Dr. Fauci, Science, and Congressional Dysfunction

 

Similar to Anthony Fauci, I spent a career leading careful, deliberate, nonpartisan efforts to use science – in my case, social science – to improve the quality of life for all people in equitable ways. (By coincidence, Dr. Fauci and I attended the same high school in New York City, although his graduation preceded mine by 10 years.) So, via C-Span, I watched with great interest his appearance at the Select Subcommittee on the Coronavirus Pandemic. 

Ostensibly, the committee meeting had the worthy goal to identify steps we can take to prevent another pandemic similar to COVID19. In contrast, it was a seesaw conversation with red representatives trying to blame Dr. Fauci for one thing or another and blue representatives rising to Dr. Fauci’s defense. Few questions from committee members had anything to do with subjects that could protect the health of the American people. 

This half day event provided plenty of examples of the misunderstanding that some people have about science, and it put into relief the dysfunction of our Congress. 

Many of the representatives don’t know, or don’t want to admit, how science works, and how it can inform policy, government action, and community action. Scientific research begins with questions; activities occur to gather information to respond to those questions; scientists analyze that information; they then produce findings. Usually, the findings answer only some of the original questions, and the answers that the research provides are usually better and more complete for some questions than for others. 

Given the research findings, anyone can interpret what those findings mean, what strength they have, what limitations they have. Based on research findings, anyone can draw conclusions. If interested in using the findings to inform a decision or to guide an action, anyone can do so. 

Rarely does research on a specific question of interest provide the absolute, definite, immutable answer to that question. A specific study does the best it can at a particular time with the findings it can produce. Later research tries to address unanswered questions; it also often tests to see if the findings from earlier studies really had the strength that everyone thought and/or whether they continue to apply in a changing world. In this way, knowledge based on scientific research evolves, corrects itself, and improves over time. 

Apply that to the situation with COVID. COVID arrived in the United States as a completely novel pathogen and immediately began to kill people. We faced a severe crisis. Decisions about policies and action to stave off this killer could not draw on research because little research existed on the ways that specific virus transmitted itself and on specific means of prevention. No evidence existed on best treatments. So, very logically, public health experts made decisions based on closely related evidence, gathered new information, and revised their thinking and their recommendations about COVID as they learned more. 

Some early decisions produced positive results; some did not. All of the decisions about how to treat the virus and stop its transmission had social and economic impacts in addition to health impacts. Schools and businesses closed, or changed operations, for example – with major costs for families, individuals, and companies. All of those impacts need to be analyzed so that we understand their benefits and costs and can use that understanding when challenged by a future virus. Sadly, the activities of the committee did not move in that direction. 

Which raises the issue of the dysfunction of our U.S. Congress. A hearing such as this should contribute to our understanding of how to put science to use in preventing future national tragedies such as COVID. This committee should ask Dr. Fauci and others questions such as: What have we learned about public health measures that work and don’t work for prevention? What steps should we take if we suspect another powerful virus has begun to infect our population? How can we ensure effective, equitable care if a new epidemic occurs? How can we train and sustain the motivation of health care workers, to empower them to defeat future pandemics? 

Those questions received little consideration. The press release “wrap up” on the committee’s website contained a litany of criticisms of Dr. Fauci; it did not mention anything that could protect the future health of our population. 

Many of the Republican representatives used precious time to ask whether Dr. Fauci had used his personal email for official purposes. Each time someone raised the question, he said no. None of them had any evidence that he had done so. Regardless, does Dr. Fauci’s use of email several years ago contribute in even the slightest way to building our nation’s protection against a future pandemic? No. 

A staff person for the red side had the opportunity to ask questions of Dr. Fauci, after the elected representatives had completed their questioning. Commendably, he addressed some of the issues relevant to the protection of the public’s health. It seemed that most of the committee members had left by that time – which is too bad, since they might have learned something, and maybe by learning they could put science to good use.