Science fairy tales – Upcoming series

There are fairytales in science – and like the real, old-fashioned fairy tales they don’t always have a glossy finale, a kiss and a happily ever after.

There are tales in science that have a happy ending…

Those are tales of the moments of great discovery resulting from hard, year-long work or sometimes from pinch of serendipity – like the almost accidental discovery of Penicillin a drug that helped shaped the modern world by significantly contributing to the increase in life expectancy - from a meager 47 years at birth at the beginning of the 20th century to close to 80 years (in the US). A happy ending for the scientist Alexander Fleming (who’d forgotten to throw out his experimental plates before going on vacation), and a happy ending for humanity who suddenly had a new ally in the war against the microbial invaders.

There are darker tales too…

Dystopian scenarios introduce us to a world in which the scientific discovery feels like an already open Pandora’s box. One of the things that emerged from this box recently is gene editing, a technique that allows changing the genomes of species from mosquitos to humans in an unprecedentedly simple way, so simple in fact that you could do it at home with a preordered kit (if you are in a country which hasn’t banned the technology). A group of researchers who had discovered gene editing, the ones who had opened Pandora’s box, called for a moratorium on gene editing early on, before the public or politicians had caught wind of the potential dangers of the technology (we will read a lot more on gene editing in upcoming posts).

In equally dystopian scenarios the scientific discoveries that have protected us from hostile outside invaders that want to hijack our bodies – vaccines and antibiotics – fail due to human unwillingness to behave reasonably.

There are science tales that almost feel like horror stories…

Maybe one of the most gruesome stories of modern science is that of lobotomies, in which a steel spike (the most prominent lobotomist Walter Freeman later changed to icepicks) is pushed into a person’s frontal brain to cure all kinds of symptoms from depression to schizophrenia, often leaving patients devoid of the symptoms, but also devoid of anything that resembled their former personality. Thousands and thousands of lobotomies were performed and the scientific community (or at least a part of it) was so convinced of the merits of lobotomy that its discoverer Egas Moniz, even received the Noble Prize for it.

Next Friday, we’ll start the science fairy tale series with one of the happy Science Tales – a true Snow-White story in which frozen people can be awoken with a kiss (though no dwarfs will be involved)…

4 reasons why science can’t give us the answers during a time of crisis (3/4)

After introducing reasons 1 &2 yesterday, lets discuss two more today. If you haven’t read yesterday’s post yet, and you have a few extra minutes check out reasons 1& 2 there…

3.      Scientists aren’t altruistic robots

Scientists aren’t selfless creatures who care only about doing good for humanity. Though these characteristics might apply to some individuals, scientists as a whole are like any other tribe of human beings. They have to be political to negotiate their way through the demands of the academic system and the funding agencies. A good pinch of narcissism helps as well, it makes it easier to survive rotating around the same research topic for decades, while giving up so much of your free time for often little reward – be it recognition or money. If you attack the scientist’s pet theory, you run the risk of attacking the scientist. If you ask the scientist a question the answer might be driven by more than the hard facts of the data.

4.      Science isn’t free

At least not completely. This doesn’t mean that biomedical scientists are the slaves of the pharmaceutical industry. But there’s a more subtle manipulation at play. Biomedical research costs a lot of money. The math is easy: the more money you pour into a research field, the more people want to study it.

There are different motivations for the pharmaceutical industry, government and private foundations to dedicate funds to certain research areas. One such motivating factor is the urgency of the topic. The concentrated funding effort into research on HIV/ AIDS has turned the disease from a death sentence into a manageable and maybe even curable condition. Unfortunately, other motivations for choosing where funds are headed are less humane. The pharmaceutical industry focuses on areas where money can be made. The funds that go into antibiotic research for example are so limited that we’re running blind-sided into an approaching catastrophe of antibiotic resistance.

Private foundations like the Bill and Melinda Gates foundation are trying to rectify this situation by donating to causes that have little prospect of creating revenues, including infectious and rare diseases. It’s a thing to be grateful for, but this type of funding oligarchy induces another kind of bias.

The understudied areas in biomedical science are those were we lack the answers most urgently and the Corona pandemic might be a wake-up call to seek answers in a societal effort.

So, let’s get back to our original quest: what are the correct answers to those questions?

An honest answer from a scientist, to a question like ‘Does a facemask protect against the virus?’ might sound something like: ‘I have evaluated three studies and none of them has gathered sufficient data to answer your question. There are probably three other studies I don’t know about.’  OR ‘I don’t have time for this, I’m busy with a private feud with one of my coworkers in the laboratory who wants to be first author on my paper.’ OR ‘I can’t tell you, there’s no money in this field of research because no one has cared about it until three months ago.’

That’s not what you want to hear the scientist say, and it likely won’t be the answer in an interview.

But maybe not having simple answers to complex scientific questions (even the crisis questions) isn’t that bad, as long as we manage the expectations of what we can deduce from scientific data (a single study in ten patients usually does not hint to a new wonder drug) and as long as everyone applies their own common sense (don’t try the supposed wonder drug until it’s proven to be safe). 

The problem is that in science – and in life – things are rarely as easy as we’d like them to be. 

4 reasons why science can’t give us the answers during a time of crisis (1 &2)

‘So what is the correct answer to this question. You’re a scientist, you should know!’

Should I? I’ve been a biomedical scientist for years. Still, I could name only a few scientific questions to which I know the correct answers. Among the questions that I, like so many other scientists, can’t answer with certainty are:

The big questions: ‘Will we find a cure for cancer?’ OR ‘What’s the origin of the universe?’ OR ‘How do we stop climate change?’

The questions beloved by media: ‘Will eating butter kill me or was that margarine, or maybe both?’ OR ‘Will drinking a glass of red wine ward off heart disease?’ – I mean wouldn’t it be nice if butter and wine were good for my health – even if I might drink two glasses on occasion?

The crisis questions: ‘How does the Corona virus spread?’ OR ‘Am I protected from the virus by wearing a facemask and protective gloves?’ OR ‘How long does it take to develop a vaccine or drug?’ 

What are the correct answers to those questions?

While many scientists voice their opinions, the media, the politicians and the public aren’t always happy with the answers - too vague, too many contradictions, too many maybes.

There are many reasons why science doesn’t provide easy answers to complex questions. Here are four of them:

1.      The results of scientific studies aren’t facts set in stone

Science works by hypothesis generation, followed by falsification of the hypothesis, followed by new rounds of hypothesis generation and falsification (yep, it does get tedious), until we reach a hypothesis that sticks. The method of falsification is the scientific experiment. If we want to believe the results of such an experiment, we need to be sure they’re more than coincidence and that they aren’t driven by bias. Any study, no matter how perfectly designed, no matter how ethically pristine will contain a certain bias.

Only if different researchers do the same study again and again and find the same results, do we really believe the hypothesis.

Therein lies the problem.

If you do the same study over and over, you will get a variety of different outcomes, some supporting the hypothesis, some contradicting it. So if you ask a scientists a seemingly simple question about a hypothesis (like if wearing a facemask protect you from a virus), you might get a variety of answers, depending on which study the scientist believes in and if the scientist in question even knows all the studies that are out there.

2.      Not all scientific data are being recognized

Which brings us to the next problem. The fact that the scientist has done the experiment and found the results doesn’t mean the scientific community recognizes them. If the results are negative, the scientist will often choose not to publish them at all. And even published data simply disappear into the vacuum of the scientific publication landscape. Maybe the theory sounds too crazy, maybe the scientist is not in the right place at the right time, maybe the advocates of the opposing theory are too powerful.

And then there is the question of the sheer number of scientific publications. Not even the most experienced expert in a field will find the time to read all the literature on a certain topic. You could try, but it might take more than a lifetime.  And that wouldn’t leave any time for experiments, or sleep, or a glass of wine with friends…

Tune in again tomorrow for reasons number 3 and 4…

Searching for the magic bullet – high hopes, desperate measures and bitter disappointments

Searching for the magic bullet

An infectious lung disease spreads across Europe. The disease can be transmitted through the air – you can catch it if the person next to you coughs or sneezes or just talks.

Nope, not Covid-19.

Tuberculosis in the 19th century.  

Tuberculosis has been around for as long as humans existed. But after the industrial revolution, the disease tightened its grip on newly urbanized Western Europe, until it turned into a real pandemic. While there was some air of tragic heroism created around the victims of the ‘romantic disease’ – how can you not cry when Mimi dies in La bohème - in the end there is nothing heroic about it. Tuberculosis was (and in many parts of the world still is) nothing but an ugly, life-threatening lung disease.

Just like we hope to find a drug or a vaccine for Corona virus/ Covid-19 – a magic bullet that will rid us of the threat the disease poses to our lives, our livelihood and our freedom once and for all - the people of the 19th century were hoping for a cure for tuberculosis. And like us today, they wanted their magic bullet sooner rather than later.

Lucky for them, the scientific world had just been turned upside down by the discovery that many diseases are not caused by internal imbalances of the bodily humors but by tiny, hostile invaders – microorganism. In the 1880s, the German microbiologist & physician Robert Koch found the bacterium which causes tuberculosis - Mycobacterium tuberculosis (for some reason we scientists can’t resist writing the Latin species names in italics, since that’s the way we learn it at university).

A little competition is good for business

In the newly founded field of microbiology, there were two titans, the French Louis Pasteur and the aforementioned Robert Koch. The two men were locked in a scientific wrestling match for large parts of their careers, trying to trump the other’s successes, trying to be the first to make the discovery. If you want to win a race, sometimes you have to take risks.

They did.

Pasteur vaccinated children with an untried rabies vaccine. He was lucky, it worked.

Koch developed a supposed wonder drug to treat tuberculosis and in 1890 let it loose on the public. He wasn’t as lucky as his French colleague, the concoction he sold under the name tuberculin didn’t cure Tuberculosis.

History forgave him this epic failure. He was awarded the Nobel Prize in 1905 and he is remembered for his successes and not for this one big screw-up. The question is if his contemporaries, who’d been treated with the ineffective drug forgave him so easily.

Giving him the benefit of the doubt, I would say that Koch meant well. His biography does not give the appearance of a mountebank, a scientific scam artist who’d set out to cheat his patients. He had good intentions. But he became impatient.

The Principle of Hope

Good intentions can take you a long way.

Hope and daring can take you a long way.

But they can only take you so far. 

If you read the news today you see scientists and pharma representatives and politicians (and plenty of other people who feel the need to voice their opinion) speculate passionately about the earliest release date of a vaccine and about the potential miracle drugs (and some other scary ideas we’d rather not discuss here).

Vaccine development usually takes years up to decades. To show the vaccine works, you have to vaccinate a healthy person and wait until that person encounters the pathogen in the wild. An alternative are so-called challenge trials – in which volunteers are exposed to the pathogen in an experimental setting. In the case of Covid-19, with its unpredictable effects in different individuals, this approach is ethically questionable.

And, there is no guarantee that any of the vaccines candidates under scrutiny will work. Two of the most promising candidates are the vaccines from moderna and BioNTEch/ Pfizer. Both companies rely on the so-called mRNA technology and have seen a hype even before the Covid-19 pandemic, reflecting the hopes set in the technology.

But hope doesn’t have to mean success.

Another contester is a DNA vaccine from the University of Oxford, which like the other candidates is still in early stage development. Nevertheless, the ‘Vaccine king of India’ (to be honest, anyone who’s called the King and who isn’t Elvis makes me suspicious) is starting mass production of the basically untested vaccine.

Hope is good. Hope is necessary. But hope isn’t enough to will a miracle drug or vaccine into existence. And there is a fine balance between necessary daring, and using people as guinea pigs for untried concepts, as Koch and Pasteur did.