By: Steven Friedman,
SOUTH AFRICA’s debate is often loud. It also prides itself on giving a hard time to anyone in authority. But it becomes soft-spoken and obedient when the people it focusses on are scientists. The country’s response to Covid-19 has, on the surface, been hotly debated. Only weeks into the national lockdown, the government has been yelled at by people demanding an end to the restrictions. It has become almost routine in some media to blame the government for what the country has endured this year. This seems to show that the debate is vigorous and as determined as ever to hold the government to account. A closer look tells a different story.
It is worth pointing out that, despite its loudness, the anti-lockdown brigade may represent only the view of business and the minority who live in suburbs, both of whom began lobbying for an end to restrictions very soon after they were imposed. But there is nothing remarkable about that: the South African debate excludes at least 70% of the country. What is unusual is that, despite the energy devoted to yelling about the lockdown, the debate never raised the slightest doubts about the scientific advice the government was receiving and whether it enabled the country to keep illnesses and deaths as low as possible.
Following the Science
The fact that the government has taken scientific advice on Covid-19 seriously has been widely cheered. On the surface, the celebration seems justified.
This is not the first pandemic democratic South Africa has experienced. The first was HIV and AIDS – and a key feature of that epidemic is that the government rejected the science. President Thabo Mbeki waged a campaign against the mainstream science on AIDS, encouraging discredited fringe scientists who denied that the disease existed or that it was a serious problem. His then Health minister, Manto Tshabala-Msimang, co-operated with peddlers of fake remedies and claimed that beetroot, garlic and lemon would fend off AIDS. The government either attacked or ignored mainstream scientists.
This sounds topical because it is. The AIDS denialism in which the then government engaged was not much different to today’s Covid denialism, which has cost many lives and caused many to fall ill. Then, fake science was used to deny the need for people to take medicines which enabled them to live normal lives with AIDS. Today, fringe scientists are trotted out to deny the need to wear masks, restrict activities or curb gatherings. Given this, it would seem obvious that South Africa is better off this time around because the government has taken scientists seriously and has commissioned modelling exercises which assess the spread of the virus so that the health system can plan and so cope with patient numbers.
But there is an important problem with ‘following the science’ this time. When HIV and AIDS arrived here, scientists agreed on what caused it, how to avoid it, and what medicine to take to reduce its harm. None of this applies to Covid-19. Because it is very new, there is little scientific agreement on anything to do with it, even among the vast majority of scientists who know that the disease is real and that we need to prevent its spread. And so, to ‘follow the science’ means to accept the view of some scientists and reject those of others – it is to make a choice, which can be challenged by people who make a different choice. And so South Africa does not ‘follow the science’ – it follows one scientific view.
This view, first expressed publicly by the chair of the government’s medical advisory council, Prof Salim Abdool Karim, but shared by almost all South Africa’s medical scientists, is that a severe outbreak of Covid-19 was inevitable. All the country could do was to try to slow the spread so that the inevitable rise in cases did not overwhelm the health system. This seemed so obviously scientific to the people who influence thinking here that, within a short time, it was taken as proven fact and repeated regularly in the media.
But this was not the only scientific view. Around the world, other scientists insisted that, while Covid-19 could not be eliminated, it was possible to control it so that very few people would fall ill or die from it: they advised their governments to prevent a severe outbreak, not to manage one when it came. Nor did it take scientific training to work out that this view did not square with the facts – it was necessary only to follow the daily news. According to Karim, a severe outbreak was inevitable because no country was able to prevent one. But the news then showed that more than a few countries had avoided severe outbreaks – many of them on this continent. Despite this, no journalist or civil society group challenged the scientists to explain why they said something was inevitable when it wasn’t.
Following Which Science?
As the lockdown continued, it became clear that, while scientists here may agree that Covid-19 is unstoppable, they do not agree on everything.
Not long after the lockdown began, some scientists began denouncing it in the media. Since their views coincided with those of the journalists to whom they spoke, they were hailed as sages who had used the mighty power of science to show up the government. Nobody bothered to ask them on what their views on the lockdown were based. Nor was anyone dismayed when some expressed views which seemed motivated not by science but by the same suburban view as the rest of the anti-lockdown lobby. One, the chair of the Medical Research Council no less, declared that there had been no cases of malnutrition at Johannesburg’s Baragwanath Hospital before the lockdown when many lay people knew this could not be true. She corrected herself, but not because the media or anyone else in the public debate asked her to do this. Nor did the media’s enthusiasm for interviewing her in a fawning manner which suggested that she was incapable of error abate when she acknowledged getting a basic fact wrong.
These two examples illustrate a pattern which has been constant here since Covid-19 arrived: scientists are treated as unquestionable sources of wisdom – and they achieve heroic status when they say that the government was wrong to restrict the suburbs. What seems odd is that, even when scientists are cheered for confirming the prejudices of the cheer leaders, other scientists are not criticised for taking a different view. The government is blamed for following their view. This reached a high point of absurdity recently when the government changed its advisory council and excluded some scientists who had denounced the lockdown – this was portrayed as an act of authoritarianism akin to Stalin’s. It followed earlier ‘revelations’ in which the media were given records of the medical advisory council, showing that some scientists’ recommendations were rejected by the government.
All governments decide whose advice they want – excluding some advisors and listening to others is normal and has nothing to do with silencing anyone. The people whose advice is ignored remain free to try to influence public opinion any way they choose (which South Africa’s scientists are always eager to do). Governments can also ignore advice if they wish. Of course, if governments ignored advice which is sound, they should be held to account. But the reports did not say the advice was sound – they simply assumed that it was the government’s duty to listen to what scientists tell it.
When medical scientists were excluded because of their views, others were included because of theirs. This means that there are differences between scientists but the reports do not say that – if they did, they would have to acknowledge that not all scientists are right all the time. Both the media and the broader debate clearly believe that all scientists are right all the time because, six months into the epidemic, neither have, to my knowledge, asked a single critical question of a single scientist. The tone with which some journalists approach scientists sounds very much like their colleagues in dictatorships questioning a government official – the person they interview is treated with such grovelling deference that they seem quite apologetic that they are forced to ask any questions at all.
The Need to Question
So, media and citizens organisations which pride themselves on holding the government to account have, while hurling abuse at or making fun of the government for its lockdown rules (even when those they complain of were drafted with businesses’ help), shown not the slightest interest in whether a severe epidemic could have been avoided. No-one has asked how the health system has done at treating people or how accurate the models on which the media report are, despite a recent article pointing out that the models are almost 100 years old and don’t necessarily take into account how Covid-19 works. (Most of the scientific advice given at the outset was based on how previous epidemics had worked: inevitably, some of it was right but not all of it was).
Why this slavish support for scientists? There are probably three reasons, all related to each other. First, the mainstream debate worships at the cult of the expert. Any doctor or professor is assumed to know more than the rest of us (except those of us whose field is politics because everyone believes themselves an expert on politics). To ask them critical questions is to show that you think you know more than they do. Second, there may be people who don’t want to criticise scientists because they don’t want to sound like the Presidents of Brazil and the USA and the others who have denounced the science on which just about all scientists do agree (the science which tells us how to protect ourselves).
But the third and most worrying reason may be that the cult of the scientist is another of those prejudices which afflict much of the country’s debate. The government is always assumed to be corrupt and foolish – for many who hold this view, the same applies to people who vote for it. The suburbs and everything which comes out of them – business, the professions – are all-knowing and civilised. So, the scientists, whatever they say, must be right and the government must be wrong (even when it listens to some scientists rather than others). The refusal to challenge scientists may express a prejudice which still haunts this country, the belief that most people here are still uncivilised and need to be told what to think and do by the minority who know better. The scientists are, in this view, part of the all-knowing minority.
We should not need to point out that this prejudice against the majority makes building democracy far harder. There is also a huge difference between on the one hand asking scientists to explain what they say and then challenging them when it seems not to fit reality and on the other, denying what all the evidence shows is true – that if people don’t wear masks and distance, many will get ill and too many will die. Nor do you have to be a medical professor to challenge scientists when what they say seems wrong. You don’t need to have studied medicine to ask why a severe epidemic is inevitable when the morning headlines say there are parts of the world where it is not. Or to ask why we are placing so much store on readying the health system when we don’t know how many people do better because they are treated by it. Or to insist on knowing where the models come from and on what they are based.
In democracies, every opinion which might influence people’s lives must be questioned and debated. That applies as much to the views of scientists as to anyone else’s. The country may have paid a huge price in illnesses and lost lives because its debate has not recognised this.
Prof Steven Friedman is a research professor, politics department at the University of Johannesburg. He writes in his personal capacity.