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8/29/2020

Progress Over Process! Dealing With Science During the COVID-19 Pandemic

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I have read many social media posts during the COVID-19 pandemic by people that claim to be frustrated and confused with scientists. They say that first it was “masks are not necessary” and now it’s “wear masks”. First millions were projected to die, and then tens of thousands. A test for COVID-19 is put out, but then it doesn’t work. Articles are published showing hydroxychloroquine is dangerous and clinical trials are paused, but then then the articles are retracted, and the trials are continued. Hydroxychloroquine is authorized to be used, and now no. These people claim that they are tired of flip-flops, dithering, and mistakes. Some are even arguing that these happenstances are not random, and that they represent a pattern which is part of a conspiracy by scientists aligned with pharmaceutical companies, the left, the World Health Organization, and the Gates Foundation to scare US citizens, impose on them, deprive them of cheap effective therapies, and take away their freedoms.
 
The above reaction is not unexpected. We know that belief in conspiracy theories greatly increases in times of social upheaval that generate uncertainty, stress, and anxiety. But apart from that, a lot of the exasperation and confusion some people have with scientists and the scientific process stems from unrealistic expectations regarding what science is, what scientists do, and how they do it, coupled to the realities of doing research in the current environment. So let me set the record straight.



The history of science is awash in stories where scientists have made mistakes, flip-flopped on theories, and retracted articles in their pursuit of truth. Some of these mistakes occurred because of faulty data, technology, or procedures, and other mistakes involved scientists having wrong ideas. Normally scientists have time to sort out all these mistakes and methodological issues over the course of a few years (or in some cases decades), and they can come up with a reasonably robust approximation to the truth. This is a messy process with a lot of uncertainty, missteps, and blind alleys, but most of the time this process happens away from the limelight. When most folk come into contact with scientific discovery, what they see is the end product of this process, the tip of the iceberg if you will, and they are usually oblivious to all the blood sweat and tears that has taken to get there.
 
So, take this scientific process with all of its imperfections, mistakes, and uncertainties, and put it in the middle of a pandemic where people are dying and society needs answers, tests, therapies, and guidelines, NOW! You have just rushed the scientific process tenfold, and you have also magnified the potential for screw-ups by the same amount. Add to this the fact that COVID-19 research, from vaccines to hydroxychloroquine, has been politicized, and that every relevant announcement is interpreted in favor or against something and amplified orders of magnitude by the news cycle and social media. Finally, factor in that the general public is being exposed on a daily basis to the process of science in this difficult environment but often filtered through the sieves of partisan pundits that distort the science. What do you get?
 
What you get is one sad toxic mess. Very preliminary or questionable research is catapulted to the forefront of public attention and presented as the truth, whereas solid research is nit-picked to find flaws in order to dismiss it. Honest mistakes or changes of opinion by scientists are interpreted in the worst possible way to question the trustworthiness of the individuals involved. Many excellent scientists doing what they’ve always done the way they’ve always done it are now portrayed at best as Keystone Cops or at worst as sinister characters of questionable morals whose motives behind their actions are divorced from the well-being of the public.
 
No wonder some people are frustrated and confused with science and scientists! But my message to these people is the following: Don’t concentrate on the PROCESS of science. Focus on the PROGRESS of science.
 
Progress? Yes, progress! Science and scientists have made an immense amount of progress during the COVID-19 pandemic.
 
Scientists have isolated and sequenced the genetic material of the virus and generated a huge amount of information that has been used (among other things) to produce vaccines that are being tested for safety and efficacy, to identify strains of the virus which allow us to trace its spread, to generate diagnostic tests to detect viral infection in individuals, and even to detect the virus in sewage in order to identify which communities may have a rising caseload! At no time in the history of infectious diseases has progress happened so fast.
 
Contrary to what was initially believed, scientists have discovered that the SARS-CoV-2 virus (which causes the disease COVID-19) can infect many cell types once it has gained access to the body through the airways, including those of the lining of blood vessels, and this has changed the way we view the disease, saving and improving the lives of patients. For example, one of the problems with seriously sick patients is blood clots, and the use of anticoagulants is helping to save lives. Scientists have also tested several drugs against COVID-19, and have found steroids to be effective at reducing mortality in the sickest patients. Other approaches that may also be useful, and are being tested, are the drug remdesivir and convalescent plasma.
 
After being ambivalent with regards to masks, scientists discovered that a large amount of COVID-19 transmission occurs from people that are asymptomatic or presymptomatic. This discovery led to the issuing of the guideline to wear masks, which along with social distancing and other mitigation measures have bought us time to better understand the virus and saved lives.
 
At the level of the hospitals, doctors integrated domestic and international experiences to develop better ways of preparing for a surge in hospitalizations to handle large amounts of patients. They also recognized that delaying ventilation and placing patients on ventilation in the prone position could improve their odds of surviving.
 
The PROCESS of science can be messy and confusing, and now that it is out in the open on a daily basis, it is being presented to the general public in the worst possible light by many people interested in disavowing science or pursuing their own agendas. When it comes to science, try to understand that scientists are human. They have disagreements, they make mistakes, and they change their minds. You may not understand all the technical terms and issues and all the back and forth among scientists and what’s true and what isn’t. But the PROGRESS of science is a different matter. Science has delivered for us in the past, science is delivering for us now, and science will continue to deliver for us in the future. Concentrate on the end result, on what scientists have achieved. Progress over Process!

 
Progress sign by Nick Youngson from Alpha Stock Images was modified and is used here under an Attribution-ShareAlike 3.0 Unported (CC BY-SA 3.0) license. Coronavirus image by Alissa Eckert, MS; Dan Higgins, MAM, from the CDC's Public Health Image Library is in the public domain and was modified.

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2 Comments
Sherry
10/15/2020 10:48:47 am

This is an accurate, easily readable explanation, the best I've seen for people who complain about the changing advice with regard to the virus. It also shows a lot more empathy than I've been able to summon. I'm sharing!

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Rolando garcia
10/16/2020 07:44:54 pm

Thank you for your comment, Sherry. I'm glad to be able to reach people out there with meaningful explanations that will hopefully clarify things.

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