Long-term strategy corona policy

Long-term strategy Corona policy

The government is thinking about long-term corona policy. The recent period has shown that the Omikron variant is contagious, but that the number of hospital admissions remains limited. The cabinet has therefore decided to phase out the corona measures. However, there is a chance that hospital admissions will increase in the future. For example, when autumn starts or when a new variety spreads. The government takes various possible scenarios into account.

Should the government introduce corona measures in these scenarios? What goals should the government actually pursue with its corona policy? And which indicator should be controlled on? The answers to these questions are important to arrive at good policy.

The research

Populytics carried out two preference surveys in February 2022 on behalf of the Behavioral Unit of the RIVM to answer the following questions:

Which social goals do citizens consider important in corona policy?
Which measures do citizens find desirable and/or acceptable in four different scenarios?
At what point do citizens think that the government should decide to introduce measures?
What preferences do citizens have with regard to the policy decision-making process?

Populytics is a TU Delft start-up that specializes in measuring preferences of individuals using the Participation Value Evaluation (PVE) method. The essence of a PVE is that citizens can give advice on a government choice issue. Citizens are, as it were, put in the seat of a policy maker. The choice issue of a government is simulated in an online environment. Citizens are then asked what they would advise if they were in the shoes of the policymaker. This study is a successor to an earlier preference study in which 36,000 Dutch people contributed ideas about how the corona measures should be scaled up in the event of a revival of the virus (Mouter et al., 2021a).

We performed two PVE experiments. In the first experiment, we presented four scenarios for how the pandemic could develop. Citizens gave advice on the implementation of measures for each scenario. Participants were given information about the extent to which the chance that hospitals will become (too) crowded if the measure is introduced. We then asked what they would advise their governmentand why they would advise this. It concerns the following four scenarios:

A situation where the virus is under control. Few people with corona are in hospital. Hospitals don't have to postpone surgeries. There is also no dangerous new variant of the virus that causes problems.
A situation in which the virus spreads more quickly in the autumn, whereby especially vulnerable people and people who have not been vaccinated end up in hospital. In this scenario, the pressure on healthcare increases.
A situation in which a new, more contagious variant of the virus has been found in another country. It is not yet clear how sickening this variant is. It can be better than expected and then nothing will happen with the pressure on care, but it can also be disappointing and then the pressure on care will increase sharply.
A situation in which a new, more contagious variant of the virus has been found in another country that is also more pathogenic. In this situation, it is certain that the pressure on healthcare will increase enormously if the government does not take additional measures quickly.

In the second PVE experiment, we investigated the preferences of the Dutch for the goals of the corona policy. We asked the participants to award points to various goals that the government can pursue. When they supported a cause, they could award a lot of points to it. We first asked them to prioritize social goals of the corona policy. We then asked them to prioritize goals related to sharing the burden of corona policy. Finally, we asked them to prioritize goals for decision making. Some of the participants also received information about which measures would fit these goals. In this way we could measure whether people give different advice when they receive more extensive information. It follows from the study that providing extra information in none of the choice tasks led to substantially different advice from participants. After participants had divided their points, we asked them why they had divided their points in this way. The answers to the in-depth questions provide insight into the motives, values and fairness considerations underlying the participants' choices. We also analyze whether different groups in society share or think differently about certain preferences, goals and values.

A representative group of Dutch people was approached to participate in both studies. The first experiment ran from February 3 to February 10, 2022 and a total of 2,011 participants completed the PVE. The second experiment ran from February 18 to March 1, 2022 and a total of 2,958 participants completed the PVE.

Key results and findings

: Keeping healthcare accessible is the most important goal for most people. Citizens consider it of great importance that operations have to be postponed and that it is not too busy in the ICUs. They put these goals above other goals of corona policy such as 'ensuring that strict measures never have to be taken again' and 'ensuring that special moments with family and friends can continue as normal as possible'. The primary reason why participants prioritized the goal of “ensuring hospitals don't have to delay surgery” is that they believe everyone has the right to healthcare. It should be noted, however, that unvaccinated people attach relatively little importance to these goals. They consider the preservation of individual freedom more important than preventing the postponement of operations, they attach relatively great importance to the equal treatment of vaccinated and non-vaccinated people, while they consider 'preventing crowds in ICUs' to be an unimportant goal. However, preventing surgeries from having to be postponed for unvaccinated remains the second most important goal in a scenario in which corona is under control. In addition to keeping healthcare accessible and preserving individual freedoms, participants find it important that citizens can lead the same life as before the corona crisis, that sectors can remain open, that mental complaints are prevented and that learning delays are prevented. Ensuring that young people and children do not develop learning disabilities is weighted about the same by different groups of Dutch people (old/young, vaccinated/unvaccinated).
: In a situation where corona is under control and few people need care, more than 85% of the participants advise to keep one or more advice/measures. In this situation, more than half recommend the existing current advice on hygiene (washing hands, do not shake hands), staying at home and testing in case of complaints, and ventilation. In this scenario, almost half opt for advice to keep a distance and the advice to work from home a few days a week. Women, vaccinated persons and people who currently comply with the basic measures are relatively positive about maintaining basic measures. Participants who are positive about the maintenance of basic measures indicate that the rules require little effort and that they are already used to the rules.
: Particularly in a scenario in which the virus flares up in the autumn and the pressure on healthcare increases, younger and older participants disagree about the desirability of corona measures. Young participants are prepared to accept a higher risk that health care will come under pressure and recommend considerably fewer measures than older participants. A similar relationship can be found between the extent to which people recommend measures and the extent to which they estimate that they are at risk of becoming ill after a corona infection. People who estimate that they have a high risk of becoming ill recommend relatively many measures in the PVE. Even in the scenario where a variant has been discovered, the consequences of which are not yet known, younger participants and participants who estimate that they run a low risk of becoming ill from corona also recommend relatively few measures.
: In view of the relative importance that various groups in society (young and older people and both vaccinated and unvaccinated) attach to preventing operations from having to be postponed, the government could consider including the number of (expected) postponed operations as an indicator. for determining corona policy.

: In the scenario in which the pressure on healthcare increases sharply due to a new variant that is more sickening, there is support in all segments of the population to start a booster campaign and there is also a lot of support for strict home working advice. In addition, various groups in society are positive about a weighty advice to receive a maximum of 2 visitors and a advice to do higher education online or with a maximum number of students per lecture. There is little support for measures that imply substantial restrictions on freedom of action, such as closing schools, sports clubs, catering or cultural institutions. Experiment 2 shows that participants find it important that various interests are taken into account in this scenario, such as keeping care accessible, preventing learning disadvantages, preventing sectors from being closed, preventing mental complaints such as loneliness, ensuring that people can keep exercising and moving. It is important in this scenario to clearly explain how account has been taken of the multitude of goals and values that the Dutch consider important in this scenario.
: Citizens value two contrasting goals – “we know in advance what measures the government will take when things get worse and better” and “the government adapts the measures as much as possible to the situation” - approximately equally weighted. If the government focuses strongly on one of the two goals (for example, only sticking to a predefined plan or only continuously adapting to new developments), this does not correspond to the preferences of citizens. Young participants find it more important that the government trusts in citizens' own responsibility and that citizens are allowed to contribute ideas about government decisions. Older participants more often feel that the enforceability of measures should be taken into account in decision-making and that experts should be consulted.
: We asked the participants based on which indicator the government could best decide to introduce new measures. No clear preference emerged from this. Some people think that when deciding when to take which measures, the number of infections should be considered, others should look at the number of admissions to hospitals, some believe that the situation in their own country should be looked at primarily, others the situation in the country where a new variant of the coronavirus has been discovered.
: Participants recommend almost the same measures in the autumn scenario and in the scenario in which a new variant was discovered abroad that turns out to be highly contagious, but it is still unclear how ill people become from it. In both scenarios, home working advice, a mask obligation in public transport, shops and catering, the stimulation of self-tests and the immediate start of a booster campaign are relatively popular. This may be a reason to pursue the same corona policy in both scenarios. That makes communication easier. The same corona policy can be pursued if the virus flares up in the autumn or if a more contagious variant has been identified (previously) whose consequences are still unknown.

Comparing different forms of support

In the two experiments we conducted in this study, participants were asked in two different ways about support for corona measures. In the first experiment, we asked them what they would choose for themselves if they were sitting in the driver's seat (active support); in the second experiment, we asked a different group of participants per measure to what extent they would find it acceptable if the government decided to do so (passive support).

In the first three scenarios, we see that the percentage of participants that would actively opt for a measure is lower than the percentage that would accept the measure if the government decides to do so. We conclude from this that a substantial group of citizens prefer to accept a bit more risk themselves (they choose fewer measures) if they have to make decisions from the role of a policymaker (also for others), but nevertheless support certain measures if they are introduced by the government and therefore imposed from above. In the fourth scenario, we see that the percentage of participants who recommend or find radical measures such as closing schools, catering and sports facilities acceptable is very low. It is striking that participants in experiment 1 and experiment 2 rank the measures in almost the same way. Thus, measures most often advised by participants in Experiment 1 are also seen as the most acceptable measures by participants in Experiment 2.

Citizens increasingly feel that their preferences should be taken into account

The results of the study form a piece of the puzzle that the government must complete. Of course, other studies are also being conducted and the government is also taking other elements into consideration. 23% of the participants believe that the advice of citizens should weigh more heavily than the advice of scientists or that only citizens should be listened to. In a study into the relaxation of corona measures in May 2020, this was only 5%. Citizens therefore increasingly believe that their preferences should be taken into account in policy. On the other hand, about 40% of the participants think that advice from scientists should be more important than advice from citizens. In May 2020 this was still 70%. The vast majority of participants believe that both advice from citizens and advice from scientists should be taken into account by politicians in decision-making about corona measures.

More than 70% of the participants found the Participative Value Evaluation to be a good method for involving citizens in choices that the government has to make regarding corona policy. 5% of the participants thought this was not a good method. More than 60% of the participants say that the final decision will be more acceptable to them because the government involves citizens on a large scale in corona policy through this research, while 9% indicate that the fact that the government has this research carried out has no effect on their acceptance of decisions about corona policy.

Read the Dutch report here

FAQs

: What should the government do if a new variant emerges that makes many people sick? And what if a less violent variant shows up? What goals should the government actually try to achieve with the measures? We answered these questions with a Participation Value Evaluation (PVE). PVE is a method that enables large-scale citizen participation. This gives the Dutch government insight into the values and preferences of its citizens.
: A total of almost 5000 Dutch people took part. This group reflects Dutch society in terms of age, gender and education level. They participated via our online citizen participation platform Wevaluate. They could do this at home and whenever it suited them.
: The results of our research have been incorporated into a recommendation by the Behavioral Unit of RIVM. Ernst Kuipers, Minister of Health, Welfare and Sport (VWS), referred to this advice in the letter to parliament. He advised to use our research and the advice of the RIVM in the further elaboration of the corona strategy.