What the Lyme wars can teach us about COVID-19 and how to find common ground in the school reopening debate – KRQE News 13

(THE CONVERSATION) Ive spent the past 11 yearsresearching and writing aboutthe controversy over how to diagnose and treat Lyme disease, one of the most contentious medical issues in the United States. Lyme is a tick-borne bacterial infection, and disagreement about it hinges on whether it can persist beyond standard antibiotic treatment in the form of chronic Lyme disease.

SinceLymes discoveryin Lyme, Connecticut, in 1982, the physicians who treat it have fallen into opposing camps: the mainstream and the self-described Lyme-literate. The mainstream camp argues that, in most cases, Lyme disease is easily diagnosed and treated and that chronic Lyme disease is a medically unexplained illness. The Lyme-literate camp argues that diagnostic testing is unreliable and that chronic Lyme disease should be treated with extended antibiotics.

Class-action lawsuits,protests,congressional hearingsandstateandfederalinvestigations have followed.

Few scientific issues are as polarizing, which is why the current debate over how to reopen schools during the COVID-19 pandemic reminds me of the Lyme wars. The school reopening debate has often been framed as one betweendisgruntled parents and obstinate teachers unionsand school administrators. But it has alsodivided scientistsand pittedDemocrats against Republicans.

As schools reopen, concerns over a delta-driven surge in cases, vaccine ineligibility for children younger than 12 and varying opinions about mask use in school settings loom large. I believe that the Lyme controversy offers four lessons on how parents, school districts, elected officials and scientists can find common ground and a path forward in the 2021-2022 school year.

1. Bring divided stakeholders face to face

After nearly 40 years of controversy over how to diagnose and treat Lyme disease, the U.S. Department of Health and Human Services established theTick-Borne Diseases Working Groupin 2016. It brought together physicians from Lymes opposing camps, as well as patient advocates, scientists and governmental officials, for in-person and online public meetings. Until 2022, when its congressional authorization ends, the groups task is to develop reports acrossdiverse viewsto guide federal decision-making on tick-borne prevention, treatment and research.

For school reopening, I believe that the formation of working groups at the district, city, county or state level would create space for real-time dialogue and constructive collaboration among divided stakeholders.

2. Find neutral zones of engagement

Within controversial terrain, whether its Lyme or COVID-19, some issues are less volatile than others. Unlike Lyme diagnosis and treatment, for example, Lyme prevention is remarkably uncontroversial. For this reason, prevention is one area where individuals across Lymes divide have been willing to collaborate.

For school reopening, a focus on less controversial aspects, such as decreasing community transmission, framing mitigation measures as tools that keep schools open and ensuring that schools are the last to close and first to reopen could help foster collaboration.

3. Seek out experts across disciplines

Multidimensional problems like Lyme disease and school reopening during COVID-19 require multidisciplinary solutions. As a tick-borne disease that affects many parts of the human body, Lyme disease requires expertise from a range of medical specialties such as infectious disease, cardiology and neurology in addition to expertise from entomologists and ecologists.

To tackle school reopening, partnered action among epidemiologists, virologists, aerosol engineers, occupational and environmental health specialists, pediatricians, infectious disease physicians, educators and social scientists would build bridges to common ground.

Over the past year and a half, disagreement about school reopening has led to accusations of epistemic trespassing or stepping outside of ones area of expertise and calls to stay in your lane. But widening the lane to include multiple perspectives and building coalitions across lanes could lead to a more complete understanding of school reopening.

4. Keep an eye on how evidence is used

For Lyme patients, physicians and scientists in the U.S., hopes of the controversys resolution were pinned on the outcome of four randomized controlled trials that studied whether Lyme patients benefit from longer courses of antibiotics. In the end, however, both sides used evidence from the trials toreinforce their original stanceandmake opposing claimsto scientific truth.

Something similar has been at play in the school reopening debate. Like Lyme, both sides, leading with phrases such as The evidence is clear or the The science says, have drawn on a range of scientific and medical evidence to makedifferent evidence-based claimsabout school reopening. As sociologist Steven Epstein inhis work on AIDS activismobserves, Uncertainty is often not just the cause of scientific controversy but its consequence.

In our intensely divided times, middle-ground solutions require too much compromise. But I believe that learning from Lyme disease and finding common ground through our differences will help communities get to the other side of another pandemic school year.

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What the Lyme wars can teach us about COVID-19 and how to find common ground in the school reopening debate - KRQE News 13