A lesson in law for investigating a public health mystery like COVID-19

By Dennis Archambault

The book Microbe Hunters, written by Paul de Kruif, helped save me in high school Biology. It’s the story of physicians and scientists who solved medical mysteries. As researchers, they accumulated evidence that stood up to scientific scrutiny. Their investigative work – leading to scientific and public health advances – engaged me enough to get through that course.

Len Neihoff’s recent column in the Detroit Free Press, “Virus reveals we all need a course in evidence,”  https://www.freep.com/story/opinion/contributors/2020/05/05/coronavirus-evaluating-evidence/3083768001/?utm_source=native&utm_medium=capi_retrofit&utm_content=inapp&build=native-web_i_p underscores the importance epidemiological work done by public health researchers throughout the world – and those trying to understand the current mystery of COVID-19. Neihoff, a professor at the University of Michigan Law School, reminds us that evidence is necessary to support advocacy. Too often, conclusions are reached based upon cultural attitudes and minimal fact, or fact that is unsubstantiated. As the saying goes, “would it hold up in a court of law?”

Americans have become “a nation of magic thinkers, making decisions based on what we hope is the case and whom we want to believe.” He argues that the national debate surrounding COVID-19 reveals a “societal failure to understand what evidence is and respect how it works.” The concept of evidence, he says, can be boiled down into two elements: the evidence must be relevant and reliable.

One of the perplexing aspects of the COVID-19 experience is how a population can be equally infected by the contagion while some groups within the population succumb to the disease more than others. Dr. Carolyn Custer, director of Quality and Community Medicine at Authority Health is working with students from the University of Michigan – Dearborn to understand COVID-19 “hot spots” – areas of high mortality from the disease – in Detroit. The students will be looking for evidence in a case that would argue why more people in a certain geographical area die from the disease. Is it age? Is it chronic disease? Is it access to health care? Is it their type of employment?

This is not a case for a traditional courtroom; rather, these investigators may offer support for an advocacy argument in the court of public opinion for population health measures. They will learn the importance of evidence.

Dennis Archambault is vice president of Public Affairs for Authority Health.