Is the change in posture about the coronavirus based on science or political ideology?
Watch today’s SYSTEM UPDATE on this topic on The Intercept’s YouTube channel, with guest Adam Gaffney of the Harvard Medical School, or on the player below.
Remember the coronavirus? That was the pandemic which we were told by public health experts since February was so grave — the worst public health threat since the 1918 Spanish Flu — that we could not go outside for any reason, even if it meant a collapse in the global economy, tens or hundreds of millions of people suffering from unemployment, the permanent shuttering of small businesses, sustained mental health damage, and the separation of people from their loved ones and communities, including barring them from visiting dying spouses and parents and children in the hospital or even attending an outdoor burial.
So dogmatic was the dictate that we all stay at home that any attempt to question or even balance it — by, for instance, arguing that the harms of the virus had to be weighed against the suffering from an economic shutdown and a global depression — was deemed immoral. Those who questioned state-mandated lockdown and stay-at-home orders, let alone left their homes to actually protest against them, were condemned as sociopaths who were willing to sacrifice the lives of old people for economic prosperity or the trivial, troglodyte desire to go to Applebees. Oftentimes those protesting lockdowns were vilified as white nationalists or at least driven by white racialist sentiments (sometimes they were that, but often they were not).
People who left their homes for any reason other than officially approved “essential” functions were — no matter how careful they were — publicly shamed if not fined and arrested. A lawyer became famous and celebrated for dressing up as the Grim Reaper to shame people for being at even deserted beaches in the sun with ample social distancing. One particularly creepy video from a police department in the United Kingdom used drone footage to castigate and denounce people who did things like walk on nature trails or go for family drives:
In sum, all decent people, by definition, accepted and submitted to the imperative of self-isolating and staying at home. No harms from that isolation — whether economic, social, or ones implicating mental and physical health — justified opposing or even questioning that decree. Not just our own health but the lives of others, the social good, concern over the well-being of nurses and doctors, and ongoing respect for science and medicine mandated that we acquiesce to this framework.
Roughly two weeks ago, everything changed. Well, not everything: there’s still no cure for COVID-19, nor any treatment, nor any vaccine against contracting the coronavirus. It is still just as lethal as it was in February and still as contagious. And in many parts of the United States, the infection curve has not plateaued but instead continues to increase. On Monday, the Los Angeles Times warned that “in the last two days, Los Angeles County officials announced 81 new coronavirus-related deaths, the highest total reported over a weekend in more than a month.” Meanwhile:
Texas reported over 2,500 new coronavirus cases Wednesday—the highest reported in a single day by far since the pandemic started—as the number of Texans currently admitted to hospitals for coronavirus climbed to a new record for the third straight day, as the state, which had one of the fastest and most aggressive reopening timelines in the nation, has seen a surge in infections about two weeks after Memorial Day.
So nothing has really changed regarding the epidemiology, infectiousness or lethality of the disease. If anything, it has become somewhat more alarming as evidence mounts that many people who manage to survive the virus will be debilitated with long-term damage to vital organs and other parts of their body.
What has changed — dramatically, radically and abruptly — is the messaging from public health experts and even public officials about the virus. Beginning roughly two weeks ago, we all watched as mass stay-at-home orders and self-isolation gave way to massive street protests, where tens or hundreds of thousands of people gathered together in the U.S. and around the world, often one on top of the other, chanting, yelling and singing: a virtual laboratory for what we had spent four months hearing was exactly what one must not do in the middle of this pandemic.
And yet, in very stark contrast to the vehement denunciations from public health experts of prior protests or out-of-the-home activities of any kind, virtually no prominent experts have denounced any of this on the ground that it will spread the coronavirus and ultimately kill more people (even though that is highly likely to happen). To the contrary, many infectious disease experts have done the exact opposite: they have endorsed and encouraged these mass street protests, claiming not that their support for them is grounded in their political values but in their health and scientific judgment. As the journalist Thomas Chatterton Williams put it in an outstanding Guardian op-ed on this question, headlined “We often accuse the right of distorting science. But the left changed the coronavirus narrative overnight”:
This feels like gaslighting. Less than two weeks ago, the enlightened position in both Europe and America was to exercise nothing less than extreme caution. Many of us went much further, taking to social media to castigate others for insufficient social distancing or neglecting to wear masks or daring to believe they could maintain some semblance of a normal life during coronavirus. At the end of April, when the state of Georgia moved to end its lockdown, the Atlantic ran an article with the headline “Georgia’s Experiment in Human Sacrifice”. Two weeks ago we shamed people for being in the street; today we shame them for not being in the street.
Examples of this are too abundant to list here (today’s SYSTEM UPDATE episode covers many of them). New Jersey’s Gov. Phil Murphy condemned anti-lockdown protests just last month, righteously announcing that public health rather than protests will guide the state’s quarantine policies; then last week, after George Floyd’s killing, Murphy praised the massive anti-police-brutality protests in his state without even attempting to reconcile that with his prior stay-at-home messaging; then, last week while he praised these protests, he extended his “public health emergency” order for 30 more days out of fear of what he called “a new outbreak of #COVID19″ — and he did all of this while maintaining his “STAY AT HOME” banner on the top of his Twitter page where he issued all of these conflicting directives.
Let’s check in on the lawyer-turned-celebrity-Grim-Reaper: is he appearing at these street protests in his now-famous costume to warn people that they are not only risking their own deaths but also those of innocent people who they might infect through their recklessness? He is not. Like Murphy and so many other elected officials, he’s doing exactly the opposite: he’s posting pictures of himself attending the protests, not as the Grim Reaper but as himself, encouraging others to join him on the streets to support this noble cause:
But it is the public health experts whose 180-degree reversal is most stark, and — given the unique importance of maintaining trust in their apolitical scientific expertise during a global pandemic — most damaging.
The epidemiologist Jennifer Nuzzo proclaimed last week that “we should always evaluate the risks and benefits of efforts to control the virus” — exactly the risk-benefit calculus that has been declared off-limits since February. With that license to balance arrogated unto herself, Dr. Nuzzo concluded that “in this moment the public health risks of not protesting to demand an end to systemic racism greatly exceed the harms of the virus.” In other words, if you care about public health, you should not remain at home out of fear of contracting or transmitting the coronavirus but do the opposite: leave your home to participate in these protests.
The former Director of the CDC and New York City Health Commissioner Tom Frieden similarly pronounced that “the threat to Covid control from protesting outside is tiny” — tiny!! — “compared to the threat to Covid control created when governments act in ways that lose community trust.” Prior to the May 25 death of George Floyd at the hands of the Minneapolis Police Department and the resulting outbreak of mass street protests, did you hear any respected, mainstream health expert minimize the risk of coronavirus transmission in that way? I most certainly did not. “People can protest peacefully AND work together to stop Covid,” he added. Prior to George Floyd’s killing, were you aware that one could “work to stop Covid” by leaving one’s house to join mass street protests?
The threat to Covid control from protesting outside is tiny compared to the threat to Covid control created when governments act in ways that lose community trust. People can protest peacefully AND work together to stop Covid. Violence harms public health.— Dr. Tom Frieden (@DrTomFrieden) June 2, 2020
But perhaps the most egregious and illustrative example of the utter manipulation of public health science and expertise for nakedly political ends is found in the open letter that was originally crafted by epidemiologists at the University of Washington and then ultimately signed by 1,300 experts from around the country.
That letter, which made headlines in media outlets around the world, acknowledges that 1) these massive protests are likely to spread the coronavirus and result in deaths from COVID-19; 2) those harms from new infections are likely to fall disproportionately on African American and Latino citizens; and 3) the use of preventative measures such as social distancing and masks is very difficult to maintain at such protests. In other words, these protests — dedicated toward protecting the lives of minority citizens — are virtually certain to result in the deaths, perhaps in large numbers, of the very people they are designed to protect.
In their open letter, these health experts nonetheless decree that support for these protests is mandated as a matter of public health and scientific expertise, while imperiously insisting that other protests should still be scorned and prohibited:
On April 30, heavily armed and predominantly white protesters entered the State Capitol building in Lansing, Michigan, protesting stay-home orders and calls for widespread public masking to prevent the spread of COVID-19. Infectious disease physicians and public health officials publicly condemned these actions and privately mourned the widening rift between leaders in science and a subset of the communities that they serve. As of May 30, we are witnessing continuing demonstrations in response to ongoing, pervasive, and lethal institutional racism set off by the killings of George Floyd and Breonna Taylor, among many other Black lives taken by police. A public health response to these demonstrations is also warranted, but this message must be wholly different from the response to white protesters resisting stay-home orders. Infectious disease and public health narratives adjacent to demonstrations against racism must be consciously anti-racist, and infectious disease experts must be clear and consistent in prioritizing an anti-racist message….[A]s public health advocates, we do not condemn these gatherings as risky for COVID-19 transmission. We support them as vital to the national public health and to the threatened health specifically of Black people in the United States. We can show that support by facilitating safest protesting practices without detracting from demonstrators’ ability to gather and demand change. This should not be confused with a permissive stance on all gatherings, particularly protests against stay-home orders. Those actions not only oppose public health interventions, but are also rooted in white nationalism and run contrary to respect for Black lives.
How is it remotely within the scope of the expertise of epidemiologists to pick and choose which political protests should be permitted and/or encouraged and which ones banned and/or denounced? Those are plainly political judgments, not scientific ones, and the shoddy, glaring conflation of them is nothing less than a manipulation, an abuse, of public health credentials. For scientists to purport to dictate which citizens can and cannot safely choose to leave their house — based not on health judgments but on their political ideology — is repressive, and certain to erode the credibility of their profession. Yet this is exactly what they are doing: explicitly and shamelessly. As Williams wrote: “But this virus – for which we may never even find a vaccine – knows and respects none of this socio-political context. Its killing trajectory isn’t rational, emotional or ethical – only mathematical.”
I’ve been a vocal supporter of these protests from their start, including their occasional use of civil disobedience and targeted property damage. My views of the protests (as distinct from the some of the repressive debate-denying tactics that have sprouted up around them) have not changed; I remain an enthusiastic supporter on the ground that we simply cannot tolerate any longer an unaccountable, paramilitarized police force that kills with impunity, especially when aimed disproportionately at African Americans and Latinos.
But what we should not tolerate, and what the scientific community cannot permit if it is to retain its credibility, is the abuse and manipulation of health expertise for political ends. One of two things is true; either 1) these protests will lead to a significant spike in coronavirus infections and deaths, in which case public health experts should reconcile that outcome with how they could have encouraged and endorsed them; or 2) it will not lead to such a spike, in which case it will appear that the months of extreme, draconian lockdowns — which caused great suffering and deprivation around the world — were excessive, misguided and unwarranted.
At the very least, it is vital that we have the same health and legal standards apply to all citizens and all political ideologies when it comes to the right to leave one’s home, protest or engage in other legal activities. And at least as importantly, we need to understand whether public health experts were too restrictive in their advocated measures at the start of the pandemic, are being too lax now, or somehow can reconcile the radical shift in their posture on scientific rather than political grounds.
Today’s SYSTEM UPDATE, which debuts at 4:00 p.m. ET on The Intercept’s YouTube channel, is devoted to an exploration of these issues. I’m joined by Adam Gaffney, a critical care physician and pulmonary specialist at Harvard Medical School, who disagreed with my critique on Twitter and then graciously accepted the invitation to examine these issues on the show. The discussion provides, I believe, very illuminating insights into the questions raised by the change in how we think about the pandemic and its relationship to mass gatherings.