Collaboration | Observing Science

In February 2003, a new severe respiratory illness emerged in Guangdong Province, China. The World Health Organization global surveillance system alerted travelers to a new disease. The search began for the cause and eleven research labs from countries around the world began to work together to find and analyze what became known as SARS. This “collaborative multicenter research project” proceeded through daily teleconferences, shared electron microscopy photos, and viral genome sequences. Scientists traded samples, debated results, made decisions about experimental dead ends, and in one week a candidate virus was isolated nearly simultaneously in two labs. Three weeks later, confirmatory studies permitted the announcement of a novel coronavirus as the cause of SARS. This model of health science collaboration at a global scale was unique, the results remarkable, speedy and effective. The virus was, according to WHO, “collectively… discovered.”

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Follow the Science | Observing Science

The COVID-19 pandemic was, in many ways, a triumph of science. The world, through collaboration by scientists across countries, sequenced a novel coronavirus almost immediately. We then, building on a novel mRNA platform, developed several highly effective vaccines faster than any vaccines had ever been developed in human history. These vaccines went on to save millions of lives and allow the restoration of social and economic function faster than anyone might have imagined. This was all the work of science. And yet, there was much that the COVID-19 pandemic did to illuminate challenges in science, and it is helpful to contemplate what the pandemic taught us that we can carry forward in the coming decades.

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Reevaluating paternalism | The Healthiest Goldfish

Sometimes we must curtail certain liberties so we can support the freedom to live a healthy life. But how much constraint is too much? How much is not enough?

Part of the aim of these essays is to engage with topics which may be challenging, reflecting the importance of having difficult conversations that advance progress. If we find that nothing we say causes us to feel a bit uncomfortable, it is hard to think we are truly having the kinds of conversations that make us better at holding a mirror up to ourselves towards a more effective pursuit of health. With this in mind, I will today address a topic that is certainly touchy, challenging, while at the same time being essential to the work we do to generate a healthier world. That topic is paternalism.

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The Perils of Scientific Disengagement | Observing Science

FThe world at times feels like it is on fire, with highly visible forms of injustice challenging our collective moral conscience. Scientists live in this world, and it comes up, time and again, whether scientists should put pressure in our particular ways on those who are committing atrocities, who are waging war, or who are oppressive to their people, in order to encourage a change in such (usually national) behavior.

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Everything, everywhere, all at once? Or not? | The Healthiest Goldfish

On conserving our energy and resources for where they can do the most good in the moment, without compromising our long-term vision for a healthier world.

Regular readers of these essays will recognize that a core theme of much of my writing is that the business of health is the business of being concerned about the world around us. The air we breathe, the water we drink, the food we eat, the places where we live, work, and play, politics, the economy, the environment, and the broader geopolitical issues of war and peace—these forces are fundamental to whether we can live healthy lives. They are, to return to the central metaphor of The Healthiest Goldfish, the water in which we swim. Creating a healthy world means attending to these forces, optimizing them for health, to ensure our water is “clean.” This work requires an intellectual and practical commitment to engaging with a “big picture” vision of health. A healthier world is a world where we tackle forces as foundational as climate change, structural racism, and individual behavioral choices, all of which affect health.

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A very narrow view of the world | The Healthiest Goldfish

Revisiting how approaching our work from a Western, high-income perspective can shape how we think and what we do.

II try to be alert to my biases when I think, write, and act. As I have written before, our biases inform the questions we ask about our health, pointing to answers that then inform action. One feature of thinking about one’s biases is the recognition this brings of having even more biases than one originally considered—more, perhaps, than anyone can fully reckon with. Social and occupational status, personal identity, our talents and lack of them, our virtues and shortcomings all constitute the lens through which we see the world. They are the water in which we swim. Just as water is to the swimmer so ubiquitous that they can forget they are in it, our biases are so ubiquitous that they can shape much of what we do and think without our being fully aware of them.

This makes it important to continually revisit our biases, in the interest of keeping them in perspective so that, even if we can never fully step outside of them, we can at least remain aware that they are there, an inextricable part of how we see the world. Addressing our biases is also core to building and maintaining the public’s trust in what we do. If we allow ourselves to become out of touch, unaware of the biases that shape our view, we are less likely to be seen as trustworthy, engaged partners in the work of promoting health, alienating us from the public. This alienation works both ways. When our vision is clouded by bias, it is harder to see the person standing in front of us, harder to understand their perspective, or what is most supportive of their health.

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It’s Time To Talk About Peer Review | Observing Science

Fifty, or even twenty-five years ago, procuring, analyzing, and presenting data in a way that illuminated larger truths was the exclusive province of scientists who did their work in institutions and then published their work in academic journals. That began changing with the democratization of data, more ready access to electronic means of disseminating writing, and with the rise of fields like data journalism, which started doing much of what scientists did—evaluated data and presented it in a way that produced meaning. These evolutions are, in the main, positive. They allow greater access to data for many well outside the confines of mainstream science, encouraging transparency. They allow for the possibility of insights that might otherwise have been missed by scientists and create ample space for publishing these same insights. In addition, these shifts have allowed for the more rapid analysis of data to address pressing contemporary issues, unbound by the processes of science.

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On not looking away from less visible global conflicts | The Healthiest Goldfish

Creating a healthier world must include paying attention to the many underdiscussed wars happening throughout the world.

The world has been appropriately riveted in the past few years by two very visible conflicts: the war in Ukraine, provoked by Russia, and the war in the Middle East, provoked on October 7 by Hamas’ horrific incursion into Israel and then perpetuated by Israel’s ongoing retaliatory attacks on Gaza. I have written extensively about both wars and they have captured the public’s attention, and rightly so, given both the enormous implications they have for global stability, and the tragedies they have wrought on people living in Ukraine, Gaza, and Israel. However, I have also acknowledged that our attention to these conflicts should not, must not, mean that we look away from other conflicts that are equally as devastating for the people in other areas whose lives have been upended by war. It is sometimes difficult, perhaps next to impossible, to recognize that regions that we have grown accustomed to seeing through the lens of war were once areas where, before the war, people lived their daily lives as we do, going to school, to work, playing in parks, falling in love, getting married, becoming sick, dying with dignity. All of these are aspects of living, and they have been disrupted by war and conflict in so many areas, some of which we do not think about or keep in our minds anywhere near as much as we should.

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