Take the airborne nature of SARS-CoV-2: early in the COVID-19 pandemic key advisory groups, such as the World Health Organisation, assumed that respiratory droplets were the dominant mode of transmission. This led to advice on and practices of social distancing, hand-washing, wiping surfaces, wearing plastic face shields, and putting up plastic barriers between customers and servers in shops.
As more research was conducted the evidence emerged that SARS-CoV-2 is airborne. It can be transmitted both at closer and longer ranges. So, while social distancing remained important, mask wearing and air ventilation became other crucial tools to fight the spread of COVID-19.
This shifting of knowledge can lead to uncertainty for people when making decisions based on evidence. But it can be done, if everyone – from ordinary citizens to journalists reporting on big issues and researchers trying to communicate their findings – accepts that science changes, and behaves accordingly.
Citizens need to develop the habit of asking questions about the research evidence and never taking headlines at face value. Journalists need to be well trained in understanding research, asking critical questions and communicating findings in a way that allows the public to understand the whole picture.
Researchers also need to be better at communicating the value of complete evidence bases over single studies. They need to be honest about the uncertainty within findings, and findings that keep emerging from bodies of evidence.
At the Africa Centre for Evidence, hosted by the University of Johannesburg in South Africa, we conduct research about the use of evidence in decision-making to reduce poverty and inequalities in our country and continent. We have published work about the use of evidence synthesis as central to decision-making. Our experiences of working with governments have underscored the importance of considering the body of evidence when making decisions, instead of single studies. We have also seen how important it is to engage users on what is considered as evidence for use in decision-making.
One part of the story
So, why does science shift?
First, because one part of the story is not the whole story. In almost all cases, a single research study can only answer part of the question. And the reliability, validity and ethics of that single piece of research need to be carefully examined to check the accuracy and usefulness of its findings.
A research methodology known as systematic review, or evidence synthesis, has been used for decades to ensure that all reliable research relevant to a specific question is carefully collated to provide a comprehensive and transparent answer.
Any time a decision matters, using a systematic review to inform that decision is far preferable to using a single study. A complete evidence base – a synthesis of many reliable studies – gives a more complete picture.
COVID-19 is one example of how an evidence base can offer a fuller picture than a single study. When the pandemic struck in March 2020, the world sought answers quickly. The early days and months were a scramble for understanding: we needed to know fast how the virus spread, how to avoid infection, and what treatments were effective. As the evidence base has grown, so has our collective understanding and behaviour.
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