Covid-19 was the first pandemic in the era of social media and voluminous mass communications allowed it to become an existential moment for the use and abuse of knowledge, the former acting chief medical officer of Ireland has said.
Dr Ronan Glynn was speaking about uncertainty in medicine at the annual Doolin memorial lecture hosted by the Irish Medical Organisation on Saturday.
Uncertainty in science and medicine — which is fundamental for its evolution and growth — was misrepresented as a flaw and used to “create confusion and to amplify uncertainty”, Dr Glynn said.
“Covid was the first pandemic of its kind in the era of social media. It was effectively livestreamed, with developments recorded in real time,” he said.
“And with masses of often contradicting information coming at people day after day after day, it was challenging for people to know where they should look for the most accurate information.
“And, yes, on the one hand science stood up like never before over the past two years. The virus’ genome was sequenced within days, tens of thousands of articles were published on the science underpinning covid in those early months. And we saw the development of vaccines at a speed we had never seen previously.
“But on the other hand, the last three years has also been characterised as an existential moment for the use and abuse of knowledge.”
Dr Glynn said Covid was a "classic wicked problem" with no clear solution.
“The situation was constantly changing and any attempt to solve one problem inevitably led to a multitude of others," he said.
"There was very little information on the virus itself — how it spread, who was most vulnerable, how to best detect it, how to treat it and especially how it would evolve over time."
He said that science does not exist in a vacuum; it is never some monolithic body and rarely provides clear indisputable answers. It is by its very nature uncertain, with the door constantly open to doubt the possibility of something new.
And while this inherent flexibility and dynamism of science and medicine is what allows it to adapt, improve and grow, during the pandemic, this uncertainty was manipulated and misrepresented by some.
“There were many who sought to take these normal parts of the scientific process and to willfully misconstrue them and the evidence of the science they were producing,” Dr Glynn said.
“Added to this were attempts by some to frame the issues as either black or white. And the reality is that the vast majority of issues we were dealing with could best be described as a shade of grey.
“Such framing was often used to polarise or to shut down debate, to oversimplify really complex issues, and to ignore or obscure nuance.”
Uncertainty is a constant in this messy world, he said. Suppressing or ignoring uncertainty in medicine has led to problems like the over-prescribing of antibiotics while more than 33,000 people die in Europe each year from antimicrobial resistance and it has made medicine too slow to drop procedures which are no longer understood to be efficacious.
Dr Glynn called for a new paradigm through which to view uncertainty more favourably in a fast-evolving world where medical knowledge is growing at a rate never witnessed before.