“COVID-19: The importance of science in an era of distrust and disinformation” read the headline of a press release by the American Medical Association. “In a virtual address hosted by the National Press Club on April 7, 2020, AMA President Patrice A. Harris, MD, made an appeal for science in slowing the spread of disinformation and to help turn the tide against COVID-19” continued the release.[1]
The call for greater reliance on science in the face of a global pandemic has been widespread in 2020, and so has the call for a fact-based response and ridicule for anecdotal diagnoses. For example, Johns Hopkins Medicine’s website includes an article titled “Coronavirus Disease 2019: Myth vs. Fact”[2] and the European Centre for Disease Prevention and Control web site includes a page dedicated to “Facts about COVID-19.”[3]
Unfortunately, after five months of global awareness and three months of concerted global response, the facts about the corona virus pandemic remain confused and uncertain. My own experience illustrates my point.
My experience
When I flew from Ohio to Congo at the beginning of March, many people had begun changing travel plans, and the flight across the Atlantic had many empty seats, but airlines continued with their regular schedules. Within a week that had changed completely as new “facts” came to light and old “facts” were discarded.
Likewise, when I was screened for COVID-19 on my return to the United States, I was forced to crowd into a bus that shuttled us passengers to another building. It was March 20th, yet the screeners were bunched together at long tables with little personal protective equipment and we passengers jostled each other while we lined up and then talked with our screeners.
The key symptoms identifying the novel corona virus were a high temperature and a cough when I was tested, and I experienced a moderate temperature three evenings. My wife, Cheryl, on the other hand, was never feverish at all. She did experience a headache for two days, but the health professionals that called me each day did not consider that symptomatic of COVID-19. Indeed, it was only a few days after we reported that she had lost her sense of smell and of taste that they affirmed our self-diagnosis of Cheryl’s infection. Even then, they recorded her symptoms starting from her loss of smell and taste rather than from her headaches. Only a week or two later did we find news articles suggesting that Cheryl’s headache was indeed a symptom of this virus.
Facts and Clues
We all rely on facts every day of our lives. We act as though those facts are true – even absolutely true. Yet, we are not normally surprised when we find that the facts have “changed.” Sometimes we fear such a change, but other times we hope for it. True science, as it turns out, assumes that facts will change and encourages scientists to constantly challenge the validity of existing facts. Yet we talk and write about facts as though they are the absolute authority. Indeed, the very word, “fact,” has become a synonym for unchangeable truth, as the opposite of “myth” which is situational and untrustworthy.
I would like to propose that we begin to look at information as “clues” rather than “facts.” Like facts, clues attempt to describe reality and truth, but unlike facts, we automatically assume that clues are tentative and changeable.
My temperature, then, was a clue to being infected with COVID-19. Of course, it was also potentially a clue to influenza or to malaria or to having taken a hot shower or to many other things. Indeed, given my medical history, I insisted on being tested for malaria when I was tested for the corona virus and the doctor who saw me at the emergency room explained that my nasal swab would be first tested for two strains of influenza and only if I tested negative would it be tested for COVID-19. At the same time, despite being a typical symptom, my cough was not a clue to the corona virus because it was a residual cough from the bronchitis for which I was treated in January, and it was a “wet” cough, not a “dry” one.
Likewise, Cheryl’s headache and loss of taste and smell were clues to her infection – as was her sense of tiredness over a period of a week. She never had a clinical test, but we can say with a high level of certainty that she was infected. Indeed, my own diagnosis, even with a clinical test, includes a certain element of uncertainty because a nasopharyngeal swab is less than 80% accurate, even during the first seven days of infection. What makes us confident in our diagnosis of any disease is not a single “fact” but a collection of “clues” that all point in the same direction.
The Heuristic Element
What makes clues so useful is that they have a heuristic element. In mathematics and computer science, a heuristic is a formula that is useful in finding certain kinds of solutions. G. Polya explains that heuristic reasoning “is reasoning not regarded as final and strict but as provisional and plausible only, whose purpose is to discover the solution of the present problem.” [4] It is the uncertainty of clues that makes them so powerful. They point to what we really care about, to the solution of the problem we are trying to solve.
Our goal in diagnosing someone with COVID-19 is to help them stay healthy and to protect the health of others with whom they may come in contact. For Cheryl and me, my positive diagnosis followed by Cheryl’s meant that we were quarantined for three weeks to protect others from possibly contracting the virus from us. It also meant that we received phone calls each day, from both the public health office and the Cleveland Clinic, to make sure that our own health remained stable. The clues, and even the diagnosis, were not an end in themselves but they had a heuristic character – they pointed to our health and the health of our community.
Notice that absolute facts are not heuristic. They simply “are.” Fortunately, when you or I – or scientists or politicians – use facts, we actually treat them as clues, thereby adding to them a heuristic element that makes them useful. Absolute facts, it turns out, are pretty much useless. It is when we use them as clues that we allow our eyes or our ears or our fingers or our minds to follow along to where they point. Heuristic facts can be clues.
Interestingly, once a clue or a set of clues points us to a conclusion, we often begin to recognize additional clues that we had overlooked. For example, in retrospect we recognized that my excessive tiredness about the time I experienced an elevated temperature was a clue to the corona virus and not to jet-lag as we originally thought. Likewise, after Cheryl recognized her loss of taste and smell, I realized that my own sense of smell was also compromised, although not in the same way as Cheryl’s. Clues, it turns out, can also point us to other clues.
Conclusion
If we affirm the importance of heuristics and accept that the relevance of facts is in their role as clues, then we may be more willing to accept anecdotal evidence and personal stories, for facts are but one type of clue to truth and reality. If we are more willing to accept alternative clues, then we may find ourselves also more willing to accept that it takes judgment and reason to understand how they point to the objects of our true interest. And if we recognize that judgment and reason are essential, we may also recognize that a person must be involved to judge or to reason. It is my hope that such a recognition will inspire us to listen to others and to humbly consider what they say, not as absolute, but as a clue to who they are, to what we share in common, and to our relationship to God, himself.
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[1] https://www.ama-assn.org/press-center/press-videos/covid-19-importance-science-era-distrust-and-disinformation
[2] https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/2019-novel-coronavirus-myth-versus-fact
[3] https://www.ecdc.europa.eu/en/novel-coronavirus/facts
[4] How to Solve It: A New Aspect of Mathematical Method, 1957, p. 113
