ArticlePDF Available

Abstract and Figures

This qualitative case study is part of the international research project ESCaPE (Evaluating Scientific Advice in a Pandemic Emergency) and aims at understanding how expert advice has been sought, produced and utilized in the management of the Covid-19 emergency in Italy in 2020. Italy was the first country after China having to face the devastating effects of the Covid-19 soon to be pandemic. The state of national emergency was declared on January 31st, 2020, and the Italian Government sought expert advice as an important resource in the management of the pandemic. The Covid-19 crisis in Italy witnessed the emergence of different expert advisory groups: some envisaged by the law; some instituted ad hoc and tasked to deal with specific aspects of the emergency; and others that were already in place before the pandemic but that came to play a crucial role during the unfolding of the outbreak. This case study relies on a mix of both primary (stakeholder interviews) and secondary data collection (official documents and communications by expert advisory bodies, ministerial decrees, and policy documents). Our research shows three main findings: (a) the near-complete overlap of technical advice and political response in the first phase of the pandemic in Spring 2020, with a key policy role played by the advice provided by the Technical and Scientific Committee (CTS); (b) a predominance of epidemiologists and infectious disease specialists over social scientists in the mobilisation of experts for the management of the crisis in Italy; (c) a shift in containment policies from an emergency-based, very strict, national lockdown in the spring of 2020, to proactive risk-informed colour-coded regional restrictions in the fall and winter of 2020. Our case study ends at the end of 2020 and provides an overview and encompassing representation of the mobilization of experts, and of selected types of evidence, to manage the unprecedented health emergency, in year 1 of the Covid-19 pandemic in Italy. Our findings suggest that expert politics can lead to the confirmation of knowledge hierarchies that privilege hard sciences, and corroborate prior literature indicating that economic and social expertize has not been well integrated into public health expert advice, constituting a major challenge for policymaking during a health emergency.
This content is subject to copyright. Terms and conditions apply.
ARTICLE
Mobilization of expert knowledge and advice for
the management of the Covid-19 emergency in
Italy in 2020
Silvia Camporesi 1, Federica Angeli 2& Giorgia Dal Fabbro3
This qualitative case study is part of the international research project ESCaPE (Evaluating
Scientic Advice in a Pandemic Emergency) and aims at understanding how expert advice has
been sought, produced and utilized in the management of the Covid-19 emergency in Italy in
2020. Italy was the rst country after China having to face the devastating effects of the
Covid-19 soon to be pandemic. The state of national emergency was declared on January 31st,
2020, and the Italian Government sought expert advice as an important resource in the
management of the pandemic. The Covid-19 crisis in Italy witnessed the emergence of dif-
ferent expert advisory groups: some envisaged by the law; some instituted ad hoc and tasked
to deal with specic aspects of the emergency; and others that were already in place before
the pandemic but that came to play a crucial role during the unfolding of the outbreak. This
case study relies on a mix of both primary (stakeholder interviews) and secondary data
collection (ofcial documents and communications by expert advisory bodies, ministerial
decrees, and policy documents). Our research shows three main ndings: (a) the near-
complete overlap of technical advice and political response in the rst phase of the pandemic
in Spring 2020, with a key policy role played by the advice provided by the Technical and
Scientic Committee (CTS); (b) a predominance of epidemiologists and infectious disease
specialists over social scientists in the mobilisation of experts for the management of the crisis
in Italy; (c) a shift in containment policies from an emergency-based, very strict, national
lockdown in the spring of 2020, to proactive risk-informed colour-coded regional restrictions
in the fall and winter of 2020. Our case study ends at the end of 2020 and provides an
overview and encompassing representation of the mobilization of experts, and of selected
types of evidence, to manage the unprecedented health emergency, in year 1 of the Covid-19
pandemic in Italy. Our ndings suggest that expert politics can lead to the conrmation of
knowledge hierarchies that privilege hard sciences, and corroborate prior literature indicating
that economic and social expertize has not been well integrated into public health expert
advice, constituting a major challenge for policymaking during a health emergency.
https://doi.org/10.1057/s41599-022-01042-6 OPEN
1Kings College London, London, UK. 2University of York, York, UK. 3University of Trento, Trento, Italy. email: silvia.camporesi@kcl.ac.uk
HUMANITIES AND SOCIAL SCIENC ES COMMUNICATIONS | (2022) 9:54 | https://doi.org/10.1057/s41599-022-01042-6 1
1234567890():,;
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
Introduction
The Covid-19 pandemic provides an unparalleled opportu-
nity to observe and evaluate how scientic advice is sought
by policymakers, translated in policy measures, and
accepted by the public, in a highly scrutinized situation of global
emergency. This qualitative study is part of the international
research project ESCaPE (Evaluating Scientic Advice in a Pan-
demic Emergency) and aims to evaluate the role played by expert
advisory bodies during the Covid-19 outbreak in Italy in 2020,
and to understand how expert advice has been sought, produced,
and utilized in the design and implementation of Covid-19
containment measures in Italy in in 2020. The Italy case study is
particularly interesting as Italy represents the rst country in the
world, after China, having to face and manage the SARS-CoV-2
outbreak in 2020, with the highest degree of uncertainty regard-
ing the new pathogen (Severgnini, 2020).
Background
Italys political system. Italy is a parliamentary republic with a
degree of federalism at the regional level. The executive branch of
power resides with the Council of the Ministers, presided over by
the Prime Minister (art. 92 of the Italian Constitution) (Con-
stitution of Italian Republic, English Version). The Government
has the authority to initiate legislation, yet the main legislative
branch of power resides within Parliament, divided into the
Chamber of Deputies and the Senate of the Republic (art. 55). In
normal times, ministers present bills to the Parliament for dis-
cussion, however in cases of urgency or emergency, as in the
context of the pandemic, ministers can pass decrees(decreti-
legge), ofcial orders that have the force of law. The President of
the Republic is elected by the Parliament and is in place for seven
years. The President of the Republic is the guarantee of the Italian
Constitution, does not participate directly in the executive, leg-
islative, judicial branches of power, but nominates the Prime
Minister, generally - although not always, as noted below - on the
basis of the results of the elections.
Italys political history over the last three decades has been
marked by the emergence of technocratic governments as an
institutional response to political crises. (Pastorella, 2016)Therst
technocratic government in Italy was led by Carlo Azeglio Ciampi,
a former Bank of Italy governor, and was formed in 1993. This was
a highly unstable socio-political moment of Italian history, when
the country was torn by maa massacres, political corruption
scandals (initiated by the 1992 Clean Handsinvestigation), and
consequent social tensions and deligitimation of political institu-
tions. Ciampis government mandate by President of the Republic
Luigi Scalfaro was specically to create a government of social
cohesionand above political parties, which could enable the
transition to a new electoral law leading to new political groups and
dynamics which could bring stability to the country. Ciampis
cabinet remained in place for little over a year until May 1994 and,
after a short interlude with the rst Silvio Berlusconis government
in 1994, it was followed by Lamberto Dinis technocratic
government in January 1995. Dinis(anotherformerBankofItaly
governor) cabinet remained in place for one year and 4 months.
After a longer interlude, the technocratic formula was reinstated in
2011 with Mario Monti, a former European Commissioner, who
was nominated to the role by President of the Republic Giorgio
Napolitano with the mandate to implement austerity policies
necessary to face the wider Euro crisis. Then, in 2018, Giuseppe
Contefor the rst time in Italian political history, a university law
professorwas given by the President of the Republic Sergio
Mattarella the mandate to form a bipartisan government with the
mandate to overcome a political impasse between the populist Five-
start movement and the Northern League. As his mandate was
renewed in 2019 after a political crisis, the coalition changed, now
including the Democratic Party. While himself a technocrat, both
Giuseppe Contesrst government in 2018 and second government
in 2019 were formed mostly by politicians, with only a few
technocrats. More recently, Mario Draghi (former European
Central Bank Governor) replaced Conte in February 2021 as Italys
Prime Minister, with the task to administer the EU recovery fund
and boost Italys post-Covid recovery. Overall, the technocratic
cabinets in Italys republican history have offered a quick response
to large systemic crises, with the aim to create a bipartisan political
consensuses. Yet, technocratic governments are by many considered
anti-democratic, as they replace direct elections and, in the case of
the Italian political system, the Prime Minister is nominated by the
President of the Republic not on the basis of the results of the
elections. As such, these governments are known to be short-lived
with quickly eroding public trust and political consensus.
Covid-19 timeframe. Two Chinese tourists in Rome were hos-
pitalized at Spallanzani hospital in Rome in late January 2020 for
viral pneumonia (Severgnini, 2020). At that time, the new
pathogen did not have a name, however there were worrying
reports of a new coronavirus coming from Wuhan, China,
causing a new type of viral pneumonia. The new pathogen would
be given its ofcial SARS-CoV-2 (severe acute respiratory syn-
drome coronavirus 2) name by the The International Committee
on Taxonomy of Viruses (ICTV) on February 11th, 2020 (WHO,
2020). As the two tourists tested positive for the new coronavirus
on January 31st, 2020, a national state of emergency was declared,
and all ights to and from China were suspended (Council of
Ministers Declares State of Emergency, January 31st, 2020). On
the same day, the Prime Minister Giuseppe Conte, in agreement
with the Minister of Health Roberto Speranza, as set out in the
Italian national preparedness plan described below, delegated to
the Head of the Civil Protection Department Angelo Borrelli the
management of the emergency and the task of convening of
the Civil Protection Operative Committee (Sole 24 ore, 2020).
The rst native case (known as Patient 1 from Codogno) was
recorded on February 19th, 2020 (ANSA, 2020a). After a rst
phase of attempted contact tracing and case isolation through
mobilization of the army, the national government escalated the
restrictive measures initially applied only to the affected areas,
and declared a national lockdown on March 9th, 2020 (Sole 24
ore, 2020). The national lockdown lasted in Italy until May 5th,
2020, and was one of the most stringent lockdowns in Europe,
with major restriction on individual movements, and the closing
down of factories and all production lines, which were not con-
sidered absolutely essential (Horowitz, 2020).
Methods
This case study employs a qualitative methodological approach,
and relies on a mix of both primary and secondary data collection
and analysis. Ethical approval for the project was obtained by
Kings College London on September 1, 2020 (reference number
MRA 19/20 -21073) and all research was performed in accor-
dance with relevant guidelines. The primary data collection
involved nine key stakeholder interviews. The sample was
designed to ensure theoretical representativeness (Eisenhardt and
Graebner, 2007), hence to cover the views and opinions of experts
involved in the management of the Covid-19 pandemic in Italy in
2020. Our denition of expert is one who belongs to an expert
committee, using the analytical distinction rst drawn by Eyal
(2013) between expertsand expertize, which allows us to
distinguish on the one hand between the actorswho are pro-
fessionals recognized as being expertsand those professionals
ARTICLE HUMANITIES AND SOCIAL SCIENCES COMMUNICATIONS | https://doi.org/10.1057/s41599-022-01042-6
2HUMANITIES AND SOCIAL SCIENCES COMMUNICATIONS | (2022) 9:54 | https://d oi.org/10.1057/s41599-022-01042-6
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
who are not (necessarily) recognized as being expertsbut who
have the capacity to do so. In Italy the management of the
pandemic adopted a classic top-down approach with the con-
stitution of key expert committees, of which we interviewed key
members. In Italy, although there was a proliferation of inde-
pendent expertswho talked to the media, only experts who
belonged to expert committees contributed to the production of
policy advice in 2020. Hence we focus only on the recognized
professional experts as they were the key players in the produc-
tion of expert advice for policymaking in Italy in 2020.
In our sample, we interviewed members of the Technical and
Scientic Committee (Comitato Tecnico-Scientico, CTS),
members of the Economic and Social Committee (Comitato di
esperti in materia economica e sociale, CES), members from the
Italian National Institute of Health (Istituto Superiore di Sanità,
ISS), Italys main public health research center, and members of
the national bioethics committee (Comitato Nazionale per la
Bioetica, CNB).
The nine semi-structured interviews were conducted between
October and December 2020 and followed a general protocol and
topic guide based on the goals and aims of the wider ESCaPE
project (https://escapecovid19.org/), which was adapted to the
specic role and function of the respondent. The interviewees
were asked to describe their role and function within the pan-
demic response, the changes (if any) in their role between the rst
and second Covid-19 wave in 2020, their views on the production
and use of evidence in in the managemenf of the pandemic, and
their views on the relationship between expert advice and policy
decision-making. The interviews were conducted over Zoom, in
Italian. They were video recorded in agreement with the parti-
cipants, following their verbal informed consent to the project
and in line with KCL ethical guidelines. The data are stored in a
University online research repository according to GDPR reg-
ulations. The Italian transcripts were obtained through an auto-
mated service, curated and fact-checked collectively by the
members of the research team, with relevant excerpts translated
into English by the authors. Recruitment was not devoid of dif-
culties, as not all stakeyholders were equally receptive to our
invitations. In NovemberDecember 2020 Italy experienced a
critical surge of Covid-19 infections. The stakeholders we con-
tacted were directly involved in providing advice to the govern-
ment, and many of them had severe time limitations due to high
workload, and/or had other reservations in speaking to
researchers about their experience as Covid advisors. With the
result that, while some experts were keen to speak with us and
would also actively refer others, therefore, facilitating recruitment
through snowball sampling, others did not respond to our invi-
tations, while others who had accepted withdrew their partici-
pation shortly before the interview was scheduled to take place.
The timeline for collection of data begins with the declaration of
international emergency of the WHO and the conrmation of the
rst two cases of coronavirus in Italy (January 30th, 2020) and
terminates with the end of calendar year 2020 (Fig. 1). The sec-
ondary data collection relied on ofcial documents and com-
munications by expert advisory bodies, ministerial decrees and
governmental documents. Figure 2lists the type of documents
produced and analyzed within the framework of this research.
Italy preparedness plan and key advisory expert groups
The Italian pandemic preparedness plan. Under Italys con-
stitution, every citizen has the right to health (Article 32, Con-
stitution of the Italian Republic). This right is enacted through the
Italian National Health System (Sistema Sanitario Nazionale-
SSN), a system of structures and services aimed at protecting
citizenshealth established in 1978 through law n.833 (Law
December 23rd, 1978), and based on the collaboration between
the State and the twenty regions (of which ve enjoy greater
autonomy than the others based on historical and geographical
reasons: Friuli-Venezia Giulia, Sardinia, Sicily, Trentino-Alto
Adige, and Val dAosta). The State establishes the Essential Levels
of Assistance (ELA) that must be guaranteed on the entire
national territory free of charge or upon payment of a partici-
pation fee, while the twenty Regions enjoy full autonomy in
programming and managing healthcare practices in the relevant
territory of their competence.
In 2003, following the outbreak of the A/H5N1 virus in Asia,
the WHO recommended that all countries prepare a pandemic
preparedness plan following the established guidelines and WHO
recommendations of 2005/2006 (WHO, 2005). Italy developed a
pandemic preparedness plan in 2006 according to the 6 pandemic
phases identied by the WHO. This plan sets out clear
organizational guidelines in case the Council of Ministers declares
a state of emergency (National Plan for Preparedness and
Response 2006). Of direct relevance for this case study, the
preparedness plan details thatin the case of an emergency
coordination functions will be the responsibility of the Prime
Minister, upon advice from the Department for Civil Protection.
The European Center for Disease Prevention and Control
(ECDC) keeps an updated list of the preparedness plans on its
Fig. 1 Timeline of key events in the Covid-19 outbreak in Italy in 2020. Figure by GDF.
HUMANITIES AND SOCIAL SCIENCES COMMUNICATIONS | https://doi.org/10.1057/s41599-022-01042-6 ARTICLE
HUMANITIES AND SOCIAL SCIENC ES COMMUNICATIONS | (2022) 9:54 | https://doi.org/10.1057/s41599-022-01042-6 3
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
website (ECDC List of inuenza pandemic preparedness plans).
According to our analysis, there seemed to be a general
momentum in Europe to draft national pandemic responses
plans following the outbreak of the H5N1 inuenza virus in Asia
in 2003, however that momentum drive petered out afterwards.
While some preparedness plans were updated somewhat more
recently (France in 2011, Finland in 2012, Germany in 2016),
others had been not updated since the 2005/2006 WHO
recommendations, including the Italian pandemic preparedness
plan. Although Italy was not the only European country failing to
update its preparedness plan, it was the rst to the bear the brunt
of the epidemic in 2020, and it was the European country for
which the lack of updating had the most momentous con-
sequences. The lack of an updated plan was at the center of a
heated media debate and public scrutiny in 2020, which may have
contributed to our difculties in recruiting key stakeholders for
our interviews (Giuffrida and Boseley, 2020). In January 2021,
Italy submitted a new preparedness plan to respond to the
eventuality of a pandemic inuenza.
The Technical and Scientic Committee. The committees and
institutions involved in the management of the health emergency
evolved during year 1 of the pandemic in Italy (Fig. 3).
During the rst wave in the spring of 2020, the main advisory
body for the production of expert advice in Italy was the
Technical and Scientic Committee (CTS), set up by the Head of
the Civil Protection Department, with Ordinance n. 630,
February 3rd, 2020 (Ordinance n. 630, Civil Protection
Department, 2020a). The setting up of this committee was
envisaged by the Italian preparedness plan, as well as the
provision that the committee was to remain in place for the entire
duration of the national emergency (still in place at the time of
revising this article, December 2021). According to its terms of
reference, the CTS was vested with a clear consultative role of
technical and scientic support to the Civil Protection Depart-
ment. The members of the CTS were nominated by the Head of
the Civil Protection Department upon suggestion of the Ministry
of Health, on the basis of representation criteria, i.e., as
representatives of the major national authorities and major
national institutions with technical competencies in the manage-
ment of infectious disease outbreaks (Ordinance n. 630,
Department of Civil Protection, 2020). As the composition of
the CTS, which initially consisted of 14 members, reected the
top management of the main national authorities for health and
emergency management in Italy, women were not present in the
initial composition of the CTS, as much as they were excluded
from any of the senior roles represented in the committee.
Because of this striking (although not surprising, for Italian
standards) gender imbalance, the composition of the CTS was
redened in April of 2020 with the introduction of six new female
members (Ordinance n. 663, Department of Civil Protection
2020) for a total of twenty members (this number was later
brought down to 14 with the appointment of the new chair
Franco Locatelli with the Ordinance n. 751 of March 17th, 2021.
The Special Covid Commissioner. On March 18th, 2020, the
Prime Minister Giuseppe Conte nominated Domenico Arcuri as
Special Covid Commissioner(Decree of the President of
Council of Ministers, March 18, 2020). The Special Covid
Commissioners role was one of primus inter pares,orrst
among equalswithin the experts tasked with the management of
the Covid-19 pandemic in Italy. Arcuri was previously CEO of
Fig. 2 Type and number of secondary documents collected and analyzed for this case study. Figure by GDF.
ARTICLE HUMANITIES AND SOCIAL SCIENCES COMMUNICATIONS | https://doi.org/10.1057/s41599-022-01042-6
4HUMANITIES AND SOCIAL SCIENCES COMMUNICATIONS | (2022) 9:54 | https://d oi.org/10.1057/s41599-022-01042-6
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
Invitalia, Italys National Agency for Inward Investment and
Economic Development (https://www.invitalia.it/eng). External
to all expert committees, and responding directly to the Prime
Minister Giuseppe Conte, key tasks assigned to Arcuri in his role
as Special Covid Commissioner included the organization,
acquisition, and support of the production of goods necessary to
counter the health emergency, including the acquisition and
distribution of medicines and personal protective equipment. In
the rst phase of the pandemic in 2020, the Special Covid
Commissioner issued several decrees. Among the most signicant
ones, Arcuri introduced a cap on the retail price of facemasks at
0.50 euro (Ordinance 1/11 of Special Covid Commissioner, April
26, 2020)in the spring of 2020 in Italy, facemasks in scarce
supply were sold for up to 40 euros each (La Repubblica, 2020).
The Special Covid Commissioner also nominated several Deputy
Commissioners tasked with the implementation of the emergency
measures at the regional level. During the second wave in 2020, the
Special Commissioner Arcuri played an important role in the
initial planning of the vaccination campaign: he issued a decree
identifying in the military airport of Pratica di Mare southwest of
Rome the hangar for storage and distribution of the vaccines. On
March 1st, 2021, Arcuri was replaced by General Francesco Paolo
Figliuolo as new Special Covid Commissioner, with the main task
of revising, and accelerating, the vaccination campaign. The
appointment of an army general as Special Covid Commissioner
was meant to be a strong sign by the newly installed government
led by the Prime Minister Mario Draghi to invest full speed in the
vaccination campaign (Reuters, March 1st, 2021). A complete list
of the decrees issued by the Special Covid Commissioner is avail-
able on the ofcial government webpage (https://www.governo.it/
it/dipartimenti/commissario-straordinario-lemergenza-covid-19/
cscovid19-ordinanze/14421).
The Control Room of the Health Ministry. The Cntrol Room of
the Health Ministry is a consultative body of the Italian gov-
ernment, which was set up with decree on April 30th, 2020 with
the following mandate: to provide a weekly updated classica-
tion of the level of risk of uncontrolled and unmanageable
transmission of SARS-CoV-2 in the Regions/autonomous
provinces(Decree of Health Ministry, April 30, 2020). Unlike
the CTS, whose setting up was envisaged by the Italian pre-
paredness plan, the Control Room was not (it was created later).
The April 30th decree is key to understanding the management of
the epidemic in Italy in the second phase, as it sets out the key
monitoring activity of the spread of the virus. It also demarcates
the shift from an emergency response based on external data
coming from China and mathematical modeling predictions
based on those data, to an evidence-based response with risk-
based scenarios based on Italian data produced by the regions.
State/Regions conference. The State/Regions conference is a
permanent collegial organ of the Italian government aimed at
supporting institutional collaboration and political negotiations
between the central Government and the Regions, a role that was
maintained also in the current pandemic. Representatives of the
Regions supported the interests of the regional entities in all
negotiations regarding Covid-19 measures, from the re-opening
of economic and social activities in summer, to the re-
organization of public transport and the development of guide-
lines for the administration of the vaccine. The State/Regions
conference acquired a special signicance in the second wave of
the pandemic in 2020, as discussed in section Within-group
dynamics and management of disagreement.
The Economic and Social Council (CES). On April 10th, 2020,
the Prime Minister Giuseppe Conte set up a Council of experts on
economic and social matters(also known as T task force for
phase 2,orColao Committeefrom the name of its chair,
Vittorio Colao) with the mandate to investigate the impact of the
pandemic on socioeconomic activities, and to provide key
recommendations on how to support the Italian social and eco-
nomic recovery after the lockdown). The CES was initially
composed of 17 experts of social and economic matters, entrusted
by the Prime Minister (Decree of President of the Council of
Ministers, April 10, 2020). Many of these experts on economic
and social matters came from academia and several had a strong
international standing and recognition. The committee delivered
in June 2020 a 77-page report for Italian recoveryin the period
Fig. 3 Key players in the management of the Covid-19 crisis in Italy in the rst and second wave in 2020. Diagram by GDF.
HUMANITIES AND SOCIAL SCIENCES COMMUNICATIONS | https://doi.org/10.1057/s41599-022-01042-6 ARTICLE
HUMANITIES AND SOCIAL SCIENC ES COMMUNICATIONS | (2022) 9:54 | https://doi.org/10.1057/s41599-022-01042-6 5
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
20202022 (CES Report, 2020). The report provided very specic
recommendations in three key areas: (1) digitalization and
innovation; (2) green revolution; (3) gender balance, diversity and
inclusion in the workplace. These were referred to in the report as
the three strengthening cornerstones(assi di rafforzamento),
the three key areas on which the experts recommended the Italian
government to invest for a successful recovery and positive
transformation of the country after the lockdown. However, these
recommendations did not have a direct impact on national
decrees, in stark contrast with the advice provided by the CTS, as
discussed in section Evidence-based containment policies: a
focus on natural sciences and hard data.
Findings
The qualitative data resulting from the semi-structured interviews
was analyzed through an abductive approach via thematic ana-
lysis, allowing us to combine theory-derived deductive categories
with themes emerging from the data (Angeli et al., 2020; Tim-
mermans and Tavory, 2012). For the deductive part, analysis of
both primary and secondary data followed a protocol shared
among all 19 case studies of the overarching EScAPE project,
aimed at identifying common themes, similarities and differences
across the countries involved in the project. Inductive analysis
was based on thematic analysis of the qualitative material.
Evidence-based containment policies: a focus on natural sci-
ences and hard data. One of the key tasks of the CTS throughout
the pandemic was to screen and scrutinize available evidence, as
well as to distinguish between reliable and non-reliable scientic
data, and identify key ndings and actionable knowledge from the
wide amount of Covid-related research which was churned out
daily in the early phases of the pandemic. To this end, the CTS
operated a daily review of the latest medical and epidemiological
evidence. Names of well known scientic international peer
reviewed journals were often mentioned in our interviews.
International key reference points that were consistently refer-
enced for the work of the CTS were the European Centre for
Disease Prevention and Control, the World Health Organization,
and Imperial College London, for the epidemiological projections
that were also key to guide UK policies.
Within the government buildings of Lungotevere we would
meet every day. At that moment it is important to say we
were studying what was happeningor what we were
thinking was happeningin China. That was the informa-
tion we had and that we obtained through ofcial channels,
not only studying what was published. We are talking about
the beginning of February. Apart from those [data] we did
not know anything. We were looking at what was
happenining in China and were thinking what we should
do when the moment of what was happening there [in
China] would happen here.
Thisquotereferringtothetypeofinformationonwhichthe
CTS relied in the early phases of the Covid emergency in Italy
speaks to the uniqueness of the Italian situation in early 2020;
when there were no data available to help the CTS manage the
diseases emergence in Italy except those coming from Wuhan.
The data coming from China, as highlighted by our stake-
holders, were met with some degree of skepticism as they were
perceived to contain some degree of untrustworthiness
(inafdabilità). The fact that the Chinese were constantly
changing how they were counting their conrmedcoronavirus
deaths generated confusion and possibly distrust as there was
the perception that the Chinese were covering up the actual
numerofdeaths(Feuer,2020).
In early February the CTS produced and presented to the
government a rst national health plan in response to the Covid-
19 health emergency. In this rst plan, the members of the CTS
made mathematical predictions (for a timeframe of up to a year)
of possible scenarios with different levels of infection ratios,
namely RT =0, RT =1, RT > 1,15; RT > 1,30, RT > 2, and laid out
the corresponding measures, which were to be adopted in each
scenario. As emerged in our conversations with members of the
CTS, this rst plan based on mathematical predictions included
three stages: the thirda worst-case scenariomade a hypothesis
of 70,000 deaths in the rst year (on January 7th, 2021, the
number of Covid-19 related deaths in Italy was indicated as
77,291, thus exceeding the worst-case scenario prediction of the
CTS for the rst year of the pandemic in Italy). This rst plan was
never released in the public domain, likely because of the highly
sensitive and potentially panic-inducing information it contained
(Luna, 2020; Guerzoni and Sarzanini, 2020).
In early April of 2020, a working group within the CTS was set
up and tasked to develop an occupational health risk assessment
method for the industrial sector (production, manufacturing) to
enable a tailored exiting from national lockdown and manage-
ment of subsequent outbreaks. The working group of the CTS
collaborated closely with the Ministry of Labour and Social
Policies (Ministero del Lavoro e delle Politiche Sociali) to produce
industry-specic protocols, on the basis of prevention and
precaution. Hundreds of business-specic protocols were devel-
oped. Often, systemic interventions aimed to mitigate the risk of
contagion were suggested. On the one hand, cafés were required
to stop serving sugar packets with espressos, but to deliver instead
individual sugar packets to patrons upon request. On the other
hand, stores and supermarkets, for their part, were required to
install plastic panels at checkouts, with a view to enhance the
protection of workers as well as customers. These business-
specic protocols have informed the management of the second
wave and, to the best of our knowledge, represent a unique
occupational health risk provision in the management of the
epidemic among the landscape of international Covid-19
management provisions.
Although Prime Minister Conte had set up the Economic and
Social Committee specically to gather the input of social
scientists to support the recovery phase, after the end of the rst
lockdown in May 2020, it appears that the report produced by
CES was not widely distributed or signicantly used in
subsequent policies. Our interviewees from CTS did not seem
to be aware of or had plainly forgotten that an economic and
social council existed. In the words of one of our stakeholders:
To be honest, that group had a very short and tormented
life, it must have lasted perhaps two or three weeks.
In fact, the committees activity lasted much longer, from April
10th, when the committee was rst set up, to June 15th, 2020,
when the nal report was delivered, although the committee has,
to the best of our knowledge, never been ofcially dismantled.
One respondent even mentioned that the CES mission and work
was something that everybody can do in the country. Another
participant elaborated by mentioning that:
While analysis of the epidemiological progression of the
virus relies on specic competencies, analysis of business
and socio-cultural recovery involves the entire parliament.
The CES was therefore introduced in a very active and
aggressive arena of competing actors and experts.
On the contrary, the CTS was consistently perceived as a body
with hyperspecialized, elite knowledge, which does not deal with
subjects that can be debated. Interesting to note, though, that
after the resignation of Prime Minister Conte on January 26th,
ARTICLE HUMANITIES AND SOCIAL SCIENCES COMMUNICATIONS | https://doi.org/10.1057/s41599-022-01042-6
6HUMANITIES AND SOCIAL SCIENCES COMMUNICATIONS | (2022) 9:54 | https://d oi.org/10.1057/s41599-022-01042-6
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
2021, the new government led by Prime Minister Mario Draghi
nominated Vittorio Colao as Minister of Technological Innova-
tion and Digital Transition on February 13th, 2021, an
unprecedented type of Ministry in Italy. In an interesting turn
of events, hence, the rst of the three key areas of the report by
the Task Force chaired by Colao (digitalization and innovation)
seems to have had an impact on policy, although after the
conclusion of the mandate of the Prime Minister who had rst
appointed the committee.
Similaralthough not identicalconsiderations as those for-
mulated for the CES apply to the Italian Committee for Bioethics
(Comitato Nazionale di Bioetica, CNB). Unlike the CES, the CNB
was not set up in response to the pandemic, but is a governmental
body that has been in place in Italy since 1990, tasked with the
mandate to produce reports to address the ethical and legal
problems that arise from progress in scientic research and
technological applications on life. However, its members are
nominated directly by the Prime Minister, as it was the case for
the CES. Also similarly to the CES, the CNB was very productive
in 2020, releasing several reports on a variety of topics, from
criteria for allocating scarce life-saving resources, to criteria for
prioritizing vaccines, to criteria for triage in a pandemic
emergency (Italian Committee for Bioethics - Opinions on
Covid-19). Incidentally, the CNB was never tasked directly by the
government to work specically on pandemic-related issues, but,
as customary for this committee, the committee selected their
own topics and constituted working groups to deliver specic
reports. It seems however that the CNB reports produced in 2020
did not have, overall, a direct policy impact. The only exception
was the report on vaccine prioritization, which outlines that
priority should be given to the most vulnerabledened as those
at higher risk of contracting Covid-19 because of their profession
(i.e., healthcare workers), age or existing comorbidities (Italian
Committee for Bioethics. Opinion on Vaccines and Covid-19).
Overall, we found that the expert advice that supported the
management of the pandemic in Italy saw a strong predominance
of epidemiologists and infectious disease experts. The input of
socioeconomic experts, ethicists and other non-health disciplines
did not have a substantial impact on policy decisions. To note, all
the expert committees discussed in this case study worked
completely pro-bono. This added to the gender bias dimensions
of the committees and expert advice, as it has been highlighted by
some of our key interviewees.The fact that the very intense work
required in all committees was unpaid and went in addition to the
ordinary tasks of the involved professionals has had a strong
crowding out effect on potential female participants and
disproportionally burdened the already enrolled female experts,
who typically have caring duties and cannot easily travel. In the
words of one of our stakeholders:
It was really the usual old boysclub, as all the experts
enrolled were all men, highly efcient, perfectly function-
ing, wealthy, at the height of their mental and physical
energies and without any further burden. Not because they
do not have any family ties, but without any burden beyond
their absolute devotion to the job. They were having so
much fun doing all of this. They would address the highly
important task at stake with responsibility and sense of duty
but in a sort of narcissistic, self-enhancing way. Thinking
how good we are. Instead, when I received the call the
rst thing that came to my mind was the crushing
responsibility and the enourmous amount of work, efforts
and commitment I was facing. They were thinking instead
about the praise and appreciation they would receive.
This quote speaks of the different ways in which additional
(pro-bono) work was perceived by male and female members of
the expert committees set up to manage the Covid-19 crisis in
Italy, together with the internal and external rewards that go with
it. In fact, the gender imbalance within the expert committees was
intensied by the fact that most women could only participate
remotely because of caring duties intensied during the
pandemic, while male colleagues would most often be able to
meet in person.
Delphis oracle and Mosestablet: the role of the CTS minutes
in the management of the pandemic. The advice provided by the
CTSin the form of the meetings minutesplayed a key policy
advisory role in the management of the pandemic in Italy, cov-
ering a quasi-legislative function. In that early phase of the out-
break in Italy in March of 2020, the Government would request
the CTS minutes in word format instead of pdf format to facilitate
drafting of the decrees. One of our key stakolders provided an apt
analogy: the CTS was perceived in this rst phase as the Delphi
oracleand the minutes as Mosestablets. The CTS members,
however, resisted being portrayed as policymakers by the media,
with some stakeholders publicly threatening to resign unless the
clear consultative role of the expert committee was maintained.
We have become legislators. The problem is we dont want
to be legislators, we only want to be a consultative tool. We
are trying hard to keep our function of consultative group
however its not our own strength but othersweaknesses
which transforms us into something else.
And:
Our task was always to provide a series of elements on
which the politicians could decide; we provided a risk
analysis. We gave the elements to evaluate the risk, we were
not able to judge other elements. Its the politician who is
tasked with the synthesis [of different elements]. This was
and has always been our reference point.
In the minutes n. 65 of May 3rd, 2020, the CTS rmly
advanced the necessity of a norm that safeguards the work of the
CTS, in absence of which the Committee threatened to resign
(Minute n. 65, CTS, for Foundation Luigi Einaudi 2020). As far as
we are aware, this norm was not discussed in the public arena,
and the CTS continued to be perceived as a Delphi oracle as long
as it came to unanimous decisions (more on this in section
Within-group dynamics and management of disagreement),
and as long as it was convenient for the politicians to rely heavily
on expert advice. Members of the CTS and of the CSE were
forbidden from talking to the media by strict non-disclosure
agreements. One interviewer from the CTS recalls signing non-
disclosure agreements twice a day, while a member of the CSE
indicates that it was strictly prohibited for them to have any
contacts with the media in any capacity, neither as members of
said committees nor at a personal level. Members of the CTS and
the CES, therefore, never talked to the media, except for the
committee chairs, but even then, only on very few and pre-agreed
occasions. This position was challenging for many members of
the CTS and CES, especially for those participating in other
public activities or holding academic posts. These strict non-
disclosure clauses imposed on the technical experts may have led
to a proliferation of unofcial or non-appointed experts
becoming regular guests in news channels and TV shows. Italian
citizens felt a desperate need for information in the midst of a
highly uncertain and frightening crisis, and the media grappled to
satisfy it. Throughout 2020, a plethora of virologists, immunol-
ogists and epidemiologists regularly appeared on TV as
consultants on different pandemic-related topics. The opinions
shared by these independent experts were often divergent and
HUMANITIES AND SOCIAL SCIENCES COMMUNICATIONS | https://doi.org/10.1057/s41599-022-01042-6 ARTICLE
HUMANITIES AND SOCIAL SCIENC ES COMMUNICATIONS | (2022) 9:54 | https://doi.org/10.1057/s41599-022-01042-6 7
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
contradictory, leading to heated live arguments and discussions,
as well as questionable declarations, such as famously that the
Covid-19 virus was clinically deadin the summer of 2020
(Agenzia Italia, 2020). This proliferation of independent experts
talking to the media likely contributed to generate a situation of
general confusion and misinformation in the public opinion,
which undermined the ownership of, and trust in, expert advice
in the pandemic. Italy, a country traditionally characterized by a
high degree of perceived trustworthinessof scientists, for the
rst time witnessed a diminishing trust in scientists in 2020, as
emerging from the biannual survey sent out from Observa, the
observatory for science in society of the University of Bologna
(Observa, 2021).
Initially, the minutes of the CTS meetings were not made
available to the public. According to our stakeholders, this
decision was based on the fact that the content of the meetings
was particularly delicate, as the CTS was making projections
about the evolution of the pandemic, based on data coming from
China and on mathematic modeling, including some quite
concerning scenarios (which would later be revealed as under-
estimates) in terms of numbers of deaths. According to the chair
of the CTS, the expectations on the minutes of the meetings had
been too highand it was incorrect to refer to the minutes as
classied(secretati) as, technically, they were never classied.
They were, instead, kept condential (riservati) to avoid panic
(AND Kronos 2020). This distinction may not have been well
explained by the media. The decision to avoid the disclosure of
the minutes of the CTS to the public was highly contested. After a
spirited debate in the public, the Government decided to grant
access to the foundation Ludovico Einaudi
1
to ve of the most
important minutes of the CTS, which were published on the
website of the Foundation on August 6th, 2020. Later, on
September 4th, 2020, the Department of Civil Protection
published all 95 min of the CTS meetings held between February
7th and July 20th, 2020. From that moment on, all CTS minutes
have become available on the website of the Department of Civil
Protection, although with a 40-day delay from the date of the
corresponding meeting.
There was an extensive debate in the Parliament, an
extensive debate in the government. In the end, the decision
was the following: The Minutes are public. But from the
moment of writing up the minutes [to when they are
published] there needs to be at least 45 days in between.
[] So in practice theres a margin of a month and a half
which is simply somewhat strategic. []Its clear the
minutes need to remain public and be available to be
viewed but should be given to the public opinions feast
[messi in pasto allopinione pubblica] only after the debate
is over.
Hence, a solution was reached, which included a cooling off
period between the date of the meeting, and the publication of the
minutes. This cooling off period was the agreed compromise
between the request to publish the minutes, and the need to get
things done in the midst of a health emergency without having to
discuss every single decision. Democracy and management of
health emergencydo not always go hand in hand, as one of our
key stakeholders put it.
Within-group dynamics and management of disagreement.
The specication of the CTSmandate did not include a provision
outlining how decisions were to be reached. The CTS minutes
were always signed unanimously in the rst phase of the pan-
demic. Although there was not an explicit framing of issues in
terms of valuesthe committees points of reference for decision-
making were still exclusively scientica mediation of different
positions was taking place within the CTS, but without an explicit
acknowledgement of the different values informing the different
positions, as discussed in section Discussion.
To the question of how disagreement within the committee
was managed, one of our key stakeholders responded:
Swearing, lots of swearing and bad words. But the
important thing was that one [to achieve consensus]. In a
way, we could say we were operating a bit union-like, the
end-point was to nd a common denominator to conciliate
different positions. Up until now, there hasnt been a single
minute which has not been signed unanimously.
The union-likemode of working mentioned in this quote as a
reference point for reaching an agreement is a clear and easily
relatable reference point for Italian ears. Italy has a long history
and tradition of unions, with a mode of working, which includes
the participation of each and every one, making for long and
heated discussions, with the aim to reach a compromise, that
could be palatable to all stakeholders.
Another key theme emerging from our interviews is the
unprecedented level of openness in Italy in terms of inter-
institutional cooperation: data that pre-Covid would have
required layers and layers of burocreatic approval to be shared
between institutions in pre-pandemic times, were now being
shared via whatsapp. Hence a new, positive collaborative spirit
seemed to emerge, prompted by the unprecedented perceived
urgency of the situation and the feeling of shared responsibility
across the committee members.
The rst example of disagreement within the CTS took place in
late October of 2020, in relation to the debated issue of closing
down gyms and pools (Sarzanini, 2020). School opening/closure
also became a topic of heated disagreement in December of 2020,
with the chair of the CTS, Agostino Miozzo, publicly talking with
the media about the short-sighted decisionsof the government
to close schools and referencing data about mental health issues
(cabin fever) resulting from protracted lockdown for younger
generations (Fregonara, 2020).
We know school is a potential point of contagion but in
truth contagion doesnt take place primarily within school,
but takes place before and after school when kids
congregate. Schools have rigid rules in place [to avoid
contagion]. Students wear masks, they sanitize their hands,
keep physical distancing in place. Unfortunately, some
governors [of regions] have found a sort of shortcut, that of
closing down schools, on the basis that closing down
schools reduces congregating on public trasport.
Instead, as the CTS had been suggesting since May 2020,
reducing crowding at peak times on public transport could have
been achieved through focused investments to expand public
transporation capacity and by staggering school opening and
closing times. The decision not to stagger school start times and
end times with consequent congregation of students on public
transport and outside of schools led to a heated controversy
around the persistency of remote schooling at high school level
(13 years old and older) in Italy. This seemed to be a sore topic
for our stakeholders, with noted tensions between the central
government and regions.
In the second wave of the pandemic in Italy in 2020,
disagreements within the CTS became more frequent. An
example was the disagreement in the CTS over which measures
to adopt during Christmas break (Guerzoni and Sarzanini,
2020bis). The second wave of the pandemic was also character-
ized by the emergence of a unique arm-wrestling between the
central government and regional-level politics. This led to heated
ARTICLE HUMANITIES AND SOCIAL SCIENCES COMMUNICATIONS | https://doi.org/10.1057/s41599-022-01042-6
8HUMANITIES AND SOCIAL SCIENCES COMMUNICATIONS | (2022) 9:54 | https://d oi.org/10.1057/s41599-022-01042-6
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
conicts, with some regions not respecting the algorithm that had
been put in place at central level to evaluate the level of regional
risk and the corresponding local restrictions. One example was
the case of Abruzzo, a region in Southern Italy that was assigned
to the red zone(highest restriction level) on December 12th,
however the Governor of Abruzzo issued a counter-order that
placed it into the orange zoneand allowed restaurants and cafés
to be open for take-away as well as commercial business to
operate. The Administrative Regional Tribunal (TART) of the
City of Aquila (capital of the Abruzzo region in Southern Italy)
subsequently suspended the order by the President of the Region
and the Region entered the red zone(ANSA, 2020bis). The
frequent conicts in the second wave of the pandemic in Italy
between the central government and regional politics led to a
destabilization of the central government, which was evident in
the political crisis which led to the Prime Minister Conte
resigning on January 26th, 2021. As emerged from interviews
with our key stakeholders, there was a perception that an effective
management of the epidemic could not be democratic; when it
started being so in the second wave of the outbreak in 2020, the
arm-wrestlingbetween central government and region con-
tributed to the collapse of the government. The inability of the
CTS to achieve consensus in the second phase of the pandemic as
well as its implications for the CTSperceived responsibility and
role in the management of the pandemic will be investigated
more in depth in section Discussion.
Shift in containment policies: from emergency-based national
lockdown to proactive, risk-informed, color-coded regional
restrictions. In the summer of 2020, the management of the
epidemic was, temporarily, under control at the national level,
and the Ministry of Health issued a 110 pages report titled
Prevention and response to Covid-19: evolution of strategy and
planning in the transition phase for the autumn-winter season.
This document (dated August, 12th, 2020) laid out four different
scenarios for the fall and winter months, based on different levels
of transmission of Covid-19 in the population (Urbani et al.,
2020). The document was updated in October 2020 with specic
indications as to which actions were to be put in place to contain
the spread of the virus on the basis of a number of elements,
called indicators, which, through an algorithm, determined four
different risk-scenarios with corresponding restrictive measures
in place for each scenario (Fig. 4). From that moment on, the
updated Prevention and Response to Covid-19document
represented the main point of reference for Italys response
measures, thus informing the regional lockdowns during the
second wave in the fall and winter of 2020. The CTS itself, in its
ofcial minutes, has often pointed out that this document con-
stitutes the technical instrument against which response activities
shall be measured (see for example CTS minute n. 122, October
30th, 2020, available here: https://www.fondazioneluigieinaudi.it/
i-verbali-del-comitato-tecnico-scientico/).
The introduction of the Ministry of Health Control Roomin
April 2020 enabled the bi-directional knowledge exchange
underpinning the relationship between state and regional
authorities and marked an increasingly regionalized approach
to the management of the pandemic. This new approach was
aimed at avoiding a second national lockdown while tailor-
making restrictions around local needs.
From November 3rd, 2020, the 20 Italian regions started
producing weekly data on the spread of SARS-Cov-2 at the local
level. Data are sent by each region to the Italian National Institute
of Health (ISS), which analyzes the data on the basis of 21
indicators of risk level divided into three sections: (a) monitoring
capacity; (b) diagnosis, track and tracing capacity; and, (c)
hospitals and healthcare servicescapacity. Such indicators are
then analyzed by an algorithm that, through an estimation
matrix, produces a nal risk assessment. The weekly nal risk
assessment produced by the Italian National Institute of Health is
sent to the CTS, which expresses an opinion on the epidemio-
logical curvethis intermediate step is referred to by the legal
phrase: having taken into account the opinion of the CTS
(sentito il parere del CTS)and sends a recommendation to the
Fig. 4 Levels of risk and corresponding restrictions for each color-coded area as implemented in the second wave of the pandemic (fall/winter 2020)
in Italy. Figure by GDF.
HUMANITIES AND SOCIAL SCIENCES COMMUNICATIONS | https://doi.org/10.1057/s41599-022-01042-6 ARTICLE
HUMANITIES AND SOCIAL SCIENC ES COMMUNICATIONS | (2022) 9:54 | https://doi.org/10.1057/s41599-022-01042-6 9
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
Ministry of Health. The Ministry is then tasked with drafting a
summary which, on the basis of the level of risk identied by ISS
and evaluated by the CTS, places the regions and autonomous
provinces into four different risk-scenarios (low, medium, high,
very highwhite, yellow, orange and red, respectively, depicted in
Fig. 4), which dene what kind of restrictive measures need to be
adopted in each region. To note that the ISS is the main national
public health research center in Italy (Italian National Institute of
Health Mission, 2021). The ISS has played a key role in the
management of the pandemic in Italy in terms of analysis of data
determining each regions level of risk and the subsequent
restrictions in place. Within the ISS, there were a number of other
ISS expert working groups, which were set up in response to the
Covid-19 outbreak in Italy and had very specic roles. Among the
most active was the ISS working group on Epidemiological Data,
Diagnostic and Microbiological Surveillance and Preparedeness.
The complete list of the ISS Covid-19 working groups is available
here: https://www.iss.it/web/iss-en/iss-for-covid-19.
While during the rst wave in the spring of 2020, the impact
on the economy of lockdown and stringent containment
measures was not taken into account by the CTS, the second
wave was managed with a much stronger awareness of trade-offs
between the need to contain the virusmorbidity and mortality,
and to support the economy and safeguard the populations well-
being and mental health.
For sure in some way the political, value-based aspect has
penetrated the scientic aspect and in some ways, I think
this has led to the erosion in part of the consensus within
the [CTS] committee.
And also:
We are still writing [the minutes] as we used to write them.
We keep saying that the juridical-administrative connota-
tion of the committee has not changed. However, the socio-
political connotation of the [CTS] committee has changed.
Hence, while the CTS has strived to maintain its medical-
epidemiological characterization, these trade-offs have necessarily
come into play also during the second phase of the pandemic.
The combination of different factors, including the introduction
of different values to the management of the Covid-19 crisis, the
inability of the CTS to achieve consensus which emerged in the
fall and winter of 2020, and the introduction of other expert
committees and players in the management of the health crisis,
such as the Control Room and the governors of the regionshave
led to a perceived diminishment of the moral responsibility of the
CTS in the management of the pandemic in Italy, as discussed
more in depth below.
Discussion
During the rst wave in 2020 (February through April) the
overlap of technical advice and political response in Italy was
near-complete. In this rst phase, the decision-makers (the Prime
Minister, the Ministry of Health) fed daily questions and pro-
blems to the CTS, to which the committee was required to
respond and provide solutions, based on the available empirical
evidence. The government closely followed the recommendations
put forward by the CTS in their policies (decrees). There was an
active effort spearheaded by the politicians themselves to take the
politicsout of the management of the pandemic through the
use of expert knowledge. Although this was not unique to Italy, in
our case study this has been vividly illustrated by the direct use of
the minutes provided by the CTS meetings in the text of the
decrees during the rst phase of the pandemic (Fig. 5). The cut
and pastefeature of the CTS minutes seemed to imply that the
advice produced by the CTS was policy ready, as the members
of the CTS had in a sense stripped away all the uncertainties
relative to the science and produced something that was ready to
be used in policy. According to this interpretation, the members
of the CTS have not only played the role of issue advocates
(Pielke, 2007)where the dening characteristic of issue advo-
cates is a desire to reduce the scope of available choice, often to a
single preferred policy outcome among many possible outcomes,
without necessarily being explicit about about the value judge-
ments that this type of choice impliesbut of policymakers. This
role, however, was not entrusted to the experts without resis-
tance, as members of the CTS repeatedly tried to push back
against their perceived role as policymakers and to reiterate their
purely technical and consultative role, as noted above. Their
attempts were however not entirely successful. The very close
adaptation of the minutes of the CTS meetings into decrees in
this rst phase of the pandemic became an object of extensive
reection for the members of the CTS, who saw a discrepancy
between the consultative role of their committee (as per the terms
of reference) and the way their recommendations were being
used as executive orders by policymakers. As put by our key
stakeholders, the policymakersunwillingness to be in charge
transformed the CTSs role from consultative into legislative:
because when the advice of the CTS meetings is close to being
copied and pastedinto a law decree, the CTS factually becomes
a quasi-legislative body.
The type of discomfort experienced by CTS members towards
aforced uponpolitical role and responsibility is well recognized
in the literature. While policymakers may be tempted to keep
pushing experts to make those [difcult] judgments for them, this is
generating discomfort [in the experts], and may well compromise
the viability of the newfound reliance on experts as a model to (re)
Fig. 5 The unique 'copy and past' feature of expert advice into policy in the rst phase of the epidemic in Italy in 2020, as vividely illustrated by this
juxtaposition of minutes of the CTS on March 7th 2020 (left) and the decree of the Prime Minister of March 8th, 2020 (right).
ARTICLE HUMANITIES AND SOCIAL SCIENCES COMMUNICATIONS | https://doi.org/10.1057/s41599-022-01042-6
10 HUMANITIES AND SOCIAL SCIENCES COMMUNICATIONS | (2022) 9:54 | https://d oi.org/10.1057/s41599-022-01042-6
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
introduce into normalpolicymaking(Boin et al., 2020, pp.
342343). The overlap of technical advice and political response
is a well-established phenomenon described in the political
responses to emergencies, when politics resorts to expert advice
and to expert-based policy, or expert politics(Iles and Mon-
tenegro de Wit, 2020). Similarly, the following the scienceclaim
was a common thread in the rst phase of the pandemic,
described also in the UK context as well as in other countries
(Horton, 2020). Lavazza and Farina (2020, p. 5) write that
Overall, this delegation of power and of responsibility to experts
has allowed leaders and governments to lighten their own
responsibility toward society. This delegation however appears to
be temporary, as the role of the CTS evolved towards a dimin-
ished perceived responsibility in the second phase of the pan-
demic in Italy in 2020. The diminished perceived responsibility
was signaled by the entrance of new playersin the eld (the
Control Room principally, but also the governors of the regions)
and by the emergence of disagreement, which put an end to the
Delphi oracleunanimous verdicts of the CTS.
The question of expert disagreement has emerged as a key
aspect in devising public health policies during the pandemic.
Our denition of expert was provided at the beginning of this
article as the expert who is afliated to an expert committee. This
was the type of expert decision-making used in Italy to manage
the pandemic, with a classic top-down approach. Although there
were independent experts talking to the media about issues, those
lie beyond the scope of our case study as their advice did not feed
into recommendations or policymaking in the rst year of the
pandemic in Italy. Within the top-down nominated experts, there
is another, narrower, issue of disagreement. As emerged from our
interviews, there was not a clear way of managing disagreement
laid out in the terms of reference of the CTS. In the rst phase of
the pandemic, the members strove to achieve unanimous
recommendations and largely succeeded in doing so. This was
possible because there was a clear, although tacit, consensus, on
the goal of the policies: saving the highest possible number of lives
from Covid-19. There were no other values in place that needed
compromising, as economic and other types of considerations
(e.g. psychological, mental health) came a distant second. The
consensus on the single preferred policy outcome as the unan-
imous recommendation provided by the CTS meeting, which was
always obtained in the rst phase of the pandemic, broke apart in
the second half of 2020, with the emergence of a range of possible,
viable, policy outcomes, based on a different, although always
implicit, weighting of the three key public health policy values
liberty, equality, and utility. In a recent article, we discuss the
ethics value compass in public health policies, and show, through
a comparative analysis of Italy and the UK, how the policies in
place in Italy consistently ranked utility (i.e. saving highest pos-
sible number of lives) above liberty. Hence, Italy adopted a very
cautious approach, which resulted in one of the strictest, if not the
strictest lockdown in Europe (Angeli et al., 2021). The disagree-
ment that experts displayed in the second phase of the pandemic
in 2020 can be understood by ascribing different weights to the
three key values in public health policy.
In Italy, the knowledge hierarchies in the management of the
health emergency strongly favored evidence coming from expert
knowledge in epidemiology and infectious diseases. In the rst
phase of year 1 of the epidemic in Italy (February - May 2020),
the main type of evidence used by the CTS was mathematical
modeling based on data coming from China. In the second phase
(October - December 2020) mathematical modeling was still
widely relied upon, although it was based on data produced
weekly by Italian regions, and fed into the production of local
risk-based scenarios, which through the use of a specic algo-
rithm, determined the type of restrictions in place. In general, in
our case study there seemed to be a shared perception that soft
evidence and expert knowledge could be left to the political
domain. While knowledge about the progression of infectious
diseases, epidemiology and crisis management is considered
highly specic, the political and sociological evaluations of social
scientists and ethicists were perceived to overlap to a much larger
extent with policymakersassessment and core competencies,
hence redundant. In addition, there are known difculties in
representing social and economical knowledge as politically
neutral, contrary to scientic knowledge drawn from natural
sciences (Frickel and Moore, 2006) and there seemed to be some
lingering confusion about the mandate of the CES committee. It
might be that something that came to be seen as Prime Minister
Contes own personal project, the CES, became an object of
partisan criticism.
Our ndings corroborate the literature describing how eco-
nomic and social expertise are often poorly integrated into public
health expert advice, constituting a major challenge for policy-
making during a health emergency (Bjørkdahl and Carlsen,
2019). In Italy, expert politics has clearly led to the conrmation
of knowledge hierarchies and power relations that see a pre-
dominance of hard sciences over social sciences. The reasons
behind the much stronger emphasis on some scientic dis-
ciplinary elds over others are multifaceted: policymakers were
focused on managing the public health emergency rather than on
mitigating long-term repercussions of lockdown measures, espe-
cially during the rst wave in the Spring of 2020. The narrow
dening of the boundaries of the Covid-19 pandemic to a health
emergency only, by governments, shaped the type of knowledge
and evidence that could be mobilized in the management of the
crisis, to the detriment of the social sciences. We have seen this
clearly at play in our case study, where for most of 2020, the only
goal of the policies in place for the management of the Covid-19
crisis was saving the highest possible number of lives, whereas the
consideration of the economic and social consequences of the
same policies came a distant second.
The proliferation of independent experts that emerged in
parallel in Italy in the second phase of the pandemic in 2020 can
be possibly linked to the perceived vacuum of transparency of the
CTS, caused by the non-disclosure agreements and the media
investigationnow a formal legal investigation (De Lorenzo,
2020)into the non-disclosure of the rst health emergency plan
formulated by the CTS in February of 2020. The diminishing
trust in scientists recorded in Italy by the Observatory for Science
in Society of the University of Bologna was explained by the
respondents as caused by the multiplicity of the recommenda-
tions produced by scientists, the lack of consensus registered at all
stages of the pandemic, and the perceived lack of transparency in
the motives of scientists, which left space open for speculations of
conspiracy theories (de Melo-Martin and Intemann, 2018).
Another key feature of the second phase of the pandemic in Italy
is the changing role of epidemiological data. While in the rst
wave, characterized by a national lockdown, the data produced by
the regions were used retrospectively to analyze the level of risk,
in the second wave of the epidemic in Italy regional data acquired
a new, operational role, and were used prospectively to inform the
level of risk of each region thus determining the level of restric-
tions in place. Italy has therefore seen a clear shift in the man-
agement of the pandemic from an emergency response mode in
the rst wave (when the only data available were those coming
from China), to an evidence-based, data-informed approach in
the second wave of the Covid-19 outbreak in 2020.
Finally, the high level of public support for the governments
measures in the rst phase of the pandemic in Italy waivered as
soon as the acute emergency was over. The strong political
consensus that characterized the rst wave proved itself
HUMANITIES AND SOCIAL SCIENCES COMMUNICATIONS | https://doi.org/10.1057/s41599-022-01042-6 ARTICLE
HUMANITIES AND SOCIAL SCIENC ES COMMUNICATIONS | (2022) 9:54 | https://doi.org/10.1057/s41599-022-01042-6 11
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
tenuous, while members of parliament beginning to criticize the
governments choices in the management of the epidemic,
leading to the resignation of the Prime Minister Giuseppe
Conte at the end of January 2021. This type of instant revi-
sionism is not rare after emergencies, nor is the decreasing
public support to government a unique feature of our case
study, as outlined by Kaniasty and Norris (2004). In the second
year of the Covid-19 pandemic, political crises are evident in
many countries in Europe and beyond, although Italy is the
only countryto date (January 2022)where the political crisis
has directly led to a change in government.
Conclusions
This case study adopted a qualitative methodological approach
and relied on a mix of both primary and secondary data col-
lection and analysis, to investigate how expert advice has been
sought, produced and utilized in the management of the Covid-
19 pandemic in Italy in 2020. The primary data collection
involved nine key stakeholder interviews. The secondary data
collection relied on ofcial documents and communications by
expert advisory bodies, ministerial decrees, and governmental
documents, released in the year 2020. The Italy case study is
particularly interesting as Italy represents the rst country after
China having to face and manage the SARS-CoV-2 outbreak.
The Italy case study is therefore unique in the way the country
had to deal with the highest degree of uncertainty regarding
the new pathogen. There are three key features of the man-
agement of the pandemic in Italy, which emerge from our
analysis of the data:
i. The near-complete overlap of technical advice and political
response in the rst phase of the pandemic in the spring
of 2020;
ii. The shift in the management approach to the pandemic
from a national lockdown in the spring of 2020 to a
prominently regionalized approach in the fall and winter,
and leading into 2021;
iii. The conrmation by expert politics of knowledge hierar-
chies that privilege hard sciences to the detriment of soft
sciences (social sciences and humanities).
Our analysis ends at the end of 2020. It is neither exhaustive
nor necessarily complete, as we are very much still in the midst of
the pandemic as we nalise this article, however our case study
provides what we believe is an accurate snapshot and repre-
sentation of the mobilization of experts, and of selected types of
evidence, to manage the unprecedented health emergency, in year
1 of the Covid-19 pandemic in Italy. An interesting follow up
from our case study would be to investigate the decision, on
February 13th, 2021 of the Italian President of the Republic,
Sergio Mattarella, to constitute a Public HealthTechnical
Government led by a technicalPrime Minister Mario Draghi
(former Head of the European Central Bank). In a new critical
juncture of health emergency, Italian politics resorted again to
expert-based policymaking. As outlined in the background sec-
tion, Italy has a long history of technocratic governments going
back to the early 1990s. However, these governments are known
to be short-lived with quickly eroding public and political con-
sensus. This should not come as a surprise: as outlined in this
case study, as soon as the peak of the health emergency is per-
ceived to be over, partisan differences emerge and expertsadvice,
as well as their trustworthiness and impartiality, are called into
question. The active effort by Italian politicians to take the
politicsout of the management of the pandemic by resorting to
expert knowledge was not by any means unique to Italy. Quite on
the contrary, this has emergence as a key feature of the
mobilisation of expert knowledge in the management of the
Covid-19 health emergency across many different countries, with
different political systems, throughout the world. This nding, we
believe, could become a lesson for future emergencies. Expert-
based politics can only be a temporary solution for politicians.
The continued resorting to expert-based advice beyond the strict
limits of the emergency can lead to diminished trust in experts
with longstanding consequences for science. Finally, our ndings
corroborate prior literature indicating that economic and social
expertize has not been well integrated into public health expert
advice, constituting a major challenge for policymaking during a
health emergency.
Data availability
The qualitative data collective through the interviews as well as
the policy documents analyzed are stored in a university online
research repository according to GDPR regulations.
Received: 27 June 2021; Accepted: 5 January 2022;
Note
1 The Einaudi foundation is a private research center that promotes the dissemination of
liberal values in Italy, rst and foremost an open and constructive dialogue about facts
and ideas.
References
ADN Kronos August 7th, 2020, CTS: Minutes condential, not classied, to avoid
panic(CTS: Verbali non segreti ma riservati per non creare panico)https://
www.adnkronos.com/cts-verbali-non-segreti-ma-riservati-per-non-creare-
panico_1BmmRbsVWzSMl1EddHvXLB. (Accessed: Jan 23rd, 2022)
Agenzia Italia (2020) Sono più scienziato io di tanti altri, anche in Cts, dice Zangrillo
https://www.agi.it/cronaca/news/2020-06-01/cosa-pensano-virologi-virus-
morto-zangrillo-8784242/. (Accessed: Jan 23rd, 2022)
Angeli F, Camporesi S, Del Fabbro G (2021) The Covid-19 wicked problem in
public health ethics: conicting evidence, or incommensurable values?
Humanit Soc Sci Commun 8(1):18
Angeli F, Raab J, Oerlemans L (2020) Adaptive responses to performance gaps in
project networks. In: Braun T, Lampel J (eds). Research in the Sociology of
Organizations. Emerald Publishing Limited, vol. 67, pp. 153178
ANSA (2020a) Coronavirus: un contagiato in Lombardia. (Coronavirus: rst
infected case in Lombardy). February 21st, 2020) https://www.ansa.it/sito/
notizie/cronaca/2020/02/21/coronavirus-un-contagiato-in-lombardia_
dda62491-4ae1-40af-9cd4-e7dc8402b493.html. (Accessed, Jan 23, 2022)
ANSA (2020bis) Covid: Abruzzo, zona rossa per un giorno, negozi chiusi-Abruzzo-
ANSA.it. December 12th, 2020 Available at: https://www.ansa.it/abruzzo/
notizie/2020/12/12/covid-abruzzo-zona-rossa-per-un-giorno-negozi-
chiusi_feb8d8ce-3bf8-41eb-bc3a-6128bc211d88.html. (Accessed: Jan 23rd,
2022)
Bjørkdahl K, Carlsen B (2019) Pandemics, publics, and politics. Staging Responses
to Public Health Crises. Palgrave Pivot, Singapore
Boin A et al. (2020) Beyond Covid19: ve commentaries on expert knowledge,
executive action, and accountability in governance and public administration.
Can Public Adm 63:339368
Constitution of Italian Republic, English Version. Available at: https://www.senato.it/
documenti/repository/istituzione/costituzione_inglese.pdf. (Accessed: Jan 23rd,
2022)
De Lorenzo G (2020) Piano segreto, ora c'è la data X. Il governo nisce in
tribunale. Il Giornale, December 10th, 2020 https://www.ilgiornale.it/news/
politica/piano-segreto-ora-c-data-x-governo-nisce-tribunale-1908807.html.
(Accessed: Jan 23rd, 2022)
Decree of Health Ministry (2020) Available at https://www.gazzettaufciale.it/eli/
id/2020/05/02/20A02444/sg. (Accessed, Jan 23, 2022)
Decree of Ministry of Interior (2020) (Decreto del Ministero dellInterno, 20
Aprile 2020) https://www.gazzettaufciale.it/eli/id/2020/04/16/20A02169/
sg. (Accessed: Jan 23rd, 2022)
Decree of the President of the Council of Ministers (2020) Decreto del Presidente
del Consiglio dei Ministri, 10 aprile, 2020 https://www.gazzettaufciale.it/eli/
id/2020/04/11/20A02179/sg. (Accessed: Jan 23rd, 2022)
Eisenhardt KM, Graebner ME (2007) Theory building from cases: opportunities
and challenges. Acad Manag J 50:2532
ARTICLE HUMANITIES AND SOCIAL SCIENCES COMMUNICATIONS | https://doi.org/10.1057/s41599-022-01042-6
12 HUMANITIES AND SOCIAL SCIENCES COMMUNICATIONS | (2022) 9:54 | https://d oi.org/10.1057/s41599-022-01042-6
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
European Centre for Disease Prevention and Control - List of inuenza pandemic
preparedness plans (2021). Available at https://www.ecdc.europa.eu/en/
seasonal-inuenza/preparedness/inuenza-pandemic-preparedness-plans.
(Accessed: Jan 23rd, 2022)
Eyal G (2013) For a sociology of expertise: The social origins of the autism epi-
demic. Am J Sociol 118(4):863907
Feuer W (2020) Confusion breeds distrust:China keeps changing how it counts
coronavirus cases. CNBC February 26, 2020 https://www.cnbc.com/2020/02/
26/confusion-breeds-distrust-china-keeps-changing-how-it-counts-
coronavirus-cases.html. (Accessed: Jan 23rd, 2022)
Fregonara G (2020) Schools: Miozzo (CTS) says the government is short-sighted.
Scuola: Miozzo (CTS) Governo Miope. Corriere, December 17th, 2020
https://www.corriere.it/scuola/secondaria/20_dicembre_17/scuola-miozzo-
cts-governo-miope-citta-che-sono-pronte-riaprano-97bf529e-408a-11eb-
b55d-be40d0705ed1.shtml. (Accessed: Jan 23rd, 2022)
Frickel S, Moore K (eds.) (2006) The new political sociology of science: Institutions,
networks, and power. Univ of Wisconsin Press
Giuffrida A, Boseley S (2020) Italys pandemic plan old and inadequate, Covid
report nds. The Guardian, August 13, 2021 https://www.theguardian.com/
world/2020/aug/13/italy-pandemic-plan-was-old-and-inadequate-covid-
report-nds. (Accessed: Jan 3rd, 2022)
Guerzoni M, Sarzanini F (2020a) Covid in Italy: the secret plan of the government:
here are the three scenarios outlined in February. (Covid in Italia, il piano
segreto del governo: i tre scenari delineati a febbraio). Corriere. 8 settembre
2020. Available at: https://www.corriere.it/cronache/20_settembre_08/Covid-
ecco-piano-segreto-governo-tre-scenari-delineati-febbraio-c9b3ad06-f14b-
11ea-9f2b-89b4229fc5bf.shtml. (Accessed: Jan 23rd, 2022)
Guerzoni M, Sarzanini F (2020bis) Italy: red or orange for Christmas? The fracture
within the CTS (Italia: zona rossa o arancione a Natale, e rischio assem-
bramenti. Il CTS si spacca). Corriere, December 20th, 2020 https://
www.corriere.it/cronache/20_dicembre_15/italia-zona-rossa-o-arancione-
natale-cts-maggiori-controlli-evitare-assembramenti-c75e2ce8-3ebc-11eb-
9172-c7bb2a56a969.shtml. (Accessed: Jan 33rd, 2022)
Horowitz J (2020) Italy Announces Restrictions Over Entire Country in Attempt to
Halt Coronavirus. The New York Times, March 9, 2020 https://www.nytimes.
com/2020/03/09/world/europe/italy-lockdown-coronavirus.html. (Accessed,
Jan 23, 2022)
Horton R (2020) Ofine: science and politics in the era of Covid-19. Lancet 396:1319
Iles A, Montenegro de Wit M (2020) Who gets to dene the Covid-19 problem?
Expert politics in a pandemic. Agri Hum Value 37:659660
Italian Committee for Bioethics. Opinion on Vaccines and Covid-19: Ethical
aspects on research, cost and distribution(2020). November 27th, 2020
Available at: https://bioetica.governo.it/media/4234/p140_2020_riv_vaccines-
and-Covid-19-ethical-aspects-on-research-cost-and-distribution.pdf. (Acces-
sed: Jan 23rd, 2022)
Italian Committee for BioethicsOpinions on Covid-19 (Comitato Nazionale per la
Bioetica-I pareri del CNB sul Covid-19). Available at: http://bioetica.
governo.it/it/documenti/i-pareri-del-cnb-sul-Covid-19. (Accessed: Jan 23rd,
2022)
Italian Council of Ministers declares the state of emergency. (Consiglio dei min-
istri dichiara stato demergenza) (2020). Available at: https://
www.gazzettaufciale.it/eli/id/2020/02/01/20A00737/sg. (Accessed Jan 23,
2022)
Italian National Institute of Health (2021) Our Mission (Istituto Superiore della
Sanità, la nostra missione). Available at: https://www.iss.it/web/iss-en/
mission. (Accessed: Jan 23rd, 2022)
Italys National Plan for Preparedness and Response to an Inuenza Pandemic,
February 10, 2006 Available at: https://www.salute.gov.it/imgs/C_17_
pubblicazioni_501_ulterioriallegati_ulterioreallegato_0_alleg.pdf. (Accessed:
Jan 23rd, 2022)
Kaniasty K, Norris FH (2004) Social support in the aftermath of disasters, cata-
strophes, and acts of terrorism: altruistic, overwhelmed, uncertain, antag-
onistic, and patriotic communities. In: Ursano RJ, Norwood, AE, Fullerton
CS (eds.), Bioterrorism: psychological and public health interventions.
Cambridge University Press. pp. 200229
Lavazza A, Farina M (2020) The role of experts in the Covid-19 pandemic and the
limits of their epistemic authority in democracy. Front Public Health 8:356.
https://doi.org/10.3389/fpubh.2020.00356
Law December 23rd, (1978), n. 833. Institution of the National Health System.
Istituzione del Servizio Sanitario Nazionale, Available at: https://
www.trovanorme.salute.gov.it/norme/dettaglioAtto?id=21035&completo=true
. (Accessed: Jan 23rd, 2022)
List of Ordinances of Special Covid Commissioner (2021). (Presidenza del Con-
siglio. Covid19 Ordinanze del Commissario Straordinario). Available at:
http://www.governo.it/it/dipartimenti/commissario-straordinario-lemergenza-
Covid-19/csCovid19-ordinanze/14421. (Accessed: Jan 23rd, 2022)
Luna R (2020) Il piano anti Covid cera. Ma i tecnici decisero: Va tenuto segreto-
la Repubblica. 5 settembre 2020 Available at: https://www.repubblica.it/
cronaca/2020/09/05/news/il_piano_anti_covid_tenuto_segreto-266283298/.
(Accessed: Jan 3rd, 2022)
de Melo-Martín I, Intemann K (2018) The ght against doubt: How to bridge the
gap between scientists and the public. Oxford University Press
Minutes of CTS Covid-19 for Foundation Luigi Einaudi (I verbali del Comitato
Tecnico Scientico Covid-19) Fondazione Luigi Einaudi. Available at: https://
www.fondazioneluigieinaudi.it/i-verbali-del-comitato-tecnico-scientico/.
(Accessed: Jan 23rd, 2022)
Observa, Science in Society (2021) Vaccini anti Covid-19 diminuisce lo scetticismo
https://www.observa.it/vaccini-anti-covid/. (Accessed: Jan 3rd, 2022)
Ordinance n. 11/2020 of Special Covid Commissioner, (April 26th, 2020). Ordi-
nanza n. 11/2020. Il Commissario Straordinario per l'emergenza Covid-19,
Domenico Arcuri, ha rmato l'Ordinanza n. 11/2020 che ssa i prezzi
massimi di vendita al consumo delle mascherine facciali (TheSpecial Covid-
19 Commissioner, Domenico Arcuri, signs the decree n. 11/2020 which
establishes the maximum costs for facial coverings). Available at: https://
www.governo.it/it/dipartimenti/14520. (Accessed Jan 23rd, 2020).
Ordinance n. 630, Civil Protection Department, February 3rd, 2020.ORdinanza n.630,
Dipartiemnto della Protezione Civile. Primi interventi urgenti di protezione civile
in relazione allemergenza relativa al rischio sanitario connesso allinsorgenza di
patologie derivanti da agenti virali trasmissibili- Available at: https://
www.gazzettaufciale.it/eli/id/2020/02/08/20A00802/sg. (Accessed, Jan 23, 2022)
Ordinance n. 663, Civil Protection Department, April 18, 2020 (Protezione Civile.
Ocdpc n. 663 del 18 aprile 2020). Ulteriori interventi urgenti di protezione
civile in relazione allemergenza relativa al rischio sanitario connesso allin-
sorgenza di patologie derivanti da agenti virali trasmissibiliAvailable at:
https://www.gazzettaufciale.it/eli/id/2020/04/22/20A02260/sg. (Accessed:
Jan 23rd, 2022)
Ordinance n. 751, (2021) Ulteriori interventi urgenti di protezione civile in rela-
zione allemergenza relativa al rischio sanitario connesso allinsorgenza di
patologie derivanti da agenti virali trasmissibili. Dipartimento della Prote-
zione Civile, Presidenza del Consiglio dei Ministri, 17 marzo 2021 https://
www.protezionecivile.gov.it/it/normativa/ocdpc-n--751-del-17-marzo-2021.
(Accessed Jan 23rd, 2022)
Pastorella G (2016) Technocratic governments in Europe: getting the critique right.
Polit Stud 64(4):948965
Pielke RA (2007) The honest broker: Making sense of science in policy and politics.
The Honest Broker: Making Sense of Science in Policy and Politics. Cam-
bridge University Press
Report of the experts on economics and social matters for the President of the
Council of the Ministries (2020) (Comitato di esperti in materia economica e
sociale Iniziative per il rilancio Italia 20202022, Rapporto per il Presidente
del Consiglio dei Ministri. Giugno 2020) https://www.governo.it/sites/
new.governo.it/les/comitato_rapporto.pdf. (Accessed: Jan 23rd, 2022)
La Repubblica (2020) Coronavirus: Face-masks at 40 euros. (Coronavirus,
mascherine a 40 euro. Consumatori: Speculazione vergognosa). la Repub-
blica. February 24th, 2020 Available at: https://www.repubblica.it/cronaca/
2020/02/23/news/coronavirus_amuchina_mascherine-249358877/. (Acces-
sed: Jan 23rd, 2022)
Reuters March 1st, (2021) ItalysDraghires Covid commissioner with vacci-
nation drive in spotlight. March 1st, 2021 https://www.reuters.com/article/
health-coronavirus-italy-commisioner-idUSR1N2JW033. (Accessed: Jan
23rd, 2022)
Sarzanini F (2020) Gyms and pools: open, or closed? New fracture within the CTS
(Chiusura palestre e piscine: così si spacca il CTS sul nuovo DCPM). Cor-
riere.it October 20th, 2020 https://www.corriere.it/cronache/20_ottobre_20/
rigoristi-contro-tolleranti-cosi-si-spacca-cts-d5476e28-1243-11eb-9ff9-
df76cb96fbac.shtml. (Accessed: Jan 23rd, 2022)
Severgnini C (2020) Coronavirus, rst two cases in Italy: its two Chinese tourists
(Coronavirus, primi due casi in Italia: sono due turisti cinesi). Corriere della
Sera. Available at: https://www.corriere.it/cronache/20_gennaio_30/corona
virus-italia-corona-9d6dc436-4343-11ea-bdc8-faf1f56f19b7.shtml. (Accessed:
Jan 23rd, 2022)
Sole 24 Ore (2020) Things that humans could never imagine. Chronicle of pandemic
in Italy (Cose che noi umani. Cronistoria della pandemia in Italia). Sole 24 ore.
https://lab24.ilsole24ore.com/storia-coronavirus/. (Accessed: Jan 23rd, 2022)
Timmermans S, Tavory I (2012) Theory construction in qualitative research. Sociol
Theory 30:167186
Urbani A et al. (2020) Prevent ion and response to Covid-19: evolution of strategy
and planning in the transition phase for the autumn-winter season. English
version. Ministero della Salute, Istituto Superiore di Sanità, Rome, https://
www.iss.it/documents/5430402/0/Covid+19_+strategy_ISS_MoH+%281%
29.pdf/f0d91693-c7ce-880b-e554-10.1057/s41599-022-01042-6643c049ea0f3?
t=1604675600974. (Accessed: Jan 3rd, 2022)
World Health Organization (2005) WHO global inuenza preparedness plan.
Department of Communicable Disease Surveillance and Response Global
Inuenza Programme. https://www.who.int/csr/resources/publications/inue
nza/WHO_CDS_CSR_GIP_2005_5.pdf. (Accessed: Jan 3rd, 2022)
HUMANITIES AND SOCIAL SCIENCES COMMUNICATIONS | https://doi.org/10.1057/s41599-022-01042-6 ARTICLE
HUMANITIES AND SOCIAL SCIENC ES COMMUNICATIONS | (2022) 9:54 | https://doi.org/10.1057/s41599-022-01042-6 13
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
World Health Organization (2020) Naming the coronavirus disease (Covid-19) and
the virus that causes it. Available at: https://www.who.int/emergencies/diseases/
novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-
(Covid-2019)-and-the-virus-that-causes-it. (Accessed: Jan 3rd, 2022)
Acknowledgements
We are deeply grateful to all our participants for giving us some of their time at a
moment of national emergency. Many thanks go to Roger Pielke at the University of
Colorado Boulder and EScAPE (https://escapecovid19.org/) project lead.
Competing interests
The authors declare no competing interests.
Ethical approval
Ethical approval for the project was obtained by Kings College London on September 1,
2020 (reference number MRA 19/20 -21073) and all research was performed in accor-
dance with relevant guidelines.
Informed consent
Informed consent for videorecording the interviews for the purposes of this research and
anonymous use of quotes was obtained verbally by all participants. The nal manuscript
was shared with all participants ahead of publication.
Additional information
Correspondence and requests for materials should be addressed to Silvia Camporesi.
Reprints and permission information is available at http://www.nature.com/reprints
Publishers note Springer Nature remains neutral with regard to jurisdictional claims in
published maps and institutional afliations.
Open Access This article is licensed under a Creative Commons
Attribution 4.0 International License, which permits use, sharing,
adaptation, distribution and reproduction in any medium or format, as long as you give
appropriate credit to the original author(s) and the source, provide a link to the Creative
Commons license, and indicate if changes were made. The images or other third party
material in this article are included in the articles Creative Commons license, unless
indicated otherwise in a credit line to the material. If material is not included in the
articles Creative Commons license and your intended use is not permitted by statutory
regulation or exceeds the permitted use, you will need to obtain permission directly from
the copyright holder. To view a copy of this license, visit http://creativecommons.org/
licenses/by/4.0/.
© The Author(s) 2022
ARTICLE HUMANITIES AND SOCIAL SCIENCES COMMUNICATIONS | https://doi.org/10.1057/s41599-022-01042-6
14 HUMANITIES AND SOCIAL SCIENCES COMMUNICATIONS | (2022) 9:54 | https://d oi.org/10.1057/s41599-022-01042-6
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
1.
2.
3.
4.
5.
6.
Terms and Conditions
Springer Nature journal content, brought to you courtesy of Springer Nature Customer Service Center GmbH (“Springer Nature”).
Springer Nature supports a reasonable amount of sharing of research papers by authors, subscribers and authorised users (“Users”), for small-
scale personal, non-commercial use provided that all copyright, trade and service marks and other proprietary notices are maintained. By
accessing, sharing, receiving or otherwise using the Springer Nature journal content you agree to these terms of use (“Terms”). For these
purposes, Springer Nature considers academic use (by researchers and students) to be non-commercial.
These Terms are supplementary and will apply in addition to any applicable website terms and conditions, a relevant site licence or a personal
subscription. These Terms will prevail over any conflict or ambiguity with regards to the relevant terms, a site licence or a personal subscription
(to the extent of the conflict or ambiguity only). For Creative Commons-licensed articles, the terms of the Creative Commons license used will
apply.
We collect and use personal data to provide access to the Springer Nature journal content. We may also use these personal data internally within
ResearchGate and Springer Nature and as agreed share it, in an anonymised way, for purposes of tracking, analysis and reporting. We will not
otherwise disclose your personal data outside the ResearchGate or the Springer Nature group of companies unless we have your permission as
detailed in the Privacy Policy.
While Users may use the Springer Nature journal content for small scale, personal non-commercial use, it is important to note that Users may
not:
use such content for the purpose of providing other users with access on a regular or large scale basis or as a means to circumvent access
control;
use such content where to do so would be considered a criminal or statutory offence in any jurisdiction, or gives rise to civil liability, or is
otherwise unlawful;
falsely or misleadingly imply or suggest endorsement, approval , sponsorship, or association unless explicitly agreed to by Springer Nature in
writing;
use bots or other automated methods to access the content or redirect messages
override any security feature or exclusionary protocol; or
share the content in order to create substitute for Springer Nature products or services or a systematic database of Springer Nature journal
content.
In line with the restriction against commercial use, Springer Nature does not permit the creation of a product or service that creates revenue,
royalties, rent or income from our content or its inclusion as part of a paid for service or for other commercial gain. Springer Nature journal
content cannot be used for inter-library loans and librarians may not upload Springer Nature journal content on a large scale into their, or any
other, institutional repository.
These terms of use are reviewed regularly and may be amended at any time. Springer Nature is not obligated to publish any information or
content on this website and may remove it or features or functionality at our sole discretion, at any time with or without notice. Springer Nature
may revoke this licence to you at any time and remove access to any copies of the Springer Nature journal content which have been saved.
To the fullest extent permitted by law, Springer Nature makes no warranties, representations or guarantees to Users, either express or implied
with respect to the Springer nature journal content and all parties disclaim and waive any implied warranties or warranties imposed by law,
including merchantability or fitness for any particular purpose.
Please note that these rights do not automatically extend to content, data or other material published by Springer Nature that may be licensed
from third parties.
If you would like to use or distribute our Springer Nature journal content to a wider audience or on a regular basis or in any other manner not
expressly permitted by these Terms, please contact Springer Nature at
onlineservice@springernature.com
... Nella primavera-estate 2020, si è realizzata una graduale riapertura delle attività dopo il lockdown e si è verificato un periodo di trasmissione contenuta del virus denominato "prima fase di transizione epidemica" (vedi Figura 1). A partire dal mese di aprile 2020, per fronteggiare una attesa ripresa epidemica nel periodo invernale (8), l'Italia ha rafforzato la dotazione in personale e infrastrutture dei propri servizi sanitari (9), ha sviluppato checklist di preparedness (10), ha disegnato un sistema di monitoraggio del rischio epidemico (11) e predisposto una strategia di risposta (12), che si è concretizzata nel passaggio alla fase 2 della risposta epidemica con un approccio evidence based (13). La fase 2 ha previsto una riapertura parziale e la modulazione degli interventi di sanità pubblica al fine di mantenere un equilibrio tra la necessità di riprendere le attività logistiche-commerciali-produttive del Paese, mitigando l'impatto socioeconomico della pandemia, e l'esigenza di minimizzare la trasmissione del virus in attesa della disponibilità di farmaci e vaccini efficaci e sicuri, mitigando l'impatto della malattia sulla popolazione (morbilità e mortalità) e sui servizi sanitari. ...
... I risultati delle analisi di sensitività sono presentati come intervalli degli eventi evitati stimati per indicare l'incertezza. 13 La Figura 7 riporta il tasso cumulato osservato e atteso di diagnosi, ospedalizzazione, ricovero in terapia intensiva e decesso per 100.000 abitanti per mese. ...
... mentre il tasso osservato è stato pari a 21 ricoveri per 100.000. Nello stesso mese il tasso di ricovero in terapia intensiva e la mortalità attesa sono stati stimati pari rispettivamente a 9 (8-11) e 15 (12)(13)(14)(15)(16)(17)(18)(19)(20) contro un tasso osservato pari rispettivamente a 2 e 3. Con l'aumentare della popolazione con dose aggiuntiva/booster, l'effetto preventivo della vaccinazione è aumentato. In generale fra novembre e dicembre 2021, mesi caratterizzati da un'elevata diffusione del virus dovuta all'introduzione e successiva diffusione della variante Omicron (lignaggio B.1.1.529), ...
... On January 31, 2020, the Italian government proclaimed a state of emergency and implemented the first measures to contain the infection on the entire national territory (Camporesi et al. 2022). ...
Article
Full-text available
Coronavirus disease 19 (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus, which is responsible for the ongoing global pandemic. Stringent measures have been adopted to face the pandemic, such as complete lockdown, shutting down businesses and trade, as well as travel restrictions. Nevertheless, such solutions have had a tremendous economic impact. Although the use of recent vaccines seems to reduce the scale of the problem, the pandemic does not appear to finish soon. Therefore, having a forecasting model about the COVID-19 spread is of paramount importance to plan interventions and, then, to limit the economic and social damage. In this paper, we use Genetic Programming to evidence dependences of the SARS-CoV-2 spread from past data in a given Country. Namely, we analyze real data of the Campania Region, in Italy. The resulting models prove their effectiveness in forecasting the number of new positives 10/15 days before, with quite a high accuracy. The developed models have been integrated into the context of SVIMAC-19, an analytical-forecasting system for the containment, contrast, and monitoring of Covid-19 within the Campania Region.
Article
Full-text available
While the world was facing a rapidly progressing COVID-19 second wave, a policy paradox emerged. On the one side, much more was known by Autumn 2020 about the mechanisms underpinning the spread and lethality of Sars-CoV-2. On the other side, how such knowledge should be translated by policymakers into containment measures appeared to be much more controversial and debated than during the first wave in Spring. Value-laden, conflicting views in the scientific community emerged about both problem definition and subsequent solutions surrounding the epidemiological emergency, which underlined that the COVID-19 global crisis had evolved towards a full-fledged policy “wicked problem”. With the aim to make sense of the seemingly paradoxical scientific disagreement around COVID-19 public health policies, we offer an ethical analysis of the scientific views encapsulated in the Great Barrington Declaration and of the John Snow Memorandum, two scientific petitions that appeared in October 2020. We show that how evidence is interpreted and translated into polar opposite advice with respect to COVID-19 containment policies depends on a different ethical compass that leads to different prioritization decisions of ethical values and societal goals. We then highlight the need for a situated approach to public health policy, which recognizes that policies are necessarily value-laden, and need to be sensitive to context-specific and historic socio-cultural and socio-economic nuances.
Chapter
Full-text available
Project networks are an increasingly salient organizational temporary form to deal with complex problems. It remains unclear, however, whether and how project networks adapt over time, and hence implement changes, both within the span of the specific project and across projects. We apply the performance feedback perspective to explore how adaptive responses to performance feedback are organized and absorbed within project networks. We investigate these matters in the area of humanitarian and development aid efforts, which represent complex social issues. In this context, project networks involve a multitude of actors at different distances from the implementation field, from the donor, through an international Non-Governmental Organization, to the NGO’s country offices, local NGOs and the beneficiary communities. Our qualitative findings, which we generate through an abductive analytical process, highlight that project networks dealing with complex social issues face six paradoxes based on DeFillipi and Sydow (2016): the distance, difference, identity, learning, temporal and performance paradoxes. Collective goal-setting, adaptive monitoring and evaluation practices, and continuous re-negotiation of aspiration levels emerge as coping mechanisms enabling project networks to internalize insights from the field and translate them into adaptive behavioral responses, mainly at the intra-project level. We contribute to a better understanding of adaption in these temporary forms, and particularly in its behavioral consequences. The study also advances knowledge on the performance feedback perspective, through its application in temporary settings, on the level of the project network and in the context of complex social issues, where organizational arrangement strive to pursue multiple interdependent goals.
Article
Full-text available
en Several Canadian and international scholars offer commentaries on the implications of the COVID‐19 pandemic for governments and public service institutions, and fruitful directions for public administration research and practice. This first suite of commentaries focuses on the executive branch, variously considering: the challenge for governments to balance demands for accountability and learning while rethinking policy mixes as social solidarity and expert knowledge increasingly get challenged; how the policy‐advisory systems of Australia, Canada, New Zealand, and United Kingdom were structured and performed in response to the COVID‐19 crisis; whether there are better ways to suspend the accountability repertoires of Parliamentary systems than the multiparty agreement struck by the minority Liberal government with several opposition parties; comparing the Canadian government’s response to the COVID‐19 pandemic and the Global Financial Crisis and how each has brought the challenge of inequality to the fore; and whether the COVID‐19 pandemic has accelerated or disrupted digital government initiatives, reinforced traditional public administration values or more open government. Sommaire fr Plusieurs universitaires canadiens et internationaux ont offert des commentaires sur les implications de la pandémie du COVID‐19 pour les gouvernements et les institutions de la fonction publique, ainsi que des orientations productives pour la recherche et la pratique en administration publique. Cette première série de commentaires se concentre sur le pouvoir exécutif, en considérant de diverses façons : le défi pour les gouvernements d'équilibrer les exigences de responsabilité et d'apprentissage tout en repensant les combinaisons de politiques alors que la solidarité sociale et les connaissances d'experts sont de plus en plus remises en question; comment les systèmes de consultation en politique de l'Australie, du Canada, de la Nouvelle‐Zélande et du Royaume‐Uni ont été structurés et mis en œuvre en réponse à la crise du COVID‐19; s'il existe de meilleures façons de suspendre les répertoires de responsabilité des systèmes parlementaires que l'accord multipartite conclu par le gouvernement libéral minoritaire avec plusieurs partis d'opposition; comparer la réponse du gouvernement canadien à la pandémie du COVID‐19 et à la crise financière mondiale et comment chacune a mis le défi de l’inégalité au premier plan; et si la pandémie du COVID‐19 a accéléré ou perturbé les initiatives du gouvernement numérique, renforcé les valeurs traditionnelles de l'administration publique ou un gouvernement plus transparent.
Article
Full-text available
In the 2020 Covid-19 pandemic, medical experts (virologists, epidemiologists, public health scholars, and statisticians alike) have become instrumental in suggesting policies to counteract the spread of coronavirus. Given the dangerousness and the extent of the contagion, almost no one has questioned the suggestions that these experts have advised policymakers to implement. Quite often the latter explicitly sought experts' advice and justified unpopular measures (e.g., restricting people's freedom of movement) by referring to the epistemic authority attributed to experts. The main goal of this paper is to analyze the basis of this epistemic authority and the reasons why in this case it has not been challenged, contrary to the widespread tendency to devalue expertise that has been observed in recent years. In addition, in relation to the fact that experts' recommendations are generally technical and supposedly neutral, we note that in the COVID-19 crisis different experts have suggested different public health policies. We consider the British case of herd immunity and the US case of the exclusion of disabled people from medical care. These decisions have strong axiological implications and affect people profoundly in very sensitive domains. Another goal is, therefore, to argue that in such cases experts should justify their recommendations-which effectively become obligations-by the canons of public reason within the political process because when values are involved it is no longer just a matter of finding the “best technical solution,” but also of making discretionary choices that affect citizens and that cannot be imposed solely on the basis of epistemic authority.
Book
Full-text available
Pandemics are potentially very destructive phenomena, and for that reason, they both fascinate and frighten us. And because they are shot through with uncertainty, they often become sites of contestation and conflict. This book presents research on the 2009 pandemic and other public health crises in an attempt to describe and analyze the distinctive challenges that such diseases pose today. Thanks to vaccines, more reliable provision of medical services, more effective means of communication, and a more educated public, some argue we will not see a new Black Plague – or even Spanish Flu – in our time. Today we face new challenges, however, which can both enable diseases to reach pandemic scales and affect our ability to enact an appropriate response. Those include fragmentation of media, tribalization of “knowledge regimes,” the increasingly troubled status of scientific and political expertise, growing cross-continental mobility, as well as the globalization and commercialization of pandemic response systems. These distinctive complexities make the need to stage public action in response to pandemics and other public health crises a crucial problem, on which thousands of human lives hinge. This volume consists of a handful of social science and humanities studies of precisely such complexities, and thus offers a much-needed supplement to existing research on pandemics and pandemic response.
Book
Full-text available
The lack of public support for climate change policies and refusals to vaccinate children are just two alarming illustrations of the impacts of dissent about scientific claims. Dissent can lead to confusion, false beliefs, and widespread public doubt about highly justified scientific evidence. Even more dangerously, it has begun to corrode the very authority of scientific consensus and knowledge. Deployed aggressively and to political ends, some dissent can intimidate scientists, stymie research, and lead both the public and policymakers to oppose important public policies firmly rooted in science. To criticize dissent is, however, a fraught exercise. Skepticism and fearless debate are key to the scientific process, making it both vital and incredibly difficult to characterize and identify dissent that is problematic in its approach and consequences. Indeed, as de Melo-Martín and Intemann show, the criteria commonly proposed as means of identifying inappropriate dissent are flawed and the strategies generally recommended to tackle such dissent are not only ineffective but could even make the situation worse. The Fight Against Doubt proposes that progress on this front can best be achieved by enhancing the trustworthiness of the scientific community and by being more realistic about the limits of science when it comes to policymaking. It shows that a richer understanding of the context in which science operates is needed to disarm problematic dissent and those who deploy it. This, the authors argue, is the best way forward, rather than diagnosing the many instances of wrong-headed dissent.
Article
Project networks are an increasingly salient organizational temporary form to deal with complex problems. It remains unclear, however, whether and how project networks adapt over time, and hence implement changes, both within the span of the specific project, and across projects. We apply the performance feedback perspective to explore how adaptive responses to performance feedback are organized and absorbed within project networks. We investigate these matters in the area of humanitarian and development aid efforts, which represent complex social issues. In this context, project networks involve a multitude of actors at different distances from the implementation field, from the donor, through an international Non-Governmental Organization, to the NGO’s country offices, local NGOs and the beneficiary communities. Our qualitative findings, which we generate through an abductive analytical process, highlight that project networks dealing with complex social issues face six paradoxes based on DeFillipi and Sydow (2016): the distance, difference, identity, learning, temporal and performance paradoxes. Collective goal-setting, adaptive monitoring and evaluation practices, and continuous re-negotiation of aspiration levels emerge as coping mechanisms enabling project networks to internalize insights from the field and translate them into adaptive behavioral responses, mainly at the intra-project level. We contribute to a better understanding of adaption in these temporary forms, and particularly in its behavioral consequences. The study also advances knowledge on the performance feedback perspective, through its application in temporary settings, on the level of the project network and in the context of complex social issues, where organizational arrangement strive to pursue multiple interdependent goals.
Article
In Europe, technocratic governments have become a popular topic of debate. Commentators have condemned them as a ‘suspension of democracy’ or even as ‘the end of democracy as we know it’. However, no academic analysis has assessed whether technocratic governments are indeed undemocratic. This article is intended to fill this gap by assessing technocratic governments' democratic credentials. It compares them to party governments along the main dimensions of party democracy, including representation, deliberation, constitutionality and legitimacy. It concludes that technocratic governments in Europe are not undemocratic per se, but are still a worrying phenomenon insofar as they reveal shortcomings that remain hidden in normal party governments: a loosening of delegation and accountability ties between voters, parties and cabinets; increasing external pressures on domestic political actors; and the weakening of partisan ideology-based politics. The article will add further elements to reinforce the already vast literature on the crisis of – especially party – democracy in Europe.