In a recent article published in STAT, Nicholas Florko asked, “Where does the public health field go from here?” Seeing that the American public has had mixed reactions to how the COVID-19 pandemic has been handled and, more recently, how they view the vaccines currently in distribution, Florko raises pertinent questions about how public health officials can forge better relationships and rebuild trust with America.
Similar to the questions posed by Florko, James Harvey Robinson, an American historian, asked an equally relevant question nearly 100 years ago in the wake of the Spanish flu: “How is scientific knowledge to be democratized?”
In overcoming a pandemic of disease, and more generally, a pandemic of information hysteria, we have to ask ourselves: How can medical and scientific authorities reforge trust with the public? How can scientific knowledge be democratized? Where do we as health care givers, public health workers and scientists go from here?
I invite my colleagues in these respective fields to consider two recommendations.
First, we must listen, really listen, to the problems and concerns of the public. This will enable us to identify the problems that the public faces in a health crisis. We need to remember that we are not only advocates for health, but also for the public.
At the beginning of the pandemic, the general reaction was not to turn toward science and academia, but to rush to the grocery store to stock up on what was deemed essential for our peace of mind and well-being. This is not a fault of the public, nor is it a fault of science. This is a normal response to a very real threat to our sense of security. Our anxiety and uncertainty are not characterized by the emergence of a novel coronavirus, but by the lack of security in life, liberty, property, and consequently our pursuit of happiness.
A unique characteristic of our system of government is that the states, not the federal government, have the ultimate authority and responsibility to direct public health efforts for their residents. Ours is a large country made of a diverse population; such diversity demands flexibility in drafting and implementing policy. We fell short, however, when we failed to not only listen to the public, but also each other in developing a universally applicable and locally flexible approach to mitigate the spread of COVID-19. We are not unified and we are consequently experiencing a civil war between rights and responsibilities. We can only make reparations when we put aside our own agendas and sincerely listen to others.
We need to remember that we are not only advocates for health, but also for the public.
Second, after listening, we need to respond to these concerns not with the heavy jargon of academia, but with simple and plain language that anyone can understand.
Robinson makes this observation: “Scholars and men of science almost always write more or less unconsciously for one another. This is a natural outcome of their training. ... The specter haunts them, not of a puzzled and frustrated reader, but of a tart reviewer, likely to accuse them of superficiality or inaccuracy. There is a heavy prejudice in learned circles against the popularizer.”
In addressing the concerns and criticisms of others, it’s worth remembering the popular religious anecdote where William Tyndale vowed to cause “a boy that driveth a plow to know more of scripture” than the theologians of his day. Tyndale’s desire was not to produce as accurate of a translation as possible, necessarily, but to make the biblical message more accessible to lay members of society.
We live in an age where facts and information are easily accessible, and while scientific literature is necessary to preserve our understanding of the world, how that information is transmitted to the public is important. In the hands of the general public, our scientific literature is likely to cause more concern and confusion than solve our day-to-day problems. In addition to producing scientifically robust literature, we also need to create marketable-friendly material. We need science for the plowboy.
Samuel Nicholes is a graduate student studying epidemiology at the George Washington University Milken Institute School of Public Health.