For those who believe that science is a universal language, something disturbing occurred during this Covid-19 crisis: while all governments claim to be guided by “THE” science, each country seems to be guided by a different science. How come?
We believe in Science
Science is based on data collected by trained people, the scientists, following established protocols designed by them and generally embracing best practices in the field. Results and data are usually subject to interpretation and thus can lead to different conclusions, particularly when the data is not entirely clear-cut or conflict with previously published data.
However, concerning the Covid-19 epidemic, much of the data related to the lethality of SARS-CoV2 and its ability to spread were reasonably clear at a fairly early stage of the pandemic, as was the effectiveness of the lockdown measures that would need to be enacted in order to stop the contagion. On 31st December, Chinese scientists announced publicly that a dangerously contagious and potentially lethal virus had infected humans. Shortly after, its transmission from human to human was confirmed. On the 31st January, the WHO declared a global emergency. Such a declaration should have prompted all governments to take lockdown measures to protect their population. Only East Asians and eventually Australians and New Zealanders acted early and were spared the worse of the epidemic. In the meantime, the virus rampaged freely in Italy, France, Spain, the UK and the USA before they too locked down. By then, it was too late.
What is striking is that all claimed to be guided by “THE” science. Of course, some of it is plain hubris. We now know that, on the same day (3rd March) the UK prime minister was shaking hands with coronavirus patients, his SAGE group of experts had recommended that no one should. Nevertheless it seemed laudable to see governments appearing to pay attention to what the scientists had to say. The problem is that the scientists in one country or one region of the globe appeared to say something differing substantially from what scientists in other countries or other regions of the globe appeared to say. “THE” science seemed to deliver diverging and sometimes contradictory messages.
Herd immunity or lockdown, mask or no mask ?
Take “herd immunity”. One pervading concept in British scientific circles influencing governmental policy was that the virus should be allowed to rampage free so that a critical threshold of the entire population gets the chance to develop immunity to the virus. Past that threshold, the contagion should stall and disappear. The concept of herd immunity is well known in vaccine science and industry. For measles, for example, 93 to 95% of the population must be vaccinated to achieve herd immunity. The problem with the concept of herd immunity is that it only applies safely to vaccine, not to on-going viral epidemics, and even less to viruses for which we know almost nothing. The UK Government Chief Scientific Adviser (GCSA), a fervent proponent of herd immunity, claimed a threshold of 60% for SARS-CoV2 would need to be reached for herd immunity to kick in, making three terrible mistakes in the process: firstly, there is no place for the concept of herd immunity in the context of an on-going epidemic; secondly, 60% was a number randomly drawn out of hat, nothing being known about SARS-CoV2; thirdly, it wasted precious time where the UK could have prepared. The UK GCSA claim was rapidly debunked and the country went into lockdown a little more than 10 days after herd immunity was first promoted. No other scientists in Europe or Asia had advised working towards herd immunity as a recommended policy for government. Is there something like British science exceptionalism going on?
Another example of science’s diverging message concerns the issue of masks. Are masks efficient at stopping the spread of the disease and does it provide protection to individuals wearing them? When you ask a Chinese or a South Korean scientist or a member of the public whether a mask should be worn, the response is a resounding “yes”. There is no doubt in their mind that masks, together with distancing, provide an effective means to contain the contagion. And they are right: scientific evidence suggests that the protective attributes of face masks are real. Yet, scientific advice in the West has been strangely inconsistent on this issue. As a result, the position of several Western country governments, no doubt “guided by the science”, has evolved remarkably, dismissing masks earlier on but recommending their usage later on (see the Spanish, German or French governments as well as the Governor of the State of New York in the USA, and now the UK).
Getting ahead of oneself
Finally, science can take diverging paths within a country. For example, take the promotion of hydroxychloroquine as a cure for Covid-19 by Professor Didier Raoult in France, rapidly promoted by influential individuals. Dr Raoult first started to experiment successfully with hydroxychloroquine in the treatment of bacterial infectious diseases in the 1990s. The drug in combination with others became standard treatments for Q fever and Whipple’s disease. His faith in the drug grew so strong that, when SARS-CoV2 started to make the headlines, he naturally turned to hydroxychloroquine for a cure. “Coronavirus, game over” he claimed on a YouTube video posted on 26th March. But faith is all what it was: his drug trial was neither randomized nor double-blind. At the end of the day, Raoult may be proven right. Live experiments are ongoing with Poland and some other countries having adopted hydroxychloroquine for treatment or prevention of Covid-19. The NIH has now started a large randomized double-blind study to test the effect of hydroxychloroquine on Covid-19 patients. We’ll have to wait its results before concluding whether Prof. Raoult’s claim is substantiated.
Under influence ?
These stories invite the following question: is science entirely the rational pursuit that scientists claim it is or is there a pervasive influence of other factors? The fact is science does not operate in a vacuum. Data might be ambiguous, leaving room for interpretation, but context also plays a part. Prof Raoult early success with hydroxychloroquine might have helped him jump to premature conclusion concerning SARS-CoV2. Concerning masks, scientists knew how unprepared Western European governments were and that a rush on PPE (Personal Protective Equipment) would have deprived hospital medical staff of protection from infected patients. As a result, they diluted their recommendations. Concerning herd immunity, the GCSA and his SAGE group appeared then wielded to the flu textbook of pandemics, even after WHO had clearly demonstrated that SARS-CoV2 was a very different beast than flu.
But other factors exerting influence on science come into play, one of the most pervasive being the need to publish and to compete. Publishing is naturally the means by which productivity in science is assessed. Researchers are pressured to publish a maximum number of papers and, as a result, mediocrity in publishing reigns supreme. A tide of low-cost, undemanding publishing houses has submerged the science ecosystem. Almost anything can be published without much quality control. When it comes to the high-end publishing houses, they can make or break careers. As a result, reckless competitive behaviour becomes the norm at the elite end of the academic spectrum. Ruthless behaviour from lab heads makes for miserable postdocs. In their unrelenting quest for glory, researchers will push the limits. The h-index has become the gold standard of scientists’ career evaluation, leading to attempts to inflate it either by seeking to have one’s name listed in as many papers as possible (even those to which they contributed nothing e.g. institute directors signing all papers coming out of their institute, a profoundly unethical behaviour) or simply by splitting results over many publications. Of course, the joy of discovery plays a large role, but advancing up the academic and societal pecking order also. At the lower end of the spectrum, the vast majority of researchers who cannot compete just give up, either quitting, or churning out risk-averse, “safe”, research where unimaginative and risk-free approaches and questions produce predictable levels of outputs. In that very “human” context, it is therefore not so surprising that the mantra “guided by the science” might be a little misleading. After all, behind all scientists there is a man or a woman, influenced by society, under pressure from colleagues and peers, or simply trying to make it professionally.