Scientific temper can ‘Rest in Peace’ in not just India but elsewhere too  

One of our teachers in medicine would tell us that doctors were the only set of people who practised the art of medicine derived from a shared scientific knowledge based on transparent and reproducible research. This exclusive scientific temper set us apart from shamans, voodooists and other faith healers.

I was reminded of his words while listening to the India-born Nobel Laureate Prof Venkatraman Ramakrishnan who explained that science was international and ‘scientific temper’ was a process of thinking and acting involving observation, questioning, testing and drawing inferences based on evidence which were reproducible.

But when we look around in 2020 and see what is going on in the name of science in modern medicine, we sadly find science to have become a conjuror’s act, a contrived and fabricated exercise. Deliberate obfuscation tends to be more prevalent today than sharing research for science and the wellbeing of mankind. Covid-19 pandemic has brought this malady out in the open.

Those who are already anguished at the erosion of scientific temper in modern medicine, found vindication in an open letter written by Eric Topol, Editor-in-Chief of Medscape and addressed to Stephen Hann, Commissioner, FDA (USA). In a hard-hitting indictment of how FDA (Food and Drug Administration) had departed from its own mission statement by acting on all other considerations than ‘accurate, science-based information’, Topol accused the FDA of ignoring and acting against scientific evidence.

The hasty Emergency Use Approval (EUA) given for the use of Hydroxychloroquin ‘without any sufficient or meaningful supportive evidence’ for use in Covid-19 following its advocacy by Donald Trump and the revocation of the approval in less than three months, Topol pointed out, was damning.

‘Disregard for due diligence’ on the part of a watchdog amounted to grandstanding, which though anathema to science is addictive to organisations. High on this intoxication the FDA chief repeated his grandstanding on plasma therapy (following not so subtle a nudge from the White House) in announcing, “I just want to emphasise this point, because I don’t want you to gloss over this number. We dream in drug development of something like a 35% mortality reduction. This is a major advance in the treatment of patients. This is a major advance and a 35% improvement in survival is a pretty substantial clinical benefit. What that means is — and if the data continue to pan out — [of] 100 people who are sick with COVID-19, 35 would have been saved because of the admission of plasma.”

This was blatant misrepresentation of data, if not an outright lie. First, the data emanated from a preprint non peer reviewed article that did not qualify as acceptable research; more importantly, the 35 percent risk reduction was not an absolute figure but indicated a relative risk reduction that actually meant a miniscule actual reduction in risk, which was also outweighed by the potential risks of plasma infusion.

Similar concerns have been flagged at the EUA (Emergency Use Approval) of other drugs like Remdesivir and in case of vaccines, for cutting corners and short-circuiting the universally accepted due processes, while keeping the data outside the purview of international scrutiny with the objective of getting vaccines ready by a politically set agenda.

The long and scathing letter ends by saying, ‘these repeated breaches demonstrate your willingness to ignore the lack of scientific evidence, and to be complicit with the Administration’s politicization of America’s healthcare institutions’.

Closer home, to the bewilderment of the scientific community, ICMR (Indian Council of Medical Research) issued a diktat to produce vaccines by a scientifically impossible deadline, only to come up with some face-saving clarifications to wriggle out of the outrage it had caused. For a reason that is obvious even to an egg head, ICMR remains in a persistent denial mode of community transmission in spite of it being plainly in evidence for months on end. Scientific temper and evidence be damned.

The sheet anchor against this drift of scientific temper is transparent data sharing. When ICMR makes an innocuous public health data like Sero prevalence rate a closely guarded state secret and refuses to explain why the data are secret, it is not being scientific.Communiqués issued by the Government in electronic and print media asking unsuspecting people to take all sorts of potions, decoctions and concoctions are abundant, backed more by lore than scientific evidence.

But when modern medicine has taken a turn towards the dark ages, why outrage against the Government when the distinction between modern and alternative medicine is increasingly getting blurred?

What is outrageous is a systemic encouragement, under the garb of traditions, to repudiate scientific temper. We are in the process of creating a binary where scientific temper stands in opposition to our perceived identity. Unfortunately, I do come across even science teachers, engineers and technical professionals who increasingly display a serious discord between their beliefs and their professional training.

Lg Nobel Prize that ‘first make people laugh, and then make them think’, awarded the prize in medicine for year 2020 jointly to nine heads of the government. The recognition is “for using the COVID-19 viral pandemic to teach the world that politicians can have a more immediate effect on life and death than scientists and doctors can.” It is no laughing matter. Scientific temper drove the engine of growth and progress. But when standard bearers of science surrender to extraneous, commercial or political considerations, it is the eco- system that must be blamed for promoting scientific defeatism.