The Virus Can Be Conquered Through Contamination. Of Knowledge

ALESSIA MELEGARO, DEMOGRAPHER AND DIRECTOR OF THE COVID CRISIS LAB, IS CONVINCED OF THIS. A CONTAMINATION AND A NETWORK THAT MUST BE BUILT IN PEACETIME BECAUSE IT IS DIFFICULT TO IMPROVISE DURING AN EMERGENCY. THIS IS WHY THE NEW LAB IS FIRST AND FOREMOST A MODEL, BECAUSE TODAY WE HAVE A WORD THAT HAS BROUGHT US TOGETHER, WHICH IS COVID, BUT TOMORROW THERE COULD BE OTHERS

In an academic world in which there has always been a tendency to reward excellence in specialization and pigeonhole people in specific disciplinary sectors, Alessia Melegaro, Associate Professor of Demography and Social Statistics at Bocconi, has always promoted and applied multidisciplinarity and contamination as a research idea. All the more reason today that, in her role as Director of the recently established Covid Crisis Lab, a point of contact for research on the virus at Bocconi, she coordinates the work of more than 30 researchers from the University's eight Departments, creating connections and weaving threads between seemingly different subjects.

In this sense, the Covid Crisis Lab is also an experimental model.
I don't like theory very much, I think everything we do even as researchers should have a practical value. In my case, it is to answer which vaccine is best or most affordable, when to administer it, or which health policy decisions should be supported. This has become even more relevant with Covid because the first phase focused entirely – and rightly so – on medical and health aspects, while the contribution of all disciplinary areas is required for Phase 2, and dialogue between various experts is critical. The Covid Crisis Lab can become a model to be replicated in other areas, even less dramatic areas we hope, because today we have a word that has brought us together, which is Covid, but tomorrow there could be others.
How much has the research done to date prepared you for what happened?
In the UK there was talk of an impending pandemic in epidemiology and public health institutes as early as 2000. Simulations, real time evaluation, ad hoc modeling were also carried out and there was considerable pressure to prepare guidelines. The problem is that all infections are different and there is an essential element of improvisation. So what you can prepare for is to create useful connections to deal with the problem. If you can't have an answer ready, at least so you know who to ask. And of course this network must be built in peacetime because it is difficult to improvise during an emergency.

Over the past few months there have been moments of considerable confusion and even scientists, from virologists to economists, have seemingly not always agreed with each other. So is there always a subjective factor in research? How do you personally deal with this aspect?
I always try to be guided by scientific evidence, by studies, which are the result of experience, work and generally a close scrutiny of the validity and reproducibility of the same. The overabundance of opinions regarding the facts is a phenomenon that was not new with Covid but I believe that in this case too, adopting a multidisciplinary approach in discussions, though challenging, will only lead to better results: if virologists stop where their expertise ends and pass the ball to epidemiologists who then involve mathematicians, demographers or economists in the answer, in the end the loop closes with a positive outcome for everyone. They don’t all answer, but they all answer together. To this I would add that we should begin to accept that a question can also be answered with: "I don't know, I have to check." You shouldn’t be ashamed or think of it as a defeat; especially in forecast models there is always a gray area. For communication and the media this is a taboo, but for anyone doing research, uncertainty is a parameter around which information that is not yet known gravitates; one should not be afraid to face it and, when appropriate, to affirm it.

Policy decision makers have often been the recipients of your research. What do you think the dialogue between science and politics has been like during Covid?
I would say the case in the UK is emblematic. There are very good scientists in London, who have been preparing for these emergencies for decades, yet it is currently the European country with the highest number of deaths. It is not just the fault of politics, it is also a communication problem. It is not easy to transfer the results of an epidemiological model analysis to a community, the media or policy makers, it is a fundamental step in the chain that must be optimized. Here's an example: the monitoring of the RT index in Italian regions should not be the prerogative of the media, but carefully monitored by a technical-scientific committee, otherwise you end up chasing data that, taken individually, have no value and maybe scream emergency as soon as there is a number above the threshold. A competent committee, on the other hand, could observe long-term evidence, identify troubling signs and pass on indications that have already been thought out to those making decisions.

Do you agree with the idea that the Covid era will end when a safe and accessible vaccine is available?
We are slowly enjoying a return to normal but, it seems to me, with a different individual awareness and this should help. The level of immunity in the Italian population is still very low, reaching peaks of 30-40% in areas with high prevalence or in groups of people who have been exposed to the virus, so we are nowhere near the 60-70% national average required to feel comfortable. However, the disease is better understood, interventions are being completed earlier and more effectively, contact tracing is being done. In short, we are learning a lot and this makes me optimistic.

 

WHO IS ALESSIA MELEGARO
She graduated from Bocconi with a thesis on mathematical models applied to the spread of tuberculosis, immediately combining an economic education with her interest in quantitative demography and a dialogue with epidemiology. "After graduation, I moved to the UK," says Melegaro, "where I completed my PhD at the University of Warwick and worked at Public Health England, the equivalent of Italy’s ISS. Even then, there it was normal for mathematicians and statisticians to talk to clinicians and immunologists." Returning to Bocconi at the Dondena Center in 2008, she was awarded a European Research Council Grant to coordinate the DECIDE project on the impact of demographic trends in the spread of infectious diseases with particular reference to developing countries. "This gave me the opportunity to delve into modeling research applied to healthcare, while also integrating demographics. Furthermore, work with countries in sub-Saharan Africa also added strong personal motivations to the study, a very important aspect when doing field research."

by Emanuele Elli
Translated by Jenna Walker