Worldwide COVID 19 Response: Moving Forward Based on “Science”
In dealing with this whole COVID thing, I have heard over and over that we will move forward based on “Science”. It sounds good, makes sense, and even tends to inspire confidence. The problem is I have seen virtually no science and lots of theory.
Carl Hempel, one of the global greats of scientific philosophy, came up with one of the more useful statements about the properties of scientific theories: “The statements constituting a scientific explanation must be capable of empirical test.” And this statement about what it exactly means to be scientific brings us right back to things that scientists are very good at–experimentation and experimental design.
If I propose a scientific explanation for a phenomenon, it should be possible to subject that theory to an empirical test or experiment. We should also have a reasonable expectation of universality of empirical tests. That is, multiple independent (skeptical) scientists should be able to subject these theories to similar tests in different locations, on different equipment, and at different times and get similar answers. Reproducibility of scientific experiments is therefore going to be required for universality.
To answer some of the questions we might have about reproducibility:
Reproducible by whom? By independent (skeptical) scientists, working elsewhere, and on different equipment, not just by the original researcher.
Reproducible to what degree? This would depend on how closely that independent scientist can reproduce the controllable variables, but we should have a reasonable expectation of similar results under similar conditions.
Wouldn’t the expense of a particular apparatus make reproducibility very difficult? Good scientific experiments must be reproducible in both a conceptual and an operational sense.
If a scientist publishes the results of an experiment, there should be enough of the methodology published with the results that a similarly-equipped, independent, and skeptical scientist could reproduce the results of the experiment in their own lab.
Theory and experiment are the two traditional legs of science. But through this whole “COVID Situation,” simulation is fast becoming the “third leg”. Modern science has come to rely on computer simulations, computational models, and computational analysis of very large data sets.
Perhaps the most prominent example for this is the simulation created by the Imperial College COVID-19 Response Team which stated that:
In total, in an unmitigated epidemic, we would predict approximately 510,000 deaths in GB and 2.2 million in the US, not accounting for the potential negative effects of health systems being overwhelmed on mortality. 
This simulation has been the basis of government officials in crafting their policies at the beginning of the pandemic. As commented by Alex Engler of Brookings, this model “agitated drowsy policymakers into action.” 
Another example of such simulations is the one from the Centers for Disease Control and Prevention. CDC recently released a national forecast that “suggests that the number of cumulative reported deaths are likely to exceed 100,000 by June 1st” 
These methods for doing science are all reproducible in principle. For very simple systems and small data sets, this is nearly the same as reproducible in practice. As systems become more complex and the data sets become large, calculations that are reproducible in principle are no longer reproducible in practice. Thus we have multiple models and simulations. These are NOT science. They are simply complex theories based on massive amounts of data that lack the ability to be reproduced.
Some experienced people guess, based on previous experience with viruses, about what might happen. But we know that COVID-19 is unlike any other virus there has ever been. We can make educated guesses about the reliability of these theories, but they are not science. We have the data, we can even draw some reasonable conclusions BUT it is not yet anything CLOSE to science.
The direness of the situation and time precludes the ability of scientists to subject these theories to empirical testing and experiment to ensure reproductivity. That is not to say that things are hopeless. They are not. There is real science involved in the production of COVID treatments. There is real science involved in the production of a vaccine. The fact is there are real treatments and there are real vaccines.
We are simply now in the process of catching “science” up to both. I am confident that we will soon have both readily available. What I am not confident in is the decisions being made on the spread, exposure, or returning to my favorite watering hole based on models, being touted as science.
So please, as Rare Disease patients, be careful and protect yourself. Decisions being made by non-scientists and political leaders based on what THEY are calling “science” are a response to that third leg called models. They may well be a correct model, but they could as easily be an incorrect model. Please do not let your guard down.
Wash your hands. As much as possible, stay home. And double-check with your doctors before making any decision related to your health. Their guess, based on their knowledge of you and your condition, is likely to be the best guess that you can get.
 Neil M Ferguson, Daniel Laydon, Gemma Nedjati-Gilani et al. Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand. Imperial College London (16-03-2020),doi:https://doi.org/10.25561/77482.
 Engler, Alex (2020, April 23). A call for a new generation of COVID-19 models. Brookings. Accessed May 18, 2020.
 COVID-19 Forecasts (Updated May 14, 2020). Centers for Disease Control and Prevention. Accessed May 18, 2020. https://www.cdc.gov/coronavirus/2019-ncov/covid-data/forecasting-us.html