An evaluation of North Carolina science advice on COVID-19 pandemic response

This qualitative case study contributes to the international research project EScAPE (Evaluating Scientific Advice in a Pandemic Emergency) and aims to understand how state leaders mobilized science advice in pandemic response during 2020 and into the early months of 2021. North Carolina, a state in the southeastern United States, mobilized much of its pandemic science advice through the state’s Department of Health and Human Services. A fluid relationship between advisors and the governor—credited as a crucial component of a science driven, balanced pandemic response—created an opaque hub of advising and power. I analyze three advisory processes apparent during early stages of pandemic response noting strengths in mutual respect and trust between advisors and policymakers, data transparency, and commitment to equitable vaccine distribution. The interpersonal dynamics that provided these “good” science advice outcomes are a result of the individuals involved but the dynamic is not guaranteed in government over time. Also, while North Carolina provided data transparency it is unclear how data trends connected to decisions. There is a general lack of transparency around the breadth and content of advice. Transparency of advisory mechanisms is important to maintain public trust in government. Deep partisanship in the United States and distrust between leaders of opposing parties underscores the need for states to develop strong institutions for science advise to policymakers in an emergency. This article closes with several recommendations.