Testing the public’s trust in science
They never tell you this in school, but sometimes even asking a question is wrong.
Some questions invite so much correction that the question itself is a crime against knowledge. They can subtract from the sum of human understanding.
But people have goals other than pure scientific understanding these days, especially the politicians who have been asking the most urgent scientific questions in the pandemic: What is it? What is it doing? Where is it going? What can we do?
The way they seek answers has been revealing, if not always for them, at least for everyone else. The result is a massive international case study for public trust in science, which has been tested like never before by the shutdown, and will be tested again by the reopening, and later by the vaccine.
It is not going especially well. The other day, for example, when U. S. President Donald Trump turned to the scientists on his task force and asked if disinfectant injections to the lungs or ultraviolet light through the skin could destroy the virus in living people, he might have felt a frisson of real curiosity, but science was being abused in that moment.
The question was wrong. It is as simple as that. But his task force coordinator Deborah Birx played along, more or less, and kept silent, only later saying Trump meant no harm because when he gets new information, “he likes to talk that through out loud and really have that dialogue.”
On the contrary, it was a monologue, but Birx, a physician, immunologist and diplomat, has a new reputation for compliance and deference to the president. In Trump’s scientific orbit, her fame has lately eclipsed that of Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, who got tagged by Trump supporters with the nickname “Doctor Doom” for his predictions and refusal to endorse Trump’s optimism.
The picture in Canada has been more sedate, exhibiting what Heather Macdougall, a historian of medicine and Canadian public policy on infectious diseases like SARS and avian flu, described as the “feminization of public health work.” Many of Canada’s chief medical officers are women, notably the ones whose profile and public trust has been highest through the pandemic, such as Bonnie Henry in British Columbia and Theresa Tam nationally.
“Trump would not be able to handle the strong women who are dealing with this crisis in this country, because he has to be totally in charge. I think it says a lot about Canadian politicians that basically from the get- go, they have recognized that these people are the experts and it’s up to the politicians to take their advice and make it palatable to the public,” MacDougall said.
She described a different sort of deference and compliance at the highest level of pandemic decision- making, as Justin Trudeau made clear he was taking his cues on science — not just the answers, but the questions, too — from Theresa Tam, Canada’s Chief Public Health Officer.
“Politically, everything flows from that,” Macdougall said. “It is definitely a matter of trust.”
Misunderstanding of science and the scientific method has contributed to the celebrification and personalization of public health in the pandemic, MacDougall said, but there is also something deeper, below conscious knowledge, in the realm of instinctive trust.
In normal times, trust in scientific medical authority is most commonly tested over vaccines and public health advice. Mistrust is the main problem, not stupidity or malice, because most people are neither scientific experts nor evil monsters. They are humans unsure how to ask and answer the important scientific questions.
In a paper in the Canadian Medical Association Journal, University of Guelph philosophy professor Maya Goldenberg reported last year that hesitancy of parents to vaccinate their children is not primarily driven by scientific illiteracy and online misinformation. “Instead, it’s a problem of public mistrust of scientific institutions,” she wrote. Non- experts take the necessary “leap of faith” only if they are confident that the experts are competent and honest.
That confidence has been taxed lately, in America especially.
Birx and Fauci have become extreme example of what can happen when a leader tries to pick and choose their scientists, to get advice, but also to piggyback on their prestige to justify decisions.
The United Kingdom has offered scandalous examples of the newly famous public health celebrity. First was Catherine Calderwood, Scotland’s chief medical officer, busted by reporters for travelling during the isolation period to her second home outside her main home of Edinburgh. Then came “Professor Lockdown,” Neil Ferguson, who became a household name for his role on a pandemic advisory group, then became a boldfaced name when reporters revealed his married girlfriend had twice crossed London for romantic encounters at his house during the lockdown.
“It is not often that the sex life of a scientist affects the destiny of a nation,” noted The Times dryly, as Ferguson resigned.
As ever, the core problem was not the sex, it was the trust. Major scientific questions have been derailed by issues of trust: political self- dealing, media hype, professional hypocrisy, public confusion and general gullibility.
These questions include whether the virus is evolving to become more contagious, and whether certain drugs for malaria and other diseases might be an effective treatment for COVID-19.
They also include whether the virus emerged naturally from bat, snake and other wildlife populations via a market in Wuhan, or whether it came from the Chinese government’s Wuhan Institute of Virology, accidentally or on purpose.
This theory was debunked early in the pandemic when an international team of leading scientists found the coronavirus is “not the product of purposeful manipulation” and no laboratory origin story is “plausible.”
But just as Iran’s Supreme Leader Ayatollah Ali Khamenei blamed the virus on America back in March, so did Trump recently endorse the theory that it came from a Chinese government lab, claiming he has seen evidence, as part of a comment criticizing the World Health Organization, which he moved to de- fund, for being too easy on China.
Fauci, who is to appear before a U. S. Senate committee next week, told National Geographic the evidence is strongly against deliberate manipulation. “A number of very qualified evolutionary biologists have said that everything about the stepwise evolution over time strongly indicates that it evolved in nature and then jumped species,” he said.
Even the question of whether a lockdown is even necessary, in the eyes of scientists, was upended by Ferguson’s quarantine assignation.
Mostly, though, the scientific action has been around predictions. Macdougall pointed out Tam’s efforts to explain arcane concepts like confidence intervals and other details of statistical interpretation without implying that everyone in Canada should understand.
“And why should they?” MacDougall said. Statistics is not for everybody, especially in a pandemic, and sometimes the only thing to do is trust people who know better.