Leading epidemiologists come together to discuss how COVID-19 has changed the meaning and process of science in this lecture presented by South Africa’s National Research Foundation (NRF) and the Embassy of Sweden.
Publication title: Virtual nobel inspired lecture the meaning of science in the age of covid-19
Author(s): South Africa’s National Research Foundation and the Sweden Embassy in Pretoria
Publication date: 8 October 2020
What the lecture is about:
This panel discussion pays a closer look at the effects the COVID-19 pandemic has had on science and society. It features a discussion between renowned epidemiologists Salim Abdool Karim, co-chair of the South African COVID-19 Ministerial Advisory Committee, and Anders Tegnell, Sweden’s state epidemiologist. The lecture continues the annual partnership between South Africa’s National Research Foundation (NRF) and the Sweden Embassy in Pretoria where prominent researchers give a lecture in the style of the Nobel Laureates in Stockholm, Sweden.
Key take-aways from the lecture:
The process of science:
- The pandemic changed how interventions are implemented.
- Prior to the pandemic time would be spent unravelling the particular ways a disease spreads. Evidence about how to prevent it would be poured over and scrutinised. Intervention programmes would then be conceptualised and piloted. These programmes would then be implemented to early adopters.
- The pressing nature of the virus has required a more agile policy and intervention process. Governments, scientists and healthcare systems need to respond to ever changing variables, quickly.
- South Africa’s response:
- South Africa recorded its first case of COVID-19 in early March. The first three weeks of the epidemic saw a rapid increase in the number of cases, similar to cases reported in countries such as the UK.
- South Africa’s intervention response was quick — the government announced a state of disaster within the first weeks of the epidemic. Schools were closed, international travel and mass gatherings were restricted. Eventually, a hard lockdown was imposed which required the country to stay at home. These interventions helped slow the spread of the virus “we saw a drastic change from an epidemic doubling every two days to an epidemic doubling every 15 days,” Abdool Karim says.
- This early intervention gave South Africa time to fortify its healthcare infrastructure. “It bought us time to build our field hospitals to ensure we have adequate supplies of oxygen to ensure that we could scale up our testing to put in place all of the prevention mechanisms”.
- But hard lockdown wouldn’t be sustainable, Abdool Karim explains, particularly with the anxiety it produced in many. The preceding interventions needed to give citizens a sense of agency. “We had to move from a situation where people were anxious… to [a situation of] agency where they could now start taking control of their own lives and influencing their own risk”. This means trusting people to wear masks, keep a social distance and practice hand hygiene. This individual action then speaks to a broader collective community responsibility where individuals take these precautions for the community’s benefit. “If I put myself at risk, I’m putting my friends at risk, I’m putting my family at risk, I’m putting my community at risk.”
- Abdool Karim explains: “I am because you are. So I am safe, because you are safe, you are safe, because I’m safe and building that collective interdependence is going to be critical as we move forward in dealing with this epidemic”.
- The COVID-19 pandemic has democratised knowledge, he says. “The science is no longer confined to ivory towers, including the language and idiom of epidemiology. People have seen how that scientific evidence empowers them to be able to act and to take agency over their own lives.”
- Sweden’s response:
- As in the South African case Sweden used a combination of regulations and voluntary action.
- A ban was placed on visiting nursing homes. Secondary schools were closed and distance learning was implemented for these grades. Primary school pupils however continued in-pupil learning. Restrictions were placed on restaurants and gatherings were limited to a maximum of 50 people.
- Compliance with voluntary measures was easy to gain as Sweden has a history of trust between its citizens and institutions, Tegnell says.
- Additionally, other country policies facilitated compliance with voluntary measures — such as compensation schemes which allow workers to get paid even if they’re sick at home; this encouraged people to stay at home.
- South Africa’s response:
An influx of information:
- Research and studies about the coronavirus have increased exponentially since the beginning of the pandemic. But this growth in science isn’t always good with many questionable and inaccurate papers being published, Tegnell says.
- Scientific evidence has even been politicised, Abdool Karim said, with politicians promoting unproven treatments to further their views. Take for example, hydroxychloroquine. Continued clinical trials later determined the drug to be ineffective and possibly life threatening. “That just highlights the importance of rigour, and made us realise we need to be aware of the snake oil salesman before he flourishes when people are desperate,” Abdool Karim says. “We need to protect ourselves. And science helps us do that”.
- Another consequence of the pandemic is that it has strengthened collaboration and sharing among scientists.
- In Sweden, for example, a national database is kept and updated of people with communicable diseases. Each person is uniquely tagged with an identifier that corresponds to other national databases. This means different datasets can be combined and analysed to get more detailed information on how a communicable disease like COVID-19 affects the population.
- While Sweden’s Public Health Agency doesn’t conduct any research of its own it keeps close ties with research networks in academia, Tegnell says.
Communicating conflict and consensus in science:
- Tegnell and Abdool Karim agree that the scientific process inherently includes a process of conflict and consensus.
- In Sweden, the public understands “that science is not always yes or no, it can also be something in between,” Tegnell noted.
- “The public needs to understand that differences among scientists are not personal. It’s not conflict. It’s just the scientific process. If we didn’t have those differences of opinion, then we have a problem, because then we have groupthink,” says Abdool Karim.
- Scientists will hold differences of opinion in their interpretations of data and a level of uncertainty will always remain. As Abdool Karim puts it: “Science is about uncertainty in the midst of data, contestation of ideas, differing interpretations, and is not necessarily value free. Scientific conclusions are views, they are interpretations of evidence. And with substantial uncertainty, they are more shades of grey than there are black and white. So we take the good, we take the bad, and we take the complicated in science, mainly because it seems to be more objective for decision making than many of the alternatives.”
Monday morning coach:
- It’s important to remember the advantage hindsight provides when interpreting data, Abdool Karim cautions. “it’s not always clear to people, that when you look at data, and you have the benefit of hindsight, that you always look at the problem differently than when you did initially”. He likens this to the Monday morning coach who, come Monday morning, knows exactly what players should have done on the pitch the day before.