2020 has been the year of the scientist, or at least thepublic health scientist.
Science is a method, not adiscipline; it includes social science, because socialscience does at least notionally apply the scientificmethod.
While being about the discovery of truth, thescientific method implies that truth (with the exception ofidentities such as mathematical truths) is unattainable.With the scientific method, 'meaningful' propositions areeither false or yet to be falsified. The latter 'yet to befalsified' propositions are regarded as provisionallytrue.
The word 'meaningful' here is a technical word;it relates to propositions that are capable of being testedby 'empirical' evidence. It does not relate to certain otherpropositions, which are easily understood (but notmeaningful in a scientific sense), such asthese:
Thelatter example could be regarded as meaningful if an agreedcriterion for 'better' is provided. But two differentaccounting methods can both be 100% accurate.
William McNeill (Plagues and Peoples,1976) tells us that the suppression of the ThirdPlague Pandemic was probably the most importantachievement, ever, in public health applied science. Most ofus know nothing of this, precisely because the Third PlaguePandemic was suppressed.
This was a supreme effortthat took place only when (in the 1900s' decade) 'germs'were only just coming to be understood as the principalcauses of infectious diseases. Further, it was only thisevent that enabled the more infamous Second Plague Pandemicto be adequately understood.
First, we must note that'plague' is the name of a disease that comes in two mainforms: 'bubonic' and 'pneumonic'. Bubonic plague is spreadby fleas which live on burrowing rodents which mayinclude rats for whom the disease is endemic. The morelethal pneumonic plaque is spread much like Covid19, personto person and often through super-spreader events. UnlikeCovid19, plague is treatable with antibiotics. But it mustbe treated quickly; case fatality rates for pneumonic plaguewere about 90 percent, and fatality could take place withina day of infection.
The first plague pandemic occurredbetween the years 550 and 750, affected mainly in theMediterranean coastal areas, and most likely originated inCentral Africa.
The second plague pandemic originatedin the steppes of Central Asia in the 1330s, and finished inManchuria in the 1920s; the Manchuria outbreak was the lastsubstantial outbreak linked to that Central Asian contagionreservoir. The most renown episode within this pandemic wasthe European 'Black Death' of 1348 to 1352.
The thirdplague pandemic originated in the borderlands of China,Burma (now Myanmar) and India in the 1850s. It festered inChina's Yunnan province until it spread to Canton (nowGuangzhou) and Hong Kong in the 1890s. From Hong Kong, itspread via tramp steamers, ship rats and fleas toseaports all over the world, much as Covid19 spread acrossthe world via people in aeroplanes. While largely suppressedby the 1920s, significant late outbreaks linked to thatinitial Yunnan source took place in North Africa after WorldWar 2, and in Gujarat, West India, in the early1990s.
Among the most significant transmissions werethose in California, Bombay (now Mumbai) and Sydney. Theplague came to New Zealand from Sydney in 1900, with anestimated death toll of 7 people (and many thousands ofrats). My partner's great-great-grandfather was a member ofthe Auckland Health Board that successfully managed theplague outbreak here. The death toll in Australia was about500, mostly in the Sydney area.
The scientific workwas done mainly in Hong Kong and Bombay. It was only thenthat bubonic plague was scientifically linked to rats andfleas. Ironically, that gave us this huge mental picture ofthe medieval black death as being linked to medievalpoverty, with homes in Europe in that time supposedlyinfested with rats. Yet few pictures from the time showrats, and transmission patterns away from seaports wereinconsistent with rats and fleas as being the only vectorsof the disease. It now appears that the Black Death wasmainly pneumonic plague, spread person to person bysuperspreaders. This pattern of transmission wasparticularly evident in the 1924 Los Angeles outbreak ofpneumonic plague.
The third plague pandemic wassuppressed much as the SARS1 coronavirus pandemic of2003 (more lethal than SARS2, Covid19) was suppressed through a mix of excellent scientific work and the politicalwill to implement the scientific requirements. (Politicaloverkill did take place, however, especially inBritish-ruled Hong Kong and India, and with littlecompensation for those who lost their homes and theirlivelihoods.) Had that pandemic not been supressed hadpneumonic plague got out of control like the SARS2coronavirus did in 2020 the modern world as we know itwould have collapsed. In the pre-antibiotic era, thispestilence both lethal and highly infectious couldhave halved the world's population had the science notprevailed.
Unfortunately, as a result of the thirdplague pandemic, a number of new plague reservoirs formedlast century in Argentina, Peru, South Africa and NorthAmerica. The North American reservoir covers at least thewestern two-thirds of the United States. Most human cases inthe United States these days occur in the western one-third(and are cured), and in the public estate rather than onfarms; farming practices help to minimise the risk of thedisease from overflowing from the burrowing rodents intourban human populations. Nevertheless, the fourth plaguepandemic, when it comes, will most likely start in theUnited States, some time after antibiotics have becomeineffective and public order has already becometentative.
Many very bad things havebeen done in the name of science.Eugenics is an applied science thatbecame central to our way of thinking, especially around theyears 1870 to 1930. Eugenics is the science of artificialselection; the 'survival of the fittest' enhanced by expertsdeciding who is fittest, and henceforth who may be permittedto breed.
Eugenics is not false in the way thatalchemy is false. Eugenics is indeed widely applied infarming, and other breeding programmes such as thoroughbredracing horses and pedigree breeding for home pets.
Inhumans, applied eugenics was called things like 'theimprovement of the race'. It formed a pseudo-scientificbasis for racism. Eugenics was 'pseudo'-scientific becauseit was built upon cultural premises about what constitutedfitness, and it was built upon a past lack of understandingby scientists of the importance indeed the biologicalfitness of diversity. (We note that eugenics, applied infarming, is also problematic in this regard. Eugenicpractices have substantially reduced the diversity of ourfood crops and domesticated animals, increasing ourvulnerability to animal and plant pandemics; and,potentially, to human pandemics.) Good science requiresimagination, and few scientists 100 years ago wereable to imagine the importance of biological diversity tothe fitness of the biosphere.
Eugenics became acultural-scientific enterprise that built on a particularinterpretation of Charles Darwin's published works onbiological evolution. While Darwin himself should not beunderstood as a eugenicist, the 'father' of 'scientific'eugenics was Darwin's cousin Francis Galton. Further,eugenics conflated in the Victorian upper middle class mindwith the 'Social Darwinism', an emergent socialpseudo-science championed by Herbert Spencer.
Science is the practice of forming provisionaltruths through the elimination of verified falsehoods. Inpractice, this process doesn't really work. In socialscience, it is almost impossible to definitively assign aproposition to the scientific dustbin.
In physicalscience, falsification has also proved problematic. Doctors practitioners of medical science clung onto theidea, long after the miasma theoryof infection had been disproved, that they did not need towork in sterile environments. One result was that in NewZealand in the 1920s when it became normal for women to givebirth in hospitals rather than in the home while theinfant mortality rate went down, the maternal mortality rateincreased. The problem turned out to be doctors bringinginfections with them from general wards into maternitywards.
More generally, the big dichotomy in nineteenthcentury medical science was the 'miasma theory' versus the'germ theory' explanation of infectious diseases.
Themiasma theory became the mainstay of medical practice fornearly two millennia, following the second century writingsof Galen. The theory prevailed until the 1880s, and wasstill widely believed at the time of the onset of the ThirdPlague Pandemic. Miasmas were essentially 'bad airs' arisingfrom the ground, especially disturbed or filthy ground. Onereason for the ongoing belief in the miasma theory is thatit did suggest quarantine and environmental cleanliness asremedies, and these remedies were often effective.
Thecompeting germ theory (or 'contagionist' theory) was firstproposed in the sixteenth century, and had many adherents bythe eighteenth century. (The case for quarantines was evenstronger under the germ theory than under the miasmatheory.). But in the nineteenth century, medical sciencetook a major setback; the germ theory was falselyfalsified.
William McNeill tells us(p.271) that: "French doctors, when yellow fever broke outin Barcelona in 1822, seized the opportunity to make adefinitive test of the contagionist as against the miasmaticschool of thought. They concluded that there was nopossibility of contact among the different persons who camedown with yellow fever in Barcelona. Thus contagionismseemed to have been fully and finallydiscredited."
McNeill continues to note that theproblem was that "no one as yet imagined [myemphasis] that insects might be carriers of disease". Andthat "British liberals, in particular, saw quarantineregulations as an irrational infringement of the principleof free trade" and lobbied strongly and largelysuccessfully for 'the economy to be prioritised'. Thiswas in the early years of systematised classical politicaleconomy; later the same mercantile lobby prevailed duringthe Irish potato famine.
An important consequence ofthis false falsification of the germ theory, is that whenJohn Snow discovered that the mid-century London choleraoutbreak was caused by contaminated water, his findings werelargely ignored. The end of the prevalence of the miasmatheory in medical science only came when Robert Koch in 1882physically and definitively identified the bacteria whichcaused cholera.
In 2020 our own SiouxsieWiles has promoted in New Zealand the John SnowMemorandum which strongly lobbies for politicians andadministrators to take Covid19 seriously.
Science including social science has become a career for many of our brightest minds. But thenecessity to build a career can get in the way of thequality of the science. Further, every now and again, careerscientists get much more public attention than they wouldnormally get. Even more important than their new-found mediaexposure is the fact that these scientists suddenly findthat they have the ear of senior decision-makingpoliticians; a select few scientists become public warriorswith a cause, rather than cloistered academics researchingon the margins of public attentiveness.
One importantexample of this phenomenon was the 'dry' academic leaders ofeconomic liberalism in the 1980s. (Paul Krugman himselfhaving a second career as a media economist has widelydiscussed the compromises that career-building places onscientific truth in the social sciences.) Treasury in NewZealand at that time preferred to recruit economists fromthe 'dry' universities, or people who had graduated in otherdisciplines and could subsequently be inculcated into 1980s'Treasury ways of thinking. And the worse the economy got thanks to the recommendations of these very people themore politicians and media looked to these dry economistsfor explanations and solutions.
In public healthtoday, different countries have adulated different schoolsof public health. The Swedish public health school has beendiametrically opposed to the New Zealand public healthschool. Yet both schools' leaders have been subject to asharply heightened media exposure and sense of becoming themilitary generals of the Covid19 battle. And that cancompromise good science.
In the 'battle' againstCovid19, there are essentially four pre-vaccine ant-covidmeasures: lockdowns, border management, contact tracing, andmask wearing. All almost certainly play a role, but the waysthese different measures interact can be complex, andunhelpful messaging much coming from scientists hascontributed to the pandemic. The scientists in particularunderstand their disciplines, but not the wider pictures ofpeoples' lives.
Economics can help here but notthe dogmatic kind that ruled over us in the later 1980s andearly 1990s. The principal is that an action should be takenif the marginal benefit exceeds the marginal cost of thataction. The result of this principle is that restrictivepolicies should be proportionate as well aseffective.
It appears that New Zealand was effective,early, through its lockdowns (through the system ofemergency levels); then, border management and contacttracing became critically important to New Zealand's successin 'eliminating' Covid19. In New Zealand, these measureswere sufficient; there has been no evidence that communitymask-wearing has had any additional effect. Where anunpopular measure has minimal benefits (and masking in NewZealand is revealed as unpopular by the general absence ofvoluntary masking), it violates the economic principal ofbalancing marginal costs and marginal benefits. Onlypoliticians, not scientists, should be making these kinds ofeconomic decisions; and the politicians need to be takingadvice from a range of relevant perspectives, and not justadvice from one group of scientists.
In Taiwan, andsome other East Asian countries, the critical measures havebeen border management and contact tracing. In the absenceof lockdowns, masking in crowded indoor environments almostcertainly played an additional role in the early stages.But, when a country has eliminated the virus from communitytransmission (as both New Zealand and Taiwan have), thecompulsory wearing of masks can make no difference; andcompulsion itself has significant costs, in some culturesmore than others. In countries without community covid, thecompulsory wearing of galoshes or codpieces would have thesame impact on Covid19 as the wearing of masks.
Thegeneral application of the economic rule about marginalbenefits and marginal costs is that contextuallyineffective measures should never be taken except underformal emergency conditions that are by their naturecharacterised by a lack of information, ie a lack of knowingin which contexts the measures are effective.
Theexpedient approach is to delegate power to disciplinaryexperts, whose lives are themselves necessarily structuredaround expedient careers choices. And the expedient approachtends to be to overregulate, rather than to seek an optimalbalance; and it doesn't always remove regulations when theyare no longer sensible. On the latter point, allemergency-type rules should always be time-limited from theoutset, albeit subject to timeextensions.
Science plays an importantrole in our lives, and sciences have much to offer as weseek to improve our lives, and seek to address circumstancesthat threaten our normal lives. But science is fallible, andno science contains the whole truth about the particularsituations we face as we navigate our lives individually andcollectively. Sometimes, big mistakes are made in the nameof science. Truth isprovisional.
Scoop Media
Political Economist, Scoop Columnist
Keith Rankin taught economics at Unitec in Mt Albert since 1999. An economic historian by training, his research has included an analysis of labour supply in the Great Depression of the 1930s, and has included estimates of New Zealand's GNP going back to the 1850s.
Keith believes that many of the economic issues that beguile us cannot be understood by relying on the orthodox interpretations of our social science disciplines. Keith favours a critical approach that emphasises new perspectives rather than simply opposing those practices and policies that we don't like.
Keith retired in 2020 and lives with his family in Glen Eden, Auckland.
Read the rest here:
Science: The Good, The Ugly, The False, And The Expedient - Scoop.co.nz
