Biting the Hand that Treats You. Unwarranted Assaults on Healthcare Advice

Anyone who has been paying attention to the developing COVID-19 crisis in the United States will have noticed a puzzling and damaging paradox. While political leaders claim to be taking action against the pandemic based on the best scientific advice available, when this advice conflicts with what they perceive to be in their own best political interests, they reject it. Worse, they denounce the advice being given as bad science and the advisers as being bad scientists. The attacks seem to become additionally virulent when a scientific advisor changes his or her mind.

An egregious, and perhaps deadly, example of this is Donald Trump’s withering denunciations of the numerous “mistakes” that have been made by Dr. Anthony Fauci.

For decades, Dr. Fauci has been a recognized American and world authority on dealing with and blunting the potential ravages of viral infections. He has served as director of the U.S. National Institute of Allergy and Infectious Disease (NIAID), which is part of the National Institutes of Health (NIH), the primary agency of the U.S. government responsible for biomedical and public health research. In January 2020 Dr. Fauci was named by President Trump to become a member of the Administration’s White House Coronavirus Task Force.

In early July, President Trump said, “Dr. Fauci is a nice man, but he’s made a lot of mistakes . . . A lot of them said don’t wear a mask, don’t wear a mask. Now they are saying wear a mask. A lot of mistakes.”

There were two reasons for the advice at the beginning of the pandemic for the general public not to wear masks. First, masks were not common, so the health officials were fearful of panic buying up of the high-quality professional face masks needed by healthcare workers, notably doctors and nurses treating COVID-19 patients in ICUs (intensive care units). Second, research was just beginning to see what kind of masks would be appropriate for the general public, i.e. something equivalent to a professional medical mask or something less high-tech, less cumbersome, and less costly.

This bipolar position–love science when it supports preconceived notions, denigrate science when it doesn’t—is nothing new. In 1989 Dr. Isaac Asimov explored this inimical phenomenon in his own inimitable style in an essay titled “The Relativity of Wrong.”

If you don’t recognize this author’s name, then you are probably not a scientist or have any close association with science. Isaac Asimov (1920–1992) was a well-respected scientist (biochemistry), a premier author of science-fiction novels, a premier author of science and non-science books for the layman, and a delightful essayist.

This essay was written in response to a non-scientist (in fact an English literature student) who thought he had come up with a “gotcha” example to prove that science is unreliable. The student’s argument was science keeps changing its mind; therefore it is not dependable. Asimov’s response was science constantly changing its mind is precisely what makes it dependable. This is because science rigorously eschews dogma and is constantly open to new information and new ideas without pre-emptively judging whether they are good, or bad, or fit for purpose.

As we are daily witnessing, the clash of cultures between science and non-science portrayed in Asimov’s essay can have serious consequences.

As Asimov recounts in his essay:

"The young specialist in English Lit , having quoted me, went on to lecture me severely on the fact that in every century people have thought they understood the universe at last, and in every century they were proved to be wrong. It follows that the one thing we can say about our modern 'knowledge' is that it is wrong.

"The young man then quoted with approval what Socrates had said on learning that the Delphic oracle had proclaimed him the wisest man in Greece. ’If I am the wisest man,' said Socrates, 'it is because I alone know that I know nothing.' The implication was that I was very foolish because I was under the impression I knew a great deal.

"My answer to him was, 'John, when people thought the earth was flat, they were wrong. When people thought the earth was spherical, they were wrong. But if you think that thinking the earth is spherical is just as wrong as thinking the earth is flat, then your view is wronger than both of them put together.

"The basic trouble, you see, is that people think that 'right' and 'wrong' are absolute; that everything that isn't perfectly and completely right is totally and equally wrong.

"However, I don't think that's so."

And this is the key point. Science builds on available data. If the data strongly indicates something in one direction, then this is probably the most fruitful direction to pursue. When further data becomes available, then the direction must be changed. However, even if the new direction seems radically different from the old, even the reverse, it seldom is. Rather, it is a stunning modification of the old direction.

Asimov cites the well-known example of the shape of the earth.

"In the early days of civilization, the general feeling was that the earth was flat. This was not because people were stupid, or because they were intent on believing silly things. They felt it was flat on the basis of sound evidence. It was not just a matter of 'That's how it looks,' because the earth does not look flat. It looks chaotically bumpy, with hills, valleys, ravines, cliffs, and so on

"Of course there are plains where, over limited areas, the earth's surface does look fairly flat. One of those plains is in the Tigris-Euphrates area, where the first historical civilization (one with writing) developed, that of the Sumerians.

"Perhaps it was the appearance of the plain that persuaded the clever Sumerians to accept the generalization that the earth was flat; that if you somehow evened out all the elevations and depressions, you would be left with flatness. Contributing to the notion may have been the fact that stretches of water (ponds and lakes) looked pretty flat on quiet days.

"Another way of looking at it is to ask what is the curvature of the earth's surface Over a considerable length, how much does the surface deviate (on the average) from perfect flatness. The flat-earth theory would make it seem that the surface doesn't deviate from flatness at all, that its curvature is 0 to the mile.

"Nowadays, of course, we are taught that the flat-earth theory is wrong; that it is all wrong, terribly wrong, absolutely. But it isn't. The curvature of the earth is nearly 0 per mile, so that although the flat-earth theory is wrong, it happens to be nearly right. That's why the theory lasted so long."

He continues this analysis to finally arrive at the modern concept of the earth as being an oblate spheroid, which is still not 100 percent correct, but certainly not 100 percent wrong.

"What actually happens is that once scientists get hold of a good concept, they gradually refine and extend it with greater and greater subtlety as their instruments of measurement improve. Theories are not so much wrong as incomplete."

He cites another well-known example of this principle.

"This can be pointed out in many cases other than just the shape of the earth. Even when a new theory seems to represent a revolution, it usually arises out of small refinements. If something more than a small refinement were needed, then the old theory would never have endured.

"Copernicus switched from an earth-centered planetary system to a sun-centered one. In doing so, he switched from something that was obvious to something that was apparently ridiculous. However, it was a matter of finding better ways of calculating the motion of the planets in the sky, and eventually the geocentric theory was just left behind. It was precisely because the old theory gave results that were fairly good by the measurement standards of the time that kept it in being so long."

He does not use the term, but I think what Asimov is saying is that scientific “truth” is asymptotic. You can get closer and closer to being absolutely right, but you will never quite reach it. Why? Because absolutely right (scientific truth) probably doesn’t exist. The nature of the universe seems to be infinitely manifold, so no matter how far you go, there will always be something just over the horizon that will make it necessary to go a bit further. But as long as you stick to the data and go where it leads, you will never be thrown off the right track.

If you haven’t already read this essay, please do so. I think you will find it quite enjoyable. You can find it at: https://chem.tufts.edu/AnswersInScience/RelativityofWrong.htm. However, if you are inclined to show it to a non-science oriented friend or acquaintance to educate them, you probably shouldn’t. It is much too detailed and therefore likely to provoke the all-to-common reaction: “Oh, you’re just trying to dazzle me with science. I don’t buy it.”

So what can we do about this ignorant rejection of ideas, theories, and recommendations based on facts?

In the short term, very little. The anti-science attitude represents a fundamental failure of our educational systems. I once met a university student who was proud of the fact that he didn’t understand science because that somehow made him a “better person.” There is nothing about ignorance that makes anyone a better person. Any educational system that can produce someone with such a pernicious attitude is in need of root and branch reform.

Inculcating a basic understanding of science should be a prime objective of education, perhaps starting as young as kindergarten and continuing all the way to the end of high school. I don’t mean just in science lessons, but suffused throughout the entire curriculum.

Whether or not someone “likes” science is irrelevant. Doubt is laudable; ignorance is lethal. Realizing this is extremely important because many people who think they don’t like or understand science are constantly being called upon to vote on issues about science. To cite just a few examples:

  • Should we be so concerned about global warming as to spend billions and billions of dollars to fight it?
  • Should we ban nuclear energy as being too dangerous and too untrustworthy?
  • Are genetically modified foods potentially so damaging that they should be prohibited even if they may be the best hope for feeding the world’s burgeoning population?
  • Should homeopathy and other alternative medical treatments be recognized as legitimate, and paid for by government and private insurance plans?
  • How can we best battle and defeat COVID-19?

But is suffusing the education system with scientific understanding from top to bottom really feasible?

Many people believe understanding science requires a special kind of thinking, i.e. that your brain must be wired differently from other people. According to Albert Einstein, who knew a thing or two about it, “The whole of science is nothing more than a refinement of everyday thinking.”

In other words, scientific thinking is just an extension of the way we already think. This is excellent news, because it means people who say they are incapable of understanding science are probably wrong. They do understand science, but were never aware of it.

What distinguishes scientific thinking from ordinary thinking is only that scientists do it in a more rigorous way. Scientists are practiced in constructing packages of evidence to support their opinions and prognostications. They are always ready to modify these whenever new data dictates that they should. Other people should admire this.

At the very least, it would eventually minimize pernicious proclamations about scientists making “mistakes” by persons in authority who should know better, but don’t. We will get through COVID-19 pandemic somehow, but doing so will take much longer and do considerably more damage than it might have. I am not so sanguine about the next major global crisis, whatever it may be.

“A mind that cannot be changed is unworthy of being called a mind; it is a dead thing pretending to be alive. An idea that cannot be questioned is unworthy of being called an idea; it is unspeakable ignorance disguised as unimpeachable wisdom.”—Anonymous.