Independence Day thoughts on Science and the art of spreading panic

The world is facing a global “iatrogenic” disaster. The freedom and autonomy of people have been severely curtailed with every wave of the pandemic or the apprehension of a wave, ostensibly for saving people from the novel coronavirus. Frequent lockdowns are destroying livelihoods and in the long run more people will die from poverty associated conditions than will be saved from COVID-19.

In this environment the mind is full of fear and it is difficult to hold the head high.

What about knowledge? Knowledge, particularly scientific knowledge, thrives when opposite points of views and alternative hypotheses are debated and discussed. Great disagreements generate great science. History of medicine has many examples of doctors who did not conform to group-think and were ridiculed and dismissed as mavericks only to be proved right later.

Ignaz Semmelweiss, a Hungarian physician, in the 19th century advocated hand-washing to prevent infections which caused high mortality after birth. In his lifetime he was ridiculed and ostracised by the medical community who declared his inference, in spite of evidence, outlandish. Dejected, he took to alcohol and ended in an asylum in 1865 where he was beaten to death. He paid a heavy price for his courage of conviction. After more than a century and a half, the world is following his advice with gusto!

Going against group-think is not easy and can endanger one’s academic and scientific career. History is repeating itself. Any viewpoint against the present medical consensus is censored instead of being debated. Dogma is replacing debate.

In the era of “grants driven research”, the scientific script is often influenced by the sponsors. Knowledge is not free. To acquire it through research one needs research grants.

How to realize Tagore’s dream of knowledge being free when research is possible only by grants from sponsors with vested interests? Perhaps one way can be more investment by the state in research. A corpus for research generated by anonymous donors from corporate business houses can also be considered.

The pandemic has broken up the world into fragments. The response to it led to severe travel restrictions. After the availability of vaccines, “vaccine passports” are being contemplated. Scientists questioning the safety and efficacy of vaccines are labelled as “anti-vaxxers” instead of rebutting them with evidence and hard data. This debate with evidence and hard data will also convince the people better and will remove “vaccine hesitancy” rather than propaganda and caller tunes. Alas, this clear stream of reason, envisaged by Tagore, has lost its way.

What is the way forward to clear the stream of reason and steer it towards the proper course?

Fear is generated by ignorance. Fuelled by media and vested interests the panic spreads like a forest fire, faster than any virus. Population panic makes people vulnerable to exploitation by vested interests. They would like the mass hysteria to be as prolonged as possible.

Regrettably, most countries, except for few notable examples like Sweden, treated people in a paternalistic manner rather than as free citizens. Like parents who invoke fear to make children behave in a desirable manner, governments, media and even academics, spread panic and fear, to coerce people to comply with varying restrictions.

The vaccine for mass panic is risk communication. This should be transparent and informed. Creating panic and fear, with its offshoots of stigma and shaming and ridiculing is manipulation and not risk communication.

People should be made to realise that daily we live with some amount of risk to life. This risk can never be reduced to zero. So, if we wait for zero cases of Covid we would be in perpetual lockdown and most of us will die of starvation before the virus reaches us. Similarly, like all respiratory viruses there will be seasonal fluctuations. These molehills can be converted into mountains by vested interests.

The risk of dying after catching the coronavirus is 0.3% globally and lower in India because of its younger population. Based on this hard data, it can be communicated to people that if a healthy person gets infected with the novel virus, chances of survival for that person is 99.7%. This survival is far higher than most of our endemic diseases. Even this risk is not uniform across the age strata. Healthy children have almost zero risk of dying from COVID-19.

Risk communication should also stress on the high risk groups such as people with co-morbidities, the frail elderly, and perhaps even younger people with co-morbidities. Focused protection can be advised for them while the healthy that face minimal risk can carry on their routine activities.

The implications of the results of the latest serosurvey by ICMR in which almost 67% of the population have shown to have protective IgG antibodies if properly communicated can also allay the population panic.

Let us hope that this Independence Day, reason and rationality leads us back “into ever-widening thought and action; and into that heaven of freedom...” envisaged by Tagore.

(The writer is Professor & Head, Community Medicine and Clinical Epidemiologist at Dr DY Patil medical college, Pune)