Science as Scorekeeping

If there is one thing about the coronavirus pandemic that both sides of the political spectrum seem to agree on, it’s that the science that bears on it should never be “politicized.” From the left, former CDC directors of the Obama and Clinton administrations warn of how the Trump administration has politicized the agency’s science: “The only valid reason to change released guidelines is new information and new science — not politics.” From the right, the Wall Street Journal frets about the scientific journal Nature publishing a politically charged editorial about why China shouldn’t be blamed for the coronavirus: “Political pressure has distorted scientific judgment.” What both sides assume is that political authorities should defer to scientists on important decisions about the pandemic, but only insofar as science itself is somehow kept free from politics.

But politicization, and even polarization, are not always bad for science. There is much about how we can use science to respond to the pandemic that is inescapably political, and that we cannot simply leave to scientists to decide.

There is, however, a real problem with how political institutions in the United States have engaged with science. Too much of the debate over coronavirus science has centered on how bad the disease really is, with the administration downplaying its risks and the opposition insisting on its danger. One side sees the scientists warning of peril as a political obstacle that must be overcome. The other side sees them as authorities to whom we must defer, not as servants of the public who could be directed toward solving the problem. The false choice between these two perspectives on how science relates to politics obscures a wide range of political choices the country faces about how we can make use of our scientific resources in responding to the pandemic.

One of the defining issues in the early phases of the pandemic was the failure to establish adequate coronavirus testing. As M. Anthony Mills has argued, the cause of this failure was excessive centralization in the country’s coronavirus response, which made the CDC a single point of failure and prevented the country’s diverse range of scientific resources from being used to deal with the problem. By early May, testing had begun to improve significantly, though many areas have continued to lack sufficient testing volumes and have suffered from the slow speed of getting results.

The testing debacle has been the subject of widespread political debate, and of endless media coverage and attention from political leaders. Democrats have used it routinely to criticize the president, with Senate minority leader Chuck Schumer tweeting the same message almost every day in May, and again in late July and early August: “President Trump still doesn’t have an adequate national testing strategy.” The president, for his part, has repeatedly made remarks about how testing makes us “look bad” by increasing the apparent number of cases.

There’s some truth to both of these comments — especially to Schumer’s — but they also reflect a narrow vision of what testing is for. Absent some other explanation of what actions expanded testing would enable, Senator Schumer’s tweets give the impression that the main policy goal is simply to monitor the spread of the pandemic — perhaps to better allow the administration to be blamed for failing to contain it. President Trump’s comments seem to treat testing the same way: as a mere indicator for when the government can decide to stop worrying and reopen the economy.

But if we reopen the economy when the number of cases declines, then what reason do we have to think that infections won’t spike right back up? If this is our only use for testing, then we are acting as if the government is a spectator, the disease is a game, and science is a scorekeeper: When scientists find through testing that the score is looking better, the government can decide that the game is won and that life can go back to normal.

The science behind coronavirus testing can and should be used not just to tell us how fast the disease is spreading, but how to actually slow its spread. The most obvious way to do this is through contact tracing and isolation of the infected.

Experts have been calling for such efforts since the pandemic began, and for obvious reasons: It is the gold standard of public health responses to outbreaks of infectious disease, and it is how countries like South Korea managed to rapidly control their Covid-19 outbreaks. The privacy implications of contact tracing and isolation are controversial in the United States, and the actual logistics of implementing these measures at scale will be very complicated and expensive. Getting this done will require funding from the federal government and sustained attention from policymakers to the complex details of executing an effective and acceptable contact-tracing plan.

Compared to the political conflicts over testing — the numbers of tests being carried out, the ways testing data is reported to the public, the relationship between testing data and the true scope or danger of the pandemic — there has been far too little political debate over how to implement the contact tracing and isolation measures that testing might make possible. Considering the barriers they have faced, the scientific community in the United States has done a good job scaling up coronavirus testing, with scientists developing new methods for testing and displaying considerable ingenuity in getting around supply-chain shortages and logistical hurdles. Political leaders have eagerly watched and debated the significance of the results of such testing for whether and when we might reopen the economy, but they have not done enough to deploy public resources in ways that could take advantage of our gains in testing. Testing is seen as a way for the scientific community to tell us how much to worry about the ongoing spread of the virus, rather than as a tool society can use to actually stop its spread.

As testing defined the beginning of our coronavirus response, the development and deployment of a vaccine will define the end. Unlike testing, vaccines are not seen mainly as a way of keeping score, but rather as a tool that science will provide for dealing with the virus. Most (though not all) Americans eagerly await its development. The media follows every bit of news about the different vaccine candidates, with positive and negative stories about their prospects triggering billions of dollars of trading on the stock market.

The biomedical research community is doing an impressive job bringing vaccines to clinical trials at unprecedented speed, and government agencies like the National Institutes of Health, the Biomedical Advanced Research and Development Authority, and the “Warp Speed” initiative have been well funded by the federal government. When it comes to vaccine development, the attitude seems to be that if we just give scientists lots of money and let them work, they will eventually produce a vaccine, and that will be the magic bullet that ends the pandemic.

Without a doubt, there are many aspects of vaccine development that should not be politicized. We don’t need members of Congress weighing in on dosage levels or on whether mRNA or adenovirus vectors are more likely to work. It is best to leave these important questions to professional scientists. And it would also be perilous if the administration rushed to approve a vaccine by October in order to boost President Trump’s re-election prospects, as some commentators fear.

But there are other important issues and questions around vaccine development that are political, that can’t be settled by just providing scientists with funding and leaving them alone. Whether to use vaccines that rely on fetal cell lines derived from abortion is one morally pressing question that has so far not received much political attention even from pro-life politicians.

Other vaccine development strategies also raise moral and political challenges. Some scientists and ethicists have called for deliberately infecting volunteers to more quickly test the efficacy of vaccine candidates. Whether such an effort would in fact hasten vaccine development is scientifically controversial, and of course morally controversial too. Scientists, on their own, cannot settle whether it is ethically appropriate to carry out such experiments. While some members of Congress have spoken out in favor of it, there has been little public debate over these kinds of experiments and little effort either to carry them out or to expressly prohibit them.

Another question concerning vaccine development is that of which international vaccine companies the government should partner with. An anonymous scientist working on the government’s Warp Speed vaccine initiative told Science magazine that while the initiative would not rule out any type of vaccine, they would not consider any made in China, a decision the scientist says was “above my pay grade.”

It is indeed entirely proper that such a decision should not be left to scientists: Whether the United States works with Chinese companies is a legitimate, and indeed urgently important political and diplomatic question. Yet it has received virtually no public debate.

Given the inherent uncertainty at this stage of the vaccine development process, scientists can hardly rule out the possibility that some of the Chinese vaccine candidates could prove to be safe and effective months before any of the vaccines produced by American companies. If that proves to be the case, then it would hardly be an exaggeration to say that making those vaccines available in the U.S. could save tens of thousands of lives, millions of jobs, and hundreds of billions of dollars. Pro-life Americans are being asked to accept vaccines that are made using fetal cells from abortions without much debate, and yet the idea of asking Americans to accept a vaccine developed by a Chinese company is not even seen as worth contemplating.

In both cases, the lack of debate reflects a thoughtlessness on the part of America’s political leaders. Perhaps there is a sense that vaccine development is simply a technical, scientific matter, and that other than appropriating the necessary funding, Congress has no role to play in decisions about how vaccines are developed. But just because there are technical questions that are outside the scope of politics does not mean that there are not also important political questions that need to be addressed.

Whether and how to reopen schools is the most pressing question facing Americans today. One approach to this question is to look to the scientific evidence about how dangerous Covid-19 is for children, or about how likely they are to spread the virus. Fatality and hospitalization rates suggest that children are much less likely to suffer from severe disease than older adults, while evidence about the risk of children spreading the virus is mixed. Political leaders clearly recognize that reopening schools is important. And there has been an effort to develop and implement strategies for making schools safer: better air filtration and ventilation; staggered start times, smaller class sizes, and other methods for social distancing; providing students with masks and school staff with high-quality personal protective equipment.

But the question of whether to reopen schools cannot be settled by appeals to the epidemiological data, or even by the development of technical strategies for keeping students and teachers safe. The decision is inescapably political: It’s about balancing the competing goods and making judgments about society’s priorities. The health and safety of children, parents, teachers, and school staff are important, but the education of children is likewise very important.

Political leaders do seem to recognize these competing values, but they have failed to make actual choices about how to prioritize reopening schools relative to other ways of controlling the spread of the virus in their communities. In Washington, D.C., for instance, schools will not be reopening in the fall, but bars and restaurants have been open throughout the summer. Whether schools will pose a greater risk of spreading coronavirus than will indoor dining is perhaps a difficult scientific question to answer with certainty, but whether it is more important for schools or bars to be open is not a difficult question — schools are quite obviously more important.

Prioritizing schools over recreational activities is broadly uncontroversial. Yet America’s political institutions — at the local, but also the state and federal levels — are so dysfunctional that our leaders have not acted as though they really believe that reopening schools matters more than reopening bars. Even when the underlying political priorities are as clear as they are in the case of schools, our political institutions have failed to take the actions they need to. It’s little wonder, then, that on other, more difficult political problems they have been so eager to abdicate their responsibility for governing to scientists.

We all recognize that science can provide answers to politically important questions: questions about how many people could be killed by the coronavirus, questions about what kinds of treatments, vaccines, or other measures could prevent deaths from the disease. But we should not forget that political institutions can provide answers to questions that matter to science: questions about how to work with other countries to develop vaccines, or about the kinds of experiments that we are willing and able to carry out, or about the resources and efforts society can devote to gathering information about the virus and how it spreads.

When it comes to important challenges facing society, like the coronavirus or climate change, the science that bears on these problems will inevitably be politicized. This politicization becomes fundamentally dysfunctional when political leaders, instead of addressing the problems facing society, choose deference or defiance as their only ways of responding to science. Political institutions must take responsibility for making decisions and taking actions — they cannot leave these decisions to scientists. But they can and should make use of the knowledge and tools that science provides.