Science Is Under Attack

There is no question that science is under attack, and in a systematic and coordinated fashion. I have been studying this in the context of the pandemic for the past 5 years, and there were many recurring signs and patterns I could see that were tip offs that the person spreading disinformation was doing so intentionally rather than mistakenly and that the person, while touting expertise, was really an ideologue (rather than being scientifically curious and open to evolving evidence, they were committed to a particular point of view or belief and could not be swayed by contradictory evidence or faults in their own reasoning when pointed out to them. Sometimes they would state that a study showed X, but then when I reviewed the study they referred to, it didn’t say that at all and often contradicted what the disinformation purveyor asserted. Other times, it was far more devious with data or graphs displaying the data manipulated to try to prove the point they wanted, rather than what the study actually demonstrated).

To be clear, questioning the science and challenging it has always been at the very heart of science, but it has to be in good faith to be legitimate. As scientists, we come up with hypotheses, design studies to try to answer the question raised by the hypothesis, then collect data, and finally interpret the data. And, science evolves. Often, studies answer some questions, but then raise new ones. Rarely is a study so large, so comprehensive, that we can apply those findings to the entire population of people. For example, a study in adults may not necessarily apply to children, and vice versa. A study in immunocompetent persons (those without immune deficiencies or conditions or treatments that cause their immune systems to be suppressed or impaired) may not be applicable to immunocompromised patients. We gain confidence in the results of studies when those studies are reproduced by other scientists coming to the same or similar results, when the studies are subjected to rigorous peer review, and when we see the results and conclusions hold up over time as we continue to gain more experience with more patients with those conditions over time.

High quality science has always been subject to external peer review by experts in the field. Peer review seeks to determine whether potential biases that could have influenced the data or produced data that were not as generally applicable as the investigators may have asserted were accounted for or called out as limitations to the results of the study. [An example of bias could be a study to identify the effectiveness of air purifiers in the workplace in reducing the transmission of influenza conducted in the winter of 2020/2021 in comparison to transmission rates in prior years, but upon closer look, the study did not take into consideration that during that study time period, many workers were working remotely, which itself would reduce the risk of exposure of those in the workplace and did not consider the confounding factors that this was a time when people were physically distancing, having fewer large group meetings, etc.)  Peer review determines whether the design of the study was sufficient to answer the question being asked and whether limitations to the applicability of the results are identified and pointed out. Peer review also looks to determine whether a study is sufficiently powered (e.g., a sufficient number of study participants) to give confidence that the results are applicable to a broader population, whether the conclusions drawn were based upon data that were statistically significant to support those conclusions.

I write all this because I will continue to fight disinformation for as long as I can and as best I can, but realize that the rate of new disinformation and volume of disinformation is increasing dramatically, and disinformation groups have learned how to coordinate messages and social media activity so that they reinforce and further amplify disinformation. And, unfortunately, some algorithms may favor and disseminate that disinformation much more and wider than the post that tries to point out the errors and misinformation. Further, it takes me longer to explain why the information is wrong or misleading than it does for them to put it out there. The point being that I will continue to provide good information and explain why particular disinformation is wrong, but I cannot stay ahead of it, and frankly can’t even keep up with it, therefore, I need to teach you how to spot it and how to evaluate it for yourselves.

I do this because ever since I began my practice of medicine, my belief, philosophy, and ethics have been that I should present my patients with the facts as best as I know them, in an understandable way, with an explanation of the treatment options in the setting of a clear explanation of my best estimation of the risks of a particular treatment or not taking the treatment and the likely consequences of either approach so that my patients can make an informed decision as to what is best for them, as opposed to presenting the information in such a way as to manipulate them into making the decision that would cause them to select the option that I prefer or that would benefit me personally. What irritates me about the physicians who are spreading disinformation (that is, those relatively few, but outspoken, physicians who are repeatedly spreading information that they know or should know is false and doing so out of ideology or personal gain or both) is that they are using their credentials in an effort to manipulate people into making a decision aligned with that physician’s ideology or in a way as to promote that physician’s personal interests. I worked hard to become a physician, I consider it an honor and a privilege, and the thought that I would ever abuse that position of trust is abhorrent to me.

So, here are my tips as to how to spot these disinformation purveyors. In my experience, they tend to:

1. Never admit that they have been wrong or mistaken about anything they stated or projected during the pandemic. I have been surprised and mistaken more than once, but I have also admitted publicly that I was mistaken and corrected myself. It is unreasonable to assume that any expert could be right about everything as a novel virus with which we have no experience is spreading and evolving over many years.
2. They tend to make absolute statements. For example, a number of the physicians spreading disinformation claimed boldly that every patient they treated with such and such avoided severe illness and death. There is no medical condition that I can think of off the top of my head for which we have a treatment or preventive that is 100 percent effective. That is because an elderly patient is different than a young, healthy child; an immunocompetent patient is very different than an immunocompromised patient; and sometimes, women respond differently than men.
3. Along the same lines, I cannot think of a time when one of these prominent purveyors of disinformation expressed doubt or that there were things we just don’t know yet.
4. If you listen to them long enough or read what they write long enough, you tend to see common phrases being used that are not used by legitimate scientists. For example, early on it was very common to see these physicians using phrases like “crimes against humanity,” “violations of the Nuremberg Code” (which isn’t even applicable to the situation), and others, but also, you not infrequently see symbols or signs that are affiliated with certain political or religious groups. Legitimate scientists tend to avoid politics and religion like the plague.
5. It takes time for the system to catch up to these doctors, but you also tend to see some of these physicians being disciplined by their state boards or losing their board certification by the national accrediting board.
6. As I mentioned above, they also tend to misrepresent studies they refer to, misinterpret the data, or alter it. You will also rarely hear or see them state that a study that they offer for support of their position has any limitations.
7. You can also frequently find fact checks by reputable organizations that help point out the flaws in the disinformation being circulated, and some of the better ones have nationally renown experts or even the authors of the study that is being misinterpreted interviewed and included in the fact check.

I am now working on a blog post in which we will go through line-by-line some of the disinformation being perpetuated by our HHS Secretary and our NIH director (and others) regarding the mRNA vaccines so that you can see for yourself how I analyze statements being made as to their veracity, using common sense, critical thinking, and simple data so that you don’t have to be an expert to spot it.