‘Calling Bull____’ and the Threat of a Show Vaccine

HEFFNER: I’m Alexander Heffner your host on The Open Mind. I’m delighted to welcome to our broadcast today Professor Carl Bergstrom, biologist at the University of Washington. Welcome to the program today.

 

BERGSTROM: Thanks a lot, Alex. Great to be here.

 

HEFFNER: You are author of the new book called “Bull_____: The Art of Skepticism in a Data Driven World.” I am eager to discuss this book with you and the scholarship on bull____. Harry Frankfurt of course wrote a little volume on that subject and you are really importantly exposing it in an age of viral deception, disinformation and misinformation. What prompted you to write the book? Is it what is obvious in front of us, the manipulation of fact?

 

BERGSTROM: It’s part of that, you know, it’s, it’s I think the way that my colleague Jevin West, the coauthor on the book and I had had seen information, particularly quantitative information being misused to try to confuse people. So, you know, Frankfurt’s original essay was written, I think in ‘86, it’s really focusing on you know, qualitative, and verbal BS. And, you know, as we’ve come into a world where data is so important in decision-making and presented so centrally in the public sphere, but we felt like it needed an update to help people take on data that was sort of being present, you know, misinformation, disinformation, BS being presented in the form of statistics or facts and figures, data graphics, that kind of thing.

 

HEFFNER: So I’m going to use malarkey as our BS for the purpose of this conversation.

 

BERGSTROM: Absolutely.

 

HEFFNER: And also because one of our leading presidential candidates loves to employ that word malarkey. So malarkey is not new to American political life. But there has been a vast anti intellectual anti-science campaign in this country. We’re living through the greatest health crisis, not just of our lifetimes professor, but possibly of the entire American experience. And there’s no doubt that there’s the most malarkey emanating from America and maybe some of the other nations that are most plagued by the pandemic, namely Brazil and the anti-science campaign there. So there is a uniqueness to your subject matter. How can the book be constructive in the way we view the malarkey around the pandemic?

BERGSTROM: I think what the book tries to do is to show every single reader that you don’t need to have a degree in statistics or epidemiology or computer science or mathematics or anything else to be able to see through numerical misinformation. You just have to be able to think clearly about the way that people are analyzing the kinds of data that they’re presenting to you. To sort of give you an example. You know, we talk in the book a lot about selection bias. And this is the notion that when people take a statistical sample that might be convenient to collect, but it doesn’t actually represent the population that they’re trying to study. And we saw this with the coronavirus pandemic. There are these couple of doctors in Bakersfield who tested the patients coming into their clinic and they said, oh, wow. You know, like an awful lot of the patients coming into our clinic have COVID. And therefore we’re going to extrapolate that to everyone in California and conclude that COVID is extremely prevalent throughout California. You don’t need a degree in statistics to see that these guys screwed up. The people that go into a clinic during the middle of a pandemic are far more likely to be infected with the disease than the population at large.

 

HEFFNER: What about the problem of disrespect for expertise?

 

BERGSTROM: This is a challenge. I think there’s a sort of an ongoing you know, as you mentioned, campaign to undermine the authority of people in positions of expertise, because often the information that they provide is politically inconvenient and that is a substantial problem if one is trying to say that, you know, this pandemic, isn’t going to be a big deal. It’s no worse than flu. It’s going to go away. It’s going to magically disappear on April 1st. And you have a bunch of epidemiologists who have spent their lives working on this at the CDC saying, well, wait a minute. No, that’s not right. You know, you’ve got, you can either correct course, or you can try to you know discredit the people that are, that are you know, presenting these this information,

 

HEFFNER: Do you take the short or long-term view of bull____? Do you take the view that it is a means to an end and that end is ultimately, you know, salvaging civil society? Or do you view it as the corrupting force against civil society right now?

 

BERGSTROM: Well, I think it’s, it’s I, you know, more the more the latter I think that, you know, there’s a difference between BS and lying as well. So, you know, BS often people don’t even really care about the particular facts that they’re trying to present to you. They’re just trying to persuade you, impress you, that kind of thing, as opposed to leading you away from some particular truth. So I think we’re seeing this mix of BS and lying in this case where, you know where we actually sort of active you know, lying campaigns where we’re say trying – where people are say trying to you know, provide misinformation about their, just information about the prevalence of disease in the United States or the likely future trajectory. And then, you know, you have this, whereas a lot of what the book is looking at is sort of this sort of passive misinformation of the sort where people don’t care what you believe they’re just trying to make you think they’re authorities, they’re trying to seem, you know, official that kind of thing,

 

HEFFNER: Right. Well you use the word passive. I think the, the idea to some is that that malarkey, or BS is more of a passive or maybe even in some cases, unintentional, it’s not the kind of malicious lying that you see in public discourse. But, how much of what you’re writing about is intended to deceive the difference between disinformation, which a demagogue would want to incite the population or, you know, project lies and is intentionally misinforming people, how much of the malarkey is, is in that vein of disinformation versus error in misinformation?

 

BERGSTROM: You know, I think in the book, an awful lot of it is sort of error and misinformation. We spend a lot of time talking about the way that you know, well-meaning researchers in science can come up with conclusions that collectively can be misleading so we talk a lot about this problem of publication bias in science, where because positive results are exciting, negative results are boring people tend to publish, you know, almost exclusively positive results. And so if something doesn’t work, you might not see the paper saying that it doesn’t work. You’ll just see the one where it kind of appeared by mistake to work. So I think, you know, in the book, we’re really focusing a lot on the sorts of accidental misinformation that are out there and how to avoid being deceived by that. We don’t draw a really sharp distinction in terms of the motive the way that, the way that Harry Frankfurt did so Harriet for Harry Frankfurt you know, malarkey is in the is in the mind of the malarkey-er. And, for us we’re following G.A. Cohen and some of the other philosophers have written about this and we see, you know, malarkey more in the mind of the receiver. So it almost doesn’t matter what the intent was. It’s like, can you see through it or not?

 

HEFFNER: You as a biologist and a scientist are the person we most want to hear about malarkey because we’re in the midst of this pandemic and what you draw attention to in the book are some practices that could really misinform the response to a vaccine, for instance.

 

BERGSTROM: Absolutely.

 

HEFFNER: So can you talk about that?

 

BERGSTROM: Yeah, so you know, I think that what is very important for people to be aware of is that, you know, when presenting quantitative information, there are tricks that people can use to make a story feel one way, even if the numbers lean in the other direction. And so we really stress things like it’s very, very important to make fair comparisons when you’re looking at quantitative information, you know if you pick an example for back before the pandemic there was a study that was you know, widely reported about how the airport security trays were much germ-ier than the airport toilets, and that made it on the news headlines everywhere. And it was pretty disgusting thought. But if you actually look at what the study did, the study swab both toilet seats and airport trays for the presence of respiratory viruses and only respiratory viruses. And so people aren’t sneezing on toilet seats for the most part. And so this really wasn’t a fair comparison. Of course there were of private seats, right.

 

HEFFNER: IF you were looking for fecal,

 

BERGSTROM: But they weren’t sampling for that. And so I mean, the whole thing is like, you know, just to, just to, you know, this is another one that you don’t have to know any of the statistics, you don’t have to be an expert, you just have to ask like, okay, what are they sampling? Is this actually a fair comparison between A and B? And I think, you know, coming at, the whole book is really about empowering our audience to recognize that they can be informed and critical consumers of scientific and quantitative information in the popular press and beyond, and by asking fairly straightforward, simple questions, and by you know, learning various rules of thumb about how to actually make sense of the media landscape that we’re in, where we’re getting all kinds of sources of information coming, flowing across social media and everything else. And sort of the importance of looking at where information is coming from. You know, if something seems too good to be true or too bad to be true, it probably is, the importance of sort of tracking back to the source, triangulating, everything a good reporter would do.

 

HEFFNER: Right.

 

BERGSTROM: And so then the challenge as well, none of us have the time to be a good reporter in our sort of daily media consumption. So how can you build up a set of habits of mind that give you an effective BS detector?

 

HEFFNER: Right. So in that detector, we have to consider the fact that that skepticism, not just malarkey is in the eye of the beholder, but skepticism too is. And so you have this wave and I think that the Q Anon and anti-vaxxer movements, they may be more than waves of,

 

BERGSTROM: Yeah,

 

HEFFNER: I don’t think we should use the word skepticism. What is the appropriate way to delineate that?

 

BERGSTROM: Yeah, this is super important. I mean, I think that there’s, you know, there’s skepticism and then there’s sort of you know, conspiracy theorizing, right? And so you know, with, with skepticism, one wants to sort of, you know, one, one wants to make sure that the, you know, the data are coming from legitimate perspective. One wants to understand about a data source, you know, who’s telling me this, how do they know it? What are they trying to sell me? But then one, you know, as one tries to create you know, your own view of the world, you then if you’re taking the skeptical perspective or scientific perspective, then you turn those same tools on your own hypotheses and your own theories about how things are going on. And you’re just as skeptical of, you know, your own explanations for things as you would be of anyone else’s. And this, you know, this, this notion of like Neil Postman stresses this, and he says, you know, instances, cause it’s Postman’s Second Law of, of BS is that the BS you have to be the most concerned about is that coming from yourself. And so I feel like with some of these conspiracy theory movements, people, you know, it’s almost this game of stringing together, these really wild theories that then don’t get subjected to the same level of critical questioning that …

 

HEFFNER: Have you studied how many people are self aware or introspective about the fact that they are spewing BS? How many, how many of us know that we’re conscious of the fact that we are engaged in that?

 

BERGSTROM: So I haven’t personally studied this, you know, my strong sense is that we all, we all, we all, there are times when we all do it and know we’re doing it. And you know, whether that’s, you know, just kind of telling stories with people or making excuses or, you know, or whatever you know, those of us, you know, those of us who are still in school, you’re writing an essay on a book you haven’t read or whatever the case may be. And then I think that there is this level to which we all can improve our ability to question our own explanations for things. And as a scientist, this is so important that when you are studying some particular problem and the data seemed to all fall into place beautifully, and now you’ve got a lovely explanation and you’re thinking, wow, this is going to be a marvelous paper. You have to sit down and try as hard as you can to break that, you know, try as hard to break that as you would have, you know, some claim that completely countered all of your beliefs and intuitions.

 

HEFFNER: Right.

 

BERGSTROM: And, and that’s what we were trying to teach in the book, because like, yeah,

 

HEFFNER: There’s a different level of BS from the, the gang leader of a Facebook page that is spewing disinformation or bullying with disinformation and Mark Zuckerberg, who is profiting off of disinformation and misinformation. So there are different levels of malarkey there and societally, they’re different, you know, again, I don’t know if, if it is, if BS is the right way to characterize it but what’s going on at the corporate level, in preserving a system that is capitalizing and exploiting the malarkey versus sort of the malarkey in day-to day interactions that they work in conjunction, but, you know, who’s most guilty of spreading it? And that would be the people who were actually amplifying it or the infrastructure for amplifying it.

 

BERGSTROM: This is a really important observation. And we talk a fair bit in the book about this, is that the way that we get our information has changed radically in the last 20 years. And every time there’s been a big change in the way that information is distributed in sort of human history, there are big changes in the nature of information that gets shared as well. And of course, our big change, most recently, is this transition to you know linking up all the computers in the world, allowing everybody to be a content producer with digital typesetting and web typography and all of that. And then the notion of going to social media, where once you’re on, once you have a system on social media and we sort of dispense with professional editors and producers and that, and we all decide what our friends see, and that’s become a huge problem, because then you have these media companies, like you say, you know, Facebook, Twitter, whatever it is that are not invested in trying to get accurate information to share. What they’re trying to do is they’re trying to get engaging information to share, what what’s engaging well, these you know, these machine learning algorithms that they’re running and everything else are discovering that what’s engaging is stuff that shocking scandalous, surprising not accurate. And so they’ve created this entire information ecosystem. It’s all predicated on engagement rather than accuracy, and that’s a major fundamental problem. And it’s why, you know, a big component of dealing with all of this is, you know, bringing media literacy into the whole story,

 

HEFFNER: Absolutely information literacy. So we have to have the confidence and I want to lean on your perspective as a scientist and biologist again, here in the drug makers and the scientists who are investigating vaccines and therapeutics for the pandemic, that it’s not going to be the way it is for the social media companies. In other words, accuracy is going to take precedent over engagement. Do you have confidence in the current academic and corporate pharmaceutical ecosystem that this is going to be done?

 

BERGSTROM: I think that you know, they’re all, there’s always room for improvement. I think that overall the incentive, I mean, I think about incentives and the way incentive structures are lined up. And you know, in the pharmaceutical ecosystem is we’re thinking about, say vaccine development no one can afford a mistake here. And, and I, you know, I’m really worried about you know, countries like China and Russia that may be rushing into deploying vaccines that haven’t been properly tested. Here in the United States if we go forward with a vaccine that turns out not to work and, and cause it causes, you know, negative side effects and things like that, that’s going to really harm people’s trust in the vaccine system more broadly. We could end up not only losing the battle with COVID, but we could lose a bunch of the previously vaccine preventable diseases, as well as people become more and more skeptical of the value and safety of vaccines. So I think everyone is acutely aware of this. And so, you know, barring some kind of, you know, barring some political pressure that gets mounted with respect to the election timing and so forth. I don’t think that there is going to be a rush to bring an unsafe vaccine onto the market here in the United States, because everyone is so acutely aware of that particular issue.

 

HEFFNER: What are the kinds of not so innocuous BS that would manipulate the vaccine results? In other words, it’s not impossible that if a vaccine, what I like to call a show vaccine for our show president you know, that, that if he poached, you know, the rotten apples from companies that were prepared to you know, do it ethically but if he, if, basically he, and, and the drug administration said, we’re going to do this in, in the, the, you know, the most unsavory way possible, what are the ways that, that unscrupulous scientists could try to gin this up to satisfy his desire for a show vaccine,

 

BERGSTROM: You know I think it would be mostly involve taking the data from phase three trials, early data from phase three trials and spinning stories around those data, exactly manipulating those data so that, you know, not as necessarily faking the data, but you know, making claims based on those data – doing, not doing unsavory statistics, that kinds of things to a claim that, that the safety profile of the vaccine is better understood than it is. And possibly the efficacy is better understood than it is. Now, I mean, on the positive side, I do think that there are very few academic scientists who are unsavory like this. There does seem to be this suspicion that, oh, you know, all the public health scientists are on the take from Pharma or something like that. And while certainly Pharma does have a reach into prescribing behavior and all these other things, I think there are very, very few people, even the ones that I think are making terrible mistakes, who are doing this for the money. I mean people are doing this because they believe in the results that they’re finding. You know, so when we see some of the big controversies that are going on in know around the science of COVID right now, you know, there are people that are accused of you know, monetizing essentially…

 

HEFFNER: So what are, what are tactics that be employed that are not intentionally malicious, but that could lead to not an effective result, but by using maybe a sample size, that’s not comprehensive enough, or by just not doing enough due diligence with respect to that third stage of a vaccine trial.

 

BERGSTROM: Yeah. You know, I mean, luckily the, the, the sort of, you know, procedures for doing a phase three trial are fairly well worked out. I mean, I think that the, one of the main tactics that you might see if people try to push things through in sort of a show manner would be to make arguments about the about the relative importance of acting quickly versus safety. And so arguments about continuing to collect data as, you know, as, as things go forward, maybe we, you know, instead of running a full phase, we had this proposal, there’s a proposal in Forbes from Steven Salzberg that he then backed off cause he changed his mind about it, which I think was a very admirable thing to do, where he said maybe instead of running, you know, a full phase three trial, we can start to do you know sort of compassionate-use rollout of vaccines that seem to be working now. And he was extremely well intentioned in doing this and had thought through it carefully and then talked to his colleagues extensively after this came out and then reversed it and published a nice reversal after that. But I think that that would be the sort of thing that we’d see would be, we’d see you know, we’d see this vaccine rolled out on under the sort of grounds of, well, you know, we’ve got to do something right away and it’s really important that it’s saving lives and chances are it’s going to be fine because that’s really been the, the approach that this administration has taken to the pandemic all along. Let’s, let’s hope for the best and act accordingly. Right. And I could see that sort of behavior with the vaccine too. They keep thinking, you know, we’re going to get lucky with this. It’s not going to happen on our watch and they keep not getting lucky, and I can see the same mistake being made again.

 

HEFFNER: And it’s hard to call BS or malarkey on 160,000 American souls gone.

 

BERGSTROM: Right.

 

HEFFNER: It’s hard to make a persuasive case for yourself to excuse that, right. I mean, I’m wondering if the threshold for sort of tolerable or allowable, malarkey or BS is, you know, it’s 160,000 dead Americans and the most irresponsible reckless response to a pandemic in history, it’s like, you know, pretty above the threshold.

 

BERGSTROM: It’s certainly, that’s certainly my view. I mean, I think, you know, there are a lot of different efforts to try to divert and diffuse blaming and one side you do these, you know unreasoned, you know, not really fair comparisons and you say, well, that’s actually fewer than who are dying of heart disease. So who cares and then ignoring the fact that this is, these are excess deaths and we’ve radically changed society it, to prevent it from being an even larger number. But then the other thing that we, that we see is you know, maybe attempts to say, well it’s not really the administration’s fault because hydroxychloroquine works and the doctors wouldn’t let us use it. And so, you know, these, we see, so we see all of these attempts and people are just throwing stuff against the wall to see what sticks. But that’s on I’ve seen lately is that, you know, I think some of the pressure for hydrochloric would, may have less to do with trying to get rid of the purchase doses as, as to find an excuse for this 160,000 deaths that doesn’t involve absolute incompetence in the White House.

 

HEFFNER: Do you think any of that was motivated by the idea that if you took that drug you know, if everybody were to take that drug, we might have a greater immunity and it meant more of us would have immunity?

 

BERGSTROM: Because we would have been exposed to the disease and we had had, or that the drug itself would be protective.

 

HEFFNER: Right. Right. For the same reason that folks had advocated or espoused reintroducing the polio vaccine that like that drug taken as a protective measure, or, you know, taking the old polio vaccine would have, would have ginned up enough antibodies or protection. I mean, because there were some scientists and still some who talk about that as working for certain patients.

 

BERGSTROM: Right. Some people do. I mean, I think the people who are advocating, you know, many of the scientists who are advocating for that drug firmly believe that it will work. The, and I think that is the motivation for most of the scientists that are promoting it. My sense is that we keep getting, you know, negative result after negative result, after negative result in the properly run clinical trials, the ones that come through positive are these small, poorly designed trials. And you’re seeing this publication bias issue whereas if I run a small poorly designed trial and it doesn’t work then that just ends up in my desk, drawer, run a small poorly designed trial, and it does work then I can publish that.

 

HEFFNER: Was the proposition that it was, was it only, and is it still only being advocated as a treatment, or as a proactive regimen that one could take?

 

BERGSTROM: Both, I mean, people have tried all sorts of things, right? People are thinking of it as prophylaxis. They’re thinking of it as they’re thinking of it, you know, people have explored it for pre-exposure prophylaxis, post-exposure prophylaxis. People are looking at it for late stage, late stage disease. I mean, some people are trying a bunch of different things and the next sort of frontier is to try it in combinations with various other drugs. None of these things seem to be working adequately.

 

HEFFNER: Final question for you, professors, human challenge trials. Are you an advocate of them? I know you just alluded to one of your colleagues –

 

BERGSTROM: Steven Salzberg. Yeah. Right. But,

 

HEFFNER: But is there a point at which that is ethical to do? It’s a very difficult question. I don’t have a strong position on that. I think that it’s a discussion that’s worth having. I don’t have the background in medical ethics to have, you know, firmly decided that this is right or wrong. What is interesting to me, you know, obviously you have to be very careful about the populations on whom you run these human challenge trials. So you don’t want them to be you know, you don’t, want it to be people who are now suddenly out of work and are forced with the decision of feeding their kids and so on. But what’s very interesting is the number of medical students who volunteered for these human challenge trials is enormous. You could run the trials exclusively on you know, people who have other options and are simply doing this because they believe that there are relatively low risks, and they have that desire to help. And so, because of that, I think it’s a conversation worth having. If we didn’t have those people and it was just, you know, forcing people into it by financial insecurity, then I would be completely opposed.

 

HEFFNER: And if you’re safely guarding it and making sure,

 

BERGSTROM: It has to be safely guarded; you have to give people the proper standards of care and all that. But yeah.

 

HEFFNER: University of Washington biologist, Carl Bergstrom, author of a new book on malarkey which is “Calling BS, “Calling Bull____” – that might’ve just been bleeped. Thanks for joining me today.

 

BERGSTROM: Yeah. Great to talk to you, thanks. Take care.

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