Tag Archives: Jeremy Samuel Faust

COVID-19: caution and concern not panic

There’s a lot of information being pumped out about COVID-19 and not all of it is as helpful as it might be. In fact, the sheer volume can seem overwhelming despite one’s best efforts to be calm.

Here are a few things I’ve used to help relieve some fo the pressure as numbers in Canada keep rising.

Inspiration from the Italians

I was thrilled to find Emily Rumball’s March 18 ,2020 article titled, “Italians making the most of quarantine is just what the world needs right now (VIDEOS),” on the Daily Hive website. The couple dancing on the balcony while Ginger Rogers and Fred Astaire are shown dancing on the wall above is my favourite.

As the Italians practice social distancing and exercise caution, they are also demonstrating that “life goes on” even while struggling as one of the countries hit hardest by COVID-19.

Investigating viruses and the 1918/19 pandemic vs. COVID-19

There has been some mention of and comparison to the 1918/19 pandemic (also known as the Spanish flu) in articles by people who don’t seem to be particularly well informed about that earlier pandemic. Susan Baxter offers a concise and scathing explanation for why the 1918/19 situation deteriorated as much as it did in her February 8, 2010 posting. As for this latest pandemic (COVID-19), she explains what a virus actually is and suggests we all calm down in her March 17, 2020 posting. BTW, she has an interdisciplinary PhD for work largely focused on health economics. She is also a lecturer in the health sciences programme at Simon Fraser University (Vancouver, Canada). Full disclosure: She and I have a longstanding friendship.

Marilyn J. Roossinck, a professor of Plant Pathology and Environmental Microbiology at Pennsylvania State University, wrote a February 20, 2020 essay for The Conversation titled, “What are viruses anyway, and why do they make us so sick? 5 questions answered,”

4. SARS was a formidable foe, and then seemed to disappear. Why?

Measures to contain SARS started early, and they were very successful. The key is to stop the chain of transmission by isolating infected individuals. SARS had a short incubation period; people generally showed symptoms in two to seven days. There were no documented cases of anyone being a source of SARS without showing symptoms.

Stopping the chain of transmission is much more difficult when the incubation time is much longer, or when some people don’t get symptoms at all. This may be the case with the virus causing CoVID-19, so stopping it may take more time.

1918/19 pandemic vs. COVID-19

Angela Betsaida B. Laguipo, with a Bachelor of Nursing degree from the University of Baguio, Philippine is currently completing her Master’s Degree, has written a March 9, 2020 article for News Medical comparing the two pandemics,

The COVID-19 is fast spreading because traveling is an everyday necessity today, with flights from one country to another accessible to most.

Some places did manage to keep the virus at bay in 1918 with traditional and effective methods, such as closing schools, banning public gatherings, and locking down villages, which has been performed in Wuhan City, in Hubei province, China, where the coronavirus outbreak started. The same method is now being implemented in Northern Italy, where COVID-19 had killed more than 400 people.

The 1918 Spanish flu has a higher mortality rate of an estimated 10 to 20 percent, compared to 2 to 3 percent in COVID-19. The global mortality rate of the Spanish flu is unknown since many cases were not reported back then. About 500 million people or one-third of the world’s population contracted the disease, while the number of deaths was estimated to be up to 50 million.

During that time, public funds are mostly diverted to military efforts, and a public health system was still a budding priority in most countries. In most places, only the middle class or the wealthy could afford to visit a doctor. Hence, the virus has [sic] killed many people in poor urban areas where there are poor nutrition and sanitation. Many people during that time had underlying health conditions, and they can’t afford to receive health services.

I recommend reading Laguipo’s article in its entirety right down to the sources she cites at the end of her article.

Ed Yong’s March 20, 2020 article for The Atlantic, “Why the Coronavirus Has Been So Successful; We’ve known about SARS-CoV-2 for only three months, but scientists can make some educated guesses about where it came from and why it’s behaving in such an extreme way,” provides more information about what is currently know about the coronavirus, SATS-CoV-2,

One of the few mercies during this crisis is that, by their nature, individual coronaviruses are easily destroyed. Each virus particle consists of a small set of genes, enclosed by a sphere of fatty lipid molecules, and because lipid shells are easily torn apart by soap, 20 seconds of thorough hand-washing can take one down. Lipid shells are also vulnerable to the elements; a recent study shows that the new coronavirus, SARS-CoV-2, survives for no more than a day on cardboard, and about two to three days on steel and plastic. These viruses don’t endure in the world. They need bodies.

But why do some people with COVID-19 get incredibly sick, while others escape with mild or nonexistent symptoms? Age is a factor. Elderly people are at risk of more severe infections possibly because their immune system can’t mount an effective initial defense, while children are less affected because their immune system is less likely to progress to a cytokine storm. But other factors—a person’s genes, the vagaries of their immune system, the amount of virus they’re exposed to, the other microbes in their bodies—might play a role too. In general, “it’s a mystery why some people have mild disease, even within the same age group,” Iwasaki [Akiko Iwasaki of the Yale School of Medicine] says.

We still have a lot to learn about this.

Going nuts and finding balance with numbers

Generally speaking,. I find numbers help me to put this situation into perspective. It seems I’m not alone; Dr. Daniel Gillis’ (Guelph University in Ontario, Canada) March 18, 2020 blog post is titled, Statistics In A Time of Crisis.

Hearkening back in history, the Wikipedia entry for Spanish flu offers a low of 17M deaths in a 2018 estimate to a high of !00M deaths in a 2005 estimate. At this writing (Friday, March 20, 2020 at 3 pm PT), the number of coronovirus cases worldwide is 272,820 with 11, 313 deaths.

Articles like Michael Schulman’s March 16, 2020 article for the New Yorker might not be as helpful as one hope (Note: Links have been removed),

Last Wednesday night [March 11, 2020], not long after President Trump’s Oval Office address, I called my mother to check in about the, you know, unprecedented global health crisis [emphasis mine] that’s happening. She told me that she and my father were in a cab on the way home from a fun dinner at the Polo Bar, in midtown Manhattan, with another couple who were old friends.

“You went to a restaurant?!” I shrieked. This was several days after she had told me, through sniffles, that she was recovering from a cold but didn’t see any reason that she shouldn’t go to the school where she works. Also, she was still hoping to make a trip to Florida at the end of the month. My dad, a lawyer, was planning to go into the office on Thursday, but thought that he might work from home on Friday, if he could figure out how to link up his personal computer. …

… I’m thirty-eight, and my mother and father are sixty-eight and seventy-four, respectively. Neither is retired, and both are in good shape. But people sixty-five and older—more than half of the baby-boomer population—are more susceptible to COVID-19 and have a higher mortality rate, and my parents’ blithe behavior was as unsettling as the frantic warnings coming from hospitals in Italy.

Clearly, Schulman is concerned about his parents’ health and well being but the tone of near hysteria is a bit off-putting. We’re not in a crisis (exception: the Italians and, possibly, the Spanish and the French)—yet.

Tyler Dawson’s March 20, 2020 article in The Province newspaper (in Vancouver, British Columbia) offers dire consequences from COVID-19 before pivoting,

COVID-19 will leave no Canadian untouched.

Travel plans halted. First dates postponed. School semesters interrupted. Jobs lost. Retirement savings decimated. Some of us will know someone who has gotten sick, or tragically, died from the virus.

By now we know the terminology: social distancing, flatten the curve. Across the country, each province is taking measures to prepare, to plan for care, and the federal government has introduced financial measures amounting to more than three per cent of the country’s GDP to float the economy onward.

The response, says Steven Taylor, a University of British Columbia psychiatry professor and author of The Psychology of Pandemics, is a “balancing act.” [emphasis mine] Keep people alert, but neither panicked nor tuned out.

“You need to generate some degree of anxiety that gets people’s attention,” says Taylor. “If you overstate the message it could backfire.”

Prepare for uncertainty

In the same way experts still cannot come up with a definitive death rate for the 1918/19 pandemic, they are having trouble with this one too although, now, they’re trying to model the future rather than trying to establish what happened in the past. David Adam’s March 12, 2020 article forThe Scientist, provides some insight into the difficulties (Note: Links have been removed)

Like any other models, the projections of how the outbreak will unfold, how many people will become infected, and how many will die, are only as reliable as the scientific information they rest on. And most modelers’ efforts so far have focused on improving these data, rather than making premature predictions.

“Most of the work that modelers have done recently or in the first part of the epidemic hasn’t really been coming up with models and predictions, which is I think how most people think of it,” says John Edmunds, who works in the Centre for the Mathematical Modelling of Infectious Diseases at the London School of Hygiene & Tropical Medicine. “Most of the work has really been around characterizing the epidemiology, trying to estimate key parameters. I don’t really class that as modeling but it tends to be the modelers that do it.”

These variables include key numbers such as the disease incubation period, how quickly the virus spreads through the population, and, perhaps most contentiously, the case-fatality ratio. This sounds simple: it’s the proportion of infected people who die. But working it out is much trickier than it looks. “The non-specialists do this all the time and they always get it wrong,” Edmunds says. “If you just divide the total numbers of deaths by the total numbers of cases, you’re going to get the wrong answer.”

Earlier this month, Tedros Adhanom Ghebreyesus, the head of the World Health Organization, dismayed disease modelers when he said COVID-19 (the disease caused by the SARS-CoV-2 coronavirus) had killed 3.4 percent of reported cases, and that this was more severe than seasonal flu, which has a death rate of around 0.1 percent. Such a simple calculation does not account for the two to three weeks it usually takes someone who catches the virus to die, for example. And it assumes that reported cases are an accurate reflection of how many people are infected, when the true number will be much higher and the true mortality rate much lower.

Edmunds calls this kind of work “outbreak analytics” rather than true modeling, and he says the results of various specialist groups around the world are starting to converge on COVID-19’s true case-fatality ratio, which seems to be about 1 percent.[emphasis mine]

The 1% estimate in Adam’s article accords with Jeremy Samuel Faust’s (an emergency medicine physician at Brigham and Women’s Hospital in Boston, faculty in its division of health policy and public health, and an instructor at Harvard Medical School) estimates in a March 4, 2020 article (COVID-19 Isn’t As Deadly As We Think featured in my March 9, 2020 posting).

In a March 17, 2020 article by Steven Lewis (a health policy consultant formerly based in Saskatchewan, Canada; now living in Australia) for the Canadian Broadcasting Corporation’s (CBC) news online website, he covers some of the same ground and offers a somewhat higher projected death rate while refusing to commit,

Imagine you’re a chief public health officer and you’re asked the question on everyone’s mind: how deadly is the COVID-19 outbreak?

With the number of cases worldwide approaching 200,000, and 1,000 or more cases in 15 countries, you’d think there would be an answer. But the more data we see, the tougher it is to come up with a hard number.

Overall, the death rate is around four per cent — of reported cases. That’s also the death rate in China, which to date accounts for just under half the total number of global cases.

China is the only country where a) the outcome of almost all cases is known (85 per cent have recovered), and b) the spread has been stopped (numbers plateaued about a month ago). 

A four per cent death rate is pretty high — about 40 times more deadly than seasonal flu — but no experts believe that is the death rate. The latest estimate is that it is around 1.5 per cent. [emphasis mine] Other models suggest that it may be somewhat lower. 

The true rate can be known only if every case is known and confirmed by testing — including the asymptomatic or relatively benign cases, which comprise 80 per cent or more of the total — and all cases have run their course (people have either recovered or died). Aside from those in China, almost all cases identified are still active. 

Unless a jurisdiction systematically tests a large random sample of its population, we may never know the true rate of infection or the real death rate. 

Yet for all this unavoidable uncertainty, it is still odd that the rates vary so widely by country.

His description of the situation in Europe is quite interesting and worthwhile if you have the time to read it.

In the last article I’m including here, Murray Brewster offers some encouraging words in his March 20, 2020 piece about the preparations being made by the Canadian Armed Forces (CAF),

The Canadian military is preparing to respond to multiple waves of the COVID-19 pandemic which could stretch out over a year or more, the country’s top military commander said in his latest planning directive.

Gen. Jonathan Vance, chief of the defence staff, warned in a memo issued Thursday that requests for assistance can be expected “from all echelons of government and the private sector and they will likely come to the Department [of National Defence] through multiple points of entry.”

The directive notes the federal government has not yet directed the military to move into response mode, but if or when it does, a single government panel — likely a deputy-minister level inter-departmental task force — will “triage requests and co-ordinate federal responses.”

It also warns that members of the military will contract the novel coronavirus, “potentially threatening the integrity” of some units.

The notion that the virus caseload could recede and then return is a feature of federal government planning.

The Public Health Agency of Canada has put out a notice looking for people to staff its Centre for Emergency Preparedness and Response during the crisis and the secondment is expected to last between 12 and 24 months.

The Canadian military, unlike those in some other nations, has high-readiness units available. Vance said they are already set to reach out into communities to help when called.

Planners are also looking in more detail at possible missions — such as aiding remote communities in the Arctic where an outbreak could cripple critical infrastructure.

Defence analyst Dave Perry said this kind of military planning exercise is enormously challenging and complicated in normal times, let alone when most of the federal civil service has been sent home.

“The idea that they’re planning to be at this for year is absolutely bang on,” said Perry, a vice-president at the Canadian Global Affairs Institute.

In other words, concern and caution are called for not panic. I realize this post has a strongly Canada-centric focus but I’m hopeful others elsewhere will find this helpful.

Therapeutic nanoparticles for COVID-19 (disease caused by severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2])—don’t hold your breath!

Last week (specifically, Tuesday, March 3, 2020), someone moved away from me during a class. I’d sneezed.

The irony of the situation is that of the two of us, with my lung issues I’d be the one most at risk of getting very ill and/or dying from COVID-19. ([1] Yes, I confirmed that was the reason she’d moved. [2] The therapeutic nanoparticles news item is coming later) Here are the risk factors to take into account (from the US Centers for Disease Control’s People at Risk for Serious Illness from COVID-19 webpage,

  • Older adults [Note: In one report the age range was stated as ‘people over 70’]
  • People who have serious chronic medical conditions like:
    • Heart disease
    • Diabetes
    • Lung disease

I’m not suggesting that all precautions be abandoned but it would seem that panic might not be called for. Jeremy Samuel Faust, an emergency medicine physician at Brigham and Women’s Hospital in Boston, faculty in its division of health policy and public health, and an instructor at Harvard Medical School, has written a calming March 4, 2020 article (COVID-19 Isn’t As Deadly As We Think; Don’t hoard masks and food. Figure out how to help seniors and the immunosuppressed stay healthy.) for Slate.com (Note: Links have been removed],

There are many compelling reasons to conclude that SARS-CoV-2, the virus that causes COVID-19, is not nearly as deadly as is currently feared. But COVID-19 panic has set in nonetheless. You can’t find hand sanitizer in stores, and N95 face masks are being sold online for exorbitant prices, never mind that neither is the best way to protect against the virus (yes, just wash your hands). The public is behaving as if this epidemic is the next Spanish flu, which is frankly understandable given that initial reports have staked COVID-19 mortality at about 2–3 percent, quite similar to the 1918 pandemic that killed tens of millions of people.

Allow me to be the bearer of good news. These frightening numbers are unlikely to hold. The true case fatality rate, known as CFR, of this virus is likely to be far lower than current reports suggest. Even some lower estimates, such as the 1 percent death rate recently mentioned by the directors of the National Institutes of Health and the Centers for Disease Control and Prevention, likely substantially overstate the case. [emphases mine]

But the most straightforward and compelling evidence that the true case fatality rate of SARS-CoV-2 is well under 1 percent comes not from statistical trends and methodological massage, but from data from the Diamond Princess cruise outbreak and subsequent quarantine off the coast of Japan.

A quarantined boat is an ideal—if unfortunate—natural laboratory to study a virus. Many variables normally impossible to control are controlled. We know that all but one patient boarded the boat without the virus. We know that the other passengers were healthy enough to travel. We know their whereabouts and exposures. While the numbers coming out of China are scary, we don’t know how many of those patients were already ill for other reasons. How many were already hospitalized for another life-threatening illness and then caught the virus? How many were completely healthy, caught the virus, and developed a critical illness? In the real world, we just don’t know.

Here’s the problem with looking at mortality numbers in a general setting: In China, 9 million people die per year, which comes out to 25,000 people every single day, or around 1.5 million people over the past two months alone. A significant fraction of these deaths results from diseases like emphysema/COPD, lower respiratory infections, and cancers of the lung and airway whose symptoms are clinically indistinguishable from the nonspecific symptoms seen in severe COVID-19 cases. And, perhaps unsurprisingly, the death rate from COVID-19 in China spiked precisely among the same age groups in which these chronic diseases first become common. During the peak of the outbreak in China in January and early February, around 25 patients per day were dying with SARS-CoV-2. Most were older patients in whom the chronic diseases listed above are prevalent. Most deaths occurred in Hubei province, an area in which lung cancer and emphysema/COPD are significantly higher than national averages in China, a country where half of all men smoke. How were doctors supposed to sort out which of those 25 out of 25,000 daily deaths were solely due to coronavirus, and which were more complicated? What we need to know is how many excess deaths this virus causes.

This all suggests that COVID-19 is a relatively benign disease for most young people, and a potentially devastating one for the old and chronically ill, albeit not nearly as risky as reported. Given the low mortality rate among younger patients with coronavirus—zero in children 10 or younger among hundreds of cases in China, and 0.2-0.4 percent in most healthy nongeriatric adults (and this is still before accounting for what is likely to be a high number of undetected asymptomatic cases)—we need to divert our focus away from worrying about preventing systemic spread among healthy people—which is likely either inevitable, or out of our control—and commit most if not all of our resources toward protecting those truly at risk of developing critical illness and even death: everyone over 70, and people who are already at higher risk from this kind of virus.

This still largely comes down to hygiene and isolation. But in particular, we need to focus on the right people and the right places. Nursing homes, not schools. Hospitals, not planes. We need to up the hygienic and isolation ante primarily around the subset of people who can’t simply contract SARS-CoV-2 and ride it out the way healthy people should be able to.

Curtis Kim of Vancouver, Canada, has created a website dedicated to tracking the statistics and information about COVID-19 in Canada and around the world. Here’s more about Kim and the website from a March 8, 2020 article by Megan Devlin for the Daily Hive,

Curtis Kim, who studied Computer Systems Technology at the British Columbia Institute of Technology [BCIT], launched the site this week after getting frustrated he was spending so much time on various websites looking for daily coronavirus updates.

The site breaks down the number of cases in Canada, the number of deaths (zero in Canada so far), and the number of people who have recovered. Further down, it provides the same stats for global COVID-19 cases.

There’s also a colour-coded map showing where cases are distributed, and a feed of latest news articles about the virus. Kim also included information about symptoms and how to contact Canadian public health services.

Kim is looking for work and given what I’ve seen of his COVID-19 website, he should have no difficulty. Although I think it might be an idea for him to explain how the ‘lethality’ rate on his website has been obtained since Faust who seems to have more directly relevant experience suggests in his article that the numbers are highly problematic,

My name is Curtis, recently graduated from BCIT. I thought it would be a serious worldwide issue considering the speed of the spread of this virus ever since this COVID-19 occurred. I frequently googled to check up the current status by going through many websites and felt I was wasting time repeatedly searching with same keywords and for sure I wasn’t the only one feeling this way. That’s why I started creating this application. It provides up-to-date information on the COVID-19 broken by province and country around the world, key contact information, and latest news. I like to help people, and want them to understand this situation easily using this application. Hopefully this situation improves soon.

If you have any further inquries about the information on this web application, Please reach me at curtisk808@gmail.com

At about 11:45 am (PT) on March 9, 2020, Kim’s COVID-19 website was updated to include one death in Canada. As you might expect, ti was a resident in a long term care home. Wanyee Li’s March 9, 2020 article for The Star presents the news,

A resident at a long-term care home experiencing a COVID-19 outbreak in North Vancouver has died after contracting the virus, B.C. health officials confirmed Monday [March 9, 2020].

It is the first reported death in Canada linked to the virus.

The outbreak at the Lynn Valley Care Centre has so far been linked to three community transmission cases of the virus.

Provincial Health Officer Dr. Bonnie Henry confirmed five new cases of COVID-19 in B.C. on Monday [March 9, 2020], putting the total in the province at 32.

The five new cases include one health-care worker, two people who are close contacts of an existing case, one person who recently returned from travel to Iran and another who was in Italy recently.

Officials are conducting an investigation into the three community transmission cases at the long-term care home to determine how a health care worker contracted the virus.

I looked up the population figures for the province of British Columbia (BC; Wikipedia entry for Demographics of British Columbia). As of the 2016 census, there were 4,648,055 people in the province. Assuming that population number holds, 67 cases in all of Canada (with 27 cases in BC) of COVID-19 don’t seem like big numbers.

We should definitely take precautions and be careful but there’s no need to panic.

Nanoparticles and a COVID-19 treatment?

Don’t hold you breath. This March 5, 2020 news item on Nanowerk is speculative,

There is no vaccine or specific treatment for COVID-19, the disease caused by the severe acute respiratory syndrome coronavirus 2, or SARS-CoV-2.

Since the outbreak began in late 2019, researchers have been racing to learn more about SARS-CoV-2, which is a strain from a family of viruses known as coronavirus for their crown-like shape.

Northeastern Ûniversity] chemical engineer Thomas Webster, who specializes in developing nano-scale medicine and technology to treat diseases, is part of a contingency of scientists that are contributing ideas and technology to the Centers for Disease Control and Prevention to fight the COVID-19 outbreak.

The idea of using nanoparticles, Webster says, is that the virus behind COVID-19 consists of a structure of a similar scale as his nanoparticles. At that scale, matter is ultra-small, about ten thousand times smaller than the width of a single strand of hair.

..

This scanning electron microscope image shows SARS-CoV-2 (round gold objects) emerging from the surface of cells cultured in the lab. SARS-CoV-2, also known as 2019-nCoV, is the virus that causes COVID-19. The virus shown was isolated from a patient in the U.S. (Image: NIAID-RML)

A March 4, 2020 Northeastern University news release by Roberto Molar Candanosa, which originated the news item, delves further into Webster’s thinking process,

Webster is proposing particles of similar sizes that could attach to SARS-CoV-2 viruses, disrupting their structure with a combination of infrared light treatment. That structural change would then halt the ability of the virus to survive and reproduce in the body.

“You have to think in this size range,” says Webster, Art Zafiropoulo Chair of chemical engineering at Northeastern. “In the nanoscale size range, if you want to detect viruses, if you want to deactivate them.”

Finding and neutralizing viruses with nanomedicine is at the core of what Webster and other researchers call theranostics, which focuses on combining therapy and diagnosis. Using that approach, his lab has specialized in nanoparticles to fight the microbes that cause influenza and tuberculosis. 

“It’s not just having one approach to detect whether you have a virus and another approach to use it as a therapy,” he says, “but having the same particle, the same approach, for both your detection and therapy.”

I wish Webster good luck. As for the rest us, let’s wash our hands and keep calm.

After the April 22, 2017 US March for Science

Since last Saturday’s (April 22, 2017) US March for Science, I’ve stumbled across three interesting perspectives on the ‘movement’. As I noted in my April 14, 2017 posting, the ‘march’ has reached out beyond US borders to become international in scope. (On the day, at least 18 marches were held in Canada alone.)

Canada

John Dupuis wrote about his experience as a featured speaker at the Toronto (Ontario) march in an April 24, 2017 posting on his Confessions of a Science Librarian blog (Note: Links have been removed),

My fellow presenters were Master of Ceremonies Rupinder Brar and speakers Dawn Martin-Hill, Josh Matlow, Tanya Harrison, Chelsea Rochman, Aadita Chaudhury, Eden Hennessey and Cody Looking Horse.

Here’s what I had to say:

Hi, my name is John and I’m a librarian. My librarian superpower is making lists, checking them twice and seeing who’s been naughty and who’s been nice. The nice ones are all of you out here marching for science. And the naughty ones are the ones out there that are attacking science and the environment.

Now I’ve been in the list-making business for quite a few years, making an awful lot of lists of how governments have attacked or ignored science. I did a lot of work making lists about the Harper government and their war on science. The nicest thing I’ve ever seen written about my strange little obsession was in The Guardian.

Here’s what they said, in an article titled, How science helped to swing the Canadian election.

“Things got so bad that scientists and their supporters took to the streets. They demonstrated in Ottawa. They formed an organization, Evidence for Democracy, to bring push back on political interference in science. Awareness-raising forums were held at campuses throughout Canada. And the onslaught on science was painstakingly documented, which tends to happen when you go after librarians.”

Yeah, watch out. Don’t go after libraries and librarians. The Harper govt learned its lesson. And we learned a lesson too. And that lesson was that keeping track of things, that painstakingly documenting all the apparently disconnected little bits and pieces of policies here, regulations changed there and a budget snipped somewhere else, it all adds up.

What before had seemed random and disconnected is suddenly a coherent story. All the dots are connected and everybody can see what’s happened. By telling the whole story, by laying it all out there for everyone to see, it’s suddenly easier for all of us to point to the list and to hold the government of the day accountable. That’s the lesson learned from making lists.

But back in 2013 what I saw the government doing wasn’t the run of the mill anti-science that we’d seen before. Prime Minister Harper’s long standing stated desire to make Canada a global energy superpower revealed the underlying motivation but it was the endless litany of program cuts, census cancellation, science library closures, regulatory changes and muzzling of government scientists that made up the action plan. But was it really a concerted action plan or was it a disconnected series of small changes that were really no big deal or just a little different from normal?

That’s where making lists comes in handy. If you’re keeping track, then, yeah, you see the plan. You see the mission, you see the goals, you see the strategy, you see the tactics. You see that the government was trying to be sneaky and stealthy and incremental and “normal” but that there was a revolution in the making. An anti-science revolution.

Fast forward to now, April 2017, and what do we see? The same game plan repeated, the same anti-science revolution under way [in the US]. Only this time not so stealthy. Instead of a steady drip, it’s a fire hose. Message control at the National Parks Service, climate change denial, slashing budgets and shutting down programs at the EPA and other vital agencies. Incompetent agency directors that don’t understand the mission of their agencies or who even want to destroy them completely.

Once again, we are called to document, document, document. Tell the stories, mobilize science supporters and hold the governments accountable at the ballot box. Hey, like the Guardian said, if we did it in Canada, maybe that game plan can be repeated too.

I invited my three government reps here to the march today, Rob Oliphant, Josh Matlow and Eric Hoskins and I invited them to march with me so we could talk about how evidence should inform public policy. Josh, of course, is up here on the podium with me. As for Rob Oliphant from the Federal Liberals and Eric Hoskins from the Ontario Liberals, well, let’s just say they never answered my tweets.

Keep track, tell the story, hold all of them from every party accountable. The lesson we learned here in Canada was that science can be a decisive issue. Real facts can mobilise people to vote against alternative facts.

Thank you.

I’m not as sure as Dupuis that science was a decisive issue in our 2015 federal election; I’d say it was a factor. More importantly, I think the 2015 election showed Canadian scientists and those who feel science is important that it is possible to give it a voice and more prominence in the political discourse.

Rwanda

Eric Leeuwerck in an April 24, 2017 posting on one of the Agence Science-Press blogs describes his participation from Rwanda (I have provided a very rough translation after),

Un peu partout dans le monde, samedi 22 avril 2017, des milliers de personnes se sont mobilisées pour la « march for science », #sciencemarch, « une marche citoyenne pour les sciences, contre l’obscurantisme ». Et chez moi, au Rwanda ?

J’aurais bien voulu y aller moi à une « march for science », j’aurais bien voulu me joindre aux autres voix, me réconforter dans un esprit de franche camaraderie, à marcher comme un seul homme dans les rues, à dire que oui, nous sommes là ! La science vaincra, « No science, no futur ! » En Arctique, en Antarctique, en Amérique latine, en Asie, en Europe, sur la terre, sous l’eau…. Partout, des centaines de milliers de personnes ont marché ensemble. L’Afrique s’est mobilisée aussi, il y a eu des “march for science” au Kenya, Nigeria, Ouganda…

Et au Rwanda ? Eh bien, rien… Pourquoi suivre la masse, hein ? Pourquoi est-ce que je ne me suis pas bougé le cul pour faire une « march for science » au Rwanda ? Euh… et bien… Je vous avoue que je me vois mal organiser une manif au Rwanda en fait… Une collègue m’a même suggéré l’idée mais voilà, j’ai laissé tomber au moment même où l’idée m’a traversé l’esprit… Cependant, j’avais quand même cette envie d’exprimer ma sympathie et mon appartenance à ce mouvement mondial, à titre personnel, sans vouloir parler pour les autres, avec un GIF tout simple.

March for science RWanda

” March for science ” Rwanda

Je dois dire que je me sens bien souvent seul ici… Les cours de biologie de beaucoup d’écoles sont créationnistes, même au KICS (pour Kigali International Community School), une école internationale américaine (je tiens ça d’amis qui ont eu leurs enfants dans cette école). Sur son site, cette école de grande renommée ici ne cache pas ses penchants chrétiens : “KICS is a fully accredited member of the Association of Christian Schools International (ACSI) (…)” et, de plus, est reconnue par le ministère de l’éducation rwandais : “(KICS) is endorsed by the Rwandan Ministry of Education as a sound educational institution“. Et puis, il y a cette phrase sur leur page d’accueil : « Join the KICS family and impact the world for christ ».

Je réalise régulièrement des formations en pédagogie des sciences pour des profs locaux du primaire et du secondaire. Lors de ma formation sur la théorie de l’Evolution, qui a eu pas mal de succès, les enseignants de biologie m’ont confié que c’était la première fois, avec moi, qu’ils avaient eu de vrais cours sur la théorie de l’Evolution… (Je passe les débats sur l’athéisme, sur la « création » qui n’est pas un fait, sur ce qu’est un fait, qu’il ne faut pas faire « acte de foi » pour faire de la science et que donc on ne peut pas « croire » en la science, mais la comprendre…). Un thème délicat à aborder a été celui de la « construction des identités meurtrières » pour reprendre le titre du livre d’Amin Maalouf, au Rwanda comment est-ce qu’une pseudoscience, subjective, orientée politiquement et religieusement a pu mener au racisme et au génocide. On m’avait aussi formellement interdit d’en parler à l’époque, ma directrice de l’époque disait « ne te mêle pas de ça, ce n’est pas notre histoire », mais voilà, maintenant, ce thème est devenu un thème incontournable, même à l’Ecole Belge de Kigali !

Une autre formation sur l’éducation sexuelle a été très bien reçue aussi ! J’ai mis en place cette formation, aussi contre l’avis de ma directrice de l’époque (une autre) : des thèmes comme le planning familial, la contraception, l’homosexualité, gérer un débat houleux, les hormones… ont été abordées ! Première fois aussi, m’ont confié les enseignants, qu’ils ont reçu une formation objective sur ces sujets tabous.

Chaque année, je réunis un peu d’argent avec l’aide de l’École Belge de Kigali pour faire ces formations (même si mes directions ne sont pas toujours d’accord avec les thèmes ), je suis totalement indépendant et à part l’École Belge de Kigali, aucune autre institution dont j’ai sollicité le soutien n’a voulu me répondre. Mais je continue, ça relève parfois du militantisme, je l’avoue.

C’est comme mon blog, un des seuls blogs francophones de sciences en Afrique (en fait, je n’en ai jamais trouvé aucun en cherchant sur le net) dans un pays à la connexion Internet catastrophique, je me demande parfois pourquoi je continue… Je perds tellement de temps à attendre que mes pages chargent, à me reconnecter je ne sais pas combien de fois toutes les 5 minutes … En particulier lors de la saison des pluies ! Heureusement que je peux compter sur le soutien inconditionnel de mes communautés de blogueurs : le café des sciences , les Mondoblogueurs de RFI , l’Agence Science-Presse. Sans eux, j’aurais arrêté depuis longtemps ! Six ans de blogging scientifique quand même…

Alors, ce n’est pas que virtuel, vous savez ! Chaque jour, quand je vais au boulot pour donner mes cours de bio et chimie, quand j’organise mes formations, quand j’arrive à me connecter à mon blog, je « marche pour la science ».

Yeah. (De la route, de la science et du rock’n’roll : Rock’n’Science !)

(Un commentaire de soutien ça fait toujours plaisir !)

As I noted, this will be a very rough translation and anything in square brackets [] means that I’m even less sure about the translation in that bit,

Pretty much around the world, thousands will march for science against anti-knowledge/anti-science.

I would have liked to join in and to march with other kindred spirits as one in the streets. We are here! Science will triumph! No science .No future. In the Arctic, in the Antarctic, in Latin America, in Asia, in Europe,  on land, on water … Everywhere hundreds of thousands of people are marching together. Africa, too, has mobilized with marches in Kenya, Nigeria, Uganda ..

And in Rwanda? Well, no, nothing. Why follow everyone else? Why didn’t I get my butt in gear and organize a march? [I’m not good at organizing these kinds of things] A colleague even suggested I arrange something . I had an impulse to do it and then it left. Still, I want to express my solidarity with the March for Science without attempting to talk for or represent anyone other than myself. So, here’s a simple gif,

I have to say I often feel myself to be alone here. The biology courses taught in many of the schools here are creationist biology even at the KICS (Kigali International Community School), an international American school (I have friends whose children attend the school). On the school’s site there’s a sign that does nothing to hide its mission: “KICS is a fully accredited member of the Association of Christian Schools International (ACSI) (…)” and, further, it is recognized as such by the Rwandan Ministry of Education : “(KICS) is endorsed by the Rwandan Ministry of Education as a sound educational institution”. Finally, there’s this on their welcome page : « Join the KICS family and impact the world for christ ».

I regularly give science education prgorammes for local primary and secondary teachers. With regard to my teaching on the theory of evolution some have confided that this is the first time they’ve truly been exposed to a theory of evolution.  (I avoid the debates about atheism and the creation story. Science is not about faith it’s about understanding …). One theme that must be skirted with some delicacy in Rwanda is the notion of constructing a murderous/violent identity to borrow from Amin Maalouf’s book title, ‘Les Identités meurtrières’; in English: In the Name of Identity: Violence and the Need to Belong) as it has elements of a pseudoscience, subjectivity, political and religious connotations and has been used to justify racism and genocide. [Not sure here if he’s saying that the theory of evolution has been appropriated and juxtaposed with notions of violence and identify leading to racism and genocide. For anyone not familiar with the Rwandan genocide of 1994, see this Wikipedia entry.] Ihave been formally forbidden to discuss this period and my director said “Don’t meddle in this. It’s not our history.” But this theme/history has become essential/unavoidable even at the l’Ecole Belge de Kigali (Belgian School of Kigali).

A programme on sex education was well received and that subject too was forbidden to me (by a different director). I included topics such as  family planning, contraception, homosexuality, hormones and inspired a spirited debate. Many times my students have confided that they received good factual information on these taboo topics.

Each year with help from the Belgian School at Kigali, I raise money for these programmes (even if my directors don’t approve of the topics). I’m totally independent and other than the Belgian School at Kigali no other institution that I’ve appraoched has responded. But I continue as I hope that it can help lower milittancy.

My blog is one of the few French language science blogs in Africa (I rarely find any other such blogs when I search). In a country where the internet connection is catastrophically poor, I ask myself why I go on. I lose a lot of time waiting for pages to load or to re-establish a connection, especially in the rainy season. Happily I can depend on the communities of bloggers such as: café des sciences , les Mondoblogueurs de RFI , l’Agence Science-Presse. Without them I would have stopped long ago. It has been six years of blogging science …

It is virtual, you know. Each day when I deliver my courses in biology and chemistry, when I organize my programmes, when I post on my blog, ‘I march for science’.

Comments are gladly accepted. [http://www.sciencepresse.qc.ca/blogue/2017/04/24/march-science-rwanda]

All mistakes are mine.

US

My last bit is from an April 24, 2017 article by Jeremy Samuel Faust for Slate.com, (Note: Links have been removed),

Hundreds of thousands of self-professed science supporters turned out to over 600 iterations of the March for Science around the world this weekend. Thanks to the app Periscope, I attended half a dozen of them from the comfort of my apartment, thereby assiduously minimizing my carbon footprint.

Mainly, these marches appeared to be a pleasant excuse for liberals to write some really bad (and, OK, some truly superb) puns, and put them on cardboard signs. There were also some nicely stated slogans that roused support for important concepts such as reason and data and many that decried the defunding of scientific research and ignorance-driven policy.

But here’s the problem: Little of what I observed dissuades me from my baseline belief that, even among the sanctimonious elite who want to own science (and pwn [sic] anyone who questions it), most people have no idea how science actually works. The scientific method itself is already under constant attack from within the scientific community itself and is ceaselessly undermined by its so-called supporters, including during marches like those on Saturday. [April 22, 2017] In the long run, such demonstrations will do little to resolve the myriad problems science faces and instead could continue to undermine our efforts to use science accurately and productively.

Indeed much of the sentiment of the March for Science seemed to fall firmly in the camp of people espousing a gee-whiz attitude in which science is just great and beyond reproach. They feel that way because, so often, the science they’re exposed to feels that way—it’s cherry-picked. Cherry-picking scientific findings that support an already cherished and firmly held belief (while often ignoring equally if not more compelling data that contradicts it) is epidemic—in scientific journals and in the media.

Let’s face it: People like science when it supports their views. I see this every day. When patients ask me for antibiotics to treat their common colds, I tell them that decades of science and research, let alone a basic understanding of microbiology, shows that antibiotics don’t work for cold viruses. Trust me, people don’t care. They have gotten antibiotics for their colds in the past, and, lo, they got better. (The human immune system, while a bit slower and clunkier than we’d like it to be, never seems to get the credit it deserves in these little anecdotal stories.) Who needs science when you have something mightier—personal experience?

Another example is the vocal wing of environmentalists who got up one day and decided that genetically modified organisms were bad for you. They had not one shred of evidence for this, but it just kind of felt true. As a result, responsible scientists will be fighting against these zealots for years to come. While the leaders of March for Science events are on the right side of this issue, many of its supporters are not. I’m looking at you, Bernie Sanders; the intellectual rigor behind your stance requiring GMO labelling reflects a level of scientific understanding that would likely lead for calls for self-defenestration from your own supporters if it were applied to, say, something like climate change.

But it does not stop there. Perhaps as irritating as people who know nothing about science are those who know just a little bit—just enough to think they have any idea as to what is going on. Take for example the clever cheer (and unparalleled public declaration of nerdiness):

What do we want?

Science!

When do we want it?

After peer review!

Of course, the quality of most peer-review research is somewhere between bad and unfair to the pixels that gave their lives to display it. Just this past week, a study published by the world’s most prestigious stroke research journal (Stroke), made headlines and achieved media virality by claiming a correlation between increased diet soda consumption and strokes and dementia. Oh, by the way, the authors didn’t control for body mass index [*], even though, unsurprisingly, people who have the highest BMIs had the most strokes. An earlier study that no one seems to remember showed a correlation of around the same magnitude between obesity and strokes alone. But, who cares, right? Ban diet sodas now! Science says they’re linked to strokes and dementia! By the way, Science used to say that diet sodas cause cancer. But Science was, perish the thought, wrong.

If you can get past the writer’s great disdain for just about everyone, he makes very good points.

To add some clarity with regard to “controlling for body mass index,” there’s a concept in research known as a confounding variable. In this case, people who have a higher body mass index (or are more obese) will tend to have more strokes according to previous research which qualifies as a confounding variable when studying the effect of diet soda on strokes. To control for obesity means you set up the research project in such a way you can compare (oranges to oranges) the stroke rates of obese people who drink x amount of diet soda with obese people who do not drink x amount of diet soda and compare stroke rates of standard weight people who drink x amount of diet soda with other standard weight people who do not drink x amount of diet soda. There are other aspects of the research that would also have be considered but to control for body mass index that’s the way I’d set it up.

One point that Faust makes that isn’t made often enough and certainly not within the context of the ‘evidence-based policy movement’ and ‘marches for science’ is the great upheaval taking place within the scientific endeavour (Note: Links have been removed),

… . There are a dozen other statistical games that researchers can play to get statistical significance. Such ruses do not rise to anything approaching clinical relevance. Nevertheless, fun truthy ones like the diet soda study grab headlines and often end up changing human behaviors.

The reason this problem, what one of my friends delightfully calls statistical chicanery, is so rampant is twofold. First, academics need to “publish or perish.” If researchers don’t publish in peer-reviewed journals, their careers will be short and undistinguished. Second, large pharmaceutical companies have learned how to game the science system so that their patented designer molecules can earn them billions of dollars, often treating made-up diseases (I won’t risk public opprobrium naming those) as well as other that we, the medical establishment, literally helped create (opioid-induced constipation being a recent flagrancy).

Of course, the journals themselves have suffered because their contributors know the game. There are now dozens of stories of phony research passing muster in peer-review journals, despite being intentionally badly written. These somewhat cynical, though hilarious, exposés have largely focused on outing predatory journals that charge authors money in exchange for publication (assuming the article is “accepted” by the rigorous peer-review process; the word rigorous, by the way, now means “the credit card payment went through and your email address didn’t bounce”). But even prestigious journals have been bamboozled. The Lancet famously published fabrications linking vaccines and autism in 1998. and it took it 12 years to retract the studies. Meanwhile, the United States Congress took only three years for its own inquiry to debunk any link. You know it’s bad when the U.S. Congress is running circles around the editorial board of one of the world’s most illustrious medical journals. Over the last couple of decades, multiple attempts to improve the quality of peer-review adjudication have disappointingly and largely failed to improve the situation.

While the scientific research community is in desperate need of an overhaul, the mainstream media (and social media influencers) could in the meantime play a tremendously helpful role in alleviating the situation. Rather than indiscriminately repeating the results of the latest headline-grabbing scientific journal article and quoting the authors who wrote the paper, journalists should also reach out to skeptics and use their comments not just to provide (false) balance in their articles but to assess whether the finding really warrants an entire article of coverage in the first place. Headlines should be vetted not for impact and virality but for honesty. As a reader, be wary of any headline that includes the phrase “Science says,” as well as anything that states that a particular study “proves” that a particular exposure “causes” a particular disease. Smoking causes cancer, heart disease, and emphysema, and that’s about as close to a causal statement as actual scientists will make, when it comes to health. Most of what you read and hear about turns out to be mere associations, and mostly fairly weak ones, at that.

Faust refers mostly to medical research but many of his comments are applicable to other science research as well. By the way, Faust has written an excellent description of p-values for which, if for no other reason, you should read his piece in its entirety.

One last comment about Faust’s piece, he exhorts journalists to take more care in their writing but fails to recognize the pressures on journalists and those who participate in social media. Briefly, journalists are under pressure to produce. Many of the journalists who write about science don’t know much about it and even the ones who have a science background may be quite ignorant about the particular piece of science they are covering, i.e., a physicist might have some problems covering medical research and vice versa. Also, mainstream media are in trouble as they struggle to find revenue models.

As for those of us who blog and others in the social media environment; we are a mixed bag in much the same way that mainstream media is. If you get your science from gossip rags such as the National Enquirer, it’s not likely to be as reliable as what you’d expect from The Guardian or the The New York Times. Still, those prestigious publications have gotten quite wrong on occasion.

In the end, readers (scientists, journalists, bloggers, etc.) need to be skeptical. It’s also helpful to be humble or at least willing to admit you’ve made a mistake (confession: I have my share on this blog, which are noted when I’ve found or when they’ve been pointed out to me).

Final comments

Hopefully, this has given you a taste for the wide ranges of experiences and perspectives on the April 22, 2017 March for Science.