Exploring Human Potential

Truth and Trust in Science.

Posted on | September 29, 2022 | 6 Comments

Mike Magee

“The key is trust. It is when people feel totally alienated and isolated that the society breaks down. Telling the truth is what held society together.”

Those words were voiced sixteen years ago in Washington, D.C. It was October 17, 2006. The HHS/CDC sponsored workshop that day was titled “Pandemic Influenza – Past, Present, Future: Communicating Today Based on the Lessons from the 1918-1919 Influenza Pandemic.”

The speaker responsible for the quote above was writer/historian and Johns Hopkins School of Public Health adviser, John M. Barry. His opening quote from George Bernard Shaw set a somewhat pessimistic (and as we would learn 14 years later, justified) tone for the day:

“What we learn from history is that we do not learn anything from history.”

This was two years after the close of the 2002-2004 SARS epidemic with 8,469 cases and an 11% case fatality, and six years before MERS jumped from Egyptian camels to humans, infecting over 2,500 humans with a kill rate of 35% (858 known deaths.)

Specifically, John Barry was there that day in 2006 to share lessons learned from another epidemic, the 1918 Flu Epidemic which is now estimated to have killed roughly 700,000 Americans among a population that was roughly 1/4 our current size, with 2/3 of the deaths occurring over just a 14 week period from September through December, 1918.

The main point that Barry was trying to make that day focused on public communication during an epidemic, namely that “The truth shall set you free.”

Here were some of his 2006 reflections on 1918, a public health catastrophe at a time when the U.S. was focused on promoting strength not weakness during WW I.

“At best, they communicated half-truths, or even out-right lies. As terrifying as the disease was, the officials made it more terrifying by making little of it, and they often underplayed it. Local officials said things like ‘if normal precautions are taken, there is nothing to fear’…”

“Communication was rarely honest, because honesty would hurt morale.”

“There was a lot of cognitive dissonance. People heard from authorities and newspapers that everything was going fine, but at the same time, bodies were piling up.”

 “Many times public health officials knew the truth but did not tell it. ..In many cases they were just plain lying.”

“The attitude of authorities was: ‘This isn’t happening, don’t worry about it.’”

Barry’s primary message that day was that communication breeds trust, and without trust, society breaks down. His words:

“The key is trust. It is when people feel totally alienated and isolated that the society breaks down. Telling the truth is what held society together.”

“The fear was so great that people were afraid to leave home or talk to one another. Everyone was holding their breath, almost afraid to breathe, for fear of getting sick.”

“False reassurance is the worst thing you can do. Don’t withhold information, because people will think you know more. Tell the truth— don’t manage the truth. If you don’t know something, say why you don’t know, and say what you need to do to know. Drown people with the truth, rather than withhold it.”

“The final lesson of 1918, a simple one yet one most difficult to execute, is that…those in authority must retain the public’s trust.”

But clearly that day, there was also a bit of a self-congratulatory air as well, an arrogance that today rings naive. John Barry says, “Today, I think, as opposed to back in 1918, we don’t have as much of a problem with misinformation…I want to emphasize that it is not likely that public health officials would tell outright lies.”

Twelve years later, on the 100th Anniversary of the 1918 Flu Epidemic, Barry re-released his New York Times best seller, “The Great Influenza: The Story of the Deadliest Pandemic in History”, a title that may not hold up as long as Covid-19 stubbornly holds on.

With Covid came Trump and his sycophants, and Barry’s theory (that mistrust can destroy societal order) was put to the test. In a 2020 interview at the University of Rochester, Barry holds strong to his messaging. “Those in authority must retain the public’s trust. The way to do that is to distort nothing, to put the best face on nothing, to try to manipulate no one.”

It is perhaps too easy to lay our current problems all on poor leadership at the top. Would that have been enough to deny the threat initially for months, and then spread false claims on fake cures, and then declare victory again and again prematurely? Was the public not somehow primed to accept such nonsense?

In the world I lived in for many decades, a profit driven world with vast rewards for scientific entrepreneurs, a world where progress up an integrated career ladder required cooperation, support for medical marketing on steroids, and bending the truth while turning a blind eye to errors of omission, truth was negotiable and trust was for the uninitiated.



6 Responses to “Truth and Trust in Science.”

  1. Dr Rick Lippin
    September 30th, 2022 @ 4:12 pm

    Dr. Magee – Excellent essay on the extreme importance of trust and the requirement to openly communicate truth as we know it repetitively.If ones understanding of scientific truth changes communicate that modified truth openly without shame or fear. An important “sister” of truth is humility which also remains sadly lacking in most medical communications which has contributed to the current severe erosion of trust in our medical profession from which we may me never fully recover?- Dr Rick Lippin

  2. Mike Magee
    September 30th, 2022 @ 5:46 pm

    Thanks, Rick, for the thoughtful commentary. Humility for health professionals ideally should be baked in. That humans entrust us, seek us out in times of need, allow us to process their fears and worries, and include us in their families and communities, is humbling indeed! Comfort enough to admit “I don’t know,” presence physically and emotionally, and staying power all contribute as well. These are not easy jobs, but they are undeniably “real jobs.”

  3. Rick Lippin
    September 30th, 2022 @ 6:48 pm

    Mike – l finally got to the point of telling my patients that if their doctors don’t periodically say “I don’t know” that they should find other doctors.To me doctors should say “I don’t know” when they don’t but “I will be here for you anyway and take care of you”. Many scientific mysteries in medicine remain unsolved but caring and comfort should always be provided to the patient.- Rick

  4. Lawrence Williams
    October 2nd, 2022 @ 7:10 am

    Thanks Dr. Magee for pointing out the basic need for trust in all kinds of situations encountered in daily life in 2022.

    The problem is “Who Do You Trust?”. We trust people close to us who have demonstrated their respect for us in their interactions with us in all kinds of the personal situations of daily life. They do what they said they would do, help in times of trouble, and don’t put their own interests before ours when we interact. But we don’t have that personal contact with our national leaders and those who provide us with information about matters on national or international issues. And far too often that “information” is actually misinformation twisted to serve the political needs of unscrupulous leaders rather than the real needs of his/her constituents. This misinformation tells the target groups just what they want to hear so they believe and trust. And with the ease of mass communication today millions can be misled in an instant resulting in criminal activity up to and including insurrection, see
    January 6, 2021. So how do we teach people to discern truth from lies before they trust the liars? We’ve still got a long way to go on that one.

  5. Mike Magee
    October 3rd, 2022 @ 5:36 pm

    I agree, Larry. On the fringes, at either end, are those who can never tell a lie, opposed on the other end by those who can never tell the truth. The rest of us live together in the middle, reaching out through language, cultures, tribes, and all manner of alliances to certyfy to each other that we are trustworthy. My father was a very truthful person (most of the time), and would often say to us “All I have is my good name. My name is my bond.” Not particularly original, I know. But what I think he was communicating to patients, neighbors, family and friends was “You can trust me.”

  6. Mike Magee
    October 3rd, 2022 @ 5:37 pm

    Couldn’t agree with you more, Rick. Thanks!

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