Fauci, Alda: Social media, political rhetoric pushing distrust in science

over the past nine months is this virus has raged

throughout society

There's been a crisis of confidence in science and growing

mistrust in our public science institutions for vaccine uptake to

be successful for the public to accept and adhere to

public guidance about measures that we can take as individuals

to reduce and prevent the spread of SARS

Kobe too And for us to emerge united in the

days passed this global crisis we must find ways to

rebuild and restore public faith in our science institutions to

do so and to discuss how we can move ahead

together we're honored to welcome our distinguished guests for today

Dr Anthony Fauci Mr Alan Alda and our moderator Stanford

Law Professor Hank really will be addressing many of the

questions that you raised for our conversation today

With no further ado I handed over to Professor Greely

Thank you Nita

And good morning from Stanford

Um it's good to sort of see the thousands of

you who are on this show none of whom came

to listen to me so I will not say very

much

It helps that these literally or to people who need

no introduction so they'll get very short introductions from me

in alphabetical order starting with Alan Alda who you may

know as a surgeon with a cutting wit or a

senator from California who I am pleased to say went

to Stanford Law School and graduated

You did very well in law school at Stanford Allen

but you may not know that he has for the

last many decades been focused on science communication improving science

communication both from scientists and to the public

And it's in that role that important role that we

have him here today

And it's in that role also that he has two

entries in the National Library of Medicine's pub Bed Central

the repository of all of the biomedical research done across

the world

Anthony Fauci on the other hand is most important as

the husband of my beloved bioethics colleague Christine Grady from

N

I

H

But he's also since 1980 Forbidden

The director of this thing the National Institute for Allergy

and Infectious Disease on has lived through in that role

everything from AIDS to now see a serc

Evie to Dr Fauci it turns out is also in

the repository of all knowledge about screen appearances

He has 78 credits in the Internet movie database I

M D B

But unlike Mr Older he doesn't seem to have the

great range because in each of those appearances he's playing

himself

Now all I want to do is let these two

guys tell you what they think about trust in science

where it is now and what we need to do

to get it to where it should be

I'm gonna let them talk with very little further introduction

for me for and have 15 20 minutes or so

And then I'll throw in some questions that we've gotten

in advance from the audience

And so gentlemen the floor is yours

Um in either order you want

Well first of all Dr Fauci I'm shocked that you

have mawr entries in the database for movies than I

dio

Sorry Alan this is the end of our love affair

right now

E noticed that you only had like 67 I was

going to mention that but thought No that's a little

too a well

It's a pleasure to be with you again

Let me get you on the screen so I can

see you better

What do you think What This seems to be this

awful fall off of trust in science science agencies

And now at the worst possible time for that when

we're suffering this terrible pandemic how do you think How

do you think we can regain that trust I don't

think it's going to be easy Alan

I think that what we've seen particularly over the last

year uh was kind of the evolution of a manifestation

of lack of trust

That kind of culminates on things that have been going

on for the previous couple of years is that we

have a public health crisis right now and in so

many respects it is evolved in the midst of the

divisiveness in our society the likes of which we've not

seen before and science you know in the sense of

people assuming that science is authoritative people don't like to

be told what to do

They think that science is authoritative in its approach and

you have what's almost an instinctual pushing back on things

that are so obviously scientifically correct and the idea about

using data and evidence from either studies or observations or

other approaches towards collecting data and evidence seemed to be

pushed aside

And what you have is statements and policies and and

attitudes that have evolved that have really almost reached

You know the point that now that we're in this

extraordinary situation of ah public health crisis it had become

very very frustrating where you have such divisiveness that people

are essentially developing their own set of facts as toe

looking as a supposed to the faxes they exist and

interpreting the facts

It's been very frustrating

I don't know why and how that evolved

It's been a gradual process you know

You have anti science that's merged with the anti vax

uh attitude that we have now which I think is

gonna be very difficult if that prevails as we try

to get vaccines for Cove in 19

I think it's a very difficult situation that the only

way that we're gonna be able to get around it

is to try and be open and transparent as we

possibly can when we talk about scientific facts how we

got the fax what the evaluation of the facts are

and the interpretation of the fax and I think that

what you said about people not wanting to be talked

down to or told what to think

I think that's very important and we we don't have

to present science in that way were at the center

of the Communicating Science at Stony Brook University that I

helped start 11 years ago

We've trained 15,000 scientists and one of the main objectives

is to do exactly what you said and what you're

able to do yourself which is to communicate with the

audience with respect with contact personal contact where trust builds

up more quickly and to direct the message based on

that contact what you know about them as an audience

What are they ready Thio here What terms can you

use to convey it to them Those things can be

learned and I think training our spokespeople who do communicate

with both broad audiences and smaller audiences and church basements

and so on

They could be trained to communicate much better and I

think it's urgent that we do that now because you've

got it

You have it naturally

Did you study it or is this just just come

out of your Italian background Oh it must have been

my Italian background

That was They were all natural actors as Italian

Yeah something like that

You know Alan just said something that triggered him

You know I remember

And I totally agree with you is that when you're

trying to communicate science you got to do two major

things that I tell my fellows and the people that

are involved with me here in the N I H

Is that first of all you've got to know your

audience know who you're speaking to and number to know

what your message is

You have to have a defined message and you've got

to know who the audience is because you want to

fashion the message to the audience and make sure that

as you said you don't speak down to them

But you understand who they are

The other thing that I have found very helpful to

tell people is that when you are speaking science to

a group any kind of a group the main goal

is to not impress them as to how smart you

are

The goal is to get them to understand what you're

talking about

And I think one of the problems when you have

scientists communicating with people is that they feel they have

to get very granular and very arcane about what they

say because they want to appear very scholarly

That I think is almost the antithesis of what you

want to do

You want to be able to explain fax in a

way that are easy to understand without necessarily talking down

to anyone

And I think it's easy to remember that three audience

for the most part of broad audience is not going

to have spent their lives studying your subject in the

detail that you've spent your life

So it's they're not stupid for not knowing this stuff

They just haven't directed their attention to it

And you have to go back to where they are

in their general education about this

And it is a mark of respect I think and

connection

No one message is the message for everybody

It's not a question of finding the right words to

describe what you know

It's a question of finding the words that will land

on the person you're talking to and you said that

very well

You also talked

You were speculating about how it began this division that

we have in in the country about science itself fax

There are there are presented now fax that are not

factual not based on evidence what people believe them

And I I on my podcast

I've interviewed people who helped create the social media networks

Twitter Facebook alot of them and they described the process

That's a little hair raising theology

A rhythms that were designed to make these social media

platforms work were not designed with any evil intent but

there was an unexpected outcome that they didn't expect that

that that is dangerous

The algorithms just want to keep you on the screen

so they can sell your eyeballs to advertisers

It's a business model

It's not a nefarious but the unexpected outcome is that

they give you to keep you on the screen

They keep showing you what you want to see and

that includes your biased opinions and you not only get

confirmed in your bias after a while you get addicted

to your bias

It feels good to hear that you're right about something

over and over again so you you want to get

more and more of that you get a shot of

the happy hormones

What happens is as soon as you hear one word

that indicates to you that this person is in a

camp that's not your camp all nuance disappears and you

you suddenly realize you're talking to an idiot or you

you believe you are because this person is not going

to confirm your bias

And that's when we start calling each other socialist lib

turds and Nazis

And we're not listening to each other because we've been

convinced over and over again that Onley our viewers right

I don't know how to fix that

That sounds like a really important problem if not one

of the most important

What can we do about those algorithms Very well said

Alan

I don't know the answer to that but it is

really very disturbing

I think many of us uh may have done the

experiment that that I tried a few times over the

past couple of months is that when you hear something

announced as ah half something happened or something occurred and

you switch toe one channel enlists in for five minutes

and here what their interpretation

Switch to the other channel and here and it is

beyond polar opposites

It's just you couldn't be further away from each other

with the same announcement or the same set of facts

And I tell you that's the kind of thing that

it's very frustrating because you shrug your shoulders and you

say How are we ever going to get out of

this pickle that we're in But you said it very

eloquently

You're just listening to people who are confirming your own

ideas and anyone that's against that is obnoxious to you

Which is it gets to be hard to find the

mean because it's like Heisenberg's uncertainty principle

Like I think it was Heisenberg

Maybe he's the other guy that the cat is in

the box and the cat is both alive and dead

at the same time

You can't

It's hard to find a middle ground between those two

right Right So I have a question and I think

mainly for Tony but also for Alan

Is it easier or harder to be a convincing spokesperson

for science coming from the government And this This has

nothing to do with who may be on top of

you in the government

But people's reaction to information from government sources versus non

government sources

Do you think that makes a difference You know in

some respects it does because I think superimposed upon the

broad anti science uh situation that we've discussed is a

mistrust in government

Uh clearly because if ever there was the authority of

all authorities is government and people don't seem to like

that they push back

So when government you know the old saying Yeah

Hello

I'm from the government

I'm here to help you Is the first thing where

you've got to put your guard up because people just

don't trust which is really unfortunate because you know government

at its best is so important for the betterment of

society you know and for the helping of people who

need help

So Thea idea that you don't trust government is really

unfortunate

But in direct answer to your question is that information

coming out from government I think sometimes raises suspicion right

from the get go Mhm

I think that trust is so valuable so important in

this in this effort we're making now to to encourage

everybody to take vaccines as you mentioned before the anti

vaccine uh movement has melded with the coronavirus vaccine problem

for many people

When I think we have to get trusted people heroes

in the commute heroes in the social world like athletes

musicians um whoever whoever is trusted by the people to

get their vaccinations on camera

And it occurred to me a couple of days ago

What do you think of this What do you think

it is Dr

Fauci It seems to me the most trusted people the

best ambassadors might be the people who are getting vaccinated

themselves because they've made the choice to do it and

they have a good reason to do it

And there's a 15 minute period

I understand where they're being observed after the shot

If during that period somebody could suggest to them Tell

your friends tell your friends why you did it

Tell them how it's going for you and why any

discomfort might be worth it to you

To just spread the word just asking them to spread

the word to people who trust him

And then it occurred to me

What about this is an idea if it's possible to

take a selfie while you're getting the shot and posted

on the Web posted on social media

The people you know trust you and you can spread

the word that way

So instead of taking a selfie take a vax e

right Good idea Allen

Good idea

No you make a very good point

I mean that's one of the things when you're talking

about trust and the relationship between government trust and trust

the people that you feel you can identify with because

they're your heroes and you're right

They could be athletes

They could be entertained as they could be people who

relate to the individuals in a way that they're looked

up to

And when someone who you look up to does something

you feel that it's much much easier to be convinced

that you should do that That that's what we're actually

trying to do right now because we feel it's so

important to get the overwhelming majority of the people in

this country vaccinated with the covert 19 vaccine

Because really quite frankly that is the only way we're

gonna put an end to this outbreak without getting so

many people infected

You know we talk about herd immunity

You could get hurt immunity by getting so many people

infected that everybody is now immune

But a lot of people are gonna die before that

happens

So the way do you really want to do it

is to get the overwhelming majority of the population vaccinated

And the only way you do that is to convince

people of the reality that it is a safe and

effective vaccine

And there are reasons why people have skepticism about that

Rather than reject or criticize their skepticism I think you

need to explain that you have empathy with that skepticism

but explain why it's not based fundamentally on reality and

on facts and that requires a lot of outreach

And that gets to your original question about trust

Who do you get to get out there To tell

people about that like the vaccine was done very very

quickly

That is true

It is the fastest we have ever gone from the

time you recognize a new particular in this case virus

that is causing a historic pandemic to the time you

actually get vaccine into someone's arm

It's the quickest that has ever been done in history

The normal reaction to that is Well wait a minute

if you did it so quickly it must have been

careless and reckless

But that's not the case

The reason it was done so quickly is because it

was utilizing the exquisite advances scientific advances in vaccine platform

technology

We need to explain that to people in a way

that they can understand it and embrace it

So my feeling is find out why their skepticism

Find out why there's reluctance and try to address it

in a way that's respectful to the people that you're

trying to convince

That's where we've got to go in the next few

months

You know you you came close Thio dealing with the

question that my granddaughter one of my granddaughters asked me

this morning

She's very concerned about this and very up on it

But she wonders How long will it take before we

know Or do we know now how long the vaccine

will protect us Is it is it three months Is

it forever Is it two years What do we think

it might be Well one of the things about communication

Alan that you know and you've taught people you've got

to be humble honest and transparent and when you do

not know the answer you need to say I do

not know

And the fact is we do not know how long

protection would last

I doubt if its lifetime the way a measles vaccine

would be

I imagine it's gonna be enough to get us through

a couple of cycles but I think we just need

to wait and see

And that's the reason why you follow people in vaccine

trials and in post vaccine follow ups things that we

call phase for where you just continue to follow people

And we will know the answer to your question Alan

in due time

But right now since we're literally only a few months

into the vaccinations we won't know how long that immunity

last until we follow it

I hope it's long enough that we won't require a

yearly boost

We may require an intermittent boost the you know the

duration of which we're not sure right now

But we've got to just be honest with people and

say it's important to get vaccinated

I believe we'll be able to end this pandemic by

vaccinating the overwhelming majority of the people in the country

and ultimately in the world for that matter

But we need to just follow it carefully enough to

know when that immunity ceases the last great

I wanna push on something that the Tony was at

the edge of

I mean I think the three of us are all

agreed on the importance of trust in science and of

particularly of coded vaccination

But we're three white guys of shall we say mature

years

Um one of the saddest ironies in this whole pandemic

is the people who are getting hammered the hardest by

this tend to be people from ethnic and racial minorities

Hispanics native Americans African Americans and those air also groups

that for a variety of understandable historic reasons tend to

have less trust in science and and an authority than

white guys of a certain degree of mature years

Um how to both of you How can we How

should we reach out to those groups This is a

question that came up from quite a few people who

are watching so advice thoughts Yeah I think you need

to get the messenger to look like and understand the

people to whom you are delivering the message and that's

the reason why we talk about the importance of getting

brown and black people who are respected in the community

to go out and try and convince people of a

similar racial and ethnic background of why it's important to

get vaccinated

We could do that

We have a lot of people who would like to

do that

In fact just literally

This morning I was down at the White House when

surgeon General Jerome Adams was publicly gotten vaccinated and got

up and spoke to his brothers and sisters who are

brown and black people saying It's very important that you

follow and seeing what I've done because I have great

faith that this vaccine is safe and effective

And quite frankly I think that his getting up and

saying that that way was infinitely more effective than as

you say the three of us saying that no doubt

about that

So we've got to get the right messengers to deliver

the correct message and that's what we're gonna be doing

over the next few months of trying to get respected

people in the community who look like and are coming

from the same background is the people that were trying

to reach

I think that's so important and one of the elements

that you mentioned is not only looking like the population

you're talking to but understanding their cultural habits

They're the mores and we only can get that from

the people themselves

We can't guess it what that is

And I heard somebody talking the other day saying that

in her experience she was black and her experience

The part of the culture is you don't go to

the doctor unless you're really really sick

And that means you are not going to go to

the doctor to get a vaccination because you're not sick

yet

And that that's not even with regard

Thio not trusting the government because of unethical experimentation that's

going on

It's just a cultural habit a norm

If that's true somehow we have to get around that

But when I think the overall message from that you

can derive is that we can't guess about the people

were trying to talk to we have to get some

evidence from them

I mean we train we trained people who were speaking

to an audience to read the audiences faces

That's one way to do it to know what they're

thinking while you're talking to him

But the other thing is if there's a bias against

the vaccine that's particular to a group of people

You got to know exactly what that is so you

can answer it

So what you were talking about before Tony about about

knowing your audience really well and that info will get

from the people themselves

Yes indeed

Thank you

Was gonna eso changing subject It's a little bit um

success stories

Is there anything in your experiences that you would point

to is saying Hey here's a time when we did

it right when it worked um and everybody benefit worked

it being of course you know good science communication

Tony you did great work on age

Yeah

Yeah I was just um thinking about that as soon

as the word came out of Hank's mouth

Yeah

One of the things that really turned out ultimately to

be a success story was what started off as the

lack of communication between the scientists the academic community the

federal officials the regulatory community and the people literally in

the trenches during the early years of HIV AIDS predominantly

men who have sex with men predominantly young men who

have sex with men who appropriately and understandably felt that

the federal government was not understanding or responding to the

special needs that they had of being included in the

deliberations about clinical trials which would greatly affect them in

their lives and would ultimately evolved

And this is you know one of the things that

I feel that um I've done right

Um um I I think back at the time of

the decisions I made to absolutely reach out to people

even the people who appear to be adversaries to you

because maybe they're not really adversaries

They're really trying to gain your attention about something that

maybe you should have been paying attention to to begin

with

And that's how the success story of the relationship between

me my scientific colleagues and the regulatory agencies that rule

on drugs and vaccines and interventions was able to embrace

the activist community to the point where the kinds of

decisions about clinical trial design the kind of decisions about

what the input should be of the community into research

that would ultimately impact them

After all that's very important because they are the ones

that you're doing the research for the idea about putting

aside what appear to be differences and sitting down and

just listening to each other we found out and that's

why I consider it an extraordinary success story that when

you put aside all the perceived differences the confrontation that

theatrics the iconoclastic behavior and say Wait a minute where

are we going What is our goal What do we

all want And how do we get there in a

way that synergistic as opposed to opposing Well you know

actually you look decades later and the same activists who

seemed to have been confronting us back then are now

integral and important contributory components of everything we do

So to me that's a next roar dinero Reese ACC

cess story of going what looked like a negative interaction

and turned it into something that was very positive merely

by ultimately listening to what the other person has to

say

Interesting to think about how that might play out in

the covert context

Yeah right that is true

I mean it's a little bit of a difference but

there is something there that has some similarity of of

just listening to what the other person has to say

and try to understand why they're coming from the position

they're coming from

So we're down thio 10 minutes a little less

Um one question has come up from a lot of

people is what can I do What can individuals out

there who don't necessarily have quite the bully pulpit that

you to have What can they do to make things

better I thought Alan suggested about vax ease and posting

them on social media

Brilliant

Um other ideas for what Our listeners can do it

because many of us we're gonna be talking I hope

in many cases via Zoom or Elektronik Lee

But with the holidays upon us people are gonna be

talking to friends and family members some of whom will

have very different ideas from theirs about science and particularly

about the covert vaccine

What would you What would you tell ordinary people Well

no one is an ordinary person

What would you tell Um what would tell our listeners

to dio what would you tell the extraordinary people who

are listening to us to do in their own lives

with respect to this Alan

Any thoughts Well my thought

And thanks for mentioning it

Is the vaccine the little selfie at the moment if

they let you do it do you think Tony it's

there's a problem in taking a picture or video in

an in an institution where you're getting ah shot

Is there any any security or No I don't

I mean if it's you personally you're the one that

I mean But what you wouldn't want is someone taking

a shot of you without telling you and then spreading

it around

But if you do it yourself there's absolutely nothing wrong

with that

And even if it's not of the shot itself could

just be a shot of you looking at your band

aid afterward

Look exactly course I can't do that until February or

March or April when I had my number comes up

I'm older than you

Probably after that

You know Hank Well before that Yeah yeah

You know an answer to your question I think people

should not underestimate Even though they are not someone that

is well known or a celebrity to get out there

And everyone who recognize them they shouldn't underestimate the impact

that they may have in their own immediate environment

But just speaking about things that they feel are important

and getting a message and passing it on either through

their own social media among their family and their friends

that's how messaging gets started in an effective way

I people should not say Well I'm just a nen

vivid jewel person that you know isn't widely known

Therefore what impact can I have You shouldn't underestimate the

fact that you with your friends with your family and

with your own social connections can actually spread the word

around

That would be very helpful to the broad goal that

we're all trying to reach now regarding things like ending

this outbreak I always have a great deal of respect

for and faith in what the individual could do even

one who is not particularly well known

Okay well we've got only five minutes left although in

a way what you just said might be this

But I thought I'd give you both a chance to

give parting advice your last thoughts on on trust in

science in general and in the context of this this

dreadful pandemic

Alan I would

I'm eager to hear what Tony has to say

What all I can say is science will save us

Science has given us extra little years to live

The average lifespan has increased so much in the last

century

It's going to now save us from this terrible pandemic

and from pandemics to come because every time as Tony

has said every time we go through this we learn

more about how to deal with it

We learn more about how nature works so we can

counterattack the attacks we get from our mother nature

And if we don't recognize science as our savior were

we're looking

We're barking up the wrong tree Tony

I leave it to you

You know Alan very well said

And I think I just want to underscore that by

just taking this issue of vaccines in general just to

get people to appreciate toe look at the fax

So there are so many areas in human health in

which science has benefited us

But science goes beyond biology and beyond the biomedical sciences

and go to so many things that science does for

us

But you know as a physician and as a biomedical

scientist

I just would ask people to just take a moment

to think about the science that's gone into the development

of vaccines against diseases that a century or more ago

would have had the life expectancy of people in this

country be significantly less than it is right now

Vaccines against the common childhood diseases that often killed Children

vaccines globally against smallpox which was one of the great

scourges of the world against measles against polio

And now we're dealing is Allen said with the current

situation that biomedical research and science has given us something

that just a decade ago would have seemed unimaginable to

be able to have a new virus that we had

never had experience before being thrust upon us and throw

us into one of the most extraordinary destructive pandemic in

over 100 years

And just over the past few days science has allowed

us to have a vaccine that when we distributed to

people throughout the country and hopefully throughout the world we

will crush this outbreak that has really terrorized us for

the last 11 months not only here in the United

States but worldwide

It's damaged severely

The economy and lead to people suffering things not necessarily

directly related to being ill themselves but all the secondary

consequences that go with the effects of a global pandemic

such as this

So when this is over which it will be over

we're gonna look back and say it was science that

got us out of this pure science the typical way

where people discover and build upon previous discoveries

Until you get to a point where you have an

intervention that's extraordinarily effective

So that's what I would like to leave the audience

who have any skepticism about science with that thought

That's a great upbeat note to end on

We now have only 13 days left in 2020

I don't think any of us is gonna be sorry

to see 2020 in the rear view mirror usually on

New Year's Eve

I'm celebrating the old year

This year I'm definitely celebrating the arrival of the new

year but I think one thing that we can take

from it we need to learn from this experience and

we've learned how to make vaccines faster

We've learned a lot about public health

We've learned a lot about I hope and you guys

have helped us learn about science communication

We need to take those lessons moving forward

I'm sure that the 5000 or so people who you

can't hear applauding would join me in applauding both of

you

Thank you so much

I'd like Thio on behalf of the Duke Initiative for

Science and Society Stanford Center for Law and the Biosciences

and all the other many co sponsors of this very

deeply

And sincerely thank both of you for taking time from

your busy schedules to be in this program uh to

everyone

Uh stay safe

Stay well active holidays and 2021 is coming

Thank you so much

Goodbye

Thank you Hank

Thank you Alan

Good to see you again

Great to see you again Tony

Thank you Hank

By by you both