The return of the experts? Or the muddying of the experts?
March 27, 2020
Scientific experts seem to have taken center stage with the corona pandemic. Often this is applauded as policy — finally! — being informed by science.
However, what I see are scientific experts no longer acting as scientists, but overstepping into proto-policy making. Sure, it’s nothing new that experts need to “sell” scientific knowledge to make it accessible to the public. But the Coronavirus crisis has brought some egregious examples of local but powerful scientific experts going in against science.
Here is a puzzling example; judge for yourself.
Belgium has a “National Committee for the Corona Virus”, consisting of virologists advising politicians and the public. All have impeccable scientific credentials. They even get praise from the Financial Times. But is the Committee sufficiently trustworthy?
On the 2nd of March, Phillippe Devos, the head of a Belgian medical association, made a back-of-envelope calculation that 50.000 Belgians could die if no measures were taken. He made this simple calculation based on (1) how many people are infected with the flu on a yearly basis, (2) the higher infection rate of the SARS-CoV-2, (3) the estimated mortality rate of Covid-19.
Incensed, Steven Van Gucht, the head of the National Committee, told the media that “People, definitely doctors, should better think before they send something like that into the world.” Instead, Van Gucht made his own calculation.
“The worst-case scenario in Belgium would entail 13.000 diagnosed cases, 2-3.000 hospitalizations, and 500-700 patients on intensive case. This is what a bad seasonal flu could cause as well. These numbers are not based on all sorts of mathematical detours [unlike Devos’s].” They are based on the situation in Wuhan and the province of Hubei, where the virus showed up first in December. I don’t expect that things will get so bad here. In Hubei people weren’t prepared and the authorities reacted too slowly in the beginning. “We are prepared.”
So the head of the National Committee, a professional virologist with incredible influence on politicians and the media, explicitly claimed that the worst-case scenario was a bad seasonal flu.
He also claimed that his calculation was based on Chinese data.
On January 24th the Lancet published a study on the ‘novel coronavirus’ with an estimated case-fatality rate of 3%. On February 8th, based on 20.000 confirmed cases, the mortality rate was estimated at 2%. Of course, estimating fatality rates is a very uncertain business – since you can never know for sure how many people actually contracted the virus. But those 20.000 data points are not to be dismissed. They were enough to seriously look at the possibility that the ‘new coronavirus’ was many times more lethal than the season flu (with an official mortality rate of 0.1%).
Conclusion: it was clear, already in January and February as the Chinese started testing massively, was that the ‘novel coronavirus’ was possibly and even likely many times more lethal than the seasonal flu.
Now look at the reproductive number, or the average number of people an infected person infects. On the 29th of January, the New England Journal of Medicine published a study estimating the ‘basic reproductive number’ to be 2.2 (and almost definitely bigger than 1.4, and smaller than 3.9). To place that in context, according to one systematic review the influenza virus has a reproductive number of 1.28, and that of Spanish flu, which killed around 50 million people world, was 1.8.
Another conclusion: it was crystal clear, already in February, that the SARS-CoV-2 was very likely very infectious.
Van Gucht is a professor of virology. I am not, and neither are you in all likelihood. But strengthened by the authority of The Lancet or NEJM, anyone could see we were possibly dealing with an alarmingly deadly and infectious virus. Philippe Devos was absolutely right to send out a warning in the way he did. In fact, his warning could even have come by the beginning of February. That Van Gucht reproached Devos publically is even more jarring.
Why did Van Gucht play down the seriousness of the SARS-CoV-2 virus? Why did others on this team do the exact same, like Marc Van Ranst, another professor of virology, who on March 8, as Italy went into lockdown, implied that they were overreacting from a medical perspective because Covid-19 is just like the seasonal flu?
Was it negligence? Was he not reading the Lancet or the New England Journal of Medicine? Or did he act out of some kind of paternalistic instinct, not to let ordinary people panic?
I can understand that non-scientists played down the seriousness of SARS-CoV-2. I can also understand – or at least, fail to be surprised -- that politicians as Trump played up the comparisons with the flu. However what bewilders me is that professional virologists did the exact same, and we lost precious weeks in preparation. Massive trust is being placed in these scientific experts. Belgian media is currently treating them like heroes or gurus.
This consternation was the push for me to start this blog. However, in the following blog posts I want to investigate this further. Was it misplaced but well-intentioned paternalism? Was it downright negligence? Or was it, perhaps a certain arrogance towards the Chinese (like: ‘oh this can’t happen in the West’)? Or were these experts under political pressure?
To be continued…