Post-truth and anthropogenic climate change: asking the right questions

The connection between climate skepticism and climate denial and what has become known as post‐truth culture has become the subject of much interest in recent years. This has lead to intense debates among scientists and activists about how to respond to this changed cultural context and the ways in which it is held to obstruct wider acceptance of climate science. Drawing on research in the sociology of scientific knowledge, science and technology studies, social psychology, and philosophical reflections on evidential reasoning, it is argued that these debates are focused on the wrong topic. The idea of post‐truth implies that a once‐straightforward linear relationship between scientific evidence and decision‐making has been eroded. But such an idealized relationship never existed. The proper role of scientific evidence in informing belief and action in response to the prospect of anthropogenic climate change needs reconsideration. A key part of this is to make uncertainties related to processes within the climate system and their potential outcomes into the main focus of public discussion around climate change. Instead of keeping the focus of debate on how to “get the science right,” such a reframing makes precautionary questions about the prospect of unacceptable losses into the main focus. This brings a variety of ethical and political values into the debate, perhaps creating better conditions for a minimal consensus about what to do

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection