How to Reignite the Candle of Critical Thought
Lighting a path through tribalism and dogma in post-pandemic health discourse.
It is June of 2022, and the world is starting to breathe again. Thanks to a herculean effort by the global medical and scientific community, multiple COVID-19 vaccines have been developed on a timescale so accelerated that it should have been outright impossible. What’s more, in a completely unprecedented coordination of manufacturing and public health efforts, billions of doses of these vaccines were just as quickly prepared, distributed, and administered around the world. The first comprehensive retrospective analysis of this immunization efforts estimates that tens of millions of lives were saved by these vaccines in their first year of existence[i].
“It was the most amazing scientific and medical accomplishment in my lifetime, and I'm old enough to have a lifetime that includes the polio vaccine,” says Dr. Paul Offit, pediatrician, professor, author, rotavirus vaccine co-inventor, and director of the Vaccine Education Center at Children’s Hospital of Philadelphia. “We isolated the virus in January of 2020, sequenced it, developed genetic vaccines, and within 11 months we had two large clinic trials. Then, in the following 7 months, we mass vaccinated 70% of the US population. In a country where we didn’t really have an infrastructure for mass vaccinating adults. Simply amazing.”
But what of that other 30 percent? Some of the unimmunized, of course, were unable to receive the vaccine for medical reasons. But, many more consciously chose not to protect themselves during a deadly pandemic.
“It's always going to be a battle,” says Dr. Offit. “There will always be a significant percentage of the public who will simply not trust anything that comes from people perceived as experts or people perceived as representing the government or people perceived as in any way representing industry. In the name of freedom and bodily autonomy, a great many people lost their lives.”
Outcomes like this—battle lines drawn across the map of science and understanding—are not unique to COVID-19, nor are they unique to the United States. Around the globe, good science is increasingly rejected out of hand or, equally dangerous, held so tightly for so long that it transforms from science to dogma. Either way, people get sick. People suffer. And people die.
The question it falls on us to ask is: Why?
People are smart. Any easy answer that implies otherwise is incoherent. Our goal, with Miss Trust, is to investigate the complex aspects of decision-making and thinking, particularly in domains where scientific investigation has provided a strong basis for knowledge. Our hope is that, by untangling the personal, social, and political forces that shape human behaviour, we can chart a course towards a way of thinking that allows us to reduce harm without alienating one another.
The current atmosphere of circled wagons and misplaced trust, of consensus elevated above critical thought, of fundamental insularity, puts everyone at risk. And, in fact, the easy answers—the answers insisting the other side has been duped—are symptomatic of the exact same underlying poison.
“It has become a very dangerous world for a critical thinker,” says Craig Thompson, Senior Director of the Public Health Association of British Columbia, Executive Director of the Society for Intelligence Management, and Co-Founder of Miss Trust. “Most people don’t dare to think critically at all, and I can understand why.”
It is still June of 2022, and a new bivalent COVID-19 vaccine booster is up for review in the United States by the FDA’s vaccine advisory committee. Dr. Paul Offit sits on that committee. And, though it is expected that the approval of this new vaccine will be waved through with little fanfare, Dr. Offit instead votes against recommending it for the population at large on the grounds that, in his words, “the immunological data show that this vaccine is unlikely to be better than the monovalent vaccine.” The backlash comes swiftly.
“Suddenly, I was the bad guy,” says Dr. Offit. “I was hammered by the public health community. There were people who directly blamed me for low vaccine uptake in 2022. You can’t criticize anything in public health because the minute you criticize, you’re off the bus. You’re perceived as playing into the hands of the anti-vaccine movement.”
While Dr. Offit—who has dedicated his life to developing and championing vaccines, remember—is being excoriated in the court of public opinion as an enemy of immunization, he finds himself also receiving grateful messages from anti-vaccine activists, thanking him for challenging the scientific buttresses of public health orthodoxy. Members of this same, admittedly heterogenous, faction who previously sent Dr. Offit and his family threats credible enough to launch FBI investigations. Strange bedfellows indeed.
But Dr. Offit does not flinch or recoil. He stands firm in the unpopular position that evidence still matters, that the worthy pursuit of public immunization cannot abide seeing scientific rigour and open discourse fall as casualties. He takes the opportunity to engage with those anti-vaccine activists who have newly warmed to him now that he is cast as an enemy of public health. And, for some, this dialogue becomes the first step away from long-held anti-vaccine beliefs. It becomes the foundation on which a new understanding can be built, stone by stone, with evidence and criticism considered equally in the cold light of day.
“I think a number of people trust me now who wouldn't have trusted me before, just because I told the truth as I saw it,” says Dr. Offit. “I get emails thanking me, from people who were once skeptical of the value of vaccines, saying that they now understand. People are convincible. They are.”
And so, our goal with Miss Trust is indeed to convince you. But we’re not trying to convince you to blindly trust us, nor even to trust the experts we platform or the research we present. Unexamined fealty to any source of information is always a mistake. It is, in fact, the same error that has helped to create this environment in which simply questioning the received wisdom incurs a social cost. Good science does not trade in certainty. It does not trade in trust. Good science shows its work and encourages others to replicate it. If we do our job right, every line of reasoning you find in Miss Trust will do the same.
The scientific consensus did eventually come around to the view that the bivalent and monovalent vaccines were clinically indistinguishable. And so, Dr. Offit was exonerated. But the lesson here is that questioning the immunological data for that vaccine, and voting against the recommendation, was the correct call regardless. Not because Dr. Offit could see into the future and predict the results of future studies, but because he could look at the present with open eyes and recognize the disconnect between data and accepted conclusion.
The scientific method is a powerful tool. Collecting data, interpreting it, theorizing on it, testing where our theories fail, and then diligently refining these theories, no matter how firmly or widely held. This is how the entire corpus of human knowledge has been built. When science offers us an answer, it is essential that we have the clarity and confidence to accept it, but it is also essential that we have the humility never to canonize it. We must never stop kicking the tires of our ideas.
In this inaugural post of Miss Trust, we are inviting you to join us on a journey. Along the way, we hope to encourage you to stretch — indeed strengthen — your muscles of critical thought as you develop new tools and strategies for navigating the vast sea of information and opinion. This will be a lengthy expedition we undertake together, and we may well venture through territory that feels dangerous. That sense of peril, indeed, will be the sure sign that the voyage is worthwhile. After all, the questions that make us most uncomfortable may just be the ones most worth asking.
[i]. Watson OJ, Barnsley G, Toor J, Hogan AB, Winskill P, Ghani AC. Global impact of the first year of COVID-19 vaccination: a mathematical modelling study. Lancet Infect Dis. 2022 Sep;22(9):1293-1302. doi: 10.1016/S1473-3099(22)00320-6. Epub 2022 Jun 23. Erratum in: Lancet Infect Dis. 2023 Oct;23(10):e400. PMID: 35753318; PMCID: PMC9225255.