The lack of trust for many of us was Public Health being wrong in real time and not acknowledging or apologizing for the mistakes. Instead, they acted like Shamans and Astrologists, always defending their failed predictions with after-the-fact explanations and promoting unfalsifiable terror scenarios (YLE for example in fall 2021 made a widely circulated post on Facebook stating that PICUs would be overrun by 30% with kids which never happened, but parents pleaded to have schools canceled based on fear like this).
I’m sure you are a very nice person, mean well, but you too have engaged in this and I am sure you aren’t even aware. (making claims of being close to Herd Immunity, supporting mandates on a non sterilizing vaccines, promoting the vaccine in children while the rest of the world paused vaccinations on people under 55-65, etc).
I brought myself up to speed on your writings over the last 4 years on Covid going through your blog over the weekend (I have a lot of free time 😊). A lot of your early work resonated with me.
For example from your 5/10/20 piece “Lessons from Graduate School for the COVID Pandemic” you note:
“It is easy to only pay attention to the data that supports your hypothesis (and ignore
the data that goes against your hypothesis)” and “It is easy to get fooled by early data.”
On 2/9/201, you have an excellent post on “When you can never be wrong: the unfalsifiable hypothesis” outlining the perils of having a theory where counterfactuals can’t be constructed to test and refute a theory.
Great stuff, and I agree with all of that of course, as you are describing the tenets of scientific pursuit outlined by Merton, Feynman, Sagan, Randi, Shermer, etc.
Yet as I continued to go through your blog, I felt you were inadvertently committing the very mistakes you warn your readers against.
Consider on 10/9/21 your piece “If you’re vaccinated, why does it matter if I am not?” where you make an attempt to justify the vaccine mandates and make what I consider to be an unfalsifiable claim:
“I just spent a month in New England (which has a higher vaccination rate overall), and my risk of getting COVID there was much lower than my risk of getting COVID back home in Texas (which has a lower vaccination rate).”
Consider that on 10/9, the 7 day average for cases in Texas was 7232, against a population of 29 million. That means .025% is positive for Covid. Vermont, which was touted as the state where “no one was left to vaccinate” (and I choose Vermont too because Katelyn Jetelina referenced them in a post around 2021 as well I encouraged her to double check her claim [1]) – on October 9th, Vermont had 197 cases/day against 647K population, rate of .03%. Slightly more than Texas.
Why in that post did you believe that Texas was doing poorly while you were safe in New England? Doesn’t the most vaccinated state in New England having more cases per population than Texas falsify your claim? If it doesn’t, can your hypothesis even be falsified?
Further, consider that Covid would absolutely explode across the country and the world, following the vaccine rollout. You make claim in 16 different parts of your essay how “being vaccinated significantly reduces transmission”, yet Covid cases would increase 10-fold in both Texas AND Vermont within 3 months. The NYT graph for vermont: https://imgur.com/a/tptVuaR
Vermont would hit a peak of 2K cases/day, representing .31% of the population, while Texas would have an almost identical peak of 68K cases/day, at .23% of the population.
To me, that should have been enough to reject your claim that Texas was doing worse than New England and caused you to reconsider your entire hypothesis. Your appeals to base rate fallacy crumble when Covid is now up a magnitude post vaccine.
Especially since any confounder you search for to prop up this now tenuous claim favors Texas.
Population denominator Texas grew due to mass migration into the state. The baseline health of Texans is far worse than Vermont..ians? There was a surging undocumented migrant population pouring into Texas, further increasing the population denominator. Texans had tossed aside the masks and social distancing long before Vermont would… at this point you have to get creative to data dredge/p-hack your way into supporting your claim.
You may say “Fine, Covid is surging equally in Texas and Vermont, despite my claim Texas is worse off than New England, but it still greatly reduces your changes of severe outcomes”
That is also wrong.
Following your 10/9/21 post, Texas would have 22.6% more deaths than expected through the end of 2021, near identical than Vermont’s 23.1% - and again, the confounders you may search for all favor Texas having a better outcome.
I am not trying to get you in a “gotcha”. Brilliant people who know how science works make these mistakes ALL OF THE TIME. It’s easy to get fooled as Feynman notes in his takedown of Social Science as “A science which isn’t a science”.[2]
William Farr, a brilliant man and one of the greatest statisticians of the modern era, had all the data he needed to see that Snow’s hypothesis disproved Miasma theory for Cholera, yet Farr stuck to his favored hypothesis for 9 more years.
I could keep going through your blog, finding examples of you making claims that were easily falsified [3], but then I would succumb to Brandolini’s Law.
On a closing note, as I read your blog I see you inadvertently and repeatedly made the mistake of “one directional skepticism”. That is, the things you think are true get a free pass-regardless of how poor the supporting evidence – while only the ideas you disagree with do you apply skepticism.
Ivermectin and HCQ didn’t work, and you were right to explain why in your posts. Yet as noted in footnote [3], you fail to apply that same level of skepticism to the easily debunked claims in the Financial Times articles you cite that high vaccination rates are suppressing the spread of Covid.
A (to me) damning example of one-directional skepticism is your 7/22/20 post “Masked Science: Fact-checking Mask Studies” where you apply rigorous skepticism to a dozen studies claiming cloth masks don’t work, pointing out all the flaws in methodology, rigor, design, and conclusions.
Of course, the consensus on cloth and surgical masks has pivoted back to what we knew 1920-2019 – they don’t work – but you felt inclined to only debunk all the studies suggesting masks didn’t work. Why didn’t you eventually write a blog post admitting “hey we got cloth masks wrong – here is why”?
I wonder, why didn’t you apply that skepticism equally to the hundreds of nonsense studies claiming cloth masks were incredibly effective? Why not tear apart the 2 Stylists in a Missouri salon paper the CDC promulgated? The ridiculous Kansas Mask Study? Abaluck’s RCT in Bangladesh?
Katelyn has made the same mistake – any terrible study showing the wonders of cloth masks got a pass and added to her “Think masks don’t work? Look at the evidence” social media threads [4], while she suddenly became concerned with study design, confounders and p-values when an RCT suggested what we would find out to be true – they are largely worthless after all [5]
It seems to me, as a dispassionate scientist, that you entered the Social Media Covid Blog World with your mind made up – masks work, Covid vaccines work, lockdowns work, etc, and wound up stuck defending these extraordinary and failing theories for reasons I can only guess (Politics? Sunk Cost Fallacy? Availability bias?) using the very pseudoscientific practices you claim to reject.
I apologize if this comes off harsh, I am not trying to be mean spirited – there are just only so many characters we can put in a comment and I don’t know if any of this will be read anyway 😊
(PS 100% agree with your post “don’t censor threads” even if threads is dead – the message is spot on)
[3] For example your 7/21/21 piece: “Some vaccinated people are getting COVID. What does this mean?” cites a FT article based on terrible data making a claim that the UK and Portugal are doing great by comparing them to sub-Saharan Africa – and of course right after this article UK and Portugal would explode in cases and deaths, while Africa would shrug and throw out unwanted vaccines.
[4] It is fascinating to me to this day how after 100 years of not being able to find much benefit of masking against respiratory viruses, we conjured 35+ studies instantly showing how amazing they are in a few months
Couple points. I do not understand why you struggle with nuance- immunity is not a binary. Your continued point that cases surged after vaccines ignores the fact that vaccinated people (especially initially) had lower rates of infection, and continued lower rates of hospitalization and death. Why do you never address this?
Why do you just post your talking points continually barely addressing the content of the articles you are responding to?
Also I'd recommend some self reflection- I see a lot of projection in your posts. "One directional skepticism" is pretty rich given your propensity to ignore huge swaths of data, and continue to link to literal propaganda. All I see in your posts is continued logical fallacies- false equivalence, straw man arguments, cherry picking data, false dilemmas, and confirmation bias. You're using the same strategies you claim to rail against.
I would love to see the following questions answered by Katelyn and Kristen:
1) How do you recommend a vaccine in children where there are zero excess deaths? What is the NNT?
2) Why did some of the worlds most highly vaccinated countries have some of the worst all-cause mortality spikes *after* their populations were fully vaccinated (South Korea and Taiwan for example, given their love of masking)
3) Why didn't countries with low vaccination rates suffer the poor outcomes predicted and instead threw out their unused shots?
SK "(you) ignore the fact that vaccinated people (especially initially) had lower rates of infection, and continued lower rates of hospitalization and death. Why do you never address this?"
I agree that is what the early studies suggested, so I weighed that hypothesis as real time data came in. Two things stuck out:
1) The early studies were fairly weak
2) The predictions the studies made were failing simple tests as time moved on
I suspect your belief that vaccine was working (especially initially) is because you saw all the charts and graphs showing it was a miracle (Kristen shared one such graph in her initial post in this series).
Now I may be projecting as you say, but I suspect you don't have background in statistics, study design, nor probably are abreast of the replication crisis?
Many of these impressive charts often contained biases, errors, and non-transparent methods. Common issues included:
- Included deaths/hospitalizations of people vaccinated but only within last 4 weeks (needed 2 weeks from second shot to be moved to the "Vaccinated Bucket")
- Using incorrect denominator for population estimates which inflated unvaccinated risk
- Automatically assuming anyone they couldn't confirm vaccinations status as unvaccinated. (Imagine you are in NYC on a trip from Virginia, have a heart attack, and brought to morgue where PCR test confirms you also had Covid - you can't tell them your vaccine status so you're considered unvaccinated)
- Early belief that the vaccine was sterilizing, so people who died of but where vaccinated were assumed to have died from something else.
- Not showing cohort breakdown of the unvaccinated dead - why weren't they vaccinated? Was it because they were in Hospice and had a week to live? That's roughly the outcome of 10% of our deaths at any given time. If a fraction of hospice patients decided to skip a vaccine, that would wildly inflate "Unvaccinated Covid Deaths"
Now, I had those concerns early on, but still hoped these would be the miracle promised.
But simple sanity checks as time went on were failing. States with low vaccine rates having identical All Cause Mortality Curves as highly vaccinated states was early indicator. Highly vaccinated countries having explosions of Covid demonstrated there must be something wrong with the studies. Again, South Korea had an enormous amount of deaths in their vaccinated population, and not once has Katelyn or Kristen written about that.
You keep saying "Well it worked early", but the vaccines were administered *while* Covid was plummeting on it's own as it was seasonal. Credit was being given to the vaccine for cases and deaths receding Feb-May 2021, but vaccine uptake was 2%-10% in many places, or not happening at all, and Covid followed the same curve regardless. But you don't know this because it seems you aren't double checking everything you are told - I guess?
Then, when Covid was exploding despite vaccination, the new claim was that "Red Counties are doing worse than Blue Counties". Well guess what? That has been true for 100 years with the flu and common cold. The confounders aren't that Covid hates republicans, it's that Red Counties are older, fatter, suffer from more comorbidities.
SK: "Why do you just post your talking points continually barely addressing the content of the articles you are responding to"
Kristen's asking a great and important question "why is trust in vaccines failing" and I disagree with her premise that it was a just a communication issue. It was a "you got a lot of this wrong and aren't owning up to it" issue why people don't trust Public Health.
Today she is saying "we should have been nicer to the unvaccinated to convince them we were right"
I am pointing out, no, you got so much wrong the last 4 years and don't even seem to know it. The example I used of her telling readers "she was so much less likely to get Covid in New England than Texas" in a 2021 blog was demonstrably false the very day she wrote it, had she decided to quickly check her claim with data. These types of mistakes compounded, and there is an obliviousness to it. She and Katelyn recommend vaccinating children, and seem not to be aware there have been zero excess deaths in children 0-14 the *entire pandemic* in the *entire world*. The NNT is infinity.
I'm not trolling. I am trying to help these young scientists realize they got bamboozled.
SK: "All I see in your posts is continued logical fallacies- false equivalence, straw man arguments, cherry picking data, false dilemmas, and confirmation bias. You're using the same strategies you claim to rail against."
As we discussed yesterday, I am facing an unfalsifiable hypothesis.
We have been struggling to make sterilizing flu vaccines for 80 years, and would openly admit "we don't know why they don't work". We spent 20 years trying and completely failing to make a Coronavirus vaccine.
As Kristen notes in her blog "Medical research is a loooooooooong process. Like, really long." [1]
So it was extraordinary that we could solve an 80 year old problem in 6 months back in 2020. We should have been skeptical, and initially PH Social Media Influencers were skeptical [2] but it seems mainly because they were worried Trump would get credit.
Bottom line SK, the burden of evidence is on those making the claim. If you claim that tying an Onion to your Belt wards off the Flu, and I show you that countries who don't tie Onions on their Belts (as was the style at the time) have identical or better rates of Flu, don't come at me with claims of "Cherry Picking" or "False Dilemmas".
You are welcome to email me further if you don't want to explain the following major challenges to the Covid Vaccine I started with above:
1) How do you mandate a vaccine in children where there are zero excess deaths?
2) Why did some of the worlds most highly vaccinated countries have some of the worst all cause mortality spikes *after* their populations were fully vaccinated (South Korea and Taiwan for example).
3) Why didn't countries with low vaccination rates suffer outcomes predicted?
Bonus: 4) Claims were made that without boosters, hospitalizations and deaths would soar, yet the opposite happened as the public moved on from Covid.
"We were on a path for a vaccine emergency authorization (EUA) before November 3rd. Thanks to the FDA, Trump's plan was disrupted. That won't happen. First real sign of the independence of FDA since the pandemic started. And that's important."
I really wish you could focus your arguments and points, but I suspect this approach to gish gallop has worked for you.
You have so many claims, and so little sources.
Let's address a couple.
1. COVID-19 was causing hospitalizations and deaths in kids at a higher rate than any other infectious disease (yes a comparatively low rate to adults, but kids aren't supposed to die), and we had an effective vaccine to lower the risk of that. Also I'm not aware of any pediatric vaccine "mandates." California thought about it, but never did it. We don't have many excess deaths from measles right now in the US, should we not vaccinate? When has excess deaths ever been used as a metric for deciding to vaccinate?
2. No country was 100% vaccinated, and the vaccine didn't prevent every death. But it substantially lowered the risk. New variants, waning immunity and easing of restrictions explain the spikes to me.
3. First of all: https://www.sciencedirect.com/science/article/pii/S2772707623000115 Second, this keeps bugging me. You seem to expect the same results everywhere no matter what, ignoring all context. I'm not a global health expert, but I know countries that struggled with the administrative burdens of vaccination (or cost) also struggle with accurate reporting.
I do have some epi background and no I don't think I've been fooled by fancy graphs. I'm talking about multiple, large prospective and retrospective cohort studies that repeatedly and continue to demonstrate reduced risk of serious illness, hospitalization and death due to COVID-19 with vaccination. I'm happy to list them if you like.
One last point, since you brought up a background in statistics. Let's do a thought experiment. I think it is likely the majority of those working in biostatistics, epidemiology, public health and medicine would disagree with your view that the COVID-19 vaccines did not prevent serious illness and death. What seems more likely, that they, with all their knowledge and expertise are wrong, or that you (and a small minority of other scientists in this field) have cracked the code and they were all duped? This is not an appeal to authority, majorities of scientists have obviously been wrong in the past, but rather a thought experiment. How likely is it that you have figured it all out?
"SK: You have so many claims, and so little sources"
I encourage you to point out specific claims I failed to source, and I will do so, just as I did yesterday. A lot of the things I am saying I am taking for granted are common knowledge at this point (e.g., zero excess deaths ages 0-14 worldwide) so for a bit of brevity move quickly. Again, my email is in my profile and you are welcome to have side conversations through email where you might be more comfortable. I have had wonderful discussions with several readers of this blog and others the last 4 years this way.
SK: " Let's do a thought experiment. I think it is likely the majority of those working in (science) would disagree with your view that the COVID-19 vaccines did not prevent serious illness and death. What seems more likely..."
To be clear, I'm open to the vaccine having benefit to the elderly. I scheduled my parents shots in 2021.
But it's 2024. The crowd has thinned, many moved to the other side. Now we know:
The data is overwhelming that the vaccine did not slow transmission. https://imgur.com/a/9ueSF21 (I know you will say "cherry picking" but I could repeat this for any state, any country - they are all "cherries")
The data is overwhelming there were never any excess deaths in children, before covid, during covid, after covid
**There are enough counterfactuals of the highest vaccinated countries having excess mortality surges not seen in lower vaccinated countries to call into the question the hypothesis the vaccine prevented serious illness and death.** Again, and I await your explanation, what happened in Taiwan and South Korea? These two countries were constantly promoted as shining examples of "doing it right" throughout the pandemic by public health until deaths exploded. Then they stopped talking about them. Understanding how South Korea could have all cause mortality doubled (this is literally without precedent) Spring 2022 in an entirely vaccinated population (yes, all people over 65 in SK were vaccinated, and this is the cohort where all the deaths occurred) should one of the most highly studied topics of the pandemic as literally, the exact opposite of what we would expected happened to them.
I can't stress how big a problem the South Korea mortality data poses to you, but you seem incurious, which isn't surprising, as the people you follow are also incurious.
I am not the man shouting the crowd of experts "you are all wrong", because there is no crowd anymore. What is left is a handful of Social Science Media Influencers stuck "holding the bag" on the vaccine hype. Covid as a problem exists entirely now on Social Media. It's talked about on Twitter and r/ZeroCovid, and some SubStack blogs, but doctors with patients have moved on. They are largely not recommending the vaccine anymore to anyone except the elderly (and even that is hit or miss).
The vaccine passport and mandates were overturned and many who advocated for them have distanced themselves.
Covid Boosters and Vaccine uptake have cratered. Not among Republicans, but Democrats too. And politicians, and doctors, and nearly everyone. It's anecdotal, but my friend group largely consists of physicians in the Cleveland area, I am not aware of any who have bothered boosters since 2021. I am sure there are, but they are the outliers.
Not just Africa, but Europe is trashing millions of vaccines. Yet the public health influencers you are following predicted that without boosters things would get worse, yet the oppositive happened. As our hysteria and disinterest in Covid subsided, so did excess deaths. Why?
Quick address of your 3 counters to my questions though:
1) The measles vaccine worked. The predictions materialized. Cases disappeared, overall mortality reduced. And we see (unfortunately) "tests" of this hypothesis anytime some population decides to stop being vaccinated against measles - cases surge and deaths increase.
But just because one medical treatment works doesn't mean another one does. We have had plenty of vaccines we thought would work, but when they didn't, we shelved it and went back to try again (Rotavirus in 90's for example). Difference is they weren't politicized.
The covid vaccines were determined after careful consideration by the rest of the world not outweigh their negatives in children, which is why the rest of the world rejected them (either initially or after it became clear the evidence wasn't there). Again, I am not the "man shouting you are wrong" to the crowd. "The Crowd" agrees.
2) There are enough examples of countries having a near 100% vaccinated cohort population (i.e., 65+) yet still experiencing incredibly high mortality spikes. I strongly encourage you to dig into Taiwan and South Korea data tables, and if you don't know how to do this, I would be more than happy to walk you through so you can see for yourself. It does not make sense.
As for your possible confounder explanations, let run through them:
a) "New variants" - low vaccinated countries had the same variants
b) "waning immunity" - If a vaccine only provides 2-3 durability, does it work? Or is it "kicking the can down the road"? Would it be realistic to get 4 shots a year? 6? Can that claim be tested?
c) "easing of restrictions" - In the case of Taiwan and South Korea, they were still wearing masks. Their lockdowns were ended over a year earlier (almost two). South Korea children back in school Spring 2020. This doesn't explain it. And corolllary, if the easing of restrictions was the reason, why did the countries wth the shortest lockdowns, earliest return to school, lowest mask use, etc, have the best outcomes? (Nordic Countries: Sweden, Norway, Finland, Denmark).
3) I expect reproducible results. That is the foundation of science. The hypothesis must pass rigorous scrutiny and exceptions must be faced head on. In the case of Sub Saharan Africa, yes, the administrative burden was high. Testing was spotty. Mortality data is almost nonexistent. These countries face challenges much higher than Covid, and that's the point - they face challenges bigger than Covid. Throughout 2020 and into 2021 there was so much hand wringing by Public Health about how much Africa would suffer from Covid, how we needed to pay for their vaccines, and in the end, the New York Times was puzzled why Covid didn't seem to be a problem there and their Public Health trashed the shots. Actions speak loudly on this.
I do love that you bring up the "Gish Gallop", as that is the challenge I face when discussion this.
I say "please explain how a completely vaccinated and masked 65+ population in South Korea had explosion of deaths", and I'm met with 100 old studies, models, preprints showing how much worse they would have fared without the vaccine.
Why not consider instead that the fastest vaccine developed in human history, by an order of a magnitude, against a virus we tried and failed to vaccinate for 20 years, against a family of viruses we have struggled to develop effective vaccines for 80 years, simply didn't work once we saw everyone get stick anyway and death regularly increase or stay unchanged?
"I am not the man shouting the crowd of experts "you are all wrong", because there is no crowd anymore. What is left is a handful of Social Science Media Influencers stuck "holding the bag" on the vaccine hype."
Agreed. I knew this day would come. It was a mathematical certainty.
How do you validate the data you reference with regard to hospitalization and death rates among the vaccinated vs. unvaccinated? Wouldn't you say that you are taking the CDC at their word? There's nothing wrong with that. Many people do, what choice do they have? These organizations have the data and we don't.
I am just curious why you would trust an organization like the CDC which continually confirmed that the Covid shots were safe and effective and have undergone the "most rigorous testing" of any vaccine. Safe and Effective are arbitrary terms and terms that are co-dependent.
How could they have been rigorously tested if they were authorized after only an average of six weeks of observation?
Why would the CDC continue to ignore the hundreds of thousands of serious adverse events reported in VAERS and dismiss them as "unverified". Isn't it their job to verify the data in their own event capturing system?
Why would the CDC dismiss a previous Covid infection with antibody titers as inadequate to confirm "immunity" and "recommend" vaccination because antibodies aren't proof of protection yet turn around and use antibody levels as proof of efficacy in the pediatric trials? This double standard was also employed in booster studies during the spring of 2022.
Have you thought about the mathematical implications of ignoring outcomes in the recently vaccinated while including them in the pool of "fully vaccinated"? This will automatically create false effectiveness, no matter what outcome you are looking at.
By March of 2022 the Office of National Statistics was publishing data across their 35 million population indicating that the risk of infection was anywhere between three to five times higher in the vaxxxed than the unvaxxed. Then they stopped reporting that metric.
Throughout 2021 the CDC never published infection rates by vaccination status yet continued to claim very high levels of effectiveness against infection. Why wouldn't they just publish the data while folks were weighing the risks and benefits?
My point here is that the folks that are telling us what the data shows still have a lot to answer for.
Wow! That was a lot of reading, I’m honestly impressed. I don’t have time to respond to all your points, but can hopefully provide clarification on a few matters.
I agree that many in public health made “predictions” that didn’t turn out to be true, and that left a lot of people confused and disappointed. At the same time, scientists were working with the data they had at the time, and it’s not necessarily fair to expect them to anticipate all the curve balls the pandemic through at us. Looking back at my own writing, I think I could have done a better job communicating uncertainty, and is something I can apologize for and hope to do better moving forward.
As far as the specifics you mention, I think you may have misread what I said. I didn’t endorse vaccine mandates or tackle the topic of COVID vaccines in children. (And I don’t remember writing about herd immunity, but maybe I did?) I did write about the data behind vaccination and why vaccination benefits your neighbor, but that’s very different than endorsing the mandates, as policy decisions like this aren’t only about science, but also about weighing different values and priorities (collective good vs individualism). That’s actually the topic of the last post of this series, coming next week. I personally don’t like politics, so try to focus my writing on data, and less often delve into policy arguments. Some will infer political motives on top of my writing, but I have found those inferences are often inaccurate.
As far as the month in New England, that was Connecticut in August, not Vermont in October. I left an ER rotation in Houston and went to an ER rotation in New Haven, and the differences in COVID cases showing up the the ER was striking — far more COVID was hitting Houston than New Haven. I took a quick look at the county level data in August through October 2021, and New Haven county, CT had lower cases and deaths per capita (1372 cases and 10 deaths per 100,000) compared to Harris county/Houston (3218 cases and 51 deaths per 100,000). I agree you need to account for confounders like underlying comorbidities, there have been quite a few studies digging into this. Omicron certainly changed the dynamic on vaccines and transmission when it arrived later that winter — the topic of transmission is a complicated one, and more than I can go into at the moment. I think it deserves its own post, looking back and what the data said, when, and how things changed with the different variants.
Regarding the masks post, that was “one-directional” because it was focused on a specific meme that was circulating. It was not meant to be a comprehensive review of the literature on masks. As far as what I choose to write about generally, there is a bias — I only pick topics I have time to tackle and that I think will be helpful. For example, there were valid questions and concerns about natural immunity, and it was a topic I always wanted to write about, but the literature was so messy and I didn’t have time to do it justice. My time constraint as a trainee means that some of the more nuanced topics never got written.
I hope this helps, and thanks for your kind review of my early work and the Threads post.
I greatly appreciate taking the time to read through my post which I know comes off as a diatribe for space constraints. I always think of that XKCD "Duty Calls" (https://xkcd.com/386/) when I write these long winded replies. I always try my best to grant charity and grace while attempting to offer counter hypotheses/critiques.
I also don't like politics (well, I used to be insufferable during the Bush years... *shudder*), though I assume we vote the same way regardless.
Quick explanations on why I made assumptions on your views - not trying to create a time consuming "Back and Forth" though:
>KP: "I didn’t endorse vaccine mandates"
I made the assumption you did endorse based on your piece from Oct 9 "If you’re vaccinated, why does it matter if I am not?" where you opened with "With the introduction of the COVID vaccine mandates, one common question has arisen..." and then went on to explain why the vaccine was effective (as opposed to taking a moment to oppose or at least acknowledge the danger of mandates).
>KP: "As far as the month in New England, that was Connecticut in August, not Vermont in October."
I chose Vermont only because how much media attention it was getting mid 2021 as example of the "power of the vaccines working", and I wrote a (I thought) careful rebuttal to this premise back in 2021 to Katelyn
And I hate to further criticize, but since your post arguing Texas was doing worse than NE was posted on 10/9/21, you could have double checked if your experience in August was still accurate by the time you published that piece in October, and had you done that, you may have reconsidered your hypothesis.
>KP: " I think it (transmission) deserves its own post, looking back and what the data said, when, and how things changed with the different variants.
100% agree! Look forward to it, and hopefully a healthy dialectic!
>KP: "Regarding the masks post, that was “one-directional” because it was focused on a specific meme that was circulating"
I could write books on this topic of how and why the belief that cloth masks were an effective slice in the "swiss cheese" method of virus control swept over us so rapidly using the weakest of evidence, to the point everyone became convinced they could "crush the pandemic in weeks" (Robert Redfield) and justify forcing children to wear them.
I would hope at this point, 4 years later, you agree with the updated consensus they don't work (which was the pre 2020 consensus) and be curious what lead us to overlook the terrible studies that convinced so many of their (false) efficacy.
>KP: "I hope this helps, and thanks for your kind review of my early work and the Threads post."
You are welcome, and I read and agreed with many more of your blog posts I didn't comment on, one that stood out was how you described your MD/PHD combo, and it was really impressive - as I know 2nd hand part of the challenge - I dated my eventual wife through her journey to become a vascular surgeon, who initially wanted to do only research before she caught the "surgeon fire" - through undergrad, med school, residency, fellowship, all the board exams - so I completely respect the time and dedication (and sacrifice) you had to put in to get where you are today.
Michael, I believe you express the frustration, disappointment and mistrust of millions of people.
As a public health official during the pandemic, I believe the reasons for those reactions can be traced directly to a failure of effective Crisis Communication. That failure took place at many levels of leadership.
I learned in clinical practice that if you outlined in advance the potential benefits AND the potential adverse outcomes of any given course of treatment, patients / families were grateful and understanding even when the optimal result was not forthcoming.
In contrast, if something untoward, yet reasonably foreseeable did occur that you had not discussed with the patient / family, then even the truth came off as an excuse.
I believe effective Crisis Communication while the pandemic was unfolding could have and should have addressed every point you raise.
I appreciate the thoughtful comment, and I would agree that failure caused frustration for many, but that wasn't the case for me.
My frustration was with the extraordinary claims being promulgated by people who should know better. Often these claims were wrong in real time or could be discredited in a short amount of time, yet Public Health treated Covid almost as a religion - where skepticism was eschewed for Orthodoxy.
I went through several examples in my lengthy comments already, so won't rehash them, but as we come out of the fugue of the last few years I am reminded on the War on Terror and The War on Drugs (I'm not old enough to remember the post War on Vietnam - but I suspect the same thing) - where a terrible idea became politicized, criticism was shunned, and by the time everyone realized it was a terrible idea, no one wants to be accountable for the decisions.
Our War on Covid had many terrible decisions. There was some grace "we worked with the facts at hand" to some extent, but facts were often ignored.
We knew by summer of 2020 that closing schools was not necessary as many countries demonstrated this fact.
We knew almost immediately Covid posed no more harm to children than the common cold.
We knew for 100 years that cloth masks were ineffective against respiratory viruses, but made children suffer wearing them anyway because 30+ terrible studies were conjured out of nowhere promising amazing benefits that never materialized.
We knew mass testing couldn't stop the virus by the end of 2020 but we wasted billions anyway.
We knew by the end summer 2021 the vaccine unfortunately didn't repress the virus and was tearing through the vaccinated, yet we didn't stop coercing people with threats of economic losses, denied medical care, removal from school, etc.
And none of these errors I see being apologized for in these threads. And this is why people don't trust PH.
Practicing physicians don't trust PH. Just look at how many stopped with the vaccines, the masks, all the hysteria. Kristen is an ER resident, I assume her hospitals are just like the Cleveland Clinic and UH here - Covid is a thing for Reddit and Twitter. Or do they still take boosters and mask on the east coast?
Real accounting of the last 4 years needs to happen.
Completely agree. I am a practicing physician, and I am extremely concerned about the blows public health took these last four years. Anemic efforts to make amends are doing more harm than good. If anything it is proving that the medical orthodoxy will never be able or willing to admit what they got wrong when big mistakes were made. Clear headed people really ought to be even more concerned after a series of posts like this.
Excellent commentary Michael. I am also encouraged to see that Kristen has responded. Like you I have over the last 18 months left detailed and reasonable critiques to some of the authors' positions. Not one was ever addressed. Perhaps things are shifting.
I would also agree that Kristen and Katelyn are fine human beings with good intentions. However, like many educated people, they are unaware of their own biases even though they are the very same ones they point out in others. Thank you for explicitly pointing this out.
While most of the world recognized that the old and those with serious co-morbidities were most at risk, our government health experts were scaring the daylights out of all of us and pushing the vaccine as the only way to survive this curse. Most of the funding for the FDA and our health agencies comes from the drug companies.. They fund a lot of their research. Most of their budget comes from user fees. The government scientists can get a cut of the action via royalties. There's an inherent conflict of interest in this arrangement. A lot of what we were told about the covid shots was false. They don't prevent infection or transmission and aren't safe. As noted above, a number of European countries have now restricted the admin. of these vaccines to the elderly. Peer reviewed research papers are being published lately confirming that the "conspiracy theorists" were right about a lot of this stuff, yet they seem to be ignored by the media on purpose. For instance this study last June found that vaccinated children were six times more likely to get early onset asthma within a year of the shot than the unvaccinated kids. The authors will probably never get another research grant from Pfizer or Moderna!
Bless you, Michael, for taking the time to research and write this. You should write for the NYT or similar large-audience publication. A+
I sometimes wonder what, if anything, did we as a society learn from the pandemic?
When it comes to hypothesis driven thinking, one thing people forget is we can never prove our hypotheses. But all it takes is one piece of data to disprove a hypothesis.
I understand that cloth masks don’t help. Any thoughts on whether K95 masks work? Or are those the same as surgical masks?
The problem with n95 masks is that even the slightest break in seal (you always see this around nose, chin, sides of face) likely renders it useless, as you are now pulling air flow predominately through the gaps. They also get moist which increases the micopores.
I always remind people that we only discovered viruses in because some invisible pathogen undetectable by the most powerful optical microscopes was passing through Ceramic Water Filters (Chamberland Filters), and scientists named this invisible pathogen "filter passing virus" which they wouldn't be able to "see" until the invention of the electron microscope 40 years later.
It's possible a single use n95, worn on a cleanly shaven face, properly donned and doffed, with perhaps surgical tape sealing the perimeter to your face might work.
Yet even then, you could place up to 22,000 Covid virions side-by-side in the space of a single micropore in an n95. These things are incredibly small sneaky fuckers.
I do have a suggestion for another way for you to look at outcomes from the pandemic. The deaths per 100,000 of population by state really tells the story.
I agree 100%. And the difference pre and post pandemic suggests none of our “rain dances” mattered. Whether it was closing schools, wearing cloth masks, vaccine uptake, you can’t accurately predict which states did what measures when blinded more than 50%.
Unsurprising when we are dealing with pseudoscience and rain dances.
I think we made assumptions, that everyone would see us as SMEs and that they would "understand" and comply with our advice. No one expected that the POTUS would openly challenge our expertise. No one expected that several Red State Governors would openly challenge our expertise. I don't have a counterargument for politicians who have little or no respect for science. I don't have any counterarguments for politicians who do not have the health, safety, and welfare of their citizens as their primary motivation during a pandemic. I know that we did the best, we could do, given the circumstances. But nothing changes the fact that (maybe) 3M Americans died needlessly during the pandemic, mostly because they either choose to ignore us, because they believed politicians over the "expertise" or politicians muddy the water enough, to confuse a significant number of Americans; that they decided that no action was their best option.
1. Public health is PUBLIC. It depends on government funding with the usual government oversight. And in the early days of the pandemic, in the US, it became highly politicized. Orders from on high as to who was allowed to say what depending on the perceived political costs.
2. I cannot recall another event where we were all watching science happen in real time. We had to figure out if this was trasmited by fomites, droplets, or something else. We made a (reasonable in my view) guess that social distancing, masks, various closures, etc. would stop the spread or at least provide some limited personal protection. In hindsight, a lot of that advice was not great. But given what we knew and when we knew it, we did the best we could in the face of imperfect knowledge and government meddling.
3. Too many of us are scientifically illiterate. As a consequence, we want to be told ONCE what to do, that it works, and how to do it. The advice on Covid was not consistent (see point 2 above). And that drove a lot of people nuts because they just wanted to know what to do and got frustrated and angry when the advice kept changing. Ideally, science is self-correcting. Good advice WILL change. But when it changes fast and often, we just get frustrated.
I only hope to heaven we have learned from the mistakes we made with Covid and do not repeat them whenever the next virus from hell rears its ugly head.
And Drs Fauci and Hotez deserve a Nobel Prize, not the firing squad so many are calling for.
“ And Drs Fauci and Hotez deserve a Nobel Prize, not the firing squad so many are calling for.”
Excuse me, but do you realize what Saint Anthony actually did? It started with so called “gain of function” research at UNC Chapel Hill, by Ralph Baric, where deadly viruses were modified to make humans susceptible to them. Oh, the claim was that it would help develop vaccines or whatever, which I don’t buy. In any case, this research was declared too dangerous to perform and became prohibited at the federal level. Instead of shutting it down, it got moved to a communist country, known for lax hygiene standards (do you recall the guy coming out of the Wuhan Covid “hospital” which was cots on a gymnasium floor walking out and pissing on the side of the building live on CNN?). This research was funded by NIH dark money, and laundered through that eco health alliance by the Dansak guy and others. Then there is the whole emergency HVAC replacement in this “lab” and next thing we know is that what was obviously an engineered virus, and there is plenty of evidence that it was engineered, spreading around the globe.
that's quite a statement. hateful, innacurate and totally wrong. Of course Dr. Fauci is not responsible for COVID deaths. Not one. You really don't play fair or want to be just in your judgements.
Nice column. A lot to consider. But if one side continually devalues fact, reason and patience in favor of fiction and outright lies - and engages in threats of violence - how can the attempt to focus on shared values gain any traction? You hit a wall at some point. I do my research and get the vaccinations I deem safe and appropriate. Too many others, though, go straight to the disinformation and take up permanent residence there with no thought of ever dislodging their minds from such a perch. I'll take care of myself first and foremost. I find it's fruitless to converse with the other side. I guess you can fault me for giving up, but that's where I am at age 68.
I'm with you. I'm exhausted from receiving only derision and outright lie-based responses to my years of attempting to engage positively from an empathy & data driven place. I can't approach people with reason anymore if they are behaving & speaking in dangerous, disrespectful, and thoughtless ways.
Since 2022, when my oldest was diagnosed with cancer at 19 months old and I had a 3 month old baby who clearly wasn’t fully vaccinated I have struggled with effective ways to counter antivaxxers in any sense. Appealing to emotion doesn’t work “why should I potentially harm MY kid in order to keep yours safe?!” (the most common come back I see) or “if you are so worried about it just stay home!!” (As if my kids don’t deserve the ability to be in the outside world at all because they don’t have the appropriate immune systems to fend off vaccine preventable diseases due to the lack of vaccines and chemo effects - they are already fairly isolated but they deserve to be able to exist in a society too!) it’s been a rough 2.5 years and isn’t over for us yet. Luckily my youngest is fully vaccinated up to date but my son still isn’t able to receive his re-vaccines.
Love the bottom line here: “We must use science to figure out how to regain trust in science. And the science is clear: shaming isn’t helpful.” A wonderful object lesson there, so clever. I also think the wise words in this piece are useful for every interaction we have, whether in person or online. Too often, ad hominem attacks and name-calling take the place of any civilized, respectful exchange of views. The suggestions here offer great ways to get past that problem. (I particularly enjoyed, in that regard, the advice to rant in private😎.)
"It [is] fundamentally about believing that evidence-based medicine actually works—that systematically collecting data and analyzing it will give us a clearer picture of reality than anecdotes. That we don’t have to go back to the days of basing medical decisions on hunches, fears, and vibes. We have a better way of figuring out what’s real and true.
The rejection of carefully collected, peer-reviewed data in favor of rumors and memes is understandably infuriating. If universally adopted, this would make our society collapse. For people who have devoted their lives to science, medicine, and public health, it makes sense that this gets under our skin and infuriates us."
I love reading this and strongly agree. This is one of the reasons I am so frustrated with gender medicine in our country. Medical organizations and political leaders are doing exactly what anti-vaxxers say that progressives do - use their authority and "science" to support purely political goals without regard to evidence. A different topic, of course, but I think the perception that the left is willing to promote non-evidence based policy and twist the facts for ideological purposes is absolutely true in the field of gender medicine. It is going to (justifiably) harm the public's faith in experts and science, which will make public health that much more challenging in the future. If we want to promote science and evidenced based decision making, we have to be consistent - that's kind of what science is.
“I so agree with your statement that “If we want to promote science and evidenced based decision making, we have to be consistent - that's kind of what science is,” and your example is right on point. It is particularly distressing to see the rejection of science persist in the area of gender medicine despite the publication of the Final Cass Report. (If of interest to anyone here, this is a link: https://cass.independent-review.uk/home/publications/final-report/)
The Cass Review is rife with problems, including methodological flaws and ignoring evidence-based science behind gender affirming care. It has been rejected by many medical organizations around the world. The substack newsletter Erin in the Morning by journalist Erin Reed covers the issues well. Here are links to some of Erin Reed's reporting:
Another International Medical Org Rejects Cass Recommendations On Trans Youth:
The Cass Review was carried out according to strict standards of systematic reviews, over a three year period. It was commissioned by the National Health Service England and completed under the guidance of Dr Hilary Cass, a former president of the Royal College of Paediatrics and Child Health. The Review commissioned the University of York to conduct a series of independent systematic reviews of existing evidence. https://adc.bmj.com/pages/gender-identity-service-series
I trust this process more than I do a substack author, and more than the providers who have financial and professional stakes in gender affirming care, who have not done systematic reviews of the evidence (except for one which they suppressed because the results did not please them). Per the editor of the British Medical Journal (whom I also trust), "The evidence base for interventions in gender medicine is threadbare, whichever research question you wish to consider—from social transition to hormone treatment." https://www.bmj.com/content/385/bmj.q837
The BMJ article is excellent. Thanks for noting it, and I commend it to all. It is a tragedy that this issue has gone so far down the partisan rabbit hole. I do want to urge all interested in/concerned about these issues to read the Cass report directly, and also to learn about Dr. Cass, who is a wonderful, dedicated, and caring pediatrician. She came in with no preconceptions and followed only where the facts and science led her and her team. Her level of caring for distressed and confused children is something to which we all should aspire. They deserve the best from us, and they are not getting it. Way too much noise stands in the way of scientific inquiry and knowledge on these issues, and we all really do need to find our way out of that. In that regard, thanks again to you, V Dale, for sticking your head above the parapet on this. You are to be commended.
Thank you for your comments, Susan - I completely agree. Including your description of Dr Cass. She cares very much for the young people affected and wants to achieve the high level of care they deserve. It's great to encounter others who believe in science and reason, as well as kindness!
What are you saying? It sounds like what you’re doing is dismissing the evidence-based science behind gender affirming care without citing which data you’re challenging or providing any of your own… almost as if your personal biases are getting in the way of making a logical argument.
The existence of one study that feeds your need for vindication to dismiss trans people and their need for care does not equate an absence of evidence-based science promoting gender-affirming care. You are literally dismissing everything else that has been written or studied on the subject. I am sorry trans people make you uncomfortable but that’s not science- that’s a you problem.
There is evidence-based science behind gender affirming care. In addition to the links I cited above, here is another article to familiarize yourself with the problems with the Cass Review as well as studies that demonstrate the benefits of gender affirming care:
Endocrine Society And American Academy Pediatrics Respond To Cass, Reject Bans
On reflection, just about everything CDC recommended turned out to be wrong.
At the same a number of countries in Europe got most of it right. Europes input was based on input from practicing physicians and some input from epidemiologists. US came primarily from epidemiologists which is largely using statistical input. All these decisions need a good douse of input from practicing physicians
I understand your points sure!! But in some ways maybe not that simple!! I think the issue of online misinformation & disinformation is so rampant that how that is countered is the bigger question. When there are still daily death threats against docs like Hotez & Fauci, political ones like Rand Paul calling for Fauci to be jailed, etc. etc. Yes, empathy is vital but not sure it's enough to counter all the stuff coming the way of public health professionals. Public health messengers never said they were perfect or got everything right in '20 or after.
The question that I have - who, or what, profits from the dis-informed world? And I remember that a sage from long ago said that politics is the highest science of man......
I just think everything has gotten so polarized & entwined especially with Fox, ones like RFK Jr, large segments of the GOP now that it will take a least a generation & likely longer to get back to most of the public listening to public health establishment. Yes, there might be some at the individual level that can be swayed away from the anti vax/science mentality which is fine, but any big changes will take a while.
“ it will take a least a generation & likely longer to get back to most of the public listening to public health establishment”.
A while back there was a bit of a local brouhaha when the leader of the county health department published an article stating something to the effect of self perceptions among black students in the county schools was grounds for declaring racism a public health emergency. The thing was, he got caught cherry picking data and excluding portions that actually showed the black students doing better against whatever the metric was, including compared to white students. In other words, the guy lied in order to try to declare an emergency. Why would he do this? Because once it’s declared an emergency, then it opens the door for regulatory power.
Now, I’m supposed to trust this guy when it comes to real public health issues? Not on your life.
One of the problems that I see is that folks are being forced into binary camps on this position: either for or against, and that doesn't necessarily reflect reality. As I have said previously, I am not "anti vax", but neither do I blindly swallow the current recommendations, which to me seem like a load of bullshit with a dose "I'm an expert trust the science" to try to mask the flavor. To put things in perspective, I was born in 1971. From what I can find it looks like at that time, the vaccinations I received would have been: DTP, Polio and MMR. There was no vaccine for chicken pox, which I contracted in first grade.
Now, let's compare that to the current recommendations:
RSV, Hep B, Rotavirus, DTP, HIB, Pnemonacoccal, Covid, Influenza, MMR, Chicken Pox, and Hep A.
Not mentioned would be HPV administered as a teenager.
I look at this and say, WHOA! And God forbid I should question any of this. Hepatitis? The first time I recall someone getting a hepatitis vaccine was it being offered to the person who cleaned the bathrooms at the first place I worked after graduating from college.
This is easily double the number of vaccines I was given and most of these are three and four doses. I didn't get three or four doses of anything as a kid. You're damn right I question this, especially when juxtaposed against some of the supposed "misinformation", which has become a buzzword to try to stop the conversation as a put down, about the effects. And don't give me crap about being a health expert or even a damned doctor. As an engineer I am quite capable of understanding and interpreting "the science" and even have more college education than most doctors. Calling yourself an "expert" doesn't cut it.
If you'd like some fun reading, here is some great background on how the ACIP decides what gets put on the vaccine schedule. It is fascinating and comprehensive stuff!:
This is a really important and difficult topic; thank you for writing about it. I’m an MD/PhD (immunology) and work in Neurocritical care, and now & then will see a family which makes decisions based on a data set entirely different from mine. I also use values-based discussion, and I lead with “We all have the same goal: to do as well by [the patient] as we can. Let’s start there.” The situation is so complex (ventilator, pressors, stroke, ICH, TBI, cerebral edema, etc) that we talk a lot (almost a mini med school course on what is happening and why) which helps people come to grips with how we look at cause and effect relationships and helps overcome distrust.
It’s all about the shared goal. I want the same thing you want, you can see the work being done, I’ll answer all of the questions you have, and we’ll both see results as they happen.
I think this kind of practical discussion might work in many different spheres.
Did you notice how JD Vance was speaking lies in the debate, but was doing so in a way that sounded friendly, kind, polite? It scared me more than Trump, because I can see that people will respond to him positively. It's an example of your point in action.
I love this series! I’ve been able to be this way and have shared it with others. But not as clearly and articulately as you have here. Excellent. As an example, I saw that when I wasn’t well-informed about a subject, e.g., race, politics, and history, I couldn’t really “weigh in” effectively. So, over time, I started absorbing more and more information from my weaker areas, especially politics and history, because the topic became clearly important. Oh yeah, and systemic racism and repression. Now when I talk to people in the neighborhood, family gatherings, the grocery store, the clinic, workers fixing my house or yard, I can figure out their values and only respond to what they’ve already said with a suggestion like, “I recently read that Biden’s build back better program means …” this or that. You know you’re on the right track when the other person says, “I didn’t know that.” And you can say what relief or joy or amazement you felt when that happened, too. It opens the door of their mind even if you never see them again. It’s even better when you do see them again and haven’t offended them or put them on their guard against you.
I absolutely get what you are laying out here, and the goal of helping people see how science helps us is spot on. I will say that in this current climate trying to, even very politely, have a conversation on such topics is extremely difficult. I volunteer at Planned Parenthood as an escort helping clients get into the clinic while protesters yell horrible things at them. Since the spring I have made it my mission to talk to the protesters not about the issue of abortion or all of the other services going on at the clinic, as we of course don't agree, but to try and humanize each other, to try and not "other" each other, talking about regular life stuff. I will continue to participate in trying to humanizing each of us, but I honestly don't see any sign of these people seeing any reason to try and think differently, to try and learn from getting to know the "other" person. I know my example is different than what the article is about, but the challenge of what I'm trying to do seems similar to me.
I’m not an anti-vaxxer. I am only skeptical about whether I really need to participate in this mRNA experiment. In my mind it’s a simple risk/benefit analysis. I caught a mild case of Covid before the vaccines were developed. I did my own experiment and had my blood tested regularly for antibodies over the following 18 months (IgG and Tcell). They were robust. It seems I had naturally acquired protection. Given the low IFR and high rate of SAEs reported in VAERS, I concluded that I didn’t need to take the risk just to give me something I already have. I had a keen interest in this and watched all of the Trump Covid Task Force TV reports. It seemed to me that there was a lot of uncertainty and conflicting information about this novel virus. Yet early on we did have the results of one of the best experiments on the lethality of Covid: The Diamond Princess cruise ship. The stats on those passengers told us a lot. There are many others like me who aren’t anti-vaxxers per se. We don’t cover our ears to your message. We just have healthy skepticism about an experimental injection, do our own research and critical analysis.
Many prominent doctors and scientists have advised against the mRNA shot and were censored as quacks and conspiracy theorists. Some even lost their jobs and hospitals privileges. Much of what they said has now been validated. All scientists agree only when you censor the ones who don’t.
I love & respect Science; Science has helped save Humanity & made evolutionary progress for Humanity; but sometimes science also gets it wrong; sometimes profits are prioritized over human life; WHY can't we talk about ALL THE MULTIPLE COMPONENTS that can contribute to the fears of vaccines, drugs, meds, etc.? Think Perdue & the rampant Opioid Epidemic; think the common high blood pressure pill Losartan pulled off the market bec it contained a verified cancer-causing agent due to the lack of Quality Controls/Oversight, etc. And why was there a sudden ramp up of kids who (coincidentally or not) became autistic or had instant physical problems immediately after getting vaccinated? Why hasn't there been an answer to that issue that helped bolster the anti-vaccine movement? I got every Covid shot & took a "leap of faith" to get them because what choices did we have: Stay on the SSCovidTitanic or jump over & take a "new" vaccine that was developed on an unheard off timeline though I had already been reading about the new monoclonals in science newsletters, etc., about 5-7 years prior to the Covid pandemic. (Which included Dr. Michael Osterholm of CIDRAP who, years prior, went on the History channel on an episode of ancient plagues & talked about the potential for another major pandemic/plague in the modern world; I do believe his words were (when asked what modern man could expect from the next pandemic).... "It's gonna be a doozy..." but maybe I got that wrong... :)
Kristen,
The lack of trust for many of us was Public Health being wrong in real time and not acknowledging or apologizing for the mistakes. Instead, they acted like Shamans and Astrologists, always defending their failed predictions with after-the-fact explanations and promoting unfalsifiable terror scenarios (YLE for example in fall 2021 made a widely circulated post on Facebook stating that PICUs would be overrun by 30% with kids which never happened, but parents pleaded to have schools canceled based on fear like this).
I’m sure you are a very nice person, mean well, but you too have engaged in this and I am sure you aren’t even aware. (making claims of being close to Herd Immunity, supporting mandates on a non sterilizing vaccines, promoting the vaccine in children while the rest of the world paused vaccinations on people under 55-65, etc).
I brought myself up to speed on your writings over the last 4 years on Covid going through your blog over the weekend (I have a lot of free time 😊). A lot of your early work resonated with me.
For example from your 5/10/20 piece “Lessons from Graduate School for the COVID Pandemic” you note:
“It is easy to only pay attention to the data that supports your hypothesis (and ignore
the data that goes against your hypothesis)” and “It is easy to get fooled by early data.”
On 2/9/201, you have an excellent post on “When you can never be wrong: the unfalsifiable hypothesis” outlining the perils of having a theory where counterfactuals can’t be constructed to test and refute a theory.
Great stuff, and I agree with all of that of course, as you are describing the tenets of scientific pursuit outlined by Merton, Feynman, Sagan, Randi, Shermer, etc.
Yet as I continued to go through your blog, I felt you were inadvertently committing the very mistakes you warn your readers against.
Consider on 10/9/21 your piece “If you’re vaccinated, why does it matter if I am not?” where you make an attempt to justify the vaccine mandates and make what I consider to be an unfalsifiable claim:
“I just spent a month in New England (which has a higher vaccination rate overall), and my risk of getting COVID there was much lower than my risk of getting COVID back home in Texas (which has a lower vaccination rate).”
Consider that on 10/9, the 7 day average for cases in Texas was 7232, against a population of 29 million. That means .025% is positive for Covid. Vermont, which was touted as the state where “no one was left to vaccinate” (and I choose Vermont too because Katelyn Jetelina referenced them in a post around 2021 as well I encouraged her to double check her claim [1]) – on October 9th, Vermont had 197 cases/day against 647K population, rate of .03%. Slightly more than Texas.
Why in that post did you believe that Texas was doing poorly while you were safe in New England? Doesn’t the most vaccinated state in New England having more cases per population than Texas falsify your claim? If it doesn’t, can your hypothesis even be falsified?
Further, consider that Covid would absolutely explode across the country and the world, following the vaccine rollout. You make claim in 16 different parts of your essay how “being vaccinated significantly reduces transmission”, yet Covid cases would increase 10-fold in both Texas AND Vermont within 3 months. The NYT graph for vermont: https://imgur.com/a/tptVuaR
Vermont would hit a peak of 2K cases/day, representing .31% of the population, while Texas would have an almost identical peak of 68K cases/day, at .23% of the population.
To me, that should have been enough to reject your claim that Texas was doing worse than New England and caused you to reconsider your entire hypothesis. Your appeals to base rate fallacy crumble when Covid is now up a magnitude post vaccine.
Especially since any confounder you search for to prop up this now tenuous claim favors Texas.
Population denominator Texas grew due to mass migration into the state. The baseline health of Texans is far worse than Vermont..ians? There was a surging undocumented migrant population pouring into Texas, further increasing the population denominator. Texans had tossed aside the masks and social distancing long before Vermont would… at this point you have to get creative to data dredge/p-hack your way into supporting your claim.
You may say “Fine, Covid is surging equally in Texas and Vermont, despite my claim Texas is worse off than New England, but it still greatly reduces your changes of severe outcomes”
That is also wrong.
Following your 10/9/21 post, Texas would have 22.6% more deaths than expected through the end of 2021, near identical than Vermont’s 23.1% - and again, the confounders you may search for all favor Texas having a better outcome.
I am not trying to get you in a “gotcha”. Brilliant people who know how science works make these mistakes ALL OF THE TIME. It’s easy to get fooled as Feynman notes in his takedown of Social Science as “A science which isn’t a science”.[2]
William Farr, a brilliant man and one of the greatest statisticians of the modern era, had all the data he needed to see that Snow’s hypothesis disproved Miasma theory for Cholera, yet Farr stuck to his favored hypothesis for 9 more years.
I could keep going through your blog, finding examples of you making claims that were easily falsified [3], but then I would succumb to Brandolini’s Law.
On a closing note, as I read your blog I see you inadvertently and repeatedly made the mistake of “one directional skepticism”. That is, the things you think are true get a free pass-regardless of how poor the supporting evidence – while only the ideas you disagree with do you apply skepticism.
Ivermectin and HCQ didn’t work, and you were right to explain why in your posts. Yet as noted in footnote [3], you fail to apply that same level of skepticism to the easily debunked claims in the Financial Times articles you cite that high vaccination rates are suppressing the spread of Covid.
A (to me) damning example of one-directional skepticism is your 7/22/20 post “Masked Science: Fact-checking Mask Studies” where you apply rigorous skepticism to a dozen studies claiming cloth masks don’t work, pointing out all the flaws in methodology, rigor, design, and conclusions.
Of course, the consensus on cloth and surgical masks has pivoted back to what we knew 1920-2019 – they don’t work – but you felt inclined to only debunk all the studies suggesting masks didn’t work. Why didn’t you eventually write a blog post admitting “hey we got cloth masks wrong – here is why”?
I wonder, why didn’t you apply that skepticism equally to the hundreds of nonsense studies claiming cloth masks were incredibly effective? Why not tear apart the 2 Stylists in a Missouri salon paper the CDC promulgated? The ridiculous Kansas Mask Study? Abaluck’s RCT in Bangladesh?
Katelyn has made the same mistake – any terrible study showing the wonders of cloth masks got a pass and added to her “Think masks don’t work? Look at the evidence” social media threads [4], while she suddenly became concerned with study design, confounders and p-values when an RCT suggested what we would find out to be true – they are largely worthless after all [5]
It seems to me, as a dispassionate scientist, that you entered the Social Media Covid Blog World with your mind made up – masks work, Covid vaccines work, lockdowns work, etc, and wound up stuck defending these extraordinary and failing theories for reasons I can only guess (Politics? Sunk Cost Fallacy? Availability bias?) using the very pseudoscientific practices you claim to reject.
I apologize if this comes off harsh, I am not trying to be mean spirited – there are just only so many characters we can put in a comment and I don’t know if any of this will be read anyway 😊
(PS 100% agree with your post “don’t censor threads” even if threads is dead – the message is spot on)
_______________________
[1] https://yourlocalepidemiologist.substack.com/p/state-of-affairs-europe-should-we/comments?s=r
[
2] Should be mandatory viewing for everyone, especially social scientists https://www.youtube.com/watch?v=tWr39Q9vBgo
“I might be quite wrong” – my mantra
[3] For example your 7/21/21 piece: “Some vaccinated people are getting COVID. What does this mean?” cites a FT article based on terrible data making a claim that the UK and Portugal are doing great by comparing them to sub-Saharan Africa – and of course right after this article UK and Portugal would explode in cases and deaths, while Africa would shrug and throw out unwanted vaccines.
https://x.com/nathanwpyle/status/1176860147223867393/photo/1
[4] It is fascinating to me to this day how after 100 years of not being able to find much benefit of masking against respiratory viruses, we conjured 35+ studies instantly showing how amazing they are in a few months
https://www.facebook.com/permalink.php?story_fbid=202002698114314&id=101805971467321
[5] https://www.facebook.com/permalink.php?story_fbid=pfbid01SraZhfgd3fvJ969SrsjufxCuWE92DJRTW8dXbYqMFemjX5WYVUwD85GPJbMFVQyl&id=101805971467321
Michael,
Couple points. I do not understand why you struggle with nuance- immunity is not a binary. Your continued point that cases surged after vaccines ignores the fact that vaccinated people (especially initially) had lower rates of infection, and continued lower rates of hospitalization and death. Why do you never address this?
Why do you just post your talking points continually barely addressing the content of the articles you are responding to?
Also I'd recommend some self reflection- I see a lot of projection in your posts. "One directional skepticism" is pretty rich given your propensity to ignore huge swaths of data, and continue to link to literal propaganda. All I see in your posts is continued logical fallacies- false equivalence, straw man arguments, cherry picking data, false dilemmas, and confirmation bias. You're using the same strategies you claim to rail against.
SK,
I would love to see the following questions answered by Katelyn and Kristen:
1) How do you recommend a vaccine in children where there are zero excess deaths? What is the NNT?
2) Why did some of the worlds most highly vaccinated countries have some of the worst all-cause mortality spikes *after* their populations were fully vaccinated (South Korea and Taiwan for example, given their love of masking)
3) Why didn't countries with low vaccination rates suffer the poor outcomes predicted and instead threw out their unused shots?
SK "(you) ignore the fact that vaccinated people (especially initially) had lower rates of infection, and continued lower rates of hospitalization and death. Why do you never address this?"
I agree that is what the early studies suggested, so I weighed that hypothesis as real time data came in. Two things stuck out:
1) The early studies were fairly weak
2) The predictions the studies made were failing simple tests as time moved on
I suspect your belief that vaccine was working (especially initially) is because you saw all the charts and graphs showing it was a miracle (Kristen shared one such graph in her initial post in this series).
Now I may be projecting as you say, but I suspect you don't have background in statistics, study design, nor probably are abreast of the replication crisis?
Many of these impressive charts often contained biases, errors, and non-transparent methods. Common issues included:
- Included deaths/hospitalizations of people vaccinated but only within last 4 weeks (needed 2 weeks from second shot to be moved to the "Vaccinated Bucket")
- Using incorrect denominator for population estimates which inflated unvaccinated risk
- Automatically assuming anyone they couldn't confirm vaccinations status as unvaccinated. (Imagine you are in NYC on a trip from Virginia, have a heart attack, and brought to morgue where PCR test confirms you also had Covid - you can't tell them your vaccine status so you're considered unvaccinated)
- Early belief that the vaccine was sterilizing, so people who died of but where vaccinated were assumed to have died from something else.
- Not showing cohort breakdown of the unvaccinated dead - why weren't they vaccinated? Was it because they were in Hospice and had a week to live? That's roughly the outcome of 10% of our deaths at any given time. If a fraction of hospice patients decided to skip a vaccine, that would wildly inflate "Unvaccinated Covid Deaths"
Now, I had those concerns early on, but still hoped these would be the miracle promised.
But simple sanity checks as time went on were failing. States with low vaccine rates having identical All Cause Mortality Curves as highly vaccinated states was early indicator. Highly vaccinated countries having explosions of Covid demonstrated there must be something wrong with the studies. Again, South Korea had an enormous amount of deaths in their vaccinated population, and not once has Katelyn or Kristen written about that.
You keep saying "Well it worked early", but the vaccines were administered *while* Covid was plummeting on it's own as it was seasonal. Credit was being given to the vaccine for cases and deaths receding Feb-May 2021, but vaccine uptake was 2%-10% in many places, or not happening at all, and Covid followed the same curve regardless. But you don't know this because it seems you aren't double checking everything you are told - I guess?
Then, when Covid was exploding despite vaccination, the new claim was that "Red Counties are doing worse than Blue Counties". Well guess what? That has been true for 100 years with the flu and common cold. The confounders aren't that Covid hates republicans, it's that Red Counties are older, fatter, suffer from more comorbidities.
SK: "Why do you just post your talking points continually barely addressing the content of the articles you are responding to"
Kristen's asking a great and important question "why is trust in vaccines failing" and I disagree with her premise that it was a just a communication issue. It was a "you got a lot of this wrong and aren't owning up to it" issue why people don't trust Public Health.
Today she is saying "we should have been nicer to the unvaccinated to convince them we were right"
I am pointing out, no, you got so much wrong the last 4 years and don't even seem to know it. The example I used of her telling readers "she was so much less likely to get Covid in New England than Texas" in a 2021 blog was demonstrably false the very day she wrote it, had she decided to quickly check her claim with data. These types of mistakes compounded, and there is an obliviousness to it. She and Katelyn recommend vaccinating children, and seem not to be aware there have been zero excess deaths in children 0-14 the *entire pandemic* in the *entire world*. The NNT is infinity.
I'm not trolling. I am trying to help these young scientists realize they got bamboozled.
SK: "All I see in your posts is continued logical fallacies- false equivalence, straw man arguments, cherry picking data, false dilemmas, and confirmation bias. You're using the same strategies you claim to rail against."
As we discussed yesterday, I am facing an unfalsifiable hypothesis.
We have been struggling to make sterilizing flu vaccines for 80 years, and would openly admit "we don't know why they don't work". We spent 20 years trying and completely failing to make a Coronavirus vaccine.
As Kristen notes in her blog "Medical research is a loooooooooong process. Like, really long." [1]
So it was extraordinary that we could solve an 80 year old problem in 6 months back in 2020. We should have been skeptical, and initially PH Social Media Influencers were skeptical [2] but it seems mainly because they were worried Trump would get credit.
Bottom line SK, the burden of evidence is on those making the claim. If you claim that tying an Onion to your Belt wards off the Flu, and I show you that countries who don't tie Onions on their Belts (as was the style at the time) have identical or better rates of Flu, don't come at me with claims of "Cherry Picking" or "False Dilemmas".
You are welcome to email me further if you don't want to explain the following major challenges to the Covid Vaccine I started with above:
1) How do you mandate a vaccine in children where there are zero excess deaths?
2) Why did some of the worlds most highly vaccinated countries have some of the worst all cause mortality spikes *after* their populations were fully vaccinated (South Korea and Taiwan for example).
3) Why didn't countries with low vaccination rates suffer outcomes predicted?
Bonus: 4) Claims were made that without boosters, hospitalizations and deaths would soar, yet the opposite happened as the public moved on from Covid.
_______________
[1] https://youcanknowthings.com/2020/06/17/why-does-it-take-so-long-to-develop-medical-treatments/
[2] Charltan Eric Topol for example:
"We were on a path for a vaccine emergency authorization (EUA) before November 3rd. Thanks to the FDA, Trump's plan was disrupted. That won't happen. First real sign of the independence of FDA since the pandemic started. And that's important."
https://twitter.com/EricTopol/status/1314979190555340800
Michael,
I really wish you could focus your arguments and points, but I suspect this approach to gish gallop has worked for you.
You have so many claims, and so little sources.
Let's address a couple.
1. COVID-19 was causing hospitalizations and deaths in kids at a higher rate than any other infectious disease (yes a comparatively low rate to adults, but kids aren't supposed to die), and we had an effective vaccine to lower the risk of that. Also I'm not aware of any pediatric vaccine "mandates." California thought about it, but never did it. We don't have many excess deaths from measles right now in the US, should we not vaccinate? When has excess deaths ever been used as a metric for deciding to vaccinate?
2. No country was 100% vaccinated, and the vaccine didn't prevent every death. But it substantially lowered the risk. New variants, waning immunity and easing of restrictions explain the spikes to me.
3. First of all: https://www.sciencedirect.com/science/article/pii/S2772707623000115 Second, this keeps bugging me. You seem to expect the same results everywhere no matter what, ignoring all context. I'm not a global health expert, but I know countries that struggled with the administrative burdens of vaccination (or cost) also struggle with accurate reporting.
I do have some epi background and no I don't think I've been fooled by fancy graphs. I'm talking about multiple, large prospective and retrospective cohort studies that repeatedly and continue to demonstrate reduced risk of serious illness, hospitalization and death due to COVID-19 with vaccination. I'm happy to list them if you like.
One last point, since you brought up a background in statistics. Let's do a thought experiment. I think it is likely the majority of those working in biostatistics, epidemiology, public health and medicine would disagree with your view that the COVID-19 vaccines did not prevent serious illness and death. What seems more likely, that they, with all their knowledge and expertise are wrong, or that you (and a small minority of other scientists in this field) have cracked the code and they were all duped? This is not an appeal to authority, majorities of scientists have obviously been wrong in the past, but rather a thought experiment. How likely is it that you have figured it all out?
"SK: You have so many claims, and so little sources"
I encourage you to point out specific claims I failed to source, and I will do so, just as I did yesterday. A lot of the things I am saying I am taking for granted are common knowledge at this point (e.g., zero excess deaths ages 0-14 worldwide) so for a bit of brevity move quickly. Again, my email is in my profile and you are welcome to have side conversations through email where you might be more comfortable. I have had wonderful discussions with several readers of this blog and others the last 4 years this way.
SK: " Let's do a thought experiment. I think it is likely the majority of those working in (science) would disagree with your view that the COVID-19 vaccines did not prevent serious illness and death. What seems more likely..."
To be clear, I'm open to the vaccine having benefit to the elderly. I scheduled my parents shots in 2021.
Now, you are proposing that I am on the losing side of the "no, you are all wrong" meme (https://knowyourmeme.com/photos/2368486-yes-you-all-are-wrong) , which I agree, if I were saying these things in 2021, would have been the case.
But it's 2024. The crowd has thinned, many moved to the other side. Now we know:
The data is overwhelming that the vaccine did not slow transmission. https://imgur.com/a/9ueSF21 (I know you will say "cherry picking" but I could repeat this for any state, any country - they are all "cherries")
The data is overwhelming there were never any excess deaths in children, before covid, during covid, after covid
https://docs.google.com/spreadsheets/d/1WLCmgaOJSd0m-lXAw6-rTEaJiiTC9F3c452-J-3t1NI/edit?usp=sharing
**There are enough counterfactuals of the highest vaccinated countries having excess mortality surges not seen in lower vaccinated countries to call into the question the hypothesis the vaccine prevented serious illness and death.** Again, and I await your explanation, what happened in Taiwan and South Korea? These two countries were constantly promoted as shining examples of "doing it right" throughout the pandemic by public health until deaths exploded. Then they stopped talking about them. Understanding how South Korea could have all cause mortality doubled (this is literally without precedent) Spring 2022 in an entirely vaccinated population (yes, all people over 65 in SK were vaccinated, and this is the cohort where all the deaths occurred) should one of the most highly studied topics of the pandemic as literally, the exact opposite of what we would expected happened to them.
I can't stress how big a problem the South Korea mortality data poses to you, but you seem incurious, which isn't surprising, as the people you follow are also incurious.
I am not the man shouting the crowd of experts "you are all wrong", because there is no crowd anymore. What is left is a handful of Social Science Media Influencers stuck "holding the bag" on the vaccine hype. Covid as a problem exists entirely now on Social Media. It's talked about on Twitter and r/ZeroCovid, and some SubStack blogs, but doctors with patients have moved on. They are largely not recommending the vaccine anymore to anyone except the elderly (and even that is hit or miss).
Every country but the US and Canada halted the vaccine being administered to anyone under 55-65 age depends on country, (though as of last year Austria still went as low as 30) am I wrong? Perhaps, I haven't updated my notes found here since last year: https://docs.google.com/spreadsheets/d/1oJusZ0yAve1cCCSS5MGjp1XYjNc7qJffqJsz7ARlnLg/edit?usp=sharing
The vaccine passport and mandates were overturned and many who advocated for them have distanced themselves.
Covid Boosters and Vaccine uptake have cratered. Not among Republicans, but Democrats too. And politicians, and doctors, and nearly everyone. It's anecdotal, but my friend group largely consists of physicians in the Cleveland area, I am not aware of any who have bothered boosters since 2021. I am sure there are, but they are the outliers.
Not just Africa, but Europe is trashing millions of vaccines. Yet the public health influencers you are following predicted that without boosters things would get worse, yet the oppositive happened. As our hysteria and disinterest in Covid subsided, so did excess deaths. Why?
Quick address of your 3 counters to my questions though:
1) The measles vaccine worked. The predictions materialized. Cases disappeared, overall mortality reduced. And we see (unfortunately) "tests" of this hypothesis anytime some population decides to stop being vaccinated against measles - cases surge and deaths increase.
But just because one medical treatment works doesn't mean another one does. We have had plenty of vaccines we thought would work, but when they didn't, we shelved it and went back to try again (Rotavirus in 90's for example). Difference is they weren't politicized.
The covid vaccines were determined after careful consideration by the rest of the world not outweigh their negatives in children, which is why the rest of the world rejected them (either initially or after it became clear the evidence wasn't there). Again, I am not the "man shouting you are wrong" to the crowd. "The Crowd" agrees.
2) There are enough examples of countries having a near 100% vaccinated cohort population (i.e., 65+) yet still experiencing incredibly high mortality spikes. I strongly encourage you to dig into Taiwan and South Korea data tables, and if you don't know how to do this, I would be more than happy to walk you through so you can see for yourself. It does not make sense.
As for your possible confounder explanations, let run through them:
a) "New variants" - low vaccinated countries had the same variants
b) "waning immunity" - If a vaccine only provides 2-3 durability, does it work? Or is it "kicking the can down the road"? Would it be realistic to get 4 shots a year? 6? Can that claim be tested?
c) "easing of restrictions" - In the case of Taiwan and South Korea, they were still wearing masks. Their lockdowns were ended over a year earlier (almost two). South Korea children back in school Spring 2020. This doesn't explain it. And corolllary, if the easing of restrictions was the reason, why did the countries wth the shortest lockdowns, earliest return to school, lowest mask use, etc, have the best outcomes? (Nordic Countries: Sweden, Norway, Finland, Denmark).
3) I expect reproducible results. That is the foundation of science. The hypothesis must pass rigorous scrutiny and exceptions must be faced head on. In the case of Sub Saharan Africa, yes, the administrative burden was high. Testing was spotty. Mortality data is almost nonexistent. These countries face challenges much higher than Covid, and that's the point - they face challenges bigger than Covid. Throughout 2020 and into 2021 there was so much hand wringing by Public Health about how much Africa would suffer from Covid, how we needed to pay for their vaccines, and in the end, the New York Times was puzzled why Covid didn't seem to be a problem there and their Public Health trashed the shots. Actions speak loudly on this.
I do love that you bring up the "Gish Gallop", as that is the challenge I face when discussion this.
I say "please explain how a completely vaccinated and masked 65+ population in South Korea had explosion of deaths", and I'm met with 100 old studies, models, preprints showing how much worse they would have fared without the vaccine.
Why not consider instead that the fastest vaccine developed in human history, by an order of a magnitude, against a virus we tried and failed to vaccinate for 20 years, against a family of viruses we have struggled to develop effective vaccines for 80 years, simply didn't work once we saw everyone get stick anyway and death regularly increase or stay unchanged?
Another great response.
"I am not the man shouting the crowd of experts "you are all wrong", because there is no crowd anymore. What is left is a handful of Social Science Media Influencers stuck "holding the bag" on the vaccine hype."
Agreed. I knew this day would come. It was a mathematical certainty.
SK,
How do you validate the data you reference with regard to hospitalization and death rates among the vaccinated vs. unvaccinated? Wouldn't you say that you are taking the CDC at their word? There's nothing wrong with that. Many people do, what choice do they have? These organizations have the data and we don't.
I am just curious why you would trust an organization like the CDC which continually confirmed that the Covid shots were safe and effective and have undergone the "most rigorous testing" of any vaccine. Safe and Effective are arbitrary terms and terms that are co-dependent.
How could they have been rigorously tested if they were authorized after only an average of six weeks of observation?
Why would the CDC continue to ignore the hundreds of thousands of serious adverse events reported in VAERS and dismiss them as "unverified". Isn't it their job to verify the data in their own event capturing system?
Why would the CDC dismiss a previous Covid infection with antibody titers as inadequate to confirm "immunity" and "recommend" vaccination because antibodies aren't proof of protection yet turn around and use antibody levels as proof of efficacy in the pediatric trials? This double standard was also employed in booster studies during the spring of 2022.
Have you thought about the mathematical implications of ignoring outcomes in the recently vaccinated while including them in the pool of "fully vaccinated"? This will automatically create false effectiveness, no matter what outcome you are looking at.
By March of 2022 the Office of National Statistics was publishing data across their 35 million population indicating that the risk of infection was anywhere between three to five times higher in the vaxxxed than the unvaxxed. Then they stopped reporting that metric.
Throughout 2021 the CDC never published infection rates by vaccination status yet continued to claim very high levels of effectiveness against infection. Why wouldn't they just publish the data while folks were weighing the risks and benefits?
My point here is that the folks that are telling us what the data shows still have a lot to answer for.
Wow! That was a lot of reading, I’m honestly impressed. I don’t have time to respond to all your points, but can hopefully provide clarification on a few matters.
I agree that many in public health made “predictions” that didn’t turn out to be true, and that left a lot of people confused and disappointed. At the same time, scientists were working with the data they had at the time, and it’s not necessarily fair to expect them to anticipate all the curve balls the pandemic through at us. Looking back at my own writing, I think I could have done a better job communicating uncertainty, and is something I can apologize for and hope to do better moving forward.
As far as the specifics you mention, I think you may have misread what I said. I didn’t endorse vaccine mandates or tackle the topic of COVID vaccines in children. (And I don’t remember writing about herd immunity, but maybe I did?) I did write about the data behind vaccination and why vaccination benefits your neighbor, but that’s very different than endorsing the mandates, as policy decisions like this aren’t only about science, but also about weighing different values and priorities (collective good vs individualism). That’s actually the topic of the last post of this series, coming next week. I personally don’t like politics, so try to focus my writing on data, and less often delve into policy arguments. Some will infer political motives on top of my writing, but I have found those inferences are often inaccurate.
As far as the month in New England, that was Connecticut in August, not Vermont in October. I left an ER rotation in Houston and went to an ER rotation in New Haven, and the differences in COVID cases showing up the the ER was striking — far more COVID was hitting Houston than New Haven. I took a quick look at the county level data in August through October 2021, and New Haven county, CT had lower cases and deaths per capita (1372 cases and 10 deaths per 100,000) compared to Harris county/Houston (3218 cases and 51 deaths per 100,000). I agree you need to account for confounders like underlying comorbidities, there have been quite a few studies digging into this. Omicron certainly changed the dynamic on vaccines and transmission when it arrived later that winter — the topic of transmission is a complicated one, and more than I can go into at the moment. I think it deserves its own post, looking back and what the data said, when, and how things changed with the different variants.
Regarding the masks post, that was “one-directional” because it was focused on a specific meme that was circulating. It was not meant to be a comprehensive review of the literature on masks. As far as what I choose to write about generally, there is a bias — I only pick topics I have time to tackle and that I think will be helpful. For example, there were valid questions and concerns about natural immunity, and it was a topic I always wanted to write about, but the literature was so messy and I didn’t have time to do it justice. My time constraint as a trainee means that some of the more nuanced topics never got written.
I hope this helps, and thanks for your kind review of my early work and the Threads post.
I greatly appreciate taking the time to read through my post which I know comes off as a diatribe for space constraints. I always think of that XKCD "Duty Calls" (https://xkcd.com/386/) when I write these long winded replies. I always try my best to grant charity and grace while attempting to offer counter hypotheses/critiques.
I also don't like politics (well, I used to be insufferable during the Bush years... *shudder*), though I assume we vote the same way regardless.
Quick explanations on why I made assumptions on your views - not trying to create a time consuming "Back and Forth" though:
>KP: "I didn’t endorse vaccine mandates"
I made the assumption you did endorse based on your piece from Oct 9 "If you’re vaccinated, why does it matter if I am not?" where you opened with "With the introduction of the COVID vaccine mandates, one common question has arisen..." and then went on to explain why the vaccine was effective (as opposed to taking a moment to oppose or at least acknowledge the danger of mandates).
>KP: "As far as the month in New England, that was Connecticut in August, not Vermont in October."
I chose Vermont only because how much media attention it was getting mid 2021 as example of the "power of the vaccines working", and I wrote a (I thought) careful rebuttal to this premise back in 2021 to Katelyn
https://yourlocalepidemiologist.substack.com/p/state-of-affairs-europe-should-we/comment/3633256
And I hate to further criticize, but since your post arguing Texas was doing worse than NE was posted on 10/9/21, you could have double checked if your experience in August was still accurate by the time you published that piece in October, and had you done that, you may have reconsidered your hypothesis.
>KP: " I think it (transmission) deserves its own post, looking back and what the data said, when, and how things changed with the different variants.
100% agree! Look forward to it, and hopefully a healthy dialectic!
>KP: "Regarding the masks post, that was “one-directional” because it was focused on a specific meme that was circulating"
I could write books on this topic of how and why the belief that cloth masks were an effective slice in the "swiss cheese" method of virus control swept over us so rapidly using the weakest of evidence, to the point everyone became convinced they could "crush the pandemic in weeks" (Robert Redfield) and justify forcing children to wear them.
I would hope at this point, 4 years later, you agree with the updated consensus they don't work (which was the pre 2020 consensus) and be curious what lead us to overlook the terrible studies that convinced so many of their (false) efficacy.
>KP: "I hope this helps, and thanks for your kind review of my early work and the Threads post."
You are welcome, and I read and agreed with many more of your blog posts I didn't comment on, one that stood out was how you described your MD/PHD combo, and it was really impressive - as I know 2nd hand part of the challenge - I dated my eventual wife through her journey to become a vascular surgeon, who initially wanted to do only research before she caught the "surgeon fire" - through undergrad, med school, residency, fellowship, all the board exams - so I completely respect the time and dedication (and sacrifice) you had to put in to get where you are today.
Michael, I believe you express the frustration, disappointment and mistrust of millions of people.
As a public health official during the pandemic, I believe the reasons for those reactions can be traced directly to a failure of effective Crisis Communication. That failure took place at many levels of leadership.
I learned in clinical practice that if you outlined in advance the potential benefits AND the potential adverse outcomes of any given course of treatment, patients / families were grateful and understanding even when the optimal result was not forthcoming.
In contrast, if something untoward, yet reasonably foreseeable did occur that you had not discussed with the patient / family, then even the truth came off as an excuse.
I believe effective Crisis Communication while the pandemic was unfolding could have and should have addressed every point you raise.
I appreciate the thoughtful comment, and I would agree that failure caused frustration for many, but that wasn't the case for me.
My frustration was with the extraordinary claims being promulgated by people who should know better. Often these claims were wrong in real time or could be discredited in a short amount of time, yet Public Health treated Covid almost as a religion - where skepticism was eschewed for Orthodoxy.
I went through several examples in my lengthy comments already, so won't rehash them, but as we come out of the fugue of the last few years I am reminded on the War on Terror and The War on Drugs (I'm not old enough to remember the post War on Vietnam - but I suspect the same thing) - where a terrible idea became politicized, criticism was shunned, and by the time everyone realized it was a terrible idea, no one wants to be accountable for the decisions.
Our War on Covid had many terrible decisions. There was some grace "we worked with the facts at hand" to some extent, but facts were often ignored.
We knew by summer of 2020 that closing schools was not necessary as many countries demonstrated this fact.
We knew almost immediately Covid posed no more harm to children than the common cold.
We knew for 100 years that cloth masks were ineffective against respiratory viruses, but made children suffer wearing them anyway because 30+ terrible studies were conjured out of nowhere promising amazing benefits that never materialized.
We knew mass testing couldn't stop the virus by the end of 2020 but we wasted billions anyway.
We knew by the end summer 2021 the vaccine unfortunately didn't repress the virus and was tearing through the vaccinated, yet we didn't stop coercing people with threats of economic losses, denied medical care, removal from school, etc.
And none of these errors I see being apologized for in these threads. And this is why people don't trust PH.
Practicing physicians don't trust PH. Just look at how many stopped with the vaccines, the masks, all the hysteria. Kristen is an ER resident, I assume her hospitals are just like the Cleveland Clinic and UH here - Covid is a thing for Reddit and Twitter. Or do they still take boosters and mask on the east coast?
Real accounting of the last 4 years needs to happen.
Completely agree. I am a practicing physician, and I am extremely concerned about the blows public health took these last four years. Anemic efforts to make amends are doing more harm than good. If anything it is proving that the medical orthodoxy will never be able or willing to admit what they got wrong when big mistakes were made. Clear headed people really ought to be even more concerned after a series of posts like this.
Excellent commentary Michael. I am also encouraged to see that Kristen has responded. Like you I have over the last 18 months left detailed and reasonable critiques to some of the authors' positions. Not one was ever addressed. Perhaps things are shifting.
I would also agree that Kristen and Katelyn are fine human beings with good intentions. However, like many educated people, they are unaware of their own biases even though they are the very same ones they point out in others. Thank you for explicitly pointing this out.
While most of the world recognized that the old and those with serious co-morbidities were most at risk, our government health experts were scaring the daylights out of all of us and pushing the vaccine as the only way to survive this curse. Most of the funding for the FDA and our health agencies comes from the drug companies.. They fund a lot of their research. Most of their budget comes from user fees. The government scientists can get a cut of the action via royalties. There's an inherent conflict of interest in this arrangement. A lot of what we were told about the covid shots was false. They don't prevent infection or transmission and aren't safe. As noted above, a number of European countries have now restricted the admin. of these vaccines to the elderly. Peer reviewed research papers are being published lately confirming that the "conspiracy theorists" were right about a lot of this stuff, yet they seem to be ignored by the media on purpose. For instance this study last June found that vaccinated children were six times more likely to get early onset asthma within a year of the shot than the unvaccinated kids. The authors will probably never get another research grant from Pfizer or Moderna!
https://link.springer.com/article/10.1007/s15010-024-02329-3
Bless you, Michael, for taking the time to research and write this. You should write for the NYT or similar large-audience publication. A+
I sometimes wonder what, if anything, did we as a society learn from the pandemic?
When it comes to hypothesis driven thinking, one thing people forget is we can never prove our hypotheses. But all it takes is one piece of data to disprove a hypothesis.
I understand that cloth masks don’t help. Any thoughts on whether K95 masks work? Or are those the same as surgical masks?
Thanks again for all you do.
The problem with n95 masks is that even the slightest break in seal (you always see this around nose, chin, sides of face) likely renders it useless, as you are now pulling air flow predominately through the gaps. They also get moist which increases the micopores.
I always remind people that we only discovered viruses in because some invisible pathogen undetectable by the most powerful optical microscopes was passing through Ceramic Water Filters (Chamberland Filters), and scientists named this invisible pathogen "filter passing virus" which they wouldn't be able to "see" until the invention of the electron microscope 40 years later.
It's possible a single use n95, worn on a cleanly shaven face, properly donned and doffed, with perhaps surgical tape sealing the perimeter to your face might work.
Yet even then, you could place up to 22,000 Covid virions side-by-side in the space of a single micropore in an n95. These things are incredibly small sneaky fuckers.
Thank you. Now go enjoy your weekend!
Any good book recs?
I do have a suggestion for another way for you to look at outcomes from the pandemic. The deaths per 100,000 of population by state really tells the story.
I agree 100%. And the difference pre and post pandemic suggests none of our “rain dances” mattered. Whether it was closing schools, wearing cloth masks, vaccine uptake, you can’t accurately predict which states did what measures when blinded more than 50%.
Unsurprising when we are dealing with pseudoscience and rain dances.
I think we made assumptions, that everyone would see us as SMEs and that they would "understand" and comply with our advice. No one expected that the POTUS would openly challenge our expertise. No one expected that several Red State Governors would openly challenge our expertise. I don't have a counterargument for politicians who have little or no respect for science. I don't have any counterarguments for politicians who do not have the health, safety, and welfare of their citizens as their primary motivation during a pandemic. I know that we did the best, we could do, given the circumstances. But nothing changes the fact that (maybe) 3M Americans died needlessly during the pandemic, mostly because they either choose to ignore us, because they believed politicians over the "expertise" or politicians muddy the water enough, to confuse a significant number of Americans; that they decided that no action was their best option.
You hit the key points of our Covid years.
A couple of points.
1. Public health is PUBLIC. It depends on government funding with the usual government oversight. And in the early days of the pandemic, in the US, it became highly politicized. Orders from on high as to who was allowed to say what depending on the perceived political costs.
2. I cannot recall another event where we were all watching science happen in real time. We had to figure out if this was trasmited by fomites, droplets, or something else. We made a (reasonable in my view) guess that social distancing, masks, various closures, etc. would stop the spread or at least provide some limited personal protection. In hindsight, a lot of that advice was not great. But given what we knew and when we knew it, we did the best we could in the face of imperfect knowledge and government meddling.
3. Too many of us are scientifically illiterate. As a consequence, we want to be told ONCE what to do, that it works, and how to do it. The advice on Covid was not consistent (see point 2 above). And that drove a lot of people nuts because they just wanted to know what to do and got frustrated and angry when the advice kept changing. Ideally, science is self-correcting. Good advice WILL change. But when it changes fast and often, we just get frustrated.
I only hope to heaven we have learned from the mistakes we made with Covid and do not repeat them whenever the next virus from hell rears its ugly head.
And Drs Fauci and Hotez deserve a Nobel Prize, not the firing squad so many are calling for.
“ And Drs Fauci and Hotez deserve a Nobel Prize, not the firing squad so many are calling for.”
Excuse me, but do you realize what Saint Anthony actually did? It started with so called “gain of function” research at UNC Chapel Hill, by Ralph Baric, where deadly viruses were modified to make humans susceptible to them. Oh, the claim was that it would help develop vaccines or whatever, which I don’t buy. In any case, this research was declared too dangerous to perform and became prohibited at the federal level. Instead of shutting it down, it got moved to a communist country, known for lax hygiene standards (do you recall the guy coming out of the Wuhan Covid “hospital” which was cots on a gymnasium floor walking out and pissing on the side of the building live on CNN?). This research was funded by NIH dark money, and laundered through that eco health alliance by the Dansak guy and others. Then there is the whole emergency HVAC replacement in this “lab” and next thing we know is that what was obviously an engineered virus, and there is plenty of evidence that it was engineered, spreading around the globe.
Fauci is responsible for every Covid death.
that's quite a statement. hateful, innacurate and totally wrong. Of course Dr. Fauci is not responsible for COVID deaths. Not one. You really don't play fair or want to be just in your judgements.
No, it is not wrong. Research it.
Show all of us your data, your research please. Ad hominem attacks are gutless.
All virology research is gain of function. Audit a virology course. Stop displaying your ignorance.
Nice column. A lot to consider. But if one side continually devalues fact, reason and patience in favor of fiction and outright lies - and engages in threats of violence - how can the attempt to focus on shared values gain any traction? You hit a wall at some point. I do my research and get the vaccinations I deem safe and appropriate. Too many others, though, go straight to the disinformation and take up permanent residence there with no thought of ever dislodging their minds from such a perch. I'll take care of myself first and foremost. I find it's fruitless to converse with the other side. I guess you can fault me for giving up, but that's where I am at age 68.
I'm with you. I'm exhausted from receiving only derision and outright lie-based responses to my years of attempting to engage positively from an empathy & data driven place. I can't approach people with reason anymore if they are behaving & speaking in dangerous, disrespectful, and thoughtless ways.
When a position becomes tribal, an argument against that position is taken as an affront to the tribe. and reason is no longer relevant.
Since 2022, when my oldest was diagnosed with cancer at 19 months old and I had a 3 month old baby who clearly wasn’t fully vaccinated I have struggled with effective ways to counter antivaxxers in any sense. Appealing to emotion doesn’t work “why should I potentially harm MY kid in order to keep yours safe?!” (the most common come back I see) or “if you are so worried about it just stay home!!” (As if my kids don’t deserve the ability to be in the outside world at all because they don’t have the appropriate immune systems to fend off vaccine preventable diseases due to the lack of vaccines and chemo effects - they are already fairly isolated but they deserve to be able to exist in a society too!) it’s been a rough 2.5 years and isn’t over for us yet. Luckily my youngest is fully vaccinated up to date but my son still isn’t able to receive his re-vaccines.
Love the bottom line here: “We must use science to figure out how to regain trust in science. And the science is clear: shaming isn’t helpful.” A wonderful object lesson there, so clever. I also think the wise words in this piece are useful for every interaction we have, whether in person or online. Too often, ad hominem attacks and name-calling take the place of any civilized, respectful exchange of views. The suggestions here offer great ways to get past that problem. (I particularly enjoyed, in that regard, the advice to rant in private😎.)
"It [is] fundamentally about believing that evidence-based medicine actually works—that systematically collecting data and analyzing it will give us a clearer picture of reality than anecdotes. That we don’t have to go back to the days of basing medical decisions on hunches, fears, and vibes. We have a better way of figuring out what’s real and true.
The rejection of carefully collected, peer-reviewed data in favor of rumors and memes is understandably infuriating. If universally adopted, this would make our society collapse. For people who have devoted their lives to science, medicine, and public health, it makes sense that this gets under our skin and infuriates us."
I love reading this and strongly agree. This is one of the reasons I am so frustrated with gender medicine in our country. Medical organizations and political leaders are doing exactly what anti-vaxxers say that progressives do - use their authority and "science" to support purely political goals without regard to evidence. A different topic, of course, but I think the perception that the left is willing to promote non-evidence based policy and twist the facts for ideological purposes is absolutely true in the field of gender medicine. It is going to (justifiably) harm the public's faith in experts and science, which will make public health that much more challenging in the future. If we want to promote science and evidenced based decision making, we have to be consistent - that's kind of what science is.
“I so agree with your statement that “If we want to promote science and evidenced based decision making, we have to be consistent - that's kind of what science is,” and your example is right on point. It is particularly distressing to see the rejection of science persist in the area of gender medicine despite the publication of the Final Cass Report. (If of interest to anyone here, this is a link: https://cass.independent-review.uk/home/publications/final-report/)
The Cass Review is rife with problems, including methodological flaws and ignoring evidence-based science behind gender affirming care. It has been rejected by many medical organizations around the world. The substack newsletter Erin in the Morning by journalist Erin Reed covers the issues well. Here are links to some of Erin Reed's reporting:
Another International Medical Org Rejects Cass Recommendations On Trans Youth:
https://www.erininthemorning.com/p/another-international-medical-org?r=rzr4r&utm_campaign=post&utm_medium=web
Yale Researchers, International Experts Release New Paper Rebuking Cass Review:
https://www.erininthemorning.com/p/yale-researchers-international-experts?r=rzr4r&utm_campaign=post&utm_medium=web
British Medical Association Calls Cass Review "Unsubstantiated," Passes Resolution Against Implementation:
https://www.erininthemorning.com/p/british-medical-association-calls?r=rzr4r&utm_campaign=post&utm_medium=web
The Cass Review was carried out according to strict standards of systematic reviews, over a three year period. It was commissioned by the National Health Service England and completed under the guidance of Dr Hilary Cass, a former president of the Royal College of Paediatrics and Child Health. The Review commissioned the University of York to conduct a series of independent systematic reviews of existing evidence. https://adc.bmj.com/pages/gender-identity-service-series
I trust this process more than I do a substack author, and more than the providers who have financial and professional stakes in gender affirming care, who have not done systematic reviews of the evidence (except for one which they suppressed because the results did not please them). Per the editor of the British Medical Journal (whom I also trust), "The evidence base for interventions in gender medicine is threadbare, whichever research question you wish to consider—from social transition to hormone treatment." https://www.bmj.com/content/385/bmj.q837
The BMJ article is excellent. Thanks for noting it, and I commend it to all. It is a tragedy that this issue has gone so far down the partisan rabbit hole. I do want to urge all interested in/concerned about these issues to read the Cass report directly, and also to learn about Dr. Cass, who is a wonderful, dedicated, and caring pediatrician. She came in with no preconceptions and followed only where the facts and science led her and her team. Her level of caring for distressed and confused children is something to which we all should aspire. They deserve the best from us, and they are not getting it. Way too much noise stands in the way of scientific inquiry and knowledge on these issues, and we all really do need to find our way out of that. In that regard, thanks again to you, V Dale, for sticking your head above the parapet on this. You are to be commended.
Thank you for your comments, Susan - I completely agree. Including your description of Dr Cass. She cares very much for the young people affected and wants to achieve the high level of care they deserve. It's great to encounter others who believe in science and reason, as well as kindness!
Thank you.
What are you saying? It sounds like what you’re doing is dismissing the evidence-based science behind gender affirming care without citing which data you’re challenging or providing any of your own… almost as if your personal biases are getting in the way of making a logical argument.
There is no evidence behind gender affirming care. See the link regarding the Cass Review above.
The existence of one study that feeds your need for vindication to dismiss trans people and their need for care does not equate an absence of evidence-based science promoting gender-affirming care. You are literally dismissing everything else that has been written or studied on the subject. I am sorry trans people make you uncomfortable but that’s not science- that’s a you problem.
There is evidence-based science behind gender affirming care. In addition to the links I cited above, here is another article to familiarize yourself with the problems with the Cass Review as well as studies that demonstrate the benefits of gender affirming care:
Endocrine Society And American Academy Pediatrics Respond To Cass, Reject Bans
https://www.erininthemorning.com/p/endocrine-society-and-american-academy?r=rzr4r&utm_campaign=post&utm_medium=web
On reflection, just about everything CDC recommended turned out to be wrong.
At the same a number of countries in Europe got most of it right. Europes input was based on input from practicing physicians and some input from epidemiologists. US came primarily from epidemiologists which is largely using statistical input. All these decisions need a good douse of input from practicing physicians
I understand your points sure!! But in some ways maybe not that simple!! I think the issue of online misinformation & disinformation is so rampant that how that is countered is the bigger question. When there are still daily death threats against docs like Hotez & Fauci, political ones like Rand Paul calling for Fauci to be jailed, etc. etc. Yes, empathy is vital but not sure it's enough to counter all the stuff coming the way of public health professionals. Public health messengers never said they were perfect or got everything right in '20 or after.
Totally agree.
The question that I have - who, or what, profits from the dis-informed world? And I remember that a sage from long ago said that politics is the highest science of man......
I just think everything has gotten so polarized & entwined especially with Fox, ones like RFK Jr, large segments of the GOP now that it will take a least a generation & likely longer to get back to most of the public listening to public health establishment. Yes, there might be some at the individual level that can be swayed away from the anti vax/science mentality which is fine, but any big changes will take a while.
“ it will take a least a generation & likely longer to get back to most of the public listening to public health establishment”.
A while back there was a bit of a local brouhaha when the leader of the county health department published an article stating something to the effect of self perceptions among black students in the county schools was grounds for declaring racism a public health emergency. The thing was, he got caught cherry picking data and excluding portions that actually showed the black students doing better against whatever the metric was, including compared to white students. In other words, the guy lied in order to try to declare an emergency. Why would he do this? Because once it’s declared an emergency, then it opens the door for regulatory power.
Now, I’m supposed to trust this guy when it comes to real public health issues? Not on your life.
One of the problems that I see is that folks are being forced into binary camps on this position: either for or against, and that doesn't necessarily reflect reality. As I have said previously, I am not "anti vax", but neither do I blindly swallow the current recommendations, which to me seem like a load of bullshit with a dose "I'm an expert trust the science" to try to mask the flavor. To put things in perspective, I was born in 1971. From what I can find it looks like at that time, the vaccinations I received would have been: DTP, Polio and MMR. There was no vaccine for chicken pox, which I contracted in first grade.
Now, let's compare that to the current recommendations:
RSV, Hep B, Rotavirus, DTP, HIB, Pnemonacoccal, Covid, Influenza, MMR, Chicken Pox, and Hep A.
Not mentioned would be HPV administered as a teenager.
I look at this and say, WHOA! And God forbid I should question any of this. Hepatitis? The first time I recall someone getting a hepatitis vaccine was it being offered to the person who cleaned the bathrooms at the first place I worked after graduating from college.
This is easily double the number of vaccines I was given and most of these are three and four doses. I didn't get three or four doses of anything as a kid. You're damn right I question this, especially when juxtaposed against some of the supposed "misinformation", which has become a buzzword to try to stop the conversation as a put down, about the effects. And don't give me crap about being a health expert or even a damned doctor. As an engineer I am quite capable of understanding and interpreting "the science" and even have more college education than most doctors. Calling yourself an "expert" doesn't cut it.
If you'd like some fun reading, here is some great background on how the ACIP decides what gets put on the vaccine schedule. It is fascinating and comprehensive stuff!:
https://www.cdc.gov/acip/media/pdfs/2024/09/ACIP-Evidence-to-Recommendations-Framework-cdc.pdf
https://www.cdc.gov/acip/media/pdfs/2024/09/ACIP-EtR-Users-Guide_October-1-2020.pdf
This is a really important and difficult topic; thank you for writing about it. I’m an MD/PhD (immunology) and work in Neurocritical care, and now & then will see a family which makes decisions based on a data set entirely different from mine. I also use values-based discussion, and I lead with “We all have the same goal: to do as well by [the patient] as we can. Let’s start there.” The situation is so complex (ventilator, pressors, stroke, ICH, TBI, cerebral edema, etc) that we talk a lot (almost a mini med school course on what is happening and why) which helps people come to grips with how we look at cause and effect relationships and helps overcome distrust.
It’s all about the shared goal. I want the same thing you want, you can see the work being done, I’ll answer all of the questions you have, and we’ll both see results as they happen.
I think this kind of practical discussion might work in many different spheres.
Did you notice how JD Vance was speaking lies in the debate, but was doing so in a way that sounded friendly, kind, polite? It scared me more than Trump, because I can see that people will respond to him positively. It's an example of your point in action.
I love this series! I’ve been able to be this way and have shared it with others. But not as clearly and articulately as you have here. Excellent. As an example, I saw that when I wasn’t well-informed about a subject, e.g., race, politics, and history, I couldn’t really “weigh in” effectively. So, over time, I started absorbing more and more information from my weaker areas, especially politics and history, because the topic became clearly important. Oh yeah, and systemic racism and repression. Now when I talk to people in the neighborhood, family gatherings, the grocery store, the clinic, workers fixing my house or yard, I can figure out their values and only respond to what they’ve already said with a suggestion like, “I recently read that Biden’s build back better program means …” this or that. You know you’re on the right track when the other person says, “I didn’t know that.” And you can say what relief or joy or amazement you felt when that happened, too. It opens the door of their mind even if you never see them again. It’s even better when you do see them again and haven’t offended them or put them on their guard against you.
I absolutely get what you are laying out here, and the goal of helping people see how science helps us is spot on. I will say that in this current climate trying to, even very politely, have a conversation on such topics is extremely difficult. I volunteer at Planned Parenthood as an escort helping clients get into the clinic while protesters yell horrible things at them. Since the spring I have made it my mission to talk to the protesters not about the issue of abortion or all of the other services going on at the clinic, as we of course don't agree, but to try and humanize each other, to try and not "other" each other, talking about regular life stuff. I will continue to participate in trying to humanizing each of us, but I honestly don't see any sign of these people seeing any reason to try and think differently, to try and learn from getting to know the "other" person. I know my example is different than what the article is about, but the challenge of what I'm trying to do seems similar to me.
I’m not an anti-vaxxer. I am only skeptical about whether I really need to participate in this mRNA experiment. In my mind it’s a simple risk/benefit analysis. I caught a mild case of Covid before the vaccines were developed. I did my own experiment and had my blood tested regularly for antibodies over the following 18 months (IgG and Tcell). They were robust. It seems I had naturally acquired protection. Given the low IFR and high rate of SAEs reported in VAERS, I concluded that I didn’t need to take the risk just to give me something I already have. I had a keen interest in this and watched all of the Trump Covid Task Force TV reports. It seemed to me that there was a lot of uncertainty and conflicting information about this novel virus. Yet early on we did have the results of one of the best experiments on the lethality of Covid: The Diamond Princess cruise ship. The stats on those passengers told us a lot. There are many others like me who aren’t anti-vaxxers per se. We don’t cover our ears to your message. We just have healthy skepticism about an experimental injection, do our own research and critical analysis.
Many prominent doctors and scientists have advised against the mRNA shot and were censored as quacks and conspiracy theorists. Some even lost their jobs and hospitals privileges. Much of what they said has now been validated. All scientists agree only when you censor the ones who don’t.
I love & respect Science; Science has helped save Humanity & made evolutionary progress for Humanity; but sometimes science also gets it wrong; sometimes profits are prioritized over human life; WHY can't we talk about ALL THE MULTIPLE COMPONENTS that can contribute to the fears of vaccines, drugs, meds, etc.? Think Perdue & the rampant Opioid Epidemic; think the common high blood pressure pill Losartan pulled off the market bec it contained a verified cancer-causing agent due to the lack of Quality Controls/Oversight, etc. And why was there a sudden ramp up of kids who (coincidentally or not) became autistic or had instant physical problems immediately after getting vaccinated? Why hasn't there been an answer to that issue that helped bolster the anti-vaccine movement? I got every Covid shot & took a "leap of faith" to get them because what choices did we have: Stay on the SSCovidTitanic or jump over & take a "new" vaccine that was developed on an unheard off timeline though I had already been reading about the new monoclonals in science newsletters, etc., about 5-7 years prior to the Covid pandemic. (Which included Dr. Michael Osterholm of CIDRAP who, years prior, went on the History channel on an episode of ancient plagues & talked about the potential for another major pandemic/plague in the modern world; I do believe his words were (when asked what modern man could expect from the next pandemic).... "It's gonna be a doozy..." but maybe I got that wrong... :)