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COVID-19 has upended the typical “look” of a scientist. Gone are the days of enjoying an episode of Bill Nye the Science Guy every week in middle school or taking a virtual trip with Ms. Frizzle on The Magic School bus. Nowadays, our mainstream scientists are Drs. Tony Fauci (NIAID), Robert Redfield (CDC), and Deborah Birx (White House Coronavirus Task Force Coordinator), whom have been dealt the challenge (or burden) as our nation’s public health experts to communicate everything we know about SARS-CoV-2 and COVID-19. This is especially difficult (or daunting) as researchers unearth more facts around the virus and disease, which requires science communicators to evolve their message to policymakers and the public at large.
Drs. Fauci, Redfield, and Birx possess nearly a combined century’s worth of experience in infectious disease research and public health crises, yet they have all come under scrutiny for their remarks or comments throughout the pandemic. Although more Americans today trust scientists than 2016, public trust in our institutions are slowly being eroded away in favor of identify politics, and facts are increasingly disregarded in favor of political polarization.
This is a huge topic, one of which I will never be able to address in its entirety in a single blog post on the internet. Our political system combined with the digital age of information has been shaped over the past several decades to solidify how our institutions operate. Do Citizens United and campaign contributions influence our elections? You betcha. Superpacs? Absolutely. Is the private sector influenced by the bottom line during public health crises? For sure.
The goal of this post is to briefly look at two public health examples on how trust in our science experts can alleviate infectious disease burdens.
Vaccine Hesitancy
Let’s start with a doozy of an example, vaccines. Vaccine hesitancy – defined as either delaying the typical vaccine schedule or forgoing them all together – has increased 5-fold over the past two decades. What is the number one thing that deters vaccine hesitancy: a strong recommendation from their doctor [1-3]. Why? Because parents trust their doctors! If a doctor is hesitant about vaccines, then the parents are more likely to be as well.
Ebola 2014
Here’s another public health example: In Richard Preston’s recounting of the 2014 Ebola outbreak in West Africa, Crisis in the Red Zone (reviewed by me here), he describes how people in the villages of Guinea and the Makona Triangle attacked humanitarian aid workers trying to contact trace the disease and treat infected patients.
Looking at it from the outside in, that makes no sense to attack humanitarian aid workers. Why would they attack people who are trying to help them?
In the book, Preston describes a more relatable scenario to the reader:
“If a group of powerful foreigners who spoke no English…were to set up a camp of tents in suburban Wellesley, MA, and they were wearing biohazard moon suits and were telling townspeople that an extreme virus had gotten loose in Wellesley and that anybody who had symptoms must go into the camp and stay there until they died, there might be some opposition from the Wellesleyites. And if most people who went inotht ec camp were never seen again, dead or alive, and if the foreigners were burying white body bags next to the camp, and if quite a few of the bags obviously held dead children, and if social media lit up with rumors of hideous experiments, it’s a pretty sure bet that the Wellesleyites would be reaching for their guns and doing anything they could to get the hell out of Wellesley.” [pg. 75].
Quite simply, “People in the Makona Triangle had never heard of Ebola,” he states. [pg. 75]. The humanitarian aid workers, amid the Ebola chaos, had no time to establish and build trust among the communities and educate their residents afflicted by the Ebola epidemic. Until public health experts were able to communicate in native languages, respect their cultures, and demonstrate the importance of mitigating practices to slow the spread of Ebola, infections would continue to rise. Establishing trust was crucial in this endeavor.
Final Thoughts
Whether it is fair or not, scientists are held to a higher standard to convey facts and statements accurately. Facts change as data is gathered, and statements conveying those facts may change as well. Unfortunately, this can lead to confusion. First, we were told not to wear masks, now CDC recommends we do. Initially the virus can live on surfaces for days, now the CDC says we do not need to worry about it (these are different issues though: a virus “living” on a surface for days and risk of transmission are two separate matters – this highlights the importance of effective communication!).
I challenge those critical of our scientists to be patient because the very thing being criticized is the scientific process itself! Science – by its very definition – is the pursuit to gather unbiased observations that uncover the truths in the physical world. We are still collecting those observations as COVID-19 plays out. It is up to scientists to communicate those observations well and for the public have patience and trust our experts as we learn more about the disease.
Vaccine Hesitancy sources:
1. Allison MA, Dunne EF, Markowitz LE, et al. HPV vaccination of boys in primary care practices. Academic pediatrics. 2013;13:466–74.
2. Dorell C, Yankey D, Strasser S. Parent-reported reasons for nonreceipt of recommended adolescent vaccinations, national immunization survey: teen, 2009. Clinical pediatrics. 2011;50:1116–24.
3. Opel DJ, Heritage J, Taylor JA, et al. The architecture of provider-parent vaccine discussions at health supervision visits. Pediatrics. 2013;132:1037–46.