Sunday, November 13, 2005

In defense of The Flu Wiki: reply to Mattison

I've been attending to personal matters for the last couple of weeks and missed the spirited exchange about whether the Flu Wiki is a trustworthy source of information, initiated by librarian David Mattison on his Ten Thousand Year Blog. My two editor colleagues have replied to Mattison via his comment threads. I thought I'd make my reply here because he raises a crucial point that bears some discussion (although we won't discuss it to the extent it merits, since that would require a book length treatise).

Before I get to the only issue of substance he raises (trust), I would like to clear the air about some of his minor rhetorical points. He accuses my fellow editors DemFromCT and Cassandra and me (Revere) of hiding behind email addresses. I will speak only for the Reveres here. We have quite public lives that involve advising government entities on matters of public health and also have substantial and large research programs funded by NIH, CDC and other government agencies. We have also been highly critical of government policies here and have used diction suitable for a blog but not for professional discourse. Mr. Mattison may not be aware of it, but this is a highly punitive administration and we are protecting our colleagues, our students and our institutions by separating our blog lives from our public and professional lives.

Moreover, I could tell him our names and it would probably mean nothing to him because he doesn't know anything about public health, just as I know little about librarianship and archivists. He describes himself as an archivist-historian. I have to take that on faith (and I do), but knowing his name tells me nothing.

Which brings me to his main point, with which I both agree and disagree. The key issue here is one of trust. Not authority. An authority is just a source one trusts because of its station or status, so it is just a trust issue wrapped up in complicated perceptions as to who is trustworthy and why. Moreover, as Steve Shapin notes in his study of 17th century science in England (A Social History of Truth), trust is at the basis of all science. When I read a scientific paper there is a great deal I must take on faith: that the authors are telling the truth, that the data really are as described, that the citations say what they are supposed to say, etc. I can check some of these things (like the citations, but then those citations have other citations, etc.), but not others. I must take them on trust, trust which is sometimes misplaced as we have learned in recent years. But Mattison believes that if the authors were to identify themselves this would allow him to tell if what they were saying was true or not. Not likely or even plausible. I also note that I don't demand that of many other sources of information, like dictionaries. Nor if I use the efforts of a librarian, whom I don't know. I only know he or she works at the library.

Of course we all look for indicia of trustworthiness, of which some are the credentials of the speaker, their educational background, their experience, etc. I am gratified and touched by Mr. Mattison's reverence for authority and credentials, as it is useful to me in my public life. But it is a misplaced confidence misses the point of the Flu Wiki and goes to the heart of Mattison's misunderstanding of what the Flu Wiki's intentions and method are.

First, let me digress to give some of the history of the Flu Wiki project. I had been writing for many months on this blog about the looming problem of a potential pandemic from avian influenza long before it had received much notice from the media and very little in the blogosphere. Two other bloggers, Melanie Mattson at Just a Bump in the Beltway and DemFromCT, a former front-pager at DailyKos and by then starting his own group blog, The Next Hurrah, were also posting informed pieces, but there were few others. It turns out each had good reasons to be well informed but that is part of their story and for them to tell, not me. More importantly, I trusted their judgment from the content of their posts long before I knew anything about their backgrounds.

In June of 2005, one of my commenters suggested I take a couple of my expository pieces and put them on Wikipedia. I had already done some light editing and correcting of technical matters on the influenza entries there and I liked the idea, but was afraid the subject would get lost. So I contacted both DemFromCT and Melanie and suggested we start a wiki devoted to avian influenza. Melanie knew a technically savvy blogger who could get us started (pogge) and that's what we did.

Because we saw the problem as urgent, we jumped right in, populating the wiki initially with some links and original background or primer entries on the science of influenza, which I wrote. The latter are up there still in the Basic Science category (although they have been edited and reformatted a number of times). They have been looked at by a number of other experts and been found accurate, but if there were mistakes, they could easily have been corrected and I fully expected that would be the case. Unlike "authoritative sources" like a scientific paper (of which I have written about 100) or textbooks (to which I have contributed chapters), errors, mistakes or new knowledge can be corrected in a wiki. In that sense it is a superior medium.

But technical detail and precision, while necessary, was not the Flu Wiki's main objective. Nor was providing the kind of information resource one finds on the CDC, WHO or state health department sites (which at that time were pretty non-informative). The problem of a pandemic was that it could produce debilitating illness in a large fraction of the population for weeks at a time. We learned in the 1918 pandemic the kind of disruption to civil society this could cause. But many of the problems were not public health problems in the conventional sense, but problems caused by a 30% - 40% absenteeism rate. We worried what would happen, say, in the northeast if absenteeism caused deferred maintenance, interruptions in a just-in-time inventory system for spare parts, uncleared roads because of shortages in plow drivers and short staffing of linemen during a blizzard or ice-storm. Instead of power being out for a day or two, it could be out for a week or more, with cascading effects on interdependent critical infrastructures.

This is just an example. There were many, many more, and most were foreseeable by someone who knew their business and took the time to think about the consequences. The relevant "experts" might be owners of a small bodega the neighborhood depended on for food, a rural pharmacist who supplied insulin or blood pressure meds to a wide area, or the director of a small water system with one person who ran the chlorinator or did the routine analyses. What if key personnel were out sick? Often the problems could be worked around if some advance thought were given to what to do in the event of a pandemic. This is now called "continuity of operations" planning. But the consequences and the solutions were well out of the expertise and the scope of CDC or WHO and weren't being addressed by anyone at that time. Our thought was that a wiki was a perfect vehicle for harvesting the vast amount of experience and wisdom available in our communities to think through these problems, and just as importantly, make them available to others. Hence the Flu Wiki.

I would say from my perspective it has surpassed our expectations in some respects and has still to realize them in others. There are now over 1000 pages of content, some original, many in the form of collected and organized links to other "authoritative" sources. (One of them is Dr. Woodson's manual, which Mr. Mattison trusts because he knows the name of the author, although I suspect he has no other means to vouchsafe its contents.) Unexpectedly the Forum function has become a vibrant and active venue where a great deal of activity and discussion takes place by well-informed and thoughtful people. It is clearly a place for debate and discussion. The site itself gets a couple of thousands visits a day and there is a great deal of activity. On the downside, there has not been as much original contributions as I had hoped for. We are working on ways to increase this. Still, organizing and presenting the information in one place has made the Flu Wiki a trusted source of information to many, and there is good evidence it has influenced the format and contents of the new site.

Finally, surprisingly at the end of his critical post about the Flu Wiki, Mr. Mattison (an archivist-historian) presents his own agenda for dealing with avian influenza. It is a prescription he apparently gathered from a recent issue of National Geographic. None of his suggestions are objectionable, except that they are just handwaving exercises. Reforming industrial poultry operations is a complicated issue, involving cultural practices and economic considerations well beyond the scope of the National Geographic article. Ditto for patent issues. They have been discussed on this blog and at various places in the Flu Wiki, but not on the CDC website.

Mr. Mattison is free to get his information wherever he chooses and it is important he have trust and confidence in his sources. But the problem is considerably more nuanced than he gives it credit for and isn't solved by merely Googling "flu" (try it), going to the CDC site or reading a magazine. That may suffice for some of the more superficial questions, but not most of the practical problems we will face should a pandemic materialize. I invite him to actually try to use one of his "authoritative" sites to find out what might happen to electric power in a pandemic and what might be done about it.

The comments thread is open for any response he (or anyone else) might care to make and if he wishes, I'll make the top available to him as well. We look forward to any of his reflections on this important question.

Update, 11/15/05: David Mattison has chosen not to reply, although apparently he couldn't resist lobbing a little snarkiness:
At least Paul Revere and other leaders and ideologues of the American Revolution such as Thomas Paine had the courage to be identified by name with what they believed in.

Since I feel enough’s been said on the subject of the Flu Wiki as a trustworthy source of information, I’ve now closed off comments on this entry.
Too bad. I thought it was an interesting topic.