Little Data, Big Headlines


Published Winter 2021

The New Atlantis

One weekend while on call at the hospital before the Covid-19 pandemic, three out of four of the severe stroke patients I saw developed a clot in the right middle cerebral artery of the brain. In comparison to other weekends — when, at most, one of these patients shows up in our hospital — this was shocking. In just a few days, these strokes suddenly became far more common. Was there some miasma in the air that weekend leading to clots in that particular artery? Were we witnessing an epidemic of right middle cerebral artery strokes? Highly unlikely. While it was certainly unusual, one could not make reliable assertions about why this sudden increase was occurring. In order to conclude anything definitive about a disease or a treatment, we must study a large group of patients over an extended period of time. Otherwise, the apparent trends we observe are likely due to chance alone rather than reflecting reality.

Back in March we knew little about the novel coronavirus except that it was contagious and deadly. We watched helplessly as thousands of Covid-19 patients overwhelmed hospitals in regions of China, Italy, Spain, and the United States. Entire countries shut down to mitigate the contagion. Researchers and clinicians sought guidance on how to deal with, think about, and treat this new infection. Case reports and short papers elucidating the nature of the pathogen flooded prestigious scientific journals. To give some sense of the magnitude of Covid-19 research published in 2020: As of this writing, searching for “Covid-19” on PubMed, the central repository of scientific literature, yields over 67,000 results.

The media, in its attempt to keep up with the rapidly changing science, translated findings for the public. Unfortunately, their analyses often lacked validity as they threw caution and uncertainty to the wind and exaggerated what little information scientists had. Such hyperbolic reporting obfuscated our tenuous grasp on reality — and ought to serve as a cautionary tale for science and medicine, and our interpretation of it, in the future.

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