Can you remember the early months of COVID-19? We humans are wired somehow to suppress truly horrible memories. Unless I force myself to go back and look at notes or media reports from that year, I find it hard to remember just how awful it was. In many urban settings, hospital emergency rooms were overwhelmed with the sick and dying, ICUs were unable to handle the demand, and the morgues were overflowing.
As director of the National Institutes of Health, it was my job to marshal all possible resources to focus on rapid development of vaccines, drug treatments, and diagnostic tests. Vaccines generally require many years to develop, so much of 2020 was fraught with uncertainty about what exactly was going to happen in our world. We assembled the world’s scientific experts; convinced partners in government, academia, and industry to drop their usual legalistic skepticism about each other’s contributions; designed master protocols that would ensure that any trials of vaccines and therapeutics would be rigorous and definitive; and set up a “shark tank” to test bold ideas about how to make home testing for COVID-19 easy and accurate. It was the year of no sleep.
The Centers for Disease Control and Prevention’s development of a COVID test ran into serious problems, and public-health recommendations got off to a rocky start. There wasn’t much data to go on, and this was a genuine crisis—public-health agencies were doing the best they could with inadequate information. Initial recommendations included some confusing information about masks not being necessary. But then, once it became clear that the virus could be readily transmitted by people who had no symptoms, the CDC reversed course and recommended that masks should be worn. The recommendation was correct, but the reasoning was not always made clear.
One strong motivation for the recommendations in the spring of 2020 was to “flatten the curve”—to delay the number of new infections so that overwhelmed hospitals would not completely go under. Temporary school and university closures were put in place to try to reduce transmission. Given the lower risk of serious illness in children and young adults, the concern was only partly about their health; it was also about preventing infected kids and young adults from bringing the disease home to vulnerable parents and grandparents. Similarly, seeking to reduce acute transmission, closures of many businesses and a limitation on mass gatherings were instituted in early 2020, though the rigidity of the rules varied a lot across the country.
Today many argue that these measures in the first few months of the pandemic were too draconian. Some even say they did more harm than good. But a detailed 2021 evidence-based analysis of the outcomes of “flatten the curve” measures in 41 countries showed that most of them provided benefit in reducing transmission during the first wave of the pandemic. Of the various measures, closing schools and universities and limiting gatherings to 10 people or fewer had the most significant effect. Closing nonessential businesses delivering personal services (like gyms and hair salons) had a moderate effect. Targeted closures of face-to-face businesses with a high risk of infection, like restaurants, bars, and nightclubs, had a small to moderate effect. Adding a stay-at-home order provided only a small additional benefit to these other measures. Those are the data.
But there were trade-offs; without question harms were also done by these public-health measures, particularly in less-populated areas, and those began to mount as the months went by. The school closures were supposed to be temporary—but because the alarm about the risks of transmission had already been raised, it became hard for parents, teachers, and public-health officers across the country to retreat from these recommendations, despite the growing potential harm to children’s learning and socialization. In some locations, weeks turned into months, or dragged into a second year. Similarly, business closures that were extended over long periods created a great deal of economic stress for millions of people, especially among hourly workers and those in rural communities.
Public trust in the government began to fray. Mixed messages from the White House, including truly outrageous comments from the commander in chief about injecting bleach to treat COVID-19, did not help. As a physician and the NIH director at that time, I was totally focused on trying to advance the science of both vaccines and therapeutics. Yet I was increasingly aware that the public was becoming frustrated and distrustful of the actions that we were pursuing.
I believe that history will recognize the development of vaccines in just 11 months as one of humanity’s finest health achievements. Based on an analysis by the Commonwealth Fund, as of 2022, more than 18 million hospitalizations and 3 million deaths were prevented in the United States alone. But at the same time, the distrust that had been building during 2020 and early 2021 led to a decision by about 50 million Americans to pass up the vaccine. An assessment by the Kaiser Family Foundation concludes that distrust of the safety and efficacy of COVID vaccines caused more than 230,000 needless deaths in the U.S. alone.
People of faith were particularly hard hit by misinformation. White evangelical Christians (my own group) were the most resistant demographic of all, worried about rumors that the vaccines contained tracking chips or represented the “mark of the beast” from the Book of Revelation.
Political partisanship also played a major role. A recent cross-sectional study in two states, Ohio and Florida, showed that the rate of death in those states was strongly associated with political-party affiliation. After May 2021, when vaccines were freely available to all adults, the death rate for Republican voters was 43 percent higher than for Democratic voters. The long echo of the negative public response to COVID-19 has led to greater resistance to all forms of vaccination, putting children at risk for diseases such as measles and polio that had almost been eradicated in the developed world. This may be the most consequential example of distrust of science in modern history.
We are in serious trouble when some believe that their faith requires them to distrust science, or when others believe that political allegiances are a better source of wisdom than truth, faith, or science. Something deep within our culture is wrong. In many aspects of our daily discourse, the links among truth, science, faith, and trust seem to have been broken.
But before blaming all of this on other sources of misinformation and disinformation, I have to point the finger at myself and my other colleagues as well; our communication was not always as clear or as helpful as it needed to be. We often did a poor job of explaining the emerging nature of our understanding. People like me were aware of how uncertain our picture of the virus was on any given day, but we didn’t always convey that in public statements. In every pronouncement on CNN, MSNBC, or Fox, we presented what we thought was true at that moment (though the media format often limited comments to a sound bite).
But we should have said: “Today’s recommendation is the best we can do based on current evidence—the information is changing quickly, and the recommendations next week might need to be different.” There are many examples where the story had to evolve, but that often surprised and frustrated the public. We didn’t know at first that asymptomatic people could be infectious. The related coronavirus diseases SARS and MERS weren’t like that. Once we learned that, we had to recommend that everyone wear masks indoors—but the reasons for the change were not clear to most people. We didn’t expect the emergence of variants that in some instances (like Omicron) were so different from the original virus that it was almost like starting a completely new pandemic. That led to the conclusion that the original vaccine preparations would not have the durability we had hoped for; they would have to be reengineered, and another round of boosters would be needed.
We urgently need to learn from what happened here. The worst pandemic in more than a century, driven by the dangerous and highly contagious virus SARS-CoV-2, should have energized and unified us. COVID was the real enemy. But instead, the pandemic tore us apart. False claims gained a rapid foothold, and the sources (including me) that were supposed to share objective information, admit uncertainty, and inspire public trust often failed to achieve that. Seeing this situation, people put their trust in other sources of even more questionable value—especially social media. Politicians piled on with a shocking willingness to distribute information that served their own purposes but was of questionable validity.
All of this would be unfortunate if we were debating opinions about which baseball team is the best. But with COVID, this was life or death—and for 230,000 Americans, it turned into tragic and unnecessary death. This loss of an anchor to facts and evidence should never have happened in a society based upon reason and knowledge. If we are serious as individuals and communities about traveling down the road to wisdom, we have a lot of lessons to learn—whether in dealing with the next pandemic, addressing climate change, or defending democratic elections.
There are profound reasons for each of us to engage. It is crucial to see that what we are fighting for is great and glorious, and worth every bit of the effort from each of us. Truth, science, faith, and trust are not just sources of relief from a painful period in our country’s life. They represent the grandest achievements and insights of human civilization. They literally hold out the promise of a better life for every person on this planet—in material terms, in spiritual terms, and in social and cultural terms. To give up on them would be to give up on humanity’s potential. To fight for them would be not just to fight against divisiveness and ignorance, but to fight for a brighter future for us all. To take up this challenge would therefore be an act not born of exhaustion or desperation, but one arising from the hopeful pursuit of the promise of greater flourishing of our entire human family.
This article has been adapted from Francis S. Collins’s new book, The Road to Wisdom: On Truth, Science, Faith, and Trust.
By Francis S. Collins
When you buy a book using a link on this page, we receive a commission. Thank you for supporting The Atlantic.