The Secret Scientist starts her new insider series for Byline Times by reminding us that there is not just ‘one science’, and its validity rests on constant probing and peer review.
I recently called a radio talk show to make the point that it was too early to make an assessment as to whether the Government had succeeded in its attempts to tackle the Coronavirus. The host believed that the Government had “followed the science” and that the public ought to stop criticising it and criticise the World Health Organisation (WHO) instead.
I made clear that my intention was not to criticise the Government but, as a doctoral student with scientific training, from a scientific perspective, there hadn’t been much transparency around ‘the science’ that the Government has claimed to be stringently following.
Given reports that modelling which indicated that stricter lockdown measures might slow transmission of COVID-19 had been presented to the Government on 2 March, why were such measures not introduced until 23 March?
The more open one is about a problem the more people can contribute towards solving it.
Why hadn’t recommendations from the WHO not been followed or considered sooner? Why weren’t the meeting minutes of SAGE (the Scientific Advisory Group for Emergencies) accessible to independent scientists?
The host would have none of this and cut me off.
There is no One Science
The problem is that the language of media sensationalism and political soundbite is not compatible with the plain realities of science, which is complex, multi-disciplinary, messy and – most importantly – ever-evolving. There is no ‘one science’. There is only ever an array of evidence that feeds into an international within-discipline peer-reviewed consensus.
Early in the Coronavirus outbreak, independent scientists called for greater transparency about the evidence informing Government strategy because they believed that, if the science informing the strategy was in-line with independent expert consensus, it ought to stand up to scrutiny.
To show one’s own working and allow other experts to question and evaluate it is, after all, the very basis of peer-reviewed science. This transparency is what enables scientific discovery and progression. To scientists, it is not so much a question of ‘following the science’ as it is of which science to follow, what the strengths and weaknesses of that science are, and how it is used in the cost-benefit analyses that eventually inform policy.
Models are only as good as the data on which they are based and, during an evolving pandemic, all data need to be monitored and updated in real-time.
What did the Evidence Say?
Early in March, it seemed implausible to many independent scientists that any data could be better than data provided by countries which were further along the curve. On this basis, the UK’s apparent ‘herd immunity’ strategy appeared to increase the likelihood of an unmanageable first peak that could bring the NHS to its knees and lead to a catastrophic number of fatalities.
The scientists who called for greater transparency back then did so because they, like everyone else, wanted the Government to succeed in combating the virus. They questioned that there was an evidence-based way to ‘take the right steps at the right time’.
The evidence indicated that it was crucial to take the right steps as soon as possible. There were, after all, no data on the virus’ ability to mutate, or that could guarantee natural long-term immunity, and every passing day was another day of exponential transmission. The decision to abandon community testing also puzzled many. It might have been understandable in London where the outbreak began spiralling out of control, but less so in other parts of the country where case numbers were relatively low.
Transparency and Surveillance
Independent scientists are calling for greater transparency now. Not because of a political agenda to make malicious points in hindsight, but because it is essential that any lockdown-easing strategies are based on independent, scientific consensus to ensure they have the best chance of success.
Scientists are acutely aware that lockdown strategies have economic, societal and human costs and are unsustainable in the long-term. The challenge is to strike a balance that maximises life and to minimise the costs of 1) lockdown when transmission rates spiral, and 2) distancing measures when transmission rates are manageable. Emerging consensus is that to safely ‘ease-out’ we need to monitor the rate of transmission in real-time; we need technology and manpower for case detection, testing, contact tracing, and quarantining in every community across the country. We need an adult conversation about the social mobilisation required to achieve this, in which constraints and possibilities are laid bare.
Transparency around privacy and surveillance concerns will be vital. We need to look to countries that seem to have effectively implemented such strategies including South Korea, which demonstrated that technology can be used to reduce the time it takes for a symptomatic case to be isolated.
Scapegoating the WHO and China
The absolute terms in which journalists and politicians speak are unhelpful in a situation that is governed by unfolding science. Science is probability-based, neither certain nor absolute and there is an issue with politicians and journalists forming strong, beyond-reproach opinions about science without looking into and understanding the nuances of that science.
Similar arguments can be made about the apparent scapegoating of China and the WHO that is prevalent in certain tabloid outlets and political rhetoric. Spill-over events that facilitate an outbreak could happen in any country, at any time, and are made more likely by our increasing involvement in and disruption of ecosystems and natural habitats.
Science and social mobilisation, are, after all, the only weapons that will defeat this virus and the fight has only just begun.
The WHO is not a perfect organisation and China is not a perfect model for society and neither had a perfect response to the pandemic. But to narrow-in on minute aspects of a large, multi-faceted national and international chain reaction is to confuse the wood with the trees.
China, whilst it reportedly attempted to cover-up its outbreak initially, shared on 12 January the full genetic profile of the Coronavirus. The WHO, on 14 January tweeted a study which found no clear evidence of human-to-human transmission, but consistently in an evidence-based manner warned about the significant threat that the Coronavirus posed.
This was reflected in the WHO’s briefing on the same day, that the “risk of wider human-to-human transmission should not be regarded as ‘surprising’ given the similarity to earlier SARS and MERS outbreaks”.
As the science evolved it lost no time in updating its advice and declaring a “public health emergency of international concern” on 30 January, and this plea to nations on 28 February: “This is a reality check for every govt on the planet. Wake up. Get ready. You have a duty to your citizens. You have a duty to the world to be ready.” Again, whilst imperfect, the WHO is the best placed organisation to help foster the global cooperation required to tackle this pandemic.
Anyone who understands that science is ever-evolving will appreciate that the WHO’s description of a single study should not form the basis of an assessment of their entire response to the pandemic. Testing, contact tracing, and quarantining, along with increasingly stringent social distancing measures when outbreaks spiral, have been at the heart of the evidence-based approach advocated by the WHO, informed by decades of experience managing epidemics.
Ask the Right Questions
The mainstream media did not listen to the evolving evidence and belittled many independent experts who asked legitimate questions early in the outbreak such as Dr John Ashton, Professor Anthony Costello, Professor Devi Sridhar and the editor of the Lancet medial journal Dr Richard Horton.
Politicians and journalists can use the power of hindsight to criticise organisations such as the WHO for making judgements with the evidence available at the time which are no longer valid. But the same politicians and journalists aren’t prepared to undergo the same scrutiny when assessing their past actions.
What evidence did the Prime Minister have about the escalating threat when, on 3 March he stated that he had been to a hospital treating Coronavirus patients where he “shook hands with everybody”? Or when, on 5 March, he explained that “one of the theories is, that perhaps you could take it on the chin… allow the disease… to move through the population”?
If it is true that the Government had received worst-case modelling on 2 March and was therefore aware of the risk-to-life posed by such a strategy, these statements appear very difficult to justify.
As a scientist, I appreciate that there isn’t enough evidence to know what politicians knew and understood about the international data and their own preparedness when these statements were made. It is also too early to judge the ultimate soundness of the UK response – in part because this pandemic has only just begun and, whilst there is time to change its course, it is unlikely to just disappear.
Openness is the Only Way
One thing is clear: there have been failures in communication. To avoid such failures, politicians, journalists and scientists alike must be humble – in terms of appreciating the limits of their own understanding – and transparent, so that as many independent experts can be consulted as possible.
The more open one is about a problem the more people can contribute towards solving it. Reducing the debate to sensationalist opinion and self-congratulating soundbites, in the absence of supporting evidence or with cherry-picked evidence, serves only to increase tension and division.
Questions and open debate are as vital in science as they are in a healthy democracy. Independent scientists who ask questions and seek greater transparency simply want to help ensure that the response is scientifically sound. The world needs independent scientists more than ever. Why attack them for their eagerness to immerse themselves in scientific nuances, details and debate to serve on the frontline of science as it were?
Science and social mobilisation are, after all, the only weapons that will defeat this virus and the fight has only just begun.
Secret Scientist is a researcher who wishes to remain anonymous in order to provide Byline Times with more unfettered revelations and transparency about the practice, funding and politics of science.