The present and future of science intersect in Seattle

COVID-19: Unease and uncertainty

During the AAAS conference, infectious disease experts signaled their deepening unease of coronavirus COVID-19. 

“This is one of the most threatening outbreaks that I have seen in my career,” said Dr. Scott Dowell, deputy director for surveillance and epidemiology at the Gates Foundation, where he has been advising the organization on the outbreak’s global health implications.

In a special session devoted to the disease, Dowell said it is apparent that the virus is readily transmissible, will be difficult to contain and could have a major impact on low-income countries.

“Often it is the poor, the most marginalized, who get hit the hardest,” he said.

One of the uncertainties is how many people who come down with severe illness will die of this new disease. The signs are not reassuring. Currently in China, this “case fatality rate” is about 2.5%, but that number could move up or down as more is learned about the outbreak.

Dowell told session attendees that in China, the typical time from exposure to death has been 18 days. Because so many patients are newly diagnosed, it is still unknown how lethal this new disease may be. 

“At this stage of a rapidly expanding outbreak, to put it bluntly, most people haven’t had time to die,” he said.

However, the case fatality rate could fall dramatically if it turns out that most infections are mild. Unfortunately, patients with mild illness are more likely to be out and about, and thus more likely to silently spread it.

Columbia University epidemiologist Dr. Jeffrey Shaman described a complex disease forecasting model that takes into effect travel patterns, such as the movement of millions of people between cities during the Lunar New Year.

It suggests that as much as 85% of coronavirus cases in China are undocumented by medical authorities — patients whose cases have not been recorded, or people who were not sick enough to seek medical attention.

“I think we are looking at something with great pandemic potential,” he said. “Undocumented infections contribute substantially to this outbreak, and that means it will be difficult to control.”

— Sabin Russell

Harnessing algorithmic power in research

Science in many fields is increasingly reliant on the power of algorithms to make meaning out of data and kick-start new advances. 

One speaker warned students interested in becoming scientists that they must enroll in a program where they can learn computational methods, or “you simply will not be prepared to be a scientist in the 21st century.”

Scientists at AAAS showcased the range of projects where computational science is making an impact. In addition to Bedford’s work to track viruses, scientists shared how they are designing algorithms, for example, to create new types of protein drugs and computer-generated genomes for human-designed helpful microbes.   

Things are especially hot in one particular corner of this world: artificial intelligence, in which algorithms are designed to perform tasks that typically require a human brain. “It’s a very exciting time,” Gates said during his keynote address, noting that AI processing speed is increasing faster than Moore’s Law would predict.

AI is increasingly involved in overcoming critical health problems, he said, and several scientific sessions at AAAS illustrated the breadth of scientific challenges AI is now helping humans tackle. Highlights included: 

• An AI to identify toxic chemicals based on the corpus of published studies without time-consuming, expensive and poorly reproducible animal studies.

• An AI to help scientists keep on top of the staggering amount of scientific knowledge in the world (2,200 new studies published every day) and quickly synthesize information on a topic. 

• A “virtual human” — really, a series of AI tools to simulate different human physiological functions — that could be used to aid clinical decision-making, for example.

— Susan Keown 

Revealing the inner workings of cells

New technologies, including those that offer a window into the inner workings of individual cells, are giving us unprecedented insights into the human body. Using new single-cell technologies, scientists around the globe are collaborating on the Human Cell Atlas, working toward comprehensive reference maps of the human body, from our cells (all 37 trillion of them) to our organs, in health and disease. Though the HCA is still a work in progress, scientists are still making discoveries based on the new information gleaned from the cutting-edge technologies used to build the first few maps, including discovering new cells in the trachea and the developmental trajectory of human organs. 

“Humans are diverse and cells are diverse — no one lab should build [these maps] alone,” said Dr. Aviv Regev, a biology professor at the Massachusetts Institute of Technology, a core member of the Broad Institute and a Howard Hughes Medical Institute investigator who co-chairs the HCA organizing committee. 

 Scientists from 71 countries are contributing to the HCA, including several Hutch researchers. Dr. Ed Lein from the Allen Institute for Brain Science, who is also a part of the HCA, spoke of the Allen Institute’s efforts to map the human brain using single-cell technology and tissue donated post-mortem and from living donors. Living donors and study participants can provide invaluable information to health researchers, including through avenues outside of academia. The head of research at the direct-to-consumers genetic testing company 23andMe spoke about the company’s efforts to study Parkinson’s disease using genetic and clinical information provided by consumers. 

 But the unprecedented insights we can obtain from donors opens the door to new ethical concerns. New insights rely on people, so those who want to should be able to — but they need to truly volunteer, said Dr. Karen Rommelfanger of Emory University. She addressed patients’ right to decide the fate of their body, their authority over their biospecimens, and to contribute to how their data may be archived for future use.

“The scientific process and societal value are undermined if even one person is reduced to a standing reserve of body parts and tissues,” Rommelfanger said.

— Sabrina Richards

Spreading the word about science

In the crowded information and media landscape, science may be getting less attention — and authority — than in the past. Several sessions provided case studies, tools and tips to help scientists and science communicators  improve their efforts.

There was a particular focus on improving the use of scientific evidence in policymaking, which has faced increased resistance in recent years, as exemplified in the quote, “People in this country have had enough of experts," made by British conservative politician Michael Gove during the Brexit campaign in 2016. 

Stephan Lewandowsky of the University of Bristol, U.K., presented research showing the dissociation of people's beliefs in specific claims from their voting intentions or feelings for a political candidate. The impact of this has been an increase in falsehoods and propaganda spread by politicians who are no longer compelled to be honest because facts aren’t important to how people vote. 

There were more positive case studies presented about campaigns in Spain and Canada that successfully used social media to mobilize the scientific community and connect with voters to demand greater use of scientific evidence by legislators. 

Additionally, media outlets (NOVA, KQED and PBS NewsHour) partnered with academic researchers to better understand the effectiveness and impact of the content they were creating about science. They shared their learning and offered potential models for encouraging similar, future collaborations.

— David Patton

Overcoming health disparities

But even amid all the innovative scientific advances and achievements, an old foe remained: racial inequities. 

Virginia State Health Commissioner Dr. Norm Oliver opened a panel discussion on health disparities through the lens of history, psychology, law and medicine with a quick rundown of U.S. racial inequities in health, which he said are still “quite rampant.”

“In almost every disease category, African Americans die in excessively high numbers,” he said. “We get sicker at a younger age, we have diseases that are more morbid, more serious in terms of consequences and we die at a younger age. When it comes to diabetes and stroke and some cancers, we die at twice the rate. And these disparities exist in many other populations, as well.” 

Importantly, he said, the differences cannot be explained by mutations that drive more aggressive disease. 

“This is not because of genetic differences between African Americans and whites. Or Latinos and whites,” he said. “This is a result of the social inequities in our society that impact those populations.”

Oliver shared research showing how people of color are still subject to overt racial bias, unconscious racial bias and a slew of false beliefs, such as the longstanding myth that black people tolerate pain better than white people. As a result, black people are often under-prescribed pain medication, even when dealing with serious injuries like broken bones.

But there is good news, Oliver said. 

“The important thing to understand about health inequities is that we can reduce them,” he said. “There’s a way to tackle the problem. We have to start off by understanding that racial inequities in health are a particular instance of social inequities in our society.”

At Fred Hutch, the Office of Community Outreach and Engagement works to reduce disparities in Washington state and elsewhere by partnering with community groups to bring science, research and cancer prevention to all people, particularly African Americans, Hispanic/Latinx people, Native Americans, Asian Americans, people in rural areas and other underserved groups. Ongoing projects encourage early cancer screenings, raise awareness about obesity, address the psychosocial aspects of cancer survivorship, and encourage healthy eating and fitness — efforts all designed to close the gap in health disparities and reduce diagnosis and mortality rates from cancers and other diseases. Learn more about Fred Hutch’s efforts to serve all populations at the May 15 Pathways to Equity Symposium. Registration opens April 1.

But there is much more to do, according to the health commissioner.

“We need to change the way we teach and practice medicine,” Oliver said. “And we also need to deal with the structural basis for these inequities.” 

— Diane Mapes

Best lines, wildest stories: Top picks from AAAS

Writer Jake Siegel chose these best-of moments from the meeting:

Best overheard line that summed up the AAAS crowd: "As a radiochemist, I always like to ask people what their favorite isotope is."

Most ominous anniversary: Jan. 20 marked the 220th anniversary of the last mega-earthquake to hit the Cascadia subduction zone. The excellently titled "Is the Coast Toast?" session unpacked how scientists are preparing for the next one.

Fun fact: Apparently Seattle sits on a basin of sediment that will shake like a bowl of jelly when the next one hits. Meanwhile, La Grande, Washington, 60ish miles to the south, will ride out a magnitude 9 quake a lot more smoothly. "We should have built Seattle in La Grande," an engineer from UW’s M9 Project dryly noted. 

Line most likely to keep me up at night: "If it has DNA, somebody is probably trying to CRISPR it already." That's from Fred Hutch's Dr. Jen Adair, who spoke at Friday’s press breakfast event and gave a flash talk on gene editing. Adair, who holds the Fleischauer Family Endowed Chair in Gene Therapy Translation, wants to bring gene therapies to patients worldwide and wrestles with the ethical challenges the technology poses.  

Most humbling moment: AAAS held a Family Science Days event next door, and I made the rounds with a 9-year-old. As he chatted with a materials engineer and took notes as part of a Science Storytellers session, I realized he was a better interviewer than me. (Kudos for a fun event, AAAS!) 

Wildest making-lemonade-out-of-lemons story: Dr. Alfred Morgenstern of the European Commission Joint Research Center discussed his promising research on radioactive molecules that can attack cancer cells with little to no damage to surrounding healthy tissue. One such molecule: Thorium 229, a byproduct of making nuclear weapons. It blew my mind that waste from one of the ghastliest chapters of the 20th century is offering hope in the 21st.  

— Jake Siegel