The role of public health scientists within the German political discourse on the COVID-19 pandemic

Abstract Background During the COVID-19 pandemic politics was in search of scientific evidence to underpin decision making like never before. It is remarkable that voices from public health were less noticeable than those of virologists or immunologists. The aim of our ongoing study is to explore how public health scientists perceive their role in the relationship of their discipline and politics. Methods We conducted 10 reflexive interviews with epidemiologists and public health scientists from Germany and collected documents (official statements and policy briefs of scientific societies). Data from both sources were analysed using situational analysis (Clarke, 2018), an approach used to map and analyse discourses in complex situations. To ensure data quality we used respondent validation. Results According to participants, (1) improving population health was the top priority. Politicians tended to focus on short-term goals rather than long-term consequences. (2) Recognition of public health was increased by the pandemic in Germany. (3) However, politicians favoured virology, biomedical and clinical perspectives. (4) The strong motivation of public health scientists to support politics at the beginning of the pandemic turned into disillusionment. (5) The composition of advisory boards was described as non-transparent. (6) Initiatives by the public health community were not sufficiently impactful. (7) Expectations of policymakers regarding future cooperation were not clear to participants. Conclusions The results present different facets of a delicate relationship between public health sciences and politics. The pandemic increased the visibility and impact of public health in Germany on the one hand but also demonstrated that the realms of public health (science) and politics were not well connected. Involving scientific expertise in politics requires more transparency and the normative assumptions underlying the logics of science and politics need to be made more explicit. Key messages • The potential of public health to address the covid-19 pandemic has not been sufficiently acknowledged by policymakers, and the involvement of its experts requires greater transparency. • Reflecting on the normative assumptions underlying the different logics of public health sciences and politics can support their cooperation in the future.


Background:
To face the second COVID-19 wave, Italy implemented a tiered restriction system with different risk levels (yellow = low; orange = medium, red = high).It is unknown whether the effect of the tiers was equal among provinces with varying levels of socioeconomic deprivation (SED).At each restriction level, we analyzed the impact of the province's SED on the SARS-CoV-2 daily reproduction number (Rt).

Methods:
We considered the Rt (Nov 2020-May 2021) as the dependent variable and the SED as the independent variable.The Rt was estimated using daily incidence data from the Civil Protection Department as the instantaneous Rt.The province SED was measured using the percentage of individuals whose yearly income was less than 10,000E (2019 data from the Ministry of Economy and Finance).We used multilevel linear regression models with random intercepts stratified by restriction level to estimate the effect of the SED on Rt (b) and its Standard Error (SE).Our analyses adjusted the estimates for the number of days into the tier first and then for other covariates.

Results:
We found different levels and trends of Rt by SED in every restriction.Days-adjusted models found a containing effect for the red and the orange tier, while the Rt had an increasing trend in yellow.Higher SED was associated with higher Rt: b was positive and significant in red (b = 0.004 SE = 0.001) and orange (b = 0.002 SE = 0.001) but not in the lowest tier (b = 0.001 SE = 0.001).We found a significant interaction between the number of days into the restriction and the SED in the complete models.Compared to less deprived, more deprived provinces had slower Rt reduction in the highest tier.However, they had steeper Rt reductions in orange and slower increasing trends in yellow.

Conclusions:
The highest restriction had milder effects in more deprived provinces, while lower tiers were more effective.These results

Background:
During the COVID-19 pandemic politics was in search of scientific evidence to underpin decision making like never before.It is remarkable that voices from public health were less noticeable than those of virologists or immunologists.The aim of our ongoing study is to explore how public health scientists perceive their role in the relationship of their discipline and politics.

Methods:
We conducted 10 reflexive interviews with epidemiologists and public health scientists from Germany and collected documents (official statements and policy briefs of scientific societies).Data from both sources were analysed using situational analysis (Clarke, 2018), an approach used to map and analyse discourses in complex situations.To ensure data quality we used respondent validation.

Results:
According to participants, (1) improving population health was the top priority.Politicians tended to focus on short-term goals rather than long-term consequences.( 2 However, politicians favoured virology, biomedical and clinical perspectives.(4) The strong motivation of public health scientists to support politics at the beginning of the pandemic turned into disillusionment.(5) The composition of advisory boards was described as non-transparent.(6) Initiatives by the public health community were not sufficiently impactful.( 7) Expectations of policymakers regarding future cooperation were not clear to participants.

Conclusions:
The results present different facets of a delicate relationship between public health sciences and politics.The pandemic increased the visibility and impact of public health in Germany on the one hand but also demonstrated that the realms of public health (science) and politics were not well connected.Involving scientific expertise in politics requires more transparency and the normative assumptions underlying the logics of science and politics need to be made more explicit.

Key messages:
The potential of public health to address the covid-19 pandemic has not been sufficiently acknowledged by policymakers, and the involvement of its experts requires greater transparency.
Reflecting on the normative assumptions underlying the different logics of public health sciences and politics can support their cooperation in the future.
Abstract citation ID: ckac129.463Italian survey on the use of a multidisciplinary approach for age assessment of UAM

Issue:
Many methods are used to assess the age of unaccompanied foreign minors (UAM).In Italy, in the frame of a new legislative asset, a multidisciplinary protocol has been adopted in July 2020 with the aim of ensuring that all UAMs are assessed uniformly throughout the country when their age is in doubt.The assessment is based on a multidisciplinary -social, psychological and physical -evaluation performed by a team of specialists.The local health authorities (ASL) carry out the assessment when requested by the Juvenile Court.

Description:
One year after the establishment of the protocol, INMP launched a national survey, through an online questionnaire, to investigate the formal adoption of the protocol by the ASL and their adherence in practice.The survey started on 10 January 2022 and closed on 8 March 2022.

Results:
Out of 118 ASL that were asked to participate, 102 (85%) answered.37 declared to have a multidisciplinary team for age assessment.Of them, 18 use the formal protocol, 11 use an approach ''in line'' with the protocol and 8 have a forensic team, out of the rules of the protocol.Of the 65 that did not set up the team, 22 declared that they were ready to do so.846 age assessment requests were reported and 687 were carried out.398 migrants were recognized as minors, 222 migrants were not recognized as minors, and the age of 67 migrants remained uncertain.

Lessons:
The pandemic period prevented the effective adoption of the protocol by the ASL, that were strongly engaged in the COVID 19 response.There is still great variability in the way the age assessment of UAMs is conducted and in order to counteract the use of inadequate/outdated practices, it is necessary to actively promote and support the adoption of the protocol.In addition, a continuous comparison/dialogue between the multidisciplinary teams, the Juvenile Court, and the Police Headquarters is also needed, so that the procedure is requested only when necessary and carried out properly.

Key messages:
In case of doubt, the age of all UAM has to be assessed in a uniform manner throughout the country.The adoption of the multidisciplinary protocol has to be actively promoted and supported to counter the use of inadequate or outdated assessment practices.
) Recognition of public health was increased by the pandemic in Germany.(3) 15th European Public Health Conference 2022