Catching bad science communication by scientists and physicians during this pandemic- and always
Updated: Aug 10, 2020
Have you come across a news story about a local scientist claiming that they’ve found a cure? Or have you come across an interview with a physician claiming major success stories in their clinic using off label drugs? Throughout this pandemic, I’ve seen worrisome news stories that fell directly onto my radar, and they don’t seem to be major outliers, so I’m guessing many of you have seen this type of thing too.
This pandemic has inspired a lot of amazing print, audio, and video coverage on different media platforms, and I’ve seen both scientists and science writers step up to the plate and create informative, accurate, and accessible content. But this pandemic has also unleashed a massive amount of information, and not all of the media we're consuming is created equal. I’m not talking about “air time” given to physicians and scientists taking part in the widespread promotion of diets and supplements to “boost your immune system” that lack any evidence of effectiveness against COVID-19. I’m not talking about the blatant spread of misinformation that’s disrupting trust in the research and medical communities in the form of YouTube videos(1). And I’m not even going to talk about the premature claims about hydroxychloroquine by Didier Raoult that were amplified and exaggerated that are now falling way short in clinical trials, because there’s a lot to unpack in there, though the hardcore promotion of the drug was not good science communication (2,3). I’m talking about stories of STEM professionals who are actually in the clinics and in major research universities trying their best to help, with adequate training and expertise in their given field, and good hypotheses that are supported by sound reasoning and supported by others.
With the vast amount of information we have bombarding us everyday, scientists should be helping to communicate accurate, ethical, and concise representations of our current consensuses. Yet most of us in research are not trained in communicating to the general public, and we cannot always control the narrative of news stations who have different goals than the experts being interviewed. Researchers are taught to communicate to other scientists and experts in our field, and therefore we expect our typical audiences to not only know the jargon we use, but the normal process of science and drug development and the limitations to our data. The limitations and next questions are arguably the most important parts of any data, and they deserve as much attention as the actual findings, especially in the media and in broader forms of communication.
There is now more attention paid to science communication in the scientific world, but the community as a whole won't be experts at it anytime soon, so let's dig into a few of these stories so that you catch where we fall short:
· See this print interview with Dr. Sachdev Sidhu, a professor at the University of Toronto, helping to engineer a novel coronavirus fighting antibody: here.
· See this video interview with Dr. Drew Jones, a Pulmonary and Critical Care Medicine physician, helping to treat COVID-19 patients in Richmond, VA: here.
In both interviews, these experts express far too much certainty and not enough skepticism given the lack of patient data and clinical trials for their treatments of interest. Dr. Sidhu called a synthetic antibody developed in his lab “a cure” with 99% certainty, despite only testing his antibody in a cell culture dish, and Dr. Jones called anti-IL-6 antibody therapies “a light at the end of the tunnel”, pointing to an anecdotal story for the evidence behind his optimism. While these are both promising therapies being considered and tested around the world, and we want scientists to believe in their work, these stories are poor examples of the scientific process and how we use evidence to make conclusions (explore more about why anecdotes are not evidence here). Research generally begins with anecdotes or studies in cells or with viruses in a dish, but then we test different conditions, animal models, and many levels of clinical trials before we start to consider a drug for FDA approval. Even when really promising drugs make it past animal studies, 90% fail in clinical trials (4), and despite 30 years of clinical trials that have been conducted for sepsis, a disease similar to ARDS in severe coronavirus patients, there is no FDA approved therapeutic treatment (5). And as you've seen in real time, drugs like chloroquine are not living up to the early hype based on anecdotes (6,7), so it would've been helpful for both experts to accurately state the long road ahead. Be cautious of anything pegged as a cure or medical treatment without adequate evidence.
Dr. Sidhu also took it a few step further and claimed that he has enough trust in his drug that they should skip animal testing and move directly into humans. While I want to think he was just saying this to give you all hope that we have a lot of great drugs that do have a lot of potential, it would be unethical to test a drug in humans before we know that it can protect against the virus in a body. Now I will mention that some pharmaceutical companies are simultaneously running studies in primates to determine if the vaccine can protect against disease and phase I trials to determine if the vaccine is safe for human use, but they have already tested these vaccines in mice with immune systems that have been engineered to be the same as humans. And most importantly all trial phases are still being fully completed (8). So even if Dr. Sidhu has faith that his synthetic antibodies will work, it would've been helpful for him to ensure readers that these antibodies will still be adequately tested. Again, be cautious of anything pegged as a cure or medical treatment without adequate evidence.
Moreover, both men made it sound like they had developed hot new methods to help treat COVID-19, yet previously published data and many registered clinical trials suggest that neither were the first to attempt to use these therapeutics. Especially at a time when there have been a lot of "lone ranger" stories spread to promote distrust in the government and medical communities, it is dangerous to suggest that scientists work completely in isolation. If anything, scientists are sharing data and ideas faster than ever with the rise of "pre-prints", or articles that have not been fully vetted for accuracy of proper methods and interpretation. When experts come up with great ideas, they often vet the ideas with experimentation and by talking to many many colleagues. Those who sell their hypotheses as fact are no better than snake oil peddlers, so it would've been helpful for both experts to mention that there are many clinical trials being conducted to test their hypotheses. You can search the complete list of US clinical trials by drug and disease here. And while physicians are allowed to use compassionate care guidelines to try off-label or investigational drugs for patients as a last resort (9), the drugs are required to, and should, go through adequate formal testing before being approved for use in the wider population (10,11). It would've been helpful for Dr. Jones to further elaborate on this process. Be cautious of lone rangers, because promising treatments with adequate evidence will have lots of support within the scientific community.
So while we all like to read success stories and stories of hope, and there is a lot of fantastic reporting on the science of this pandemic, be very skeptical of hot takes, brand new hypotheses without decent evidence, and preliminary data that aren’t yet supported by controlled human studies. Be cautious of the preprints and unpublished data. And start seeing red when anyone claims certainty or cures, because both are very rare to come by in science.
There’s a lot to be hopeful for and a lot of scientists who are rocking scientific communication, but as a scientific community as a whole, can still do a lot better.
And if you are a scientist interested in learning how to communicate science better, checkout these sources here. Because our stories and our work are important. But they should also be ethical, accurate, and evidence based.