Is there such a thing as an “evolution-proof” drug? (part the third)

A claim that scientists need to quit making:

I’ve written about these types of claims before. The first one–a claim that antimicrobial peptides were essentially “resistance proof,” was proven to be embarrassingly wrong in a laboratory test. Resistance not only evolved, but it evolved independently in almost every instance they tested (using E. coli and Pseudomonas species), taking only 600-700 generations–a relative blip in microbial time. Oops.

A very similar claim made the rounds in 2014, and the newest one is out today–a report of a “super vancomycin” that, as noted above, could be used “without fear of resistance emerging.” (The title of the article literally claims “‘Magical’ antibiotic brings fresh hope to battle against drug resistance”, another claim made in addition to the “no resistance” one in the Scripps press release by senior author Dale Boger). This one claims that, because the modified vancomycin uses 3 different ways to kill the bacteria, “Organisms just can’t simultaneously work to find a way around three independent mechanisms of action. Even if they found a solution to one of those, the organisms would still be killed by the other two.”

A grand claim, but history suggests otherwise. It was argued that bacteria could not evolve resistance to bacteriophage, as the ancient interaction between viruses and their bacterial hosts certainly must have already exploited and overcome any available defense. Now a plethora of resistance mechanisms are known.

Within the paper itself, the limitations are much more clearly laid out. Discussing usage of the antibiotic, the authors note of these conventional semisynthetic vancomycin analogs:

“However, their use against vancomycin-resistant bacteria (e.g., VRE and VRSA), where they are less potent and where only a single and less durable mechanism of action remains operative, likely would more rapidly raise resistance, not only compromising its future use but also, potentially transferring that resistance to other organisms (e.g., MRSA).”

So as they acknowledge, not really so resistance-proof at all–only if they’re used under perfect conditions and without any vancomycin resistance genes already present. What are the odds of that once this drug is released? (Spoiler alert: very low).

Alexander Fleming, who won the 1945 Nobel Prize in Physiology or Medicine, tried to sound the warning that the usefulness of antibiotics would be short-lived as bacteria adapted, but his warnings were (and still are?) largely ignored. There is no “magic bullet;” there are only temporary solutions, and we should have learned by now not to underestimate our bacterial companions.

Part of this post previously published here and here.

HIV’s “Patient Zero” was exonerated long ago

The news over the past 24 hours has exclaimed over and over:

HIV’s Patient Zero Exonerated

How scientists proved the wrong man was blamed for bringing HIV to the U.S.

Researchers Clear “Patient Zero” from AIDS Origin Story

H.I.V. Arrived in the U.S. Long Before ‘Patient Zero’

Gaetan Dugas: “patient zero” not source of HIV/AIDS outbreak, study confirms

HIV’s supposed “Patient Zero” in the U.S., Gaetan Dugas, is off the hook! He wasn’t responsible for our outbreak!

This is presented as new information.

gaetan_dugas
Gaetan Dugas, from Wikipedia.

It is not, and I think by focusing on the “exoneration” of Dugas, a young flight attendant and one of the earliest diagnosed cases of AIDS in the U.S., these articles (referencing a new Nature paper) are missing the true story in this publication–that Dugas was really a victim of Shilts and the media, and remains so, no matter how many times the science evidence has cleared his name.

First, the idea that Dugas served to 1) bring HIV to the U.S. and 2) spark the epidemic and infect enough people early on that most of the initial cases could be traced back to him is simply false. Yes, this was the hypothesis based on some of the very early cases of AIDS, and the narrative promoted in Randy Shilts’s best-selling 1987 book, “And the Band Played On.” But based on the epidemiology of first symptomatic AIDS cases, and later our understanding of the virus behind the syndrome, HIV, we quickly understood that one single person in the late 1970s could not have introduced the virus and spread it rapidly enough to lead to the level of infections we were seeing by the early 1980s. Later understanding of the virus’s African origin and its global spread made the idea of Dugas as the epidemic’s originator in America even more impossible.

When we think of Dugas’s role in the epidemiology of HIV, we could possibly classify him as, at worst, a “super-spreader“–and individual who is responsible for a disproportionate amount of disease transmission. Dugas acknowledged sexual contact with hundreds of individuals between 1979 and 1981–but his numbers were similar to other gay men interviewed, averaging 227 per year (range 10-1560). And while Shilts portrayed Dugas as a purposeful villain, actively and knowingly spreading HIV to his sexual partners, that does not jibe with both our scientific knowledge of HIV/AIDS or with the assistance Dugas provided to scientists studying the epidemic. Dugas worked with researchers to identify as many of his partners as he could (~10% of his estimated 750), as the scientific and medical community struggled to figure out whether AIDS stemmed from a sexually-transmitted infection, as several lines of evidence suggested. There’s no evidence Dugas was maliciously infecting others, though that was the reputation he received. Dugas passed away from complications of AIDS in March of 1984–weeks before the discovery of HIV was announced to the general public.

Furthermore, the information in the new publication is not entirely novel. Molecular analyses carried out in part by Michael Worobey, also an author on the new paper, showed almost a decade ago that Dugas could not have been the true “Patient Zero.” The 2007 paper, “The emergence of HIV/AIDS in the Americas and beyond,” had the same conclusions as the new paper: HIV entered the U.S. from the Caribbean, probably Haiti, and was circulating in the U.S. by the late 1960s–when Dugas was only about 16 years old, and long before his career as a flight attendant traveling internationally. So this 2007 molecular analysis should have been the nail in the coffin of the Dugas-as-Patient-Zero ideas.

But apparently we’ve forgotten that paper, or other work that has followed the evolution of HIV over the 20th century.

What is unique about the new publication is that it included a sample from Dugas himself, via a plasma contribution Dugas donated in 1983, and other samples banked since the late 1970s. The new paper demonstrated that Dugas’s sample is not in any way unique, nor is it a “basal” virus–one of the earliest in the country, from which others would diverge. Instead, it was representative of what was already circulating among others infected with HIV at that time. In supplemental information, the authors also demonstrated how notation for Dugas in scientific notes changed from Patient 057, then to Patient O (for “Outside California”) to Patient 0/”Zero” in the published manuscript–which Shilts then named as Dugas and ran with in his narrative.

patient-zero-graphic
Graphic of sexual network of early AIDS cases, from Auerbach et al., Am J Med 1984.

 

The media then extended Shilts’s ideas, further solidifying the assertion that Dugas was the origin of the U.S. epidemic, and in fact that he was outright evil. The supplemental material notes that Shilts didn’t want the focus of the media campaign initially to be about Dugas, but was convinced by his editor, who suggested the Dugas/Patient Zero narrative would result in more attention than the drier critiques of policy and inaction in response to the AIDS epidemic by the Reagan administration.

And the media certainly talked about it. A 1987 edition of U.S. News and World Report included a dubious quote attributed to Dugas: “‘I’ve got gay cancer,’ the man allegedly told bathhouse patrons after having sex with them. ‘I’m going to die, and so are you.’” NPR’s story adds “The New York Post ran a huge headline declaring “The Man Who Gave Us AIDS. Time magazine jumped in with a story called ‘The Appalling Saga Of Patient Zero.’ And 60 Minutes aired a feature on him. ‘Patient Zero. One of the first cases of AIDS. The first person identified as the major transmitter of the disease,’ host Harry Reasoner said.”

This is the real scandal and lingering tragedy of Dugas. His story was used to stoke fear of HIV-infected individuals, and especially gay men, as predators seeking to take others down with them. His story was used in part to justify criminalization of HIV transmission. So while science has exonerated him again and again, will the public–and the media–finally follow?

 

 

 

 

“The Hot Zone” and the mythos of Ebola

The Hot Zone was first released in 1994, the year I graduated high school. Like many readers, that book and Laurie Garrett’s The Coming Plague* really sparked my interest in infectious diseases. In some sense, I have those books to thank (or blame?) for my career.

But I’m still going to criticize The Hot Zone, because as a mature infectious disease epidemiologist and a science communicator in the midst of the biggest Ebola outbreak in history, The Hot Zone is now one of the banes of my existence. A recent article noted that the book is back on the bestseller list, going as high as #7 on the New York Times list recently, and #23 on Amazon. It’s sold over 3.5 million copies, and it’s reported as “a terrifying true story.” Many people have gotten almost all of their Ebola education from just The Hot Zone (as they’ve told me over, and over, and over in the comments to this blog and other sites).

Here’s why The Hot Zone is infuriating to so many of us in epidemiology and  infectious diseases.

First–the description of symptoms.Preston himself admits that these were exaggerated. Over and over, he uses words like “dissolving,” “liquefy,” “bleeding out” to describe patient pathology. (If I had been playing a drinking game while reading and did a shot every time Preston uses “liquefy” in the book, I’d be dead right now).

Of a Marburg patient, pseudonymously named Charles Monet, he describes him as

“…holding an airsickness bag over his mouth. He coughs a deep cough and regurgitates something into the bag. The bag swells up….you see that his lips are smeared with something slippery and red, mixed with black specks, as if he has been chewing coffee grounds. His eyes are the color of rubies, and his face is an expressionless mask of bruises. The red spots…have expanded and merged into huge, spontaneous purple shadows; his whole head is turning black-and-blue…The connective tissue of his face is dissolving, and his face appears to hang from the underlying bone, as if the face is detaching itself from the skull…The airsickness bag fills up to the brim with a substance known as the vomito negro, or black vomit. The black vomit is not really black; it is a speckled liquid of two colors, black and red, a stew of tarry granules mixed with fresh red arterial blood. It is hemorrhage, and smells like a slaughterhouse….It is highly infective, lethally hot, a liquid that would scare the daylights out of a military biohazard specialist…The airsickness bag is brimming with black vomit, so Monet closes the bag and rolls up the top. The bag is bulging and softening, threatening to leak, and he hands it to a flight attendant.

“…the body is partly transformed into virus particles…The transformation is not entirely successful, however, and the end result is a great deal of liquefying flesh mixed with virus…The intestinal muscles are beginning to die, and the intestines are starting to go slack…His personality is being wiped away by brain damage…He is becoming an automaton. Tiny spots in his brain are liquefying…Monet has been transformed into a human virus bomb.

“…The human virus bomb explodes…The victim has “crashed and bled out.”…He becomes dizzy and utterly weak, and his spine goes limp and nerveless and he loses all sense of balance….He leans over, head on his knees, and brings up an incredible quantity of blood from his stomach and spills it onto the floor with a gasping groan. He loses consciousness and pitches forward onto the floor. The only sound is a choking in his throat as he continues to vomit while unconscious. Then comes a sound like a bedsheet being torn in half, which is the sound of his bowels opening and venting blood from the anus. The blood is mixed with intestinal lining. He has sloughed his gut. The linings of his intestines have come off and are being expelled along with huge amounts of blood. Monet has crashed and is bleeding out.”

And later, at autopsy:

“His liver…was yellow, and parts of it had liquefied–it looked like the liver of a three-day-old cadaver. It was as if Monet had become a corpse before his death…Everything had gone wrong inside this man, absolutely everything, any one of which could have been fatal: the clotting, the massive hemorrhages, the liver turned into pudding, the intestines full of blood.”

And I didn’t even get to what Preston says about Ebola and testicles. Or pregnant women. Seriously, there’s pages upon pages upon pages of this stuff.

Throughout the book, Preston presents these types of symptoms as typical of Ebola. Not “in worst case, this is what Ebola could do,” but simply, “here’s what happens to you when you get Ebola.” It’s even beyond a worst case scenario, as he notes in part: “In the original ‘Hot Zone,’ I have a description of a nurse weeping tears of blood. That almost certainly didn’t happen.”

Compare that to just about any blog post by actual workers with Médecins Sans Frontières, healthcare workers on the front lines of this and many previous Ebola outbreaks. Stories are scary enough when the reality of the virus is exposed, and with it the dual affliction of poverty and the terrible health system conditions of affected countries. I interviewed MSF’s Armand Sprecher a few years back during a different Ebola outbreak, and he noted this about symptoms–quite different from the picture Preston paints:

The patients mostly look sick and weak. If there is blood, it is not a lot, usually in the vomit or diarrhea, occasionally from the gums or nose.

The clinical picture of Ebola that people take away from The Hot Zone just isn’t accurate, and with 3.5 million copies sold, is certainly driving some (much? most?) of the fear about this virus.

Second, airborne Ebola. Though this trope is often traced back to “Outbreak,” Preston clearly suggests that both Zaire Ebolavirus and Reston Ebolavirus can be airborne. What he never discusses nor clarifies is that the “evidence” for this potential airborne spread is really thin, and not even indicative of animal-to-animal or animal-to-person transmission.

Rather, it’s much more likely that if airborne spread was involved, it was aerosols generated by husbandry (such as spraying while cleaning cages), rather than ones which would have been generated by infected primate lungs (a necessary step for primate-to-primate transmission via a respiratory route). Indeed, this is the paper that Nancy Jaax et al. published on the findings Preston talks to Jaax about, 13 years after the fact (the experiment is marked as 1986 in The Hot Zone), and noting that transmission due to husbandry practices could not be completely ruled out. It’s unclear also that the Reston strain moved through the primate facility via air, rather than via spread due to caretakers, equipment, or husbandry. Nevertheless,  it’s frequently cited as fact and without any qualification that Reston is an airborne type of Ebola.

Instead, here is what Preston says about it:

“If a healthy person were placed on the other side of a room from a person who was sick with AIDS, the AIDS virus would not be able to drift across the room through the air and infect the healthy person. But Ebola had drifted across a room. It had moved quickly, decisively, and by an unknown route. Most likely the control monkeys inhaled it into their lungs. ‘It got there somehow,’ Nancy Jaax would say to me as she told me the story some years later. ‘Monkeys spit and throw stuff. An when the caretakers wash the cages down with water hoses, that can create an aerosol of droplets. It probably traveled through the air in aerosolized secretions. That was when I knew that Ebola can travel through the air.'”

He then comes back to “airborne Ebola” several times, based in part on this idea.

But here’s the thing. Just about any virus or bacterium could be aerosolized this way–via high pressure washing of cages, for example. If it can bind to lung cells and replicate there, as we already know Ebola can, it can cause an active infection.

But that’s not the same as saying “Ebola can drift across the room” from one sick person to a healthy person and cause an active infection, as Preston tries to parallel with HIV in the above paragraph. Even in Jaax’s experiment and others like it, there’s zero evidence that primates are expelling Ebola from their lungs in a high enough concentration to actively infect someone else. And that is the key to effective airborne transmission. Think of anthrax–if it’s released into the air, we can inhale it into our lungs. It can replicate and cause a deadly pneumonia. But anthrax isn’t spread person-to-person because we don’t exhale the bacteria–we’re dead ends when we breathe it in. This is what happens with primates as well who are experimentally infected with Ebola in a respiratory route, but Preston implies the opposite.

Third, if it wasn’t for points one and two, The Hot Zone really could be read as a “damn, Ebola really isn’t that dangerous or contagious so I have little to worry about” narrative. Preston describes many “near misses”–people who were exposed to huge amounts of “lethally hot” Ebola-laden body fluids, but never get sick–but doesn’t really bother to expose them as such. All 35 or so people on the little commuter plane Monet flies on between his plantation in western Kenya and Nairobi, deathly ill, vomiting his coffee grounds and dripping nasal blood into the airsickness bag he handed to a flight attendant–none of them come down with the disease.

The single secondary infection Monet causes is in a physician at the hospital where he’s treated, after his bowels “ripped open” like a bedsheet. That physician, Shem Musoke, not only swept out Monet’s mouth until “his hands became greasy with black curd” but also was “showered” with black vomit, striking him in the eyes and mouth. Monet’s blood covered Musoke’s “hands, wrists, and forearms,” because “he was not wearing rubber gloves.” Musoke developed Marburg virus disease, but survived–one of the few secondary cases of infection described in the book.

Another “close call” was that of Nurse Mayinga N. She had been caring for one of the Ebola-infected nuns at Ngaliema Hospital in Kinshasa during the 1976 outbreak in Zaire, the first detected entry of Zaire Ebolavirus into the human population. Beginning to feel ill herself, she ditched her job and disappeared into the city for two days. She took a taxi to a different, larger, hospital in the city, but was sent away with a malaria shot. She’s examined at a third hospital and sent away. Finally she returns to Ngaliema hospital and is admitted, but by that time, had caused a panic. Preston says:

“When the story reached the offices of the World Health Organization in Geneva, the place went into full-scale alert…Nurse Mayinga seemed to be a vector for an explosive chain of lethal transmission in a crowded third-world city with a population of two million people. Officials at WHO began to fear that Nurse Mayinga would become the vector for a world-wide plague. European governments contemplated blocking flights from Kinshasa. The fact that one infected person had wandered around the city for two days when she should have been isolated in a hospital room began to look like a species-threatening event.”

How many secondary cases were the result of Mayinga N’s wanderings? That possibly “species-threatening” event? Preston again devotes several paragraphs to Mayinga’s gruesome illness and death, and notes that 37 people were identified as contacts of hers during her time wandering Kinshasa. He tells us they were quarantined “for a couple of weeks.”

The fact that exactly zero people were infected because of Mayinga’s time in Kinshasa merits half a paragraph, and not dramatic or memorable. “She had shared a bottle of soda pop with someone, and not even that person became ill. The crisis passed.” <–Yes, that is a direct quote and the end of the chapter on Mayinga. Contrast that to Preston’s language above.

Finally, beyond the science and the fear-mongering about Ebola, beyond everything and everyone in the story “liquefying” and “dissolving” and “bleeding out,” reading this book again as an adult, as a woman in a science career with a partner and kids, I was also left annoyed at the portrayal of the scientists. All of the major characters except one, Nancy Jaax, are men of course, ranging in age from late 20s to 50s-60sish. Understandable since this is in a mostly-male military institution and in a BLS4 setting to boot, but the one Preston focuses on for much of the narrative is Jaax.

While Preston may have been trying to portray Jaax as the having-it-all, tough-as-nails woman scientist, the fact that she’s the only one with any kind of home life is telling–mostly because he devotes more paragraphs to how she neglects both her children and her dying father than any success she has in her life outside of work. She is told early on by one of her colonels that “This work is not for a married female. You are either going to neglect your work or neglect your family.” This thought comes up repeatedly for Jaax, and in the end, while she was accepted and even honored by her colleagues and bosses, we hear over and over again how her children are left on their own to microwave meals and tend to their homework. How they desperately wait up for her to get home after work, often eventually falling asleep in her bed before she arrives. How she tells her father, dying of cancer back in Kansas and both knowing he only has a few hours to days to live, good-bye and “I’ll see you at Christmas” over the phone. How she barely arrives on time for his funeral after he passes.

We hear one paragraph about how another colleague, Thomas Geisbert, had a crumbling marriage with two small children, and how he left the children at his parents’ house for a weekend. Other than that, the personal lives of any other characters are practically absent, save for Jerry Jaax, Nancy’s husband. Even with him, much of the character development revolves around his fears of his wife working in a BSL4 lab.

The Hot Zone, for me, is unfortunately one of those books that you read as a young person and think is amazing, only to revisit years later and see it as much more shallow and contrived, the characters one-dimensional and the plot predictable. The problem is that The Hot Zone is not just a young adult novel–it’s still presented and defended as an absolutely true story, especially by huge Preston fans who seem to populate comment threads everywhere. And now it looks like there will be a sequel. At least it should be good for a drinking game.

 

*I’ll note that The Coming Plague is much more measured when it comes to Ebola–the two were grouped together because temporally, they were released close together, not because they display the same type of hype regarding the virus.

Skeptical science and medical reporting (#Scio13 wrap-up)

Ivan Oransky and I moderated a session last week at ScienceOnline, the yearly conference covering all things at the intersection of science and the internets. We discussed the topic ““How to make sure you’re being appropriately skeptical when covering scientific and medical studies.”

We started out discussing some of the resources we’d put up at the Wiki link. Ivan teaches medical journalism at NYU, and noted that he recommends these criteria when evaluating medical studies. I noted I use similar guidelines, and as a scientist, think about papers in a journal club format before I cover them on the blog, considering their strengths and weaknesses (especially in study design and analysis). Ivan also mentioned the need sometimes to consult a real statistician if you don’t understand some of the analyses–suggesting to “keep a biostatistician in your backpocket” or, failing that, to reach out to those at you local university, as “they tend to be lonely people anyway.” (Just kidding, biostats friends and colleagues!) A number of stats references for journalists were also mentioned (see the Storify for specific links). From here, we handed the discussion over to the audience.

One of the first topics we reviewed was just what is meant by being “appropriately skeptical,” which was a theme of the session that we kept coming back to. How does one do that without being an asshole? The importance of criticizing the study’s limitations and weaknesses–and not necessarily being a jerk to the authors–was noted. No study is going to be perfect, after all. It was also pointed out that anyone reporting on the study should go beyond the press release, and not to do so is in fact “journalistic malpractice.” Bora also started an interesting tangent–are medical studies more likely to be fake (or more deserving of skepticism about results) than more basic science reports? Also, is it worth reporting on bad studies? Sometimes this can help to point out the bad science (like that recent mouse-GMO study, which was reported on–negatively–in many venues). This recent study on “out” versus “closeted” homosexuals in Montreal was also brought up by Annalee Newitz–a small study that was widely reported, but was it designed and powered correctly to examine the questions it supposedly answered? (I haven’t read it, but just looking over the article, looks like “no”.)

Audience members also asked how to find sources to comment on studies. Ivan has previously written a post on this, and others in the audience recommended looking at other references in the story itself, or looking at reviews or meta-analyses on the topic to see who else may have expertise in these particular areas. However, SciCurious also noted that you need to be somewhat skeptical of those as well, and examine if the authors of these reviews or analyses have their own biases that may skew the information being presented.

The idea of “Glamour Mags” was also introduced. How should those reporting on a story know whether the results were published in a “good” journal or not? Several pointed out that just because a study is in a lower impact-factor journal doesn’t necessarily mean it’s not to be trusted. Eli elaborated, noting that fraud is actually higher in the big, fancy journals, and that many studies that end up in lower-tier journals actually go through *more* peer review in some cases, as they have been rejected from higher impact publications.

Unfortunately as I was moderating, I wasn’t taking notes, and I can’t recall what we ended the session on (but it was a great comment and general agreement that it nicely tied things up). I’ve also tried to Storify the session based on the #medskep hashtag, but I’m new to Storify and it doesn’t want to embed for me. If you were there, please feel free to add to the discussion in the comments below.

Is the HPV vaccine “weak science?” (Hint: no)

Oh, Discover. You’re such a tease. You have Ed and Carl and Razib and Phil and Sean, an (all-male, ahem) cluster of science bloggy goodness. But then you also fawn over HIV deniers Lynn Margulis and Peter Duesberg. Why can’t you just stick with the science and keep the denial out?*

But no, now they’ve let it spill into their esteemed blogs. I was interested to see a new blog pop up there, The Crux, a group blog “on big ideas in science and how these ideas are playing out in the world. The blog is written by an outstanding group of writer/bloggers and scientist/writers who will bring you the most compelling thoughts throughout the world of science, the stuff most worth knowing.” Sounds ok, let’s see what stories are up…oh, one on HPV! Right up my alley. And hey, a woman! Bonus.

*Reads story*

Ohhhhh, it’s actually one on HPV vaccine misinformation, written by the author of the fawning Duesberg article referenced above. Faaantastic.
Continue reading “Is the HPV vaccine “weak science?” (Hint: no)”

Epidemiology and social media: conference fail

I have written and deleted this post. Twice. But damn it, it needs to be said.

I’m here in charming Montreal for the North American Congress of Epidemiology. It’s a good-sized meeting, as far as epi meetings go. The site notes that it’s a joint effort between four major Epi organizations: The American College of Epidemiology (ACE); The Society for Epidemiologic Research; the Epi section of the American Public Health Association, and The Canadian Society for Epidemiology and Biostatistics. Collectively, those associations represent a lot of epidemiologists.

The conference started off well. The first night kicked off with a movie about bioterrorism preparedness followed by a panel discussion. Great–movies! Engaging public in novel ways! Love.

On to Wednesday, when the first real sessions begin. The opening plenary discussed Science, skepticism, and society. Great again–this is a perfect warm-up. Later that afternoon, there was another session titled “Communicating Epidemiology: The Changing Landscape”. I was happily surprised when the room for this was pretty packed, as these types of meetings tend to be heavy on chronic disease epi and epidemiology methods. However, I was disappointed with the content. While the first talk was to give “a snapshot of how premier science journals experiment with features that blur old distinctions: blogs, data repositories, standard-setting, and advance online publications,” almost none of that was discussed–instead, it focused on how Nature Genetics was doing…something….about datasets. (Unfortunately I don’t have great notes and was at this point still trying to get the wifi to work; more on that later). Either way, it wasn’t anything as advertised in the description I quoted above, and it discussed *only* Nature Genetics–surely there are more “premier science journals” than just NG? (Why only NG discussed? The talk was by Myles Axton, who is the Editor).

Next on tap was Jennifer Loukissas, communications manager at the National Cancer Institute’s Division of Cancer Epidemiology and Genetics, to discuss “When epidemiologists talk to press and public.” However, there really wasn’t any “public” involved–it was a media training session. Period. Use soundbites, stay on target, think about your message, control the interview, call the journalist back in 5 minutes if you need to collect yourself, etc. Good stuff for scientists to know, to be sure, but isn’t there a world out there beyond talking to journalists? More on that later as well.

The third talk was Jonathan Samet of USC, on “Communicating around conflict.” He’s recently worked on the WHO cell phone-and-cancer opinion that was released earlier this month, and essentially extended what Loukissas began as far as what to and not to say to interviewers, particularly in controverisal areas.

This was not exactly my idea of science communication in 2011, especially since everyone agreed at the beginning of the session that scientists were terrible communicators, our messages frequently ended up getting distorted, all the typical canards. Merely telling scientists to stop being so jargon-y and prepare soundbites–while necessary–isn’t going to solve these problems.

During the (very brief) Q&A, I asked about scientists directly communicating with the public–via their websites, blogs, web video, etc., to get their own message out there and not have to worry about journalists messing it up. Loukissas was the main one to answer the question, saying–incredibly–she hadn’t thought about that.

It was all I could do to keep myself from saying “d’oh!,” complete with facepalm.

The reality is that scientists don’t have to be passive any longer, relying only on reporters to translate their work for them in order to send it along to the public. We should have our soundbites, but realize that we can go beyond our manuscripts (I’ve had ones recently trimmed down to 1200 or even 800(!) words). We can write about the research if it’s behind a paywall. We can write about the realities of doing our work as a jumping-off point after a journalist covers your research, and go beyond the dry data that goes into the paper. We can go beyond the press release and talk about what may be interesting to us about our findings, but maybe aren’t the “meat” of the publication, or are secondary to the “main point” that you’ve worked on for your soundbites and want to emphasize to interested journalists. We can elaborate on interesting research done by others, to discuss subtleties that you can’t fit into a 20-minute interview.

And more.

Communication-wise, this meeting has unfortunately been a bit of a letdown. The science is interesting and there have been some great speakers, but I haven’t been able to share much of that because wifi wasn’t arranged for in the conference rooms. I have internet in my room ($14.95/day, of course), but the password from my hotel room isn’t valid downstairs (something it took me almost a day and a half to find out, after getting the run-around from various people), and the organizers either didn’t care, didn’t think, or couldn’t afford to allow attendees to use the wifi network in the hotel conference rooms. So while I was able to take conference notes from the American Society for Microbiology meeting right on Twitter and share them with everyone via the conference hashtag, not so for this meeting. (ASM even had their own mobile app for smartphones).

The thing is, *epidemiologists need to be plugged into these kinds of things.* So many of the studies reported in the media have to do with epidemiological topics–cell phones and cancer, vaccines and autism, “chronic” lyme, does the internet really give you “popcorn brain”, just to take one current story from CNN. We can’t sit in our towers and just wait for a journalist to call us about those studies anymore–and why should we?

Last year, Craig McClain wrote about why scientists need to use Twitter. That post, while good, focuses mainly on the benefit to the scientist (though he does note that the public can also find information there). We need more of this. We need good, reliable information to be out there on the internet, freely available–and if that’s not possible in your academic publishing model, it’s still possible with a blog, or YouTube video, or basic website that you keep updated with recent news. Epidemiologists are certainly using social media and Google to explore disease; why not give back by wading out there and actually taking part in the conversation?

Margulis does it again

We all know of once-respected scientists who ended up going off the deep end, adhering to an unproven idea despite massive evidence to the contrary. Linus Pauling and his advocacy of megadoses of Vitamin C, or Peter Duesberg’s descent into HIV denial. It’s all the more disappointing when the one taking a dive is a woman, since there are, compared to men, relatively fewer female “big names” in the sciences. So when one goes from views that were, perhaps, outside of the mainstream (but later proven largely correct) to complete science denialism, it makes it all the more depressing. Even worse, mainstream popular science magazines like Scientific American (with this article by Peter Duesberg) and Discover (Duesberg again) give these ideas reputable press. And now Discover has done it again by giving “maverick” biologist Lynn Margulis a profile in their latest issue. More after the jump.
Continue reading “Margulis does it again”

Science and the media: three new books

There has been a surge of interest recently in science denial, particularly revolving around the issue of vaccines. Last year saw the release of Michael Specter’s Denialism; in the last few months, three others have been released: Seth Mnookin’s Panic Virus, Robert Goldberg’s Tabloid Medicine, and Paul Offit’s “Deadly Choices.” More about each of them after the jump.
Continue reading “Science and the media: three new books”

Rock Stars of Science, part deux: coming to a GQ near you

The second edition of the Rock Stars of Science is now out online, and in the November 23rd (“Men of the Year”) edition of GQ magazine. As Chris Mooney notes, this is a campaign funded by the Geoffery Beene Foundation, working to raise recognition of scientists’ work (and scientists, period, since roughly half of the American population can’t name a single living scientist). Part of the campaign is to make science noticeable and “cool;” I’ll quote from the press release:

ROCK S.O.S™ aims to bridge a serious recognition gap for science, observes journalist Chris Mooney, co-author of the recent book, Unscientific America, and a partner of the campaign.

“The current gap between science and our popular culture,” says Mooney, “keeps Americans from recognizing the centrality of science to their daily lives. They think science is some strange activity performed by slightly geeky others in white coats. In fact, science fuels our economy and is our great hope for cures to diseases that affect all of us.”

“The RSOS™ campaign shines the spotlight on this critical national issue,” says G. Thompson Hutton, CEO and Trustee of the Geoffrey Beene Foundation, supported by the designer menswear brand Geoffrey Beene, LLC, which dedicates 100 percent of net profits to philanthropic causes. “If we invest in research, we will save lives now and trillions of dollars later.”

So, I think it’s a great cause, and a unique way to spread the word. From that side of things, I’m all for it.

But… (there has to be a “but,” right?)

The first campaign didn’t exactly knock my socks off. Chris gives an update on the participants at The Intersection; if you read through it, you may notice the 2009 participants had many things in common: they were universally older, white men. To be sure, they include older white men doing great things (Tony Fauci, head of the National Institute of Allergy and Infectious Diseases, NIAID, was one of those featured)–but they promoted the stereotype of scientists as, well, old white guys.

This time around, the lineup is more diverse, featuring 17 scientists–including 4 (white) women and 2 men of color (though still, mostly older). The scientists chosen include notables such as Nobel prize winner Elizabeth Blackburn and physician/astronaut Bernard Harris. The lineup is also heavy on cancer researchers and other biomedical types; understandable, since they are focused on disease and cures. I realize these are easier to “sell” to the public, because we all know someone who has experienced cancer–but if the foundation does a round 3, perhaps some more physical scientists could be included? Even if they maintained the focus on health, climate change, for instance, has the potential for huge impacts on health–and many engineers, physicists, and chemists work on health-related problems.

They also have a cutesy Q&A with each scientist, providing them all the same questions. Some I find to be fairly lame (“What was your worst part-time job?” “Alternate career choice?” “Longest med school study session” [!? why the emphasis on med school?]), along with some that I think make a better impact, like discussing misconceptions of their work, or their best moment in science/research. I realize the “lame” ones are to help the audience see that scientists are just like them, and spent time in crummy jobs, but diversity in the questions would be nice to shake things up a bit. Then they have a portion where the scientist’s research is described…which is terrible. I don’t know if this made it into the print version or is only online, but in many cases, these descriptions are lifted right off the scientist’s professional website. Look at Catriona Jamieson’s, for instance (taken verbatim from her lab website):

Dr. Jamieson specializes in myeloproliferative disorders (MPDs) and leukemia. Myeloproliferative neoplasms are a family of uncommon but not rare degenerative disorders in which the body overproduces blood cells. Myeloproliferative neoplasms can cause many forms of blood clotting including heart attack, stroke, deep venous thrombosis, and pulmonary emboli and can develop into acute myelogenous leukemia. Although some effective treatments are available, they are laden with serious side effects. In addition, individuals can become resistant to the treatments. Dr. Jamieson studies the mutant stem cells and progenitor cells in myeloproliferative neoplasms. These cells can give rise to cancer stem cells. Cancer stem cells may lie low to evade chemotherapy and then activate again later, causing disease progression and resistance to treatment. Her goal is to find more selective, less toxic therapies. In the past two years, Dr. Jamieson’s stem-cell research studies have taken a great leap: from identifying a promising treatment in the laboratory to opening and completing the first clinical trial to target cancer stem cells in humans. This trial is the result of teamwork that has brought together her discoveries in myeloproliferative neoplasms and a local pharmaceutical company’s drug development track.

I mean, really?? I’m a scientist, and just reading that even made *my* eyes glaze over. If one thing they’re trying to convey is the importance and relevance of the scientist’s research to GQ readers, what percentage of the readers are really going to walk away with a deeper understanding of what Dr. Jamieson does by reading that description? It would have been a small thing to ask each participant to submit a layman-friendly version of their research (their “elevator talk” description, for example) for GQ to include.

Finally–one of the “scientists” is Dr. Oz. What is he doing in there? One, I would think he’s already well-known enough; why not save that spot for another scientist? Two, yes, I know he’s actually done research and published, and is on the faculty at Columbia. Fantastic. He’s also a serious woo peddler, who has even featured everyone’s favorite “alternative” doc, Joseph Mercola, on his talk show, and discussed how vaccines may be playing a role in autism and allergies (despite mounds of evidence to the contrary). This seems to completely contradict their goal of “research funding as a national priority,” since Oz is often (and Mercola is always) highly critical of “mainstream medicine.” I really don’t understand his inclusion, and think it’s to the detriment of the rest of the campaign.

I know, this is quite a lot of complaining (isn’t that what bloggers *do*?), but I’m sincere in hoping that this campaign does raise awareness. I hope they expand it beyond GQ–why not do something similar in magazines with a larger female readership, such as Good Housekeeping or even People magazine? Women are the ones who make many of the healthcare decisions, after all. We’re often advocates for health and healthcare research–and if more funding is what they’re ultimately looking for, we vote too.

[Edited to add: Science has an article on the campaign as well.]

The development of a conspiracy theory

Interesting post today at juggle.com, showing the evolution of a conspiracy theory akin to a game of telephone. Interestingly, it starts with an article in Wired by author (and former Scienceblogger) Johah Lehrer. Lehrer wrote an article on the effects of chronic stress on health outcomes, and one researcher’s work to develop something akin to a vaccine to mitigate the stress effects. Sounds reasonable, no?

Next, the Daily Mail picked up the article, and focused on the “stress vaccine” angle.

Finally, the folks at Alex Jones’ Prison Planet–who’ve never met a conspiracy theory they didn’t like–took the Daily Mail story and morphed it into a discussion of “brain eating vaccines,” and a government conspiracy to eliminate all emotions from an unknowing public (follow-up here, and they even have a third article bashing Lehrer. Impressive!

Now, I’m not necessarily blaming the Daily Mail as the intermediate in this. Yes, their story was certainly more sensational and less nuanced than the original Wired piece, but PrisonPlanet could also take the most innocuous story on any scientific breakthrough and make it out to be some kind of vast governmental-scientific-pharmaceutical plot. However, it does emphasize again the need to be aware of what’s going on out there in these corners of the internets–look how they encouraged their readers to manipulate Google so that “brain-eating vaccines” would trend on the site. This kind of thing is their bread-and-butter, and the fact is that “the facts” don’t always win converts to any scientific argument.

Addendum: several on Twitter pointed out this PhD comic, which succinctly summarizes the cycle.