By Dr. Lissa Rankin, MD
A few days ago on Facebook, I made a casual comment questioning part of the dominant narrative (that the anti-viral remdesivir is indeed worthy of Dr. Fauci’s optimism and a lightning speed rush to FDA approval.) A physician and medical director challenged me, saying he was concerned I was dismissive of science and worried I might influence people in ways that would make them turn away from science. I welcomed his challenge and asked for his email so I could get him to peer review something I was writing about remdesivir. He peer reviewed what I wrote and wrote a cogent response, which he also ran by some of his trusted medical sources. I was grateful for his scientific engagement and for the opportunity to have a respectful discussion. However, I noticed as I read his response to what I had written that his response was based on assumptions I was questioning (assuming that Covid-19 tests or Covid-19 death rates are accurate, for example).
Unless we’re willing to be transparent about where we’re uncertain, attempts at false certainty will only mislead the public and potentially interfere with personal and collective wise decision-making. After writing a first draft of this list, I also asked for peer review from ten medical doctors and researchers who I know well and trust that they have no hidden agendas or financial conflicts of interest. I then shared it with hundreds more doctors asking for feedback, including Gabor Mate, MD, author of When The Body Says No.I realized that if any of those assumptions turned out to be false, our seemingly logical discussion could be at risk of cognitive error. This respectful scientific discourse with a professional colleague inspired me to make a list of all of the other assumptions I was questioning, which inspired me to crowdsource this list on Facebook), asking for help from my community to make a comprehensive list of assumptions we’re making in public health policymaking and clinical decision making. It’s clear that there are many things we don’t yet know about COVID-19 and the SARS CoV-2 virus, but I have yet to see any “expert” clearly admit what we don’t know, so I thought I’d take a stab at it.