE, are very interdisciplinary, they’re very multidisciplinary. And it strikes me that setting up the unit in the first place, even deciding who’s going to talk about a problem, and the disciplinary perspectives that they’re bringing to the table when they do so, is already setting the table enormously for the way that the problem will get framed.

So I’d like to use this as a bit of a pivot point to talk about the second boundary now that’s being really challenged by COVID, which is the boundary between behavioral science and other research disciplines. So is there something in your experience that you think is really emblematic of this type of change, the way that behavioral science is engaging differently with other disciplines, perhaps in the context of government science advice? If you have other examples, as well, love to hear those.

Susan: Well, I think behavioral science is very multidisciplinary. So for example, on the behavioral science advisory group of SAGE, we have health psychologists, social psychologists, many different kinds of psychologists. We also have sociologists, we have anthropologists, we have communication experts, we have implementation experts. So we have a huge range of different disciplines that come under the rubric of behavioral science. So I mean, maybe we should talk about behavioral sciences, plural, rather than singular.

In terms of interaction with other disciplines outside of behavioral science, as I said, that doesn’t really happen in the government SAGE group, because we’re a separate group, and we just feed that advice into the main group. If you’ve led a report for the behavioral group, which I have on a couple of occasions, then you’ll attend the main SAGE group to present that.

We also have three people who are sub chairs and co chairs, who will be part of the group. Back in 2009, when I was on SAGE, the government SAGE, and it’s pretty small, I think there were 14, 16 of us, and that was it, a couple of people from the secretariat to support us. So it was very small, we all got to know each other. And I think none of the rest of them had worked with a behavioral scientist before. So they all thought it’s a good thing, but had no idea what it was, what I did.

And so part of it is showing the relevance in the areas that they’re interested in, and that they know about, and show that behavioral science can be an add on to help them think about their issues, and help with a more rounded approach to the way that they might be approaching things. And those were very good relationships. As I said, I think the current SAGE has got so big and so unwieldy. I don’t think you have those kinds of conversations so much. The independent SAGE, again, it’s a much smaller group, 13, 14 people. And we have a virologist, epidemiologists, public health experts, social psychologists, myself come through health psychology.

And we also have somebody who’s not a scientist, has worked for a non-governmental organization and knows a lot about inequalities and deprivation. So it’s very good having somebody like that, very grounded, working very closely as part of the team. And I think everybody has just learned an enormous amount from everybody else. I think there’s been so much that’s been really bleak about the last year, obviously, for the world, and for so many communities in it.

I personally, as an academic, towards the end of my career, I’ve been in a very fortunate position, relative to most. But one of the things which I’ve really, really benefited from and enjoyed hugely, has been working with so many incredibly talented people from so many different disciplines. And that’s been a total privilege. I’ve learned a huge amount.

And also, it’s been really gratifying to hear the same thing from other people, how much they’ve appreciated and learned about behavioral science. So I think it’s a fantastic opportunity when you have a new threat, because everybody’s coming into this with huge amounts of uncertainty, and still with huge amounts of uncertainty. But it’s really serious. And we’ve got to pull together in order to try and do what we can to minimize the harm and the damage that’s being made.

Brooke: Everybody thinks they know about behavior, because we all behave, we see other people behaving. But when people are able to kind of engage with the kind of evidence, the theories that we have, and see the complexity of it, then I think it just gives a whole new respect and interest and engagement with behavioral science.

So both with fellow researchers and scientists, but also with the press, that’s been another whole area, where there’s been huge interest in behavioral science. And the journalists themselves are very interested, because often, after an interview, they’ll stop and say, “Could we just talk as a one to one?” And they’ll come up with their own things they want to discuss, and that’s all great.

How COVID-19 informs our future

 

Brooke: I want to shift gears a little bit now and get into kind of the meat of COVID-19 itself. It seems that in many parts of the world, we’re fighting this as though it will hopefully be the last pandemic we ever have to fight, kind of, keep spread to an absolute minimum, race towards a vaccine, get everybody inoculated, and then you can finally relax, and it’ll all be over. Have you seen that in your work as well?

Susan: The government at the moment in the UK definitely have the approach that you’re describing that we’ll just have this lockdown for a bit longer, get everybody vaccinated, or most of the adult population, and we’ll be alright. And really not realizing quite how many adults under the age of 50 are getting ill, and quite how dangerous the situation is, with new variants emerging, especially in a country where we still have a very high transmission rates, and no border controls to speak of, this talk about half hearted measures of a couple of countries. But unless you do border controls well, unless you drive down towards zero COVID, i.e. elimination in particular regions, and have a very good test, trace, and isolate system developed alongside it, as the countries that have managed this very well protects their economies as well as people’s lives.

Then, what’s going to happen is, yes, we can drive it down. But we’ve just bought some time, it will emerge again. So there needs to be a much longer term solution. People also talk about going back to normal. And I’m not the first to say it’s normal that got us into this situation. And because there’s increasing environmental degradation, where animals and humans are coming into contact with each other in ways they’ve never have previously.

As we’ve always said, it’s not if the next pandemic comes, it’s when, but what it’s looking like is that will be much more frequent than has been previously. So really, governments need to take a real long, hard look, and societies need to have long, hard looks at themselves. We were very lacking in resilience, as many countries were, United States, United Kingdom, Brazil, being very obvious examples, whereas others, much poorer countries, Vietnam in Southeast Asia, Kerala in India, Uruguay in Latin America, Cuba in the Caribbean, Norway and Finland in Europe.

There are countries all over the world, not necessarily wealthy, but doing things in a very different way. Much more equal, much more community focused, that health is intertwined with the fabric of society more. And so I hope that the right lessons will be learned, I think there will be a battle about it, I mean, there’s a battle about everything. But I think, sadly, just as so many millions of people have fallen into poverty, have lost jobs, have lost homes, a whole generation of younger people losing hopes and visions for the future and real mental health problems, at the same time, tens of thousands of extremely rich people have got much richer on the back of pandemic.

And there’s not a public narrative, certainly in this country, about sharing that wealth more equally, about using taxation to redistribute wealth, which is a usual way of doing that. So that’s depressing, because I think that if we’re going to carry on with overcrowded housing on a large scale, with precarious and dangerous jobs, unsafe working places, on a large scale, and also to carry on with huge amounts of poverty, and especially child poverty, we’re going to carry on, being in a situation where a tiny virus can absolutely wreak havoc with hundreds of thousands , millions of people’s lives. So I think that’s one real thing we need to think about.

And a second one is, what do we do about climate change? There’s no shortcut here. This is the result of climate change, and that needs to be pushed higher up the agenda. And the third thing, I think it’s really demonstrated is that no individual is an island, no community is an island, no country is an island, we are totally interconnected. And so we do need to think much more globally. And I know over the last few decades, for many reasons, we don’t have time to go in here, the United Nations, the World Health Organizations, other really important global bodies that have set up after the Second World War have been undermined, and weakened in various ways. I think it’s imperative that they regain the resources, the support and the recognition that without these bodies, we’re going to be in a mess.

Brooke: I really appreciate the way that you responded to that question, the way that you kind of already jumped ahead to saying, this isn’t just an issue of learning about dealing with COVID-19, or even maybe this variant of COVID-19. And in fact, it’s not even an issue just of learning to deal with pandemics. It’s an issue of dealing with global grand challenges, to borrow that phrase.

And you build the muscles that you exercise. So for instance, our institutions and even our research are really developing a lot in some countries, the UK and Canada as two examples. We’re learning a lot about what’s effective and what’s not to institute hard lockdowns. But we don’t seem to be learning as much about how to build resilient human ecosystems that are just less prone to being sort of tossed about on the waves of what the world is going to throw at us. So are there specific instances where you see institutional muscles or even kind of research and knowledge muscles that are being developed down certain paths, that we might be creating path dependencies for ourselves in the way that we’ve responded to this pandemic that will limit options in future or kind of constrain our thinking in future about how we will frame the problems that we encounter?

Susan: It’s a very big question, and it’s not a question I can answer, because I just don’t have that overall knowledge about what’s going on. But I do think there are big questions being asked, and I think that people remember the last financial crash, and who paid for that. And I think people are thinking, this is another thing that was not of our making. This was the result of actual governmental policies globally. And the little people shouldn’t be made to pay for it again.

And I think there are big questions. It’s very difficult when everybody’s in lockdown, in their own homes, not able to do anything other than interact over Zoom or the telephone. But I think there will be big questions being asked, and big questions being asked by young people about how things are going to go in the future. But just as this pandemic has been incredibly unpredictable, I think the future is really unpredictable. I mean, is it Rosa Luxemburg who said, “socialism or barbarism” those are two very big extremes. And what’s going to happen? I can see things going any which way.

And I just hope that people will have the resilience to, after this pandemic, collectively work together to think about, first of all, what’s going to be the best ways forward? What have we got wrong? What should we do differently? But also, you talked about exercising muscle. How can people on the ground exercise muscle to governments, and to say, “You know what? We want something different.” So I think it’s going to be really interesting. I don’t have the answers.

Social innovation in a post-COVID world

 

Brooke: There’s a sizable segment of the population that has been, let’s say, surprised that some things that were kind of written off as not even possible, very quickly shifted from impossible to possible to actually happening within the space of weeks. The idea of a universal basic income, for instance, has been bandied about for a long time, and for the longest time, written off as completely unfeasible, shouldn’t even be on the table for discussion. And then all of a sudden, you’ve gotta lock up your economy, and universal income, all of a sudden kind of materializes in many, many countries around the world. , Modern monetary theory had trouble getting serious conversations, and then started to pick up a little bit of momentum.

Now, all of a sudden, modern monetary theory is a credible thing to talk about in public spaces. So you mentioned that there’s this unpredictability to what the world is going to throw at us. But there’s also kind of the flip side of that coin is the unpredictability about how we ourselves will react, and the kinds of narratives and stories that we tell that kind of frame the problem for us and construct the set of options that we will consider in addressing these issues.

Susan: I think that’s right. And I hope people will look to other countries in the world to look and see who’s dealt with this well, and what was it that made them able to deal with that well, and what did they do that managed things so well? Because I think that countries that have developed on a particular trajectory, have a whole narrative and a whole ideology. We had a previous Prime Minister called Margaret Thatcher, I don’t know if you ever remember her, and she was, one of her many phrases which summarizes TINA: There Is No Alternative.

And I think that people are very conditioned from very early on to think there is no alternative to the way things are at the moment. And I think that’s how seemingly irrational ways of organizing societies can keep going by different ways of projecting that. So I think it does take a leap of imagination to think that things could be very different. I mean, one obvious thing is that we’re no longer doing these massively huge long commutes into work every day, certainly living in London.

So many people have been spending hours every day, fruitlessly, hours that should be with their loved ones doing productive, fun things, they’ve been spending huge amounts of often not big incomes on travel expenses, needlessly, pumping carbon dioxide into the air, further destroying the planet and making future pandemics more likely, all of these things have been happening, nobody questions it. A virus comes along, boom! All of that’s gone.

So many people working from and can work perfectly well from home. And now, we don’t want to go back to that, it wasn’t good. But on the other hand, we’re very social beings, we need other people, we need that kind of interaction in a personal way. We don’t need to get on a plane to go and have an hour’s meeting in New York, and come back again, which was happening. But we do need to be able to have informal ways of being with colleagues. Now one of the things that I’ve been thinking about is that rather [than] having everybody living in the suburbs, or wherever, coming into the center of cities, and then back out again, why not have local working hubs?

I mean, the creative industries and IT are doing much more of this, converting loft spaces into imaginative spaces where people work together, these canteens where people can, in much smaller scale than often a lot of these huge big anonymous offices or even universities. And also shared space for meetings or performances of various kinds. And this would have a massive benefit, not only, not having to do all this commuting. And you could have themed work hubs. So there could be ones that were meant more to do with universities or more to do with whatever, PR or whatever other industry people might be involved in.

But it would also have the benefit that it would be in the communities. At the moment, we’ve got an awful lot of left behind desert tree communities, because they’re ribbons, people are just dormitory, there’s their court, aren’t they? People just kind of sleep there. Whereas if you’re sleeping and working, you’re also getting to know people who live nearby who can become your friends. I mean, what happens in my university, my research team, people are coming in from Sussex, from Reading, from Cambridge.

I was traveling, and I’ve always said to people, “Only come in sometimes; work at home the rest of the time.” But when they make friendships at work, none of them are living near to each other, they can’t see each other easily on weekends. And I think it would mean people would identify with communities, would invest in communities. So the social cohesiveness, the village kind of experience of living could be recreated.

And so I can imagine big companies could just be hiring out deskspace, because some people may be able to very happy working at home four days a week, maybe go somewhere for one day a week, other people don’t have a home situation where they can work easily at home, would need to work somewhere. But it could be flexible. So I think there’s ways in which, the phrase is “building back better.” With the right people in charge, the right kind of discussions, we could build back better.

Brooke: So that’s something that calls for a strong leadership to help us to articulate a vision of what better means and how we will build towards that. Do you see a role for behavioral science and helping to facilitate, on the one hand, conversations about what those options might look like and helping people to engage in that kind of societal discussion about what better means for us and the vision that we want to articulate for ourselves, as well as on the other hand, actually implementing that vision once we have something hammered out.

Susan: I think behavioral science is a really important part of that conversation. But it’s part of the conversation. We need to have social scientists, environmental scientists, economists, political scientists, [we need to] get many, many different perspectives, to bring together all that thinking. But going back to what we’re talking about before, science is part of society. And we should be having those conversations with the rest of society. I mean, I’ve always had a really strong belief in the importance of public engagement with science. And I’ve done many public engagement activities, including soapbox science, where you literally stand on a soapbox on the pavements, and talk about your research.

And so I think another thing going forward is we need to break down these barriers between science and research and the public. There’s not always barriers. I think the public is really interested in what is behavioral science, and how can we think about behavior? And what does being a researcher mean? So we just need much, much more engagement.

And just as we talk in our research studies, as we should co-create, co-produce with the communities that the studies are studying, bring in the public, the patients, into those discussions. So when we’re thinking about strategies and society, I think there should be much more engagement with all walks of life. And researchers and scientists are one part of that conversation.

Brooke: I think that that’s an excellent place to leave off our conversation. Susan, thank you very, very much for this great conversation. And we look forward to speaking with you again.

Susan: Well, my great pleasure, thank you for inviting me. I’ve really enjoyed talking to you.

About the Guest

Susan Michie

Susan Michie is a British psychologist and professor of health psychology at University College London, where she founded and directs the Center for Behavior Change. During the 2009 H1N1 pandemic, Michie sat on a cross-government scientific advisory group in emergencies known as SAGE. While the only behavioral scientist originally on this team, Michie organized and chaired a behavioral science subgroup that she rejoined during the COVID-19 pandemic. Michie also sits on Independent SAGE, an independent advisory group initiated by ex-chief scientific advisor, Sir David King. Through her work on SAGE, as an expert advisor on the UK’s Scientific Pandemic Influenza Group on Behavioral Science, and as a consultant for the WHO, Michie provides scientific expertise and advice on how to institute health-related behavioral change in populations. Michie has also frequently contributed to national news media as a behavior change expert throughout the pandemic.

About the Interviewer

Brooke Struck

Brooke Struck is Research Director at The Decision Lab. He holds a doctorate in philosophy of science. His dissertation research focused on the relationship between quantitative and qualitative research methods, and the relationship between research and other social systems such as language, history and politics. Since finishing his academic work, Dr. Struck has worked in science & innovation policy, first within the Canadian federal government, and then subsequently in the private sector at Science-Metrix. In recent years, he has been researching the interface of big data analytics with organizational decision-making structures, especially in policy-making contexts.

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