Infectious disease and society: communicating scientific understanding to a suspicious audience

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The manipulation of public opinion against lifesaving medicine and scientific facts is becoming an increasingly dangerous problem, but what can the science community do to convince people of the truth?

The vaccine paradox

The use of vaccines to reduce suffering and save lives is one of the greatest advancements of human civilization, with clear results across a range of infectious diseases. This year the BMJ published on the significant reduction in cervical disease thanks to routine HPV vaccination [1]. Despite this, in 2018, uptake of vaccines such as MMR fell [2] and in 2019 measles cases rose globally by 300% [3]. A depressing statistic that is difficult to explain from a purely scientific perspective.

Science and suspicion

Conspiracy and bad science are a sociological and cultural issue. Infectious Disease Hub reported in May on the issues of vaccine confidence in a ‘post-truth’ world and NHS Chief Executive Simon Stevens spoke on the issue, saying: “Across the world 2–3 million lives are saved each year by vaccination but as part of the fake news movement the vaccination deniers are getting some traction.” [4]. Quoting the obvious successes of vaccines has not proved successful, just as scientific facts on climate change do little to persuade deniers, and the lack of evidence for alternative therapies does not reduce their popularity. It is a complex and entrenched confirmation bias. The challenge as scientists, and as a society, is how we tackle this.

Ideas based on suspicion have long been part of our social fabric, but the general direction has been a move towards rational thought, spurred on by the fruits of science and technology, such as improved health and industrial advancement. However, at the same time, global wealth inequality has risen [5], as has the ease of mass communication. The political ramifications of this are apparent and one result is that scientific thought has become the enemy of powerful interest groups, as it challenges their ability to manipulate or profit. With this change, some people turn to the more approachable figure of celebrity for guiding wisdom. While some celebrities are well informed, others are strongly anti-vax or hold similarly worrying views and wield huge influence [6,7] . Image and intuition does the persuading in these cases. This raises the question: does genuine evidence suffer from an image problem?

Education and inclusion

In the ‘golden age’ of scientific development that was the 19th century, the British public were arguably more engaged with and attracted to science and discovery. We often question what happened to this engagement, but in some respects ‘science communication’ has changed little in its style since the Victorian era, employing journalistic articles and public lectures with an occasional exclusive tone. We sometimes end up preaching to the choir. Sharing scientific knowledge for the benefit of all has to keep up with how people consume information and must be combined with greater education in how to assess evidence. If people have the tools to determine the truth, and the message is presented clearly, they are perfectly able to make informed and nuanced decisions.

Scientific education must focus on the ability to assess evidence and the enjoyment of the process of deduction. Encouraging a greater diversity of people and ideas in the scientific community allows us to speak to people in terms everyone can engage with, rather than feeling shut out of the discussion or too poorly informed to contribute [8].

How do we do better?

There are some great examples of people combining creative expression and inclusion with a strong scientific message.

Marshall Shepard writes in this article for Forbes on innovative ways to communicate science, telling scientists to: “Shatter the academic uppity or elitist framing of science communicators as ‘popularizers.’” [9].

The recent elegant experiment from Harvard Medical School (MA, USA) that used a giant petri dish and increasing concentrations of antibiotic is a fine example. This beautifully illustrates how resistance occurs and how the bacteria physically evolve and move through increasingly challenging environments. The filmed experiment explains so much about antimicrobial resistance, so simply [10], as does the more art-focused work of Anna Dumitriu. Anna creates: “BioArt, sculpture, installation, and digital media to explore our relationship to infectious diseases, synthetic biology and robotics.” such as her “Antibiotic Resistance Quilt” [11].

Popular movements are often inspired by good scientific expression, such as the public rejection of non-reusable plastics, which was in part thanks to BBC wildlife documentary filmmaking. Here we saw strong public engagement with the facts resulting in a fast and powerful response.

The Extinction Rebellion climate change protests also know how to sell their argument. The movement is backed not only by good science, but also by a sense of joy, fun and presentational skill that draws people in, using social and mainstream media to their advantage. These are the ‘dark arts’ that those communicating research must understand. Whilst sometimes distasteful, there is a reason corporations use advertising to manipulate public perception. The advantage when you have genuine evidence and conviction is that there is no manipulation required.

The arts have long been able to present their honest creation with a flare and attractiveness that draws people in. Perhaps it is time for scientists to consider the same. Without better public understanding, the fight against infectious disease, antimicrobial resistance and environmental destruction becomes a fight against each other.

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  1. Palmer T, Wallace L, Pollock K et al. Prevalence of cervical disease at age 20 after immunisation with bivalent HPV vaccine at age 12–13 in Scotland: retrospective population study. 365, 1161 (2019).
  2. Wise J. Child vaccination rates drop in England as MMR uptake falls for fourth year. BMJ 362, k3967 (2018).
  3. Mahase E. Measles cases rise 300% globally in first few months of 2019. BMJ 365, 1810 (2018).
  4. Rimmer A. NHS chief attacks anti-vax “fake news” for falling uptake. BMJ 364, 1000 (2019).
  5. Chancel L. Tracking the rise of global economic inequality: new evidence from the World Inequality Report 2018. un.org/development/desa/dspd/wp-content/uploads/sites/22/2018/09/Chancel.pdf
  6. https://www.rollingstone.com/culture/culture-features/celebrities-anti-vaxxers-jessica-biel-847779/
  7. Antrim A. Anti-vaccine celebrities have inordinate amount of influence. Pharmacy Times.pharmacytimes.com/resource-centers/immunization/antivaccine-celebrities-have-inordinate-amount-of-influence
  8. Science benefits from diversity. Nature 558, 5 (2018) nature.com/articles/d41586-018-05326-3
  9. Shepherd M. Why science for the public has to be different. www.forbes.com/sites/marshallshepherd/2019/06/24/why-science-for-the-public-has-to-be-different/#538a4c2d349c
  10. Harvard Medical School. The evolution of bacteria on a “mega-plate” petri dish (Kishony lab). youtube.com/watch?v=plVk4NVIUh8
  11. Anna Dumitriu: Bioart and Bacteria. https://annadumitriu.tumblr.com/AntibioticResistanceQuilt

The opinions expressed in this piece are those of the author and do not necessarily reflect the views of Infectious Diseases Hub or Future Science Group.

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