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Francis Collins, MD, PhD, former director of the NIH and current science advisor to President Biden, spoke about Elon Musk's takeover of Twitter, his "distress" over evangelical Christians driving vaccine hesitancy, and why clinical trials for long COVID are taking so long during a Washington Post live event on Tuesday.

COVID Misinformation Abounds on Social Media

Collins noted that Musk, "a free speech absolutist," dropped Twitter's last week, characterizing the potential impacts as "pretty obvious."

"There is an unprecedented tragedy that has unfolded here, where misinformation has not been just a blow to the ability of people to discern the truth, but it has been a fatal blow," he said.

An estimated died because they passed over "a free, safe, and effective vaccine" after misinformation clouded their judgment, he added. "Our culture war is killing people" and misinformation, often spread over social media, is at least partially to blame.

Asked what he would tell Musk if he had the opportunity to speak face to face, Collins embraced the hypothetical. "So Elon, you've built your career on science. Why aren't you worried about a circumstance where there is unbridled, demonstrably false information that is dangerous to people's health?"

Collins, an evangelical Christian, acknowledged that this demographic, specifically white evangelical Christians, are "most likely to be suspicious and resistant to vaccines."

"Christians, of all people, are supposed to be people of truth. 'The truth will set you free,' the words of Jesus, John chapter 8 ... It's so upside down. And this, for me, is a source of great distress," he noted.

For this reason, he said he's tried to leverage his own background to reach this community by speaking on podcasts alongside other evangelical thought leaders, such as Rick Warren, Franklin Graham, and Tim Keller. He had even thought about writing a book on the subject until he was called to be science advisor to President Biden.

Misinformation is "contagious," Collins said, especially in our current environment where everyone has split into "tribes" of like-minded people that influence their perspective. People look at evidence through their own frameworks or "web of beliefs," he added, quoting the philosopher Willard Van Orman Quine.

"If something comes at you that doesn't fit your 'web' very well, you're going to find a reason to be skeptical or even just disregard it, and if something that comes at you that's absolutely falsifiable, but it kind of fits your framework, [you might then say] 'okay, I'll just send that to the next 10 people on my Facebook feed,'" he said.

He encouraged the use of stories and anecdotes, rather than statistics, to communicate science to non-scientists. "I think there is an incredibly important role for an anecdote that actually well-describes the data."

To illustrate his point, he shared the story of , a 36-year-old man from Alabama who belonged to an evangelical church with his wife, Christina.

They both had read about concerns around the COVID-19 vaccine on social media and decided not to get it. Over the summer in 2021, both Tidmores contracted COVID. Christina got better. Josh, who had no pre-existing conditions, died in August, days before his birthday.

When his wife told others in their church what had happened and urged them to get vaccinated, she was "pretty much ostracized," Collins said. "That breaks the heart of anybody who hears that story."

The Challenges of Conducting Research on Long COVID

The NIH was given , but the patient community has been frustrated by the lack of progress, said Frances Stead Sellers, a senior writer for the Washington Post, who interviewed Collins.

Collins said he regularly gets emails from discouraged people who are suffering from brain fog, palpitations, and fatigue.

"And the challenge, of course, is that this is a really hard, complicated problem. It is maybe not even just one disease. We don't understand the mechanism behind it," he noted.

Clinical trials are just beginning, but even those may not have results until 2024, he added.

Moreover, one lesson learned during the COVID pandemic was that after "a whole bunch of clinical trials [were] put forward in a big hurry ... most of them were small, underpowered, and you would not really have been able to get much of a conclusion," Collins said. "I think what we learned from that is, do it right. Likewise, with long COVID, you don't want to do a quick and dirty trial with something that maybe gives a hint of a result, and then it turns out to be wrong."

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