Anthony Fauci was the chief medical advisor to the president of the United States. He stated in a 60 Minutes interview, March 2020 that he believed community use of masks was unnecessary. He clarified that his statements did not imply that he believed the data was inadequate to justify cloth masks. He stated that if he had supported mask wearing (of any type), then mass panic would result and cause a shortage of N95 and surgical masks among the health care workers who are more in need. Emails obtained under the Freedom of Information Act revealed that Fauci had given the same advice against mask wearing, suggesting that it wasn't just his public stance.AdvertisementSome claim that evidence has changed in substance during the first weeks of March. However, our review of the literature doesn't support this assertion. The evidence in Fauci's 60 Minutes interview is largely the same as that in April 2020, according to our assessment. Fauci's statement can be viewed in two ways. He could have stated that his original statement was false but motivated to prevent a shortage of masks for health care workers. Another possibility is that he believed his initial statements to be true and decided to advocate cloth masks to divert focus from N95 or surgical masks or to give hope and control to an anxious and fearful public.AdvertisementAdvertisementAdvertisementFurther evidence supports the possibility that this second interpretation might be more correct. COVID expert Michael Osterholm, a COVID expert, wrote a long commentary in July 2020. He discussed the scientific uncertainty surrounding masks and supported their widespread use as one of many measures. Faucis reversed position, which occurred at a time when there was political polarization, helped to change the role of masks as a precautionary strategy and to become a badge of political loyalty. Donald Trump refused to wear a mask, and he referred to Faucis comments in the 60 Minutes interview to justify his actions. The debate continued into the presidential debates with Trump mocking Joe Biden's choice to wear the largest mask he had ever seen.AdvertisementFauci was unable to deny that one of the statements did not accurately represent the evidence. These high-profile mixed messages, which were delivered in a very short time span and without any new substantive data to support them, caused confusion and backlash from politicians, experts, and the general population.Are we asking public health officials to disclose facts and uncertainties openly? Or should they be able to manipulate information?Experts and agencies can lie to the public by presenting information they believe is false or incomplete to advance a larger agenda. While the intentions of the tellers may be genuine (e.g., an urgent need for behavioral change among lay people), the consequences can damage not only their intentions but also the public's trust in science and experts. In the age of social media and political sensitive elections, COVID-19's first year saw leaders confronted with an unknown disease. The preconditions for noble lies were made even more fertile. We witnessed many examples, not surprising. These examples are more than any other example of the destructive power of lies.AdvertisementAdvertisementFauci later in 2020 participated in another noble lie. He explained to Donald McNeil, then-New York Times reporter, that he had been shifting the target estimate of herd immunity on the basis of emerging studies in December. He also stated:I believed that herd immunity would be 70-75 percent if vaccines were given to Americans when polls indicated only half would get them. When newer surveys indicated that 60 percent of Americans would get the vaccine, I decided to push this up a bit. I then went to 80 and 85.He stated that he had adjusted his target range for herd immunity in order to increase vaccine uptake. His comments were meant to influence public actions to increase vaccinations (a noble effort). But the fundamental dilemma is: Do we want public officials in public health to be transparent about facts and uncertainties? Or, do we want them using nudges to get the public to take certain actions, or to make information more transparent? To facilitate democratic policymaking, the former encourages open and honest communication with the public. The second is a subversion of democracy. It implies that those who create the media narrative or set the rules are entitled to withhold information from the public that they might consider or value differently.AdvertisementAdvertisementApart from the question of truthfulness, it is important to consider whether telling noble lies is ethical in order to elicit socially beneficial behavior. Experts in infectious diseases may not be experts in social behavior. Faucis claims that he did not emphasize the importance of wearing masks in order to avoid a panic, but we can wonder how he could have known that his noble lie was more effective than being truthful and explaining to people why it was so important to ensure adequate supplies of masks for medical personnel.The potential for these misleading messages to backfire was made more apparent with the introduction of vaccines in 2021. The Centers for Disease Control and Prevention, key opinion leaders, and agencies all stated that once you have been vaccinated, everything changes. This implied that experts didn't know whether it was safe or unsafe to loosen restrictions and precautions, such as social distancing and mask wearing, after vaccination. Others, including epidemiologists, questioned the validity of this stance. They pointed out the high efficacy and suggested that social distancing could be reduced in certain situations. The no-change message, which may have been meant to discourage mass gatherings, or because people fear they will lie about their vaccination status, could have been detrimental. Surveys show that people are more interested in getting vaccinated if they are told it is possible to stop masking.AdvertisementAdvertisementA fourth noble lie was made by government agencies or officials more recently. The agency made the claim that adolescents were being hospitalized more frequently by citing data from March to February. It tweeted: The report highlights the importance of #COVID19 vaccine for adolescents Hospitalization rates have been rising, it was true. However, the hospitalization rates for this age group had fallen again at the time of the media coverage. Many commenters pointed out that the CDC's promotion of a rise in hospitalization rates was outdated at the time it was mentioned. This raised questions about the CDC's ability to promote dated statistics when they had the most current information.AdvertisementThis obvious error was repeated weeks later at a meeting by the Advisory Committee on Immunization practices. The committee met to discuss the facts and controversies surrounding myocarditis and heart inflammation. This was most evident in young men who had received the vaccine. During the meeting, representatives from the CDC presented a model that suggested that young adults could be vaccinated instead of getting the disease.AdvertisementAdvertisementThis model had some issues. It used outdated rates of community SARS/CoV-2 spread. The rates had dropped to lower levels by the time the meeting took place, which meant that the benefits of vaccination would have been reduced but that the risks would remain the same. It did not separate the risks for girls and boys, as they appear to have a significantly different risk of developing myocarditis (more so in boys). It also did not consider the possibility of a middle ground, such as a single dose of vaccine that provides a lot of benefits but has fewer myocarditis risks. The CDC instead presented only one or two doses of the vaccine as an option. Fourth, the modeling didn't consider natural immunity. This means that the vaccines risks to children who have already recovered from COVID-19 may be the same but the benefits are far lower, as these children do have some natural immunity. The model also failed to consider that young adults who have preexisting conditions or are otherwise healthy might have different risk-benefit profiles. This is because the former account for a large proportion of COVID-19 hospitalizations.AdvertisementThese are all the information decisions made by government agencies or officials regarding vaccination of young adults. To support rapid deployment of two doses mRNA to all children between 12 and 17 years old, we need to amplify out-of date statistics and build a model that supports vaccination. This may be the CDC's policy goal, which we sympathize with. This is not a noble lie, but it is possible to distort evidence in order to get this result. Part of scientific exploration of data is the objective reporting of current risks to adolescents and exploration of other dosing options.We are concerned that the vaccine policy of supporters of vaccines is becoming more influenced by the irrational views and policies of those who oppose them. They will always pursue the opposite. The anti-vax movement is an extreme attempt to reject vaccination. They exaggerate the current risk of the virus and fail to find middle ground positions. This appears to be a reflexive effort to vaccinate at any cost. Despite falling adolescent rates, it creates fear and pushes the idea that there are only two options.AdvertisementNoble liessmall untruthsyield unpredictable results. Nietzsche once said, "Not that you lied to my, but that you no longer believe me," which is a statement that explains why public health messaging relies on trust. This trust transcends the vast complexity of scientific literature and allows for effective communication. The communication is not reliable if there is a breach of trust. If trust is broken, the message becomes unclear and difficult to understand. The audience will attempt to reverse-engineer the statement according their interpretation of the speaker's intent. Simple words, noble lies can cause confusion and loss of credibility.Noble lies can be a trap. It is impossible to predict how the public will behave, so losing trust can be devastating. The public is too skeptical to blindly follow experts' advice, and too smart to fall for it.Future Tense is a collaboration between Slate, New America and Arizona State University. It examines emerging technologies and public policy.
