USA TODAY International Edition
Criticism of Fauci is misguided
As knowledge evolves, so do scientists
The COVID- 19 pandemic is frightening — even maddening — in its complexity. As the virus continues to spread, experts are having to update their understanding and approach in real time, and in full public view.
When we see this happening, is it because the scientists and public health experts were simply wrong, as some have claimed about Dr. Anthony Fauci, our nation’s top infectious disease doctor? As physicians and scientists ourselves, we think this is an unhelpful and inaccurate way of looking at the situation. When knowledge is evolving, we shouldn’t view it as scientists “getting things wrong.” We should view it as scientists in the process of getting things right.
Frustrating as this can be, the process takes time. COVID- 19 is termed a “novel coronavirus” for a reason: It is new. Before December, it had never been identified as a cause of human disease. We are all learning about it together — day by day, patient by patient, community by community, country by country — and applying those lessons in real time. In this still early stage, our knowledge is incomplete. But it is growing, building on itself.
This is the scientific method. Whether our field is infectious disease, cardiology or any other, we scientists use this approach for a simple reason: It offers the best path to accurate and trustworthy results. We make observations, come up with a hypothesis to explain them and test that hypothesis by making more observations.
Rethinking penicillin, ulcers
If, after that, there is a disconnect between the hypothesis and the observations, we reject the hypothesis, not the observations. We do this because the observations — the new COVID- 19 cases, hospitalizations, deaths — are facts. And as scientists, we have to be willing to go wherever the facts lead.
Sometimes those facts lead us in new and surprising directions.
Take penicillin, for example. When penicillin was discovered, it was rightly seen as a wonder drug that killed most of the pathogens that had long plagued humankind. Over time, however, researchers observed that some organisms developed resistance to penicillin, which required us to rethink how we used antibiotics — and to develop more effective ones.
Another example is that of stomach ulcers. For years, people thought pyloric ulcers were caused by spicy food and anxiety, but then it turned out, based on a discovery by an Australian scientist, they were caused by a contagious bacterium, Helicobacter pylori.
Based on our experience over the past several months, there is much we have learned and now know for certain about combating the COVID- 19 disease: Symptomless people can be contagious; social distancing is a major way to stem the spread of the virus; wearing masks is, in fact, crucial; hand washing is essential.
Even so, there remains a great deal we do not yet understand. How far, and for how long, do aerosols carry the virus? Can the virus mutate? How long do antibodies last in people? And how effective are those antibodies in preventing reinfection. As our knowledge develops, our answers will evolve. That can be disorienting — but again, it is part of the process.
In other cutting- edge fields — think of Silicon Valley — qualities like nimbleness and a willingness to adjust course in the face of rapid change are celebrated. Now more than ever, we need these qualities in our public health officials.
On the front lines
We are fortunate to see them in Dr. Fauci, as well as many others across America’s system of medical research and on the front lines of clinical care. Together, they will face many difficult questions in the months ahead.
We can’t predict the answers, but we do know how the answers will be found: by making careful observations, following the facts as we make our decisions and understanding, throughout, that as our knowledge of the virus evolves, so too must our approach.
The scientific method is our nation’s pathway toward better tests, treatments and, we hope, vaccines. It has helped us overcome other diseases, from childhood leukemia to polio. If we maintain our trust in the process — if we let it work — it will help us overcome COVID- 19 as well.