Why common sense isn’t so common

CLINICAL MATTERS

Throughout the pandemic, there were many instances when scientists and doctors were attacked by a mix of anti-science trolls, anti-vaxxers, and Covid-19 denialists.

As authorities and healthcare workers raced to save lives using evidence-based tools against the virus, a horde of attackers rose up on social media and made life difficult. With new discoveries made every day, the uncertainty and changing recommendations, which naturally occurred as more information became available, were weaponized to paint our responders and policymakers as incompetent.

Most recently, the richest man in the world Elon Musk attacked Dr. Anthony Fauci on social media, calling for his prosecution without specifying any evidence of wrongdoing. As a career scientist and physician who has given his life to servicing his country, this attack is not only monstrous but exemplifies how rabid the anti-science movement has become.

The anti-science movement is not new. In the Middle Ages, countless people were tortured by the Inquisition and killed for holding views counter to official Church teaching. One of the most famous among these was Galileo Galilei, who was forced to recant his observations that the earth revolved around the sun. Giordano Bruno, who preceded Galileo, was burned at the stake for his heretical cosmological beliefs. Copernicus escaped persecution only because his book on heliocentric theory, which was subsequently banned by the Church, was published posthumously. All these people and many others went beyond what was “common sense”—that the earth appeared to our limited senses to be flat and that the sun and the rest of the universe went around the earth—and used their expertise to show the evidence to correct that world view. For their efforts on behalf of humanity they were ridiculed, attacked, and punished.

While scientists and doctors are no longer burned at the stake, attacks on social media by politicians and influencers still put scientists and other experts in harm’s way. Too many non-experts claim that the expert recommendations go against “common sense” based on their own limited analysis and instead of providing counter evidence, proceed to ridicule real experts with ad hominem attacks. The distrust that these attacks generated has harmed people who did not take proper precautions against the virus and refused vaccination during the pandemic.

Nowhere is this more evident than in the US, where over one million people have died from Covid-19. Estimates are that without the rampant disinformation, more than half of that number could have been saved. Unfortunately, many agents of disinformation have doubled down on their attacks as exemplified by Mr. Musk. Dr. Fauci and his fellow scientists have tried to minimize the harm of Covid-19 through prudent application of the latest evidence to guide policy. In fact, Dr. Fauci was frequently the voice of reason. Many times he ran afoul of then President Trump whenever he directly contradicted the president’s unscientific pronouncements. He then became a target for right wing conspiracy theorists and has had to ask for security from the government to protect him and his family. Among the false accusations and fake news that have now been rehashed are his supposed support of unethical “gain of function studies.” These accusations have been repeatedly debunked and there is no clear evidence to support them.

Gain of function studies are basic scientific experiments where an organism under study is either bred or mutated to look at correlations between genetic changes and phenotypic expression. For instance, gain of function studies on breeding mice with a white coat versus a black coat and comparing their genetic material will help determine which genes are responsible for the black coloration. There is nothing unusual about these studies, which are done on mammals, insects, fungi, bacteria and viruses on a routine basis in laboratories around the world.

Gain of function research only becomes problematic if a potential pathogen like a virus or a bacterium is mutated to purposely increase its deadliness or transmissibility. One possible rational reason to seek to enhance transmissibility and pathogenicity of a virus is to anticipate the emergence of these kinds of viruses in the wild. There are very strict guidelines under which these experiments can occur, however, and a moratorium on these is currently in place. There are also very stringent biosafety requirements for conducting these experiments and multiple safeguards to prevent leaks. In short, there is no truth that the US NIH directly funded gain of function studies that led to the release of any deadly virus. Despite the lack of evidence, this falsehood was used to maliciously attack Dr. Fauci and the scientists who were doing their best to guide the pandemic response. A Washington Post article has gone into detail on how these allegations are false and misleading at best, but the charges are now being revived by Mr. Musk (https://www.washingtonpost.com/politics/2021/10/29/repeated-claim-that-fauci-lied-congress-about-gain-of-function-research/).

Closer to home, the controversy regarding the use of face shields has been used by partisans to attack physicians and scientists who supported their use. The Pharmally procurement controversy, which involved face shields for healthcare workers, had nothing to do with the evidence base for face shield use by the general public but nevertheless was used to muddle the situation. The original evidence for face shield use came from a Lancet article, which showed that eye protection could decrease the risk of Covid-19 infection by 85 percent. Epidemiologist and prominent evidence-based medicine guru Dr. Anthony Dans calculated that the combination of face shield, physical distancing, and face mask reduced the risk of Covid-19 infection by 93 percent (https://web.facebook.com/antonio.dans/posts/pfbid07JvLxLtFLdHSwFxDqQeocWUurf3Bt6sdMG5ZfWBiBCgu99foJJHrQmawmKCBby89l). This recommendation was adopted by the  Healthcare Professionals Alliance Against Covid-19, the Philippine College of Physicians, and the Philippines Society for Microbiology and Infectious Diseases (PSMID). PSMID in fact continues to recommend the use of face shields with masks in areas of sustained community transmission of Covid-19 as an added layer of protection (https://www.psmid.org/face-shield-evidence-summary/).

While widespread vaccination eventually made face shields less important, there is no question that face shields contributed to low cases in 2020 prior to the vaccination campaign. The removal of face shields contributed to the highest spike of Covid-19 cases in January 2021 after the highly contagious Omicron BA.2 entered the country. Had face shields continued to be required, it would have substantially reduced the number of people who got sick and died at that time. Unfortunately, this is rarely pointed out as people have decided to move on after vilifying the scientists who only wanted to save lives.

As we near the end of the emergency phase of the pandemic, it is important to take stock of the lessons learned along the way. Scientists and physicians aren’t perfect, but if we hew rigorously to scientifically sound principles, an evidence-based approach remains the most optimal way to having good outcomes. What needs a lot of work is the communication of these policies to the public, which can easily misunderstand good intentions. There are many sinister elements that seek to distort these messages and ascribe malice to what should be a united fight against a virus that has killed too many people.  Dr. Fauci, who has made immense contributions to the world with his work on HIV, Covid-19, and many other diseases is the last person who should be on the receiving end of such rancor. Instead, we should protect and cherish those who have dedicated their lives to the health of our nation and the world. After all, as we have clearly seen during this pandemic, science saves lives.