MESSAGE
| DATE | 2020-10-14 |
| FROM | Ruben Safir
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| SUBJECT | Subject: [Hangout - NYLXS] National Geopgraphic on Science,
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https://www.nationalgeographic.com/magazine/2020/11/to-end-this-pandemic-we-must-trust-science-feature/
nationalgeographic.com
To end this pandemic, we must trust science
By Robin Marantz HenigPhotographs by Giles Price
27-34 minutes
This story appears in the November 2020 issue of National Geographic
magazine.
How these images were made: The photographer chose to capture our
new routines with a thermal imaging camera to reflect how body
temperature became an indicator of whether we might have the
coronavirus. Temperatures are converted into a gradient of colors,
ranging from cool blues to warm oranges.
If a theme runs through the books and articles I’ve written over the
past 40 years, it’s a fascination with what scientists have learned
about the human body. A long career spent explaining biomedical research
has led me to a deep respect for the scientific process. Despite its
occasional missteps and self-corrections, I believe it ultimately moves
us toward a clearer understanding of the world and how to thrive in it.
So as scientists first scrambled to figure out the never-before-seen
coronavirus, I was primed to follow their advice about how to keep safe,
based on the hypothesis that the virus was transmitted mostly by
droplets from coughs and sneezes lingering on surfaces. I dutifully
wiped down countertops, refrained from touching my face, and washed my
hands so emphatically that the little diamond in my wedding ring shone
like never before.
And then, about two and a half weeks after my city, New York, shut down
restaurants, Broadway plays, and the largest public school system in the
country, scientists switched to a different message—that everyone should
wear a mask. This was a startling about-face. The initial advice,
confidently delivered, had been not to wear a mask, unless you were a
frontline health-care worker. The revision was largely based on a new
hypothesis, that the coronavirus spread mostly through the air. (See
where coronavirus casese are growing and declining in the U.S.)
Which was it, then? Surface transmission or aerosols? Should we be more
afraid of contaminated elevator buttons or people breathing near us? Did
scientists even know?
The shift in advice about masks spooked me, I must admit. Not because of
the new advice itself—I was more than happy to wear a mask if the
experts said I should—but because of the ominous meta message I sensed
beneath it: Scientists were figuring this thing out on the fly. The most
earnest pronouncements from the world’s smartest experts suddenly
sounded like little more than well-meant educated guesses.
As this devastating year draws to its raggedy close, it’s worth taking a
moment to wonder what the long-term effect will be of watching
scientists bob and weave on their way to a better understanding of the
coronavirus and how to thwart the disease it causes, COVID-19—all out in
public and all at breakneck speed. Even for a science geek like me, it
has been unsettling to watch them debate, disagree, pivot, and reassess.
I’ve been wishing instead that some lab-coated hero would just swoop in
and make it go away. I was a baby in 1955 when Jonas Salk introduced his
polio vaccine and vanquished a dread disease; ever after, my mother
spoke his name with reverence.(1)
(1) The polio virus could paralyze children and caused panic every
summer, leading to the closing of camps and pools.
As scientists hustle to deliver us from a terrifying, seemingly
intractable plague, there could be another happy ending—one that
involves not just survival but also wisdom. If we learn any big takeaway
from this doleful experience, I hope it’s not that our fellow human
beings are myopic fools but that the scientific process can be trusted
to get us through an existential crisis. (Follow National Geographic's
comprehensive coronavirus coverage.)
Make no mistake: The challenge is huge and unprecedented. If a typical
virus is a riddle wrapped in a mystery inside an enigma, the coronavirus
known as SARS-CoV-2 is all that and more. It combines contagiousness and
lethality in a ferocious mixture that Anthony Fauci, director of the
U.S. National Institute of Allergy and Infectious Diseases, has called
his “worst nightmare.” For one thing, when it appeared, no one on Earth
had immunity. Second, it’s airborne and infects the upper respiratory
tract, which means it’s readily spewed back into the air where it can
drift from person to person. Third, and arguably worst, the virus is
most contagious before it causes symptoms, meaning that carriers feel
well enough to be up and about precisely when they’re most likely to
infect us. (See what the coronavirus does to the body.)
a woman giving a temperature check to a young girl
View Images
A temperature check at L’Ecole de Battersea in South London
The tricks this virus uses to foil the body’s counterattack are
diabolically effective. Once it gets inside via the nose or mouth, the
coronavirus eludes the first line of immune defense, slides easily into
cells, churns out copies of itself by hijacking the cell’s machinery,
and makes sure those copies work by using a proofreading mechanism that
many other viruses don’t even have. Its effect is relentless: It can
turn a person’s lung cells into useless material that looks like ground
glass; blow open blood vessels or destroy them with microscopic clots;
and gunk up the workings of a kidney, heart, or liver, rendering them
too stiff to repair. It can defang the cells that attack invading
viruses and then provoke a secondary immune reaction that goes badly
haywire, paradoxically causing its own catastrophe.(2) And anyone who
comes in close contact with a person already infected is likely—though
no one is sure how likely—to get infected too.
(2) The overreactive immune response, called a cytokine storm, is
also seen with herpes, Ebola, and other viruses, as well as cancer and
auto-immune diseases.
Fauci’s worst nightmare? I could barely get to sleep.
As this pandemic threatens the entire world, the fight against it has
been a very public one. The average citizen is getting insight into
scientific theorizing that is normally confined to academic conferences
and slow-moving journals. Much of the debate over these ideas is taking
place on television, as well as on Twitter, on Facebook, and in the
backyard gatherings of lawn chair epidemiologists. I find myself
wondering if anyone engaged in this chatter understands how science
actually works.
One way it doesn’t work is through the lone Jonas Salk–like hero that
captivated me as a child. Science is a collaboration, with many heroes.
We’re seeing that now, as thousands of researchers have reoriented their
labs, no matter how far afield from virology or infectious disease, to
attack this hydra-headed problem collectively. There has never been
anything like it, with scientists collaborating across borders at full
throttle—even as some of their political leaders snipe at one another.
View Images
Lining up at a safe distance at L’Ecole de Battersea
Watching this ramped-up scientific effort has felt double-edged:
encouraging to see but so hard to follow that it also added to my
free-floating anxiety. So I did what I’ve done my whole adult
life—called up some scientists to see what they think. This is a
wonderful benefit to being a journalist, being allowed to ask dumb
questions of smart people. Usually it helps me clarify my own thinking.
This time … not so much.
Science on the frontier always exposes how little is known, even by the
putative experts, so these phone calls made it clear to me how far we
have to go. Still, it was nice to hear that a lot of scientists were
looking for answers.
“It’s been amazing to see how people are using their talents and gifts
to address this,” Gregg Gonsalves, co-director of the Global Health
Justice Partnership at Yale University, told me. “People all want to do
something,” even if their training is in law, geography, anthropology,
fine arts, or similarly far-flung fields.
There has never been anything like it, with scientists collaborating
across borders at full throttle—even as political leaders snipe at one
another.
All that research focus has led to a remarkable amount of information in
a remarkably short time. Within weeks of the first known animal-to-human
transmission, scientists had sequenced the virus’s full genome. By
summertime, more than 270 potential COVID-19 drugs were in active
clinical trials in the United States. As for the quest for the holy
grail, a vaccine, an international phalanx of researchers from the U.S.,
China, Great Britain, India, Germany, Spain, Canada, Thailand, and
elsewhere had identified more than 165 candidates by early August.
Progress was so rapid that even a hyper-realist like Fauci—who tends to
emphasize how important it is to conduct large-scale clinical trials
before introducing new drugs—has said he is “cautiously optimistic” that
a vaccine could be available early next year. If he’s right—oh please,
oh please, let him be right—that would be three years faster than the
fastest vaccine development in history.(3)
(3) The record was set in 1967 with the mumps vaccine. Scientist
Maurice Hilleman used virus he had isolated from his daughter.
Sometimes science simply cannot be rushed, though. “There is some sort
of serendipity to the scientific enterprise,” Gonsalves told me. “The
speed and scale of what is happening now could be just a prelude to the
chance discoveries we’re going to have to make over a longer period.”
Bottom line: “You can’t scream a cure out of a test tube.”
Next I called Howard Markel, director of the Center for the History of
Medicine at the University of Michigan, to talk about another source of
my anxiety: that the coronavirus seemed to shape-shift in a uniquely
terrifying way. It felt like every day I opened the newspaper to read
that a new organ system was subject to its ravages or a new age group
was vulnerable. But Markel, who has made a career studying the history
of epidemics, told me that was to be expected: The apparent explosion of
new and varied symptoms happens with any highly contagious virus when it
bursts on the scene.
View Images
Injecting a refrigerated COVID-19 trial vaccine developed at the
University of Oxford
“The more clinical material you have, the more patients, the more
chances you have to see this protean nature,” he said. It’s what
happened in the early days of the AIDS pandemic in the 1980s, when
Markel was just starting his career. At the dawn of any new disease,
strange manifestations keep showing up and surprising doctors. Even if
the odds of a rare symptom are, say, just one in a thousand, doctors are
going to see a lot of it, Markel said, because a thousand patients can
accumulate practically overnight with a crazily contagious new illness
like this one.
So the U-turns and revised pronouncements about COVID-19 aren’t signs
that scientists are flummoxed; they’re signs that scientists are
generating a torrent of new information and are trying to make sense of
it as they go.
Last I called an old friend, Stephen Morse, a professor of epidemiology
at the Columbia University Mailman School of Public Health. Morse was
the subject of a book I wrote nearly 30 years ago about emerging
viruses, in which he basically predicted our current catastrophe.(4)
Today he feels a bit put off by the frenzy.
(4) In 1989 Stephen Morse spearheaded the nation's first conference
on emerging viruses, hoping to give scientists the tools to anticipate
the next viral plague.
“This is not the way I would like to see science being done—it’s
happening so quickly,” Morse told me. He strained to look for a bright
side. “A lot of knowledge is becoming available,” he ventured. And if
some of that supposed knowledge ends up being wrong, he said, seeming to
strain even harder, couldn’t that be construed as a good thing? “Science
is a self-corrective process. Maybe even the effort to correct the
errors will lead to improved knowledge.” Maybe. But I didn’t feel better
when we hung up.
View Images
Customers waiting cautiously in line outside a drugstore in Camden Town
Still troubling me were a couple of things. First, the politicization of
the process could upend everything. Even if science closes in on a more
accurate view of COVID-19 and how to treat and eventually prevent it,
that might not be how the story is spun. Enough conflicting interests
and alliances exist for the truth to be turned on its head without too
much effort, making it seem as if scientists who amended their views
based on new evidence were pretty much wrong from the start.(5)
(5) The bizarre campaign to undermine Anthony Fauci claimed his
early advice was overly optimistic, leaving out his constant qualifier:
“This could change.”
Second, the science itself might suffer. If researchers take shortcuts
for the sake of expediency or jump too far ahead of their data to offer
advice, they might unwittingly tarnish the very process they depend on.
Indeed, not long after I spoke to Morse, I read a report from a team of
epidemiologists and biostatisticians from the Johns Hopkins Bloomberg
School of Public Health that suggested a lot of the early research was
too perfunctory to be of much use.
The scholars analyzed the first 201 COVID-19 clinical trials, which had
been conducted in China, the U.S., and other countries. It seemed there
had been a lot of corner cutting. One-third of the trials had no clear
definition of treatment success; nearly one-half were so small (100 or
fewer patients) they weren’t really informative; and two-thirds lacked
the gold standard safeguard known as “blinding,” which keeps
investigators from knowing which subjects are getting the treatment
under study.
Maybe the pandemic will persuade even the skeptics how crucial
scientific discovery is to human flourishing.
These less-than-ideal clinical trials were reported anyway, partly
because leading scientific journals, such as the New England Journal of
Medicine and those published by PLOS, had pledged to accelerate the peer
review process, rushing coronavirus articles into print in half the
usual time. Another avenue of publication involves preprint servers,
which post articles online before they’re peer-reviewed. These servers,
created to promote transparency in scientific research, predate the
pandemic, but they exploded in popularity as coronavirus studies were
churned out. Journalists, their readers ravenous for any updates, wrote
articles about studies on these preprint servers no matter how small, no
matter how tentative.(6)
(6) Peer review helps, but it’s not a guarantee; of the first 25
retractions of corona-virus papers, 14 were in peer-reviewed journals.
As new findings, even weak or conditional ones, are publicized that
contradict earlier findings, those of us trying to follow along can end
up frustrated and confused. But while frustration and confusion among
the science-minded might be unfortunate, it’s not deadly. What really
worries me is that those skeptical of science might see the apparent
flip-flops as reason to turn against evidence-based advice altogether.
The anti-science sentiment is out there, in the U.S. and elsewhere, and
it’s pernicious, having led to doubt about expert consensus on climate
change, gun control, vaccine safety, and other hot-button issues. We’re
also seeing the emergence of COVID truthers, who insist the pandemic is
either a conspiracy or a hoax. (Or maybe both? It’s hard to keep track.)
They venomously slam public health officials, some of whom have quit
after one too many death threats. It has been astonishing to watch
videos of people screaming at store owners or city council members for
requiring them to wear masks. (New algorithms can detect whether people
are complying with public health guidance.)
This is not just an American phenomenon. With coronavirus
misinformation, disinformation, and conspiracy theories circulating
around the globe, the World Health Organization has declared that we are
facing two public health outbreaks at once: the pandemic itself and an
“infodemic” of dangerously misguided ideas about it.
But you don’t need to be an unhinged COVID truther to be resistant to
learning whatever lessons this pandemic can teach us; you just need to
be an ordinary, shortsighted, fallible human.
View Images
Relaxing in Greenwich Park next to the National Maritime Museum
“Every epidemic I’ve ever studied always ends with global amnesia,”
Markel said. “We go back to our merry lives.” The “glaring problems”
that contributed to the outbreak—urbanization, habitat destruction,
international travel, climate change, war refugees—simply persist, he
said, as people lose interest in demanding that more time, money, and
brainpower be devoted to science. “Politicians move on to the next show,
while policymakers cry out in the wilderness, ‘We still need this!’ ”
Already the 21st century has been what Markel calls the century of
epidemics: SARS in 2003, H1N1 influenza (swine flu) in 2009, MERS in
2012, Ebola in 2014 to 2016, and now COVID-19 in 2019, 2020, and who
knows how many years beyond. Five epidemics in 20 years, each one a
little worse than the one before—and this one many times worse than the
other four put together.
Maybe, in a weird way, watching scientists try to build a plane while
they’re flying it—as some have described coronavirus research—will be
good for our overall understanding of the scientific process. Maybe the
pandemic will persuade even the skeptics how crucial scientific
discovery is to human flourishing.
That’s the hope of Lin Andrews, director of teacher support at the
National Center for Science Education. “People innately trust scientists
overall, but when it’s a polarized topic, things can go wonky,” said
Andrews, a former high school biology teacher. She and 10 colleagues,
seeing the pandemic as a teachable moment, have devised a five-part
lesson plan, good for classroom or home use depending on whether
particular school districts are open. It focuses on epidemiology as a
way to educate high school students—and, by extension, their
parents—about what the scientific process entails.
The course shows how scientists construct their theories, Andrews said,
by emphasizing “all these stumbles that were made along the way.” It
includes milestones in epidemiology, such as when British scientist John
Snow traced the London cholera outbreak of 1854 to contaminated drinking
water. No one believed Snow—the prevailing theory was that cholera was
spread through the air in a contagious “miasma”—until he had the handle
removed from the water pump on Broad Street, shutting off the
contaminated water supply and stopping the outbreak.(7)
(7) Until 19th-century scientists proved that microbes transmit
disease, epidemics were blamed on such causes as viscous blood and
“putrid effluvium.”
Snow’s realization came years before the confirmation of germ theory,
which explains the existence of pathogens. He didn’t understand how
cholera was transmitted in the water, simply that patterns of disease
indicated it was. Learning about the step-by-step progression of
historical discoveries will, Andrews hopes, put in context the fits and
starts of contemporary scientists’ attempts to understand COVID-19.
Maybe our unfiltered view will turn out to be a good thing. After all,
the best way to build trust in science is by showing all of its
hypothesis testing and hypothesis tweaking—maddening to watch while
we’re anxiously awaiting answers to a global plague, but in the end the
only way toward results that will allow us to move on with our lives.
Surveys show the general public is less dismayed by watching scientists
in action than I had feared. Since 2015, the Pew Research Center has
tracked what Americans think about science, and it has steadily become
more positive, including in a poll conducted in April and May 2020 as
the coronavirus was cresting and many of those surveyed were under lockdown.
In January 2019, the last survey before the pandemic, respondents were
already inclined to trust scientists, with 86 percent saying they had a
“great deal” or a “fair amount” of confidence that scientists had the
public interest at heart. That level of trust inched up to 87 percent
amid the pandemic.
But when I called Cary Funk, the director of science and society
research at Pew, to talk about these encouraging results, she told me
not to get ahead of myself, that the story is a bit more complicated.
According to Funk, the surveys show a deep partisan divide in how much
scientists are trusted. Republicans and Republican-leaning independents
still seem reluctant to embrace science wholeheartedly. They are about
half as likely as Democrats to express a “great deal” of trust in
scientists—a proportion that has stayed stubbornly low at 27 percent.(8)
(8) Shortly after July’s coronavirus surge in the U.S., Pew found
that just 46% of Republicans thought COVID-19 was a “major” public
health threat, compared with 85% of Democrats.
Pew’s surveys also reflect a deep racial divide in attitudes toward
science. Black adults, according to the poll conducted earlier this
year, are less likely than the general population to trust medical
scientists. They are also less likely to have confidence in new COVID-19
treatments or vaccines; just 54 percent of Black respondents would
“definitely” or “probably” get a COVID-19 vaccine, compared with 74
percent of whites and Hispanics. This distrust, exacerbated by the
substandard care many Black patients get in doctor’s offices and
emergency rooms, is especially troubling in the context of COVID-19,
which kills Blacks at more than twice the rate at which it kills whites.
The racial and political divides in how science is viewed are especially
insidious now, when skeptics could undermine whatever progress
scientists make in the coronavirus fight. In the worst-case scenario, if
enough doubters ignore control measures and vaccines, that could strip
science of its ability to protect us altogether.
I'd like to believe Andrews is right about this being a teachable
moment—maybe not so much for those of us already fixed in our views, but
for those whose childhood is being shaped by the coronavirus. These
children—whom some are calling Generation C—might grow up with less
patience for the polarization fogging our responses today. Let’s say
they spend their formative years watching the scientific process up
close. And let’s say that in the end, scientists actually do save the day.
Now it’s the year 2040, and Gen C is all grown up. Suddenly a new
pandemic emerges. Based on what they learned by living through COVID-19
at an impressionable age, these young adults recognize the urgency of
the new outbreak, quickly dismissing any claims that it’s a hoax. They
put on masks, maintain social distance, get vaccinated as soon as a
vaccine is developed (and it’s developed quickly, because scientists
have also learned a thing or two in the interim, as have politicians).
They follow experts’ recommendations because they know it’s the best way
to protect not only themselves but also their neighbors from a plague
similar to the one they grew up with that killed hundreds of thousands
of people around the world.
Gen C gets through the new pandemic with relatively few deaths or
economic disruptions because they learned some crucial lessons when they
were children: that public health advice is based on the best available
data, that such advice can change as new evidence accumulates, that
science is an iterative process that cannot be fast-tracked.
Maybe by then there also will be more workers in the professions that
got us through the coronavirus catastrophe: more doctors, nurses,
paramedics; more specialists in infectious disease, epidemiology,
virology, and microbiology, each of them having chosen a career that as
kids they had watched in its finest hour. It has happened before. Some
of the scientists now engaged in the struggle against the coronavirus,
such as Gonsalves and Markel, ended up where they did after working to
help untangle AIDS, an earlier viral mystery that killed us in ways
never seen before.
So the question is whether Gen C will respond with something other than
“global amnesia” when the next plague arrives, as it almost surely will.
This is what I yearn for, not just for the sake of my own bruised
confidence but also for the sake of my two beloved granddaughters, who
would have to live the reality I’m most fretting about.
Much depends on what happens in the coming months.
Imagine, for the sake of argument, that the epidemiological curves I’ve
obsessed over all year ultimately play out in our favor, and we can
return to some semblance of normal. Imagine that effective treatments
are found that make COVID-19 short-term and curable for just about
anyone. Imagine that a vaccine is developed soon and that a significant
portion of the world population gets it. If all that happens, why
wouldn’t we emerge from this with a greater appreciation of the
scientific enterprise in all its messy brilliance?
I try to hold on to that hope, despite the catcalls of politicians and
“personal choice” zealots who second-guess everything the scientists do.
I try to tell myself that sometimes our better angels prevail. And that
there’s an army’s worth of better angels—scientists, educators, doctors,
nurses, public health advocates—who, since that eerie image of the spiky
coronavirus started haunting our collective dreams, have been working
tirelessly toward a happy ending.
That’s the ending I’m trying to believe in, where we emerge from this
with a renewed appreciation of science as humanity’s best chance of
salvation from suffering and untimely death.
Robin Marantz Henig is a frequent contributor. In the July issue,
she wrote that the experts warned a pandemic was coming. Giles Price,
based in London, explores the social landscape in his photography, often
with different imaging technology.
--
So many immigrant groups have swept through our town
that Brooklyn, like Atlantis, reaches mythological
proportions in the mind of the world - RI Safir 1998
http://www.mrbrklyn.com
DRM is THEFT - We are the STAKEHOLDERS - RI Safir 2002
http://www.nylxs.com - Leadership Development in Free Software
http://www.brooklyn-living.com
Being so tracked is for FARM ANIMALS and extermination camps,
but incompatible with living as a free human being. -RI Safir 2013
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