Last month, Professor Raina MacIntyre was awarded the Eureka Prize for Leadership in Science and Innovation, an award which particularly recognised her leadership during the COVID-19 pandemic.
You would recognise Raina MacIntyre if you saw her because she has been one of the regular scientific and medical experts on our television screens — and elsewhere — in the last few years.
Her authoritative and fearless observations about the nature of pandemics and how to deal with them always cut through, even in a time when we are all self-confessed and instant experts in epidemiology.
COVID-19 has been a particularly extreme case of scientific debate unfolding before the eyes of a much wider public than normal — with real life consequences for all of us — and a scientific debate supercharged by politics both rational and extreme.
Some of the calls, you would have to say, look spectacularly bad in retrospect. Many looked bad at the time and often seemed like confusing cases of group-think gone bananas.
For example, apart from the fact that there was a worldwide shortage of masks at the time, why on earth did large slabs of the medical and political establishment here, and globally, run with the idea that washing your hands, rather than wearing a mask, was the best way of dealing with a respiratory disease?
A history of epidemics of ‘unnatural’ origins
MacIntyre has just written a book, Dark Winter, which will be released next month, which reflects her specialisation in pandemics, bioterrorism and public health.
It obviously canvasses much about the COVID-19 pandemic: how it unfolded, what went wrong and what went right.
But perhaps the more sobering and alarming reading in the book is about the history and trajectory of epidemics of “unnatural” origins throughout history, particularly by governments of all colours.
Fans of Thomas Kuhn’s The Structure of Scientific Revolutions will recognise some echoes in this book, as might those who live by the rule that “just because you are paranoid, doesn’t mean they aren’t out to get you”. And if you really want to be alarmed, you need to read what Professor MacIntyre has to say about smallpox and its future.
Apart from her history of unnatural epidemics, the picture that MacIntyre paints of the frequent resistance of the scientific community to confronting the evidence that is before it about these episodes is disturbing, to say the least.
For it does open the inevitable question of who exactly we can trust in uncertain times, and also obliges us to always have open minds to alternative ideas, and frameworks for considering them.
“The challenges of ascertaining the origins of an epidemic is partly due to established ways of thinking about outbreaks, but denial of unnatural origins of epidemics is a recurring theme throughout history,” she writes.
“Too often, the basic question of whether a disease arose from nature or from human error or terror is not even posed.”
She argues that the significance of understanding whether a disease emanates from nature or elsewhere is crucial to knowing how to respond to it. Yet, she says, health experts often don’t have the forensic skills to investigate the origins of an epidemic.
Exposing the cause of an outbreak
MacIntyre documents a particular episode in 1984 in which, even after a religious cult admitted to a bioattack in the United States, authorities regarded it as a simple case of bad hygiene in restaurants.
The case “exemplifies the failure of public health when it comes to recognising unnatural outbreaks”, she says.
“All of the elements — the failure to even ask the question as to whether the cause was natural or unnatural, the overriding of clear red-flag evidence with beliefs, and the labelling of anyone who suggested it was an unnatural cause as a conspiracy theorist — proved how hard it is to expose the origins of an unnatural outbreak.”
She speaks of the vested interest in the scientific community in denying — or refusing to believe — that there can be laboratory accidents, lest it put constraints on their future work.
A lot of this can obviously be applied to the question of where COVID-19 came from. MacIntyre clearly falls into the camp that yes, the likelihood is it did spread from a lab in Wuhan but that the evidence suggests this was an accident.
The political weaponisation of the debate about the origins of the virus by Donald Trump and others — and the conspiracy theories — have only made a rational discussion about what actually happened, and what it teaches us about the risks abroad, seem even more impossible.
Which brings us to national cabinet last week and the decision to scrap mandatory isolation periods for COVID 19.
And it’s not the decision so much that is relevant here as the framework in which it was made: that is, a framework where the chief medical officer admitted further waves of COVID were “highly likely”; where more than 80 per cent of the deaths from COVID in Australia have occurred this year and “excess deaths” remain at notable levels; and where we get disturbing new information every day about the long term impact of the disease, including on the functioning of different body organs.
It seems we — and/or our political leaders — have dumped our collective demand for decisions based on the science or medical evidence and are willing to take a chance on what that might mean for health outcomes, and everything associated with them, for the time being.
That’s regardless of the impact on those who remain particularly vulnerable to COVID and/or whose lives are circumscribed by having to avoid it.
Controlling the spread of ideas
Politics is so often a case of dealing with, or sensing, the moment for a change, whether it’s a good idea or a bad one.
For some weeks now, we’ve been watching the government letting the public debate lead it to the obvious conclusion in the budgetary circumstances that the stage 3 tax cut scheduled for 2024 — with its staggering price tag — is just nuts.
Treasurer Jim Chalmers has successfully used the debacle of the UK mini budget to expedite the case for a recasting of those tax cuts, without actually ever making it directly, with all his references for the past week to the cautionary tale the UK provided of what happens when fiscal and monetary policy move in different directions.
Everything that he and Prime Minister Anthony Albanese have said since has taken on the art of “nudge nudge, wink wink, say no more” on the need for revenue to fund massive expenditure needs left over from, and exposed by, the pandemic.
Whenever they decide to actually break cover and announce where we go next, the more interesting question will be how broadly they are prepared to let the discussion go about what we do with tax as an alternative.
Will we just have a discussion about a restructured income tax cut? Seems unlikely.
Controlling the spread of ideas, keeping them as a healthy contagion rather than an out of control epidemic, will be the great challenge.
Laura Tingle is 7.30’s chief political correspondent.