The Swan Song of Dr Collins

A shining star of scientific exceptionalism is spending the last stretch of his career trying to get people to trust science again.

To say that Francis Collins is a fallen angel is to grant too much influence and weight to Opinions on the Internet.

Dr Collins is the quintessential institutionalist scientist. A pioneer in the field of genetics, he was the director of the Human Genome Project - the most important public health advance since the eradication of smallpox. He was appointed director of the National Institute of Health (NIH) by President Obama and served there for 12 years, overseeing this core public health institution throughout the Covid pandemic. He retired at the end of 2021, concluding an astonishing career of scientific achievement and public health administration.

So why is one of the most important figures of institutional science spending his retirement years doing townhalls and discussion events on the breakdown of institutional trust?

There have already been a lot of pixels spilled on this event hosted by Braver Angels (a “cross-partisan, volunteer-led movement to bridge the political divide”) in which Dr Collins talks with Wilk Wilkinson and discusses the need to rebuild our institutions.

How Is He Going To Fix It?

I watched this event because I wanted to understand the full context of Dr Collins comments and opinions; I think I got that. Dr Collins has rightly recognized that there is a huge problem with institutional trust, stemming from the events of and responses to Covid. He wants to repair this loss of trust and this is part of his attempt to do so.

The repair of institutional trust is a fascinating and awful problem, largely because we don’t know how to do it. My goal here is to examine how Dr Collins is trying to do it, what his solutions are, and to turn the spotlight towards my own biases and ask myself what I want him to do.

There are some easy “what we got wrong” positions that Dr Collins gets out of the way. The CDCs masking flip-flop, the inability (or refusal) to communicate that there was enormous uncertainty, and the fact that the CDC’s information distribution process was atrocious. Dr Collins repeatedly despairs that our public health institutions are underfunded and implies that this was driving the unevenness in news and data.

Most of Dr Collin’s admissions of institutional failure lose some of their poignancy in his insistence that everyone in charge was doing their best and had the best intentions. There is an underlying sense in the talk that the problem did not lay within the institutions themselves but from second-order failures. The CDC didn’t *do* anything wrong, they just communicated poorly. Their data failures weren’t their fault but a failure of funding. The misinformation problem is always coming from outside the house, especially from social media.

My biggest disappointment with Dr Collins during the pandemic was his response to the Great Barrington Declaration which, to his credit, he addresses here.

The GBD was a document published in October 2020 that suggested lockdowns be scaled back and governments focus their resources on protecting those most at risk. When this document was released, Francis Collins sent an email demanding “a quick and devastating published take down" of the alternative policy proposal. At this point of the discussion (starting around 49:00), he expresses regret for his phraseology, but doesn’t seem to regret the missed opportunity to actually have a policy discussion.

Collins then references a “scathing takedown” of GBD. The problem is that, with all the things we know now, this “scathing takedown” was simply not true. It was not a scientific discussion, but an series of statements that claimed, without evidence, that masking, social distancing, hand-washing, and quarantine were the path to protection. We now know from seeing the long-term results among a variety localities that this was simply not true. It stated that lockdowns and mandates are not in conflict with economic security, which we knew at the time was not true.

To make matters worse, this political document accused the GBD of being a political document that is *not* part of the scientific debate. After delivering a series of unproven statements of faith pretending to be science, the authors claimed GBD was “masquerading as science”. In short, the scientific debate was not had. This document was not science. This was politics in all of its dishonest accusations, unproven statements, and ideological posturing.

But Dr Collins can’t see see that. Even now, he doesn’t have the objectivity to understand that this “scathing takedown” was actually a huge part of the part of the problem with institutional science.

And that’s where he has landed.

I have to take a step back here and explain that the best way to understand this talk is that Dr Collins is acting as our best insight into what has now become the solidified, established opinion of institutional science. While I think that opinion is really bad, it is very good that Dr Collins is willing to give it in plain language and to explain the reasoning around it. Without this kind of candor, it is certainly impossible to move forward.

How Do I Want Him To Fix It?

There are lots of things that are necessary to restore trust in public health institutions and Dr Collins delivers many of those things Do you want an apology? There’s some of that in here. There are regrets, apologies, a recognition of the need to communicate uncertainty, casting blame on the media, recognition of institutional failures, and an admission that pandemic policy should have been allowed to vary according to the needs of local communities.

So what is it that I want? If this talk didn’t make me feel like our institutions have learned their lesson (and it most certainly did not), what would actually make me believe that they had?

I wrote about this in 2022 and I think most of my observations have held up. The most important things we need:

1. Public admission of guilt on some of the more egregious actions (such as the silencing of dissent and the use of government misinformation squads to pressure social media companies into suppressing debate)

2. The recognition of the dignity of honest dissent and the elevation of those voices into a position of institutional power.

3. Some clear plan of how things will change (and the ability to watch those things changing). This has to be real and visible. Not just “we need more funding”; rather, what specific problem that funding is going to fix. I want to come back in 2 years and see progress on it.

While these are (I think) fine goals, they aren’t enough to actually repair the damage to public perception.

People Just Don’t Believe Them

I’m not sure there is a really effective way to reconcile in the aftermath of Covid because people don’t want to reconcile. There are clearly grievances that remain unaddressed and I don’t think this event came close to addressing them.

While the questions from the crowd were polite and respectful, they came almost entirely from a position that the government response was the incorrect one and that harm had been done by the public health establishment to the people of the United States. This was not a balanced conversation between two sides. There is a group that cares more about this and feels like they have not gotten the answers they need.

I don’t know what answers would satisfy that group and lead toward reconciliation, but I can tell you that the answers given in that event didn’t do it. People who want reform and want to know that things will be changed still feel like they are being talked at and not talked with.

I still believe there are ways to repair institutional trust, but I’m becoming convinced that it is a project that will have to wait until the old guard has passed out of the halls of power, and the institutions can invite in new experts with enough distance from these positions that they can safely say “That was an idea of another time”.