Healthcare and Scientific Expertise in the Era of Covid

As a practicing academic physician at a tertiary care medical center in Northern California, I have directly experienced the changes and challenges that the Covid-19 pandemic has brought to healthcare and to scientific discourse. Few people in medicine ever thought that the world would again face a global pandemic on the scale of the 1918 Spanish Flu. We were taught and believed that the last great “plague” was a disease of the past, before the age of antibiotics and anti-viral agents, ventilators, and advanced healthcare. However, we did not consider the possibility of a novel viral agent running amok across the world.

Would Covid-19 be as deadly as SARS1? Do we have enough equipment and bed capacity? Fear permeated our mindset. When my local area was the first in the United States to go into lockdown in March 2020, the science behind our decisions was incomplete. As my hospital began to navigate the unknown of healthcare delivery with an undetectable, highly infectious agent spreading throughout the community, we began to approach our clinical responsibilities with a different mindset, rules, and approach to patient care (e.g., personal protective equipment, diligent cleaning, and handwashing).

Our experience was not unique, as hospitals in many countries implemented similar changes to healthcare policies. Then we watched in disbelief as hospitals were overrun by Covid in Seattle, New York, and Italy and wondered if we were next. But the horror of those images were nothing compared to the shock that would come over the ensuing 18 months. Despite the development of rapid testing (so we could at least know if our patients were infected) and new therapies (e.g., convalescent plasma and monoclonal antibodies), we all awaited the creation of vaccines. As we in healthcare knew, masking and social distancing would only hold back the virus for so long.

Thankfully, multiple vaccines were developed, tested, and approved with record speed. Our prayers were answered, or so we thought. However, we watched a new horror show, the politicization of healthcare over vaccines and masks, the rise of anti-science sentiment, and the selfishness of individuals. Healthcare workers across the world were called heroes for selflessly facing the virus early in its course, but now we have been asked to continue to work in a world of variant viruses, to care for those who will not take the simple steps to get the vaccine or at least mask up. We are beyond exhausted and yet we must continue watching as Covid takes over more hospitals, leading to rationing and, in some cases, denial of care for non-Covid patients.

Within the US, the pandemic has led to the early retirement of nurses in large numbers and movement of nurses to other hospitals seeking better pay, thus further limiting patient care. I am sure similar changes to the workforce have occurred globally, or have they? The great differences among states for salary and nurse–patient staffing ratios has started a much-needed conversation about these issues and a demand for national standards. I am curious if such discussions are occurring in other countries with socialized healthcare systems.

A shortage of nurses and doctors in the United States was already predicted, but the pandemic has hastened the process. Within the United States, medical licensing is done at the state level, limiting movement of personnel. Despite similar training for doctors and nurses across the globe, acceptance of foreign graduates in the United States is hampered by arcane rules. If we are to fight more global pandemics in the future, movement of trained professionals between countries should be a priority for discussion between countries and may be necessary to ensure that we have adequate levels of healthcare staff.

Equally concerning has been the rise of anti-science and anti-intellectualism, even among our most educated. The inability of the general population to utilize critical thinking skills to assess data is not due to a lack of science education, but to a lack of teaching of those skills. Everyone is not an expert in everything, and the lack of trust in true expert opinion has only prolonged the pandemic for everyone. Social media has played a disproportionate role in creating the current situation. Healthcare workers have gone from being heroes to being pariahs in many communities and states for simply speaking truth about the effectiveness of masks and vaccines.

Despite what may appear to be a gloomy outlook, I believe that we will rise above the pandemic. Scientists, nurses, and physicians will continue to work under challenging conditions to improve patient care and find new treatments. But we need to consider why we are where we are, and what steps we need to take now so that we don’t repeat them again. It is now time to discuss increasing, not decreasing, scientific and medical cooperation between countries. More importantly, we need to address the lack of critical thinking skills among our populations and maybe change our educational system in the process.

Cooperation between countries is crucial for being prepared for any crisis and it is for this reason that I am involved with the Humboldt Network. I look forward to our future engagement and conversations.

Timothy Angelotti, AFAvH Board member

Emerging from COVID … the Impact on Networks

The International Association for the Study of German Politics (IASGP) is an association devoted to the academic study of the politics, economics, international relations, and society of contemporary Germany, Austria, and Switzerland. Its origins lie in a decade-old merger of two nationally-based associations: the UK’s Association for the Study of German Politics and the US-based Conference Group on German Politics. The highlight of the IASGP’s activities takes place every four years, when the Association organizes an election study trip to Berlin; its members from the United Kingdom, United States, and elsewhere around the world come together to observe the German federal elections and meet with politicians, pollsters, and other experts. In the intervening years, however, the UK- and US-based members have had few interactions. The IASGP’s annual conference is usually held in the United Kingdom and is attended primarily by scholars located in Europe, while the American members often meet up at conferences held in the United States, such as the American Political Science Association Annual Meeting.

The COVID-19 pandemic provided an impetus for the IASGP to become a truly international association with regular interactions among its members living across the globe. During the spring 2020 lockdown, members joined Zoom socials to chat among themselves, both about developments in German politics and to discuss the lockdown’s impact on professional activities. Graduate students in the field expressed concern for their professional futures given the expected economic slowdown. These worries spurred more senior faculty in the field to consider what could be done to assist in younger IASGP members’ professional development. The outcome of this conversation was an online graduate student conference sponsored by the IASGP in early December 2020. It featured discussions on topics of relevance—including a session on how to obtain research funding, led by a German professor; a discussion of how to successfully apply for jobs, led by a UK-based Pro-Vice-Chancellor; and a talk about effective strategies for developing an article for publication. I, a US-based faculty member, led the latter session in my capacity as co-editor of the IASGP’s journal German Politics. The conference was attended by students from a range of different institutions who would have been unlikely to come together if not for the increased use of videoconferencing technology.

The pandemic also spurred an increase in transatlantic cooperation between the IASGP and Washington, DC’s American Institute for Contemporary German Studies (AICGS). This spring, the two groups have partnered to offer a series of webinars and on-line articles about the 2021 German National election. Speakers in the series have included scholarly experts in the United States, the United Kingdom, and Germany discussing the upcoming contest with German politicians. Even though travel across the Atlantic has been impossible for many, the series has allowed both academics and members of the general public to keep up with political developments in the Federal Republic. I have enjoyed watching the webinars while at the same time being able to live chat with colleagues from around the world about German politics. Prior to the emergence of the coronavirus, such informal conversations would have likely only taken place in September, when I gathered in person in Berlin with my fellow German politics scholars. 

One silver lining of the pandemic, then, has been an increase in the routine exchange of ideas among academics across borders. Our “international” association is now more fully living up to its name.

Louise K. Davidson-Schmich, AFAvH Board member

The Humboldt Network—For the Non-Academic

As a practicing engineer, my professional life is global. Every project I am involved with can only be achieved with engagement from people around the world. The ideas that form the scientific foundation of the work we do is ageless and developed with input from every corner of our collective human understanding. The material we use to build is sourced from many different countries. The engineers, contractors, and laborers who realize the new constructions, repairs, or responses similarly hail from everywhere—and very seldomly from the same place.

Similarly, as an engineer that responds to catastrophes, I see every day that gravity is non-negotiable. Science is the basis for all the things we take for granted. We take for granted that our buildings withstand storms and protect us from the elements every day. The I-35W Bridge collapse in Minneapolis a decade ago was so shocking because we have done such a good job of managing risk and building a robust infrastructure. The ever-delayed infrastructure work notwithstanding, major bridge collapses are almost unthinkable.

So during this time, when it feels like we are restarting, we must work to reinforce and recapture the concept of facts, rigorous experimentation, and robust predictions of the future. 

Gravity goes down everywhere on earth—and on other planets the appropriate pull of gravity can be quantified. We are all in this together. There are constants and laws of physics and chemistry that are reliable. I enjoy standing on these hard spots and reaching toward new findings and new developments—and often this kind of reach works better when I am holding the hand of someone across the Atlantic. In the most mundane example, when we have a new challenge, we often look to European codes or others to find a solution to a problem that we did not know we had. We are constantly learning from one another how to make construction safer, more sustainable, and more robust by learning from and collaborating with our partners overseas.

As the daughter of Germanic literature professors, I appreciate that innovating without context feels soulless. Where the scientists and engineers may give us a how, the humanities give us the why. Knowing why we are working together, the common values and vision that we are all working toward more understanding, peace, safety, beauty, and community helps us focus, evaluate, and ultimately achieve technical outcomes and inventions that are not just novel but fundamentally make society better.

I am involved in the Humboldt Network because I am so grateful to be able to have interactions with people like you—thoughtful experts who welcome viewpoints outside their own. I look forward to the conversations to come.

Elisabeth Malsch, AFAvH Board member

It’s Time to Enhance the Diversity of the US Humboldt Network—for Science and Society

2020 has been an extraordinary year. Against the backdrop of a global pandemic, severe economic distress, and devastating natural disasters, protests calling for racial justice have spread to communities around the world. In the scientific and scholarly community, institutions are challenged to confront their histories and practices, and to identify meaningful actions to illuminate racism’s legacy and remove impediments to diversity, equity, and inclusion in our respective societies and globally. 

As concerned citizens of various nations and scholars of all disciplines, the members of the global Humboldt alumni network, working together, have tremendous potential to address not only exclusionary beliefs and practices in scholarship and international exchange, but also other critical issues at home and across borders. We, as a community, must be prepared, in these turbulent times, to actively bring to bear important and varied perspectives on scholarship and the societal challenges that lie before us.

We can begin with an honest examination of our own scholarly communities. We must also nurture and tend to our own connections, while taking nothing for granted and leaving no assumption unchallenged. 

With over 30,000 alumni in more than 140 countries, the diversity of the world-wide network of Humboldtians is realized through its global reach. Yet, if we focus only on global diversity and demographics, we ignore the factors that, unacknowledged and unseen, have shaped the national scientific enterprises that we draw on to recruit fellows and awardees. With over 5,400 members spread across more than 448 academic, non- and for-profit, and governmental organizations in the United States, the US network includes all disciplines and many professions and is geographically dispersed. But is our network truly inclusive of the best scholarly and professional talent across US society? If not, what can we do, as US Humboldtians and as a network? 

The US Humboldt alumni network, and the US context, are partial but important elements of the broader global Humboldt network. As a partner of both the Alexander von Humboldt Foundation and US alumni, the Board of American Friends of AvH therefore has proffered its commitment to encourage and support Black Americans and others from groups underrepresented in the US Humboldt ranks to apply to and participate in the Humboldt Foundation’s exchange and mobility programs. In order to create a more inclusive and equitable organization and US alumni network, the AFAvH Board drafted and adopted a pair of statements expressing our commitment to diversity, equity, and inclusion and to action for Black lives and racial equity in international science, scholarship, and professional practice.

As a first step, American Friends of AvH is compelled to better understand the US Humboldt alumni network, the communal value of the Humboldt experience, and what connects us. Through our conversations with alumni over the last three years, we have learned about the contributions and experiences of individual Humboldtians. We have confirmed that Humboldtians take diverse career paths and that many sustain strong professional and personal connections to Germany. Many also regard their Humboldt experience as transformative, opening their minds to new ways of seeing the world and new approaches to research. 

We must also critically examine our outreach and communications strategies so that we recruit inclusively and equitably within the communities on which we draw. Does our outreach overlook or exclude individual scholars, scientists, or professionals of excellence because of the way that “excellence” is defined, measured, acknowledged, and rewarded? How do we reach out to talented scientists, scholars, and young professionals underrepresented within the Humboldt network and those without previous ties to Germany? How can we demonstrate the relevance of AvH programs to their area of scholarship or professional activity, and convincingly convey that the Humboldt experience can provide valuable perspectives, experiences, contacts, and resources that will take their work in new directions?

A more diverse community engaged in global exchange will not only better reflect the composition of US society, but will also help to produce better and more relevant science and scholarship for society. As we have learned from US alumni, Humboldt programs create opportunities for connection, learning, enrichment, and exploration of shared problems. International perspectives and connectedness may also shine new light on national contexts of common experience, shared values, and mutual benefit. Such experiences may also compel us to think mindfully about the ways in which we are connected to others, when shared values, concerns, and interests may be obscured by distance, race, gender, age group, sexuality, profession, and nationality. Unpacking and disentangling these interconnections is often challenging and finding common motivation is needed to build new knowledge and bridges.

Deep diversity in the US and global Humboldt networks could also help sustain international collaboration. The global Humboldt network connects generations and diverse disciplines and sectors of society across 140 countries. Humboldtians’ experiences build connections between experts who instinctively appreciate the value of international collaboration, mutual understanding, and empathy. As world demographics shift, the fruitful transatlantic and global relationships seeded by the Humboldt Foundation could sustain opportunities to build and share collective knowledge that enhances global knowledge and conveys more equal benefit to the individuals who make up and contribute to American (and other) society(ies).

To encourage and nurture such relationships , American Friends of AvH is excited to announce a new Digital Dialogues series that will explore diversity and excellence and delve into issues of racism and scholarship. The series will also highlight the research and experiences of Humboldtians of color and will feature opportunities available through Humboldt programs and networks. 

To be certain, we are deeply indebted to the AvH for bringing us all together. However, we, as US Humboldtians, have individual and collective responsibilities to reflect honestly on our shared scientific norms, practices, and priorities. Only then, and while nurturing and tending to our Humboldt connections through our own agency, can we determine what unites us and realize our potential in a world of complex global challenges. 

We look forward to your joining us!

Andrea Stith, AFAvH Board member and Diversity, Equity, and Inclusion Task Force chair