COVID-19: Scientific Reasoning, Pragmatism and Emotional Bias

At this time of uncertainty, clinicians turn to experts and opinion leaders for advice on how to best manage a patient afflicted by a new and complex disease which affects primarily—but not exclusively—the respiratory system. Under the strains of pandemic practice, everyone is trying hard; clinicians must strike a sensitive and difficult balance in managing a relentless caseload with the limited (if not inadequate) resources at their disposal.

In the midst of early applause by the general public and intense scrutiny by healthcare systems and governments—it is clear that there has been wide variability in the provision of care for patients of similar severity affected by COVID-19. When all answers are in, is quite possible that some of the initial applause will turn eventually into fault-finding and condemnation.

In this context, it is very well to “sit on the fence” and from there launch darts of judgment at those who are trying to express a particular view, as long as these contestations help clinicians in their decision-making.

Surely, we are entitled to put forward a hypothesis to the scientific community without meeting the same unremitting finger wagging response in a time of uncertainty that demands that we choose the most logical approach to clinical problems we cannot ignore. We are left with the same conclusion: to prove and disprove something is the basis of scientific progress. It is possible, then, that future data will disprove the non-existence of spontaneously induced lung injury or prove the tragic consequences of ignoring it.