Why We Trust (or Mistrust) Medical Science
Throughout history, medicine has operated at the intersection of science and society. Healthcare professionals have long held privileged roles as both caregivers and trusted sources of information, propelling civilization forward with breakthroughs like antibiotics, organ transplants, and DNA sequencing.
But medical science has also had its dark moments, having been weaponized at times in service of discrimination and eugenics. The ever-evolving pursuit of knowledge has not always aligned cleanly with ethical and moral considerations. After all, the concept of objective scientific truth is complicated by our own human nature. “Following the science” is easier said than done; our decisions stem not just from facts and data, but also from our own unique values, experiences, and personal relationships
The COVID-19 pandemic is the latest stress test on public trust in medicine. If a vaccine were to emerge, how many would willingly take it? Who would receive it first in the event of a scarcity? Would immunization become mandatory in order to return to schools, places of worship, and sporting events? And how should health officials, scientists, and policymakers navigate misinformation, uncertainty, and skepticism?
The Institute for Science & Policy and the Center for Bioethics & Humanities at the University of Colorado recently co-hosted a discussion around this complex topic with Leslie Herod, Colorado State Representative (District 8); Stefanie K. Johnson, Associate Professor of Organizational Leadership and Information Analytics at CU Boulder’s Leeds School of Business; and George Sparks, President & CEO of the Denver Museum of Nature & Science. The session was hosted by Matthew Wynia, Director of the Center for Bioethics and Humanities at the University of Colorado. (Watch the full recording of the session here.)
This transcript has been lightly edited for clarity and flow.
MATTHEW WYNIA: I’m so pleased to be partnering with the Denver Museum of Nature & Science as well as the Institute for Science & Policy on this project. I’d like to jump right in and ask each participant to tell me the lens that you bring to this particular discussion, as well as if there is one thing you want to make sure we get to talk about tonight.
I'll give you my own answer to this question quickly. There is a group of people at the Center for Bioethics and Humanities who are friends of our center and who get together on a regular basis to reflect on and commemorate the tragic events of the Holocaust and the role of medicine and the theory of eugenics, which at the time was a scientific theory. This was actually where the idea for this trust in science discussion came up: in the context of saying look, some people mistrust science, but look at the history. There are reasons sometimes why people mistrust science. And how do we get an appropriate balance of skepticism and trust in the scientific enterprise? So I want to bring that as my lens to the conversation tonight.
George, do you mind kicking us off?
GEORGE SPARKS: Thanks, Matt. People who know me know that my passion is really climate change and climate science. So for the last 10 years, I've been studying this extensively. And it turns out, the science around climate is extraordinarily complicated. People spend their entire career trying to understand this, and then they discover they have to influence people to act on a worldwide basis to create policy to affect climate. So it's a double whammy as far as difficulty.
Along comes COVID, and for a while I was elated that we all seem to be working together. Dr. Fauci became the most respected man in America. Everybody accepted the science. But then slowly, as things started to devolve, the science came under more of an attack. There were a lot of communications issues I'll talk about later. And then the people part of this and the policy part also became much more difficult.
So the thing that I want you to remember tonight is that science is a journey. It is never over. Science is not immutable. You are always looking for the real answer and as Matt said earlier today, the more he learns about his field, the more he realizes he doesn't know. Science is the best that we have today. It involves models and theories and trials and then repeating the process over and over again. It turns out those are not the best characteristics for influencing people and influencing public policy. They want certainty, especially when it's an existential threat like COVID. We started the Institute for Science & Policy to help people understand what science is, that it's the best we have at the time, and how can we use science to influence and create better public policy.
MW: Stefanie, how about you?
STEFANIE K. JOHNSON: My PhD and background is in psychology, and so the lens that I view this through is how we make decisions and how biases and emotions impact what we feel are really logical decisions. And the thing I would want people to take away today is that although we are generally bad at making decisions and letting emotions impact the way we think and act, it's even harder to make good decisions when you're under this extreme stress that we're all experiencing together from COVID. And so I think it becomes even more important to really scrutinize the way we're viewing the world and try to make the best decisions possible based on science.
MW: Representative Herod, I’m sure you've got a few lenses that you could bring to this, so what how do you think about this issue of trust in science and is there something you'd like to really make sure we get to cover tonight?
LESLIE HEROD: Well, first I just want to say thank you, George, for making my childhood make sense! I remember growing up, I was very into science. And then, Bill Nye ─ you might know him as the Science Guy ─ lied to me. All of a sudden, science had changed and I was like, what? I thought this was fact, that everything is black and white. This is very clear, but it's a lie. So I got so mad and I literally threw away my chemistry set and said I'm moving on and started reading a lot and got into history and soft sciences. Can you believe that? Literally, it's the truth.
My brother apparently made it through the lie and said that science was evolving, which I didn't really get back in the third grade. He’s actually an anesthesiologist now. So he took it the other way, the way I think you're kind of supposed to take it: that it is evolving and that there's so much more to learn. There is a place for exploration in the sciences, which I have grown to appreciate and love so much more.
But the lens that I bring is that I'm the first African American queer person to hold office in Colorado, so my life is intersectional. For me, it's really about how do we keep society safe. As an elected official, that is my job. How do we ensure that we break down these health disparities that are very real within science period, and health disparities specifically in the medical sciences in COVID but also outside of COVID. What have we got to do to address this, and acknowledge that there are disparities, but also that there are differences? Those things can exist at the same time.
I come to this with somewhat of a skepticism, to be honest with you, but also a realization that we have to work with science. Officials really need science. We need scientists, we need science, we need the data. And we also need to be nimble enough to change. We need you. As a black person, it's just so important for me that we get more black people into the sciences, which is why my brother got into the health sciences specifically, but across the board. Because we are impacted too, and we're not at the table. There are disproportionate harmful and sometimes deadly consequences. So those are the lenses that I bring and it's always fun for me to be a part of these conversations because I'm definitely an outsider looking in, so I always learn so much. We need more policymakers who actually have science backgrounds or even just scientists advising us. It's so important.
MW: We’ve already touched on a few of the root causes of mistrust in science, and we've talked a little bit about the fact that science changes. And that's the way it's designed, right? It's a skeptical endeavor. The whole of science is about proving ideas wrong, more than it is about proving ideas right. And that's counterintuitive to many folks who, who assume that what people are trying to do in science is prove that something is right. But in fact, we're trying to prove each other wrong all the time. That's how people make their careers in science: by disproving someone else. So there's that. Are there other major factors that we really ought to be bearing in mind as we start this conversation? And I'm starting with this in the “seek first to understand, then to be understood” mindset. We should understand how someone might come to a point where they really miss trust the scientific enterprise.
GS: Studying climate is something that happens over decades and decades and many of us won't even live to see what the answer is, because it takes so long. But COVID has been really unique in that it's a real time existential threat. And we had an opportunity here to really give people confidence in the science. I think we made a few mistakes as we've gone through this and, frankly, I think we should have expected that the first one was around masks. Originally, we were told masks don't help and it turns out they told us that because they didn't want to have a run on PPE for medical folks. But they didn't really highlight that part. Later they said masks are good and finally I think most people accept that masks are good. We don't like to wear them necessarily, but we do believe that they do a good job.
And then there was this comment about asymptomatic carriers. Originally we thought they couldn't spread the disease and then the World Health Organization came out and said, oh yes they can. Then about 12 hours later they came back and said, well we don't really know for sure. And so this uncertainty in the back and forth, as we learn more literally by the day, really does give people some concern. The final one was around wearing masks in large crowds. When the protests were happening around the murder of George Floyd, you didn't hear a lot about protesters not wearing masks, but as soon as the President had a rally down in Tulsa, that was the main topic of conversation. At that point, it became a political issue, not just a scientific issue, so I think the way we communicated it was at best inartful.
MW: Stefanie, do you want to jump in here because you know I had an earlier conversation about some of the sort of psychological tricks that your mind could play, especially when you're in a circumstance of stress or fear. Does that come into play in terms of people's ability or willingness or capacity to absorb new information and change behavior as a result?
SJ: I like the tie that George made to Representative Herod’s story of Bill Nye. I think that some of what we're seeing is people feel like, if you lied to me then, how do I know you're not lying to me now? He told me not to wear a mask, now you are telling me wear a mask. Which one should I believe? So I think there's some of that going on in the politicized nature of this conversation. It's also just that our emotions affect our behavior. We're stressed out and scared.
And then there's this real desire for people to be consistent. I know I feel this way. I'm like okay, I am going to be totally locked down and I won't leave my house and I won't go to the grocery store. I'm going to do all of these things. I want to be extremely safe. But then I'm a CU professor and the students are coming back, so I'm like, well, if I'm going to go to campus and teach students then maybe I could also go to the grocery store and maybe it's not so bad to go on a driving vacation or whatever it might be. I feel like I see that a lot where people swing from being the extreme safest to the idea that if it's safe for kids to go back to school, isn't it safe for me to go to the mall or whatever. If my job requires me to come into the office, it must be safe enough for me to do these other things. It's hard to for us to really understand the relative risks of different activities.
MW: Representative Herod, there are a fair number of studies suggesting that certain minority communities ─ in particular, the Black community ─ have historical as well as contemporary reasons for having some level of mistrust in medical science and in particular, experimental science. I wonder if you would say a word about that and whether you think that is playing out in any way during the COVID pandemic.
LH: It is most certainly playing out, and I'm glad you asked that question because we have to address it. you know, our interventions when we're trying to deal with the disparities that exist around COVID. We have to acknowledge the fact that black folks have had a very complicated history of science. It’s very real that our bodies have been used as test tubes and violated in so many ways since we came over in the slave ships. We’ve been tested on and all of a sudden, no tests were done on us, and we don't know if medication has the same effects on us. So then we hear that certain medications have a worse effect on us. It was so race based and harmful for black folks and then all of a sudden it became, we need to be colorblind as scientists and that is completely inaccurate
Now we're in this place where we've actually started to break down some of the colorblind policies and say no, we have to have a racial equity lens on health and science because otherwise we're not going to be effective. And so when we're talking about COVID, I have very tough conversations with people in my community who say, what's the point? No one's talking about that because of the way that black folks are perceived in society. They go to the doctor but our pain is not seen as real or as valid as a white person's pain. We see black people dying at home from COVID in much larger numbers, because they weren't admitted to the hospital in the first place.
CU is doing some really interesting things and ensuring that if you are sent home, there's actually some type of aftercare that we could monitor to make sure that we are filtering out for disparities and bringing people in when they're feeling pain. But these things are all very real. And what I really appreciated in this moment is that medical institutions and scientists and scientists are looking at this and saying we have to have a racial equity lens on this stuff now. We have to. That wasn't happening even two years ago. I'm really appreciative of that. But it is very real and the interventions in our communities look different. It’s important that we acknowledge it directly and that we bring diverse voices to the table when we're designing interventions.
MW: Following up on that with maybe a little bit of a controversial question, but it makes very good sense to me that you might tailor a message to a given audience with respect to the history of the experiences that they bring to the issue. And yet, one of the standards or teachings in terms of public communication and risk communication is that your message should be consistent. I'm wondering if you ever have to balance that in your political work. The extent to which you tailor a message to a given audience and the balancing act of making sure that your message is consistent and follows the same track all the time. Is that is that ever an issue?
LH: Absolutely. It is an issue and I think some people do it well. And some people don't. The core thing is to be authentic in everything that you do, no matter what. Even if your message comes out differently, the core of it has to be the same. At the core of wearing masks ─ even though I'm having a very different conversation with the black community about it ─ is science, and is, you know, helping to contain the spread and to take care of our friends, families and neighbors. Period. Take care of each other. And so that core value is very much the same, but how the message is delivered just looks a little bit different. That's just real. That's meeting people where they are, something that we try to do as politicians. It's something that I think people try to do in science sometimes not as well. We've got to meet folks where they are and if that means it comes across a little differently in your initial approach, it doesn't mean that the core value and the core message has to change.
MW: Stefanie, could you also weigh in on this because I know we wanted to talk a little bit about risk communication and strategies for talking about things that are evolving and uncertain. Are there best practices around this that you could that you could articulate in terms of public communication or, for that matter, communication with friends, neighbors, Facebook friends? Tell us if there's a trick for talking to someone who seems to have moved from appropriate skepticism all the way into sort of science denial, where it feels like no matter what you bring to the table, they're not going to be able to see it because of the worldview that they've adopted.
SJ: Yeah, there's so much here. First I want to echo some of what Representative Herod said. I think it's super important that we have diverse voices communicating this message, because if you think about trust, how can you trust a group of people who don't look anything like you when there's a historical legacy of them not having your best interest at heart? I think that's something that we're not doing a great job of in this specific situation and many others.
It's so hard for science people to communicate things like, ‘we have a 95% confidence in the reliability of this task’ and what that really means to people. So I think because we don't always translate that really well, people look to other sources of data. Maybe it's anecdotes. The plural of anecdote is not data. So if three people told you that they went in the pool and didn't get COVID, that doesn't mean that it's safe to go in the pool. But that's easier for people to get their head around than, you know, one study showed this and one study showed something else. We may not know the quality of those studies or where they're published or know what it means to go through peer review.
So I think it all becomes super complicated, and some of this is understanding sources. We should be looking for consensus in reports. There's so much information that comes out, some of the onus is upon the scientists to communicate this and some of it is of course on policymakers, and the media who's often really looking for the most interesting headline rather than the best representation of science.
MW: Media is supposed to be the intermediary, they're supposed to bring this complex information in a way that is understandable. One of the things that we mentioned earlier and I want to come back to, George, as we as we turn it back to you, is the notion of confirmation bias and people seeking out information that will reconfirm beliefs that they already have or attempting to discount information that disconfirms their prior belief. All of us are prone to this, it's a human thing that we seek to confirm the things that we believe. How do you think about that as a science communicator and as an educator? How do you think about bringing someone new information that they may not want to help people essentially through a process of learning something that they didn't want to learn to begin with? Are there tricks of the trade for your work as a public communicator about science, helping people get past the confirmation bias problem?
GS: Well, we'd prefer you not call them the tricks of the trade! But I understand what you're saying there. Before we get there, I would like to comment briefly that today, Moderna (the company making a COVID vaccine) found out that they're behind because they haven't been able to enroll enough African Americans and Latinos in the study. And what that means is the study is going to be delayed for everybody. I would suspect part of it is that those communities don't trust the scientists that are doing the study, so it hurts everyone, not just the communities directly involved.
So, talking about how you influence somebody, I have this saying that life is about relationships. It turns out that you can always get down to the relationships. Everything I talked about with the science being complicated ─ it always comes down to the people you trust. You trust people and you trust institutions. Nobody is convinced because of data. As scientists, we like to say that if you just knew what I knew, the policy is self-evident. And that is absolutely not the case. We tend to just pepper people with data, data and more data and it has absolutely no effect on people. If you want to have an effect on people to change their mind about something, you have to develop a relationship with them and gently guide them through a process of understanding. All of it based on trust.
Now I would ask everybody on this call: I want you to write down the last time you changed your mind on anything substantial. We could probably sit here for the next hour and half and none of us might have come up with a single thing that we can remember that we changed our mind. Now, I can come up with one and that was around plastic bags and King Soopers. I could show you how much volume the plastic bags were going to consume, etc. But my staff and my family gently took me over the last several years to now I'm okay if we don't get a plastic bag at King Soopers. And that was a long journey for me on something that's relatively trivial in my life. Can you imagine what it's like to try to convince somebody of something around medical science that’s going to affect them directly?
SJ: That's such a funny example, George, because now plastic bags are back! I want to chime in here a little bit too. And I fully agree that the numbers don't matter. I feel like there's a real value in pairing numbers with stories that really support the data. Because our views are formed based on emotions. Science shows that the best way to change those views is through emotion.
To the point of confirmation bias, just think about where you go for news. If I'm super liberal, am I looking at Fox News, which is a more conservative news outlet? If I'm super conservative, do I spend all my time watching CNN? Probably not. If you look at our communities and things like Facebook and Twitter, your friends are probably people who think a lot like you, and then not surprisingly, they post information that's going to be consistent with your beliefs, and then you eat it up. In fact, when people don't believe consistently with you, we delete them. I feel like particularly with social media, it’s this echo chamber. We're just surrounding ourselves more and more with confirmation bias with what we read, who we interact with, and where we get the information. It's super easy to forget the information or discount what's not consistent with our already formed beliefs.
MW: I want to come back to this in a second because I want to talk a little bit about politics and politicization. But first, one of the questions that just popped up in the chat is around the role of money in the mistrust of medical science. I wonder if any of you would like to comment on whether that is playing a major role, a modest role, a small role, or no role at all. I certainly know that in the anti vaccination movement, this is viewed as a big threat. You can't trust the pharmaceutical companies and you can't trust anyone who works with them, including all the scientists, or the CDC, because they all have a financial interest in this in this endeavor. And I wonder if that's a playing a role as well in some of the anti-mask movement.
LH: I'm not seeing it in the anti mask movement as much, at least not from my perspective, although you might have other thoughts around that. But I do think that there is a very clear idea that people hold that money has a lot to do with our scientific recommendations. Again I'm going back to my Schoolhouse Rock days. The food pyramid that we learned as a young people - what we're supposed to eat and why and it's good for you. It was because of money to an industry. It's because we wanted to provide more money to ranchers, farmers, and all of that. That's real. There is money in these recommendations, especially as they intersect with policy and politics.
Also this year, I read a bill to expand access to HIV medications that honestly we could have had a long time ago. It took much longer for folks to even acknowledge that it was something that wasn't just killing gay people because they were evil. Now here we are today still breaking down some of those biases within policy making. But there is that layer of what we were investing in before and then what we're investing now. So now you have the left ─ and I'm sorry to make this a left/right thing and I'll try not to ─ but you do have folks on the far left saying don't take any of these drugs because the pharmaceuticals are really just trying to make profit off of you. So we wanted the drugs. But no, look, we have the drugs! We don't trust them, and money is a big part of that because we see the threads and then it's hard to say okay, now this is good for you, even though we know money still has an impact.
That being said, I don't see a lot of ways that we could not have money influence the process. A lot of times, money sets the priorities, and that is something I think we can really work on and shift. But you will not have a research scientist at CU without some money, you know, and so it is a balance. And it's not just an American phenomenon, it's definitely global.
GS: Let me jump in here real quick because I think we're seeing with COVID this balance between the economy and public health. That's really about money. All these businesses going out of business. And I saw a study here in the last day or so that suggests that because kids aren't going to school it estimated how much lower lifetime earnings they'll have because they missed these last six months of school. Somewhere between $6,000 and $100,000 over their lifetime because they're less well educated than they would have been otherwise. So I think in many cases, it does come back to money. Maybe not big money, but the money and resources to each of us individually.
MW: Yeah. The irony there, of course, is that had we really done the job that many other countries around the world did in managing the pandemic early on, we might have an economy that is much more recovered right now.
LH: And George, that's such a good point. We definitely heard that a lot in politics and we still do. Like, ‘is Governor Polis trying to save lives or save businesses,’ right? It's this position, which we can talk about forever. But that is what people are hearing and it seems like such a clear enemy and clear target is money in science, money in politics. Money seems like the clear common enemy, when really it's so much more complicated than that.
MW: We talked a little bit earlier today, George, about the huge push to produce a vaccine in a very short period of time and the amount of resources, not just in the US but in China. We compared it to the Manhattan Project, except it's much bigger because there's a Manhattan Project happening in China right now. And there's a Manhattan Project happening in Germany and throughout the EU. We've had projects happening in the US, five of them really, because there's five major vaccine candidates that are that are moving forward out of something like 30 candidates altogether.
I come back again to the data that we've seen recently about this trust of a potential vaccine. I don't know if others heard the NPR story the other day, but more than 50% of people that say they would not take a vaccine if it came out tomorrow for COVID. And that's obviously a lot higher number than people who normally say they wouldn't take a vaccine. Normally, the vast majority of people actually do agree that vaccines are safe and effective and worth it. But for this particular vaccine, the number of people who've expressed cynicism about it is quite high.
SJ: There was study in this week’s Bloomberg about that economic disparity and persons from lower incomes are even less likely to want to take the vaccine and people in rural areas, feel the same. And I guess it doesn't feel terribly surprising to me when some of the same people have been asked to go into work and we've communicated very clearly how much we value their health by saying nope you're going to work or you've got to go in to the office. Now we're going to offer a vaccine. If you make it free, you're almost saying we want you guys to try it. If you charge a ton for it, I think that you'd have the opposite response of like only the ones we want can get the vaccine. But I think when you're consistently given the message that we don't value you as much, you don't have access to the same healthcare, you don't have the same access to education for your kids, of course you wouldn't feel safe.
MW: I sometimes wonder though if it's easier to say you would not take a vaccine in a survey than in real life after you've watched all the Denver Broncos line up to get the vaccine. And you've watched all the Nuggets get the vaccine, and you're wondering what it is. And all the doctors and nurses are going to get the vaccine early on. And by the time it gets to the general public, I'm a little skeptical of the data that says everyone's going to turn it down until it gets to the general public. It's conceivable that people will say: How come it took so long to get us?
LH: And I think that we just have to keep pushing with what we know is right, at least at the time. So, I would be happy to see those folks get the vaccines first and obviously not have those adverse effects and then to move into the community. But I’ve got to tell you that in my community, we were like no way we're going to be first. We've been there done that. Our history just makes it even worse, because people aren't even learning about the studies and all of that in school anymore and then they hear about it later on and it's like, whoa, they're trying to go back to studying us and doing all these tests.
As an elected official and as a leader in the community in which some folks see the Broncos as leaders, we do need to go get those vaccines and show folks in our communities that we are healthy and safe, and then just know that it will take it will take a certain amount of time before we are vaccinated to a level where we can feel might be and go back to business as usual.
MW: George Do you want to weigh in on this before I go back to the politicization issue that I wanted to ask about Representative Herod about?
GS: I think this is going to be the next big controversy like masks and we're going to have to figure this out. If we go through all of this, spend all this money on great vaccines, and then we can't convince people to take it, shame on us. That's just poor leadership up and down the line, all around the world. So my best wishes to Representative Herod and to Governor Polis because I think this is going to be a big one. And Colorado has done really well in leading this state through this and I'm hoping that we can be an example for vaccines as well.
MW: Representative Herod, I want to turn to the politicization of science. And I'm thinking about a recent Pew Research study. They asked people, do you trust doctors and do you trust scientists? They've done this study year after year after year for many years and in fact from 2019 to 2020, trust in doctors went up. And in the few months after the pandemic began, these numbers were actually rising, but only among Democrats. Republicans have stayed at the same level of trust, which is, by the way, not a terrible level of trust, but it's not as high.
As a Democrat, and at risk of being, diving into partisan issues, is there something about progressive politics which is accepting of the ideals of science (the idea that things change and evolve and improve) and a conservative mindset, which might like preserving the status quo and not being too enthusiastic about changing things and maybe even going back to a prior status quo that you liked better than the one today? Is there something about that mindset difference, or are we really just talking about the political personalities that happened to be in office right now. And in fact, conservatives Republicans can be just as enthusiastic about scientific advances as Democrats and it's really sort of a personality thing that we're seeing right now?
LH: Oh, I could say so many things that would get you all in so much trouble! But I won't, and I don't want any new Twitter trolls. Let's see how I should put this. It is a leadership issue. It is 100% a leadership issue. The White House has determined to muddle science in a way that was completely is completely unnecessary and harmful. It is not a partisan issue, it is a leadership issue. You have conservative countries taking this much more seriously, putting in place policies that keep their community safe and ensure a quickness with recovery. And you don't see the politicization happening as much. It's real. And they have leaders who are saying it is real and it's deadly and it's not just the flu.
It almost feels intentional within our country. And I think it's negligent and it's dangerous. So, I hope I was at least a little bit nonpartisan on that because I honestly, I don't think it's about conservative and liberal and I don't think it's about Democratic and Republican. I do think it is about leadership and the lack of leadership when it comes to COVID and science.
MW: Stefanie, I wonder if you want to comment on that because we had a little bit of an earlier conversation and you know the numbers on this. Most people, in fact, do trust the scientists and trust the research enterprise by and large, setting aside the specifics of a vaccine that many people apparently see as being rushed into production. So are we making too much of this? And are we responding essentially to a vocal minority who are dedicated anti-science folks? (We probably should have started with this question!)
SJ: I mean, there's still people in in the U.S. who think this is all just a conspiracy, that there is no COVID and they're throwing COVID parties and taking bets on if someone here has it or how many people are going to get sick. There’s lots of people who won't wear masks or consider one, even in Colorado where we're doing a good job. I see on the morning news fights in stores because someone's walking in without a mask and another person's telling them you have to and they're like, it's free country.
So I feel like it's a huge issue, and talking about the vaccine: a good vaccine is 70% effective, and maybe 90% is what we're shooting for. But that's when everyone takes it. If only 57% of people take it, then you're still going to get a ton of community spread because of the vaccine will not be 100% perfect. I don't want to be negative, but I feel like this is a huge issue that we need to be going into communities with and helping educate people on how important this is. Someone wrote in the chat that Boulder, where I live, is among the least vaccinated counties in the country. I don't believe it is totally a conservative/liberal issue, but it is a real public health issue.
MW: Representative Herod, do you want to comment on that?
LH: Yeah, Stefanie, I agree with all the stuff that you brought up completely. Nail on the head. But the other thing that I forgot to mention is being at the Capitol right and watching this every single day unfold. There was this very odd and interesting convergence of the anti vaxxers and the open government people. And that really expanded in the anti vaxxer movement and was not all Republicans. They weren't all conservative. It became this coalition of folks who are really just anti- and can almost skew to the conspiracy theorist side. We have seen that increase a lot.
The other thing that I wonder, and I'm just going to throw this out there, because I don't know the answer to it, but Stefanie, you said the vaccine is not going to be perfect. Well no, there you go: there's someone saying that it's not going to work. You know what I mean? But it's this American exceptionalism to be like, okay, it's going to work 99% of the time, not that one. So then I could just be the one who doesn't get the vaccine and I'm fine. It’s this exceptionalism that we have, that we are so perfect in some ways that we are not even going to be affected by this “fake virus” going around. I wonder if there's something in our core values that we are going to have to address with messaging because it popped in my head like oh no, I'm going to have to hear about this one. Because it won't be perfect. That really does sit with us very differently.
SJ: I'm sorry for saying that now!
LH: But we shouldn’t be untruthful!
SJ: Like someone else said in the chat, I would have more trust in scientists who admit this isn't going to be 100% effective. There may be some side effects, just like there are with any vaccine or medication that you take, and there is the risk that something could happen to you. Those are such smaller risks than the massive risk of people getting COVID and the impact it's having on the economy. I guess I will be first in line to take it.
MW: The vaccine might be about 50% effective. That's what is required in order for it to be approved: a 50% reduction in likelihood of contracting illness if you're exposed, which by the way is not nothing. So it's worth approving that vaccine, probably. But those are the numbers we're very likely to see, something around 50% effectiveness, which is about what the flu vaccine typically runs.
George, help us wrap up by telling us if there are things that people in the audience tonight should be doing and I'm going to assume that we've got informed laypeople in the audience, but clinicians who are in the healthcare system who are medical scientists. So I guess I'd like you to speak to both of them and what are the things that the medical scientists and clinicians should be doing to ensure the trustworthiness of the science research enterprise? And on the patient side, what is it that the public should do to ensure that they are skeptical when they should be skeptical and seeking out information when they should be seeking out information, but not being so skeptical as to be in science denial or to not be able to trust, when there really is strong consensus around what is the right thing to do and why.
GS: If the basis of all of this can be solved by a higher level of trust, I think each one of us plays a part. My wife is a surgeon and I asked her this morning: How much training did you have on how to develop trust of your patients in you and in your practice? And she said, zero. She didn't receive a single minute of training in her 20-some years of medical practice and school on how to do that. So I think that people in the industry should listen more and listen with empathy. Almost all of us are at least semi rational human beings. We all have self-interests and values which are times in conflict with things, but if you can, if you're in the medical field, listen to your patients with a little more empathy. I think that would help on the other side.
You and I had a discussion today about whether Twitter is a good source of information. A well curated Twitter feed is a fabulous source of information if you get experts, you get great organizations, and you follow them. It's the best there is. Most of my climate knowledge comes through Twitter through the scientists who publish papers and they'll publish your paper and then it will be on Twitter that afternoon. But if you just accept anybody and don't curate your feed, you have a problem.
The final thing I would say is to come back to what Stefanie said about the collective good. But I believe every single one of us plays a part in it. And if today we can accept each other- gosh, you don't want to wear a mask - I understand that. Tell me why not, etc. I choose to wear one, great, we're in dialogue. We're listening. I think we're trying the best you can just to get by and make it through this. This is the time when we need to exhibit a little more grace to each other all across the board. If we do that, we can take down the level of rhetoric, create a little more trust across the board, and we'll get through this just fine.
MW: Well, thank you, all three of you, for joining us tonight and for this really terrific conversation.
Associate Professor of Organizational Leadership and Information Analytics at CU Boulder’s Leeds School of Business
Director of the Center for Bioethics and Humanities at the University of Colorado Anschutz Medical Campus.
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