The good news this week is the approval of the single-dose vaccine developed by Johnson & Johnson. We now have three highly effective vaccines that we need to administer as rapidly as possible, to as many people as possible, to bring this pandemic to an end.
Now that we have choices, increasingly
the question will be is “which vaccine should I get?” The very simple and very
clear answer is “the first one you can.”
There are some differences among the
three available vaccines. The J&J vaccine displays 66% effectiveness
overall, but critically, is close to 100% effective in prevention of severe
disease, hospitalization and death. This is an unequivocal homerun of vaccine
development.
There are potential nuances related
to variable response between age groups or effectiveness against emerging
variant strains. However, bottom line, if you have an opportunity to be
vaccinated today with any of the approved vaccines, take it. Your risk of
becoming infected and critically ill while waiting for a different vaccine is
far, far greater than any incremental benefit you might receive from waiting
for an arguably more perfect vaccine.
What I just engaged in above is
punditry – per Merriam-Webster the provision of an opinion in an authoritative
manner, usually through mass media. The word “pundit” derives from the Hindi
“pandit,” a term of respect for someone considered learned and wise. In these
modern and increasingly divisive times, the term has taken on a somewhat
negative connotation, used to describe someone who forcefully conveys an
opinion on one side or the other of an issue, often with political overtones.
Perhaps a better term would be “expert opinion.”
Regardless of what we chose to call
it, as we race to vaccinate and look forward to emerging from the pandemic, all
of us will be dependent upon reliable and responsible punditry. When can we
safely reopen schools and businesses? How should my behavior change once I am
vaccinated? When will live performing arts return? When should attendance
limits on sporting events be lifted? Can I plan a “normal” wedding in the Fall?
These questions, and others, will be
partially addressed by science and partially addressed by CDC guidance. The
black and white edges of science and guidelines are critical, but most of where
we actually live is gray and blurred. We will need to make personal and policy
decisions based on incomplete information, and experts will be necessary to
assist in this process.
There is an inherent challenge in
relying on this expert opinion. There are suddenly a lot of physician experts
out there, and sometimes the advice is contradictory. Many – I would say most –
approach their punditry with the same commitment to professionalism they would
in the care of a patient. Most experts want to provide information that is
accurate, evidence-based where possible, and delivered in a manner accessible
to the lay-person.
However, there are some who seem to
be at best ill-informed, at worst conflicted and self-promoting. The confidence
and passion of the speaker is not a reliable guide. As I have listened to the
various experts, some of the most misleading information is promulgated by
doctors who appear supremely confident. Some of the most thoughtful commentary
comes from those who appear awkward and uncomfortable in front of the camera.
How does the general public know to
whom to listen for reliable information? This is a surprisingly difficult
question to answer. I have collected a few tips below. Many are factors that
could be useful in choosing not only your trusted pundit, but your personal
physician as well.
Qualifications and Credibility
- Is the physician or scientist on the faculty of a
well-regarded school of medicine? Only half-way jokingly, I would say if
you are listening to a Baylor faculty member, you can skip the rest of
these steps. During the pandemic, we have viewed part of our community
responsibility as getting good information to the public. Eighty-eight of
Baylor faculty have engaged in over a 1,000 COVID-19-related media
appearances. As a health sciences university, we are committed to freedom
of academic expression and diversity of opinion. However, we also pay
attention to what is said by our faculty. We work to assure the
information we are providing to the public is factually accurate and
relatively free of bias. Most faculty members from major schools of
medicine would have similar expectations.
- Is the physician currently board certified
and licensed
to practice medicine? This information is readily available and helps to
identify physicians who are actively engaged in the practice of medicine,
and who have remained current in their fields.
- How would you characterize the expert’s internet
profile? A quick Google search will give you some valuable information.
Does the expert tend to be aligned with consistently controversial
opinions? Do they appear to lean heavily to one end or the other of the
political spectrum? The fact that an expert opines on controversial issues
with a clear political leaning does not necessarily mean their information
is biased, but it is a factor to consider. Have they been quoted by a
variety reputable news organizations or published in the peer-reviewed
literature? Again, this is not a guarantee, but gives me a level of
comfort they may be a credible source.
Evaluate the Media Environment
- Pay attention to what you are watching, reading or
listening. If an opinion is being offered by a hard news outlet or
publication, I would tend to give it more credence than opinions offered
on entertainment, opinion, or “infotainment” programming.
Characteristics of the Expert
- Why you choose to trust an expert is similar to why you
choose to trust your doctor. Are they speaking in a language you
understand, or are their explanations laden with jargon and buzz words?
Personally, I prefer a physician (or expert) who appears to be trying to
teach me something, rather than prove to me how much they know.
- Be wary if the expert appears overly dogmatic. Inherent
in our response to a novel worldwide infectious disease, there is much we
do not know, and our knowledge evolves over time. Be suspicious of any
expert who answers every single question with certainty. I think anyone
who has tried to make predictions about this disease would agree that it
has humbled all of us at one time or another. Especially be alert for a
special breed of dogmatism: Someone who claims to have unique command of
knowledge, that no one else possesses. If you hear something like “let me
tell you what no one else wants you to hear,” quickly cross this person
off your trusted list.
Get a Second (or Third) Opinion
- As you form your own opinion, listen to a wide range of
experts. Assess their credibility using some or all of the criteria above.
When you hear two or three qualified experts consistently hit common
themes and reach similar conclusions, you can have a greater degree of
confidence the advice is sound.
We still have miles to go before we
rest. As we engage in the happy task of reclaiming our normal lives and
activities, there are many controversies to come – how much, how soon, how
quickly? Our path will be clearer if we all become more discerning consumers of
responsible punditry.
Stay well.
(Note: Between June 2020 through November 2021, I
wrote weekly COVID-19 pandemic updates seen through the lens of a health
sciences university. My intent was to
provide reliable information, acknowledge legitimate concerns, console, and
encourage. Each posting reflects issues
our community was experiencing at that moment in time. I have reproduced selected examples on this
site).
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