Medical personnel adjust their personal protective equipment while working in the emergency department at NYC Health + Hospitals Metropolitan in New York. Photo / AP
ANALYSIS
"We shouldn't presume that a group of experts somehow knows what's best," US Senator Rand Paul lamented yesterday. Covid-19 is out of control in the US. And such deep disrespect of knowledge may be why.
Paul is by no means alone in his rejection of epidemiologist advice. The former eye doctor's lack of faith in experience, education and expert knowledge is endemic in the US.
It's an attitude rapidly growing in the rest of the world.
It's an attitude that persists even in the face of undeniable evidence.
Senior Washington-based politicians such as himself are arguing the United States must rush to reopen its economy.
This is despite state after state reporting their hospitals are on the brink of overload. That Covid-19 cases are exploding. That contact tracing is failing. That people are ignoring advice to wear masks and wash their hands.
And people – particularly older people and those with pre-existing conditions – are dying.
How did it get to this? We live in a world of information overload. And that's being actively exploited by commercial and political players, argues Tom Nichols, professor of National Security Affairs at the US Naval War College.
"Unable to comprehend all the complexity around them, (people and politicians) choose instead to comprehend almost none of it and then sullenly blame elites for seizing control of their lives," writes Nichols.
Experts propose. Elected leaders dispose. But it's very rare for elected politicians to be experts, especially under modern corporatised political party mechanics. Paul was the first US Senator to contract the virus. Now he is saying medical experts must "show caution in their prognostications" even as the nation's south and west buckle under a second wave.
He declared that Americans "just need more optimism" to a committee pandemic hearing including the director of the National Institute of Allergy and Infectious Disease Dr Anthony Fauci. Fauci had just warned the US was on track to suffer as many as 100,000 new cases daily.
Paul wants schools to reopen. He wants clubs and restaurants to reopen. He wants sporting events allowed.
"All I hear, Dr Fauci, is, 'We can't do this, we can't do that. We can't play baseball'," he said.
The Kentucky Senator opined that US citizens would become a "herd with a couple of people in Washington telling us what to do, and we like sheep blindly follow".
He didn't address the alternative, non-expert shepherd scenario.
And that, Nichols says, is a sign of how "dangerously frayed" the democratic reliance on expert input and representative decision making is.
An eye doctor is not a virologist. A real-estate agent is not a diplomat. A marketing executive is not an economist.
But, with some effort, such people can comprehend and balance counterarguments.
"Laypeople cannot do without experts, and they must accept this reality without rancour," writes Nichols. "Experts, likewise, must accept that they get a hearing, not a veto, and that their advice will not always be taken."
To many, ignorance is a virtue. Especially in politics. It's better to blindly and loudly proclaim support for the established – if outdated – dogma of the tribe than to address change. Being wrong simply never comes into it.
"Principled, informed arguments are a sign of intellectual health and vitality in a democracy," says Nichols. "I'm worried because we no longer have those kinds of arguments, just angry shouting matches."
It's an attitude virus that has spread through social and traditional media, political party rooms and front bars across the world.
"To reject the advice of experts is to assert autonomy, a way for Americans to demonstrate their independence from nefarious elites — and insulate their increasingly fragile egos from ever being told they're wrong."
The problem isn't having opinions. It's critical thinking. And critical thinking doesn't exist if one cannot accept the possibility of being wrong.
"I fear we are moving beyond a natural scepticism regarding expert claims to the death of the ideal of expertise itself: a Google-fuelled, Wikipedia-based, blog-sodden collapse of any division between professionals and laypeople, teachers and students, knowers and wonderers — in other words, between those with achievement in an area and those with none," says Nichols.
Expertise has become an "off-the-shelf" commodity. A service. Nichols argues that, for example, people are happy to go to a doctor for diabetes medication. But not for a lecture about their diet and lifestyle – the actual cause of the problem in the first place.
"(People want) their opinions treated with deep respect and their preferences honoured not on the strength of their arguments or on the evidence they present but based on their feelings, emotions, and whatever stray information they may have picked up here or there along the way."
Paul appears not to be heeding his own advice. At a June Senate hearing, he challenged Fauci saying: "We can listen to your advice, but there are people on the other side saying there's not going to be a surge, and then we can safely open the economy. And the facts will bear this out."
Those facts are in. A bar in Michigan has been identified as the epicentre of 110 new infections. A gym in West Virginia exposed 200. More than 230 contracted the virus attending a church service in Oregon. And that's just a sampler.
But the power of pandemic denial is reflected in a survey released at the weekend. It reveals some 40 per cent of US citizens now believe that the situation is under control. That the worst of it is over. That the disease has run its course.
They're wrong. Covid-19 is running rampant across the world. The US is at its epicentre – recording more than 2.7 million cases since the pandemic began. That includes 130,000 deaths. Now, a dramatic surge is exploding across the country. Some 44,000 new cases were recorded yesterday alone.
Arizona's health system is overwhelmed. Its hospitals are applying triage measures – choosing whom to treat, and whom to reject. Texas is also warning its hospital emergency units are almost full as new cases top 8000 in a day. California is now recording 5000 new cases daily, with its Governor moving yesterday to once again close restaurants, cinemas and bars.
Amid it all, Paul remains hostile to expert advice – despite it being accurate. "It's important to realise that if society meekly submits to an expert and that expert is wrong, a great deal of harm may occur," he said yesterday. "We shouldn't presume that a group of experts somehow knows what's best for everyone," he said.
Health experts admit they don't yet know exactly how this virus works, or what all its strengths and weaknesses are. There is no treatment. Which is why the world has just four weapons against this pandemic until an effective vaccine is developed. By experts. The evidence shows these measures work.
First is testing. This identifies risk. This identifies how deep the virus has penetrated a community. It allows individual asymptomatic carriers to be identified and prompt isolation and treatment of the sick.
Second is contact tracing. It's a difficult, time-consuming job. But it enabled limited resources to be marshalled to best effect. Known carriers are interviewed and investigated. Their movements during the time they were infectious are mapped. This points to people, groups and places that may have been exposed. Testing can then be redirected to head-off the virus' spread.
Third is isolation. It's crude. It's costly. But it's the only effective tool health agencies have against a Covid-19 outbreak. The virus cannot spread without an opportunity to jump to other people. And if a community stays isolated long enough, the virus burns itself out. It's simply starved of new hosts.
Fourth is personal hygiene. A cough in a club, pub, restaurant, cafe or shop can contaminate an area for hours. All it takes to catch the disease is to unknowingly touch an infected surface, and then your own face. Which is why handwashing and masks are a final line of defence.
If these four measures are not being applied correctly, the pandemic defence breaks down.
And that's the experience of the US after politicians and business leaders undermined the advice of health experts. And that bodes poorly for the future.
"Unless some sort of trust and mutual respect can be restored, public discourse will be polluted by unearned respect for unfounded opinions," writes Nichols. " And in such an environment, anything and everything becomes possible, including the end of democracy."
• Jamie Seidel is a freelance writer.
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