Herwig Ostermann, Executive Director of Gesundheit Österreich GmbH, talks about scientific evidence as a basis for wide-reaching political decisions during the COVID-19 pandemic and the PHIRI project for improved knowledge transfer in Europe.
Interview: Dietmar Schobel
Mr Ostermann, the COVID-19 pandemic has suddenly put the spotlight on public health experts. What has your experience been?
Herwig Ostermann: Due to the COVID-19 pandemic, we have really had our hands full with work and, most likely, still have busy times ahead. This has less to do with the intense media attention that our activities have suddenly received but more with the fact that many of the employees of Gesundheit Österreich GmbH have been under considerable pressure in their respective areas of work due to the COVID-19 pandemic. Nothing has fundamentally changed for us, though. A key task of Gesundheit Österreich GmbH has always been to serve the state by providing data and expertise as a solid basis for political decisions on the planning and management of the healthcare system. However, as a consequence of the COVID-19 pandemic, this now often involves decisions where the impact extends far beyond the healthcare system. This especially applies to the social measures to contain the pandemic, such as the lockdowns, which have ultimately affected all areas of society – from the economy and the educational sector to sporting events and cultural activities. In a sense, the COVID-19 pandemic has raised the general awareness of health as an issue that concerns society as a whole.
How well – or how poorly – did researchers and politicians work together during the COVID-19 pandemic?
Herwig Ostermann: In my opinion, the same principles apply here as were already in place before the COVID-19 pandemic. This means that a three-step approach should be taken, as is usual in health technology assessments (HTA), which have become an integral part of health policy decision-making for quite some time now in many countries. These steps are assessment, appraisal and decisions. Assessment refers to the collection of evidence, i.e. of established knowledge on a topic, while appraisal involves evaluating this evidence and making recommendations based on it. These in turn provide a basis for the decisions that are to be taken by politicians. I see this division of responsibilities as being particularly important. It is not up to the scientific community to engage in decision-making that has an impact on society as a whole. The democratic legitimacy lies with elected political decision-makers.
It is not up to the scientific community to engage in decision-making that has an impact on society as a whole.HERWIG OSTERMANN, EXECUTIVE DIRECTOR OF GESUNDHEIT ÖSTERREICH GMBH
COVID-19 is a newly emerging severe infectious disease about which there was initially little or no knowledge and which remains the subject of many unanswered questions today. In light of this, how well have researchers been able to perform their role of assisting in policy decisions?
Herwig Ostermann: As already mentioned, there are criteria for good practice that aim to support political decisions with scientific expertise. We need to adhere to these principles and clearly convey what information is based on reliable knowledge and what issues can only be addressed with qualified recommendations. As the COVID-19 pandemic has progressed, we have of course also learned more and broadened our knowledge. But many complex problems have arisen that need to be considered from a variety of different perspectives. Take school closures, for example: the positive impact on the general infection rate has to be balanced out against the negative social consequences, which are particularly severe for disadvantaged groups in the population. The debate on this issue in Austria, for instance, has been extremely polarising. Unfortunately, the bigger question has often been overlooked here, namely how we can ensure high-quality education – even if it appears necessary to close schools or offer hybrid teaching.
To what extent should politicians make the scientific basis for their decisions transparent, and would more transparency also lead to a higher degree of acceptance by the general public?
Herwig Ostermann: In principle, of course, we should strive for the greatest possible degree of transparency. But we constantly have to contend with questions that have no simple answers and are also the subject of heated debates within the scientific community. This has happened quite often during the COVID-19 pandemic. Hence, transparency is liable to be limited whenever a degree of nuance is required that is difficult to convey in public communication – and especially in media communication – during these fast-paced times of ours. One thing that has definitely proved successful is for politicians and scientists to appear together before the media to comment on current developments and measures.
The PHIRI project endeavours to allow European countries to benefit from each other’s experience and expertise.HERWIG OSTERMANN, EXECUTIVE DIRECTOR OF GESUNDHEIT ÖSTERREICH GMBH
How effective have data sharing and knowledge transfer been within the scientific community in Europe and around the world during the COVID-19 pandemic?
Herwig Ostermann: Cooperation among researchers and especially between national public health institutions has worked very well. However, there is still much room for improvement when it comes to the data portals that are available for this purpose. The Population Health Information Research Infrastructure (PHIRI) project, which involves Gesundheit Österreich GmbH and is supported by the European Union’s Horizon 2020 research programme, aims to ensure the effective utilisation of available sources of information. PHIRI was designed to create a digital structure to facilitate the exchange of data and knowledge on how to best contain the COVID-19 pandemic, but also with a focus on population health in general. The project endeavours to allow European countries to benefit from each other’s experience and expertise, and it seeks to provide swift answers to scientific and political questions.
Health economist Herwig Ostermann has been Executive Director of Gesundheit Österreich GmbH (GÖG) since 2016. The institution has around 200 employees and provides advice for decision-makers as the national public health institute in Austria. He is also one of 18 members of the team of advisors in the coronavirus task force, the main committee fighting the COVID-19 pandemic in the Austrian Ministry of Social Affairs, Health, Care and Consumer Protection.