Abstract
The COVID-19 pandemic has posed an extraordinary challenge for public health and health policy. Questions have arisen concerning the main strategies to cope with this situation and the lessons to be learned from the pandemic. This conceptual paper aims to clarify these questions via sociological concepts. Regarding coping strategies used during the pandemic, there is a strong tendency for health policymakers to rely on expert knowledge rather than on evidence-based knowledge. This has caused the evidence-based healthcare community to respond to urgent demands for advice by rapidly processing new knowledge. Nonetheless, health policymakers still mainly rely on experts in making policy decisions. Our sociological analysis of this situation identified three lessons for coping with pandemic and non-pandemic health challenges: (1) the phenomenon of accelerating knowledge processing could be interpreted from the organizational innovation perspective as a shift from traditional mechanistic knowledge processing to more organic forms of knowledge processing. This can be described as an “organic turn.” (2) The return of experts is part of this organic turn and shows that experts provide both evidence-based knowledge as well as theoretical, experiential, and contextual knowledge. (3) Experts can use theory to expeditiously provide advice at times when there is limited evidence available and to provide complexity-reducing orientation for decisionmakers at times where knowledge production leads to an overload of knowledge; thus, evidence-based knowledge should be complemented by theory-based knowledge in a structured two-way interaction to obtain the most comprehensive and valid recommendations for health policy.
Highlights
We found that Burns and Stalker’s contingency theory [22] delivered the best general explanation for what happened during the COVID-19 pandemic
The first lesson is that the traditional form of standardized, bureaucratic knowledge production, review, and transfer is suitable for stable environments but not for unstable environments
The second lesson is that the bureaucratic inner limits of evidence reviewing, and transferring in traditional institutions [e.g., National Institute for Health and Care Excellence (NICE) or Institute for Quality and Efficiency in Health Care (IQWiG)] was a main reason for the rise of experts during the pandemic
Summary
The COVID19 pandemic is an example of a situation where both of these problems have arisen: the lack of knowledge at the outset (phase 1) was replaced after a few months by an exponential rise in knowledge production (phase 2) This rapid increase in evidence production exacerbated the problem of research waste [1] due to the unnecessary duplication of studies and poor study quality [2]. In both phases, the knowledge deficit phase (phase 1) and the knowledge overload phase (phase 2), policymakers often need support with regard to the complex decisions they have to make
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