Timothy Caulfield is a Canada Research Chair in Health Law and Policy at the University of Alberta whose books include The Science of Celebrity … or Is Gwyneth Paltrow Wrong About Everything? and Relax, Dammit!: A User’s Guide to the Age of Anxiety, which will be published later this year.
Since the start of 2020, there have been more than 60,000 peer-reviewed academic articles about COVID-19. The Journal of the American Medical Association alone has received more than 11,000 submissions, which is nearly triple the usual rate.
COVID-19 science is being both done and circulated at a furious pace. Currently, the median time from the submission of an article to acceptance is just six days. That is an astonishing increase in pace of acceptance (heck, I’m lucky if I reply to an e-mail that fast!) from the prepandemic speed of around 100 days.
While it is inspiring to see the research community respond so vigorously to the pandemic crisis, all this activity has also created a churning sea of bad data, conflicting results and hyped headlines. One day a study, published in a renowned biomedical journal, is being hailed as definitive data that should (and does) guide our actions and policies. The next day it is retracted (or being asked to be retracted).
Even the experts are struggling to agree. Earlier this week, 239 scientists sent an open letter to the World Health Organization asking the agency to revise its position on airborne transmission. The scientists who signed the letter think it is common. The WHO does not.
Just a few months ago, I optimistically predicted that one of the legacies of COVID-19 would be a greater appreciation of the value of good science. But with representations of science becoming increasingly polarized, twisted and hyped, I now fear that this pandemic will cause trust in science to be irreparably harmed.
The public is following science like almost never before. They are observing the degree to which science can be a tangled, sputtering, muddled march toward a shifting truth. It always has been. But now the public is watching the sausages being made, so to speak. And many don’t like what they see.
A recent study suggests that the COVID-19 crisis would have a negative impact on people’s perceptions of scientists, especially among those in the public with little or no scientific education. Specifically, the researchers found that individuals exposed to science during a pandemic may become “less confident about the trustworthiness and public-spiritedness of the individuals involved in scientific endeavors.” Another study, a survey from France, found a drop in trust in science – driven mostly by public frustration surrounding two polarizing topics: the hydroxychloroquine debacle and reversals of the policies surrounding the use of masks.
To date, the public discourse in Canada has not been as polarized as we have seen south of the border and in some other countries. And despite increasing concern that things may be starting to deteriorate, trust in our health and science institutions remains relatively high. If asked, most Canadians will still say they have confidence in academics, health care providers and public health officials.
Still, we should not be complacent. Trust can be lost quickly – and with dire consequences. Indeed, many have noted that a lack of trust in public health systems and heightened polarization are associated with less successful responses to the pandemic.
As this crisis drags on, let’s consider what we can all do help science survive (so it can help all of us to survive) this pandemic.
To the public: Remember science is a difficult and (usually) slow process. It is not a list of immutable facts. U-turns, retractions, nasty disagreements between experts and conflicting data are all frustrating, but, alas, that’s how science works. It is rare for a single study – especially one that has methodological limitations – to be a definitive answer for anything. So, try to be patient. During a pandemic, public health decisions often need to be made using a less-than-ideal body of evidence. And recommendations that are based on emerging science will (and should) evolve. Revising a position as new evidence and/or social conditions change should not be viewed as a failure of the system, but as evidence that public health officials are doing their job.
To the scientific community: Let’s do our best to maintain the highest standards of scientific rigour. Let’s strive to ensure peer review – an admittedly less-than-perfect system, but still the best we’ve got – filters out the bad and fraudulent research (this may require the adoption of new safeguards, including stricter editorial standards). Let’s represent research results to the public in a balanced and transparent manner (less hype, please). And let’s become part of the public conversation, including challenging misrepresentations and spin used to further polarize public perceptions.
To the public health policy makers: Be honest and transparent about the state of the science used to inform recommendations. Unsupportable or oversimplified dogmatic pronouncements of benefit or harm – no matter how noble the justification – only help to feed the polarization process that, long-term, seems likely to do real damage to public trust and the perception of science and scientists. It is possible to provide a clear and actionable message that mobilizes our shared values in a manner that still accurately reflects the available science. Indeed, as noted by science communication expert Dominique Brossard, “at the end of the day, it’s better to say ‘the best practice is this, although we’re not 100 per cent sure and we’ll let you know as soon as we know more.’ ”
To the media: Take care not to hype science or misrepresent the certainty of a result. True game-changing breakthroughs are vanishingly rare (for example, less than 10 per cent of experimental drugs that are promising enough to be in a clinical trail will be approved for clinical use).
To the politicians: Stop twisting and/or ignoring science for political gain. Okay, I recognize that this is a naïve and futile request, not unlike asking my cats to stop napping in the afternoon. They won’t listen and it’s what they do. Populist leaders in particular have a historical disdain for science and objectively provable facts. But we should call out politicians when they are wrong and do our best to hold them accountable.
Science has always been under various forms of external pressures, including ideological mandates, Cold War paranoia and the ever-present profit motive. And, of course, the incentive structures built into academia – rewarding publication quantity and “impact factors” over quality and social benefit – also shape, for better or worse, the research enterprise.
The problems associated with how COVID-19 science is being done and represented are not new. But the urgency of the situation – and the high-profile nature of research – has made the issues more apparent and critical. So let’s use this moment as an opportunity to step up and do something about it.
Science is a human endeavour. And it needs our help.
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