Guest Notes

Medical notes

24 April 2021

9:00 AM

24 April 2021

9:00 AM

‘The Science’ versus science

Science first became unwell when we had to suddenly accept, without any possibility of debate, the rules of small numbers of health officials. Rules which were a new human experiment, never before attempted in this sort of scale, and had been explicitly ruled out by the World Health Organisation in their pre-2020 pandemic guidelines. When one of Australia’s most distinguished immunologists, and my friend, Professor Robert Clancy, wrote an article exploring the possibilities of early treatments for Covid to go hand-in-hand with vaccinations and this was portrayed as some sort of partisan political view, science was wheeled into the ICU. Professor Clancy holds the highest, and rarest, scientific degree in Australia and has no vested interest in the success or otherwise of drugs like ivermectin or hydroxychloroquine. And when YouTube banned a video of the world’s foremost scientific experts from Stanford, Harvard and Oxford for ‘disinformation’ for questioning the validity of harsh lockdowns and face masks on children, the monitor on science started to flatline. The Science had emerged and was landing some potentially mortal blows.

Medical science is rarely, if ever, completely settled. Associations between things are investigated, and the probability these associations are due to chance alone is calculated. The probability is never zero and never one. Methodology, ethics, biostatistical methods, sample sizes and all sorts of things can be debated and that’s not even considering such things as side-effects, the potential for harm and a cost-benefit analysis. The bedrock of medical science is analysis and respectful debate with all sides being heard.

When I was a student, we were required to debate scientific hypotheses from the widely accepted to the possible. Often you were allocated to the least plausible side or the side you perhaps didn’t agree with. It was a great learning tool: the best way to ensure that your beliefs were correct was to thoroughly investigate the alternative hypothesis with the goal of putting its strongest side forward. But The Science doesn’t allow this: you must accept the narrative and never question it or risk quite public censorship.

Take the now famous (or infamous) hydroxychloroquine for example: the previously common (and almost completely benign) medication now strangely associated with Donald Trump and Craig Kelly. It’s patently stupid to say there is no evidence that it works for early stage Covid infection. There is: it is peer-reviewed and published for all to see and easy to find on the most basic of internet searches. There is also evidence that it doesn’t work. It is normal for this to happen in science (but not in The Science) and usually a considered and open debate would ensue assessing the quality of each tranche of evidence. My personal view on hydroxychloroquine is irrelevant: it is the possibility for debate which is important and there are very highly qualified scientists on both sides. That would suggest that further research is probably required and our officials should at least be open to taking a middle-ground stance at this juncture. It is also a drug that has been prescribed, amongst other things, off-label, for a range of potential fertility and pregnancy complications for years (I’ve done it myself). The fact that doctors who prescribe it, off-label, for Covid could potentially face a criminal charge and jail in some states is one of the most disturbing things I have ever heard of in my medical career.

The other example is the face mask. We’ve seen the absolutely ludicrous requirement for people in remote areas of Victoria having to wear a mask outside while no one else is in sight. We’ve heard the Director of the Center for Disease Control (CDC) stand up, brandishing a mask like some sort of microbial chastity belt, loudly proclaim ‘THIS WILL PROTECT ME’. Once again, there is evidence that they are useful and there is evidence that they are not. Clearly many experts think the quality of the evidence showing a positive effect is superior to that showing a null result, but it cannot be said that there is not published evidence that face masks do not work: there is and it is not difficult to find.  Not only that, previous guidelines for face masks for flu-like respiratory epidemics have been pretty scathing on their use. Wouldn’t that make it fairly reasonable for some people to be a little sceptical and at least enquire about why such an about-face (pardon the pun) occurred?

It probably makes sense that absolutely perfect use of a face mask (changing it four-hourly, never touching it, having it properly fitted, etc.) in the early stages of this particular pandemic would help stop community transmission before it got out of hand. It also is fairly biologically plausible that the way people actually wear them in real life, and in situations where there is either rife or minimal community transmission, possibly does absolutely nothing at all. The answer is less important than the possibility of transparent debate and the sight of people being physically assaulted while not wearing one outdoors is a cause for shame I’ve rarely felt while living in Australia.

The Science doesn’t like debate: it isn’t allowed. You have to accept what you are told and the evidence base or the model parameters or the rationale or any other number of factors of public interest are usually not disclosed. If you question it, even with the best of intentions, and even with genuine scientific curiosity, you are quickly shut down by the new brigade of censors and armchair epidemiologists.

From Norman Swan’s declaration of ICU beds in Australia running out in ten days to the disgraceful Guardian hatchet job on the group of doctors (myself included) questioning the genuine science behind lockdowns, The Science is a seemingly unstoppable and cruel force. As a science lover, I am hoping for something of a miracle resurrection in 2021 and genuine, respectful public debate from all sides to be the norm again.

Got something to add? Join the discussion and comment below.

Dr Tom Cade is an Obstetrician/Gynaecologist in Melbourne. His research doctorate was on the ramifications of public policy implementation. He has a Masters in Biostatistics with distinction.

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