Rebuild Pandemic Preparedness within Society through Public-Expert Dynamics

• In Event: Vaccines and Science

Abstract

Existing research on the COVID-19 pandemic underscores the crucial role of trust between the scientific community and the public. This trust is vital for persuading individuals to adhere to mobility-restricting public policies and take up vaccination, thereby strengthening society's preparedness against public health crises. While existing research paid attention to the role of experts when studying topics such as vaccination communication, a theoretical framework is yet to be developed to understand the varying public-expert dynamics across societies that are potentially malleable during normal times. Meanwhile, relatively little is known regarding how different factors have shaped the dynamics, in particular, the public’s opinion toward experts. This work draws on two in-depth case studies on England and China to illustrate the public-expert dynamics and their longitudinal changes in each country in the 21st Century. We examine how past (realized or unrealized) public health crises, as well as the institutional environment, have contributed to the development of such dynamics over time. Although China and England are distinctive in many ways and do not form a ‘most-similar cases’ comparative design for theory-testing, this pair nevertheless offers heuristic values as they represent two very different scenarios, where the countries’ epidemic experience, the ways experts are involved in policymaking, and the infrastructures of expert-public trust are all distinctive.

Empirically, we combine both qualitative and quantitative analysis. In the descriptive narratives of the historical development of public-expert dynamics in the two cases, we employ the process-tracing method, following the inductive theory-building logic. Data are collected from a wide range of sources, including the archives of official policy documents, parliamentary debates, MP interviews and press conferences, news articles, social media data, and so on. To further unpack the distinct patterns of doctor-patient trust in China and the UK, both before and after the COVID-19 pandemic, we use evidence from existing multi-wave surveys (ISSP) and archives, demonstrating that the patterns exhibit significant stability over time in both countries, withstanding the pandemic's impact. While patients in the UK hold a neutral attitude toward trust in healthcare systems, Chinese patients consistently express a high level of trust in healthcare institutions. Concerning interpersonal trust, while patients in both countries demonstrate a high level of trust in general doctors as a profession, they hold distinctive attitudes toward specific doctors with whom they have direct interaction. In the UK, local doctors are the most trusted source of COVID-related information, while Chinese patients hold sustained suspicions about individual doctors’ skills and motivations, perceiving them as potentially self-interested. Our evidence provides a robust empirical foundation for unpacking how institutional features of healthcare systems have contributed to such cross-country differences, and with continuous work, we investigate the causal explanations from contextualized past incidents.

Authors

• Yuxi Zhang, University of Oxford

• Yan Wang, University of Manchester