The West African Ebola Outbreak As A Science Communication Challenge & Opportunity

I had the honor of speaking to a science communications seminar class at the North Carolina School of Science & Mathematics, recently described by Dave Dewitt at our NPR affiliate as, “[C]reated 35 years ago for serious NC students with grand aspirations. It was the first residential school of its kind in the country, and it’s public. The course catalog rivals many major universities, with classes in robotics, biomedical engineering, and astrophysics.”

Dean of Science, Dr. Amy Shenk, invited me to talk about the Ebola Virus Disease outbreak ongoing in west Africa in terms of its challenges to public science communication. I’ve put together my collection of stories written in my role as a contributor to the Pharma & Healthcare section of Forbes.com. With my training as a pharmacologist, I naturally focus on what drugs are in development to treat the potentially fatal disease. But what I’ve learned is that drugs have little use if a health system lacks infrastructure to even monitor blood or administer intravenous electrolytes.

General thought questions

What do you know about Ebola hemorrhagic fever (now called Ebola Virus Disease, or EVD)?

What were you thinking when news of the outbreak first broke?

What did you think about bringing infected U.S. missionaries to Atlanta for care?

What message might this send to the people of west Africa?

Where did science communication go wrong? Where did it go right?

 

For the following articles:

Which of these do you think have particularly high value (or low value!) in communicating the complexity of the Ebola situation to the general public.

Does the simple listing of facts lead to understanding, addressing legitimate concerns?

What ethical issues does the use of experimental Ebola drugs raise that present a general science communication opportunity?

Kroll Ebola articles at Forbes

Do We Have Any Drugs To Treat Ebola? – 29 July 2014

Should We Be Concerned About American Ebola Patients Coming To Emory Hospital? – 1 August 2014

Ebola ‘Secret Serum': Small Biopharma, The Army, And Big Tobacco – 5 August 2014

FDA Moves On Tekmira’s Ebola Drug While Sarepta’s Sits Unused – 7 August 2014

Beware Of Fake Ebola Supplements – 14 August 2014

American Missionaries Cured of Ebola Infections; Brantly: ‘Today Is A Miraculous Day’ - 21 August 2014

How Will We Know If The Ebola Drugs Worked? – 26 August 2014

NIAID/GSK Ebola Vaccines To Enter US, UK Human Safety Trials – 28 August 2014

BioCryst to Launch NHP Ebola Drug Safety, Efficacy Studies ‘Within Weeks’ – 29 August 2014

WHO Ebola Drug Panel: Use Survivor Serum To Treat Ebola Victims – 5 September 2014

Gates Foundation Commits $50 Million To Ebola Containment Efforts – 10 September 2014

Cuba Responds To Ebola Crisis As Black Market For Convalescent Serum Emerges – 12 September 2014

CDC Ramps Up Ebola Worker Training In Advance Of Obama Announcement – 16 September 2014

 

Explaining the drugs, informed consent

Ebola, Experimental Drugs and Informed Consent: Should Those At Risk Simply Take The Doctors Orders? – by Elaine Schattner – 31 August 2014

 

Vaccines and public health – Another science communications challenge 

Final, somewhat unrelated issue on science communications relative to tomorrow’s NOVA documentary on vaccines: The need for humility in public health communications, by Dr. Brian Zikland-Fisher of the University of Michigan. The polarization of vaccine attitudes, regardless of scientific facts, requires a middle ground where people can have legitimate concerns addressed.

  • We must acknowledge that each parent has the right and the authority to make his or her own choices, and that it is our failing (either in the quality of our vaccines or the persuasiveness of our message), not theirs, if we have failed to convince them that vaccination is the better choice.

  • We must acknowledge that we have the best chance of convincing a skeptical public when we put the weaknesses of our arguments and the risks of our interventions front and center and acknowledge the fears that they evoke.

It may seem counterintuitive, but embracing humility may be the best thing we can do. Humility will build trust in those who believe (sometimes accurately) that we are not telling the whole story. Humility might resonate with those parents who genuinely want to do right by their children but have not been convinced by “the facts.”

How to promote a science blogging network at a national scientific meeting

Bora Zivkovic, DrugMonkey, and I have been really impressed by this idea by the online folks over at the American Chemical Society’s Chemical & Engineering News. This week, their blog network, CENtral Science, has been promoting their presence at the upcoming national ACS meeting in Boston.

Folks may not know this but ACS is the largest professional scientific society in the world with 161,000 members.

DrugMonkey, the king of science blogging schwag, has previously mentioned the benefits of such a promotion several times to another science blogging network but it never got traction with the powers-that-be.  But here’s the idea from CENtral Science – from this post:

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Here’s how to win:

  • Six key words will be hidden among the blogs between August 15–22
  • Collect all six key words and bring them to the C&EN booth #527
  • Pick up your FREE CENtral Science t-shirt*
  • Wear your t-shirt in the exposition hall Monday and Tuesday and you might be selected by C&EN staff to receive one of the VISA gift cards (worth up to $50) given out every half hour

*While supplies last

CONTEST RULES: This promotion is ONLY valid from 8/15 to 8/24. A total of 350 t-shirts will be given out (one per person) from 9:00 a.m. through 5:00 p.m. on 8/23 and 8/24 at booth #527 in the expo hall only. To receive a t-shirt each individual must present all 6 (correct) key words. Winners must be ACS members to participate. ACS staff and their families are not eligible. All gift card recipients must be wearing a CENtral Science t-shirt. There is no guarantee of winning any prize. Gift card winners will be chosen at random every half hour during published expo times.

<end>

Now THAT’s how you do it.

You have to read the blogs to pick up each of the six keywords.

Three hundred and fifty T-shirts. 350!

And you wear them at the meeting.

And they give away a $50 $10, $25, or $50 gift cards every half hour for two days.

The T-shirt is very nice, by the way, and I’m grateful to C&EN Online editor, Rachel Pepling (Twitter) for sending me one. I will be wearing it for our panel discussion on Tuesday! Rachel’s also a Gator so she gets even more favor points from me.

Once again, hunt me down in Boston if you’d like to say hello.  I’ll be the one in the yellow CENtral Science T-shirt.

Why is there so much medical misinformation in The Huffington Post?

Today, I refer you to an excellent post by Peter A. Lipson, MD, at the blog, Science-Based Medicine, entitled, “HuffPo blogger claims skin cancer is conspiracy.”
The post focuses on an article by someone who contends that the link between sunlight and skin cancer is a conspiracy by dermatologists and the cosmetic dermatology industry. Dr. Lipson’s highly insightful analysis about the “interview” process and how doctors must act these days on behalf of their patients concludes:

This article shows a misunderstanding of journalistic ethics, medical ethics, and medical science. It’s a disaster. And it’s no surprise that it’s in the Huffington Post.

While this is a medicine story, my question relates to why an organization with a lot of great frontpage news so frequently posts medical articles that are wrong and, sometimes, downright dangerous.
Read the article first, then read Dr. Lipson’s analysis.
Disclosure: I am an occasional contributor to Science-Based Medicine but, like all contributors there, receive no compensation.

Case dismissed in vaccination libel case against Amy Wallace and Dr. Paul Offit

Writer Amy Wallace just tweeted and posted to her blog the fabulous news that a pending libel case against her and physician Paul Offit has been dismissed.
Amy Wallace was the author of the centerpiece article in a Wired magazine feature on how antivaccination activists create fear and confusion by distorting and misrepresenting facts about vaccines. This article “An Epidemic of Fear: How Panicked Parents Skipping Shots Endangers Us All,” was discussed in detail here back in October.
Two days before Christmas one of those individuals, Barbara Loe Fisher (also Arthur), filed a $1 million claim that Dr. Offit had libeled her in Wallace’s article by saying, “She lies,” in reference to Ms. Fisher. Condé Nast, the publisher of Wired, was also named in the suit.
Orac at Respectful Insolence wrote a very detailed post a week later explaining how Loe Fisher and other anti-science activists use the threat of legal action to suppress criticism since they can’t rely on the science.
While dismissed, this legal action has certainly created financial and emotional distress for Ms. Wallace who, unlike Dr. Offit, had no experience in dealing with the level of hostility that can be dished out by the antivaccination movement. As a freelance writer, Ms. Wallace probably also lacks the financial backstop that Dr. Offit has. In effect, I am concerned that a writer like Ms. Wallace, who wrote one of the best articles in recent memory on the antivaccinationist movement, will never take another assignment on such an issue because it is just not worth the aggravation. Even prior to the suit, Wallace noted that she had never before received such hateful letters and e-mails on any other topic in her 25 years of writing professionally. Much of the opposing correspondence made lewd sexual comments about Ms. Wallace rather than engage in a debate about the content of her article.
If my prediction is true, Orac is correct: the simple threat of legal action can be used to suppress criticism of anti-science and pseudoscience nonsense that threatens society (unlike taking a heavy metal-laden supplement product that harms only the user, withholding vaccines from children compromises herd immunity in society.)
On the other hand, this episode may embolden Ms. Wallace and encourage other writers to speak more extensively on the house of cards that lies behind antivaccinationists faulty assumptions on causality and search for true causes of autistic spectrum disorders.

Chris Mooney with a New Year’s resolution for practicing scientists: engage more with the public and the media

Steve Silberman and Rebecca Skloot just pointed out to me an editorial from science writer Chris Mooney that has appeared online and will be in the Sunday, January 3rd edition of The Washington Post.
In the essay, “On issues like global warming and evolution, scientists need to speak up,” Mooney continues his longstanding call to scientists to take ownership in combating scientific misinformation, invoking the very weak response of the scientific community to the aftermath of e-mails and documents hacked from the Climatic Research Institute at the University of East Anglia.

The central lesson of Climategate is not that climate science is corrupt. The leaked e-mails do nothing to disprove the scientific consensus on global warming. Instead, the controversy highlights that in a world of blogs, cable news and talk radio, scientists are poorly equipped to communicate their knowledge and, especially, to respond when science comes under attack.
A few scientists answered the Climategate charges almost instantly. Michael Mann of Pennsylvania State University, whose e-mails were among those made public, made a number of television and radio appearances. A blog to which Mann contributes, RealClimate.org, also launched a quick response showing that the e-mails had been taken out of context. But they were largely alone. “I haven’t had all that many other scientists helping in that effort,” Mann told me recently.

Could we have done anything differently?
I agree to some extent but, in this particular case, I don’t think that any concerted effort by scientific communicators could have overcome the bleating by Rush Limbaugh and Glenn Beck that took one or two statements out of context from among 1,073 e-mails and a million words, claiming proof of a massive global scientific conspiracy to manufacture climate change warnings.
The problem is that when one’s statements are not bound by facts, you can pretty much say whatever you want; that will be the first thing uncritical sycophants hear and remember.
It took several weeks for the AP to release its own investigative findings of the stolen documents to show that while there were petty and heated disagreements about specific data, nothing was faked. But by that time, science had lost a lot of ground to climate skeptics as detailed in an article Mooney cites:

Scientists themselves also come in for more negative assessments in the poll, with four in 10 Americans now saying that they place little or no trust in what scientists have to say about the environment. That’s up significantly in recent years. About 58 percent of Republicans now put little or no faith in scientists on the subject, double the number saying so in April 2007. Over this time frame, distrust among independents bumped up from 24 to 40 percent, while Democrats changed only marginally. Among seniors, the number of skeptics more than doubled, to 51 percent.

When a large segment of the public puts their faith in right wing miscreants that somehow have huge audiences, I have trouble seeing how scientists can respond no matter how many facts they have in their pockets or how effectively they communicate. I don’t mean to sound defeatist but I think that responding to so-called Climategate was incredibly difficult no matter how well-prepared the scientific community could have been. This single crystallizing event was far more understandable to people than decades of climate research, starting primarily with the fact that the average person seems to associate the daily weather with climatological trends. Add to this mix a media empire with people who manufacture apparent facts by repeating untruths (i.e., Saddam Hussein was behind 9/11) and feeding the American love for a good conspiracy theory.
I’m just not sure how good Climategate is as an example of a failure by scientists to communicate with the public.
“Many refuse to try; others go to the opposite extreme of advocating vociferous and confrontational atheism.”
After discussing his expert area of devastating hurricanes, Mooney then raises some excellent points about countering the denial of evolution by acknowledging that for many, evolution is an issue not of science but of faith.

“Many Christians, including fundamentalists, can accept evolution as long as it is not attached to the view that life has no purpose,” Karl Giberson, a Christian physicist and the author of “Saving Darwin: How to Be a Christian and Believe in Evolution,” told me recently. “Human life has value, and any scientific theory that even appears to deny this central religious affirmation will alienate people of faith and create opportunity for those who would rally believers against evolution.”

This quarter of the essay will likely be the part that will create froth and lather in the blogosphere so I will mostly leave it for other commentators. Most of my day-to-day colleagues are moderately to strongly religious and many use their faith as motivators for their careers in the biomedical sciences. Many religious people in my community are huge fans of science. I contend that some degree of spirituality can co-exist with science. We’re not going to talk people out of their faith; there is far more common ground here for us in science with a large swath of the US population who are religious and open to and often embrace scientific discourse.

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