The misdirected ire at WHO

On Monday, the World Health Organization dropped what was seemingly a bombshell on our understanding of the novel coronavirus: that it is "very rare" for asymptomatic patients, long believed to be the super-spreaders of the disease, to transmit COVID-19. But within 24 hours, WHO walked that information back. The news was a "premature conclusion" drawn from a "very small subset of studies" and the use of the phrase "very rare" was a "misunderstanding," the organization clarified Tuesday. In fact, by some of their estimates, "around 40 percent of transmission may be due to asymptomatic."

WHO's mistake was not a small one. Already headlines that reported the "very rare" transmission from asymptomatic patients had spread across the internet, potentially instilling confidence, erroneously, in anyone who doesn't feel sick that they therefore can't spread the disease and can stop social distancing.

Worse still, the snafu seemed to be only the latest in a long line of such missteps made by the United Nation's international public health body during the pandemic, which has, in part, led President Trump to announce his intention to defund the organization. But while WHO has not been perfect during the outbreak, science is a hit-or-miss process that's playing out before our eyes in real time, and it'd be a mistake to stop putting our faith in the experts because of their inconsistent and incorrect messaging, which is being adjusted as new information comes along.

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WHO is not above criticism by any means, though. The confusion over the messaging on asymptomatic transmission was entirely preventable, and contributes to the erosion of public trust in the institution. "Communicating preliminary data about key aspects of the coronavirus without much context can have tremendous negative impact on how the public and policymakers respond to the pandemic," scientists at the Harvard Global Health Institute slammed in a statement Tuesday. The organization has much it needs to do better.

For many, this week's gaffe was also the straw that broke the camel's back. WHO, for example, has already been criticized for saying at the start of the outbreak that masks were not needed by the general public and that "cloth masks are not recommended under any circumstance"; WHO now says everyone should wear cloth masks in public. WHO additionally began the outbreak by recommending people with symptoms of COVID-19 refrain from taking ibuprofen because the anti-inflammatory medication could worsen the effects; now WHO says it "does not recommend against" taking ibuprofen to relieve symptoms. You understand why people are beginning to get whiplash.

But it bears repeating: there has been nothing like the COVID-19 outbreak before. That means we're not only starting at square one for how to treat it, but we're also receiving information about it almost as soon as scientists learn about it themselves. In ideal circumstances, we hear about medical breakthroughs after they've been studied for years and been obsessively peer-reviewed. But with over 400,000 dead around the world from the disease, and climbing, people are desperate for any insight into COVID-19. That's led to a clamor by the public for any and all information, though any research being released at this point is, by nature of the outbreak, only a few months old. "What [the pandemic] has done is just made everyone rush to publication and rush to judgment, frankly," Dr. Ivan Oransky, who co-founded the scientific retraction blog Retraction Watch, told Mother Jones. "You're seeing papers published in the world's leading medical journals that probably shouldn't have even been accepted in the world's worst medical journals."

The tension here comes from the way the public wants experts to have all the answers during this time of great uncertainty, and are disappointed when the scientists don't deliver — or worse, when their answers change and disrupt our preconceived narratives as higher-quality data comes to light. But what the public doesn't seem to connect with is that being wrong is an essential part of the scientific process: "When a researcher gets proved wrong, that means the scientific method is working," Wired explained back in 2015. Or, as Dr. Irving Steinberg of USC was quoted by KQED as saying, it's a little like a sausage factory where production has suddenly doubled because of all the hungry customers: "You can imagine that there might be some problems that would arise in the back room where science is adjudicated — whether it's in the lab or whether it's in the editorial processes — where the sausage is made. What the public is seeing is some of the spilled sausage out of the casing." We're looking behind the curtain, when we're used to only consuming the final product.

There's been perhaps no better illustration of this than the confusion over hydroxychloroquine, which was floated as a possible COVID-19 treatment in an early study later described as "a complete failure" and "pathetic" due to it being poorly designed and managed. While studies of the drug, including one by the World Health Organization, continued, the scientific journal The Lancet subsequently published a study claiming higher mortality in patients who used hydroxychloroquine, making WHO and others then pause their research out of concern. But then that study was also found to be unreliable, and The Lancet issued a retraction. Studies resumed, and as of the time of writing, the latest research indicates "hydroxychloroquine had no benefit for hospitalized COVID-19 patients." Dizzy yet?

For some, exploiting the confusion is politically advantageous. Information from WHO is being updated as the organization learns more, but it comes across to the general population as being inconsistent or worse, inept. Adding to the trouble is the way WHO initially handled the outbreak in China. Though there are "inherent structural problems [that] make the organization vulnerable to misinformation and political influence," as The Atlantic reports, the organization can't be faulted completely for China's misinformation. As Chatham House's Charles Clift, a former WHO employee, put it to the magazine: "If countries find reasons to not be transparent, it's difficult to know what we can do about it." President Trump, though, swiftly defunded WHO pending an "investigation," calling it a puppet of China and blaming the organization for not preventing the global outbreak — in doing so, finding a neat scapegoat for himself. Trump, notably, flouted WHO's advice, failing to robustly trace domestic cases as the outbreak took hold in the U.S. Today it is the lack of government action and international cooperation, not WHO — which remains essential for combating COVID-19 as well as other diseases around the globe — that is largely behind the failings now being pinned on the organization.

Still, when thousands of people are dying and our communal lives have largely been derailed, it's understandable to feel angry at the flip-flopping guidance from the supposed international experts. But the revisions and take-backs, the updates and breakthroughs are exactly what prove the scientific process is working — confidence, for the time being, is only proof of ignorance. "Some of the things we believe will turn out to be false and some things we don't think are true will be," Andy Slavitt, the former Acting Administrator of the Centers for Medicare and Medicaid Services under President Barack Obama, tweeted this week. "That's frustrating for many, but we are in the MIDDLE of the process." There's a long road of uncertainty ahead, but trust in science — and the experts at WHO — to see it through.

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