Concerns grow over damage to public’s trust in COVID-19 science

What's happening: Researchers retracted two recent studies about the effectiveness of hydroxychloroquine in treating COVID-19, the World Health Organization has had a pattern of mistakes and miscommunication, and there's a lack of a strong scientific voice from the federal government.

1. The push for fast research is a double-edged sword. A majority of registered clinical trials for COVID-19 treatments from early to late March had "many, many shortcomings" of various degrees of seriousness, says Caleb Alexander, co-director of the Johns Hopkins Center for Drug Safety and Effectiveness.

• In a study published Tuesday in the journal BMJ Open, researchers examined 201 clinical trials around the world on drugs and plasma therapies to get a snapshot look at how they were conducted.
• One-third lacked the endpoints needed to define success/failure; one-half enrolled fewer than 100 patients; and two-thirds could be subject to bias as the patients and doctors knew who was receiving which therapy.
• "The reason they are cutting corners is that they have to, or they wouldn't get the studies done" fast enough, co-author Alexander says.
• Yes, but: There are now more than 2000 trials and some are "quite elegant and nuanced and there are many trials that are adaptive ... where the trial itself changes iteratively based on the scientific information that's learned," he added.

2. Recent events like the two studies that had to be retracted due to questionable patient data collected by Surgisphere "could potentially erode the trust that we have in science in general," Dominique Brossard, professor and chair of the Department of Life Sciences Communication at UW Madison, tells Axios.

• "It's important to stress to people that science is built upon uncertainty. It's better to say, 'Look, we do everything we can to find out what's going on and there's a lot of uncertainty, but we are moving in the right direction,'" Brossard says.
• "We may have a study or two that falls flat, and we certainly have misinterpretations of data as it comes in, but the scientific principles are sound and they've been with us for hundreds of years," Alexander points out.

3. Mixed messages from government and public health officials are eroding trust in science and scientists, several experts said.

• "There's such a mixed message from the administration, with concerns from different figures about the use of this [hydroxychloroquine] drug, while the president is saying that he himself is using it and would advocate it for anyone," says Julie Fischer, professor of microbiology and immunology at Georgetown University.

• "With the CDC effectively silenced, we're missing that strong, credible voice that's both scientifically credible and has a real public health role," Fischer says.
• Recent actions taken by the WHO are also causing confusion, Brossard adds. The WHO waffled on whether or not to include hydroxychloroquine in its studies, changed its mind on masks, and then miscommunicated the role of asymptomatic people in the pandemic.
• "At the end of the day, it's better to say 'the best practice is this, although we're not 100% sure and we'll let you know as soon as we know more,'" Brossard says.

Between the lines: "[G]overnments make policy based on limited knowledge and minimal control of the outcomes, and they often respond with trial-and-error strategies. The latter is fine if attention to policy is low and trust in government sufficiently high," Adam Wellstead, professor of public policy at Michigan Technological University, co-writes in a blog post.

• "However, in countries like the U.K .and U.S., each new choice prompts many people to question not only the competence of leaders but also their motivation."

The bottom line: Public trust in science data and top-down communication must be retained for this pandemic to be eradicated.