COVID: Media Must Rise Above Pitting Scientists Against Each other – Dealing With the Pandemic Requires Nuance

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Trish Greenhalgh, University of Oxford and Dominic Wilkinson, University of Oxford

At the start of the pandemic, there was a striking sense of shared resolve and solidarity. Facing a public health crisis greater than any in living memory, people were largely united in their support of difficult measures to protect the vulnerable, safeguard the health system and sustain key workers.

There were, of course, differences of opinion. For example, some disagreed about the severity of the threat posed by COVID, about the wisdom of different national approaches to lockdown, about the timing of restrictions, and the effectiveness face masks.

More recently, there has also been disagreement on how vaccines should be distributed, whether vaccine passports are a good idea, and whether vaccination should be mandatory for certain occupations)

Throughout the pandemic, scientists attempting to explain their findings have had to deal with unprecedented levels of dissent, anger and abuse from the lay public and occasionally from other scientists.

Since the government lifted COVID restrictions on July 19, views on how best to handle the pandemic have become more polarised than ever, broadly splitting into two camps: the “open up” camp and the “not yet” camp.

Two camps

The “open up” camp emphasises the UK’s successful vaccination programme (88% of adults have had one jab, 69% have had two), which has led to low rates of hospitalisation and death, the mild nature of COVID in children (only a fraction of under-18s are admitted to hospital, and almost all deaths have been in children who were already very ill with other conditions), potential waning of people’s patience with preventive restrictions, the dangers of lifting restrictions closer to winter, and the need to get back to normal for the sake of the economy.

The “not yet” camp calls attention to a different set of facts. COVID infections are rising rapidly in almost every region of the UK. Hospitalisation rates are rising and putting pressure on an overstretched NHS. Mild (non-hospitalised) COVID in children may still lead to long COVID, whose long-term outlook is unknown. And masks and physical distancing are evidence-based measures to reduce the spread of an airborne virus – measures that cause relatively minor inconvenience.

“Not yet” advocates propose delaying re-opening until everyone, including adolescents, have been offered vaccination and all possible measures have been put in place to make our schools, workplaces and public transport as safe as possible.

With the battle lines thus drawn, media interviewers have set up head-to-head encounters between the “open ups” and the “not yets”. We have been in the ring for such debates on opposite sides and found that these formats add heat but little light to public understanding.

It is time we recognised that this pandemic is a complex phenomenon unfolding in a complex system.

Complex systems

Complex systems are non-linear. In other words, small things can have large effects (the delta variant entered the UK, perhaps in just one infected person, and became dominant within weeks). And large things can have small effects (a huge, centralised test and trace system has proved inefficient and contributed little). Such dynamics make accurate prediction of the effect of interventions impossible. While scientists can estimate and speculate, none of us know for sure what will unfold.

What’s more, making decisions about the pandemic necessarily involve moral uncertainty, at both a personal and policy level. Decisions involve weighing and trading off ethical values. While we can all agree that these values are important, it can be difficult to know how and when to balance them. For example, many pandemic choices involve competition between medical risk (both to the individual and their wider contacts), equity and liberty. We can promote one or two but cannot maximise all the values at stake.

Complex systems must be handled in ways that embrace scientific and moral uncertainty. We need to observe the system, divine its patterns and key relationships, and empower people to respond to change in an agile and creative way. Above all, we need dialogue and deliberation to examine this highly complex problem from many different angles. The pragmatist philosopher John Dewey argued that only when people engage meaningfully with other people and with their ideas can we realise the potential of democracy. When we move beyond “us versus them”, we can come to better understand ourselves and be more likely to arrive at the best collective decisions.

Media hosts must rise above the catechism of both-sides journalism, which demands a superficial bare-knuckle fight between a “pro” and an “anti” voice. Instead, they should acknowledge common ground (we all want to protect our young; we all yearn to return to work and social activities) and help scientists, ethicists and others with different perspectives to work through the possibilities and trade-offs, to find common ground, to accept reasonable disagreement, to seek compromise.

For example, there are arguments both for and against giving children over 12 the COVID vaccine. Differences may be resolved partly by new data (randomised controlled trials of the benefits and harms of vaccines in this age group, or observational studies to confirm or refute the risk of long COVID), and partly by identifying sub-groups (high-risk, low-risk and low-risk but living in a household with a vulnerable person).

But the decision to vaccinate or not also requires moral deliberation on how to weigh up a putative risk to the child against a putative benefit to another household member. It also requires deliberation on how much a vaccine campaign in children would divert supplies or policy attention away from the increasingly difficult task of reaching every eligible adult that remains unvaccinated. These are issues on which the “yes” and “no” camps need to meet and talk.

None of us wanted a third (or fourth) wave. But we’re in it, and the ride will not be smooth. For the sake of our future, let’s discuss this in a way that goes beyond “oh yes it is”, “oh no it isn’t” soundbites.The Conversation

Trish Greenhalgh, Professor of Primary Care Health Sciences, University of Oxford and Dominic Wilkinson, Consultant Neonatologist and Professor of Ethics, University of Oxford

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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One Response to COVID: Media Must Rise Above Pitting Scientists Against Each other – Dealing With the Pandemic Requires Nuance

  • Alberto Giubilini says:

    I agree on this.

    However, I am a bit confused as to how Prof Greenhalgh can reconcile the views expressed here with those in the Lancet letter she signed (Mass infection is not an
    option: we must do more to protect our young, Lancet 398, 297-298) , where the signatories/authors “consider any strategy that tolerates high levels of infection to be both unethical and illogical” and “believe the government is embarking on a dangerous and unethical experiment” by lifting restrictions. And given that she thinks “the government should delay complete re-opening until everyone, including adolescents, have been offered vaccination and uptake is high, and until mitigation measures, especially adequate ventilation (through investment in CO2 monitors and air filtration devices) and spacing (eg, by reducing class sizes), are in place in schools”.

    This comes after in the letter the authors have given no consideration whatsoever to the devastating impact of lockdowns and other restrictions (in the young’s mental health, to give just one of the many possible examples, e.g. the under-20s with eating disorders admitted in hospitals over the past year topped 3,200, which is nearly 50% higher than in 2019-20), If in a letter without any ethical argument in it – but only a very partial list of some empirical facts about COVID-19 infections – the authors/signatories conclude that lifting restrictions is an ‘unethical experiment’ or that it is ‘unethical and illogical’ – how is that different from the ““oh yes it is”, “oh no it isn’t” soundbites that this post condemns? Because once that discussion is put in those terms, it would be very easy to reply that the real ‘experiment’ here has been prolonged lockdowns and other restrictions, which are unprecedented in human history and for which at the moment it is far for clear whether they are worth their benefit. Or to reply that vaccinating all children, as the letter advocates, is really a way of using children as mere means to protect the vulnerable and the public good – which would require precisely that level of nuanced ethical analysis that the Lancet letter completely overlooks?

    Because of the restrictions that that letter advocates, we are in a situation in which thousands of children are prevented from attending school and businesses struggle with shortage of staff , to the point that many of them need to close, given the indiscriminate use of contact tracing that requires healthy people to self isolate. Again, just one example among many.

    If we want the discussion to be more nuanced, it might be helpful to avoid strong and unwarranted claims like those put forward in that letter. I don’t know if being nuanced is necessarily a good thing in all situations, but if one wants to make bold claims, being nuanced at the very least requires providing arguments for one’s bold conclusions.

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