new coronavirus – Close Read

Avoiding ‘muddled science’ in the newsroom

On April 23, I was part of a webinar called ProtoCall, organised by Pro.to with the support of International Centre for Journalists and the International AIDS Vaccine Initiative. It happens once a week and is hosted by Ameya Nagarajan and Nayantara Narayanan. Every week there’s a theme which, together with the discussion around it, is picked to help non-science and non-health journalists cover the coronavirus pandemic. The session before the one I was part of discussed the role of data, the gaps in data and how journalists could help fill them. My session was entitled ‘How muddled science drives misinformation’, and my fellow panelists were Shruti Muralidhar and Shahid Jameel, neither of whom should need introduction on the pages of this blog.

Given a brief ahead of the session (available to read here), I prepared some notes for the conversation and which I’m pasting below in full. Note that the conversation itself panned out differently (as military historians have noted, “no plan survives contact with the enemy”), so you could watch the full video if you’re interested or read the transcript when it comes out. Both Shruti and Dr Jameel made some great points throughout the conversation, plus the occasional provocative opinion (by myself as well).

1. Science journalists should continue to do what we’ve always had to do — empower our readers to decide for themselves based on what data they have available. Yes, this is a slow process, and yes, it’s tedious, but we shouldn’t have to adopt radical tactics now just because we haven’t been doing our job properly before. Introduce the relevant concept, theories, hypotheses, etc. as well as introduce how scientists evaluate data and keeping what in mind.

I can think of at least three doctors I’ve spoken to recently – all three of very good standing in the medical research community, and one is pro-lockdown, one is anti-lockdown, and one argues that there’s a time and place to impose a lockdown. This is a new virus for everybody and there is disagreement between doctors as well. But this doesn’t imply that some doctors are motivated by ideologies or whatever. It means the story here is that doctors disagree, period.

2. Because this is a new disease for everybody, be skeptical of every result, especially those that claim 100% certainty. No matter what anyone says, the only thing you can know with 100% certainty is that you cannot know anything with 100% certainty. This is a pandemic and suddenly everyone is interested in what scientific studies have to say, because people are desperately looking for hope and there will be a high uptake for positive news – no matter how misinformed or misguided.

But before everyone was interested in scientific studies, it was always the case that results from tests and experiments and such were never 100% accurate. They all had error rates, they were all contingent on replication studies, they were and are all works in progress. So no matter what a study says, you can very safely assume it has a caveat or a shortcoming, or a specific, well-defined context in which it is true, and you need to go looking for it.

3. It’s okay to take time to check results. At a time of such confusion and more importantly heightened risk, misinformation can kill. So take your time, speak to doctors and scientists. Resisting the pressure to publish quickly is important. If you’re on a hard deadline, be as conservative in your language as possible, just go with the facts – but then even facts are not entirely harmless. There are different facts pointing to different possibilities.

Amitabh Joshi said a couple years back at a talk that science is not about facts but about interpreting collections of facts. And scientists often differ because they’re interpreting different groups of facts to explain trends in the data. Which also means expertise is not a straightforward affair, especially in the face of new threats.

4. Please become comfortable saying “I don’t know”. I think those are some of the most important words these days. Too many people – especially many celebrities – think that the opposite of ‘true’ is ‘false’ and that the opposite of ‘false’ is ‘true’. But actually there’s a no man’s land in between called ‘I don’t know’, which stands for claims, data, etc. that we haven’t yet been able to verify yet.

Amitabh Bachchan recently recorded a video suggesting that the coronavirus is transmitted via human faeces and by flies that move between that faecal matter and nearby food items. The thing is, we don’t know if this is true. There have been some studies but obviously they didn’t specifically study what Amitabh Bachchan claimed. But saying ‘I don’t know’ here wouldn’t mean that the opposite of what Bachchan said is true. It would mean Bachchan was wrong to ascribe certainty to a claim that doesn’t presently deserve that certainty. And when you say you don’t know, please don’t attach caveats to a claim saying ‘it may be true’ or ‘it may be false’.

We need to get comfortable saying ‘we don’t know’ because then that’s how we know we need more research, and even that we need to support scientists, etc.

5. Generally beware of averages. Averages have a tendency to flatten the data, which is not good when regional differences matter.

6. Has there been a lot of science journalism of the pandemic in India? I’m not sure. A lot of explanations have come forth as background to larger stories about the technology, sampling/testing methods, governance, rights, etc. But I’ve seen very little of the mathematics, of the biology and research into the virus as such.

I don’t think this is a problem of access to scientists or availability of accessible material, which to my mind are secondary issues, especially from journalists’ point of view. Yes, you need to be able to speak to doctors and medical researchers, and many of them are quite busy these days and their priorities are very different. But also many, many scientists are sitting at home because of the lockdown and many of them are keen to help.

To me, it’s more a problem of journalists not knowing which questions to ask. For example, unless you know that something called a cytokine storm exists, to you it remains an unknown-unknown. So the bigger issue for me is that journalists shouldn’t expect to do a good job covering this crisis without knowing the underlying science. A cytokine storm is one example, but I’d say not many journalists are asking more important questions, from my point of view, about statistical methods, clinical trials, scientific publishing, etc. and I suspect it’s because they’re not aware these issues exist.

If you want to cover the health aspects like a seasoned health journalist would, there are obviously other things you’re going to have to familiarise yourself with, like pharmaceutical policy, clinical trials, how diseases are tracked, hospital administration, etc.

So I’d say learn the science/health or you’re going to have a tough time asking the right questions. You can’t expect to go into this thinking you can do a good job just by speaking to different doctors and scientists because sooner than later, you’re going to miss asking the right questions.

7. Three things have worked for The Wire Science, vis-à-vis working with freelancers and other editors.

First, there needs to be clear communication. For example, if you disagree with a submission, please take time out to explain what you think is wrong about it, because it often happens that the author knows the science very well but may just not have laid it out in a way that’s completely clear. This is also exhausting but in the long run it helps.

Second, set clear expectations. For example at The Wire Science, I insist on primary sources to all claims to the extent possible, so we don’t accidentally help magnify a dubious claim made by a secondary source. I don’t accept articles or comments on papers that have not been published in a peer-reviewed journal or in a legitimate preprint repository. And I insist that any articles based on scientific papers must carry an independent voice commenting on the merits and weaknesses of the study, even if the reporter hasn’t spoken to the paper’s authors themselves.

Interestingly enough, in our internal fact-check filters, these ‘clear expectations’ criteria act as pre-filters in the sense that if an article meets these three criteria, it’s also factually accurate more than 90% of the time. And because these criteria are fairly simple to define and identify in the article, anyone can check for them instead of just me.

Third, usually the flow of information and decisions in our newsroom is top-down-ish (not entirely top-down), but once the pandemic took centerstage, this organisation sort of became radial. Editors, reporters and news producers all have different ideas for stories and I’ve been available as a sort of advisor, so before they pursue any story, they sometimes come to me to discuss if they’re thinking about it the right way.

This way automatically prevents a lot of unfeasible ideas from being followed up. Obviously it’s not the ultimate solution but it covers a lot of ground.

8. The urgency and tension of a pandemic can’t be an excuse to compromise on quality and nuance. And especially at a time like now, misinformation can kill, so I’m being very clear with my colleagues and freelancers that we’re going to take the time to verify, that I’m going to resist the temptation to publish quickly. Even if there’s an implicit need to publish stuff quickly since the pandemic is evolving so fast, I’d say if you can write pieces with complexity and nuance, please do.

The need for speed arises, at least from what I can see, in terms of getting more traffic to your site and which in turn your product, business and editorial teams have together decided is going to be driven by primacy – in terms of being seen by your readers as the publication that puts information out first. So you’re going to need to have a conversation with your bosses and team members as well about the importance at a time like this of being correct over being fast. The Wire Science does incur a traffic penalty as a result of going a bit slower than others but it’s a clear choice for us because it’s been the lesser price to pay.

In fact, I think now is a great time to say to your readers, “It’s a pandemic and we want to do this right. Give us money and we’ll stop rushing for ads.”

Full video:

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Time and the pandemic

There is this idea in physics that the fundamental laws of nature apply the same way for processes moving both forwards and backwards in time. So you can’t actually measure the passage of time by studying these processes. Where does our sense of time, rather the passage of time, come from then? How do we get to tell that the past and future are two different things, and that time flows from the former to the latter?

We sense time because things change. Clock time is commonly understood to be a way to keep track of when and how often things change but in physics, time is not the master: change doesn’t arise because of time but time arises because of change. So time manifests in the laws of nature through things that change in time. One of the simplest such things is entropy. Specifically, the second law of thermodynamics states that as time moves forward, the entropy of an isolated system cannot decrease. Entropy thus describes an arrow of time.

This is precisely what the pandemic is refusing to do, at least as seen through windows set at the very back of a newsroom. Many reporters writing about the coronavirus may have the luxury of discovering change, and therefore the forward march of time itself, but for someone who is somewhat zoomed out – watching the proceedings from a distance, as it were – the pandemic has only suffused the news cycle with more and more copies of itself, like the causative virus itself.

It seems to me as if time has stilled. I have become numb to news about the virus, which I suspect is a coping mechanism, like a layer of armour inserted between a world relentlessly pelting me with bad news and my psyche itself. But the flip side of this protection is an inability to sense the passage of time as well as I was able before.

My senses are alert to mistakes of fact, as well as mostly of argument, that reporters make when reporting on the coronavirus, and of course to opportunities to improve sentence construction, structure, flow, etc. But otherwise, and thanks in fact to my limited engagement with this topic, it feels as if I wake up every morning, my fingers groaning at the prospect of typing the words “lockdown”, “coronavirus”, “COVID-19”, “herd immunity” and whatever else¹. And since this is what I feel every morning, there is no sense of change. And without change, there is no time.

1. I mean no offence to those suffering the pandemic’s, and the lockdown’s, brutal health, economic, social, cultural and political consequences.

I would desperately like to lose my armour. The bad news will never stop coming but I would still like to get back to bad news that I got into journalism to cover, the bad news that I know what to do about… to how things were before, I suppose.

Oh, I’m aware of how illogical this line of introspection is, yet it persists! I believe one reason is that the pandemic is a passing cloud. It leapt out of the horizon and loomed suddenly over all of us, over the whole world; its pall is bleak but none of us doubts that it will also pass. The pandemic will end – everybody knows this, and this is perhaps also why the growing desperation for it to dissipate doesn’t feel misplaced, or unjustified. It is a cloud, and like all clouds, it must go away, and therefrom arises the frustration as well: if it can go away, why won’t it?

Is it true that everything that will last for a long time also build up over a long time? Climate change, for example, doesn’t – almost can’t – have a single onset event. It builds and builds all around us, its effects creeping up on us. With each passing day of inaction, there is even less that we can do than before to stop it; in fact, so many opportunities have been squandered or stolen by bad actors that all we have left to do is reduce consumption and lower carbon emissions. So with each passing day, the planet visits us with more reminders of how we have changed it, and in fact may never have it back to the way it once was.

Almost as if climate change happened so slowly, on the human scale at least, that it managed to weave itself into our sense of time, not casting a shadow on the clock as much as becoming a part of the clock itself. As humankind’s grandest challenge as yet, one that we may never fully surmount, climate change doesn’t arise because of time but time arises because of climate change. Perhaps speed and surprise is the sacrifice that time demands of that which aspires to longevity.

The pandemic, on the other hand, likely had a single onset… right? At least it seems so until you realise the pandemic is in fact the tip of the proverbial iceberg – the thing jutting above the waterline, better yet the tip of the volcano. There is a complicated mess brewing underground, and out of sight, to which we have all contributed. One day the volcano shoots up, plastering its surroundings with lava and shooting smoke and soot kilometres into the air. For a time, the skies are a nuclear-winter grey and the Sun is blotted out. To consider at this time that we could stave off all future eruptions by pouring tonnes of concrete into the smouldering caldera would be folly. The pandemic, like magma, like the truth itself, will out. So while the nimbuses of each pandemic may pass, all the storm’s ingredients will persist.

I really hope the world, and I do mean the world, will heed this lesson as the novel coronavirus’s most important, if only because our sense of time and our expectations of what the passage of time could bring need to encompass the things that cause pandemics as much as they have come to encompass the things that cause Earth’s climate to change. We’ve become used to thinking about this outbreak, and likely the ones before it, as transitory events that begin and end – but really, wrapped up in our unrelenting yearning for the pandemic to pass is a conviction that the virus is a short-lived, sublunary creature. But the virus is eternal, and so our response to it must also transform from the mortal to the immortal.

Then again, how I wish my mind submitted, that too just this once, to logic’s will sans resistance. No; it yearns still for the pandemic to end and for ‘normal’ to recommence, for time to flow as it once did, with the promise of bringing something new to the threshold of my consciousness every morning. I sense there is a line here between the long- and the short-term, between the individual and the collective, and ultimately between the decision to change myself and the decision to wait for others before I do.

I think, as usual, time will tell. Heh.

There is more than one thunder

Sunny Kung, a resident in internal medicine at a teaching hospital in the US, has authored a piece in STAT News about her experience dealing with people with COVID-19, and with other people who deal with people with COVID-19. I personally found the piece notable because it describes a sort of experience of dealing with COVID-19 that hasn’t had much social sanction thus far.

That is, when a socio-medical crisis like the coronavirus pandemic strikes, the first thing on everyone’s minds is to keep as few people from dying as possible. Self-discipline and self-sacrifice, especially among those identified as frontline healthcare and emergency services workers, become greater virtues than even professional integrity and the pursuit of individual rights. As a result, these workers incur heavy social, mental and sometimes even physical costs that they’re not at liberty to discuss openly without coming across as selfish at a time when selflessness is precariously close to being identified as a fundamental duty.

Kung’s piece, along with some others like it, clears and maintains a precious space for workers like her to talk about what they’re going through without being vilified for it. Further, I’m no doctor, nurse or ambulance driver but ‘only’ a journalist, so I have even less sanction to talk about my anxieties than a healthcare worker does without inviting, at best, a polite word about the pandemic’s hierarchy of priorities.

But as the WHO itself has recognised, this pandemic is also an ‘infodemic’, and the contagion of fake news, misinformation and propaganda is often deadly – if not deadlier – than the effects of the virus itself. However, the amount of work that me and my colleagues need to do, and which we do because we want to, to ensure what we publish is timely, original and verified often goes unappreciated in the great tides of information and data.

This is not a plea for help but an unassuming yet firm reminder that:

Emergency workers come in different shapes, including as copy-editors, camerapersons and programmers – all the sort of newsroom personnel you never see but which you certainly need;
Just because it’s not immediately clear how we’re saving lives doesn’t mean our work isn’t worth doing, or that it’s easy to do; and
Saving lives is not the only outcome that deserves to be achieved during a socio-medical crisis.

A lot of what a doctor like Kung relates to, I can as well – and again, not in an “I want to steal your thunder” sort of way but as if this is a small window through which I get to shout “There are many thunders” sort of way. For example, she writes,

Every night during the pandemic I’ve dreaded showing up to work. Not because of fear of contracting Covid-19 or because of the increased workload. I dread having to justify almost every one of my medical decisions to my clinician colleagues.
Since the crisis began, I’ve witnessed anxiety color the judgement of many doctors, nurses, and other health care workers — including myself — when taking care of patients.

Many of us simply want to make sure we’re doing the right thing and to the best of our ability, that to the extent possible we’re subtracting the effects of fatigue and negligence from a situation rife with real and persistent uncertainty. But in the process, we’re often at risk of doing things we shouldn’t be doing.

As Kung writes, doctors and nurses make decisions out of fear – and journalists cover the wrong paper, play up the wrong statistic, quote the wrong expert or pursue the wrong line of inquiry. Kung also delineates how simply repeating facts, even to nurses and other medical staff, often fails to convince them. I often go through the same thing with my colleagues and with dozens of freelancers every week, who believe ‘X’ must be true and want to anticipate the consequences of ‘X’ whereas I, being more aware of the fact that the results of tests and studies are almost never 100% true (often because the principles of metrology themselves impose limits on confidence intervals but sometimes because the results depend strongly on the provenance of the input data and/or on the mode of publishing), want to play it safe and not advertise results that first seed problematic ideas in the minds of our readers but later turn out to be false.

So they just want to make sure, and I just want to make sure, too. Neither party is wrong but except with the benefit of hindsight, neither party is likely to be right either. I don’t like these conversations because they’re exhausting, but I wouldn’t like to abdicate them because it’s my responsibility to have them. And what I need is for this sentiment to simply be acknowledged. While I don’t presume to know what Kung wants to achieve with her article, it certainly makes the case for everyone to acknowledge that frontline medical workers like her have issues that in turn have little to do with the fucking virus.

In yet another reminder that the first six months (if not more) of 2020 will have been the worst infodemic in history, I can comfortably modify the following portions of Kung’s article…

They were clearly disgruntled about my decision not to transfer Mr. M to the ICU. I tried to reassure them by providing evidence, but I could still feel the tension and fear. The nurses wanted another M.D. to act as an arbiter of my decision but were finally convinced after I cited the patient’s stable vital signs, laboratory results, and radiology findings.
Everyone in the hospital is understandably on edge. Uncertainty is everywhere. Our hospital’s policies have been constantly changing about who we should test for Covid-19 and when we should wear what type of protective personal equipment. Covid-19 is still a new disease to many clinicians. We don’t know exactly which patients should go to the ICU and which are stable enough to stay on the regular floor. And it is only a matter of time before we run out of masks and face shields to protect front-line health care workers. …
As a resident in internal medicine and a future general internist, it is my duty to take care of these Covid-19 patients and reassure them that we are here to support them. That’s what I expect to do for all of my patients. What I did not expect from this pandemic is having to reassure other doctors, nurses, and health care workers about clinical decisions that I would normally never need to justify. …
There is emerging literature on diagnosing and treating Covid-19 patients that is easily accessible to physicians and nurses, but some of them are choosing to make their medical decisions based on fear — such as pushing for unnecessary testing or admission to the hospital, which may lead to overuse of personal protective equipment and hospital beds — instead of basing decisions on data or evidence. …

… thus:

The freelancer was clearly disgruntled about my decision not to accept the story for publication. I tried to reassure them by providing evidence, but I could still feel the tension and resentment. The freelancer wanted another editor to act as an arbiter of my decision but was finally convinced after I cited the arguments’ flaws one by one.
Every reporter is understandably on edge. Uncertainty is everywhere. Our newsroom’s policies have been constantly changing about what kind of stories we should publish, using what language and which angles we should avoid. Covid-19 is still a new disease to many journalists. We don’t know exactly which stories are worth pursuing and which are stable enough to stay on the regular floor. And it is only a matter of time before we run low on funds and/or are scooped. …
As a science editor, it is my duty to look out for my readers and reassure them that we are here to support them. That’s what I expect to do for all of my readers. What I did not expect from this pandemic is having to reassure other reporters, editors, and freelancers about editorial decisions that I would normally never need to justify. …
There is emerging literature on diagnosing and treating Covid-19 patients that is easily accessible to reporters and editors, but some of them are choosing to make their editorial decisions to optimise for sensationalism or speed — such as composing news reports based on unverified claims, half-baked data, models that are “not even wrong” or ideologically favourable points of view, which may lead readers to under- or overestimate various aspects of the pandemic — instead of basing decisions on data or evidence. …

More broadly, I dare to presume frontline healthcare workers already have at least one (highly deserved) privilege that journalists don’t, and in fact have seldom had: the acknowledgment of the workload. Yes, I want to do the amount of work I’m doing because I don’t see anyone else being able to do it anytime soon (and so I even take pride in it) but it’s utterly dispiriting to be reminded, every now and then, that the magnitude of my commitment doesn’t just languish in society’s blindspot but is often denied its existence.

Obviously very little of this mess is going to be cleaned up until the crisis is past its climax (although, like ants on a Möbius strip, we might not be able to tell which side of the problem we’re on), at which point the world’s better minds might derive lessons for all of us to learn from. At the same time, the beautiful thing about acknowledgment is that it doesn’t require you to determine, or know, if what you’re acknowledging is warranted or not, whether it’s right or wrong, even as the acknowledgment itself is both right and warranted. So please do it as soon as you can, if only because it’s the first precious space journalists need to clear and maintain.