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Distance Interviews

The doubt, more precious than the truth

The epidemic made us recalcitrant toward complexity but in medicine uncertainty is a value

Interview with Paolo Giordano

Writer and physicist

By June 2020April 26th, 2022No Comments
Photo by Lorenzo De Simone

Let’s begin from the concept of distance. The Covid-19 pandemic made us realise how dangerously close we are to the rest of the global population and at the same time how strong is our need to be with others.

We gave unprecedented proof of our ability to keep the society into consideration. Even though our efforts in March and April were partly due to our fear and the impositions that came from higher up, I believe that they were also the result of a newfound sense of collective duty. We all felt invested by this sense of responsibility to protect the more vulnerable and the National Healthcare Service. I think that for a country like Italy these are great news. The transgressions are just part of the picture and they refocus the attention on our being human and on the abnormality of the situation. It is important to remember how unnatural this is; otherwise we risk idolising the greatness of social distancing, which is something awful, only acceptable when temporarily in place. I do not want to love anything about this system. I hate the facemask (even though I wear it) and I look forward to gatherings with people. This pandemic might have uncovered the risks of proximity- between the rest of the world and us- but for me it remains without question an absolute value.

We ought to wonder what the boundaries of this shared sense of responsibility are. Is it limited to the circle of our loved ones, our fellow citizens or does it expand to the rest of the world?

This is the goal of what I’ve been trying to achieve during these months. The fact that I wrote a book (editor’s note: In the contagion, Turin, published by Einaudi, 2020) was my way of using this time of emotional availability to introduce reflections that would expand the global picture, the reflections that we need to prevent similar situations from repeating in the future. This collective emotional availability was there for a time, also thanks to the political background noise- that normally covers everything else- disappearing. However it did not last long. Today it feels like there is only space to introduce “medium to long-range reflections”. According to the World Health Organisation (WHO) South America is currently the epicentre of the pandemic, where there are populations much more exposed than we are, with poor or inexistent healthcare facilities. However these topics are not even at the margin of the debate in our country. It is a direct confirmation that the global aspect of this emergency has not passed or gone away.

What about our impact on the environment? Scientific data describe epidemics as a direct consequence of deforestation and the loss of biodiversity…

It is always very challenging to sensitise the community to these topics. It is much easier to do it with a virus spreading among us, a direct threat. Environmental issues are more elusive, slower and more contradictory. At the very least we should prevent this emergency from having the opposite effect, slowing or thwarting the policies that were being developed with difficulty. The economic, industrial and commercial emergency risks being prioritised over these. Unprecedented investments are get discussed at this time and their nature will let us know whether we will choose to undermine or protect climate policies.

Once again, it will be about whether we trust science or not. However, we’ve never been more recalcitrant toward complexity. During the most acute phases of the emergency it became clear that we wanted certainties, a start and an end date. The responses we received were only opinions, reflections and doubts. In a situation like ours what role does science have?

The role of science is to bring back doubts and to highlight the importance of questions over answers, of arguments over assertive and oversimplified posts. It would be a great opportunity to limit this pandemic of superficiality, because the systems we’re immerged in are complex at a level that we’ve never seen before. If our thoughts withdraw from this complexity then an increasing amount of people will be living in a world that they only understand to a very small degree. Scientific disciplines decode, interpret and explain the countless folds of the system and exactly for this reason they should be a crucial part of the public discussion. However, this requires a change in perspective that should start with young generations and basic education. It’s not possible to change the reasoning structure of the adult population, we need to raise individuals with more exposure to sciences so that they are better enabled to read and understand this complexity.

The role of science is to bring back doubts.

Even part of the scientific community displayed a certain rejection of complexity. When faced with the need to rapidly identify efficient treatments they often chose simplified solutions and experimental designs with weak methodologies. Do you think that in an emergency situation it is legitimate to loosen up the methodology requirements?

I think it is unavoidable and right to do that. Experimental studies had to take place while dealing with a very severe emergency and extreme situations. What we should not have loosened up were other aspects, such as the communication of results that had not been validated or accurately tested. We’ve observed improper behaviour among a few physicians in this sense. They found themselves at the centre of a media storm and unprepared for that kind of exposure, which made them too casual when presenting results and when raising excessive hopes around treatment routes and the possibility to develop a vaccine. The WHO is currently taking steps back around chloroquine, a drug that some people were considering miraculous until not long ago. The scientific community should be more composed in regards to this.

In your book you state that during a pandemic “transparent information is not a right but a form of essential prophylaxis”. What do you think about how the communication around risk was managed by Italian media and institutions?

Communication was a disaster. The messages from media were very confused, particularly at the beginning. Institutional communication was transparent in its own way but there was an issue with the collection of data. Furthermore, I keep finding the decision to rely on the Italian Civil Protection for the communication of epidemiological data rather questionable, as this body normally does not deal with that. Also, despite the infection data clearly differing from the real state of things they continued to present them without providing any explanation. The issue was not just about the data because overall communications were messy and incomplete. There was a point where the implicit message seemed to be that we should trust whatever they told us, a form of scientific paternalism that I cannot stand.

At the same time the proliferation of contrasting opinions among experts created a breeding ground for fake news. In a situation like that, what is the meeting point between transparency and a good quality of communication?

The scientific community is made up of human beings. They have everything in the mix: from the experts to those seeking visibility, from the awkward scientists to the arrogant ones. The reason why the scientific method is reliable is because of its strict mechanisms of validation. During the emergency it is difficult to guarantee this continuous internal process of authentication. Perhaps media should have been responsible to filter more, being more careful, more selective and changing the approach when choosing between news that sound better and news that come from authoritative sources.

I don’t think it’s possible to draw lessons from a trauma like that, unless we continue to discuss it.

In the first pages of your book you talk about your decision to spend the quarantine period reflecting on what the epidemic allowed us discover about ourselves. Now that you’ve reached the end of this journey what has been the most important revelation, the one that we should hold on tight to in order to face what is coming?

Personally I discovered a certain freedom of expression and a strange confidence in my instincts. In terms of the collective the first things to suffer were our sense of invincibility, which had been around for a while, and the perception of limitlessness of desires and resources. The scientific disciplines have been trying for long to make us see these limits, but this time they just appeared right in front of us. I don’t think it’s possible to draw lessons from a trauma like that, unless we continue to discuss it it, and in order to do so we need someone to terminate officially the debate.

Edited by Fabio Ambrosino