The Limits of Science in the Pandemic

When the COVID-19 pandemic began, there was an incredible amount of fear and uncertainty. Beginning in China and spreading throughout the world, stories of people ravaged with high fevers, respiratory failure, and ultimately death created profound worry and bewilderment. Urgent questions abounded: What is causing this? How is it spread? Who is at highest risk? How do we treat this? How do we stop this? And the initial answer to all of these questions? We don’t know. 

But since those early days, remarkable things have happened. The virus has been typed and analyzed. Properly fitted N95 masks have been found to be effective in mitigating spread. Monoclonal antibodies and Paxlovid have offered treatment. And vaccinations have been crafted for prevention. It is pretty extraordinary.

But it has also been pretty frustrating.

As time has worn on, debates have roared and fingers have pointed. Which masks should be used? Where and when should we use them? Should vaccines be mandated for everyone? Have lockdowns worked? Should schools be open or closed? How do we navigate between community health and civil liberties, authority and freedom? From politicians to citizens, public health officials and patients, the turbulent scene has been littered with gaffes and misinformation, hypocrisy and double standards. And then someone says, “At least, we can all agree on the science.”

But can we?

Urgent and necessary work has been undertaken to understand, prevent, and treat COVID-19. And, needless to say, science has been at the center of it. The trouble begins when we make “little ’s’ science” into the idolized “big ’s’ Science.” You’ll know which one someone is speaking about when they quote literature or cite statistics with a certain breathless finality. “Science has spoken, folks.” They impatiently sniff, “There’s nothing more to see here.” But there are always important caveats to scientific findings and we know that science is never final—it is always a work in progress. One study builds upon or refutes another—our new eager hypothesis stands on the shoulders of an old provisional conclusion. And what about those sharply dressed, well-educated scientists who diligently perform their studies? They do good and necessary work. But they also earnestly answer one question in one corner of the universe under these conditions and with those assumptions to the best of their ability. And that’s okay. In fact, it is vital. It just isn’t all-knowing and unerring.

Consider my field of medicine. Because of its pervasive reach and life-and-death implications, one might reason that more money is spent on medical research than almost any other field of scientific inquiry (other than, perhaps, nuclear technology and oil research). The gold standard format for study in medicine is the randomized, double-blind, placebo-controlled trial with hard endpoints. To be sure, every effort is genuinely made to minimize bias and confounding variables in these studies. But these trials are rigorous, complicated, and expensive. Many trials out there are not these types of trials. But notwithstanding the quality of the gold standard trial and the implications it has, we can still get it wrong. But that’s just the way science is. Years after a trial told us to do one thing, we are frantically told to stop doing it because a newer trial contradicts the original. There is also the growing “replication crisis” that reveals the failure to reproduce a particular trial’s results when it is attempted again. I happen to love this self-criticism that is forever at the center of medicine because it shows we are never fully satisfied; we want to do better. Medicine, to be sure, is extraordinary; it just isn’t forever sure.

The godfather of modern medicine, Dr. William Osler, observed that “Medicine is a science of uncertainty and an art of probability.” Physicist Richard Feynman noted that “If you thought that science was certain, well, that is just an error on your part.” And Abba Eban, an Israeli diplomat, referred to consensus in politics in a way that could easily describe consensus statements in medicine, “A consensus means that everyone agrees to say collectively what no one believes individually.” The young medical student is rattled by this, but the wizened physician simply nods and admits it is so.

Adolf Hitler once defiantly insisted, “Science cannot lie.” And Winston Churchill cautiously countered, “The Dark Ages may return . . . on the gleaming wings of science.”

In particular, during the early days of the COVID-19 pandemic, some of the urgent demands for safety (“Don’t just stand there—do something!) outpaced an informed sense of what exactly we should do. In the beginning, we simply didn’t have time to study and decide. There were immense pressures to make decisions now. Should we enforce lockdowns or encourage herd immunity? Should we place people on ventilators early or should we wait a while? Should everyone be masked everywhere or only some people in some places? And these medical and public health decisions fed into decisions surrounding personal liberties and state authority. Can the state close my business? Can the schools mask my children? If I can gamble at the casino, why can’t I worship in my church? To be sure, when the science isn’t sure, there needs to be a judgment call. But since science forever carries caveats, that judgment call has to be prudent, fair, and transparent.

Adolf Hitler once defiantly insisted, “Science cannot lie.” And Winston Churchill cautiously countered, “The Dark Ages may return . . . on the gleaming wings of science.” Science, in every form, is practiced by scientists made of human clay. And whenever we bring the human element into play, we bring the spark of genius as well as the taint of fallibility. In all that we do, we will find our wisdom and insight, hopes and best intentions, but also our greed and egos, blind spots, and blunders. It is inexact to call man a rational animal. Rather, we should echo Jacques Barzun’s correction, “No—[man is] only capable of reason.” With efforts to maximize the good and minimize the bad, we will forever have pinches and smidgeons of our broken humanity in the brilliant scientific stew. Such is the human condition. C’est la vie.

Moreover, science is not all. Even though many have tried, it cannot replace faith or philosophy, art or the humanities. It is mute on the ineffable and clumsy with the transcendent. Science can make our lives better, but it doesn’t explain our reasons for living. It can help us achieve our purpose, but it doesn’t define it. It is a means, not an end. Science is an indispensable tool; it’s just a lousy god.

Now, this shouldn’t invite us to be cranky contrarians or scientific Luddites. The scientific method is a method of fits and starts, but with truly remarkable success. The development of heavenward spacecraft and bottom-scanning submarines, optimized harvests and clean water systems, antibiotics and chemotherapies proudly belong in the trophy case of science. And the cure of illness and increase in life expectancy testify that even though medical research produces its imperfect best, it still may be the best we can rely on. It is akin to Churchill’s quip when he called democracy, “the worst form of Government except for all those other forms that have been tried from time to time.”

To be sure, this pandemic has been long and taxing. But hopefully, we can emerge from the bleary haze with a modicum of wisdom learned from what we have experienced along the way. Science has achieved certain wonders, but its practitioners and representatives have had their share of blunders. Let us take pride in what we have accomplished, have humility about what we can learn, and have mercy on those we have, at times, bickered with. After all, as G.K. Chesterton once reminded, “We are all in the same boat in a stormy sea, and we owe each other a terrible loyalty.”