"Listen to the science" isn't a panacea
It would be so nice if all we had to do to make COVID go away was listen to the scientists.
I’ve been reading sentiments like this a lot recently, mainly in response to our current government policy, which is probably best described as the no-plan-plan.
The implication of these critiques is that in a world where we listened to the scientists, we could have our cake and eat it too.
We could open up the economy like Sweden and limit the spread of the virus like New Zealand.
Unfortunately, I don’t think this is true.
Now, let me be very clear before going on: the current approach that we’ve had of limiting testing, politicizing masks, and general apathy has made the pandemic much worse, leading to tens of thousands of excess deaths, millions of unnecessary job losses, and billions in economic damage. I’m not certain we could be doing a worse job if we tried.
But there are major limitations that go along with the idea of just listening to the experts that I think are worth delving into.
The meta-issue with listening to the science
Our understanding of the natural world changes as we learn more about it. As we conduct experiments (medical term: clinical trials), we rule out hypotheses and learn about what’s incorrect.
The natural progress of the scientific method means that some of our best ideas at the beginning may prove to be foolish when we look back a few months or years later.
Just think about the mask issue with COVID:
Until June 5, the WHO only recommended masks for people who had symptoms of COVID
We initially thought that use of a face mask only protected others from the wearer
We’ve now learned that everyone is protected by wearing a mask, even the person wearing it
As we get more information about a topic, the science changes.
Very quickly, the conclusions we draw from listening to the science can change, leading to messaging that’s muddled and unclear.
Public messaging based directly on the science is a recipe for chaos
This means that as the science becomes more clear and our impressions change, the public health message will change as well.
Messaging to the public is already like a game of telephone with the way that our fragmented media landscape digests and filters official recommendations before public consumption.
And when you add in a message that changes based on new data, it creates a recipe for mass confusion, not mass enlightenment.
Just think about the messaging that you personally have heard on masks from respected authorities. If you’re anything like me, listening to the experts has led to confusion!
One of the keys with public health messaging is to craft messages that connect with folks who have low health literacy. These are the people who aren’t voraciously reading every article that’s written on COVID and obsessively trying to figure out the perfect material for their own face mask (if you’re reading this newsletter, it’s probably not you!).
People with low health literacy are also most likely to have multiple chronic diseases and are the ones at highest risk of death from the virus. This means that messaging to this group is of paramount importance!
Changing messages can lead to mistrust of official sources and uncertainty regarding important public health messages.
Well intentioned scientists can disagree about the meaning of the same data
There’s a reason that people with complicated medical conditions go to see a different doctor for a second opinion - because sometimes even when the science is being followed by experts, smart and reasonable people can have completely different takes on the same thing.
Take the idea of a lockdown at the beginning of the pandemic.
A lot of experts looked what we knew about COVID and advocated for lockdowns. But while that might have been a majority scientific opinion, you could make a reasoned argument against it.
This piece from John Ioannidis argued against lockdowns back in March, basically saying that we couldn’t draw enough conclusions from the existing data and needed to think before we jumped.
This editorial got a lot of pushback! And perhaps deservedly so. [As an aside, it’s worth reading this Ioannidis interview if you’re interested in a nuanced discussion of the above points]
But it’s worth thinking about the fact that rational scientists can look at the same data and draw massively different conclusions.
And you can’t forget that scientific groupthink and informational cascades can quickly turn what feels like a scientific “consensus” into a fairly unreliable interpretation of complicated data - see the evolution of our scientific thinking on saturated fat for a consequential example in the realm of public health.
Science also doesn’t make normative judgments
Following the science doesn’t lead to truth, but it does provide evidence to help make decisions that ultimately require application of our own moral values and judgments.
And even when there is scientific consensus about the conclusions we can draw, making policy based on that is much more amorphous.
Ultimately the reason why you can’t just “trust the science” is because even very well defined science can’t make a judgment call.
The tradeoffs inherent in public policy come down to judgment and values, not just data analysis.
So while a COVID expert may be able to tell you the case fatality rate and model the number of increased deaths we might get from opening schools, the value judgment about what to do with that data doesn’t simply come from the science.
Wouldn’t it be nice if just listening to the science was a solution out of the mess we’re in? While science can help illuminate different paths forward, the decision about the right path to take is much harder and ultimately a lot more important.
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