key: cord-0799828-yqkvkd70
authors: Glick, Michael; Wolff, Mark S.; Carrasco-Labra, Alonso
title: COVID-19 and scientific illiteracy, a syndemic
date: 2021-10-09
journal: J Am Dent Assoc
DOI: 10.1016/j.adaj.2021.09.013
sha: 4342ab48b27e437650e12b1240bdf57b27f2aaf1
doc_id: 799828
cord_uid: yqkvkd70

nan

J o u r n a l P r e -p r o o f

It might be too early to reflect on all of what we learned from the COVID-19 pandemic, but some issues are apparent and must be addressed. Misinformation and disinformation about COVID-19 are rampant, and unless we start to combat misinterpretation and misunderstanding of science, the dire consequences we experience today due to this infodemic, such as refusal to wear masks or acceptance of COVID vaccination, will prevail. The World Health Organization has characterized an infodemic as a plethora of "deliberate attempts to disseminate wrong information to undermine the public health response and advance alternative agendas of groups or individuals." 1 There is no single root cause to this unprecedented phenomenon. Still, it stems from an accumulation of circumstances, including easy access to scientific and non-scientific information, the enormous and rapid proliferation of peer-reviewed and non-peer-reviewed articles and other publications about COVID-19, thriving social media platforms, conspiracy ideation, and politicization of science. Interestingly, although scientific skepticism is not uncommon, some underlying causes are starting to emerge and coalesce in different countries and across communities and cultures. 2 A syndemic is traditionally defined as interactions between concurrent epidemics. During a syndemic, these interactions, which are usually explored from a biological perspective, will increase the burden of disease. However, we contend that widespread scientific illiteracy will result in adverse disease outcomes and should therefore be recognized as part of a syndemic. As scientists, health care professionals, and educators, we can and should be a trusted resource to J o u r n a l P r e -p r o o f persons in our communities lacking our education and training. However, introducing, teaching and informing the public about scientific literacy is a difficult undertaking.

Merriam-Webster defines science as "knowledge about or study of the natural world based on facts learned through experiments and observation." More importantly, science is a process or a journey that generates provisional knowledge waiting to be disproven to glean the everelusive "Truth." This process is one of the most sophisticated and comprehensive system ever developed by humans to reach a consensus about what we consider, from a scientific point of view, a "temporary truth." The scientific methodology is full of proving and disproving, methods improvement, rectifying previous findings, and replicating the prior conclusions all over again.

This journey, quite familiar for researchers, has until now been mostly obscured to the public.

Science advocates often highlight the value that the scientific method brings to the table from an objective truth point of view; however, they rarely ever discuss the process to get there with those less familiar with this journey. In the last year, the non-scientific community has witnessed the scientific world going back and forth assessing available evidence for policy and clinical decision-making. At first, suggesting that an intervention could provide a benefit, then seeing that, as data accumulated, scientists moderated their confidence or frankly conveyed a different conclusion. As researchers, we learn to accept uncertainty yet strive for certainty. This is not an easy task for non-scientists. Unfortunately, much misinformation comes from peoples' inherited unease when not in control and a want to attribute cause rather than accept uncertainty. The public needs to understand and trust that this very journey, and the willingness to continuously revise scientific findings, is what makes science so uniquely powerful. 3 

Unfortunately, negative attitudes and distrust have been shown to be associated with belonging to ethnic minority groups, lower levels of education, and lack of regular access to health services often due to low incomes. 4, 5 Scientists know not only how to analyze data but also how to synthesize these data into practical applications. These are skills often lacking in people without scientific training.

Furthermore, interpreting the scientific literature is a science in itself and a complex skill to learn. 6 Obviously, this is not expertise we can expect from non-scientifically trained individuals, but one we should expect of all health care professionals executing on a responsibility to increase people's scientific literacy.

We must shoulder a responsibility to correct and fight misinformation -false information that is false, but communicated without an intent to cause harm, disinformation -false information with an intent to discredit a person, a political or social group, organization or even a nation, and malinformation -the intentional use of data based on reality but taken out of context to inflict harm or incite discord. The Dunning-Kruger effect -a cognitive bias where individuals with low ability continuously overestimate their ability resulting in an illusory superiority phenomenon -is rampant. We must encourage organizations, such as the oral health research organizations, national dental associations, and dental educational associations to organize and provide more and better education on how to shape clinicians who can become agents of scientific literacy, how to address false scientific claims in a way that is respectful yet effective and persuasive.

Scientists and clinicians should recognize and embrace being a scientific resource and communicator. They should be on a mission to advocate for protecting society from misguided claims and nefarious intentions, which are not scientifically based and may be conducive to harm. It is critical for the scientific community to recognize how and where non-scientists, the public, glean and consume their information. The public does not always validate the source of information as refereed and non-refereed. Information may be found by "googling ," reading a blog or a "tweet." As scientists, we may be reluctant to comment on information found on social media, yet we must develop strategies for communicating clearly and concisely to refute misinformation and disinformation. If we leave this information in the "echosphere" unrebutted, it takes on the ethos of fact in the minds of those less informed. Being a scientific resource and communicator should be an integral part of our social contract as health care professionals.

Science skepticism across 24 countries

Public perceptions of scientific advice: toward a science savvy public culture? Pub Health

Attitudes towards vaccines and intention to vaccinate against COVID-19: Implications for public health communications

Missing the point -How primary care can overcome Covid-19 vaccine "hesitancy

A march towards literacy