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Figuring out the truth is a matter of life or death
I’m deeply troubled by the growing distrust of science in our society, just at the time when its insights are most needed.
By Francis S. Collins
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I am a physician and a scientist. Over 12 years, I had the privilege of serving Presidents Barack Obama, Donald Trump and Joe Biden as the director of the National Institutes of Health. Before that, I led the U.S. component of the Human Genome Project.
I am amazed by the medical progress that has been possible in the past few decades, both in alleviating suffering and saving lives. But I am also deeply troubled by the growing distrust of science in our society, just at the time when its insights are most needed. No recent experience highlights that disconnect more starkly than the last five years of the COVID pandemic. From my vantage point on the front lines of that battle against a dangerous virus, let me highlight both the triumphs and tragedies, and propose some actions that we can all take to re-anchor our troubled society to truth, science, faith and trust — and put us back on an individual and collective journey that might be called the road to wisdom.
Go with me back to early 2020, as the worst pandemic in more than a century was spreading across the globe, and deaths in the U.S. were in the thousands every day. For me and hundreds of scientists who joined together during Operation Warp Speed, the most hopeful strategy was to develop a vaccine. We all worked to be sure the large-scale trials were scrupulously conducted, and that they involved a wide range of men and women of different racial and ethnic backgrounds.
What would success look like? The Food and Drug Administration had set the threshold for approval of this effort at 50% efficacy, about what the flu vaccine achieves most years. My colleague Tony Fauci and I frequently discussed our hopes for the outcome. Maybe it could be possible to reach 70%? I confess that I was fearful of failure. I also prayed a lot.
The results were revealed in late November 2020. For both the Pfizer-BioNTech and Moderna mRNA vaccines, there was 90 to 95% efficacy in preventing illness that caused respiratory symptoms and close to 100% efficacy in preventing severe disease and death. Side effects were minimal in the tens of thousands of volunteers who had taken part in each trial. It was a moment of profound relief, of gratitude toward all who had made this possible, of answered prayer. As I tried to speak to the dedicated team about the significance of what had just happened, I could not find words that could fully express the emotions of the moment. I was unable to hold back the tears.
Future historians will judge the development of safe and effective mRNA vaccines for COVID in 11 months as one of the greatest medical achievements in human history. We felt that at last we were on a path to conquering this disease and stopping the terrible death toll. And to a major extent, that came true: Current estimates by the Commonwealth Fund, a nonprofit foundation supporting research on health care, are that more than 3 million lives were saved in the U.S. between December 2020 and November 2022 by COVID vaccines. If you were vaccinated, you might be one of them. I might be also.
Yet ultimately more than 50 million adult Americans declined vaccination — even after the shots were made widely available at no cost. Though medicine and public health make poor bedfellows with politics, one’s political party was a strong predictor of resistance. So was religion, with white evangelical Christians (my own group) the most resistant of all. Public distrust, driven by social media, cable news and even some politicians, reflected a host of concerns: whether COVID-19 was real, whether it was really all that serious, whether the vaccines were rushed, whether there were common and serious side effects that had been hidden, whether the mRNA would alter the recipient’s DNA, and whether companies had skirted the rules about safety. More outlandish conspiracies also circulated on social media: that the vaccines contained microchips or cells from recently aborted fetuses, for example. People of faith were particularly hard hit by misinformation.
The consequences of vaccine misinformation have been utterly tragic.
The gradual waning of vaccine benefits over time, plus the continual emergence of new COVID-19 virus variants (alpha, beta, delta, omicron, JN.1, KP.2 …) challenged the durability of immune protection and required re-engineering of boosters to cover the new strains. Vaccinated people like me were still capable of getting COVID, but the most recent CDC study shows vaccines still reduced the risks of infection by more than 50%, and protection is even higher for severe disease.
They only work, though, if they are taken. For too many people, they weren’t.
The statistic that gives me the deepest heartache is this: More than 230,000 Americans died unnecessarily between June 2021 and March 2022, largely because misinformation caused them to turn away from what might have saved them in the midst of a dangerous pandemic, according to an assessment from the nonprofit Kaiser Family Foundation. This death rate is the equivalent of four fully loaded 737s crashing every day.
While the deterioration of confidence in scientific evidence and the rise of “alternative facts” did not start with COVID, it accelerated in the face of this frightening global pandemic. It is also present in our disturbing disagreements about the reality of climate change, when the evidence for human activity as the main source of significant global warming since 1950 is overwhelming.
We are in serious trouble when some believe that their faith requires them to distrust science, or when others believe that political allegiances are a better source of wisdom than truth, faith or science. This is not just a problem of one end of the political spectrum; no political party has a monopoly on virtue or vice. But something deeper in our culture is wrong. In many aspects of our daily lives, the anchor to objective truth seems to have been lost.
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What do we mean by truth anyway?
Let’s consider a set of concentric circles that represent various levels of truth. At the center is what could be called the zone of necessary truth. Items in this zone consist of statements about a concrete reality that just has to be the way that it is. Those items would have to be true in any imaginable universe, and they don’t care how we feel. In this rather narrow zone, the main entries are from mathematics and possibly from the nature of time. I don’t know anyone who would argue seriously that 2 + 2 is not equal to 4. Going further, the area of a circle with radius r is πr². These necessary truths can’t just be set aside for convenience; the careless mistake a student made on the math test cannot be justified by saying this is just his or her version of the truth.
The next circle out, which is the home for a much wider range of reality claims, is firmly established facts. These are conclusions that are overwhelmingly supported by evidence, but discerning them has required human observation. We can safely place here most scientific conclusions about objective reality that have been supported by multiple experimental approaches and sustained over many decades. In our universe, the force of gravity follows an inverse square of the distance between two objects. The earth is round (well, slightly elliptical), and it goes around the sun. (Sorry, flat earthers.) DNA is the hereditary material for humans. The average temperature of planet Earth is rapidly increasing — yes, it really is. And COVID vaccines were tested in rigorous trials in 2020 and found to be safe and effective. These statements are all established scientific facts.
With about the same confidence, we can place well documented historical events within the zone of firmly established facts. Neil Armstrong walked on the moon in July 1969. Two planes brought down the Twin Towers of the World Trade Center in New York on Sept. 11, 2001. Joe Biden won the 2020 election by 7 million popular votes and a vote of 306 to 232 in the Electoral College. Despite fringe claims about all three of these statements, the evidence is overwhelming. If something in this zone is true for you, then it has to be true for me.
As we move further out from the center, we reach claims that are potentially true, but the evidence is currently insufficient to move them into the circle of firmly established facts. We can call this the zone of uncertainty. Here’s an example: Did mask mandates provide benefit to a community in reducing COVID transmission? One careful study in Bangladesh said yes, but other large-scale studies in the West have had difficulty documenting that — with a major reason being that compliance has been so uneven. On the other hand, many studies have shown personal benefit from consistent mask-wearing in reducing risk to individuals and their close contacts.
Going even farther out, we get into territory where facts and evidence are frankly scanty or just irrelevant. This is the zone of subjective opinion. Some examples: Tattoos are cool. Dogs make better pets than cats. Shoes with brown leather tops and thick white soles look really good on men (on this last one, opinions at my house do not match). Disagreements about topics in this zone do not threaten the order of things. In fact, they make our society richer and more interesting because people have different tastes.
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When disagreements arise about what is true, it is really important to assess which zone we are working in. Looking at our concentric circles, I think we can all accept that claims in the outermost zone are subjective, so it’s fine to disagree about those. But here’s the point I really want to emphasize: As you move inward to zones where there is more and more actual evidence, it becomes more and more important to track down that evidence, and not just say that everything is a matter of opinion. When you get to the solid foundation in the innermost two circles, these are matters of currently established truth that have to be true for everybody. Those facts don’t care how you feel, and they can’t be — and are not — a matter of opinion.
When we review the breadth and depth of society’s current malaise, it’s tempting to just check out. We’re discouraged by what’s happening to the social fabric, we’re burned out and turned off by all the lies, conflict and venom, and so many of us have stepped back from the animosity to just try to take care of our families, our jobs and our sanity. In the terminology of More in Common, a nonprofit that conducts surveys, we are the “exhausted majority.”
But there is still a deep hunger in most of us for healing and hope. To achieve that, we need to overcome the exhaustion, the fatalism and the cynicism.
Here are some specific ideas about actions we can all take.
First, we should each take the time to get our own mental house in order. Let’s begin with a fundamental principle: There is such a thing as truth, and truth really matters. Are all the items in your current circle of established facts really established? Have you labeled other information you don’t like as opinion, even though it is firmly established?
Second, to move from our current divisiveness to an era of empathy and understanding, it is essential for more of us to become comfortable having conversations with people who have very differing views from ours. Keep in mind in such interactions that your goal is to listen, to understand the other person’s perspective, but not necessarily to change his or her mind. If anyone’s mind changes, it will be on the basis of their own insight, not from verbal browbeating. Be prepared to admit the parts of your own perspective where you’re honestly less sure, and where you have made mistakes.
Third, individual bridge-building can also extend to communities. The antidote to feeling hopeless is to link up with other individuals who also are motivated to address our current polarization. The “bridging field” — made up of organizations like Braver Angels (of which I am a member), whose programs aim to bring Americans together across our divides — has grown from a few dozen organizations a decade ago to hundreds today. Probably at least one or two of those is near you.
Finally, individuals are also part of a nation, and ultimately the nation should be responsive to their needs, hopes and dreams. If our nation’s political system has lost much of its commitment to truth, compromise and civility, it is up to us to turn that around. We need leaders who are capable of building consensus, not just spewing outrage on social media or cable news. Character really matters. Excusing repeated acts of lying and cruelty from a leader to achieve certain political goals is not a strategy that will lead to the healing of our nation.
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The worst thing that could happen to our democracy would be for the people to step away from the political process, feeling that nothing can possibly be done to make things better, to the point of boycotting elections. If the exhausted majority all feel that way, then only extreme voices will be represented at the polls. We will then get what we deserve: the continuation of a dysfunctional government that seems focused on media performance, drama and conflict.
I am well aware that these proposed solutions are not novel, but that doesn’t make them any less necessary or important. Practiced widely and consistently, they could be our best hope.
There is no question that we are living in a dark time. But as the Rev. Dr. Martin Luther King Jr. wrote, “Darkness cannot drive out darkness. Only light can do that.” It’s one thing to say, “Things don’t have to be like this.” It’s another to say, “I don’t have to be like this.” Guided by a determination to recover the foundation of our deepest values — truth, love, beauty, goodness, family, faith and freedom — we can be people of light.
As COVID showed us, it’s a matter of life or death.
Francis S. Collins is the former director of the National Institutes of Health and the author of “The Road to Wisdom: On Truth, Science, Faith, and Trust,” from which this essay — which first appeared in the New York Times — is adapted.
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Francis S. Collins
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