Chaos emerges in journals as they loosen standards for papers on COVID-19

Ibuprofen went from recommended to discouraged, based on a Lancet paper that expresses due uncertainty.

Representational Image | Commons

What scientists know about Covid-19 is changing fast. And people — from the public to politicians to the press — are confusing the possible with the probable. It’s causing a lot of undue guilt and fear. In times like these, we turn to experts — but what are we supposed to think when the experts themselves are so uncertain?
We’re faced with a torrent of new data, much of which is noise, but the pace of genuine scientific understanding can only go so fast. Journals have loosened their standard for papers on Covid-19 to help scientists share information. But not every new finding is going to hold up.

One respected group thought they had evidence the novel coronavirus had mutated into two strains, one more dangerous than the other. Other scientists re-examined the data and disagreed, showing how the original research over-interpreted the data. This kind of thing happens, but the original finding got instant, undeserved press.

Journalists are under pressure to get stories out faster, which means reporting on these flimsier journal articles with little or no context or cross checks by outside experts. And with the best experts becoming more in demand and harder to reach, some are lowering their standards for what constitutes a relevant expert. Just being a doctor, in any field, now qualifies people to talk about Covid-19 on television, but it shouldn’t.

“People are grasping at straws,” says virologist David Sanders, who has some experience with public straw-grasping: He’s done lab experiments on the antiviral potential of the malaria drug chloroquine — now itself a big news item because president Trump told Americans it would be a “game changer” in the fight against Covid-19. The reality is a big question mark. “We’re talking about one unpublished trial in France with 26 patients… and the President of the United States starts talking about it… That’s insane.” Nonetheless, some drugmakers are planning to ramp up production.

People understandably crave certainty, and so admitting something is not known, or is plausible but unlikely, won’t get as many clicks as a story that promises answers. That sets up a bad selection process in which the public hears from the most confident experts over the most competent. Those who couch things in uncertainty get misinterpreted. “If we tell people x, they will report x squared,” said Sanders.

For instance, will ibuprofen interfere with the body’s natural immune response to Covid-19, or help tamp patients fight it? This is still unknown. Ibuprofen went from recommended to discouraged, but this new recommendation is based on a Lancet paper that expresses due uncertainty. Sanders explains that the confusion stems from a longstanding debate about such drugs, which work by suppressing inflammation. Chronic inflammation in diseases such as rheumatoid arthritis are debilitating, but inflammation during an infection is part of the body’s so-called innate immune response. As I learned from Yale University immunologist Akiko Iwasaki, the innate immune system is what keeps you alive in the days it takes your body to create antibodies to a novel virus. Could it cause more harm than good? Maybe.

The Federation of American Scientists, a 75-year-old nonprofit think tank, has stepped into the information gap, gathering relevant experts to field questions from the public. When I first heard about it through a physicist friend, I suggested he ask them how long we’re likely to have to keep up with our currently rather drastic social distancing measures. The future of the world economy hinges on this, as does the mental health of millions of people.

I asked this not because I thought they had the answer, but because I wanted to see how they handled the fact that nobody knows the answer to this one. The answer they sent was indeed a wordier version of the admission that we have no idea.

FAS president Ali Nouri says the “ask a scientist” effort comes out of their earlier attempts to handle misinformation — much of which came from the newly looser standards of science communication. Nouri told me the anti-disinformation project led to the creation of a database of good information, and then the question-answering service which could get the good information to people on demand. The answerers are volunteers made up of experts in epidemiology and infectious diseases.

Some questions are easy enough, he says. One person wanted to know how long she should keep produce in the refrigerator before it was safe from viral contamination. The answer is the tried and true: Better to wash it thoroughly than to try to wait out the virus.

“There are times when we have definitive answers, but science works in a probabilistic realm,” he says.

This applies to good as well as bad news, like the paper showing the virus clings to surfaces for several days. The virus will be down to very low levels by then, Sanders says, so it’s much more probable to get infected from something a person touched recently, and very unlikely you’ll pick it up from something touched or coughed near days ago.

Models showing how fast the virus might spread are getting much press, but many, he says, are done hastily without incorporating the known physics, chemistry and biology of virus transmission and replication. Reports of the number of cases can be alarming, but they, too, don’t give the full picture, since only a tiny fraction of Americans, even sick ones, have been able to get a test for Covid-19.

The pace of data acquisition has accelerated, but the ability to disseminate information is still much faster; we can share false certainty faster than we can create useful knowledge.

Encouraging more scientific work is smart. Grasping at straws is wasted energy.

What we do know from data gathered during this pandemic, and a broader understanding of the way coronaviruses spread, is that staying six feet from other people will reduce rate of spread to those likely to need scarce hospital beds. And wash your hands before and after going to the supermarket or public place. Too bad the most important facts are not very exciting. By their very nature they are not likely to change. -Bloomberg