Why Scientific Evidence Matters in a Pandemic

In advance of a Senate hearing, leading doctors, scientists, and public health experts unite to stand up for transparency, accountability, and the scientific process.

While the COVID-19 pandemic surges, the US response continues to be undermined by those promoting dangerous misinformation about unfounded therapies, attacking the credibility of public health experts, and undermining trust in medical science and the nature of evidence. A hearing tomorrow sponsored by the Senate Homeland Security and Governmental Affairs Committee is just the latest example.

Leading doctors, scientists, and public health experts have signed the statement below to affirm the importance of the scientific process to counteract deadly misinformation. Scientific evidence must continue to be the fundamental force driving progress in medical care, especially during a pandemic.

STATEMENT

The 1918 influenza pandemic powered a new era of modern science, discovery and approaches to public health, helping to build the scientific and public health community, which in subsequent years produced new tests for infection, medicines for treatment, vaccines to stop the spread, and more. 

In contrast, the 2020 COVID-19 pandemic, despite having produced some notable scientific gains, has also fueled attacks on how we know what we know, raising doubts about the scientific process by which we generate facts, analyze data, and reach conclusions. We are facing a dangerous barrage of misinformation that ignores evidence and dismisses the scientific process, undermining our national response and belief in science.   

The latest attempts to promote hydroxychloroquine as a COVID-19 treatment are proof of the danger in ignoring evidence and dismissing science. After months of testing beginning in the early days of the pandemic, no evidence has emerged that the drug improves outcomes in infected persons or those at risk for infection and some studies have found it causes more harm than good. Yet patients continue to demand it from their doctors because of false information spread by politicians, advocates, and others peddling it as a cure-all. Indeed, continued advocacy of this or any unproven, even dangerous, approach feeds confusion and skepticism about the scientific process and the entire medical community, to the point that some patients decline effective treatments or vaccines. Such rhetoric can also lead to broader negative consequences, like price-hikes and shortages of the drug for patients who depend on it for its FDA-approved uses.

We cannot allow groups and individuals pushing unproven treatments to threaten the progress we have made in medical science, including the fundamental commitment to accepting scientific data as the basis for clinical decision making and public health.

Scientific evidence must continue to be the fundamental force driving progress in medical care, even during a pandemic. Scientific evidence is not the experience or intuition of one physician, or even a collection of individual experiences. Rather, it emerges from the concerted work of thousands of clinicians and scientists conducting research as they treat patients, using clear, reliable methods that minimize bias, analyzing facts and data in a rigorous way, and using standardized tools to verify findings. We are part of a medical and scientific community committed to holding each other accountable. That means calling out unfounded conclusions and poorly executed research. It means recognizing the knowledge and expertise of professional organizations of doctors, such as the Infectious Diseases Society of America or the American Association of Family Physicians, and of our key public health agencies, such as the Centers for Disease Control and Prevention, the National Institutes of Health, and the Food and Drug Administration. These professional societies and agencies use their expertise to help develop and interpret what constitutes reliable evidence and we believe that following their guidance, not simply those who have been provided a pulpit, is critical.

Bypassing the scientific process to endorse unfounded therapies ignores a century’s worth of medical progress.  In advance of the December 8 hearing before the Senate Homeland Security and Governmental Affairs Committee, the undersigned physicians and scientists declare their commitment to the scientific process and the transparency and accountability that sustains and powers that progress.

Ashish K. Jha, MD, MPH
Dean
Professor of Health Services, Policy and Practice
Brown University School of Public Health


Jerry Avorn, M.D.
Professor of Medicine
Brigham and Women’s Hospital/Harvard Medical School

Kirsten Bibbins-Domingo, PhD, MD, MAS 
Vice Dean for Population Health and Health Equity
Professor and Chair, Epidemiology and Biostatistics
UCSF School of Medicine

Linda Birnbaum, PhD, DABT, ATS
Scientist Emeritus and Former Director, National Institute of Environmental Health Sciences and National Toxicology Program

Aaron E. Carroll, MD, MS
Director, Center for Pediatric and Adolescent Comparative Effectiveness Research 
Professor of Pediatrics, Indiana University School of Medicine

Christine Cassel, MD
Department of Medicine, UCSF

Alta Charo, JD
Warren P. Knowles Professor of Law & Bioethics, University of Wisconsin

Ellen Clayton, MD, JD
Center for Biomedical Ethics and Society, Vanderbilt University Medical Center

Ronald C. Desrosiers, PhD
Professor of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine

Joycelyn Elders, MD, MS
Former Surgeon General

Paul E. Farmer, MD, PhD
Kolokotrones University Professor, Harvard University
Chair, Department of Global Health and Social Medicine, Harvard Medical School
Chief, Division of Global Health Equity, Brigham and Women’s Hospital
Co-Founder and Chief Strategist, Partners In Health

Howard P. Forman, M.D., M.B.A.
Professor of Public Health & Radiology
Yale University

Adriane Fugh-Berman, MD
PharmedOut, Georgetown University Medical Center

Monica Gandhi MD, MPH
Professor of Medicine, University of California, San Francisco (UCSF)
Infectious Diseases physician

Fiona Godlee FRCP
Editor in Chief, The BMJ
Editorial Director, BMJ

Gregg S. Gonsalves, PhD
Assistant Professor, Epidemiology of Microbial Diseases
Yale School of Public Health

Steven Goodman, MD, MHS, PhD 
Associate Dean for Clinical and Translational Research
Professor of Epidemiology & Population Health (E&PH) and of Medicine
Stanford University School of Medicine

 

Peter Lurie, MD, MPH
President, Center for Science in the Public Interest
Former FDA Associate Commissioner

 

Lawrence O. Gostin, JD
Faculty Director, O’Neill Institute for National and Global Health Law, Georgetown University

Jeremy Greene, MD, PhD
William H. Welch Professor and Chair
The Johns Hopkins University School of Medicine

Alberto Gutierrez, PhD
NDA Partners LLC, Former Director, FDA’s Office of In Vitro Diagnostics and Radiological Health

Perry N. Halkitis, PhD, MS, MPH
Dean, Rutgers School of Public Health

Peter Hotez, MD, PhD, FASTMH, FAAP
Dean, National School of Tropical Medicine
Professor, Departments of Pediatrics, Molecular Virology & Microbiology
Baylor College of Medicine
Founding Editor-in-Chief, PLoS Neglected Tropical Diseases

Steven Joffe, M.D., M.P.H.
Founders Professor of Medical Ethics and Health Policy and Professor of Pediatrics
University of Pennsylvania Perelman School of Medicine

Christine Laine, MD, MPH
Editor in Chief, Annals of Internal Medicine
Senior VP, American College of Physicians

Jeffrey A. Linder, MD, MPH, FACP
Chief, Division of General Internal Medicine and Geriatrics
Michael A. Gertz Professor of Medicine
Northwestern University Feinberg School of Medicine

Bernard Lo, MD
Professor of Medicine Emeritus, University of California San Francisco School of Medicine

Nicole Lurie, MD, MSPH

Michael J. Mina, MD, PhD
Assistant Professor of Epidemiology and Immunology, Harvard T. H. Chan School of Public Health
Assistant Professor of Pathology, Harvard Medical School

John P. Moore, PhD
Professor of Microbiology and Immunology
Weill Cornell Medical College

Martha Neighbor, MD
Emeritus Professor of Emergency Medicine, University of California, San Francisco

Steven E. Nissen, MD, MACC
Chief Academic Officer, Heart and Vascular Institute, Cleveland Clinic

Carl C. Peck, MD
Adjunct Professor, Department of Bioengineering and Therapeutic Sciences, Schools of Pharmacy and Medicine
University of California San Francisco

Marc Pfeffer MD, PhD
Distinguished Dzau Professor of Medicine, Harvard Medical School 
Senior Physician, Brigham and Women’s Hospital

Aaron S. Kesselheim, MD, JD, MPH
Professor of Medicine, Harvard University Medical School
Physician, Brigham and Women’s Hospital

 

Harold Pollack, PhD
University of Chicago

Bruce M. Psaty, MD, PhD
Professor, Medicine & Epidemiology, University of Washington

Rita F. Redberg, M.D., M.Sc., F.A.C.C.
Professor of Medicine, UCSF School of Medicine and Araxe Vilensky Endowed Chair in Cardiology
Faculty, Philip R Lee Institute for Health Policy Studies, UCSF Division of Cardiology

Douglas D. Richman, MD
Distinguished Professor of Pathology and Medicine, University of California San Diego

Joseph S. Ross, MD, MHS
Professor of Medicine and Public Health
Yale University

Eric Rubin, MD, Ph.D
Editor-in-chief, New England Journal of Medicine and Professor, Department of Immunology and Infectious Diseases , Harvard T.H. Chan School of Public Health 

Paul E. Sax, M.D.
Clinical Director, Division of Infectious Diseases, Brigham and Women’s Hospital
Professor of Medicine, Harvard Medical School

Andrew G. Shuman, MD FACS
Associate Professor and Chair, Ethics Committee
University of Michigan Medical School

Craig Spencer, MD, MPH
Director of Global Health in Emergency Medicine at New York-Presbyterian/Columbia University Medical Center and Associate Professor of Emergency Medicine and Population and Family Health at Columbia University Medical Center

Meir Stampfer, MD, DrPH
Professor of Medicine, Harvard Medical School

Eric Topol, MD
EVP and Professor, Molecular Medicine, Scripps Research     
Founder and Director, Scripps Research Translational Institute 

Seth Truger MD, MPH
Assistant Professor of Emergency Medicine, Northwestern University
Digital Media Editor, JAMA Network Open

Robert Wachter, MD
Professor of Medicine and Chair of the Department of Medicine
UCSF 

Clyde W. Yancy, MD, MSc, MACC, FAHA, MACP, FHFSA
Magerstadt Professor of Medicine, Professor of Medical Social Sciences
Chief, Division of Cardiology Northwestern University, Feinberg School of Medicine

Mark L. Zeidel, M.D.
Herrman L. Blumgart Professor of Medicine, Harvard Medical School
Physician-in-Chief and Chair, Department of Medicine, Beth Israel Deaconess Medical Center

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