Hydroxychloroquine: “Good Science” Challenges Politicized Science

Hydroxychloroquine (HCQ), for over 60 years a familiar antimalarial drug, has fast become one of the most popular subjects in daily news surrounding the COVID-19 virus pandemic  allegedly caused by Chinese Communist mismanagement of a lab in Wuhan, China.  Like any drug, the safety and efficacy of HCQ as a treatment for a new disease, ought to be thoroughly investigated.  However, in spite of numerous favorable reports of the life-saving benefit of doctor-prescribed HCQ, many influential people including Dr. Anthony Fauci continue to oppose its use.  Are there legitimate reasons for this opposition to a potentially life-saving drug?   Or are we about to see just how many lives will be lost simply because “good science” is being ignored or silenced by selfish political and economic agendas? 

So-called “good science” has been a frequent subject of my blog writing in Oikonomia (Greek = “household management; or, stewardship”).  To me, “good science” is an inquiry into the workings of the “household of creation” by those who recognize the necessity of and abide by a faith-based ethical foundation for their pursuit of truth [See “The Conscience of Science: Part 1 Ethics & Accountability.”]  A faith-based ethic enables the scientist to see that his or her pursuit of truth is good stewardship of his or her God-given intellectual gifts.  Scientists who view their science as a stewardship are more likely to contribute in ways that promote the flourishing of God’s creation.  In so doing, they bring benefit to all mankind.  Above all, “good science” ought to be guided by honesty in its inquiry and in reporting of conclusions.

We can only hope that current debate over the safety and efficacy of hydroxychloroquine (HCQ) will be governed by “good science” and later remembered by the thousands of lives it saved.  Therefore, I am encouraged by an article authored by Dr. Harvey Risch, a Yale epidemiologist, published May 27 in the Journal of Epidemiology.  In it, Dr. Risch refutes an earlier article published in The Lancet which had caused the World Health Organization to halt trials of HCQ as a treatment for COVID-19 infections.  Dr. Risch’s critique is a classic lesson in careful scientific analysis of published results.  It also illustrates the importance of peer review in verifying scientific methodology and correct application of results.  I encourage you to read the article.

In order to provide context for this stage of the COVID-19 pandemic, Dr. Risch estimates that over 1.6 million Americans have been infected and up to 10 to 50-fold larger numbers of people carry antibodies to the virus.  In spite of “flattening the curve” through mask-wearing, social distancing, etc., Dr. Risch believes that over time

…very large numbers of people in the US may eventually get the infection.  The great majority of infected people are at low risk for progression or will manifest the infection asymptomatically. For the rest, outpatient treatment is required that prevents disease progression and hospitalization.  Exposures will occur as isolation policies are lifted and people begin to mix, even with various degrees of public isolation such as mask usage and physical separation still in place.

Dr. Risch also recognizes that, while we are averaging an estimated 10,000 COVID-19 deaths per week in the US, we are facing a greater risk of deaths due to policies that have created an unsustainable economic and social condition with over 36 million Americans out of work and disruptions in many essential services necessary to maintain our physical, emotional, and spiritual well-being.  He concludes: “We are rapidly reaching a breaking point in the ability to maintain the status quo; states have begun the process of lifting their restrictions, and we thus need to evaluate what evidence we do have for promising outpatient treatments.” 

Dr. Risch’s COVID-19 treatment recommendation may be summarized as follows (emphasis mine):

… the key to returning society toward normal functioning and to preventing huge loss of life, especially among older individuals, people with comorbidities, African Americans and Hispanics and Latinos, is a safe, effective and proactive outpatient treatment that prevents hospitalization in the first place.

Based on Dr. Risch’s analysis of the results of numerous treatments in which COVID-19 patients were given HCQ in combination with the antibiotic azithromycin (i.e. HCQ+AZ), his recommendation is as follows (emphasis mine):

HCQ+AZ has been directly studied in actual early high-risk outpatient use with all of its temporal considerations and found empirically to have sufficient epidemiologic evidence for its effective and safe employment that way, and that requiring delay of such general use until availability of additional RCT (randomized controlled trial) evidence is untenable because of the ongoing and projected continuing mortality. No studies of Covid-19 outpatient HCQ+AZ use have shown higher mortality with such use than without, cardiac arrhythmias included, thus there is no empirical downside to this combined medication use.

The strong support for the use of HCQ+AZ from Dr. Risch was accompanied by two other endorsements of its therapeutic value.  Last week, President Trump announced that he has been using a prescription of HCQ, demonstrating that he is willing to put his health on the line to support his belief in the safety and efficacy of HCQ.  Then, this week, Breitbart reported that HCQ will be administered by Britain’s National Health Service (NHS) to as many as 10,000 health workers representing up to 20 hospitals as part of a clinical trial.

In conclusion, the debate continues between those who favor and those who oppose the use of hydroxychloroquine plus azithromycin (HCQ+AZ) for early treatment of high-risk COVID-19 patients.  However, the May 27 publication of Dr. Harvey Risch’s thorough analysis as summarized here ought to make the prescription of these drugs the centerpiece of our COVID-19 treatment strategy.  

It remains to be seen which voices will have the most influence on policy makers and medical health professionals--the voices of "good science" or the voices of those with political agendas that seem to care little about either “following the science” or protecting individual lives.   Meanwhile, I am siding with the voice of “good science” and can only hope HCQ+AZ will be available to me in the event that I am infected with COVID-19 and require medical intervention.  

Bring a Speedy End to the Pandemic Shutdown

Some baby-boomers like me remember a stressful part of our childhood:  having to get a penicillin shot, or waiting in line for “the needle” for vaccinations.  I’m not sure which was worse, the anticipation or the needle prick itself.  But afterwards, my fear and pain were eased by a warm feeling that I was protected from becoming ill.  Today, the results affirm the success of antibiotics and vaccines.  The anxiety and pain were a small price for a good outcome.

But what if, in order to protect us and our nation from a mortal enemy, we were required to surrender freedoms that we hold dear?  Such a request or demand would have a much more pervasive affect on our lives than the requirement to stand in line for a vaccination? 

Our COVID-19 Conundrum – Looking Back
As you know, my “what if” became a reality on March 15 of this year—the day that 65 Coronavirus deaths were reported in the US.  On that date, Dr. Anthony Fauci and the White House Task Force instituted a 14-day “national shutdown” with “social distancing” and limitations on our coming and going.  The purpose was to “flatten the curve” of daily hospitalizations and viral infections so that hospitals would not be driven beyond capacity.  But 14 days of shutdown was gradually extended to 1 month.  By that time, many voices in the medical and epidemiological fields were questioning the wisdom of this policy.

With all due regard for any loss of life due to the Coronavirus, many of us asked whether the national shutdown was actually saving lives.  Or, was it simply flattening the curve of infections and hospitalizations and delaying inevitable exposures and infections with uncertain future consequences?   By mid-April it had caused thousands of small businesses to close, millions of people to be unemployed, delays in scheduling of medical procedures, disruption of church worship and other human social interactions, and resultant mental stresses and suicides due to social isolation. 

Because of my own personal skepticism, I began to research the science and statistics related to the COVID-19 pandemic and shutdown.  At the same time, I wanted to assess my own attitude and faith in response to the pandemic threat on my life and family.  About this time (April 17), after one month of national shutdown, the US was approaching 40,000 deaths almost half of which originated in New York state.  I wrote a blog article entitled “Considerations for Our COVID-19 Conundrum” which outlines how I was personally responding to the pandemic and shutdown.  [I believe this article still contains valuable recommendations for readers who want to maintain their “health” in body, mind, and spirit.]

One week later (April 24), I had posted another article on COVID-19, entitled  “COVID-19 Policies &  Outcomes: Learning Online.”  Here, I cited experts who were concerned that the indirect effects of social distancing and the economic shutdown were having more devastating long-term effects than the COVID-19 virus itself.  The primary goal of “flattening the curve” had been reached in most parts of the US.  So, the rationale for remaining locked down shifted to a seemingly trumped up fear based on questionable predictive models and a philosophy that we ought to remain shut down until a vaccination is developed.  Fortunately, in spite of these dire warnings, several state governors began to aggressively follow the phase-in plan offered by President Trump and the White House task force. 

It’s Time to End the Shutdown
During the next two weeks, it became more and more obvious to those who followed objective media sources that the economic, social, and even medical costs of prolonged partial lockdown were exceeding the benefits in saving of lives.  Everywhere, hospital capacity and equipment to treat COVID-19 patients were all much in excess of demand.  As I wrote in “COVID-19 Policy Ignores ‘Good Science’,” “some experts such as Dr. Dolores Cahill called the lockdown policy “anti-scientific” and “anti-nature” because it has ignored the importance of the human immune system and how we need to beef up our immunity through good nutrition and vitamins.”  [Dr. Cahill’s informed logic is featured in a video interview accessible in my article, “COVID-19 Policy Ignores ‘Good Science’.”]

Today, opposition to the lockdown from professionals is being joined by an increasing chorus of Americans who want to get back to work.  Dr. Scott Atlas, MD. and senior fellow and experienced policymaker of the Hoover Institute, argues that there is no reason not to move more quickly to reopen our society with proper precautions for the elderly and other at-risk individuals.  In his op ed article published May 18, in The Hill, Dr. Atlas wrote,

The total lockdown may have been justified at the start of this pandemic, but it must now end — smartly, without irrational, unnecessary requirements contrary to medical science, common sense and logic. The goal of the strict isolation was accomplished in the overwhelming majority of places. We have direct data on risk and extensive experience, individually and as a nation, with managing it, even as new cases arise. We know that gradually relaxing total isolation will lead to more infections, but that’s acceptable, given that we know whom to protect and this disease is not harmful to the vast majority of infected people.

What Do COVID-19 Data-by-State Suggest?
Yesterday, I devoted many hours to pouring over data from multiple sources.  I chose 15 states that represent 62% of the US population but which are responsible for approximately 85% of the COVID-19 deaths in the US to date (see Table).  The data by state is ranked according to “% Recovery” from lowest (top) to highest—i.e. the percentage of individuals who were “Reported Cases” who recovered and were not tallied in “Deaths.”  Note that Michigan currently has the lowest percent recovery at 90.5%.  All other states range above this percentage and reach as high as 98.3% recovery in Tennessee.

The 7 states that make up the upper-half of the table account for just over half (51%) of the total reported COVID-19 cases in the US to date but account for 67% of the total US deaths.   It is also noteworthy that nearly all of the 7 states in the upper half of the table have governors who have been slower in opening up their state than most of the 8 states in the lower half.  This suggests that governors who have been more aggressive in opening their state have not been unwise.  Both % recovery and mortality rates are lower in these more aggressive states.  More comments on my Data Table will come below as they relate to several claims by Dr. Atlas.

Supportive Data But Poor Communication
Dr. Atlas argues that neither policymakers nor the public have received several key messages that are both critical in alleviating public fear and valuable as a guide to safe reopening of society.  In his article Monday, in The Hill, Dr. Atlas lists four policy failures at the state level, each with scientific data from the CDC and other sources to support his claims.  The four policy failures he lists are as follows (emphasis mine):

1.  There has been a failure to remind everyone that the stated goal of the policy — total lockdown and whole-population isolation — has been accomplished in most of the United States, including the epicenter of New York.

2.  There has been a failure to reassure everyone that we fully anticipate more cases will occur, whether we test or not, with continuing relaxation of today’s isolation.

Many Americans are gripped in fear when they hear that more reported cases of COVID-19 are appearing daily with even more cases reported in some areas.   But remember, we are doing more testing—more testing means more reported cases!  But notice from my Data Table above that 90 to 98% of reported cases recover. 

3.  There has been a failure to educate the public that the overall fatality rate is not only far lower than previously thought but is extremely low in almost everyone other than the elderly.

Allow me to elaborate on failure #3 as it relates to the relatively large percentage of COVID-19 deaths among the elderly.  According a New York Times article, May 11, one-third of all US deaths to Coronavirus (est. 26,000, May 18) are from nursing home residents and workers.  Notice from my Data Table that nursing home deaths vary widely in percentage of total deaths by state.  

It is now believed that the large number of deaths of nursing home residents and workers in several states including NY, MA, and PA was due at least in part to the negligence or incompetence of state government officials and nursing home administrators.  The unfortunate higher number of nursing home deaths in some of these states is reflected in their higher “Mortality” rates (#Deaths/100K) (see Data Table).  The clear implication is that we dropped the ball in protecting our high-risk seniors while focusing instead on social isolation of the rest of us who are at low-risk.

4.  There has been a failure to clarify to parents the truth about the extremely low risk to children, and that has accompanied a gross failure to offer a rational medical perspective regarding schools reopening.

The #4 failure on Dr. Atlas’s list is the unfortunate lack of clear information provided to parents of young children—information which might have relieved much anxiety, and hopefully still can.  According to a Journal of the American Medical Association article cited by Dr. Atlas, “Of the critically ill children with COVID-19, more than 80% had significant long-term underlying medical conditions. Overall survival and outcomes from critical illness in infants and children with COVID-19 in this series was far better than reported for adult patients.  At the present time, our data indicate that children are at far greater risk of critical illness from influenza than from COVID-19.” 

Lack of good information and its dilution with misinformation threatens to drive school and college administrators to consider delaying reopening of classrooms in the fall of this year.  Dr. Robert Hamilton, pediatrician and founder Pacific Ocean Pediatrics, stated in an interview on The Ingraham Angle that only around 1.7% of people infected with Coronavirus are children up to age 18.  The majority of these are asymptomatic and don’t even realize they have a virus.  Meanwhile, we are learning about the negative impacts of school shutdown on adolescents and on their parents as they adjust to online courses while being deprived of spring sports and traditional commencement observances. 

Conclusion
Every human life is of great value to our Creator.  Therefore, policies dealing with the pandemic should be designed to do the greatest amount of good for the greatest number of people.  However, given that we live in a culture where the definition of “good” is so often rigorously debated, policymakers have a difficult time.  This is especially true when we allow our definition of “good” to selfishly dominate our political agendas to the point where we allow biased interpretation of data and media reporting to create an unreal world that is far from the truth.

While I have not escaped the world of pride, selfishness, error in computations, and bias, I have tried to deal accurately and honestly in compiling my Data Table and in presenting the arguments of notable scientists and policymakers.   Based on what I have gleaned from my study, I cast my small vote with those who recommend opening our culture as speedily as possible. 

Returning to my analogy of the anxiety I felt while waiting in line for my vaccination as a boy, I gladly remember that painful experience with no regrets.  However, I believe we will all have great regrets after our current painful pandemic if we don’t soon make it a priority to reopen and restore our economy, health services, family togetherness (especially with our beloved elderly), worship opportunities, education, and recreation.  Death from disease is a reality, but life and health depend on many aspects of our culture that have been restricted or ignored all too long.  As always, I welcome your “Comments.”

Acknowledgement:
This article is a joint effort between my wife, Alvadell ("Abby"), and I.  I thank her for her patience, helpful research, and critical suggestions in the writing.

COVID-19 Policy Ignores “Good Science”

Since my last article on the COVID-19 pandemic and policy entitled, “Growing and Groaning into the ‘New Normal’,” we are beginning to see various degrees of progress in opening up more of the essential services of our economy.  Our elected leaders are realizing the great cost and resultant damage that is resulting from having chosen a policy of locking down and socially distancing the human population.   Many now believe that we were wrong to isolate entire populations as opposed to isolating the vulnerable and the infected as was done in past successful handlings of outbreaks.

Still, there is much controversy.  We have taken different sides on whether the policies of the current administration and respective state governors are too lenient or too restrictive.  When evidence that contradicts a person’s belief is presented, the frequent response is, “It depends on who you listen to.”  And, this is certainly a good point.  So, I’ve been looking carefully at the credentials of those who are vocal and influencing policy.

In view of the ongoing uncertainties and controversy over policies to “open up the economy,” this article simply directs the reader to some points of evidence that ought to have been considered three months ago.  The evidence comes from an informative YouTube video, produced by Dave Cullen on Computing Forever, entitled “MUST WATCH: Debunking the Narrative (With Prof. Dolores Cahill).  I have anticipated that many readers will not which to take the time to view all of this long video.  Therefore, I have selected some important segmentsof the video and provided links where readers can "jump in" to hear specific points on COVID-19 science and  policy.  At each "jump in point," you will hear the jist of a key point within 3 minutes at which time, you can stop viewing.  

I present these key points as an example of what we all ought to be looking for as we listen to “authorities, then consider carefully in a spirit of prayer how we ought to think about the issue, and then decide whether or not to contact our elected officials.

Credentials and Connections of the Speaker
Dave Cullen's valuable interview is with Dr. Dolores Cahill, an Irish scientist with degrees in molecular genetics and immunology.  She also has decades of global scale experience in antibody research.  Dr. Cahill is also chairperson of the Irish Freedom Party which advocates separation of Ireland from the European Union.  Political connections?  Certainly, but who among major scientific voices doesn’t?  Please listen HERE to her background and then we’ll address her scientific integrity.

Are We Using “Good Science?”
["Good science" has been defined elsewhere.] Dr. Cahill’s research on antibodies worldwide has been scientifically validated, in part because of her own effort to establish standards of research integrity.  She explains that research fraud is regarded as a criminal offense in Germany, where it is reported to the police, the fraudulent scientist’s name is published, and then he or she loses funding for 10 years.  In the process of her discussion, we learn some of the basics of how the rampant rise in scientific fraud can be controlled.  Also, Dr. Cahill addresses how the lockdown policy was “anti-scientific” and “anti-nature” because it has ignored the importance of the human immune system and how we need to beef up our immunity through good nutrition and vitamins.  Listen HERE to her comments on the efforts to assure global progress, accountability, and valid publications of results in antibody research and research in general.

Will the Authority Take Responsibility?
Science naturally refutes false hypotheses as part of progress in pursuit of a true understanding of phenomena.  So, the claims of science can change.  However, scientists who speak through the media ought to “own up” when new research refutes their previous claims.  Of particular concern to many is the amount of seemingly unquestioned authority that has been granted to Dr. Anthony Fauci.  But recent media reports like this one by Tucker Carlson this evening point out how Dr. Fauci has changed his recommendations several times in ways that seem untethered to epidemiology and immunology.  In view of this point, you will be encouraged to hear Dr. Cahill place her scientific reputation on the line to make three statements about the COVID-19 virus.

First, the Coronavirus is not as dangerous as it is claimed to be.  Second, once a person has had the virus their immune system clears it after 10 days and they are immune for life and should be able to function in the world without isolation.  And third, Dr. Cahill is offering her recommendation to the Irish minister of health that the lockdown in Ireland be stopped within the next 10 days with appropriate provisions for protection of vulnerable individuals and instructions for all others as they return to their normal activities.  Listen HERE to her confident recommendations.

“Good Science” Refutes Lockdown Policy
Finally, the main point of much of Dave Cullen’s video interview with Dr. Cahill is her reasoned interpretation of the epidemiological data on COVID-19.  In this segment, you will see a chart of U.S. Center for Disease Control (CDC) showing the percentage of hospital visits due to influenza-like illnesses during the past thirty weeks dating back into late autumn, 2019.  You will want to hear Dr. Cahill explain how these CDC data support her claim and the claim of an increasing number of epidemiologists that the lockdown was not necessary. 

Specific points Dr. Cahill makes are as follows:  First, our bodies house hundreds of thousands of different viruses and it is necessary for the well being of our “micro-biome” within our bodies that we naturally come into contact with viruses and bacteria.  Second, during the flu season this year, from December until April, there were three major viruses circulating the globe; and the third was COVID-19.  Third, COVID-19 had its peak in the US on March 22 and people were at peak infection ten days before.  Then, most of the population in America cleared the virus within 10 days and then the threat was essentially gone.  In Dr. Cahill’s words, “there was absolutely no need for lockdown,” even in the early weeks of the pandemic.  Listen HERE for a discussion of these data and the implications for policy decisions in the days ahead.

Thank you for reading, and I thank Brian, one of my former students at Cedarville University, for referring me to this video.  As always, I invite “Comments” as we continue to seek to be informed and share information and opinion in a reasoned and polite manner.

COVID-19 Policies & Outcomes: Learning Online

As the third month of the war against the COVID-19 pandemic draws to a close, we are learning more and more about our “invisible enemy” and how best to defeat it.  Many will acknowledge that the strategy of “flattening the curve” of infections and hospitalizations has bought us time to manufacture or otherwise acquire and distribute necessary medical supplies and equipment, and time to organize the medical front lines to cope with the number of COVID-19 cases.  It appears that this strategy is preventing hospitals, dedicated doctors, and nurses from being overwhelmed. 

How Fast to Restart the Economy
However, as scientists obtain more and more data, sharp disagreements are emerging about how we should proceed from here. The Coronavirus Task Force Team, and in particular, physicians Dr. Anthony Fauci and Dr. Deborah Birx, recommend a gradual startup of the American economy.  They are concerned that if we are not cautious, our gains in curve flattening could be reversed quickly. However, a significant number of influential people are questioning the wisdom of a prolonged, gradual startup.

Like many Americans, I am concerned that the indirect effects of social distancing and the economic shutdown may have more devastating long-term effects than the COVID-19 virus itself.  So, I have been wondering which strategy for restarting our economy will be wisest.  This decision requires answers to many questions, many of which need more data.  Especially, we need to know the extent of COVID-19 infections already represented in the US (and in other nations) and the rate of spread.  Thankfully, answers appear to be coming almost daily.  

Online Learning in Science, Technology, and Politics
There is no doubt we are living in a high-anxiety period.  As elderly, “at-risk persons,” Abby and I can easily feel anxious.  From a distance, there is anxiety within the homes of our son and daughter.  We have talked about our faith and how we need to draw upon our belief in God and His Word and learn how to apply it daily.  The Judeo-Christian Scriptures teach us that the wise do not “bury their heads in the sand.” 

In 1 Chronicles 12: 32, there is a praiseworthy reference to the sons of Issachar, men who understood the times, with knowledge of what Israel should do.  If we want our children and grandchildren to develop into men and women who “understand the times” and know what to do, we ought to encourage them to learn from the various media available and to help them to mentally and spiritually process the information.  The best medicine against anxiety is good information integrated with a biblical worldview.  In an earlier article, I discussed some factors that we need to take into consideration in an effort to understand COVID conundrums.

One lesson that primary school and college students, and all of us can learn from news broadcasts and online data is the amazing speed of progress in the “war” against the virus.  Within a few weeks, American industrial capacity has been harnessed into the manufacture of masks, ventilators, and other medical supplies.  At the same time, there has been an explosion of testing for infection, antibody and antigen testing, and distribution of equipment and methodology to thousands of locations across the country.  Reports and a great volume of data, updated in real time or daily in many cases, are available with the click of your computer mouse.

A case in point of science and technology in action was the excellent presentation by Bill Bryan who leads the Science and Technology Directorate at the US Department of Homeland Security. Bryan reported on the progress of laboratory studies in which suspended COVID-19 virus particles were subjected in contact with various media and subjected to treatments such as disinfectants, light, and ultraviolet light to determine how long it would take to kill the virus.  By watching this session, viewers can see science and technology in action.  A very interested and engaged President Trump and members of the news media questioned Mr. Bryan  about how their results should be factored into safe human practices and policy for restarting the economy.  If you are interested, go to C-SPAN recording of Mr. Bryan’s presentation (skip forward 20 minutes if you don’t care to watch the introductory presidential report).

Approach to Restart Economy:  Lesson from Sweden?
As part of my personal effort to learn more about how our economy should be restarted, I asked a question, “Which nation has followed the wiser strategy in dealing with the COVID pandemic, the United States or Sweden?”  Here’s some of what I am finding and some links for you to do more of your own research.

First, for some background on Sweden’s approach to combat COVID-19, check out this interview on the Laura Ingraham Angle, on April 23.  She presents virus mortality data from Sweden which has instituted a very loose lock-down policy compared to other European countries and with the United States.  Therefore, Sweden is considered an outlier in its policy but no so much in regard to the outcome.  While Ingraham makes it clear that the overall outcome remains to be seen, she advises against ignoring Sweden as the US decides its path to “normal.”

Then, Ingraham interviews Johan Norberg, senior fellow at the Cato Institute.  He points out that, in spite of a much more rigid tracking and data recording of deaths in Sweden, a larger percentage of adults at age 70 or older, and a large number of deaths in nursing homes, the mortality in Sweden, though slightly higher than that of the US, is much lower than neighboring European countries with more stringent lock-downs.  Norberg claims that the lock-down approach to “flatten the curve” may have the unfortunate effect of prolonging the deaths due to COVID-19.  In other words, in the final analysis, the disease is going to do what it does and the number of deaths will not be affected even if we try to affect the timeline by behavioral modification.  The prediction is that Sweden will reach “herd immunity” in approximately 2-3 weeks and then they will be finished with the virus.

Will Norberg’s prediction bear itself out?  Is “herd immunity” a factor that will also be verified by the passage of time and more antibody testing?   What can we learn from differences in how effective the reopening policies of different states (e.g. Georgia) are in avoiding infections and deaths.  I will leave you with these questions and refer you to excellent source of data to consult.  One source which is updated at least daily is the Our World in Data website for COVID-19.  This site provides abundant charts and tables with explanatory notes and commentary.  Another source is the Johns Hopkins Coronavirus Resource Center.

How About You?
Are you confused, anxious, or just tiring of the constant flow of information and not being sure what to believe.  I recommend that you be sure to maintain a strong faith by daily time in God’s Word and whatever connections that are possible with other people of faith.  In this way, you will not miss important lessons on the power of prayer and faith that God may want to teach you during this time.  Obviously, this pandemic is not the first great challenge Americans have faced.  A great book to gain a wider perspective on the hand of divine providence in American history is Michael Medved’s The American Miracle (Crown Forum). 

Also, try to stay informed by using a variety of news and online data sources.  Develop your own questions and do the research by examining the current data for yourself.  In this way, maybe we can exemplify and help our children and grandchildren to develop into men and women who “understand the times” and know what to do.

Pandemic—or Policy without “Good Science?”

The past two months have demonstrated an amazing response by many sectors of our nation joining in a coordinated effort to defeat the Coronavirus pandemic.  But the more Americans listen to the health experts and policy advisors, the more reason there is to question whether the policies of our government leaders are consistent with “good science.”  If they are not, we may find that the “medicine” they have prescribed in the form of very costly social and economic upheavals was much worse than the COVID-19 disease itself.

Most agree that any successful policy to defeat the COVID-19 pandemic must “follow the science.”  Or better, “must follow good science as I have defined the term elsewhere.  I will briefly list a few aspects where good answers are needed from “good science:” 
1.   Therapeutic Options:  What drugs or other therapeutics are safe and efficacious?
2.   Predictive models:  Are the data and assumptions that drive the models accurate?
3.   Death rates:  Do we have an accurate number of deaths actually caused by COVID-19?
4.   Epidemiology:  What proportion of specific populations already have COVID-19 immunity?
5.   Justification for Current Policy:  Does the science justify the policy actions taken so far?

Therapeutic Options
As of April 7, there were “no drugs or other therapeutics approved by the US Food and Drug Administration to prevent or treat COVID-19.  According to the Center for Disease Control and Prevention (CDC), “Interim guidelines for the medical management of COVID-19 will be provided soon by the Department of Health and Human Services COVID-19 Treatment Guidelines Panel.”  Hydroxychloroquine and chloroquine both have been shown to be efficacious and may have saved lives according to preliminary trials and antidotal reports.  A particularly newsworthy report from the Detroit Free Press and USA Today featured a State Representative Karen Whitsett (Democrat) of Michigan who credits President Trump’s support of doctors prescribing hydroxychloroquine to treat COVID-19 for saving her life.  It would seem of utmost urgency to establish whether hydroxychloroquine is a viable therapeutic option for treating the virus.

Predictive Models
The predictive accuracy of epidemiological models is only as good as the data and assumptions that are used to produce the model.  The Trump Administration Coronavirus task team has relied on the model created by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, and funded by the Bill Gates Foundation.  However, this model conflicts with many other models in prediction of mortality and projected peaks.  The IHME had estimated that the epidemic would kill 93,000 people nationwide.  However, the projections have since been revised downward, presently predicting only 60,400 U.S. deaths by August.  The model forecasts the peak of those deaths to arrive in just four days, April 12 instead of April 16 as previously projected.   Considering the magnitude of the downward adjustment was up to a 75% reduction does not lend a great deal of confidence to model precision.  Nor is it clear that social distancing alone accounts for the unexpected lower mortality.  Most needed is a denominator of total community infections.  Bamba Gaye, et al writing in European Heart Journal explains how important the denominator is in estimating COVID-19 mortality rates.

Death Rates
To date, deaths associated with positive tests for COVID-19 are not distinguished between people who have died with COVID-19 from those who have died because of COVID-19.  Dr. Annie Bukacek, a 30-year practicing Montana physician has had the routine role of signing death certificates.  Dr. Bukacek is concerned that “the decision for unprecedented government-mandated lockdown has been based on the alleged death rate of COVID-19.”  But she asks, “Is this death rate based on truth?  Are the reported deaths from COVID-19 truly deaths from COVID-19?” Dr. Bukacek adds that being tested positive for COVID-19 does not mean you have the disease.  She explains how the CDC and the National Vital Statistics System (NVSS) are instructing physicians as follows: “COVID-19 should be reported on the death certificate for all decedents where the disease caused or is assumed to have caused or contributed to death.”

Dr. Bukacek asked her Facebook audience the following question:  Do you know anybody personally with baseline good health who has been hospitalized for COVID-19 alone, or who has allegedly died from COVID-19?  She found, out of 350 comments, only 3 or 4 answered with a definitive “yes.”  Certainly not a scientific study, but who knows what the actual mortality due to COVID-19 is?  Why isn’t the CDC and NVSS pressing for more accuracy on death certificates?  Which leads us to the epidemiology factor.

Epidemiology
Epidemiology deals with the incidence, distribution, and strategies to control of diseases and other factors affecting health.  Maybe the most important still missing piece in the COVID-19 pandemic is the proportion of any given population that already has developed COVID-19 immunity through production of antibodies as a result of prior exposure.  Not only would widespread antibody testing which has begun in some countries already give us the denominator of total community infections, but it would identify donors of antibody-containing blood serum that could be used to treat patients infected with COVID-19.

“Good science,” if it is truly valued and used, ought to be aimed at answering other questions.  For example, Dr. David Hanson, a senior fellow at the Hoover Institution, questions the projected timeline of the outbreak of COVID-19, and believes it occurred before late December. He cites the CNN report that New York, the epicenter of the outbreak, has reported 32 times as many deaths per 100,000 residents as California.  His explaination:  “Californians developed some degree of herd immunity through earlier exposure to the virus than the rest of the country.”  Fascinating hypothesis and worthy of testing—and soon it will be tested.

Speaking of antibody testing, in Germany where “good science” seems to be progressing much faster than in the US, the so-called Heinsberg Protocol study has been launched in the town of Gangelt where the first fatalities occurred.  Health officials had estimated that approximately 5% of the population had been infected, but antibody testing revealed a surprising 15% had already had COVID-19!  These results suggest that the virus had spread three times faster than predicted and was only one-third as virulent.

Justification for Current Policy
We have briefly cites four areas in which “good science” is either lacking or is seemingly being ignored or rendered ineffective in guiding public policy toward the COVID-19 pandemic.  The results are unsettled debates about therapeutic treatment, models that disagree widely in their predictions, uncertainty of death rates with little interest in making death certificates more accurate, and an epidemiological gold mine of data still waiting to be collected—and so necessary to forming good public policy.

Given the areas of uncertainty that I have outlined above, many wonder what justifies the current policy of social distancing and isolation, and the resultant economic and social upheaval we are now experiencing with 10 million people filing for unemployment and $2 trillion being spent through the Coronavirus Relief Bill.  Most disconcerting is an analysis by the Mises Institute which compares total death statistics for all causes in March, 2018 with March, 2019 with the result that the deaths attributed to COVID-19 in March, 2020 (likely inflated as explained above).  The COVID-19 deaths this March was only 1.6% of the total deaths in March of last year; and, this 1.6% was smaller than the difference between March, 2018 and March, 2019.

In a March 30 article for The Spectator, former UK National Health Service pathologist John Lee writes what may be the question of 2020 if not this decade or century:

Total COVID-19 deaths could still increase significantly this season, but even then we must ask what percentage of total deaths warrants an international panic. Is it 5 percent? Ten percent? The question has never been addressed, and so far, a figure of 1 percent of total deaths in some places is being treated as a reason to forcibly shut down the global economy.

How About You?  
I welcome “Comments,” and meanwhile stay safe, be encouraged by this season of Hope in the Resurrection of Christ, keep investing time to be informed.

The Conscience of Science: Part 3 Why March for Science?

Kaytlin Goodwin receives 2017 SFIS award from
Dr. Dennis Flentge, Chair of Dept. of Science and Math

One of the key issues facing the scientific community today is not a lack of knowledge, but rather a lack of communication between scientists and the general population. Although I am only an undergraduate, I have already experienced the frustration of trying to relate exciting scientific information to friends and family who do not understand basic biological processes and the jargon or importance of certain natural phenomena. Research scientists regularly face similar challenges. Although their work has vital implications for both the environment and human well-being, the general public often does not understand the importance of practices that are essential for the health of the environment.  
     – Kaytlin Goodwin, Cedarville University
        Science and Faith Integration Scholarship recipient (2017)

As I write this article, scientists and supporters of science are gathering by the thousands on the Mall in Washington, DC as part of today’s March for Science.   Many of these marchers and those who are likewise participating in one of 500 marches worldwide on this Earth Day are committed to the March for Science Pledge which lists ways supporters can advance science and science-based policies.  

Related to the advancement of science, recently Abby and I were privileged to attend Academic Honor’s Chapel at Cedarville University where Kaytlin Goodwin, a senior Environmental Science major was awarded this year’s Science and Faith Integration Scholarship (SFIS).  The above quote from the integration paper which Kaytlin submitted as part of her application for the SFIS captures some of the concerns held by some of today’s Marchers for Science.  The concerns expressed by Kaytlin and at least some of the Marchers stem from a long history.

American culture has been closely aligned and influenced by the growth of science and technology since the European colonization of the Western hemisphere in the 17^th century. Today, most Americans would be unable to survive without the fruits of the natural sciences--the clean air, potable water, food, health services, transportation, and air conditioning.  Therefore, it is for good reason that Americans tend to be supportive of the sciences.

March for Science--and a march for your favorite cause?

March for Science participants aim to encourage respect for science and to encourage funding of research on issues such as global climate change, energy supply, information technology, and vaccinations.  These issues continue to be highly controversial on the political stage of an increasingly divided America.  Supporters of science who are concerned about one or more of these issues are urging scientists to use their professional prestige to take a more active role in educating and influencing policy makers and the general public.  But, is it appropriate for scientists to lend their reputations to political rallies?

Instead of joining the March for Science I am reading and thinking about the nature of science and the proper role of scientists in political organizations and rallies.  In this article, Part 3 of my “Conscience of Science” series, I want to share some of the considerations and cautions that a scientist or member of the public at large should entertain before joining the March for Science, or other political movements.  When one considers joining in pubic demonstrations in support of science or science-related issues (with some unrelated issues often included), it is essential to understand (1) the nature of science, (2) science in today’s news and entertainment media, (3) the responsibility of scientists in public education, and (4) the importance of the ethical conscience in science.

1.  The Nature of Science
We will assume that most supporters of the March for Science have at least a secondary school understanding of the nature of science.  Do you remember having to memorize a definition of science?  Most definitions include two parts, one that emphasizes the method of science, and the other, the management and communication of scientific information.  Science is a method—a systematic study of something—e.g. the natural world, living organisms, humans, human behavior, and so on.  Each field of science has a name (e.g. natural sciences, biology, psychology, theological sciences) and each has its own methodology or variation of the scientific method. 

When the scientific method is employed, the scientist obtains data that can be analyzed and used to determine the validity of a hypothesis. Repeated experimental testing contributes to the development of a systematic body of knowledge that results in the support for a scientific theory.  Theories provide the basis for understanding the scientific field in question and for continued scientific research.

Defining science is much easier than proper conduct of the process of science.  For example, scientists often find it difficult to gather data without perturbing the natural system being studied. Scientists must also avoid falling victim to error or bias.  Often the resultant theories attempt to account for abstract and complex phenomena that are difficult for the average person to comprehend.  Many of us find it difficult to comprehend the nature of a subatomic particle; or conceive of how matter becomes energy at the speed of light; or understand how scientists determine the temperature of planet Earth and use this data in complex models to predict climate trends. 

Although it is challenging to develop a scientific understanding of complex natural phenomena, it is even more challenging to communicate the resultant theories to students, policy makers, or laypeople.  Numerous studies have examined the growing influence of the internet, cable news, and the entertainment media on scientific literacy and opinions about certain hot button science-related issues like those listed above. 

2.  Science in Today’s News and Entertainment Media
According to a 2016 review entitled Americans' Attitudes about Science and Technology: The Social Context for Public Communication, commissioned by the American Association for the Advancement of Science (AAAS), …despite intensive efforts at public education, science literacy has remained relatively stable for several decades.  The review cites a survey conducted by the Pew Research Center which used an index of 12 questions to measure basic scientific literacy and understanding of science as a process.  Out of the 12 questions, the mean score among respondents was 7.9.  Twenty-seven percent of respondents answered 8 or 9 out of 12 questions correctly, while 26% answered 10 or 11 correctly, and only 6% received perfect scores.  Respondents with college degrees answered 9 or more correctly, and those without degrees, 8 or fewer (Pew, 2015).

Although science literacy in America is low, it does not stifle interest in science-related news.  A National Science Board (NSB) survey in 2012 reported that the percentage of American respondents interested in news about medical discoveries was 60%, new scientific discoveries, 40%, and new inventions, 43%.  These percentages were comparable to those interested in local school issues (50%) and economic and business conditions (43%).  However, only 16% of Americans said they “very closely” followed news about science and technology, as compared to those who “very closely” follow weather (52%), sports (26%), local government (21%), and political news (17%) (NSB 2014).  Could it be that the increasing trend of Americans using social media as their favored news source has diminished our tendency to follow any topic “very closely?”

According to Brossard (2013), …with the rapid adoption of Facebook, Twitter, and smart phones, the nature of science-related news consumption among the public is changing, becoming more social, participatory, and incidental.  As of 2015, two-thirds of American adults say they use Facebook and 41 percent say they get news via the platform. 

Again, according to the AAAS review (2016), in recent decades …political leaders, activists, and the news media have increasingly packaged almost every major policy debate in terms of clearly defined ideological differences.   Republican and Democrat parties have become brand names, each standing for a distinct set of conservative or liberal positions.  This labeling strategy has apparently contributed to the growing ideological divide between the two major parties as reflected on issues such as sanctity of human life and climate change.  The divide is enhanced and sustained by cable news networks which cover science related topics with a decided conservative (e.g. Fox News) or liberal (e.g. CNN and MSNBC) slant.

According to Tom Nichols, author of The Death of Expertise, who was interviewed on PBS NewsHour, …many Americans have become insufferable know-it-alls, locked in constant conflict with each other, while knowing almost nothing about the subject they are debating. There’s a lot of blame to go around for all of this. The smartphones and tablets that we carry around all day that we think can answer anything are only part of the problem. The American educational system, from grade school to graduate school, encourages students to think of themselves and their views as special.  An A is now a common grade.

3.  The Responsibility of Scientists
In our society characterized by low science literacy, yet blessed with multiple sources of science news and the opinions of many political ideologues, the role of scientists and science educators becomes very important.  Scientists who step beyond their laboratory to address policy makers and the public are taking on at least two additional responsibilities.  First, they must objectively and clearly communicate the content of their findings and implications to policy makers and the public.  Second, they must convey the challenging nature of science as a process--one which is easily threatened by unintended bias and often deliberate “spin” by adherents to conservative or liberal ideologues.

Although sound scientific theories are supported by strong statistical probabilities, scientists must continually emphasize to the layperson that there is no such thing as “settled science.”  It follows that modern science and culture should greatly value and pursue good science, a claim that I have made in a previous article, Conscience of Science: Part 2 Do Museums Make Us Muse?  I have defined good science as the dynamic, self-correcting pursuit of truth that tries to avoid error caused by experimental bias, personal bias, or political influence.

International Prototype Kilogram (IPK)
housed in Sèvres, France

To briefly underscore that science is tentative and not “settled,” let’s consider one aspect of the natural sciences that has been “settled”--the standards of weights and measure. While science may argue about the precise speed of light in meters per second, there should be no argument about the precise length of 1 standard meter.  Because the precise units of distance, mass, temperature, etc. are considered universally “settled,” uncertainties attributable to error in quantitative measurement are minimized as long as measuring devices and statistical sampling are employed properly.  It follows that more attention can then be directed at the hypothesis-testing part of science which is not “settled” because hypotheses can never be “proven.”  Scientific claims are accepted only so long as another experiment does not falsify supporting data.

Because of the complexity of the sciences, the great influence of science upon the American economy and culture, and the controversial nature of our contemporary political arena, it is no surprise that not all scientists accept a role as advocates in the public arena.  This notion brings us to the ethical consideration, the last of my four considerations in deciding whether or not one should join in the March for Science.

4.   The Ethical Conscience of Science
Science must shape policy.  Science is universal.  Science brings out the best in us.  With an informed, optimistic view of the future together, we can (Dare I say it?) SAVE THE WORLD! 
These are the words of Bill Nye, host of the PBS children’s science show, Bill Nye the Science Guy.  Nye spoke this morning at the March for Science gathering in Washington, DC. 

Bill Nye, the Science Guy:  "...we can save the world"

I sharply disagree with Mr. Nye.  Science without ethics would more nearly destroy the world than save it!   Science and technology have given us sharp tools, firearms, atomic energy, and drugs.  Where technology has sought to apply these tools for destructive means, millions have died.

 As I have pointed out in Part 1 of this series, “good science” is conscientious about being objective, cautious, humble, and unbiased in a culture that can easily bring bias and elicit unethical behavior.  In short, “good science” has a conscience ((Latin, conscientia = “knowledge of right and wrong within oneself”).  David Resnick, author of The Ethics of Science: AnIntroduction (Routledge), lists as the first three principles of scientific ethics: honesty, carefulness, and openness.

Is it ethical for scientists to utilize their professional status to support a specific policy or political initiative?  For example, should climatologists agree to an invitation to add their name to a list of signatories in support of limiting human-caused climate change?  John Kotcher and colleagues at George Mason University in Fairfax, Virginia attempted to address this question with a randomized survey of 1,235 Americans. Most respondents did not rate a fictitious climate scientist as less credible after hearing the scientist advocate for specific public policies.  The researchers concluded that climate scientists who wish to engage in certain forms of advocacy have considerable latitude to do so without risking harm to their credibility or the credibility of the scientific community.

Robert Lackey, a former senior biologist with the US Environmental Protection Agency, now in ecological policy and natural resource management at Oregon State University, disagrees with Kotcher :  If your day job is science and your night job is policy advocacy, why would I trust your day job?  Having worked in the environmental sciences for 50 years, Lackey has seen a steady erosion of the credibility of scientists. Lackey agrees that scientists have an important role in objectively informing the public of the facts, but the scientist who advocates for a given policy threatens to take public policy from the hands of the people.  He adds, You have to be careful here, because you end up in a debate over a technocracy versus a democracy.

Hastening to conclude this article while it is still Earth Day, I believe I have at least begun to make the case that the role of the scientist is better served by doing what scientists can do best:  striving to conduct his or her research while being honest, objective, careful, and humble; then, publishing conclusions in an objective, clear manner through print and digital platforms that are suited to others with expertise in decision making and formulation of policy. 

Knowing that there are up and coming Christian scholars in science like Kaytlin Goodwin, I have confidence in a future for the sciences when influenced by individuals with godly wisdom and integrity.  As a young advocate for both environmental stewardship and the importance of improved communication between scientists and laypeople, Kaytlin offers a positive way forward as applied to her field, the environmental sciences when she writes, If scientists and environmental educators can find ways to effectively communicate the relevance and importance of environmental issues, lasting change will be possible.  As Christians, we are especially responsible to teach others about the God-given value of the environment.

References:
I realize that this subject undertaken here is beyond the scope of this article and extends beyond my expertise.  However, I hope we have raised some worthwhile points for consideration and provided some references for further reading.

Brossard, D. (2013). New media landscapes and the science information consumer. Proceedings of the National Academy of Sciences, 110 (Supplement 3), 14096-- 14101.

Nisbet, Matthew C., et al. "Americans' attitudes about science and technology: The social context for public communication." Commissioned Review (2016). To read, click HERE

National Science Board (2014). Science and Engineering Indicators 2014. Arlington VA: National Science Foundation.

Pew Research Center (2015).  A Look at What the Public Knows and Does Not Know About Science. Washington, DC.

“Will a March Help Science?”  The Scientist (Feb. 2, 2017)