During the pandemic crisis of 2020–2023, it is likely that the successes of biomedical science were more than offset by its failures. These failures continue to undermine once-powerful ideals and hopes for science's role in societal betterment. Here, we dissect the underpinnings of these failures and argue that restoring such ideals first requires systemic reform of science itself.A new scientific elite of media-savvy experts from fields like virology and modelling (with or without relevant credentials) gained visibility and influence in political circles. The narrow, reductionist disciplinary and sometimes partisan perspectives of these scientists and ‘influencers’ helped justify the COVID-19 policies that allocated sacrifice, privation and suffering across all walks of society and hundreds of millions of lives.  The consequences for education, healthcare, small businesses, social life and democratic politics itself were often disastrous. Consequences were most acutely felt by vulnerable populations, from factory workers to school children, the old and the poor. [...]
Supposedly science-based responses to COVID-19 in turn built upon and amplified deeper contradictions at the intersections of science and public health. Some affluent nations with generously funded science, such as the United States and United Kingdom, had been experiencing slow-downs and even reversals of gains in life expectancy that predate COVID-1910, 11. These trends, unthinkable 25 years ago, both reflect and exacerbate pre-existing and entrenched health inequities. For example, life expectancy for men in London's affluent neighbourhoods is 18 years longer than for those in poor areas11. Such disparities have multiple causes, but the political economy of medical science is a critical part of the story12. Investments in health sciences focus overwhelmingly on reductionist, molecular-genetic approaches to cures, which can generate status for scientists and profits for companies, but have minimal benefits for population health and may even widen inequalities. Medical science delivered to society through market mechanisms continually inflates healthcare costs, another driver of inequities. Additional tensions at the science-health interface include misuse of direct products of science itself, such as opioids, and iatrogenic disorders. Indeed, during the lockdown, iatrogenic disease may have acquired new, unprecedented dimensions13. Yet study and communication of these disorders during COVID was too often demonized by high-level decision-makers and their scientific advisors, which in turn clouded our ability to openly debate the balance of impacts of the massive public health interventions imposed across large segments of the society.Can the systemic science–policy–public rift that became so acutely visible during COVID-19 be healed? To pursue this goal, democracies will need to embrace, over the long term, a new, different political economy of science, one that moves away from the current commodification of incentives and objectives29, 36, 37, acknowledges tensions between market incentives and public values, and accepts the limits of specialized expertise—and especially the danger of new hordes of influencers made possible by the new media38—for guiding society through challenges such as COVID-19.A necessary first step in this healing process would be for scientists and science advocates to recognize our own complicity in having supported the emergence of these problems, and in so doing to embrace the need for system redesign. Absent such commitments, we should expect a continued balkanization of science, expertise and truth, and will be left to hope that societies can discover sources of cohesion and coherence outside of the remit of science.

But what amazes me is now we're four years past the big event, and I have yet to see the definitively written retrospection on what happened. 

(I have many questions about the benefits and consequences of vaccines. I feel like there hasn't been an accounting of that either.)