Scientization Under Pressure—The Problematic Role of Expert Bodies During the Handling of the COVID-19 Pandemic

Most scholars concede that there is a grey zone between politics and administration; as well as implementing policy administrators also participate in advising political executives on policy development (Alford et al., 2017; Demir & Nynan, 2008; March & Olsen, 1989; Svara 2008; Waldo 1965). In practice, the public administration apparatus is a major political actor and not simply a neutral managerial tool. The organization of the administration is therefore a politically powerful instrument able to influence the content of public policy (Egeberg &Trondal, 2018). Moreover, the capacity and competence of the public management apparatus are crucial for the implementation of public policy. Thus, in reality public administration is comprised of political-administrative organizations that affect both the content and the implementation of public policy (Olsen, 2010).

One of the most important features of the administrative state is the quality of its civil servants’ expertise—in other words, public decisions should be based on professional decision-making premises, even if it is up to the political and administrative leadership to balance these with other premises (Rothstein & Teorell, 2008; Fukuyama, 2013; Raadschelders, 2017). There is a growing debate about the increasing reliance on scientific expertise in policymaking (Fischer, 2009). Some scholars use the term scientization of policy advice to refer to an increased reliance on advice based on scientific knowledge and provided by experts. This implies that scientized public agencies are endowed with scientific authority and framed in apolitical terms (Marcussen, 2006; Drori & Meyer, 2006; Christensen, 2018). It is often taken for granted that public administration experts represent a homogeneous body, implying that the advice the political leadership receives is unambiguous. In practice, however, that advice may differ because experts disagree or because evidence-based mechanisms are insecure and disputed. Adding to this, the organizational position of the various experts differs and hence also their impact on the decisions of executive leaders.

The handling of COVID-19 in various countries seems to be a good illustration of the differentiated impact of experts on public decision-making in crisis situations (Boin et al., 2020; Cairney & Wellstead, 2020). The COVID-19 crisis has tested the limits of what public bureaucracies are organized to handle. It is a transboundary and creeping mega-crisis characterized by complexity, uncertainty regarding means-end relations, and ambiguity regarding values. What is more, important decisions have had to be taken under great time pressure (Boin et al., 2020). Both governance capacity and governance legitimacy have been challenged (Christensen et al., 2016). Strategic crisis management is a managerial and functional matter requiring expert knowledge, but also a political issue involving value considerations and support from political executives as well as from citizens. Difficult trade-offs between life and death on the one hand, and individual freedom and civil rights on the other, together with economic issues related to unemployment and bankruptcy, social disruptions, and challenges for vulnerable groups, all need input from both types of experts if they are to be handled properly (Boin & ‘t Hart, 2003).

This case study focuses on the role of experts in the Norwegian decision-making process at the central level during the pandemic. The following research questions are asked:

These questions are answered using public documents showing the advice given by the main specialized epidemiological body—the Norwegian Institute of Public Health (NIPH)—and by the more generalized health expert body—the Norwegian Directorate of Health (NDH). The latter has a coordinating role in health-related crises like pandemics and is organizationally closer to the Ministry of Health and Care Services (MH) than the NIPH. It is shown show how the MH and the government have balanced this often different advice in their regulations. Since the national regulatory rules are very complex and have changed more than 200 times during the pandemic, the focus is on some of the major issues involved in balancing the main considerations. Two perspectives taken from organization theory—structural and cultural—are used to explain patterns and variations (Christensen et al., 2020).

In this case, the focus is primarily on the relationship between the political executive and the expert bodies subordinate to the ministry in charge of handling the pandemic. But the role of administrative executives in the MH, of whom some also have relevant expertise in the field in question, will also be discussed. The subordinate expert bodies are also administrative bodies in many respects, but the focus is on their output and expertise related to handling the pandemic.

The seminal work of Aberbach et al. (1981) teased out four images of the politics/administration dichotomy. Image I represents the most pure distinction according to which politicians make policy and civil servants administer and implement it. Image II stresses that politicians and bureaucrats both participate in policymaking, whereby politicians advance interests and values, while bureaucrats supply facts and knowledge (cf. Simon, 1957). Image III asserts that both politicians and bureaucrats engage in policymaking, with politicians representing the broad and diffuse interests of the unorganized public, and bureaucrats asserting the narrower interests of organized actors. Image IV is a pure hybrid of the other images. A lot of studies have followed up on this initial study. In a recent survey of local politicians in four countries, Bækgaard et al. (2020a) found that role perceptions are much more complex and seem to vary much more between and within countries than suggested by the Aberbach, Putnam and Rockman (1981) study.

Lodge and Wegrich (2014) discuss four different types of administrative capacity in the modern state, all of which are relevant for analyzing crisis management. The four types are delivery capacity, regulation capacity, coordination capacity, and analytical capacity. Scientization relates to analytical capacity, i.e., the government needs policy advice and information from experts to make decisions, particularly in crisis situations (Moran & Green, 2020). One important aspect of analytical expertise is how it is organized, meaning whether it is close to the political executive, as in agencies, or needs to be acquired from outside the government.

During a pandemic, evidence-based decision-making faces three obstacles (Rubin et al., 2021). First, there is a lack of reliable evidence about what to base decisions on combined with a high public risk of doing nothing. Second, new evidence about the spread and seriousness of the virus and about the effectiveness of the measures taken is continually emerging. This is illustrated by a principled approach versus a pragmatic approach (Boin & Lodge, 2020). Third, there may be a breakdown of the usual hierarchy of scientific evidence in the policymaking process. The dominance of health experts is challenged by advice from experts outside the health sector.

According to a structural-instrumental perspective, the overall relationship between political leaders and experts can be of two types: either hierarchical or characterized by heterogeneity and negotiations (March & Olsen, 1983). In a hierarchical model the top political leadership will make the most important decisions in a crisis, and experts will be subordinate, meaning that their knowledge and advice will be used to achieve public goals and balanced against other considerations by the political executive. A negotiation model takes as a point of departure the idea that public organizations are heterogeneous regarding the interests and views of both political and expert actors. Cyert & March (1963) assert that under such conditions, decisions can be made in one of three ways: the majority decides; there is a compromise; or there is a quasi-solution of conflicts, which can be based on sequential attention to goals, in others words, ‘agreeing to disagree’. This means that different actors will have their wishes fulfilled at different points in time or else priority will be granted to local rationality, whereby different subordinate bodies act according to their own goals and values (Allison, 1971). A main argument is that the organization of expert knowledge within the government conditions expert influence (Christensen, 2021).

Here, this perspective is used in three ways: first, to describe and analyze whether the political and administrative executives in the ministry determine the major decision-making premises and take the decisions required to handle the crisis; in this case expert advice will be subordinated to and balanced with broader political and societal considerations. Second, to examine the relevance of the hierarchical organization of the two main expert bodies involved in fighting the pandemic. Third, to address disagreements between the political leadership and the expert bodies as well as between the two expert bodies, and to examine how this plays out regarding major decisions taken on handling the pandemic.

According to a cultural perspective, public organizations will develop informal norms and values in a gradual process of adaptation to internal and external pressure, giving them a unique identity (Selznick, 1957). These informal norms will develop with formal structures and norms as major constraints. Cultural identity can be connected to a wider cultural context, but here the focus is on culture in a narrower political-administrative context. In this context culture can be collaborative, political, or expert-oriented; moreover, it does not need to be homogeneous but will follow what is seen as culturally appropriate (Christensen & Røvik, 1999). Cultural traditions and path-dependency are highly significant for understanding public decision-making based on such a perspective.

This perspective is used to analyze whether diverse cultural traditions are significant in the approach taken to combating the pandemic and for the degree of agreement about measures to be taken, or whether the culture is relatively homogeneous in a small country generally characterized by a close relationship between political leaders, administrative leaders, and experts (Christensen, 2003). The relevance of the different cultures of the two expert bodies is also discussed, including the fact that, while they are normally subordinated to the ministry but on a par with each other, during the pandemic the NDH has coordinated with the NIPH and has been superior in the hierarchy.

The Ministry of Health and Care Services (MH) is the central crisis management ministry in Norway for handling a pandemic, and its subordinate agencies, the Norwegian Directorate of Health (NDH) and the Norwegian Institute of Public Health (NIPH), are the main expert bodies. In addition, the prime minister and the cabinet are central actors.

For this study, analyzing the roles and collaboration between the two expert bodies, including their main tasks and their formal and actual relationship to the ministry, is paramount. The NDH has three main roles: as an executive agency, as a regulatory authority, and as an implementing authority in the area of health policy. In its professional capacity, it has two main tasks related to handling COVID-19—gathering knowledge and experience on health issues and giving advice and guidance on strategies and measures to the ministry. In 2019, the NDH had 545 employees.

The NIPH acts as a national competence institution for infectious disease control, which is most relevant for the pandemic; in this area it has far more resources and expertise than the NDH. It is responsible for knowledge production and systematic reviews of the health sector and provides information about the population’s health, the factors that influence it, and how it can be improved. Key activities are emergency preparedness, investigations, consultancy, laboratory services, and research. As of January 1, 2019, the NIPH had 866 employees.

During crises and pandemics there is a hierarchical relationship between the two agencies. The NDH leads the coordination of the health sector as the superior agency and decides which measures are necessary. The NDH has the authority to impose regulatory measures in pandemics. This means that the NIPH sends its expert advice to the NDH, which then balances this with broader health and other concerns and then forwards its advice to the ministry.

One can distinguish between three types of expert assessment. First, there are the narrower assessments by health professionals, such as analyzing the cause and spread of the pandemic and the costs and health effects of various regulations. Second, there are assessments of other factors such as the losses and challenges for families, employees, and employers posed by the regulations, gaps in schooling for children, the impact of restrictions on leisure activities and cultural events on welfare, and the negative impact of restrictions on individual rights and freedoms. Third, there are broader value assessments, such as how to assess the trade-off between life and health, on the one hand, and individual freedom and economic considerations, on the other. These are the responsibility of the political leadership. The core responsibility of the NIPH is to assess the first set of narrower considerations, while the role of the NHD is primarily related to the second broader set of assessments; the trade-offs between different values and considerations come under the purview of the government. In practice, however, there are grey zones between the responsibilities of the NHD and the NIPH. The NIPH has gone beyond the narrower issues requiring health expertise, while the NHD has also been involved in epidemiological assessments, an overlap that makes their relationship potentially challenging.

The main data for this paper are provided by public documents, including reports, websites, and media coverage related to the political and expert authorities during the first year of the pandemic. The report from the Enquiry Commission on the authorities’ crisis management of the corona pandemic is also an important source, including transcripts from its interviews with the main actors (NOU 2021:6). The point of departure is the initial and primary stance of the main expert body, the NIPH, on some major issues and the decisions taken by the government to tackle these issues, i.e. its regulations, deregulations and re-regulations, particularly in cases where they disagreed. A high level of transparency and open access to policy advice has made it easy to access the diverging views of expert bodies. The advantage of this approach is that it allows us to contrast expert advice and political decisions in cases where they differ. The disadvantage is that it could lead to an exaggeration of the degree of conflict. Moreover, on some issues the government and NIPH may have changed their views in complex ways.

The focus on the NDH is secondary, partly owing to more limited access to data. While the NDH has published reports on some issues, on others it is difficult to find out what its stance is, since this is communicated confidentially to the government. Thus, information is overall more limited. One would assume that the relationship between the ministry and the NDH would involve the NDH giving the ministry advice based on the NIPH’s views and its own expertise, but it may also include actions based on anticipated reactions from the government and pressure from the political executive to filter the NIPH’s advice in a certain way and thus exert further political pressure on the NIPH.

Ministry-agency relations. According to the Enquiry Commission, the division of responsibility between the Ministry of Health and Care Services (MH) and the subordinate agencies has been rather unclear during the management of the COVID-19 crisis, especially with respect to the Norwegian Directorate of Health (NOU 2021:6). Overall, the ministry has exerted rather tight control and its secretary general has played an active role. Altogether the NDH and NIPH have received more than 300 written assignments from the ministry during the pandemic of which several were rather small, overlapping, and with short deadlines. Thus, the ministry’s crisis management and coordination has been rather detailed, constraining its ability to make holistic and strategic assessments. However, the ministry has also delegated crucial responsibility to the NDH, such as the power to ‘push the big red button’ on March 12, 2020, with the introduction of draconian measures (Høie, 2021; Solberg, 2021). Later, daily collaborative meetings between the MH, the NDH, the NIPH, headed by the secretary general in the MH were an important ad hoc coordinating mechanism and they were also allowed to participate in the regular cabinet meetings and the inner cabinet covid-19 committee.

The relationship between the NDH and the NIPH. In the first phase of the pandemic, when the agencies were under great pressure and major decisions had to be taken quickly, there were cooperation problems and disagreement between the NIPH and the NDH about the distribution of roles and tasks and about who was responsible for what, which according to the NIPH resulted in confusion and extra work (NOU 2021:6). In early March 2020, the NIPH wanted to wait until May/June before introducing major infection containment measures, by which time the spread of infection would have been more advanced. Until March 6, the NIPH and the NDH held separate press briefings, which started to become a problem. A crisis meeting between the two agencies was held March 8. The situation then changed quickly. On March 10, the minister of health and care gave a briefing in Parliament but did not mention that the country could close down within a few days. Later the same day there was a meeting in the Emergency Response Committee for Biological Issues headed by the NDH and attended by the NIPH. At this meeting, the NIPH suggested various measures. It warned against starting too early with contact-reducing measures and was worried about setting the limit on public gatherings too low. The decision to close down Norway was, however, taken at a meeting on March 12, which the NIPH did not attend, and it was later given fifteen minutes to assess the measures proposed by NDH (NOU 2021:6). The government had given the director of the NDH the discretion to propose major regulations without involving the NIPH, which the director of the NIPH later said was rather problematic. The secretary general in the MH indicated that this was appropriate, since he thought that the NIPH should not play an active role in these regulatory decisions (Larsen, 2021); this was a controversial decision.

Once the COVID-19 regulation was introduced, the main procedure was that the NIPH’s policy advice was conveyed through the NDH as an advisory body to the political executive. Owing to internal challenges with unclear roles and responsibilities, the minister of health sent a letter in November 2020 to all involved bodies, informing them about the roles and responsibilities of the NDH. He said the NDH should coordinate, but it had no power to steer the other bodies. In case of disagreement, the authorities should try to find an agreement. If they were not able to agree, the ministry would have to decide how to resolve the disagreement. Thus, during the first phase of the pandemic, collaboration between the NDH and the NIPH was difficult, and coordination was less than optimal, but these problems decreased somewhat over time.

One rather systematic and interesting feature during the pandemic has been the general attitudes to the coupling between evidence-based knowledge represented by the NIPH and the regulations, which were a main responsibility of the NDH. The NIPH served mainly as a scientific epidemiological advice body while the NDH was a bureaucratic health authority, but in practice these roles overlapped. The government, including the NDH, has argued that the knowledge basis for the regulatory measures was weak, but that urgency based on the precautionary principle and a suppression strategy drove a lot of the regulations. The advantage of this strategy is that the government has been transparent, which is natural in such a massive health crisis, but can also be seen as a political precaution. The minister of health said in an interview with the Corona Commission that it was better to be criticized for doing too much than too little (Høie, 2021). The disadvantage is that existing knowledge has been downplayed and regulations have become very complex, because new regulations and periodic deregulations and re-regulations have been added, in a layering process (Mahoney & Thelen, 2010). The NIPH has taken a more cautious attitude, more informed by the proportional principle (Boin & Lodge, 2021). It has talked more in terms of what is known or not known and stressed that trying to find out the effects of specific regulatory measures is important.

During most of the pandemic, the political leadership and the NIPH seem to have disagreed on many questions, even though they sought to present a united front towards the public, which may reflect political pressure on the NIPH. On most central questions, the NDH agreed more with the government than with the NIPH, which reflects its proximity to the political executive. This pattern began in the first wave in March 2020, when the main rhetoric of the government was about stopping the pandemic; the NDH, by contrast, used the concept of suppressing the virus, while the NIPH focused on ‘slowing down’ the spread of infection. From then on, the NIPH argued for fewer restrictions and more liberal policies, called ‘evidence-based’ by some, but this more liberal line of argument did not have much impact on the government’s actual pandemic regulations.

In late October 2020, at the start of the second wave, some of the same pattern occurred. The government anticipated a new wave and thought it would be severe. The NDH supported this position, while the NIPH defined the situation as more uncertain. In the third wave, which started in mid-February 2021, fewer disagreements were revealed, even though the regulations were stricter than ever. There could be at least three reasons for this. The first is that the two expert bodies were indeed more in agreement during the third wave, having engaged in a kind of mutual adaptation. A second reason could be that some conflicts now took place internally rather than in public. A third possibility is that the longer the pandemic lasted, the more problematic it became to advance some of the NIPH’s views, even though they can be seen as evidence-based. An examination of individual issues reveals, however, that the pattern is still mixed concerning ‘who is right’ and there is also still a lot of ambiguity and uncertainty about which regulations have been effective.

Attitudes to specific regulatory issues. Travel restrictions were one of the first areas of conflict and disagreement to be examined in more detail. Regarding international travel, up to the end of February 2020, the NIPH did not recommend any major travel restrictions. It was possible for Norwegians to travel abroad without any testing or quarantine when they returned. When the travel and border restrictions were imposed in March 2020, they were rather weak, but still involved some limits on travel, especially for foreign citizens. The NIPH was rather skeptical towards this regulation, and one of its main arguments was that the virus had already entered Norway, mainly through ski tourists coming home from Austria and Italy, and that more border restrictions would be less effective than fighting the virus inside Norway.

Later, the NIPH moved in a more restrictive direction on this question. In June 2020, the political executives in the ministry and government opened the borders for foreign guest workers and granted them an exemption from the ten-day mandatory quarantine, against the advice of the NIPH and the NDH, who warned that there was a particularly high risk that this group would import infection. This exemption was introduced after lobbying from industry and the trade unions. Later, in the second wave from late October 2020 and the third wave from mid-February 2021, the NIPH recommended harsher regulations. At the beginning of 2021, the borders were in fact almost completely closed, even for foreign guest workers, to avoid importing infections, which resulted in a public debate and later a few adjustments for health workers and eventually for other groups as well.

It was decided in March 2021 to close all kindergartens and schools for five to six weeks. The government’s argument, supported by the NDH, was that children and young people were also contributing to spreading the virus, since they were in close proximity in these institutions. The NIPH was initially strongly against this regulation, especially for kindergartens and elementary schools, for two reasons. First, it thought that children played a marginal role in the pandemic and that the social consequences would be too negative, especially for vulnerable children. The latter argument was repeated later by the NIPH, when it was more eager than the government to open the schools again in late April/early May 2020. It is interesting that the NIPH’s concern for vulnerable young people, supported by a report from an expert group, never figured prominently in the government regulations, i.e. it was not prioritized relative to health and economic concerns. In retrospect, the prime minister admitted that school closures were one of the early measures that she regretted, and the Corona Commission was also critical on this point (NOU 2021:6).

The regulations with respect to schools were rather complex and they aroused the skepticism of the NIPH, which pointed to the difficulties of children having on-line school at home while parents were also having to work from home. In the second wave, a traffic light model was established whereby in municipalities with high infection rates, schools should not be closed but should adhere to red level regulations, including strict contact-reducing measures and less frequent school attendance. This system helped to keep schools open, but it also fluctuated a lot and was difficult to understand. This model was combined with a complicated system of geographical transmission zones, with various and changing regulations. During the past year of the pandemic, the government has never used a national regulation on closing kindergartens and elementary schools nationwide again, but it has done so in specific areas at various times. On March 15, 2021, the city of Oslo decided to close schools and kindergartens for ten days against the advice of the NIPH.

What is interesting is that the NIPH was skeptical about masks for a long time. It repeatedly cited international research showing that wearing masks had little effect, something that critics said was plainly wrong. They even gave an example, repeatedly saying that 200,000 people wearing masks would potentially save one life. NIPH also argued that masks could be harmful and that they were often used in the wrong way. Despite all this, the government decided to introduce the mask regulation, without much scientific supporting evidence, probably mainly because the measure had been widely adopted in other countries. Eventually the NIPH supported it but argued that the reason for its change of stance was the higher number of transmissions. In a publicly broadcast debate, the minister of health reacted strongly when the mediator brought up this difference in opinion between the government and the NIPH, indicating that the NIPH had been put under a lot of political pressure on this question.