Science is seldom ever black and white and this is particularly true of the Blizzard of information around Covid-19, writes Terry Maguire.

Back in October, the death of a Co Antrim town councillor from Covid-19 triggered a local media storm about online Covid-19 ‘mis’ and ‘dis’ information and identified and criticised the twisted people and dubious websites that peddled ‘poison’. Every pandemic triggers bizarre views and alternative beliefs, ideas that don’t quite fit the mainstream narrative, and it is felt that citizens believing weird nonsense will foster behaviours that put themselves and others at risk.

It is generally felt that, in a pandemic crisis, these beliefs must be stamped-out for the public good. The irony is that this creates a rigid orthodoxy that in the long run might be more damaging to public health, as citizens persist with behaviours that new data identify as wrong, but the science fails to be corrected.

Those in charge persist that there is a right and wrong, a black and a white set of data on which Covid-19 policy can be based, so we all must defend this position. Orthodoxy becomes anti-science, since it is impossible to ask valid questions or interpret data in any different way. This is very dangerous, because when we abandon science, we become rudderless.

The growth of orthodoxy was evident during the first Covid-19 wave. A BBC Radio Ulster shock-jock expressed his righteous indignation against people putting the lives of others in mortal danger because they refused to wear face-coverings when visiting shops.

This selfish behaviour was so egregious at a critical juncture in the pandemic that it justified the whole of his morning programme and led to a monthlong crusade. He would shout like a red-top and we would all be brought into line; face masks would be worn in shops, and Covid-19 would be tamed. At huge personal risk, on a garage forecourt, he had faced-off those with face masks off. It was pantomime time.

Yet he was only partly right; wearing face-coverings in shops was the law then in N Ireland, and it remains so. We must obey the law. I am happy to wear a face mask in shops and this is not the issue. My issue is that he is wrong that the science supports this as a behaviour that will have a significant impact on the spread of the SARs-CoV-2 virus. There is simply insufficient good science to support the use of face coverings.

If those in authority think that there might be a small or modest effect and as part of a package of behaviours — social distancing, hand washing, isolating and shielding — that is fine, but it is not really following the science; this is diktat.

The tragic death of the town counsellor was more nuanced. He was an anti-vaxxer and had latched onto a number of online personalities who were asking questions about the safety and efficacy of the licensed Covid-19 vaccines. As someone who shared anti-vaxxer views online and who then caught Covid-19 and sadly died as a result, his loss was viewed as someone killed not by his own beliefs and behaviours, but by pernicious misinformation spread by others.

A journalist identified one source of ‘misinformation’ used by the counsellor and to my surprise, I realised it was a website I regularly visited for views, information and discussions about Covid-19. The ‘mis’ and ‘dis’ information claim was not my reading of the website. It is not an anti-vaxxer website. It merely takes the data from studies, for example on those used to license the three vaccines on the UK market, and looks at what the science is saying. It also considers the role of vaccination in achieving herd immunity — the means by which we will move on from the lockdowns.

It also looks at the evidence for lockdowns and has some irregular insights into what we have done across the globe in the last two years. But ultimately, these views and conclusions are based only on the data and the website moderators admit when the data is incomplete, and this is always taken into account. This is not poor science, this is not pseudoscience; this is good science. Science is seldom, if ever, black or white.

And tragically, the use of science to support orthodoxy it is not restricted to keyboard warriors and priestly policy-makers. It is alive and well in mainstream science, where scientific method takes years to debunk myth, while those claiming to be scientists but with a vested interest abuse science to achieve personal gain.

I was encouraged recently by comment in both the Pharmaceutical Journal and BMJ on the launch of the first-in-class wonder drug inclisiran. This cholesterol-busting drug has a novel mode of action, interfering with RNA, and it’s claimed that it heralds a therapeutic revolution. There is no doubt from the stage 3 clinical trials that inclisiran is very good at reducing serum cholesterol. Sadly, the trials only compared inclisiran against other cholesterol-lowering drugs and in this respect, it is indeed superior.

The key problem identified by both the team from RCSI Dublin who wrote the BMJ editorial and the pharmacist who wrote a pretty erudite letter to the PJ, is that there is no evidence to date that inclisiran reduces heart disease or death in those treated. What is being challenged, and the data from many studies support this, is that a direct causal link between lowered cholesterol and a reduction in either cardiovascular events or death simply does not exist.

This challenges the medical orthodoxy of 40 years and it is gaining ground. The only cholesterol-lowering drugs that do have an effect are the statins, and it is a modest effect and might be explained by their anti-inflammatory and anti-clotting effects rather than their impact on cholesterol. Interestingly, those scientists who challenge this orthodoxy are often attacked and made to look foolish.

Moving back to Covid-19, the Great Barrington Declaration of 2020 was a statement by a group of eminent scientists and sociologists on the merits of ‘Focused Protection’, keeping a ring of steel around those most at risk of dying from infection; mainly the elderly. It stated that national and regional lockdowns were wrong policy because they were too damaging to society for the small overall gain they achieved. Their views are still valid, and history will decide if they were right.

These scientists, however, were victimised by national governments across the globe; some even lost their jobs. They dared challenge the orthodoxy using good science.

Science and scientific method brought to us by the Enlightenment is under serious threat at this juncture in history. Social media is certainly selective with the science and this, sadly, is the world we live in. Many who are ardent anti-vaxxers, for example, freely cherry-pick the views of capable scientists and in doing so, amplify and focus their views through a hardened orthodox lens.

We are all doing this, it seems. We are pretending to be scientific, when we are really abusing science. It’s been a perfect storm of social media, social crisis, and orthodoxy. Misinformation, dangerous and in some cases fatal, is being peddled by those on the loony margins and those in the corridors of power. We may need a new Enlightenment to get us back to basing our policies on real science.

CONTRIBUTOR INFORMATION

Terry Maguire owns two pharmacies in Belfast. He is an honorary senior lecturer at the School of Pharmacy, Queen’s University Belfast. His research interests include the contribution of community pharmacy to improving public health.