Oh. Never Mind

You may have read the coverage of last week’s tar-and-feathering of Dr. Anthony Fauci in a hearing of the House Select Subcommittee on the Coronavirus Pandemic. You know, the one where Majorie Taylor Greene refused to call him “Dr.”, told him: “You belong in prison,” and accused him – I kid you not – of killing beagles. Yeah, that one.

Congressional hearings aren't the best way to find the truth. Credit: BBC

Amidst all that drama, there were a few genuinely concerning findings. For example, some of Dr. Fauci’s aides appeared to sometimes use personal email accounts to avoid potential FOIA requests. It also turns out that Dr. Fauci and others did take the lab leak theory seriously, despite many public denunciations of that as a conspiracy theory. And, most breathtaking of all, Dr. Fauci admitted that the 6 feet distancing rule “sort of just appeared,” perhaps from the CDC and evidently not backed by any actual evidence.

I’m not intending to pick on Dr. Fauci, who I think has been a dedicated public servant and possibly a hero. But it does appear that we sort of fumbled our way through the pandemic, and that truth was often one of its victims.

In The New York Times,  Zeynep Tufekci minces no words:

I wish I could say these were all just examples of the science evolving in real time, but they actually demonstrate obstinacy, arrogance and cowardice. Instead of circling the wagons, these officials should have been responsibly and transparently informing the public to the best of their knowledge and abilities.

As she goes on to say: “If the government misled people about how Covid is transmitted, why would Americans believe what it says about vaccines or bird flu or H.I.V.? How should people distinguish between wild conspiracy theories and actual conspiracies?”

Credit: Menninger

Indeed, we may now be facing a bird flu outbreak, and our COVID lessons, or lack thereof, could be crucial. There have already been three known cases that have crossed over from cows to humans, but, like the early days of COVID, we’re not actively testing or tracking cases (although we are doing some wastewater tracking). “No animal or public health expert thinks that we are doing enough surveillance,” Keith Poulsen, DVM, PhD, director of the Wisconsin Veterinary Diagnostic Laboratory at the University of Wisconsin-Madison, said in an email to Jennifer Abbasi of JAMA.

Echoing Professor Tufekci’s concerns about mistrust, Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told Katherine Wu of The Atlantic his concerns about a potential bird flu outbreak: “without a doubt, I think we’re less prepared.” He specifically cited vaccine reluctance as an example.

Sara Gorman, Scott C. Ratzan, and Kenneth H. Rabin wondered, in StatNews, if the government has learned anything from COVID communications failures: in regards to a potential bird flu outbreak,  “…we think that the federal government is once again failing to follow best practices when it comes to communicating transparently about an uncertain, potentially high-risk situation.” They suggest full disclosure: “This means our federal agencies must communicate what they don't know as clearly as what they do know.”

But that runs contrary to what Professor Tufekci says was her big takeaway from our COVID response: “High-level officials were afraid to tell the truth — or just to admit that they didn’t have all the answers — lest they spook the public.”

A new study highlights just how little we really knew. Eran Bendavid (Stanford) and Chirag Patel (Harvard) ran 100,000 models of various government interventions for COVID, such as closing schools or limiting gatherings. The result: “In summary, we find no patterns in the overall set of models that suggests a clear relationship between COVID-19 government responses and outcomes. Strong claims about government responses’ impacts on COVID-19 may lack empirical support.”

In an article in Stat News, they elaborate: “About half the time, government policies were followed by better Covid-19 outcomes, and half of the time they were not. The findings were sometimes contradictory, with some policies appearing helpful when tested one way, and the same policy appearing harmful when tested another way.”

They caution that it’s not “broadly true” that government responses made things worse or were simply ineffective, nor that they demonstrably helped either, but: “What is true is that there is no strong evidence to support claims about the impacts of the policies, one way or the other.”

Fifty-fifty.  All those policies, all those recommendations, all the turmoil, and it turns out we might as well just flipped a coin.

Like Professor Tufekci, Dr. Gorman and colleagues, and Ms. Wu, they urge more honesty: “We believe that having greater willingness to say “We’re not sure” will help regain trust in science.”  Professor Zufekci quotes Congresswoman Deborah Ross (D-NC): “When people don’t trust scientists, they don’t trust the science.” Right now, there’s a lot of people who neither trust the science or the scientists, and it’s hard to blame them.

Professor Zufekci laments: “As the expression goes, trust is built in drops and lost in buckets, and this bucket is going to take a very long time to refill.” We may not have that kind of time before the next crisis.

Professors Bendavid and Patel suggest more and better data collection for critical health measures, on which the U.S. has an abysmal record (case in point: bird flu), and more experimentation of public health policies, which they admit “may be ethically thorny and often impractical” (but, they point out, “subjecting millions of people to untested policies without strong scientific support for their benefits is also ethically charged”).  

As I wrote about last November, American’s trust in science is declining, with the Pew Research Center confirming that the pandemic was a key turning point in that decline. Professors Bendavid and Patel urge: “Matching the strength of claims to the strength of the evidence may increase the sense that the scientific community’s primary allegiance is to the pursuit of truth above all else,” but in a crisis – as we were in 2020 – there may not be much, if any, evidence available but yet we still are desperate for solutions.

We all need to acknowledge that there are experts who know more about their fields than we do, and stop trying to second guess or undermine them. But, in turn, those experts need to be open about what they know, what they can prove, and what they’re still not certain about. We all failed those tests in 2020-21, but, unfortunately, we’re going to get retested at some point, and that may be sooner rather than later.