Public health should have said it might be wrong on COVID
The former NIH chief says leaders feared honesty about uncertainty would look weak, but the reversal of confident advice did more damage.
Not Dead Yet · Francis CollinsFrancis Collins still remembers the spring of 2020 in stark terms. As the head of the federal health research agency and a member of the White House pandemic team, he was trying to marshal researchers, drug companies, philanthropies, and government labs to find tests, treatments, and a vaccine, while thousands of Americans were dying every day and no one knew whether a vaccine would ever come. Part of the job, as he saw it, was to go on television and tell people how to protect themselves.
What he wishes now is that he had started every one of those appearances with a warning. "Look, this is an evolving story," he says he should have said. "We might be wrong, and we might have to change those recommendations in a few more weeks because we got better data."
Collins says he understood at the time that the science was a work in progress, and that researchers knew far less about the virus than they needed to know. The reason he and others, including Anthony Fauci, did not say so more plainly, he says, was pressure to get people to act. The White House, he recalls, was determined to move the public, and any admission of doubt risked being dismissed as weakness or giving people an excuse to tune out.
Instead, firm recommendations later changed, and the change itself did the damage. People had not been warned to expect it, Collins says, so they concluded that the experts did not know what they were talking about. Confident voices selling misinformation filled the gap, leaving the public confused about whom to believe.
For that, Collins offers an apology. He says those of us like himself who were involved deserve the opportunity to say they are sorry, a point he says he tried to make in his book, The Road to Wisdom. He adds that he wishes the people who spread misinformation would apologize too, since he believes that was about 80 percent of the trust problem.
Questions people ask
Who are Francis Collins and Anthony Fauci?
Collins is a physician and geneticist who led the National Institutes of Health from 2009 to 2021 and helped lead the Human Genome Project. Fauci is an immunologist who led the National Institute of Allergy and Infectious Diseases from 1984 to 2022 and became the public face of the federal COVID response.
Does admitting uncertainty actually keep public trust?
Research on science communication generally finds that it does. People tend to trust experts more when they explain what is known, what is still unknown, and what would change their advice, and they react less harshly when guidance later changes. Unqualified confidence tends to backfire because one reversal can discredit later, correct advice.
What does Collins mean by saying misinformation was 80 percent of the problem?
He means most of the loss of trust came from people spreading false or self-interested claims with great confidence, not from honest scientific mistakes. In his accounting, public health's failure to be open about uncertainty was real but smaller, roughly the other 20 percent. He says he wishes the spreaders of misinformation would apologize as he has.