Prof. Enrico Bucci: "Science is our weapon against COVID-19"

Since the start of the COVID-19 pandemic, Prof. Enrico Bucci has been vocal in support of research and scientific knowledge, something he views as the only solid basis for combating SARS-CoV-2.

Interview with Prof. Enrico Bucci

Prof. Enrico Bucci, Adjunct Professor at Temple University in Philadelphia, is an expert in the analysis of scientific data, with an emphasis on their integrity. Even during the COVID-19 pandemic, his voice is raised firmly in support of research and scientific knowledge: in his view, the only solid basis for combating the SARS-CoV-2 infection.

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esanum: We are living through a pandemic caused by a new virus, causing a new disease. Using the metaphor with which you open your essay "Bad Scientists", we woke up one morning in February, flipped the switch, and the light didn't come on. We called the electrician, who was in trouble because such a failure had never happened to him before. Several months have passed since that February morning. What is the situation today? What does the electrician have to do to “fix the issue”, and what do we have to do while we wait?

Prof. Bucci: Today the electrician knows much more about the fault than in February 2020, but even then “the electrician” was not completely clueless. We now know exactly what kind of virus we are dealing with, we know how it acts, we know it in terms of its genome to a greater extent than we know a great many other viruses. Moreover, we have known for a long time how epidemics behave, and precisely we are aware of which triggers are stochastic and chaotic, so that it can take months for a virus circulating under the radar to manifest itself again.

The real problem is not that we do not know how to identify the fault and how it happened. It is a fault for which we do not yet have a suitable tool to repair it. But we do have some tools that can help us. Many things have improved since February 2020. In particular, we now have ways of reducing mortality with remdesivir, with dexamethasone, with tocilizumab in certain conditions. Other drugs are on the way. Moreso we have much improved procedures in terms of hospital admission criteria. Even from the point of view of health surveillance and diagnosis, we are not in the same situation as a year ago. Today, our electrician can tell us whether there is a fault or not.

The main mistake we are making, which we have been doing so since the start of the pandemic, is that instead of relying on an electrician, we are calling dozens of technicians to our house. Not only electricians, but also plumbers so to speak. We act as if we don't have a reference for specific problems and call anyone who seems to have some technical expertise. In Italy we do not have a single scientific body to refer to, a unified voice that takes precedence over all the others and has indisputable authority, based on a scientific background. In other countries this exists, but not in Italy. In Italy, we improvise, so we have three different bodies doing analyses and providing data: the Ministry of Health, the Istituto Superiore di Sanità (Italy’s National Institute of Health), and the Protezione Civile (Civil Defence). 

Not only that, but these data come from different regions that use different methods of collection and transmission. We have created enormous confusion, not only in terms of communication, but also in operational terms. This leads, for example, to the perpetual delay of every action, which is obsolete even before it is put into practice in the field.

It is not that we have not accumulated knowledge. It is that we have not clearly identified who within the scientific community should formulate a strategy. The Italian Scientific Technical Committee (Italian acronym: CTS) itself is an advisory body, whose powers are not clearly delimited, and whose composition has not originated from a selection based on a scientific background. It is a body created out of the blue, with an advisory function, where politicians have chosen who to include. Nothing like the scientific boards of bodies such as the Hans-Knöll-Institut (Germany) or the National Institutes of Health (USA).

This situation will also be reflected in the near future. What we are experiencing will not in fact be the last wave of this virus and this will not be the last virus we will have to deal with. In Italy we do not have effective tools to deal with health emergencies. Our Civil Protection has expertise in managing various types of disasters, but shows that it has no competence in health emergencies. Entrusting it with the management of a pandemic, in these conditions, is risky. Also in view of the fact that, over the years, Civil Protection has become a sort of dependency of the Prime Minister's Office and acts with the power of ordinance, free from the control of Parliament and the President of the Republic.

We suffer from a very bad organisational design, practically improvised, of the machinery that has to manage an emergency of this kind. It is the same machinery that also creates that communicational disorder that leads citizens to stop listening to strange, incomprehensible numbers, given by different sources, and to look for their own experts on Facebook, whether it may turn out to be a professor of virology or some improvised fraudster.

 

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Prof. Enrico Bucci

esanum: Do bad scientists bear any responsibility for the fact that, in managing this pandemic, policy-makers often give the impression of being in the dark and ineffective? Have bad scientists made science less authoritative, thus indirectly causing some of the political mismanagement of this pandemic?

Prof. Bucci: The problem lies in the willingness of bad scientists to meet political expectations. Very often a bad scientist does not know that he is a bad scientist, unless he is a real fraudster. There is no shortage of fraudsters, such as the Nobel Prize winner Luc Montagnier or others who give speeches in the Chamber of Deputies. But the problem is not so much these as bad scientists who do bad science mainly because of their own bias, not because of fraud. There are a lot of them, particularly in the field of biomedicine, fewer among physicists and chemists. There are many more among biomedical scientists because of a training problem, precisely because of poor training in the scientific method and the quantitative method of analysis. The availability of a wide choice of bad scientists allows the politician to always find the scientist who can confirm an expectation of his voters. 

The bad scientist is therefore useful for the politician to gain consensus. This mechanism remains in place as long as the politician can choose the scientist from time to time. This is very wrong, but in Italy it is the norm. All this proliferation of committees, not only of the CTS, the various regional coordinations, and the various advisory bodies, come about precisely because politicians shop around for the scientists they like best, only to abandon them when they are no longer needed. At a time when people expect an answer from science, politicians use these bad scientists to support their own political agenda and to gain consensus.

Since there is no organisation, no institution that firmly expresses a scientific consent, then one can turn to committees, curating them for the occasion and maintaining them for the time necessary to gain consensus. In this sense, all scientists who lend themselves to this kind of mechanism are bad scientists. They are bad scientists not because they are bad people or because they work on bad scientific publications, but because they forget that the relationship between science and politics must be based not on individual advice, but on individual advice as an expression of collective consensus. Determining what the collective consensus is during an emergency such as the pandemic we are facing requires analytical skills that very few scientists have at the moment in Italy.

esanum: Does that mean that there were more 'bad scientists' than good scientists during the pandemic?

Prof. Bucci: Bad scientists prevailed on the scene. Behind the scenes, fortunately, good scientists still prevail, and by far.

esanum: In your essay, you described the distorting factors that can derail scientific discussion and push research in the wrong direction: 1) the role of the scientific publishing market; 2) the possibility offered to any researcher to communicate directly with the public; 3) university training that no longer provides the "general intellectual framework in which to carry out scientific reasoning"; 4) the effect of the politicisation of scientific debate. Which of these factors has played the greatest role during this pandemic and why?

Prof. Bucci: In this situation, the factor that has prevailed most and that has caused science to lose credibility is undoubtedly the proliferation of publications. The publication system and the publishing market on the one hand, and on the other the fact that to support this system we have created a criterion for evaluating scientists based on the number of publications and the amount of citations they receive. These two elements are now inextricably linked and this has led to a gigantic explosion of poor quality publications. This explosion, in turn, makes effective filtering impossible, thus increasing the amount of real rubbish that is published even in prestigious journals.

The already less-than-excellent control over what is published has been broken. Everything has been published, and we have even had to read an editorial in Nature which states that the journal will also deal with politics. This is a dangerous initiative in my view, because it is a misrepresentation of the role of the scientific journal. There is a communicative bulimia on the part of the journals, made up of both opinion articles and a very high number of scientific pieces, or supposedly so. The prevailing idea is that something new must always be published, putting the focus on a deeper assessment of the material for publication in second place.

 

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"Cattivi scienziati" (Bad Scientists) by Prof. Bucci

esanum: What is the state of research at the moment?

Prof. Bucci: The research sphere’s “immune system” has reacted quite vigorously, so much so that the number of retractions, even in very important journals, has greatly increased. In addition, the time between a report and a retraction on COVID-19 has become very short. The immune system based on online collaboration between scholars that are checking data is working. Its existence has protected us from articles based on false data published by "The Lancet" or those on the Russian vaccine. This system is working quite well, but it is not enough to produce good science. It is one thing to counteract the bad science that is published, focusing on the most egregious cases, and quite another to discourage this explosion of bad science.

In order to do this, we need to decouple scientific publication from the evaluation of researchers. We have to stop encouraging researchers to publish anything so that they can gain citations, advance in their careers, and get funding. Another point that I think is really important is the need to imagine that the process of reviewing scientific articles becomes a recognised activity for the researchers themselves. It would be really important then to have a public review process, so that the community can read the objections raised by the reviewers, even after the article is published.

To improve the science that is published, we should act vigorously in two directions. First, facilitate open, public, recognisable and incentivised peer review. Then stop using the number of publications and the number of citations as an automatic evaluation criterion, which is often done in Italy.

esanum: In this period, many pre-print articles are being published. What do you think? Is this good for science?

Prof. Bucci: Scientific studies should only be disseminated before peer-review among researchers. It is not sensible for a preprint article to be put in the hands of the public and journalists.

esanum: What do you think about the pandemic being discussed on social media? In September 2020, you wrote a post on your Facebook page announcing a stop to discussions. What happened?

Prof. Bucci: I used my Facebook page to disseminate content and to engage in discussions with the users of the page. For the past month or so I have stopped participating in discussions, I just post content. It is not possible to engage in discussions with people who have no intention of following any rules of engagement. Most of the discussions with high participation also brought together ill-intentioned participants who had no desire to engage with those who ran the page. So there is no point in discussing. 

When the interlocutor raises the barricades, defends his position and does not yield anything, then the discussion is just a waste of time. We have reached the point of outright denigrating treatment by some participants. This was an unacceptable situation for me. On a page that is followed by 30,000 people, we cannot tolerate that everyone feels entitled to write whatever comes into their head in the name of some unidentified concept that supposedly is democratic practice, even if insensitive. It became no longer a question of disseminating information, but of engaging in even aggressive confrontational modes with people who may be even their own colleagues. Some have the primary intention of discrediting the person, not the ideas.

esanum: Only a vaccine will save us from this pandemic. You have written a lot about the Russian vaccine story. What does this story teach us?

Prof. Bucci: The story shows us the difference between research carried out in a liberal, western system, where a single side effect in a trial involving tens of thousands of people blocks the clinical trial until further research is done (as in the case of AstraZeneca), and research carried out in a completely closed system, where no data is accessible. This is research that violates every rule in the scientific community regarding the sharing and discussion of data. Research that is also highly politicised.

On the one hand we have a system in which you have to take the word of those who promote the vaccine, those who are ready to inject it without giving any guarantees or protection. On the other hand, we have a system in which a single problem out of 50,000 tests blocks the study until we understand what has happened.

What this case teaches us is that transparency is a non-negotiable value in scientific research itself and then in the sharing of scientific data. Everything that is happening in Russia, as far as I am concerned, is not science.

esanum: Based on the knowledge we have, where do we stand on this pandemic? Do we have to imagine that we will have to live with this virus for a long time, accepting that nothing will ever be the same again?

Prof. Bucci: We are still at the beginning of the pandemic and no one today can know how things will evolve. We will learn to live with this virus, of course. We have learned to live with all viruses. We have eradicated only one: We continue to interact with the others. For example, we have learnt to live with HIV/AIDS, we have accepted the idea of having sex using a condom, which until the 1980s seemed unacceptable. For some religions it still is. The way we adapt to viruses involves a number of elements, not always the same ones. In February 2020 we had to adapt by being completely blindsided amidst the situation, today we have increasingly more tools in our box. We know more, we have a few more molecules (and going forward we will have even more).

Of course, what is also noticeable is maladaptation. One can clearly see a difference between the reaction of Western nations, whose ideal is based on the principle of liberal democracy protecting individual freedom and encouraging the expression of the individual, and that of Eastern nations in which the community is dominant over the individual. The virus is selective in this case.

This explains why there are many more needless deaths in our country, caused by someone's crazy ideas, than in eastern countries such as China, Japan, South Korea. When we talk about adapting to the virus, we must not think about our individual country, but we must think on a global scale. It may be that we will all accept, for example, the idea of having tracking like in Korea, with facial recognition, very privacy-invasive apps. It may be that a part of the adaptation will be not necessarily changing behaviour, but the technologies and environments around us. 

We may have to get used to the idea that, just as we have promoted solar panels to try to reduce our environmental impact, we should also promote, with our taxes, the use in every restaurant of air extraction/filtering systems to live with not only this virus, but with all the airborne diseases we will encounter. The adaptation that saved us in the nineteenth century, the keystone in the management of infectious diseases, was the architectural adaptation in cities, with the rebuilding of sewers, the creation of wide avenues and the improvement of air and light circulation.

We do not now know what adaptation to this virus will consist of. We don't know if it will be the use of a mask or having less physical contact. Something more radical will probably be needed. Consider that we not only have to adapt to this virus, but also to others. We have set up an ideal world for pandemics to break out.

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