On Flip-Flopping

Or How Does Science Make Up Its Mind

No one likes a “flip-flopper” it seems. We want public figures to stick to one clear message, be they politicians running for office, scientists announcing their latest findings, or public health authorities telling us what we need to do to avoid becoming ill. A change in that message, what we call flip-flopping, is seen at best as a sign of weakness and at worst evidence of lying and corruption.

         Let’s take the recommendation to wear face masks during the COVID-19 pandemic. It is true that at first, even the trusted Anthony Fauci seemed to be saying that only healthcare workers needed to wear them. The rest of us, experts recommended, didn’t need them.

         Several months later, however, Fauci, the U.S. Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), and a host of other experts seemed to change their minds; wearing face masks, we were then told, is a vital part of the public health strategy to prevent the spread of the novel coronavirus that causes COVID-19. Most people have complied with that recommendation and wear face masks while in public gatherings, but a constant stream of dissenters insist this change in recommendation means the authorities don’t know what they are talking about in the first place, were lying to us, and were acting out of some bizarrely concocted conspiracy to control people’s lives.

Science Marches On

         We think that what really happened is that scientists made some new discoveries about face masks that altered best practice recommendations. At the beginning of the epidemic we did not have a lot of data about face masks or about how SARS-CoV-2, the virus that causes COVID-19, is spread. In just a few months after the pandemic began in the U.S., however, data emerged on three fronts. First, studies using laboratory animals demonstrated that masks prevent the spread of SARS-CoV-2. Second, epidemiological data began to show that instances in which people wore face masks were associated with lower rates of infection. Third, scientists confirmed that SARS-CoV-2 can be aerosolized and spread through the air over long distances, meaning that face masks that prevent aerosolized particles emitted by coughs, sneezes, and talking can be an important tool in preventing viral spread.

Some people mistakenly believe that the change to recommending we wear face masks while in public represents a nefarious “flip-flop” and evidence of scientific corruption. In fact, it came about because of the gathering of new scientific evidence (image: Shutterstock).

         Those insights gleaned from laboratory and epidemiological studies changed thinking about face masks and led to all of those experts changing their minds and their recommendations. Were they wrong at first to recommend against face masks? A better way to think of it is that they made recommendations based on what was known about them at the time. Was Ptolemy wrong to say during the days of the Roman empire that the sun revolves around the earth? Of course, but it turns out that the idea was based on the best available scientific observations of the time and not on stupidity or an ulterior motive. When Copernicus, Galileo and other later scientists provided new data that proved the earth revolves around the sun, science “changed its mind.” It was very hard in the fifteenth century for many people—including many astronomers at the time–to go along with that kind of momentous change in scientific thinking and it is still hard for us to do so today. We don’t love change, not about which heavenly bodies circle each other nor about whether we should wear face masks to prevent disease spread. Yet we must be able to adjust our thinking to accept new scientific consensus when it emerges. To try to dismiss new scientific consensus by accusing the scientists behind it of lying or dark conspiratorial motives is a defense mechanism against accepting the normal way that science develops.

Science Inevitably Involves Change

         It is the nature and indeed the virtue of science that it is built to provide new insights that change current dogma. We may be about to see a radical change in physics because new experiments show that a subatomic particle called the muon has a stronger magnetic spin than current theory predicts. Physicists seem mostly excited by the prospect of developing a new theoretical understanding of how forces work in nature, even though if that turns out to be the case a lot of textbooks will have to be rewritten. The public seems interested but not particularly upset with this prospect because few of us understand the complex mathematics behind the current physics, so changing it perhaps won’t matter much to most of us. Still, at least one educated person we know queried whether his computer will still work if physics changes its theories.

The nature of scientific consensus is to be established via twists, turns, and roundabouts in the collection of scientific evidence. Change is both common and desirable (image: Shutterstock).

         When it comes to things that affect our daily lives, like how much sugar is safe to consume, whether we need to scrub every surface we come in contact with to prevent getting COVID-19, or whether we should take vitamin D supplements, we want there to be a strong and unshakeable scientific consensus. Sometimes, however, the consensus isn’t unshakeable, as we know with the dietary recommendations for sugar and fat consumption. Sometimes the consensus isn’t strong: experts and guidelines tend to suggest that only people who are clearly vitamin D deficient need take supplements, but what exactly constitutes “deficient” in this case is difficult to define and much debated among experts. That amount of change or uncertainty is unsettling and we tend to default to conspiracy theories rather than accept that change and uncertainty are vital parts of the scientific enterprise.

What Scientists Can Do

         There is an important thing that scientists can do to help people accept that change and uncertainty are natural parts of the scientific process. Scientists need to state much more forcefully when they speak to the media or the public in general that things are uncertain or incompletely known. There is a growing tendency among publicity departments at research universities and medical centers to “sell” the work of their faculties as representing major discoveries and “breakthroughs” when in fact much of what is being promoted is really just a small part of a larger, ongoing scientific process. Press releases from universities, medical schools, and teaching hospitals have become part of an attempt to increase market share rather than to carefully inform journalists and the public about how science works.

         For example, many medical and scientific authorities whom we trust initially spoke about face masks as if there was settled science proving their inability to help block transmission of COVID-19. In fact, they should have said that at that early point in the pandemic there was insufficient information to indicate their usefulness and that further scientific inquiry might alter the recommendation not to use face masks, which in fact happened. That way, the public would not have felt so misled when new data came in suggesting that face masks are indeed a very important part of the effort to contain the pandemic.

         Just as fundamentally important as having the scientific community adopt a humbler attitude about what science in fact “knows,” is the critical need to improve science education so that people are not so shocked by inevitable twists and turns in scientific consensus and public health recommendations. If we persist in teaching children and young adults science by forcing them to memorize “facts” we will continue to create the misimpression that science is set in stone. For those of us who have done experimental work, it is absolutely no surprise that outcomes of even the most rigorously designed studies often fail to support initial hypotheses, that some findings are not replicable by further experimentation, and that there is a continuous need to update what we think we know. Science is our best route to establishing true insights into the way the natural world works, but that route is nevertheless filled with twists and turns and roundabouts. We need to teach people that this is how science really works.

         We should not automatically and derisively call a change in knowledge or recommendation or even political opinion a “flip-flop.” Rather, we should welcome an open-minded approach to science and to politics in which new scientific evidence is accepted and incorporated into existing theories, even if on occasion it means that an entire theory needs to be dramatically revised. No one was lying when they advised that face masks were unnecessary to control the raging novel coronavirus. Admittedly, they were a bit too sure of themselves in saying that, but we should be relieved that scientists were willing to look foolish and change their guidance about face masks as new facts emerged from scientific inquiry. Let’s be a little kinder about the next “flip flop.”

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