Post by isthisit on Jan 6, 2021 14:53:11 GMT -5
Epidemiologists are indeed the only people qualified to study stats and patterns of communicable diseases. They are qualified public health physicians with a parallel expertise in statistics and these days disease modelling. Many have PhD’s in epidemiology (the maths of disease transmission). So in short fuck-off clever people with a work ethic to match no other, underpaid and under recognized.
But despite this, dumb journalists and Joe Public feel qualified to dip their toes into the world of epidemiology with their perceived expertise...
If members of the public feel qualified to cast doubt on the work of epidemiologists they shouldn’t contain their genius any longer. Perhaps they could pop into their local OR and help out with some heart surgery? Or maybe drop in an ICU and help out with those hypoxic and cardiovascularly unstable folks? Because this type of medicine is just as complex as epidemiology, and that’s easy enough to pick up watching the telly.
Your move DC 😉
I find this attitude pervasive and counterproductive.
The excessive reverence for expertise can be a lazy generalization of reliance like sexism, or racism. I dub it "credentialism".
Credentials are a resource others can use as shorthand to produce trust in a hurry. Two people tell you differing stories and you need to decide on a course of action, surely you can flesh out both arguments, but which advice do you follow first. If one has credentials they'll need to defend if they are wrong, it can often be wise to follow this expert.
Below the level of "epidemiologist" can be a graduate who is merely waiting on their degree to be handed to them on a stage.
Below that is a student in their second year.
Below that might be a senior in college graduating with a B.A. in Biology and having a professed interest in pathology.
Then you might take the opinion of a retired radiologist who happened across a few articles by accident a decade ago.
Then perhaps you might take into account the opinions of a businessman whose enterprises have gone bankrupt four times and you suspect wouldn't know that "Nature" is not a pictograph collection for birdwatchers.
Somewhere in that arbitrary hierarchy may fall anyone trying to share data wit you.
Every citizen should feel responsibility to understand scientific method which one can evaluate the reliability of data and its likelihood of accurately reflecting the true functioning of our world.
Everyone should be a scientist.
Relying on authorities without an interest in understanding how reproducible data and controlled studies work lead to "They said, they said" arguments that allow confirmation bias to allow everyone to do as they please without regard to data. People with credentials of differing relevance and weight can serve as the basis for action. Data should drive all and presentation of flawed data should be weakening the reputation of experts to the point of dismissal. This si why the production of false data is something of a crime in the scientific community.
There is befuddling anger afoot that objects to the censoring of falsified data like Wakefield's and plenty of ire from those that wish to spread the news of flawed studies with poor controls or omitted confounding factors. America is sorting out this problem and it's first efforts are demarcating such "information" as disproven, but without the basic understanding of science, it is interpreted as meddling in a debate akin to politics where much is unsettled and possibly permanently inchoate.
Epidemiology is highly susceptible to well designed controlled studies, but much of the public with emotional agendas seek to put their desired views on equal footing and will refuse to succumb given superior, even airtight proof because they don't understand what makes the data better and therefore renders their own data false. Our wish to be right overcomes the opportunity to be correct by changing our minds.
A willingness to be wrong is essential to all scientists and admitting you're wrong has not been widely practiced since at least 2001.
Bohr bested Einstein, and yet our Facebook friends cannot humble themselves by following the latter's example.
Regarding Andy Wakefield- your point is two decades out of date. The flawed paper to which you refer was published in 1998. The main crime here was not him for producing that rubbish (the data was not made up actually, the methodology was horribly flawed), but rather The Lancet's stupidity in publishing it based purely on his name as a big cheese at the time. Contemporary journals use anonymised peer review without exception today and have done so for the intervening twenty two years and counting (most did before 1998) so the relevance of your point is limited. And I am being polite there. I have been unfortunate enough to dispatch two children to the mortuary following measles deaths so believe me, no-one wants to strangle the little Herbert more than I do. But, citing one bad apple in a profession of altruistic and exceptionally hard working clinicians and researchers touches a nerve.
Regarding epidemiologists in the US, your analogy of an undergraduate in biology surprises me. I guess it comes down to what you choose to refer to yourself as. I suppose I could choose to identify as a Victoria's Secret runway model... but alas this is not the case and is about as accurate an analogy. I have no first hand knowledge of epidemiology in the US. However, I have first hand (not knowledge generated from widkipaedia and other shit from the internet) of epidemiology in the UK, as I count three in my professional team. All three are on the SAGE advisory committee which advises the UK government. All three have a medical degree, are bone fide clinical consultants in practice (paediatric respiratory medicine, paediatric infectious diseases and public health), and all have a PhD in communicable disease modelling topics. Two of these guys are regularly on the BBC answering questions and explaining the data and govt decision making. In short, these folks really, really know what they are talking about and are about as far away from the example you give above as is possible. I often collaborate and publish with medical academics from across Europe, Canada, Australia and New Zealand, and I am aware that standards are similar there too. The medical school to which I am attached often has visiting clinical academics from nations in the developing world, and as a minimum these folks are medical doctors with public health expertise, aiming to learn about the maths of disease transmission. It's sad to hear that a biology degree will do in the US. I will bet a few bob Tony Fauci has exceeded a biology degree.
Regarding the concept of 'credentialism". At the weekend I had a warning light come on in my car- so I took it to a garage. This was because I know bugger all about cars, and trusted the credentials of the mechanic who fixed the brakes. By proxy I was also trusting the folks who taught the mechanic, the process by which he was assessed and the person who passed him and empowered him to fiddle with the brakes and keep me, and everyone in my path safe. Perhaps I am a mug and stupidly fell victim to 'credentialism'. I wonder if a person who needs a coronary artery bypass and is smart enough not to fall for 'credentialsm' should teach themselves cardiac surgery first so they can make an informed decision? Not forgetting cardiac anaesthesia, and a spot of intensive care medicine for the post op period just to be on the safe side? My point is that for society to thrive the public need to have some trust in the competence of others with knowledge, and of course the majority of sensible people do be it a " lazy generalisation", "pervasive" or not.
Your wider point (as I understand it) is that society has a right not to blindly follow without critical enquiry, so some consensus between us there. Previous generations have been kept in the dark about matters which concern them which is paternalistic and wrong. However, in some nations societies have skipped legitimate criticality and instead hopped to being critical of and mistrusting of everything, exhibiting paranoia and spreading harmful misinformation. It is hard to see how this is a better position than before. Plenty of nations have not seen this phenomena. Criticality is not about being critical, it is about a thorough and systematic examination of evidence and the application of extensive understanding of research processes. In short you need to know a bit to understand that you don't know anything worth a damn, and this is where the public are limited in their ability to interpret and understand the complexity of the current context. The issue at the heart of this as has been discussed here before, is that in some societies the underlying problem is irresponsible and sensationalist journalism which has a huge impact on some, but not all people.
So, I am here to discuss SM's and not to flex my professional prowess, and regardless of future postings will draw the line here. It's really very hard to take though, when you spend 15 hours a day in PPE fighting to keep covid patients from the undertaker because they had the misfortune to cross paths with someone who behaves however they choose to because of their genius in not falling for 'credentialism'. Generally, people's health beliefs influence their health behaviours and this affects themselves only, and this is universally accepted and respected by health professionals. This is a difference circumstance all together. Arrogance and stupidity puts the lives of many at risk, and that is why I cannot allow these points to go unaddressed. In short folks need to wear a fucking mask, behave as directed regardless of your personal interpretation of the piecemeal information available on TV and potentially save a life. This is a time to park any sense of entitlement to freedoms and preferences or self appointed skills and knowledge. It is everyone's moral duty to protect their community and a failure to do so reflects on your personal integrity.
