Get off my lawn you experts!

Two things were suggested by Richard P Grant in his recent piece for the Guardian, as reasons why scientists are losing the battle to communicate science.[1] 

First, scientists keep telling people how to live their lives and second, scientists don't listen to people.

Okay - I agree. Scientists do that. When I started on social media, I mentally added "try not to be a supercilious git" to my list of things to do to be a better human being. That was up there with "make memories for my kids", "always work at my marriage", "don't speak ill of other people", "listen instead of interrupting", "don't be unintentionally racist", "be conscious of innate bias"...the list goes on and keeps growing. 

But I still come across as a supercilious git on occasion. I'm not really sorry about that though. The main reason I do so is because my tribe is that of the scientist (#tribescience ?). A few different science tribes really. I've spent the past 30 years picking up the ways of my tribe - certain phrases, learning to speak in certain ways, using big scientific words, writing with a certain pattern, producing documents that everyone - including me - find boring, seeing patterns and thinking about how things around me can be tested, seeking out the next big idea that will fund my life and home loan and trying to remain agile enough to be prepared to update those views and words when all that I've learned changes in an instant. Imposter syndrome for an academic can drive the need to sound just as supercilious as our peers. It's a lot of baggage to set down if you dip in and out of interpreting science for the public. Facts, not excuses.

As a little experiment, I thought I'd look at how far listening got me when related to the "dangerous ones" [1]- the hardcore anti-vaccination believers. Not my first attempt to understand this group and not my last.

I'd already been in a small chat where someone @MaykeBriggs (not an anti-vaxxer let me stress) had suggested pesticides and "vaccine toxin" exposure should be looked at in relation to Zika virus and microcephaly in Brazil. I'd asked which toxins and we'd had a discussion about phenoxyethanol, used as a preservative in vaccines.[2,3] Interestingly, phenoxyethanol is used widely, because of its fragrant properties, in shampoos, toilet soaps, decorative cosmetics and is found naturally in avocado, endive and tea for example.[3] The things you learn when you read around a topic!

Example of anti-vax brochure.

Next I received a snippet of an abstract by tweet from @LaLaRueFrench75. This went back and forth and just before I went to sleep got a request to comment on a couple of slides of aggregated science and theory by @2ndfor1st. When I woke up I had more tweets awaiting my sultana bran breakfast than on any day during the worst of the Ebola virus event (which got pretty busy for me). 

I'd apparently inadvertently poked an anti-vaccine nest with a stick.

I Storified the whole thing if anyone wants to check it out. 

The biggest thing for me was, I couldn't have told this group how to live their lives even if I'd wanted to! There was no discussion to be engaged in-just me being shown their material from several tweeters at once. Attempts to correct obviously wrong material were ignored, shouted down or artfully sidestepped.

I took a few other things away from this:

• These are not the vaccine hesitant [5] - people sitting on the fence about whether this or that vaccine may be good or bad for their child. These are fully engaged professional aggregators of content, curates into a story to support whichever thread they are interested in highlighting.
  This group create slick websites, videos, brochures and run a tight campaign to recruit like-minded followers and cast aspersions upon efforts to make our children even more healthy, reduce the burden of chronic disease and prolong life. 
• A central theme seems to be that there is a conspiracy to force their children to be injured by vaccination, perhaps mostly in relation to mandated vaccination, but vaccines in general.
  But the community today could not show me any example of this injury. It has become a ethereal symbol for the movement, but there is no form nor substance to the claims of death or severe harm by vaccination.
• If you choose to engage with this group, pick a particular point to address and do not let yourself be dragged away from it by the constant movement of goalposts you'll encounter. If you don't get the answer you're asking for, say that and move on.
• If you are a scientist planning to engage the public - engage with this group. There is much to learn about communication and about yourself.
  You may be pilloried by your peers (psst - just don't tell them), but you may also gain important experience with extreme believers and very alternate viewpoints.
• Those against using vaccines - at least based on my example - are mostly focused on the secondary ingredients especially preservatives and adjuvants - aluminium, phenoxyethanol, thiomersal.
  This is pretty low hanging fruit though, because there could be more scientific studies to address some of the questions asked. Science has made a rod for its own back here.
• This group do have valid concerns. But instead of being able to believe or engage experts, they choose to actively decry them as the puppets of commercial interests and instead seek out words, sentences, clips and snippets to support their views about their concerns.
  Based on a lot of reading this past few days, this material is often "home made", out of context, quote studies that employ excessively high amounts of the chemical in question, or use the chemical repeatedly in a way that does not at all reflect vaccination, or use studies that do not have suitable control groups (h/t @JATetro).
• The misuse of funds by medical doctors was also a big thing among this group. Apparently this extends to scientists - although that's laughable to me as I'm a science Doctor who has spent many years experiencing how hard it is to scrape together money to get to a conference let alone travel the globe in style.
  I'm aware of the conflict of interest issues pertaining to medical doctors being paid by pharmaceutical interests. The presumption today was clearly that these payments sway these evil doctors towards prescribing that company's products, including more use of vaccines.
  Oversight of vaccines both during early safety and subsequent clinical trials and when later while being monitored for adverse events once they are commercialised, requires experts to come together to review data (costly) - data which themselves are very expensive to collect and collate.
  These payments, must be transparently documented or else consumer trust is rightly shaken. 
• Those who invent, develop, administer and oversee use of vaccines are seen as different

  

  "Them and us"

  humans from the true believer anti-vaxxers. This may be for ulterior motives or because of a past bad experience.
  The impression I got was that the  professionals are not thought of as having the same skin in the game - their own families, lives and children - as do "the public".
  Do some of our science and medical doctors need to humanise more, at least in this space?  
• If you write about scientists who try and engage with the public, maybe think more deeply about the term "science communication". Currently it seems to cover everything that comes out of the mouth/keyboard of a scientist. Its too broad. How about adding some more terms? What about Science Interpretation? Science Engagement? If you paint all science communication as coming from a place of arrogance and control, you paint every scientist, even those who honestly try to do better, as arrogant and controlling.
  That's some poor research right there.
  It's also a tone that is likely to discourage other scientists out of their highly competitive, poorly funded, stressful, depressing, abusive, overcrowded, biased, "cosy little bubble and make an effort to reach people where they are, where they are confused and hurting; where the need"

Of course, if we do seek out people who seem confused, there is no guarantee we'll be able to get a word in edgewise. That does make being a tribal and supercilious git all the more challenging. But it's what we scientists excel out. Right?

References...

1. Why scientists are losing the fight to communicate science to the public
   https://www.theguardian.com/science/occams-corner/2016/aug/23/scientists-losing-science-communication-skeptic-cox
2. http://www.ncbi.nlm.nih.gov/pubmed/7764595
3. http://www.ncbi.nlm.nih.gov/pubmed/17722087
4. http://www.ncbi.nlm.nih.gov/pubmed/22036980
5. http://www.ncbi.nlm.nih.gov/pubmed/?term=julie+leask+hesitant

MERS and the media in Saudi Arabia - a match that fuels confusion....

I'm interrupting my reviews on MERS and camels to briefly critique a recent media article published in the Arab News, Wednesday 14th of October. This was also on camels, but a view into the other side of this story.

The title of the article: ‘No conclusive proof’ camels spread MERS: Expert.[1]

There are two trains of thought here - and perhaps I have not clarified them so far. The first train doesn't believe that camels have a role in human cases of MERS-I disagree completely with the sentiment here. The second train of thought wants more testing of more and different animal species. I agree with this wholeheartedly. And those who can do this should be getting on with the job of doing it or organising those who can do it instead of wishing the data we absolutely do have, were different.

Let's keep in mind that seeking out other sources is a research endeavour. You cannot write public health messaging around things for which you have absolutely no supporting evidence. You can't protect your population, especially those most at risk, if you don't have proof to support how they are at risk. Looking after the public's health requires data. Research gets those data. Support the research. Look at those data instead of ignoring them because they scare you, point a finger at your favourite animal or conjure fears of an animal-driven negative economic impact. 

Distancing humans from infected camel vectors is a here and now action. It is not the result of a future research study. Finding ways to act on the data may have an impact on cases. 

Rather than guess at what people's concerns are - let's have a read of some key sections of this article, and comment as we go.

"There is no conclusive evidence that shows camels are responsible for the spread of the deadly Middle East Respiratory Syndrome coronavirus (MERS-CoV), according to research conducted by a Saudi expert at King Saud University in Riyadh."

• This is plain wrong. There is considerable body of peer reviewed scientific literature providing evidence both for spread among camels and between camels and humans, even data strongly suggesting that direction (camel>human). A review I co-authored last year goes into a lot of that detail - it has a huge table on the camel related literature.[2]

“All the studies published in scientific journals do not at this stage show that the blood samples taken from camels have the virus present."

• This is an English language article so I am going to take that at face value. Virus in the blood, or viraemia, is not considered a major concern for spread human or camel MERS-CoV infection - the real and larger concern is virus, in high amounts, that is regularly identified in the nose of infected camels. This is quote is not evidence of an expert comment.

"The reality is that more than 80 percent of the tested samples prove that camels’ blood carry protective antibodies against the virus,” he said."

• Again, this comment highlights a lack of expertise in virology or immunology. Fields important for this discussion. The camels have antibodies because they have been previously infected. Research has found that camels seem capable of being reinfected - infected again even when they already have antibody from a previous infection. These camel antibodies may not be protective. Cell mediated immunity (h/t @MarionKoopmans) may be an important study subject here to better understand what happens in camels.

"He said some studies have found that 5 to 6 percent of shepherds and persons dealing with camels carry antibodies against MERS, and do not have the virus itself."

• This is where a science reporter would have been really helpful to Arab News. Shepherds (camel herders?) don't have the virus by the time they develop antibodies because, like many viruses, MERS-CoV causes a short-lived, or acute, infection in humans and camels. Those few percent of shepherds with antibodies were previously infected and the virus was subsequently cleared by their immune system, usually near to or before those antibodies develop.

“In our previous studies we found out that Heavy Chain Antibodies are present in the blood of camels and are carried out with its milk. This research was published in the Journal of Proteomics. This in itself proves that immunity is transferred from camels to humans,” he said."

• This does no such thing at all. This shows that antibodies are in camel blood and milk - if indeed that was what was found. What are the previous studies that showed these antibodies were ingested by humans and survived the digestive tract to remain effective against MERS-CoV? There are none that I have read but I'd be interested in seeing them.

Science tests and measures, it calculates and concludes. Very little of that process is evident here, but a sense of the confusion around this topic is. These stories should be great starting points for the Saudi Ministry of Health to work up local, relevant and specific answers, (more) factsheets or Ministry-involved media interviews and internet posts to help educate those with concerns about there camels. Listen, communicate, take feedback, re-tune, communicate, listen....

References...

1. ‘No conclusive proof’ camels spread MERS: Expert
   http://www.arabnews.com/featured/news/820181
2. Middle East respiratory syndrome: An emerging coronavirus infection tracked by the crowd.
   http://www.ncbi.nlm.nih.gov/pubmed/25656066

Two tales of the same review...

Could these articles about a recent review on Ebola virus transmission be any more different?

Which do you "believe"?

Limited airborne transmission of Ebola is ‘very likely,’ new analysis says Post
From the Washington Post
http://www.washingtonpost.com/news/to-your-health/wp/2015/02/19/limited-airborne-transmission-of-ebola-is-likely-new-study-says/

No, A New Scientific Report Does Not Say That Ebola Is Now Airborne
From Vice News
https://news.vice.com/article/no-a-new-scientific-report-does-not-say-that-ebola-is-now-airborne

The article being referred to is from a team of "Ebola experts" and is entitled: 
Transmission of Ebola Viruses: What We Know and What We Do Not Know.
http://mbio.asm.org/content/6/2/e00137-15

At this juncture might I just add that I do not consider myself a real Ebola virus disease (EVD) expert. I'm just an interested scientist who blogs about Ebola virus and the most recent outbreaks and epidemic. To be an expert, at least in my opinion, one would have to have one or more of the following under one's belt:

• to have conducted experiments on the Ebola virus and written those up in the scientific literature
• to have generated data from other derivative works with parts of the virus, such as in vaccine works, and written those up
• to have treated or cared for patients with Ebola virus disease (EVD)
• to have worked in a public health capacity managing an outbreak of EVD

The rest of us are interested parties but will likely always miss some aspect of understanding the virus and its disease having not been in close contact with it, its hosts or the response to it.

Editor's note #4

VDU's Editor asked to comment on recent WHO statement about H7N9 severity on BBC World News' Newsday show with Rico Hizon. 

Video currently viewable at the Australian Infectious Diseases Research Centre at The University of Queensland.

VDU's Editor in Chief comments...

... in an article by Jason Gale, Editor, Bloomberg News, picked up by crofsblogs and on ProMED too in the AVIAN INFLUENZA, HUMAN (47): CHINA H7N9 UPDATE update.