The Limits of Unified Expertise During the Covid-19 Crisis: Lessons for Health Crisis Management in Belgium

The Covid-19 pandemic is a particularly interesting case study of how policy-makers used scientific information to make decisions. In particular, this paper looks at how the management of the health crisis in Belgium was organized around unified expertise from the biomedical field. Although this approach has notable limitations, recent evaluation reports on Covid crisis management continue to promote a unilateral reliance on expertise. Through a single case study, we describe the current and expected future governance structures on the basis of a document analysis and semi structured interviews. During the crisis, experts held significant epistemic authority, allowing little room for alternative discourses to emerge. Numerous studies on crisis management emphasize the importance of breaking down silos in expertise by fostering more open and flexible networks (Baekkeskov 2017; Fallon et al., 2020; Stiegler 2022; Greenhalgh & Engebretsen 2022). While many social groups were severely affected by health measures that overlooked their needs, the existing ex-post evaluations of Belgium's management of the health crisis (Chambre des Représentants 2021; OECD 2023), as well as the new national health emergency preparedness plan (SPF Santé publique 2023), do not seem to take this issue into account. On the contrary, these reports seem to persist in a unilateral approach and a “top-down” crisis management style. Using the Covid crisis management within long-term care organizations in Belgium as a practical case, the paper analyzes the advisory network mobilized during the crisis and stresses the impact of this structure on these organizations. Based on this analysis, the paper proposes several avenues to improve the use of expertise in preparing for future health crises. References : Chambre des Représentants de Belgique. (2021). Commission spéciale chargée d’examiner la gestion de l’épidémie de Covid-19 par la Belgique, DOC 55 1394/002. Dryzek, J. S., Bächtiger, A., Chambers, S., Cohen, J., Druckman, J. N., Felicetti, A., ... & Warren, M. E. (2019). The crisis of democracy and the science of deliberation. Science, 363(6432), 1144-1146. Easton, M., De Paepe, J., Evans, P., W. Head, B., & Yarnold, J. (2022). Embedding expertise for policy responses to COVID-19: comparing decision-making structures in two federal democracies. Public Organization Review, 22(2), 309-326. Fallon, C., Thiry, A. et Brunet, S. (2020) . Planification d’urgence et gestion de crise sanitaire. La Belgique face à la pandémie de Covid-19. Courrier hebdomadaire du CRISP, n° 2453-2454(8), 5-68. https://doi.org/10.3917/cris.2453.0005. Greenhalgh, T., & Engebretsen, E. (Augustus 2022). The science-policy relationship in times of crisis: An urgent call for a pragmatist turn. Social Science & Medicine, 115140. Organisation for Economic Co-operation and Development, OECD. (2023). Evaluation of Belgium’s COVID-19 Responses: Fostering Trust for a More Resilient Society. SPF Santé publique. (2023). Generic Preparedness Plan HEALTH.