Before 2020, the biggest debates in science communication were often about balancing hope and hype when it came to novel discoveries. The Covid-19 pandemic introduced a new dynamic: It’s no longer just scientists disagreeing about the finer points of their field. Instead, the pandemic has substantially increased the number of non-scientists tuned in to these conversations.
Now, with a new administration promising a return to something like normalcy, what will the future of public scientific debate look like?
Megan Ranney, an emergency medicine physician and associate professor at Brown University, recently joined STAT’s podcast, “The Readout LOUD,” to discuss that issue and more. The transcript of the conversation has been lightly edited for clarity.
So, as someone doing this communicating along with your day job of actually taking care of patients, what was it like going through most of 2020?
2020 was the most unusual year I’ve ever experienced in science communication. You know, over the last decade, many of us in medicine and public health have become increasingly involved in translating our work into something that the public can relate to, whether it’s around firearm injury or around access to health care or around the opioid epidemic epidemic. We’ve become public voices talking about what we see and what the science says and sharing that with the public.
But in 2020, we weren’t just trying to share the things that we cared about. We became critical voices for the public because the public voices we normally would have trusted were so untrustworthy. It was also a moment of sprinting. It was like you woke up each morning and couldn’t believe the latest news that you were reading, whether it was, again, news from politicians or news that was coming out of the scientific community. So there was an urgency and a volume of communication that I’ve never experienced before.
And how do you see that changing now?
Arguments or internal debates that normally happen behind closed doors are happening out in public. You know, academia and science have the same political debates and the same deep disagreements that any other industry does. Normally, those occur within the pages of peer-reviewed journals and at conferences. Now they’re happening on Twitter and TikTok and in the pages of print media instead. I think it’s kind of neat that folks get to see the science get made in real time. But the worry is that it can be confusing and that these attacks can sometimes get awfully personal.
So these are preprints posted to websites like bioRxiv or medRxiv that have not gone through the peer-review process. But even Dr. Fauci cited a preprint in a White House press briefing last week when he was talking about new coronavirus variants. So what role have preprints, in particular, played through the pandemic? And do you think on the whole it’s been a positive or a negative one?
So preprints are a relatively new phenomenon in science and in medicine. They were really developed just a few years ago by a couple of physicians at Yale, Joe Ross and Harlan Krumholz, who said, you know, medicine and science should be available to the public quickly. It shouldn’t hide behind these elitist paywalls. We should be getting it out into public discourse as rapidly as possible. And I think that’s served the public in many ways very well over the past year.
As you said, Dr. Fauci himself quotes them. I had a Twitter thread just this morning where I quoted a preprint by scientists who I very much trust. But there are some dangers. By the time something gets published in a peer-reviewed journal, it has undergone multiple layers of review that give me a little bit of confidence that major flaws have been caught and fixed. When I read a preprint, I have to do so with much greater attentiveness than when I read something in a journal like The Lancet or the New England Journal of Medicine. Of course they have their flaws and have done their retractions, but I can trust them a little bit more than the unedited, unreviewed preprint. And the danger becomes some of those preprints simply are not good and then can be used or twisted by folks that want to push a certain narrative that’s not necessarily based on facts.
So there is a huge potential benefit to preprint. But as with anything else in life, we also have to recognize that there is a potential danger there that we’re going to have to figure out both as a profession but also as a society.
You mentioned scientists spent a lot of the past year combating deliberately misleading information about the virus or about vaccines. But do you think there’s a way to stop or limit the spread of outright lies without stifling the healthy debate and dissent?
I think that we’re going to see the role of scientists, physicians, and public health professionals in the public discourse hopefully continue. And that has a critical place in combating misinformation. When I would give talks about the kind of the utility of social media for physicians in the years prior to Covid, I would often make the analogy that it was like the Greek agora, right? This is the place where democracy is made. This is the place where debates happen. And if we’re not there, then we can’t have an influence on that public debate. So that’s part one.
Part two is I think that it’s on us as scientists to make sure that those debates happen in a respectful way, that we model the very behavior and nuance that we want the public and policymakers to take away from it. I think it’s on us to not let this degrade into public attacks or bullying and for us to show that we can be better people. This isn’t about chasing attention. This is about chasing the truth.
The third thing is, you know, in terms of combating that misinformation, there’s a whole field of work around combating misinformation. Many of us are doing a lot of work around this right now, around vaccine hesitancy. Education is part one, but education by itself is inadequate. We also need listening. We need community engagement and we need a multimodal communication strategy.
The last thing I’ll say is we know from our scientific research that myths and untruths, even if debunked, are likely to be remembered. And so those things that are blatantly false, just as we retract them from medical journals, similarly, there may be statements that we need to take back sometimes or limit their availability on social media.
Sometimes there’s deliberate misinformation, a black-and-white situation. But what about those gray-area issues. I just wonder, how should people trying to consume all of this information try to figure out who to trust?
I think it’s a really difficult question. And the folks with the most followers are not always the folks who are most trustworthy. I think that there are people who’ve gotten an unnecessarily bad name or an unnecessarily good name. One of the things about this pandemic is that information is coming out so quickly that it’s easy to make unintentional mistakes. And I know that I’ve made mistakes on Twitter and have either written mea culpas or have deleted the tweets that I wish that I hadn’t put out simply because we were moving too fast.
The other thing is that scientists generally don’t get trained in public communication. And so to me, this calls for a new area of focus for us, for med schools, for Ph.D. programs — that we need to teach people how to do this well and in a trustworthy way. I mean, that’s always the million-dollar question. I think trust people who provide citations, trust people who don’t attack other people. And keep your thinking hat on. Easier said than done.
You know, the Biden administration has been very vocal about making the point that its Covid policy is science-based and that it’s going to be guided by scientists. But we’ve seen over the past year that much of the country rejects the science of Covid and distrusts scientists. So do you see that changing?
I would actually reframe that. I actually don’t think most of the country rejects the science of Covid or rejects science. I think there’s about a third of the country that has bought into the misinformation that has been spread over the last year. There’s another 20 to 30 percent that aren’t really sure what they think. And I think that with good public communication and with consistent messaging as well as, again, and attention to their lived experience, to the things that worry them, to the things that motivate them, we can change that.
There is certainly an anti-elitist streak right now in the United States and really across the globe. And again, I think in some ways it’s deserved. It is on me as a scientist to hear the real concerns of teachers and staff and of parents on both sides of the debate and to think really strongly about how to translate the scientific evidence into something that makes sense for those folks on the ground. But I wouldn’t say that we’re in an anti-science moment. I think that we’re actually at a moment of tremendous potential to recapture public trust and to use science in a way that really makes people’s lives better and in a way that they can relate to.