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we all like to think we look at
scientific evidence
with cold hard objectivity putting our
own biases to one side
but this idea has been debated for many
years
scientists spend huge amounts of time
considering the question of subjectivity
when interpreting evidence in normal
times it's a cornerstone of how science
is appraised
but in these abnormal times it's that
same questioning
still happening so how healthy has our
scientific debate been
has it acknowledged what we just don't
know and has it given full weight not
just to covid
but to the consequences of covid
throughout the pandemic i have spoken to
clinicians
academics and public health doctors who
cannot speak
because their employers won't allow it
i've spoken to others who have been
disciplined for speaking publicly
and yet there are others who have
genuine expertise but are reluctant to
share their thoughts because
they're too scared the majority of us
are conducting
40 to 60 consultations every day
this is professor claire gerardo former
elected leader of the country's gps i
felt hot
i took my temperature and it was about
100 102.
talking about her own experience of
covid back in march
she was happy to publicly discuss
aspects of covert then
but is now very reluctant she says
because the debate
has become far too toxic it's very
difficult to discuss kovit
i mean clearly everybody's discussing
kobe but it's difficult
to discuss the nuances of the approach
to kobe
what you actually have to do is to
discuss debate look at options weigh up
the evidence
and then for our politicians to come to
the right decision for the right
for the right number of people but even
saying that
one gets accused of wanting to kill
people of
not wanting to save lives which is
nonsense doctor sono bhopal
is a pediatrician so i started in march
2020 thinking
okay we're going into this really severe
period where we need to throw everything
we have it covered 19
um which what needed to be done it was
absolutely the right thing to do at the
time
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but when dr bopal argued back in april
that children were at very low risk from
covert itself
but risked significant harm from covert
restrictions
he faced a furious backlash from some
accusations have been thrown at me
online which
don't know how much attention i need to
pay to them but
my number one priority throughout and
has been
about health and well-being the debate
around lockdown and shielding has been
high-profile
and toxic but it goes well beyond that
there's been significant disagreements
about issues such as
how the virus passes between us how many
of us are immune
the wisdom of mass testing how well
masks work whether we can eliminate the
virus
and that question about the closure of
schools to stop the spread
professor sam everington has been a gp
in the deprived
bromley bible area of east london for
over 30 years
i think the polarization is partly
because nobody knows the exact answer
you know what i mean and it's really
important to say that we can say
we need to be able to say in in science
you know where you are now
you know what the evidence is now but we
learn
and you need to you need to change your
approach as you go through
so there's always a level of uncertainty
and some people think that we have the
answers
to people's disease and one of the
important things i say to the patient
quite often is is i don't know
some commentators argue that the debate
has been dominated
by those who have allowed least room for
uncertainty
a footnote in a recent medical journal
editorial
provoked quite a storm in academic
circles recently
why because on the question of conflicts
of interest
it said the authors declare that all
three authors have been wrong about
covid19
in an article about how little we really
know about covid
their point was very deliberate
professor george davey smith
was one of the authors during the
pandemic i think the
acknowledgment of uncertainty in
communication
what is essentially scientific evidence
scientific knowledge
has been inadequate there's some
commentators
who say have been saying exactly the
same thing right from the beginning and
they're carrying on saying that now
whatever side of the debate there on
they're not the people that i would
aim to listen to to get useful evidence
but if the evidence is so uncertain then
why do many commentators
seem so certain remember scientists are
always human
and they will still i do think take a
position
that will not just depend on the
evidence they have in the paper they've
just written
other other their values will come into
it as well and we can see that
it's rather obvious that that's coming
to the fore not just the data
perhaps it was no surprise that
something as enormous as covid
was communicated to people in broad
strokes
has normal scientific nuance been lost
and the problem with the way
that we've communicated this partly
because it's politicized as we've tried
to come up with simplistic certainties
which have proved to be far too
simplistic and we've divided the
entire scientific community into
particular simplistic camps where
they're absolutely definite that one
course of action is right
and science just doesn't work like that
the honest answer is we really do not
know how this is going to turn out
talk to hospital doctors and many will
tell you how concerned they are about
the impact of covid
on the nhs and its ability to cope
those warnings cannot be ignored but do
we risk
not paying enough attention to other
impacts
sage have in fact modelled the impact of
the other harms
and in official press conferences they
have had some attention the idea we can
do this
without causing harm is an illusion
but it is case rates hospitalizations
and deaths
that get primary billing although
it's easy in a sense to count the deaths
from covid and count the
hospitalizations
we should be always trying to measure
the what else is going on in society in
terms of mental health
in terms of you know again life
satisfaction in terms of
abuse family breakup and so on the first
of the world health organization's
guiding principles says
health is a state of complete physical
mental
and social well-being and not merely the
absence of disease or infirmity
recent figures from the office for
national statistics
suggest that in britain things are not
looking good
this graph shows how people respond when
asked how satisfied they currently
are with their life the blue dotted line
is just pre-pandemic
we can see that the latest restrictions
have coincided
with a massive fall in life satisfaction
it's now at its lowest ever level
daisy fancord is also looking at the
impact of the pandemic
she leads the covid19 social study an
ongoing study of over 70
000 adults a lot of people are starting
to find the mental health toll of this
building up again now as we're starting
to go back into more restrictions
we found that mental health improved
over the summer but it started to take a
downwards
trajectory over the last few weeks i
think it's critical that we do talk
about
how people are experiencing this more
broadly so things like where the people
are
finding it difficult their mental health
particularly talking more about the
inequalities of this pandemic
psychologically and socially as well as
in terms of the transmission of the
virus
with governments everywhere having
finite money it is common practice to
evaluate
what spending brings maximum health
benefits
not doing so means things that should
get funding
could miss out department of health
guidelines say for every
twenty to thirty thousand pounds spent
on medical treatments
it should bring at least one year's
worth of
good health other government departments
such as the department for transport
take a different approach
they calculate that safety interventions
can broadly be valued at something in
the region of
two million pounds for the saving of a
life
but we aren't necessarily doing the same
for covid
the trade-offs that we are making need
to be made
more explicit so that we can so that we
can have informed conversations that are
not
polarized between pro and anti-lock down
that doesn't that's not helpful there's
a moral case
for examining how we use our public
resources to best effect
we're moving perhaps from a a period of
emergency response
to it to a a more an ongoing a chronic
situation of living with
the copic virus and that i think brings
in
health economics more clearly in terms
of the need to
evaluate the costs and benefits of
different courses of action
professor sam everington's experience in
tower hamlets
has led him to worry about an imbalance
in our debate
it's always about covid covet deaths
covered cases
but actually my biggest worry as a gp is
all the patients not coming forward
with early cancer heart disease so one
of the problems when you focus just on
death
and covet numbers all the time is you're
creating
mass fear actually rather than
actually taking the approaches of about
treating
people as adults for a start but also
making sure it's balanced despite there
being a range of
experts from across science who are
consulted by the government's scientific
advisory group for emergencies
some believe the focus has been too much
on medicine
and not enough on broader society there
hasn't been much diversity of thought
that the reason for that was that when
this began you have
relatively small committees interested
in a particular thing who normally don't
get much attention
interested in viruses and and the spread
of those
the group who are not included the
people who study society as a whole
and what actually matters to most
people's lives in
the realm so often with science it's
complex
nuanced and uncertain the dangling of
apparent certainty appeals because it
helps make sense of what is happening
but how well is the media being able to
grasp uncertainty
and if they haven't how is this impacted
on science
i think it must be a quite a shock for
the general public to see scientists
disagreeing
so vehemently with each other because
the traditional view of science
which i think is misguided um is that
it's a sort of monolithic body of agreed
facts
and the media is responsible for this to
a large extent by saying
scientists say and ridiculous statements
like that
but those of us you know within within
science
know that scientific communities are at
each other however in tongues
what we're finding is that the fact that
it's the most negatively associated with
mental health
is following the news on covert i think
a lot of the media headlines are focused
on covert
itself but i think that might be part of
the challenge for some people is if
they're not feeling particularly scared
about the virus itself anymore
perhaps they're more concerned about the
wider consequences the virus is having
for their lives
then it could be that the headlines are
not speaking to people in the way they
wear at the start of this pandemic
more families are going to lose loved
ones before their time
it's now over eight months since the
start of a pandemic that has changed
everything including for science but
with increasing evidence that our
response to covid
has so many other impacts are we
allowing these to be captured
and aired i'm not quite clear where the
balance lies
between coveted 19 and
aspects of the kobe 19 response and i
think
that's a great uncertainty so what
those of us in the scientific community
in the pediatric and health community
i think need to do is feel that we are
able to raise these
concerns raise these issues be taken
seriously
each day the science around covid is
becoming clearer
but perhaps the biggest certainty of all
is how much
we still don't know