Here are two science-related pieces for today’s reading. The first, by a group of people writing in the journal Science, is a fairly concise summary of what coronavirus does to our bodies, emphasizing how much we don’t know about how it wreaks havoc on us. It’s free, so click on the screenshot to read it. Warning: if you don’t like medical details about a deadly virus and how if affects our bodies, don’t read it. But I think you should.
Beginning with the depressing statement, “. . a clear picture is elusive, as the virus acts like no pathogen humanity has ever seen,” it gets even more depressing as it lists all the organ systems the coronavirus can attack. In many cases we don’t know exactly how it works, though we do know that the virus hooks onto ACE2, a cell-surface receptor especially prevalent in the nasal passages, and thereby gets itself into the body. After that, it can latch onto any cell with the same receptor, inject its RNA into that cell, and make more copies of itself.
Much of what happens then is mysterious. The famous “cytokine storm” caused by some viruses, in which the body’s immune system overreacts, possibly severely damaging many organ systems, has been frequently mentioned as a cause of COVID-19 mortality. But, as the authors note, there’s doubt about even this.
But there’s no doubt that the damage to the body extends far beyond the lower respiratory tract. Here are some other areas liable to failure or destruction:
- damage to the heart and blood vessels, including production of blood clots
- kidney failure: why dialysis machines may be as important as respirators
- damage to the brain and possibly the central nervous system
- damage to the lower gastrointestinal tract (diarrhea is a common symptom). This raises the frightening possibility of viral transmission via fecal contamination, though there’s no evidence for this and the probability seems low.
- liver damage
- inflammation of the eye (conjunctivitis)
Understanding the various ways the virus damages the body will be immensely useful in palliative care and in the design of medicine. But of course a successful vaccine, which requires only using part of the virus’s protein coat to activate the immune system, requires little knowledge of what the virus does to the body. All it requires is knowing what part of the viral proteins can provoke an antibody reaction that can successfully immunize one against future infections. But, depressingly, an effective vaccine might be impossible to design, and even a good one may be countered by mutations in the virus.
After you’ve read that bit, buck yourself up by reading a Guardian paean to science by Jim Al-Khalili, a physicist best known in the UK as a writer of popular science (click on the screenshot):
Although you might be put off, as I was, by Al-Khalili’s first sentence (“As a regular Twitter user, I choose the people and organisations I follow online carefully”), do persist. You may already know these lessons about how science works (I cover them in Faith Versus Fact), but you can always send the piece to your conspiracy-minded friends who think that the Chinese government designed the virus as a bioweapon.
A few excerpts. The first is a pet peeve of mine: the “expertise” of non experts. I, no expert either, have stopped discussing the best way to attack this pandemic, or even how to protect myself against it—save staying away from people and keeping my hands clean:
During the coronavirus crisis, everyone online seems to have a “scientific” opinion. We are all discussing modelling, exponential curves, infection rates and antibody tests; suddenly, we’re all experts on epidemiology, immunology and virology. When the public hears that new scientific evidence has informed a sudden change in government policy, the tendency is to conclude that the scientists don’t know what they’re doing, and therefore can’t be trusted. It doesn’t help that politicians are remarkably bad at communicating scientific information clearly and transparently, while journalists are often more adept at asking questions of politicians than they are of scientists.
Remember when Trump mentioned antibiotics in connection with the virus, apparently unaware of the fact that antibiotics attack bacteria, not viruses? But al-Khalili’s point is to draw a distinction between the doubt and questioning inherent in science and the unwarranted certainty expressed by conspiracy theorists (and, of course, by religionists, who claim to be “immunized by Jesus”).
A second important feature of the scientific method is valuing doubt over certainty. . .
This approach still informs how we do science today. Indeed, this is how the scientific method differs from the stance of conspiracy theorists. Conspiracists will argue that, like scientists, they too are sceptics who question everything and value the importance of evidence. But in science, while we can be confident that our theories and descriptions of the world are correct, we can never be completely certain. After all, if an observation or new experimental result comes along and conflicts with an existing theory, we have to abandon our old presuppositions. In a very real sense, conspiracy theorists are the polar opposite of scientists; they assimilate evidence that contradicts their core beliefs, and interpret this evidence in a way that confirms, rather than repudiates, these beliefs.
Often, in the case of such ideological beliefs, we hear the term “cognitive dissonance”, whereby someone feels genuine mental discomfort when confronted with evidence that contradicts a view they hold. This can work to reinforce pre-existing beliefs. Ask a conspiracy theorist this: what would it take for them to change their minds? Their answer, because they are so utterly committed to their view, is likely to be that nothing would. In science, however, we learn to admit our mistakes and to change our minds to account for new evidence about the world.
This is crucial in the current pandemic. Clearly, the world cannot wait to learn everything about the virus before taking action; at the same time, stubborn adherence to a particular strategy despite new evidence to the contrary can be catastrophic. We must be prepared to shift our approach as more data is accumulated and our model predictions become more reliable. That is a strength, not a weakness of the scientific method.
This is what has apparently happened with hydroxychloroquine, touted by some (including Trump) as a panacea. Tests are showing that it’s almost certainly not that useful, and may even be harmful—one reason that you must do double-blind studies to have good confidence in a new drug.
Al-Khalili’s final paragraph:
I have spent my career stressing the importance of having a scientifically literate society. I don’t mean that everyone should be well-versed in cosmology or quantum physics, or understand the difference between RNA and DNA. But we should certainly all know the difference between bacteria and viruses. Even more importantly, if we are to get through this crisis, we must all have a basic understanding of how science works – and an acknowledgement that during a crisis like this, admitting doubt, rather than pretending certainty, can be a source of strength.
Although I like the rhetoric of that ending, I’m not as certain as he that to get through this crisis, all of us must understand how science works. Yes, it would help us make sense of the confusing back-and-forth recommendations we hear on the news, but to get through an airplane flight, we needn’t know the principles of aerodynamics nor the way airplanes work. We simply must have confidence in the engineers and pilots.
Likewise, if we have trust in the doctors, scientists, and epidemiologists, we’ll get through this crisis. We needn’t know how their fields work, or even that doubt is an important part of their work. Of course, as a superannuated scientist, science lover, and popularizer of science, I would be delighted if people would understand how scientists work, at least in rough outline. And if they’ve had a decent education, they should.
But many people can’t be arsed to care about science, and in that case I’d just tell them, “Eventually the scientists and doctors will work it out. Just heed the latest advice.” And when that advice is conflicting, like about when to wear masks, play on the safe side. Or, you can heed the ubiquitous but unrealistic television advice: “Ask your doctor.” Of course you have to have a doctor who responds, and also one who’s up on the latest science.
h/t: Paul (for second piece) and several readers (for the first)