“There is no such thing as The Science” – an interview with Robert Winston
“If I go for a walk in the park, what’s my risk?” asks Professor Robert Winston. He is midway through an impassioned list of Covid-19 questions he believes politicians should be investigating and explaining to an anxious public.
Lord Winston – made a peer in 1995, renowned for his extensive fertility research and as the host of a dozen TV documentaries, including Child Of Our Time – has caught me off-guard by returning my call. When I left a message with the assistant of the celebrity scientist, I wasn’t expecting him to just phone me back.
He is thoroughly understanding, charming, and surprisingly willing to chat about everything from lockdown measures in Israel to which ancient manuscripts could have survived had the Library of Alexandria not perished.
What follows is the most wide-ranging interview I have ever conducted. Our conversation darts from subject to subject as my pre-planned questions are cast by the wayside – which doesn’t matter, because what he’s talking about is far more interesting.
Asking about scrutiny of the government’s coronavirus strategy sparks a fervent defence of the House of Lords as a mechanism for democratic accountability, and an anecdote about how a Lords rebellion changed government policy on terrorism detention. And a question on whether we might see a post-pandemic baby boom (Professor Winston is, after all, an expert in fertility) becomes a conversation about the poor understanding the public has around IVF success and his scorn at clinics misleading hopeful couples.
But certain key themes do emerge. Winston is on a mission: to increase public engagement with the science behind this crisis by getting politicians to explain the most pressing issues in terms which normal people can understand.
“Why does it take so long to get a vaccine?” he asks, as if ticking them off an inventory. “What’s the risk of transmitting the disease if I touch somebody else’s newspaper? Do I need to wear a mask, and if so does it really protect me?”
Those are some of the practical questions, but he also wants this nationwide science lesson to go further.
“What is a virus? How do animals get infected by viruses? Why do we need to have viruses at all? Are they wholly bad?
“And to put it in context, what sort of virus is the one causing Covid-19, and why is it so threatening? What are the issues that we need to understand to make it tameable?”
That sounds like a lot of complexity for even the Scientific Advisory Group for Emergencies (SAGE) to get their heads around, let alone the members of public, some of whom (myself included) struggle to remember basic school biology. So far, the government’s messaging has been less about elucidation and more sloganeering: Stay Home, Protect The NHS, Save Lives.
In such confusing times, with a multifaceted crisis of this scale, is there really space for MPs to adopt this level of in-depth public engagement?
“It’s a mistake not to recognise that people understand much more than government is prepared to admit,” Winston warns. “Humans are by nature inquisitive and intelligent. This is the most intelligent species on the planet – and it’s not really confined to the House of Commons.”
That doesn’t mean the answers are straightforward. In a media landscape where everyone seems to think it’s obvious what the government should be doing (and even more obvious what it should have done), the Professor is refreshingly frank about the dilemmas facing our leaders.
“Boris Johnson has a difficulty, because he understands that saving the economy and saving lives are very conflicting ethically here,” he explains. “Our ethical responsibility is to save lives. The trouble is, if you don’t save the economy, do you in fact cause more deaths? These are things which politicians have to grapple with, and I don’t think it’s an easy decision.”
But while Winston is clear that it is not his job to advise on policy, he has little sympathy for the tendencies of politicians to over-simplify and refuse to acknowledge uncertainty.
“If you don’t know, say you don’t know. That’s the right thing to do. We can only understand things by not knowing things. We’re so frightened of failure to understand, but actually failure is really important because that’s how you learn – you learn how to fail, and that means how to succeed after you’ve failed.”
*****
“Failure” is not a concept that politicians like to acknowledge, especially during a crisis that is claiming tens of thousands of lives. While national responses have differed, and no government has got its pandemic response perfect, today’s politics has no time for admitting of error.
The public is therefore greeted to a series of U-turns – on lockdown, on testing, on the efficacy of masks – that can be difficult to reconcile with the official insistence that the government is doggedly following “the science”.
According to this scientist, this is a misguided and even dangerous way of looking at the world.
“There’s no such thing as scientific truth,” he tells me. “Anybody who has mingled with scientists knows that they – like anyone else – disagree with each other. That’s what we do. We have to disagree, we have to be sceptical. When somebody publishes an article in a journal, people like me are sceptical. We read it, and we say ‘well actually, what’s the problem? What have they missed?’ We’re not suggesting there’s cheating, but suggesting they might have misinterpreted what they’ve seen. That’s how science goes.”
Indeed, there has been vast variation in epidemiological modelling, from the infamous Imperial study which estimated 250,000 deaths in the UK if the virus were allowed to spread unchecked, to the Oxford research which suggested that 68 per cent of the British population had already had it.
And that’s only in the UK. Other countries (notably Sweden) are taking a radically different approach to combatting the pandemic, while scientists across the world have found conflicting evidence on all kinds of topics: whether recovered patients can be reinfected, the risk to and from children, and the efficacy of certain treatments such as hydroxychloroquine, to name just three.
These days, it’s a challenge to find much that the experts do agree on. It’s enough to shake anyone’s faith in empiricism. Winston, however, is sanguine.
“My big quarrel with Richard Dawkins is that he believes that science is the truth. It’s not. It’s a version of the truth, because the truth does change. And it changes partly because we argue and reflect and dissect it. We find out things that we didn’t know before.
“So when Neil Ferguson (who is a colleague of mine at Imperial) gives advice to Cobra, it’s his best estimate. Now, being an expert, his guess is likely to be very good, but it’s not proof. It’s an opinion based on what he knows, and his judgement.”
And so we return once more to the issue of science communication, and how much of this thorny ambiguity people can really be expected to understand. Honestly admitting “we don’t know yet, but we’re doing our best to find out and will update you when we know more” is a high-risk political strategy, and could undermine confidence in the graphs and charts presented by medical officials at the government’s daily press briefings.
But on this, Professor Winston is unequivocal: it isn’t just a matter of trusting the public, it’s about earning their trust in return.
“If you don’t trust the public, they won’t trust you,” he says. “We should treat the public as intelligent.”
*****
It is hard to recall another single issue dominating the global media for so long in the way that Covid-19 has done. Even the 9/11 terrorism attacks and Princess Diana’s death did not consume every western news front page for two straight months. We are, as we are reminded daily, living in unprecedented times.
So while Professor Winston’s perspective on the scientific developments of the coronavirus crisis are fascinating, it’s an unexpected relief to hear him zoom out and take a more holistic view of what’s going on.
“Things like Covid-19 have been going on in human affairs ever since history began,” he reminds me, before launching into an analogy about the Black Death of 1347. It’s a comparison many have made, mostly in examining morality rates, but he has a different point.
“The Black Death was the result of human ingenuity and human technology,” he explains, referring of course to shipping, which brought the Yersinia pestis bacteria to our shores via flea-ridden rats. Today’s pandemic is the result of similar ingenuity and technology, in the form of the aircraft, which “brings us into contact with pathogens we’ve never encountered before” and enabled Covid-19 to spread across the world before we even realised what it was.
The response from governments of all political stripes – from the “America First” isolationism of Donald Trump’s administration, to the “open borders” ethos of the EU – has been to turn inwards. Stop the flights, close the borders, focus on our own.
Of course, by that time, it was already too late.
Indeed, Professor Winston is scathing about the attitude of western governments towards pandemic preparation, pointing out that we’ve been here before. The first known Ebola outbreak, for example, was in 1976 in South Sudan. But western governments only started paying attention to it nearly forty years later, when an outbreak began spreading widely and rapidly enough that there was a risk of it being transmitted via aircraft to the rest of the world.
Lessons, it seems, were not learned, and we are now suffering the consequences. And now we need to look forwards as well as back. Even if Britain is able to get its own epidemic under control, there will be a continued risk of further outbreaks here if Covid-19 is allowed to run rampant across less developed parts of the world, where health systems are unable to cope.
So rather than this pandemic sparking a trend towards more isolationism, Winston believes that the key both to tackling this crisis and to future pandemic prevention is greater global cooperation.
“One of our duties at the end of this, once we’ve got our wits together, is to recognise that we’re going to have to spend a lot of time trying to help the developing world,” he warns. “Because if we don’t, we’re going to have a real problem on our hands. It’s for our own safety, as well as theirs.”
*****
Globalisation, and whether it can survive this pandemic, is just one of the topics that has been under the media microscope when we try to envisage what life after Covid-19 might look like. The list is long. Is the era of convenient long-haul air travel over? Has the idea of the “working week” fundamentally shifted now that working from home is not just commonplace but essential? What has our reaction to this pandemic taught us about how we connect with others and the fundamentals of social interaction within our communities?
Technology lies at the heart of such issues. As face-to-face contact has been eliminated from our lives, the digital realm has stepped up to fill the void of social distancing. As such, tech concepts and companies that were treated with increasing mistrust until very recently have now become our saviours.
Should we be worried about our overnight embrace of all things Silicon Valley? This time last year, remember, the World Health Organisation was issuing dire warnings about children and screen time, cautioning parents not to allow children under five more than an hour a day looking at any screen, regardless of what was on it.
Leaving aside whether this was the best use of the WHO’s energy and resources, times have certainly changed – and Professor Winston is embracing it.
“At 4 o’clock every afternoon, I will get a call from Ruby, age three, in California. It’s a fantastic technology,” he says excitedly, pointing out how unbearable lockdown would be if we didn’t have FaceTime and Skype to stay connected with friends and family.
“We are so suspicious of the wrong technologies. We think that social media is really dangerous, that our children shouldn’t touch it. But it’s obvious that there are many aspects of social media that are really useful to humanity.”
And interestingly, he sees hidden benefits to the Zoom revolution in the unlikeliest of places: medicine.
“Medicine is not about manipulating molecules,” he tells me. “For most people it’s not about very clever, difficult, complex treatments. It’s about understanding what the patient is feeling.”
The NHS, he says, has for a while now been at risk of getting too “technologically complex”, obsessing over miracle innovations like “personalised medicine” (where treatment can be tailored to individuals based on their genome) and forgetting to consider the patient as a person.
“In my view, ‘personalised medicine’ is actually impersonalised medicine, because what you’re doing as a doctor is not looking at the patient’s face, but looking at the computer screen in front of you.”
After six weeks of lockdown, with non-Covid patients avoiding physical healthcare settings, the situation looks somewhat different – at all stages of the healthcare process, but especially in General Practice. GP surgeries that have for years resisted the idea of video or phone appointments are finally embracing this technology, and have moved almost entirely online. Not only is it more convenient for patients (as evidenced by the success of the health tech firms that have offered private virtual GP appointments for years), but the lack of physical contact could, paradoxically, bring doctors and patients closer together.
“Suddenly Zoom and Microsoft Teams and the others will make a massive difference to the way we communicate with our doctor,” Winston predicts. “It could well be that doctors actually look at the face of the patient much more on a screen than they ever did before. And a patient who sees the doctor not looking at them will quite rightly feel very disturbed and will probably say so.”
It’s a counter-intuitive view, and an unexpected one from a high-profile member of the medical establishment. But I wonder whether he might have a point. As we are all experiencing now, when physical proximity isn’t an option, humans adapt to signal their engagement in other ways. You can’t text on your phone while on a Zoom conference call in the same way you might in a normal meeting. Rather than driving us into our own individual bubbles, is the shift towards virtual life actually forcing us to properly listen to each other?
I’m not sure I’m convinced, but if life does ever return to some semblance of normality, I’ll be first in line to sign up for virtual doctors appointments.
*****
So what comes next in terms of this pandemic? Trying to pin Professor Winston down on whether there is any cause for optimism proves difficult. He discusses at length the medical community’s patchy understanding of microbes and viruses, and why finding a cure for diseases is such a challenge. One just as big, he believes, as tackling climate change.
“Of all the areas of medical specialisation, the most complex by far is immunology,” he notes, before listing instances of how these microscopic enemy hordes have disrupted human civilisations, from the Plague of Athens (possibly viral – we still don’t know) to the Spanish Flu, which killed more people than the First World War.
Classics, in fact, keeps cropping up in our discussion. Like me, Winston proves to be a huge fan of the Roman poet Lucretius, who set his thoughts about the scientific origins of the universe and atomic theory into elegant didactic verse.
“Lucretius got it right so often,” he enthuses. “The idea of infinity, the idea of atoms, the idea that once we die, that’s it – you’ve got to die, so why worry about it? He comes up with the most elegant ways of expressing the basic human frailty.”
One of the key themes of Lucretius’ De Rerum Natura (“On the Nature of Things”) is that death is both inevitable and final, and the key to human happiness lies in accepting this hard truth. This will not necessarily be the most comforting sentiment at a time when death counts are released each day and plastered over every news outlet.
But then, perhaps there is optimism even in inevitability. The human race has faced existential crises for as long as it has existed. And yet, 200,000 years on, here we still are.
There is so much to feel depressed about at the moment – the scale of this pandemic, the uncertainty of what comes next, and the refrain from politicians and scientists alike that there is no “going back to normal” after life has been fundamentally changed by the virus. With summer on the horizon, we are still asking “if I go for a walk in the park, what’s my risk?”, and seem as far away from a satisfactory answer as we were in March.
Still, next time I feel overwhelmed by anxiety, I will think first of Lucretius, and then of Professor Winston’s hopeful reminder of the ingenuity and resilience of the human spirit: “There’s never been an organism that humans haven’t found a strategy to deal with.”