Alcove

Science, culture, complexity

Tag: Wuhan coronavirus

  • Dehumanising language during an outbreak

    It appears the SARS-CoV-2 coronavirus has begun local transmission in India, i.e. infecting more people within the country instead of each new patient having recently travelled to an already affected country. The advent of local transmission is an important event in the lexicon of epidemics and pandemics because, at least until 2009, that’s how the WHO differentiated between the two.

    As of today, the virus has become locally transmissible in the world’s two most populous countries. At this juncture, pretty much everyone expects the number of cases within India to only increase, and as it does, the public healthcare system won’t be the only one under pressure. Reporters and editors will be too, and they’re likely to be more stressed on one front: their readers.

    For example, over the course of March 4, the following sentences appeared in various news reports of the coronavirus:

    The Italian man infected 16 Italians, his wife and an Indian driver.

    The infected techie boarded a bus to Hyderabad from Bengaluru and jeopardised the safety of his co-passengers.

    Two new suspected coronavirus cases have been reported in Hyderabad.

    All 28 cases of infection are being monitored, the health ministry has said.

    Quite a few people on Twitter, and likely in other fora, commented that these lines exemplify the sort of insensitivity towards patients that dehumanises them, elides their agency and casts them as perpetrators – of the transmission of a disease – and which, perhaps given enough time and reception, could engender apathy and even animosity towards the poorer sick.

    The problem words seem to include ‘cases’, ‘burden’ and ‘infected’. But are they a problem, really? I ask because though I understand the complaints, I think they’re missing an important detail.

    Referring to people as if they were objects only furthers their impotency in a medical care setup in which doctors can’t be questioned and the rationale for diagnoses is frequently secreted – both conditions ripe for exploitation. At the same time, the public part of this system has to deal with a case load it is barely equipped for and whose workers are underpaid relative to their counterparts in the private sector.

    As a result, a doctor seeing 10- or 20-times as many patients as they’ve been trained and supported to will inevitably precipitate some amount of dehumanisation, and it could in fact help medical workers cope with circumstances in which they’re doing all they can to help but the patient suffers anyway. So dehumanisation is not always bad.

    Second, and perhaps more importantly, the word ‘dehumanise’ and the attitude ‘dehumanise’ can and often do differ. For example, Union home minister Amit Shah calling Bangladeshi immigrants “termites” is not the same as a high-ranking doctor referring to his patient in terms of their disease, and this doctor is not the same as an overworked nurse referring to the people in her care as ‘cases’. The last two examples are progressively more forgivable because their use of the English language is more opportunistic, and the nurse in the last example may not intentionally dehumanise their patients if they knew what their words meant.

    (The doctor didn’t: his example is based on a true story.)

    Problematic attitudes often manifest most prominently as problematic words and labels but the use of a word alone wouldn’t imply a specific attitude in a country that has always had an uneasy relationship with the English language. Reporters and editors who carefully avoid potentially debilitating language as well as those who carefully use such language are both in the minority in India. Instead, my experiences as a journalist over eight years suggest the majority is composed of people who don’t know the language is a problem, who don’t have the time, energy and/or freedom to think about casual dehumanisation, and who don’t deserve to be blamed for something they don’t know they’re doing.

    But by fixating on just words, and not the world of problems that gives rise to them, we risk interrogating and blaming the wrong causes. It would be fairer to expect journalists of, say, the The Guardian or the Washington Post to contemplate the relationship between language and thought if only because Western society harbours a deeper understanding of the healthcare system it originated, and exported to other parts of the world with its idiosyncrasies, and because native English speakers are likelier to properly understand the relationship between a word, its roots and its use in conversation.

    On the other hand, non-native users of English – particularly non-fluent users – have no option but to use the words ‘case’, ‘burden’ and ‘infected’. The might actually prefer other words if:

    • They knew that (and/or had to accommodate their readers’ pickiness for whether) the word they used meant more than what they thought it did, or
    • They knew alternative words existed and were equally valid, or
    • They could confidently differentiate between a technical term and its most historically, socially, culturally and/or technically appropriate synonym.

    But as it happens, these conditions are seldom met. In India, English is mostly reserved for communication; it’s not the language of thought for most people, especially most journalists, and certainly doesn’t hold anything more than a shard of mirror-glass to our societies and their social attitudes as they pertain to jargon. So as such, pointing to a reporter and asking them to say ‘persons infected with coronavirus’ instead of ‘case’ will magically reveal neither the difference between ‘case’ or ‘infected’ the scientific terms and ‘case’ or ‘infected’ the pejoratives nor the negotiated relationship between the use of ‘case’ and dehumanisation. And without elucidating the full breadth of these relationships, there is no way either doctors or reporters are going to modify their language simply because they were asked to – nor will their doing so, on the off chance, strike at the real threats.

    On the other hand, there is bound to be an equally valid problem in terms of those who know how ‘case’ and ‘infected’ can be misused and who regularly read news reports whose use of English may or may not intend to dehumanise. Considering the strong possibility that the author may not know they’re using dehumanising language and are unlikely to be persuaded to write differently, those in the know have a corresponding responsibility to accommodate what is typically a case of the unknown unknowns and not ignorance or incompetence, and almost surely not malice.

    This is also why I said reporters and editors might be stressed by their readers, rather their perspectives, and not on count of their language.

    A final point: Harsh Vardhan, the Union health minister and utterer of the words “The Italian man infected 16 Italians”, and Amit Shah belong to the same party – a party that has habitually dehumanised Muslims, Dalits and immigrants as part of its nationalistic, xenophobic and communal narratives. More recently, the same party from its place at the Centre suspected a prominent research lab of weaponising the Nipah virus with help from foreign funds, and used this far-fetched possibility as an excuse to terminate the lab’s FCRA license.

    So when Vardhan says ‘infected’, I reflexively, and nervously, double-check his statement for signs of ambiguity. I’m also anxious that if more Italian nationals touring India are infected by SARS-CoV-2 and the public healthcare system slips up on control measures, a wave of anti-Italian sentiment could follow.

  • Another controversy, another round of blaming preprints

    On February 1, Anand Ranganathan, the molecular biologist more popular as a columnist for Swarajya, amplified a new preprint paper from scientists at IIT Delhi that (purportedly) claims the Wuhan coronavirus’s (2019 nCoV’s) DNA appears to contain some genes also found in the human immunodeficiency virus but not in any other coronaviruses. Ranganathan also chose to magnify the preprint paper’s claim that the sequences’ presence was “non-fortuitous”.

    To be fair, the IIT Delhi group did not properly qualify what they meant by the use of this term, but this wouldn’t exculpate Ranganathan and others who followed him: to first amplify with alarmist language a claim that did not deserve such treatment, and then, once he discovered his mistake, to wonder out loud about whether such “non-peer reviewed studies” about “fast-moving, in-public-eye domains” should be published before scientific journals have subjected them to peer-review.

    https://twitter.com/ARanganathan72/status/1223444298034630656
    https://twitter.com/ARanganathan72/status/1223446546328326144
    https://twitter.com/ARanganathan72/status/1223463647143505920

    The more conservative scientist is likely to find ample room here to revive the claim that preprint papers only promote shoddy journalism, and that preprint papers that are part of the biomedical literature should be abolished entirely. This is bullshit.

    The ‘print’ in ‘preprint’ refers to the act of a traditional journal printing a paper for publication after peer-review. A paper is designated ‘preprint’ if it hasn’t undergone peer-review yet, even though it may or may not have been submitted to a scientific journal for consideration. To quote from an article championing the use of preprints during a medical emergency, by three of the six cofounders of medRxiv, the preprints repository for the biomedical literature:

    The advantages of preprints are that scientists can post them rapidly and receive feedback from their peers quickly, sometimes almost instantaneously. They also keep other scientists informed about what their colleagues are doing and build on that work. Preprints are archived in a way that they can be referenced and will always be available online. As the science evolves, newer versions of the paper can be posted, with older historical versions remaining available, including any associated comments made on them.

    In this regard, Ranganathan’s ringing the alarm bells (with language like “oh my god”) the first time he tweeted the link to the preprint paper without sufficiently evaluating the attendant science was his decision, and not prompted by the paper’s status as a preprint. Second, the bioRxiv preprint repository where the IIT Delhi document showed up has a comments section, and it was brimming with discussion within minutes of the paper being uploaded. More broadly, preprint repositories are equipped to accommodate peer-review. So if anyone had looked in the comments section before tweeting, they wouldn’t have had reason to jump the gun.

    Third, and most important: peer-review is not fool-proof. Instead, it is a legacy method employed by scientific journals to filter legitimate from illegitimate research and, more recently, higher quality from lower quality research (using ‘quality’ from the journals’ oft-twisted points of view, not as an objective standard of any kind).

    This framing supports three important takeaways from this little scandal.

    A. Much like preprint repositories, peer-reviewed journals also regularly publish rubbish. (Axiomatically, just as conventional journals also regularly publish the outcomes of good science, so do preprint repositories; in the case of 2019 nCoV alone, bioRxiv, medRxiv and SSRN together published at least 30 legitimate and noteworthy research articles.) It is just that conventional scientific journals conduct the peer-review before publication and preprint repositories (and research-discussion platforms like PubPeer), after. And, in fact, conducting the review after allows it to be continuous process able to respond to new information, and not a one-time event that culminates with the act of printing the paper.

    But notably, preprint repositories can recreate journals’ ability to closely control the review process and ensure only experts’ comments are in the fray by enrolling a team of voluntary curators. The arXiv preprint server has been successfully using a similar team to carefully eliminate manuscripts advancing pseudoscientific claims. So as such, it is easier to make sure people are familiar with the preprint and post-publication review paradigm than to take advantage of their confusion and call for preprint papers to be eliminated altogether.

    B. Those who support the idea that preprint papers are dangerous, and argue that peer-review is a better way to protect against unsupported claims, are by proxy advocating for the persistence of a knowledge hegemony. Peer-review is opaque, sustained by unpaid and overworked labour, and dispenses the same function that an open discussion often does at larger scale and with greater transparency. Indeed, the transparency represents the most important difference: since peer-review has traditionally been the demesne of journals, supporting peer-review is tantamount to designating journals as the sole and unquestionable arbiters of what knowledge enters the public domain and what doesn’t.

    (Here’s one example of how such gatekeeping can have tragic consequences for society.)

    C. Given these safeguards and perspectives, and as I have written before, bad journalists and bad comments will be bad irrespective of the window through which an idea has presented itself in the public domain. There is a way to cover different types of stories, and the decision to abdicate one’s responsibility to think carefully about the implications of what one is writing can never have a causal relationship with the subject matter. The Times of India and the Daily Mail will continue to publicise every new paper discussing whatever coffee, chocolate and/or wine does to the heart, and The Hindu and The Wire Science will publicise research published in preprint papers because we know how to be careful and of the risks to protect ourselves against.

    By extension, ‘reputable’ scientific journals that use pre-publication peer-review will continue to publish many papers that will someday be retracted.

    An ongoing scandal concerning spider biologist Jonathan Pruitt offers a useful parable – that journals don’t always publish bad science due to wilful negligence or poor peer-review alone but that such failures still do well to highlight the shortcomings of the latter. A string of papers the work on which Pruitt led were found to contain implausible data in support of some significant conclusions. Dan Bolnick, the editor of The American Naturalist, which became the first journal to retract Pruitt’s papers that it had published, wrote on his blog on January 30:

    I want to emphasise that regardless of the root cause of the data problems (error or intent), these people are victims who have been harmed by trusting data that they themselves did not generate. Having spent days sifting through these data files I can also attest to the fact that the suspect patterns are often non-obvious, so we should not be blaming these victims for failing to see something that requires significant effort to uncover by examining the data in ways that are not standard for any of this. … The associate editor [who Bolnick tasked with checking more of Pruitt’s papers] went as far back as digging into some of Pruitt’s PhD work, when he was a student with Susan Riechert at the University of Tennessee Knoxville. Similar problems were identified in those data… Seeking an explanation, I [emailed and then called] his PhD mentor, Susan Riechert, to discuss the biology of the spiders, his data collection habits, and his integrity. She was shocked, and disturbed, and surprised. That someone who knew him so well for many years could be unaware of this problem (and its extent), highlights for me how reasonable it is that the rest of us could be caught unaware.

    Why should we expect peer-review – or any kind of review, for that matter – to be better? The only thing we can do is be honest, transparent and reflexive.