A divisive disease

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Science  18 Dec 2020:
Vol. 370, Issue 6523, pp. 1395-1397
DOI: 10.1126/science.370.6523.1395

As scientists struggled to understand and quell COVID-19, a second pandemic of misinformation and political mayhem raged.

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Angela Rasmussen is as outspoken a scientist as you are likely to find. And this year she spoke out a lot. One of many researchers who became celebrities during the COVID-19 pandemic, the virologist at Georgetown University was quoted in hundreds of articles, appeared as an expert on TV and radio, and took to Twitter to put news about mutations or reinfections into context—and to call radiologist and top U.S. government adviser Scott Atlas a “gaslighting motherf---er.”

But Rasmussen's messages did not resonate with everyone—even in her own family. Split along political fault lines in the Trump era, some of her relatives no longer speak to one another, she says. When one of her aunts ended up in intensive care with COVID-19 in the summer, Rasmussen only found out because a cousin texted her, worried that others in the aunt's household did not feel the need to quarantine and get tested. “Guess what: They all had COVID,” Rasmussen says. “But my own family, because of politics, did not reach out to the COVID expert in the family.”


A similar dynamic played out in myriad variations across the United States and the globe as the coronavirus pandemic unfolded. Researchers worked fast and furiously and achieved breakthroughs big and small. But for science's relations with the wider world, this year marked a breakdown: in communication, in trust, in the sense of a shared reality.

The pandemic was the type of threat researchers had worried and warned about for years: a deadly animal virus, new to humans, and spread in the breath we exhale. “If you had asked me 5 years ago what would keep me most awake at night, this almost defines it perfectly,” says Jeremy Farrar, who heads the Wellcome Trust.

And this virus had help. A “syndemic” is the intersection of two epidemics—two diseases ravaging a population at the same time, exacerbating each other. HIV weakens the immune system, for instance, which makes people more likely to develop tuberculosis. The world witnessed something similar this year. We live in an ecosystem that allows viruses to cross from wildlife to humans more often and spread farther and faster than ever before—that gave us SARS-CoV-2. But the virus emerged in an information ecosystem that helps misinformation and lies spread faster than scientific evidence, weakening our ability to respond to new threats. That made the pandemic far worse.

NEWS OF A CLUSTER of pneumonia cases in China emerged on the eve of the new year. Ten days later, a full genome sequence of the virus was posted online. A diagnostic test was ready a few days later. A team of experts sent to China by the World Health Organization (WHO) in February came home with a surprising finding: China had done the impossible—halting the outbreak of a respiratory pathogen—by locking down its citizens. Science was working faster than ever before.

But the virus was faster. Carried around the world by travelers, it spread surreptitiously at first but quickly sickened and killed patients at a rate that threatened to overwhelm health care systems. As scientists, doctors, and nurses worked around the clock, countries on all continents tried to follow the Chinese example, depriving the coronavirus conflagration of the oxygen it needed: human contact.

“Science is our exit strategy,” Farrar told Science in those dark days of the first peak. And in many ways, science delivered. It launched an all-out effort to develop animal models and diagnostics, chart the pathogen's path of destruction through the human body, find drugs, and develop vaccines. “We took out all our fancy tools and applied them to this virus,” says virologist Florian Krammer of the Icahn School of Medicine at Mount Sinai.

With acceleration came accidents. Preprint servers like bioRxiv and medRxiv became hubs for sharing information quickly, but they occasionally spread misinformation just as fast. A paper suggesting SARS-CoV-2 was an engineered virus, for instance, found a platform it not deserve—and widespread media coverage. Peer-reviewed journals slipped up as well. The Lancet and The New England Journal of Medicine fell for fraudulent papers purportedly containing data from hundreds of hospitals around the world, collected by a tiny company few had ever heard of. Many research results, including the stunning vaccine data of the past few weeks, were communicated directly to journalists, bypassing any scientific scrutiny. “It is a pandemic by press release,” says WHO epidemiologist Maria Van Kerkhove.

Still, for those willing to learn, this year presented an unprecedented opportunity to see science at work—to hear experts explain viruses and vaccines, see them critique each other's papers on Twitter, and understand how in science, uncertainty and self-correction are strengths rather than flaws. The process of science was rarely as visible as this year. It was like watching open-heart surgery live on TV: messy but vital and riveting.

BUT WHEN IT CAME to countering the other plague, that of disinformation and deception, the toolbox was empty. Just as videoconferencing and online shopping found massive new markets as stores, schools, and offices closed, so polarization, politicization, and a media ecosystem that elevates simple lies over complex truths were ready to take advantage of an unsettled public struggling with uncertainty. Even as hundreds of thousands died, many people downplayed the problem or refused to acknowledge its existence, no matter what the experts said. “It's a little like watching a zombie movie in which half of the people can't see the zombies and keep demanding to know what the fuss is about,” says epidemiologist William Hanage of the Harvard T.H. Chan School of Public Health. Politicians and some physicians began to promote drugs without evidence. The White House flouted epidemiologists' advice about face masks and SARS-CoV-2's propensity to spread in clusters indoors—and itself became the site of a superspreading event.

Scientists, not the virus, became the enemy for some. Top virologists needed police protection. Many other researchers reported threats and harassment, with women often subjected to the worst of it. “I used to think it only took brains, but now you need to be brave and courageous as well to do science,” Mike Ryan, executive director of WHO's Health Emergencies Programme, said during a November press conference. No wonder many scientists did not speak out.

Conspiracy theories flourished. People burned down cellphone towers, blaming them for the pandemic. Others tried to film in hospitals they said were empty. It was all planned. It was all fake. Or maybe it was both.

Scientists themselves contributed to the confusion. French microbiologist Didier Raoult touted hydroxychloroquine based on a study with few participants and no real control group. Stanford University statistician John Ioannidis, once described as “the scourge of sloppy science,” was accused of being less than rigorous himself in studies that suggested SARS-CoV-2 was not all that deadly. Three scientists with high-profile affiliations published the Great Barrington Declaration, which advocated for shielding the most vulnerable in society while letting the virus infect everyone else to build up herd immunity, a strategy most epidemiologists considered dangerously misguided.

Such episodes played into the desire for easy solutions: a cure-all pill, a disease that was less dangerous, a quick return to life before the pandemic. Some scientists may have been driven by a healthy distrust of accepted wisdom or a contrarian spirit, but the effect was reminiscent of industry's playbook in the fights over tobacco and climate change: Create just enough confusion about the evidence to allow people to carry on as before.

Science worked best when many researchers joined hands. Hundreds of small drug studies didn't result in clear answers, but two big trials—the United Kingdom's Recovery and WHO's Solidarity—convincingly relegated hydroxychloroquine and other drugs to the dustbin while showing that dexamethasone, a cheap steroid, cut deaths by one-third. Thousands of scientists signed the John Snow Memorandum, a riposte to the Great Barrington Declaration that declared the herd immunity strategy “a dangerous fallacy.” The vaccines, too, were the product of thousands of scientists and doctors working together.

In the end, science may save the day—we'll find out in the months and years ahead whether vaccines can defeat the virus. But the pandemic was a stress test for the scientific enterprise. Some cracks that had long been there, small enough to be ignored by many, widened into deep fissures.

FARRAR IS HOPEFUL that humanity will come away wiser after staring into the abyss. “I think we will look back after the horror of this and say, humanity is incredibly vulnerable,” he says. “This will inspire a whole generation to come into science.” Evidence, he says, will carry the day.

But a new crisis is coming that scientists have warned and worried about for years—one that is slower, yet even more menacing, and far easier to ignore or deny. “You know the biggest deal of this year?” Hanage asks. “When it comes to climate change we are totally screwed.”

There will be no easy scientific fix for global warming. And if this pandemic has shown anything, it is that evidence without action is like a vaccine in a freezer: It is all potential. Scientists knew deaths would follow cases as sure as thunder follows lightning. And yet politicians and ordinary citizens alike found it hard to act until morgues were overflowing. Some refused to acknowledge reality even then. How much harder will it be to act on climate change?

The upshot of this year cannot just be more research on unknown pathogens lurking in nature. It has to be an effort to revive and strengthen the bonds between science and the rest of society.

SARS-CoV-2 did not just disrupt the world. It shattered the fragile mirror we thought of as reality. Without it, we will be defenseless in the next crisis.

Correction (18 December 2020): A previous version of this story incorrectly said a study claiming SARS-CoV-2 originated in snakes was published as a preprint.

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