Carl Bergstrom is an infectious disease expert who's been thinking about the relationship between biology and social systems. One central theme in his work is information: How it flows and how it spreads.
At the University of Washington, where he lectures, he developed an online course called "calling bull----" to help students use critical reasoning to see through false health information. Off the back of the syllabus' popularity, Bergstrom and his colleague Jevin West wrote a book filled with advice about how mainstream audiences can use statistics and other data science tools to question hyped-up products and conspiracy theories that are pervasive on our social media feeds today.
There are a lot of information gaps when it comes to the COVID-19 virus. And Bergstrom is one of the scientists desperately trying to fill those gaps.
He says that early on, some of the information coming out of China felt like misinformation because it was coming from political opponents of the Chinese government, but it turned out to be "partially right." Since then, he's been noting and occasionally debunking various conspiracy theories and rumors, such as the idea that the coronavirus was a Chinese bioweapon -- and, in China, that it's a U.S. bioweapon -- and false stories of catastrophes at American hospitals. On Twitter, he also called out a neurologist, Scott Mintzer, for a "panic inducing" thread about a health system in Seattle, which was based on a second-hand account from an unnamed doctor.
Bergstrom also says that there's been plenty of anticipation of a respiratory viral pandemic like COVID-19, but he does not blame the slow response in the U.S. entirely on the current government. Rather, he notes it's politically challenging to fund pandemic preparedness without a clear and present threat.
"There was a denial and refusal to act that lost us some time, and that's part of what happened. But we also didn't have the resources in place to respond to a pandemic in terms of our coordination structure," Bergstrom said. "There's a 'not on my watchism,' which involves a choice between doing a politically unpopular thing to provide funding for pandemic preparedness that might not come, or avoid doing that and slash whatever is there. These are perceived as once-in-a-century catastrophes."
He argues that the government must play a central role in planning and responding to such catastrophes, and that advocates of small-government philosophy should understand this kind of planning is akin to raising a military.
"There are some collective action problems that even the Chicago-school economists acknowledge will not be adequately solved by the market," he says. "No one expects us to raise a powerful standing army based on private market forces (and) we consider that a central role of the government to provide national defense. Pandemic preparedness is the same."
He also suggests that current lockdowns may need to last past the summer in some areas, unless we can increase testing capacity.
"My personal feeling is that we either have a long lockdown ahead of us, or we'll get testing capacity way up."
Here's a transcript of the interview, edited for length and clarity:
FARR: Given that you track how information spreads, both true and false, where and when did you see the first groups really start to sound the alarm on this?
BERGSTROM: Interestingly, we saw some loud voices early on coming from organized campaigns from political opponents of the Chinese government. There was both a lot of hyperbole but also some truth to what they were sharing. It was feeling like misinformation at the time, but turned out to be partially right. By mid-January, I was having a lot of conversations with others in the infectious disease community, but we didn't yet have diagnosed community transmission. By February, we knew it was a real problem.
FARR: What are some of the most concerning and prevalent hoaxes or false rumors that you're seeing? Can you share your top five?
CARL BERGSTROM: There's the idea that this virus is a Chinese bioweapon. Often (I've seen) a very quickly retracted paper referenced that claimed to have found big pieces of the HIV genome in the SARS-CoV-2 genome. That was debunked within 48 hours. Interestingly, a Chinese colleague told me that in China there is a very widely spread rumor on social media that it is a U.S. bioweapon, but I do not have documentation of this. There has been a lot of talk about the SO2 levels over Wuhan, linking it purportedly to the mass incineration of bodies. There is all the 5G stuff, but I haven't even gone down that rabbit hole. And there idea that Bill Gates is somehow involved, in creating and spreading the virus, not fighting it.
Finally, there were a rash of false second-hand narratives of catastrophes at hospitals. Some are spread by well known, credentialed people. I debunked one of those from the prominent neurologist on March 15th (The neurologist Scott Mintzer deleted an alarmist post after Bergstrom pointed out flaws with a second-hand account).
FARR: As a biologist, when did you first start to personally become concerned about COVID-19?
BERGSTROM: We have a mailing list for many of us professionals in the infectious disease world. You'll see clusters of disease every so often, which we'll share. In this case, we were concerned but the the information from China in those first months wasn't great. The bottom line is that by the time things got bad in Wuhan, infectious disease professionals knew that given the size of the city and the frequent travel to the rest of the world, it would get out. We didn't know if it would turn pandemic, because there have been cases where we've stamped out little fires as they emerge.
FARR: Could we have acted much sooner in the U.S., say in late January when the picture started to become more clear about how serious of a threat this was?
BERGSTROM: There was a denial and refusal to act that lost us some time, and that's part of what happened. But we also didn't have the resources in place to respond to a pandemic in terms of our coordination structure. There was definitely planning and investment that could have been done. I was most active in these sorts of discussions in the Bush years. During that period, there was a big debate about the role of government in public health and a reluctance to invest too heavily in pandemic planning. But I argued that there are some things the government has to provide. For me, that would include the research and surveillance tools, but also the infrastructure you need for rapid vaccine production.
FARR: So the government is really responsible, and not the private sector...
BERGSTROM: I'm not saying that the government should provide pandemic planning because I want a welfare state. There are some collective action problems that even the Chicago-school economists acknowledge will not be adequately solved by the market. No one expects us to raise a powerful standing army based on private market forces (and) we consider that a central role of the government to provide national defense. Pandemic preparedness is the same.
FARR: How come we were so unprepared for this, especially when it comes to having insufficient supplies of masks and personal protective equipment?
BERGSTROM: There's a 'not on my watchism,' which involves a choice between doing a politically unpopular thing to provide funding for pandemic preparedness that might not come, or avoid doing that and slash whatever is there. These are perceived as once-in-a-century catastrophes.
FARR: You've been researching pandemics throughout your career. Did you have a fear around respiratory viruses in particular?
BERGSTROM: I don't know why people don't talk more about the potential for a GI (gastrointestinal) pandemic. It's something I'm going to be asking about. I have also researched pox viruses. Monkeypox, with a few mutations, could become quite a bad thing. But it's these respiratory ones we keep seeing again and again. The story of the past twenty years has been SARS (severe acute respiratory syndrome), and all of these smaller outbreaks, and any one of them could have flared into a disaster. It made sense to expect that something like this COVID-19 pandemic could happen.
FARR: I've read some articles pointing to folks like Bill Gates who seemed to have seen this coming. Were they prescient, or just following the data?
BERGSTROM: Well, we had a pandemic 11 years ago (with H1N1). And there are others going back further in time. People forget the severity of the 1957 flu pandemic. There really isn't an excuse to be caught unprepared, but there's certainly no excuse going forward.
FARR: Now that we're here and we're in this, do we have some tough choices to make? Do you suspect that citizens are going to be asked to make tradeoffs when it comes to privacy and civil liberties? In China, you saw temperature checks of passers-by and at buildings, and other invasive surveillance measures.
BERGSTROM: Without widespread testing, even those measures won't be effective. My personal feeling is that we either have a long lockdown ahead of us, or we'll get testing capacity way up. With temperature checks, I suspect you'd miss a lot of asymptomatic cases so I'm really in two minds about it.
But another consideration is that we already allow ourselves to be tracked in unimaginable ways so that companies can sell ads. If it came to it, we might be asked to consider whether we'd be willing to be tracked via some surveillance measures to go back to work. I might opt in because I'm a public health professional with a secure job, but I completely understand why others wouldn't. And I don't think you can impose (surveillance systems) on people in the U.S.
FARR: You've tweeted about the IMHE model, which shows projections of the spread of COVID-19, assuming full social distancing. You've also shared some reservations with these predictions. Can you elaborate?
BERGSTROM: If you believe that model, things are looking pretty good in states like Washington State by mid-May. But this is all predicated on us being successful at turning the curve around. If we do manage to get reasonable testing going and we keep following the social distancing guidelines, these models suggest life could return to normal come the summer. But if we fall short in either of those things, then we're going to be looking at some harder choices about whether we let a lot of people get infected or consider a longer lockdown.
FARR: Do we have the political will to consider the longer quarantine?
BERGSTROM: I really have no idea. In this pandemic, we don't currently have pharmaceutical measures in place, like a proven treatment. What we do have is traditional public health. We have work stoppages, stay at home orders, travel restrictions. And we also have misinformation that undercuts the trust of scientists and other authorities. There's a political pressure that is building up on our policymakers. I do hope people will do everything they can to get us on the right trajectory, but I also want us to be aware and planning for all possible outcomes.