Plausibility, not science, has dominated public discussions of the COVID pandemic

Abstract

COVID-19 put to the test the understanding of the meaning of “science” by the medical profession, the media, and the public. Unfortunately, the vast majority of individuals were misled by those who spoke on behalf of science but who confused plausible stories with scientific explanation. Scientific understanding comes from theories, which generate hypotheses, which are, in turn, confirmed or disconfirmed by empirical evidence that is evaluated using statistical methods. In our daily lives, we may judge the validity of a hypothesis based on its plausibility, and for most trivial cases that is sufficient. But it is a mistake to imagine that science can proceed on that basis. Yet, scientists themselves are often confused about the foundations of the scientific method. “Evidence-based medicine” is now being used to discredit all medical evidence other than randomized controlled trials (RCTs), the supposed “gold standard” of medical research. This insistence on a single method that is deemed “best practice” has the ironic effect of replacing science with plausibility in medicine. RCTs fail to live up to their vaunted status because of frequent insufficiencies in randomization related to confounding errors and their magnitudes. When randomized trials were compared with observational studies in a meta-analysis of thousands of studies, the differences in conclusions were negligible. The entire framework of COVID-19 policy has been based on plausible hypotheses, not backed by genuine scientific evidence. Critics are correct in claiming that COVID-19 policies have been based on politics, not science.