318 Comments

Many Americans seem to think that total knowledge of COVID-19 arrived on Day One, and thus all advice should have been perfect from then on. That's not how life works.

I'm in awe of the CDC and scientists in general and tend to attribute their factual errors to the fact (obvious only to me??) that they began, as we did, with no solid knowledge about how COVID spreads, or precisely how masks, social distancing, and vaccines protect us.

Though all info was imperfect, strong messages were immediately (and perpetually) needed to counteract anti-vaxxer lies that were being promoted by the then-President, of all people. Those lies were killing thousands of Americans day after day from Day One and continue to do so.

My own inclination has been to stay alive, not to argue. When advice changed, I adjusted my safety procedures. One day, I stopped washing groceries and patting the mail with disinfectant wipes. I first bought surgical masks then set them aside and bought the more protective kind. When advice in the media was puzzling or self-contradictory, I studied YLE and Johns Hopkins emails.

This old lady just got vaccinated for the #?th time and will keep getting boosted as often as possible. I suspect that some people are just querulous by nature, and never glimpse the big picture.

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Thank you. Science is a process that you follow to find the truth, it doesn't mean you get to know it right away and it also means that as new facts come in, you have to change your stance.

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I am another "old lady" and a retired IM doc/drug developer. CDC and docs/healthcare providers/scientists did an extraordinary job. At the beginning, we did not know anything about this virus - transmission/lethality/target organs. Due to a lot of basic research in mRNA, scientists were able to conceive and produce safe/effective vaccines in record time by short circuiting the usual time required to scale manufacturing product. FDA did an extraordinary job of reviewing filings in real time. Misinformation was received and believed from many sources in part because while we did GREAT science, we did not identify and recruit "trusted messengers". In part, it is a warning flag that we have a population that has a low literacy in science - something we need to fix. Please read: THe Premonition by Michael Lewis - PUBLIC HEALTH NEEDS HELP> We are learning as we go - we need both great science and great communications. MJW

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Great scientist tend not to be great communicators. Instead of trying to do & be everything, you just need to realize your weaknesses & hire people who are good at what you’re not good at. They probably won’t be scientists, but that’s Not what you need them for. Do not waste your time, time that should be spent doing science, trying to become ace communicators. People get degrees in communication & public relations for a reason. They like it, they’re good at it. (They flunked math & science.) Hire them to do the PR.

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This is true in so many fields. Messaging matters.

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Well said, and we are still alive and healthy!

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Seriously?

Well, all the dead people aren’t typing stuff here, so yeah, “we” are alive.

But are we all healthy? Where do you get that? 🧐

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"Though all info was imperfect, strong messages were immediately (and perpetually) needed to counteract anti-vaxxer lies that were being promoted by the then-President, of all people. "

This statement shows your extreme partisan bias and is an example of why YLE is even asking the question of why trust was lost. It erodes credibility.

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Trump promoted anti-vaxxing messaging (even before the pandemic) downplayed the severity of COVID, encouraged people to take treatments that were unproven. All of these added to the confusion and mistrust. These are facts. If you refuse to acknowledge what was actually said by Trump then you are the one with the extreme partisan bias.

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I often told others when Covid began & the vax first came out: "Look... we're all on the SS-Covid Titanic. We only have 2 choices: Jump or go down with the ship... Taking a new vaccine that was created at lightning speed was a little scary... -- (plus many assumed it was a "sterilizing" vax=you'd be 99% protected from getting Covid/spreading/etc.) -- but what other choices did we have? We either "Jumped/got vaxed" or "went down with the ship/risked Covid death, long Covid and/or the long-term consequences of viral 'hibernation' in the body... like Chicken Pox or Epstein-Barr virus... What enraged me had to do with those who were "upset/angry" that I had the 'audacity' to wear a mask to protect my own life!

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The crazy thing was that I was listening to some reputable podcasts that actually explained what the data meant and that there was no way to tell it was 'sterilizing' based on the data. It's sad because seriously getting a 95% effective vaccine was REALLY REALLY Good news, it just wasn't the complete get out of jail free card people wanted.

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Great point. also, people failed to understand that you might still get COVID even though you were vaccinated, and that the point of vaccination was to diminish the severity and impact of COVID, not physically prevent its transmission. Too subtle for people who feel entitled to simple answers and what they want when they want it. Grown ups welcome.

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I still wear a mask at times. It is an Airgame mask which is no longer available but is very distinctive. If someone asks me why I am wearing a mask I tell them it is to prevent them from getting my "Europa" stain of Covid. I hope if they Google it they will realize it is none of their business why I wear the mask.

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" (plus many assumed it was a "sterilizing" vax=you'd be 99% protected from getting Covid/spreading/etc.) -- but what other choices did we have?"

And there we some voices arguing that mass vaccination with a non sterilizing vaccine in the middle of a pandemic could put extreme evolutionary pressure on the virus, but they were shouted down, silenced, and canceled. And then came the Omicron variant which was suspected of either escaping from a lab or having mutated in an immune compromised person who had received the vaccine.

Please note, the argument was against MASS vaccination, not against vaccinating those at high or elevated risk.

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So you are saying it would have been better to allow people to die instead of mass vaccination? And how would we know about who has elevated risk and who does not when it was a novel virus? Maybe if it were more like a hemorrhagic virus (Ebola), people would have dropped their ignorant ape-egos because they fear the sight of blood? lol... The spread of other unknown zoonotic diseases will just be a repeat lesson for the human-apes until we either go extinct or grow some brains to understand "If one person isn't safe, then nobody is safe..." That's the law of disease that is contagious when a deadly virus is only a plane ride away...

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You do realize that a sterilizing vaccine is almost a completely unralistic scenario, correct? And for a coronavirus, it's virtually impossible. As Paul Offit recently observed, a respiratory virus with a very short incubation period is unlikely to be successfully eradicated by a vaccine.

I maintain, however, that we had an extremely brief window during the initial phases of mass vaccination to have gotten enough people at least in the US vaccinated that we might have made progress toward shutting down the pandemic. It couldn't last because other countries had poor access to the very successful (against the ancestral strain) mRNA vaccines, but it could well have provided a breathing space we could have used to our advantage, and if at least 85% had been vaccinated in the first 7-8 weeks, we'd have seen a significantly different outcome.

(DISCLOSURE: The percentage needed to vaccinate fully, and time period were based on my own calculations at the time.)

Since we started seeing significant anti-vaccine messaging almost immediately, and without cause, save some unknown malign intent, we never saw anything near achieving that level of coverage. And, indeed, Trump and his surrogates, especially on talk radio and online social media did significant damage in this regard. One of Trump's biggest accomplishments was certainly funding Warp Speed. That said, he questioned the utility of vaccination, and of the validity and reality of the outbreak, and didn't even disclose until much later that he and his family had been vaccinated. Instead, he often gave the impression, while admitting little in terms of verifiable fact, that he didn't need to be vaccinated. Had he encouraged vaccination, had he been shown receiving his vaccinations on television, a significant number of his followers would likely have followed suit and not suffered the dangers of subsequent infection.

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Trump is a bombastic ass and yes, his comments like "13 cases going to zero" were stupid. and kind of ironic that the US was hit harder than and had worse outcomes than most of the westernized world.

One thing that Trump did, though, is take ivermectin and man did this piss off the "left". I agree with the comment by Bay Dog that the reason this was blacklisted was because it didn't have vaccine profit written all over it and these vaccines were equally unproven. That disaster called Remdesivir was likewise unproven but sure made money for big pharma.

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Ivermectin was investigated as a possible treatment and shown to be worthless. (It was a very profitable drug for Frontline Doctors though). Other treatments that were shown to have value - like steroids (for certain patients ) and putting patients prone were used - neither of them have vaccine profit written over them either. Remdesivir showed some promise early on but was used less as the pandemic went on as were many other treatments. Vaccines have been proven over and over again to reduce death and hospitalizations. Vaccine in general are not big $$ money makers for pharma because Big Pharma can always make far more $$ treating disease than preventing it.

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Here's a summary of 101 studies, almost all of which find a benefit, the most positive find 95% reduction in deaths if used early:

https://c19ivm.org/

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Wow. You can really find "proof" of just about anything you want on the internet - and then make money off of it. I looked at those 101 'studies' and noted that in nearly all of them only 1 or 2 patients received ivermectin for COVID. the other patients got something else (usually a much larger #). The results are reported for "all patients." We know that most people recover from COVID without taking anything. So the results aren't for ivermectin - they're for the entire study sample. Most telling are the disclaimers at the very bottom of the site. It says, "We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. " now that's good advice.

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For one thing, he promoted unproven drugs, but did not take them. He was treated with 8 drugs during his COVID-19 illness. FYI - dexamethasone and remdesivir were older drug that were later approved for Tx of COVID-19 because of effectiveness.

No, it wasn't in his vaccine either. https://www.usatoday.com/story/news/factcheck/2023/06/16/trump-got-pfizer-covid-vaccine-not-ivermectin-mix-fact-check/70303213007/

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I had onchocerciasis in Malawi - my whole family got it from swimming in Lake Malawi, and the ivermectin dose worked fine against this parasite. Since COVID is a virus - and invades multiple organs as well as blood, there would be no expectation that it would work at all against COVID. And that's what the peer reviewed research showed. Peer review research - which means scientists not involved in the study read and review the results, and it showed COVID vaccines were highly effective. How anyone could read this and still think taking ivermectin- which has serious side effects (and especially at high doses given to horses) - is a good idea, is beyond me. Literally, beyond me.

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Ivermectin had shown some minor anti-viral potential in-silico in extremely large doses. If it were used in sufficient dose to have a similar effect in humans, as an "antiviral" its adverse effect on the central nervous system would have been more widely reported. Note that the Veterans Administration discontinued a large ivermectin and hydroxychloroquine study due to futility and adverse mortality outcomes.

For parasites, the effective dose is much smaller because its CNS effect on parasites requires a lower concentration, due to their relative size. Its antiviral effect was never actually proven in-silico, but that identification was made by a rather simplistic AI analysis of thousands of existing compounds early in the outbreak.

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You can't actually subscribe to Katelyn's newsletter AND be an ivermectin nut, can you??? Cmon. I don't buy it. Ivermectin is worthless for covid. Hydroxychloroquine caused 17,000 deaths. Same stupidity. Fake cures...for what? Why?

https://www.forbes.com/sites/joshuacohen/2024/01/07/trump-promoted-hydroxychloroquine-to-treat-covid-19-a-drug-now-linked-to-17000-deaths/?sh=6afd3c0b2fcd

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Ivermectin nut?

Such small words in an attempt at a put down from an ignorant leftist.

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Unkind words to be fair. But, I fail to see how someone's political leanings left - right - up -down have ANYTHING to do with reading scientific reports (which are full of arguments by the way, not ever giving 100% credibility to anything), has to do with what works to mitigate COVID or other diseases. I don't get my health advice from a politician - and I would suggest you wouldn't be wise to do so either.

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IVERMECTIN NUT. Yes. There…not small words. Ivermectin is a brilliant drug….NOT for covid! Neither is hydroxychloroquine. Understanding science and medicine basics doesn’t make me a “leftist”…it makes me normal.

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The problem is that ivermectin doesn’t combat all that covid does. Those doctors that promote it don’t tell people (or don’t know?) that there are MANY immune pathways that covid effects. It only stops one of them. 5 of my patients had to be put on oxygen while they waited for ivermectin to work and they missed the window to use monoclonal antibodies which REALLY worked . ( so wish we still have them) So I think if they had put a disclaimer and gave people parameters there wouldn’t be so much controversy. So in my opinion it isn’t the best choice to use or “complete cure.”

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Hmmm - I agree that messages were needed immediately to counter anti-vaxxer messages. I failed to emphasize that those scientific messages needed better messengers as public trust in science and scientists has declined over past decade. The pandemic accelerated that loss of trust. As a physician and scientist I am inclined to trust messages from scientists. I can understand how that might be construed as bias. Thank for pointing that out.

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Yes of course, and I pretty much did the same. But it would've been very helpful if somewhere along the line they admitted more openly that information was still coming in, and that some of their recommendations were made based on practicality, and not necessarily on the best practices for public health.

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Mar 14·edited Mar 14

We knew plenty about the virus in Feb/March of 2020. We just chose to ignore it in favor of the hysterical voices and disastrous groupthink.

How about the next time around we don't censor dissenting voices and we vigorously debate these issues instead of implementing draconian restrictions and mandates, destroying an economy, and denying our kids a proper education.

I didn't hear anybody in the media or public eye discussing trade-offs for any of their policies or using the words "I don't know" Instead, they said "This is the science" and if you question lockdowns, masks, school closures, or vaccine efficacy/safety, you're a bad person. BS it was the science.

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It's not a question of censoring "dissenting voices" from what I've seen. And no vaccine or Rx has ever been approved without rigorous discussion of its pros and cons (not in this country anyway). Science doesn't bring dogma or "truth" it brings the "most probable" result to solve a medical issue. Science isn't a church product, it's the result of hard-working, hard studying folks who follow a known and repeatable protocol to get results and then argue over them. If the vaccines and K-90 masks won the scientific consensus, they earned it.

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In fact, as I'd not seen the initial paperwork submitted to FDA, I was skeptical of the mRNA vaccines, and the speed with which they raced through Phase 1 and 2/3 trials. But, when I actually got the data and read it, it took me no time to recognize the trials had sufficient size to be scientifically valid and that their design incorporated standard and traditional end-points. The rapidity of conclusion was determined by the number of cases in the control arm that contracted the disease in the face of a respiratory-spread virus with an R(t) much greater than 1... in fact, through 2020, R(t) was well above 4, making it a very contagious disease. Add to the fact that exposed, asymptomatic people could spread the ancestral strain (not so much the more contemporary strains, it seems) and the control arm participants had no idea if, in public, they had been potentially exposed until they were either symptomatic and tested, or routinely tested in the course of the study.

I became accepting of the vaccine based on the reports of study design and their outcomes and the reports of the independent review committees. Or, in other words, the SCIENCE.

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Mar 15·edited Mar 15

Our society is too litigious, too quick to blame, too " hold accountable". Especially, where death is concerned. That's where mandates come from. There's no room for debate when there's no gray area; when there's no room for being human in crisis. We can't say, "We don't know!" Especially, those in leadership roles. One example is how nursing homes are retrospectively found guilty of 'murder'. I'd wager if your child or elderly family member died, you'd be right there in the lawsuit.

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I agree with "too quick to blame." See some of the other comments for examples.

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This old man understands that scientific inquiry is seldom linear. BUT, I trust the scientists who worked on the vaccines sufficiently to join the Pfizer trial. I'm getting boosted at every reasonable opportunity.

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Some scientists have been nakedly partisan. I was dismayed by the claims in research articles by certain virologists that dismissed suggestions that the virus might have emerged due to a research-related accident. It turns out that they themselves thought a ‘lab-leak’ was a possibility, but wanted to suppress speculation because it might harm scientists and scientific research. Disgracefully, the scientists involved in this had undeclared conflicts of interest.

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Mar 14Liked by Katelyn Jetelina

It seems the big ELEPHANT in the room is being ignored. When leaders, as in the president of the USA and Governors like mine in Florida, tell people during an active pandemic, "just ignore it, it will go away", and then State Surgeon Generals like mine in FLA tell people vaccinations are dangerous and could harm you, that creates serious disbelief in science. People seek direction from leaders. It is very hard for those that are part of the current cult that follow a flawed narcissistic leader to overcome their emotional brain and think with their executive functioning side of their brain. I know many people at the doctorate level that have suddenly become anti vaccine because of political pressure. It is so hard to comprehend that change in the face of data, yet your statistics bear that out.

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Truly, the “elephant in the room. “ Covid was politicized plain and simple.

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The other "elephant in the room" is the serious mental illness that is a clear plague of Malignant Narcissism in those who would (LIE) deny science, facts & reasonable pre-emptive action steps to protect life & limb...

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The “Let’s blame everything on Trump and Florida” narrative is not only tiresome scapegoating, it stirs up people’s hatred in a way that causes them to stop thinking about what could have been done better, which denies us from formulating and agreeing upon lessons learned.

If only 10% of people chose to get the latest Covid booster, we can no longer blame that on political affiliation. Most people don’t trust the vaccine and don’t trust the people telling them to get the vaccine. Wouldn’t it be more useful to figure this out?

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founding

It's not scapegoating. It was Trumps choice to ignore the advice from the medical experts and wreak chaos on those that follow his every word. DearhSantis did the same on a smaller level. Thousands died in Florida from a lack of a policy to mitigate viral spread. Just go back to work may have been much safer if they added, just wear a mask in close quarters to others. Instead, he mocked mask wearing as not needed. That was from a position of leadership. Decisions matter and have consequences. That was a bad decision.

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DeSantis' sole positive policy was to obtain a disproportionate supply of monoclonal antibody and make it widely available in Florida, as well as remdesivir, to those who became ill (not merely tested positive by PCR). Although too many people died in Florida, these therapies saved quite a few, including several of my friends who, to this day, believe COVID wasn't really what they had, because "COVID isn't that bad".

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It's not scapegoating. HE set the stage and fanned an ongoing flame. It was critical forTrump to be the leader he should have been, right at the start. One of unity, one purporting we were all in it "together", " for each other". we wouldn't have had near as much social drama. That's the way HE wanted it.

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As soon as he had a problem he was checked into WRAH where he got the best care in addition to an antibody. He did not use a bleach by inhalation which he suggested at one point.

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Actually, he almost had to be dragged by force, and was, per later reports told that he would be taken to WRNMC as soon as he collapsed. Per same reports, he was already hypoxic and lethargic, and had to be given oxygen so he could walk to the helicopter on his own. Note there were no cameras at WRNMC when he arrived, likely because he was transported by ambulance to the facility. His personal physician essentially misrepresented his condition and treatments at the press conferences which were designed to mislead, not report. His treatment included drugs that had to be approved for compassionate use by FDA (remdesivir) because they'd not been fully evaluated and given emergency use authorization. This involved not only the FDA but the drug companies involved.

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Wow. your observations are disturbing and I've found it hard to imagine why the Surgeon General of FL - who took an oath to serve the people of FL and as a physician - who took an oath to "do no harm" hasn't been sued or challenged for not doing either of these things. Politics should not play a role in determining the best health and medicine practices in any world. It's shocking to me that people would accept this - and the unnecessary deaths and injury resulting from it. Really people - we need to find our common ground and our common sense.

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founding

There is NO common ground with our Florida Surgeon General. He should have his medical license revoked.

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Mar 14Liked by Katelyn Jetelina

I am a community based RN and I was so angry at the CDC regarding the initial mask guidance. At first we were told that masks did not help and that was the guidance that I shared in my practice. Then we had mask mandates and it was hard to explain to people the flip flop. Then we find out that the initial guidance was because of the concern over PPE shortages. I have to admit, that was an integrity hit that was hard to over come for me personally.

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As I recall, it was more complicated. What I heard was that the WHO was convinced that COVID could not spread through aerosols, so we should concentrate on surfaces and hand-washing. When the CDC switched to masks, because of new studies, there was still a PPE shortage— we were all making our own masks for a couple months back then. But the changes in thinking, and the reasons for them, were not communicated clearly.

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"we were all making our own masks for a couple months back then"

And then came the draconian MANDATES, coupled with a bunch of hypocritical behavior on the part of "leftist" leaders and icons giving the message that the masks are for thee, not me, peasant. They became a sign of submission and a symbol of who will obey or resist.

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Gotta wonder WHO created the message of "submission"; the concept of "obey and resist." during a pandemic and why. Where was the, " we're all in this together." message?

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Mandates were necessary because many people treasured their right to infect others. Then a very few public figures who'd promoted masks idiotically went to big gatherings without wearing a mask. That fact was immediately extrapolated to mean that *all* people progressive enough to value public health were supporting a rule they didn't believe in.

The "Freedom means I have a right to infect others!" contingent started using terms like "submission" to amplify their message. America's public health has suffered from that.

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The original thought process was looking to tuberculosis and influenza as models, although the two are not necessarily similar in spread, nor generally in infectivity. The prevailing wisdom was that tuberculosis spread by large-droplet emission (for the purposes of discussion, aerosols are defined as microdroplets with single replicable virus particles, or a very small number), and that influenza must be similarly spread. Evidence was already available that influenza could be spread by aerosols, and today the thought on large-droplet restricted spread for TB has been rethought, and the probability that aerosol spread plays a role has emerged.

Simply put, we were all playing with a novel virus and playing without a rule-book. What we thought we knew about respiratory-spread viruses was, in this country, based on a significant body of work done in the George W. Bush administration when he assembled a pandemic advisory team after reading about the 1918 influenza epidemic. A lot of the assumptions made in the US public health came from that report and computer models that had been done in that era, including the thought to close schools, lock down movement, and require PPE. As you note, PPE was in short supply, and one of the early recommendations to not seek out PPE was because it was desperately needed in hospitals treating patients, and what little supply might exist was in the control of "entrepreneurs" who had bought out supplies and were charging exorbitant rates for the items. With Just In Time supply shutting down, replenishing the supplies proved near impossible. Errors by the administration to properly employ administrative power to require manufacturers to convert process and make more PPE was not properly engaged, but Ford Motor Company did make thousands of ventilators of a novel design that were not needed once we determined we were intubating and mechanically ventilating too many people based on flawed assumptions (that acute respiratory distress and the pneumonia caused by SARS-CoV-2 was in any way similar to prior ARDS cases from other agents; it wasn't) and began treating more people who exhibited low oxygen saturations on room air with high-flow non-invasive oxygen, and then if needed, modalities such as CPAP and BiPAP.

Information was coming in so quickly that, at least in my case, I barely had time to tell anyone the highlights of what I'd learned in the last 24 hours much less write a coherent story for publication anywhere. Katelyn, on the other hand, had the capability to digest the material and keep reasonable and accurate summaries of credible data flowing, something I only wish I could have done. I might have contributed in other ways, but while I'm usually a pretty good communicator with patients and families, I was not a good public communicator in the first 2 years or so of the Pandemic.

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Definitely when I lost faith in the CDC. We could at least have been wearing home-made masks. I saw Fauci asked about this later, and he actually admitted it was a fear of PPE shortages. It's one of the things that led me to this newsletter.

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Mar 14·edited Mar 14

I still harbor guilt because I had told people that masks were not helpful and based on that, they did not use them. To this day, I feel really bad about it. And I too remember when Fauci admitted this. It felt like a blow to my gut.

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It was the same in the UK. They didn't have enough masks for hospitals.

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And, to my mind, making sure that the brave souls who were caring for extremely ill COVID patients in hospitals far outweighed my own situation, in which I could reduce my exposure and the people I was around were nowhere near as likely to carry the virus as hospital patients.

I do think that companies employing "essential workers" should've 1) been given plenty of masks and 2) required to make sure their employees wore them. Those employees were infecting one another and taking the virus home to their families; they were ignored because they were impoverished and in many cases had skin that wasn't pearly white.

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Mar 14Liked by Katelyn Jetelina

Just want to express my support for having these conversations in as constructive a way as possible. This seems to be a good model of how to do that. Thanks to Kelley Krohnert for reaching out and to YLE for being receptive and respectful.

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A lot of good information came out during the pandemic. I feel that the most important information has been loudly ignored - the need to have clean indoor air. Modern commercial and residential buildings are built to be energy efficient at the expense of environmental health. To compound this the WHO in the early phase of the pandemic categorically denied airborne transmission in April 2020 despite information presented by particle physicists. The WHO finally admitted that airborne transmission might be a form of transmission later in July

We now know that virus particles (COVID, Measles and more!) and bacteria (Tuberculosis) can remain suspended in the air for long periods, somewhat like tobacco smoke. The easiest way to crudely check room air quality is to measure room air CO2. I was shocked when I first did it in my study when I raised room air CO2 levels from 600 to 1000 ppm. Even more so in my busy veterinary practice when I saw levels go the 1300 ppm within an hour!

The real key to control and prevent respiratory virus/bacterial infections is to change or filter the air in all buildings. Don't ignore the benefits of vaccination, but if you want true overall "herd health", the goal of Epidemiologists, then we must work to improve the quality of indoor air to control many diseases.

I recommend the book: Healthy Buildings: How Indoor Spaces Drive Performance and Productivity, Allen & Macomber

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This seems like the simplest, least invasive solution. I immediately bought air purifiers for my classroom and rehearsal space. I open windows any chance I can.

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And indoor air quality is only getting worse as our buildings and housing stock ages!

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Yes, my best friend's son-in-law, Joe Allen, has been a major resource on the importance of clean air in buildings! I'm vicariously proud of him.

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Mar 14Liked by Katelyn Jetelina

As someone working in public health, I expected to disagree with way more than I did. But honestly, I had some of the same concerns as was mentioned, particularly about the lack of helpful advice beyond “get vaccinated”. I once got so upset at a CDC page where I was looking for guidance, and it said “talk to your doctor”. First off, if the CDC doesn’t know what to do, how do they expect doctors to? And secondly, why is the largest public health organization in the country passing the burden to the individual??

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Yes! Even simple things like does vitamin D help prevent severe covid (many people are vitamin D deficient)? Should I take vitamin C if I get covid?

What happens when we “talk to your doctor”? Many doctors say don’t take Paxlovid and skip the booster.

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Vit D was not proven to prevent severe COVID in RCTs. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10027755/

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Thanks - does *anything* help prevent severe covid? If so, it would be nice if the CDC could tell us.

I wish scientific studies could produce consistent results! Here's one with a different conclusion:

"In this Danish observational study of 447 COVID-19 patients, we observed that deficient vitamin D levels were associated with an elevated risk of progressing to a more severe COVID-19 outcome."

https://www.nature.com/articles/s41598-022-21513-9

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Well, we have paxlovid and remdesivir for starters. The vaccine also helps as well.

As for the correlation, this is not causation. Based on observational reports from sources, Several RCTs were conducted with the results not supporting the use of Vit D.

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One problem with that study is recent work that has effectively questioned just what a “normal” D3/calciferol level really is, and if significant supplementation offered any tangible benefit.

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Well, and vitamin D supplementation is inexpensive. Though, YLE posted recently that it is unnecessary. My PCM recommends it for all her patients during Ohio winters.

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I had a bit of a chuckle there. My parents grew up in Cleveland and the newspaper would occasionally be 'give your kids cod liver oil!' with the number of days without sun posted as well. Very old school! As for supplements, I get tested and follow the recommendation here, https://www.opss.org/

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I was given Cod Liver Oil once a week when I grew up in the north where there was little sun light during the winter. Now I just make my endogenous Vitamin D from sun light exposure. I do not think I will live long enough to get skin cancer from my exposure.

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I remain convinced that CDC’s issues started in 2017 with slashed budgets, the exodus of senior scientists, and Redfield’s appointment. Later, during the pandemic, the administration inserted political appointees to make sure messaging was consistent with political needs, and Redfield was hardly the leader to prevent the political pressures.

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Spot on!

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Thank you for having this conversation. I believe that - as with many public policy issues - we all exercise confirmation bias: we heed information that bolsters our existing opinions and beliefs. For instance, I know two people who died of Covid before the vaccines were available, and a family member with underlying health conditions never fully recovered after a case of it; he died two years ago yesterday. Only a handful of people I know have *not* contracted the virus; some became very ill and clearly have long Covid - so I find the statement that “many people knew few, if any, people who were hospitalized or died from Covid” baffling, and, as someone in her 70s, I find the CDC’s messaging credible and entirely appropriate.

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founding

The paragraph opening with “A disconnect between what I experienced on the ground and the narrative I was hearing” struck me, too, though from a slightly different vantage point. In our household, attending the same small indoor gathering of older women in the 2022 holiday season, one person who didn’t know she had covid resulted in all of us contracting it. A couple of us got very sick, taking several weeks to recover, while others had slight cold symptoms. We to this day have no real idea why this variance, as, with one exception, our risk factors were about the same. In consequence, though, as one in our household was among those who got very sick, we feel it essential to remain very careful, constricting though it is.

Friends of ours, even those who are aware this happened, let alone neighbors in our building, sometimes look in askance (though usually stay politely silent) when they see us masked in close indoor spaces or on learning that we “still” do not do any indoor dining. So, I do think it is common that people who have not directly experienced severe bouts of COVID (or worse), tend to default to easing up.

This is a place where I would like to see clearer communication from public health authorities to help people understand and respect that some have had worse experiences than others, and that may not be visible. So, if you see someone, eg, with a mask on, respect that it is necessary, even if the reason is not visible to you, and act with courtesy (which might include, for example, donning your own mask while around that person and turning away and covering your nose and mouth if you need to sneeze).

It would help also, that such communications do not use buzz words like “the elderly,” which suggest a “sitting at home, out of society” cohort, which most of us definitely are not. The same holds for people I know who are immunocompromised—the issue is often not visible.

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Yes, it seems common for people think "It was mild for me so it must be for everyone."

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Mar 14·edited Mar 14

I suspect that it is impossible to make a consistent and sensible policy for something as eccentric as COVID. Like you say, among multiple people with similar risk factors, some got really sick, some had mild symptoms, and (possibly) some were infected but had no symptoms at all, and no one knows how to predict what will happen in any individual case. Eccentricity is the bane of planning and policy.

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Something we’re learning, though, is that the long-term effects of even mild infection may have significant lasting effects on multiple organ systems. We don’t yet know if these will really be long-term or transient, nor if transient, for how long. We’re still learning about the effects of the virus.

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founding

Absolutely. This makes it all the more important that public facing communications are as clear as possible, while acknowledging that some things are still unknown and others may change. Dr. Jetelina is peerless in demonstrating how this can be done.

On the specific issue I noted, it strikes me that what is needed is a “courtesy” campaign, like that the NYC subway uses for subway etiquette, using shory phrases and and eye-catching graphics to drive the points home. One I remember is of a person sitting on a seat with a row of luggage next to her. The accompanying phrase is “Seats are for butts, not bags.” Basic stuff like that.

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agreed. My neighbor's father died of Covid. My husband's RN niece contacted Covid (her sister discouraged her from being vaccinated), survived the ICU, and has never been the same since. It was hard to read about people not believing the virus is serious. That said, I applaud this post. Willingness to share opinions respectfully is where we need to be.

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Mar 14·edited Mar 14

Anecdotally, I am one of those who know very few people personally whose run in with Covid was severe or fatal. In my early forties, in a Blue state with high vaccination rates, whose social circles are mostly other white collar professionals who switched to remote work during Covid and whose children switched to remote school. So we skew younger and healthier and when we did catch Covid it was later and it was on par with a cold. (Though I did have something flu-like in early 2020 that tested negative for Flu and RSV so who knows).

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That exact quote is inaccurate for myself as well, as a friend’s family member has just passed the 1-year anniversary of his sudden death, and another friend’s robust 102-year-old mother-in-law has passed this week, from a Covid infection 3 weeks ago. She was fine before that. And those are only the most recent deaths linked to me. I can also think of 2 more--I’m sure the list doesn’t end there. Anecdotal, sure, but the web of connectivity is littered with loss. The impact definitely feels more prevalent than that statement declares.

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I agree with how you felt when you read that line.

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Maybe I’ve fallen into a rabbit hole, but I personally still mask and am concerned about long term effects of Covid. I think the new go back to work once your fever is gone is ridiculous. Many never have a fever, and we are contagious much longer than a day or two: why we think it’s okay to continue spreading this disease that thousands are still dying from each month is just crazy. Our world has lost its collective mind.

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founding
Mar 15·edited Mar 15

THANK YOU. I totally agree. I don't mask everywhere anymore, but I do wear a mask in healthcare facilities, and any other indoor place that is crowded or poorly ventilated. I stay home when I have any cold symptoms at all, and if I MUST go out with a cold, I wear a mask. If I see someone wearing a mask while I am not, I respectfully keep extra distance from them.

I had covid right after Christmas (just 7-8 weeks after my latest shot) and for me it was just like a mild but persistent cold. But I isolated at home (because I live with a higher risk senior) until I tested negative and felt almost normal -- despite the incomprehensibly weak "guidance" from the CDC that it's now OK to just run around town like a plague rat as long as you don't have a fever. Holy cow, that's dumb.

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Yes!! It isn't that difficult. I work with babies and toddlers. Both times i have gotten covid its been from them. They can't mask, so all these people out MasKless while sick or even asymptomatic are getting these innocents sick, and they bring it to me. I now mask all day in my own home with them so they do not get me sick again, and hopefully to keep them safe if i somehow pick it up. I am so done with people who don't care who they infect and think its a joke.

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Same

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I’d like to hear what Kelley learned from you- you shared what you learned from her and how some of your perceptions changed after speaking with her but I am curious what she learned from speaking with you.

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I second this motion. While I applaud the inclusion of a different viewpoint (and I believe she did have some good points), it would also be informative to know what she may have learned from the conversation.

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"You shared what you learned from her..." - I had a slightly different take on this. YLE is sharing what Kelley *said* to her, not necessarily what YLE *learned.*

I'm defining "learning" as changing one's position on a previously held belief. It's unclear whether YLE's position on any of these points has changed based on her discussion with Kelley (especially if she was tempted to insert a rebuttal).

Listening to a person and learning from them are two different things.

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What we (PH professionals) need to learn is how to better communicate. I know that every time I interact with someone like Kelley, with diametric views to mine, I can learn something even if I don’t agree with all they say. I can’t speak for Katelyn, obviously, but I suspect there are internalized lessons she took from the discussion. At least, that’s the impression I got from the piece.

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Since I’ve posted this comment, I’ve been debating what it means to learn from others. Is it enough to listen and understand, or must one be willing to change long-held beliefs?

At a minimum, I think we must listen with a willingness to change our beliefs (even if our beliefs remain unchanged after the conversation).

We all can sense when we are talking to someone who is willing to listen but isn’t willing to challenge or change their beliefs. It’s especially hard to admit we were wrong, especially when our beliefs have led to policy that has harmed others. Cognitive dissonance and all.

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Learning is not an instantaneous process. However, some of us do internalize conversations like the one referenced here, and consider it when we revisit these issues. Katelyn has demonstrated an ability to change based on new knowledge repeatedly, or that’s my impression based on following her writings for several years now. I know I will be reviewing these points, and will try to pay more attention to the points Kelley made. I’m not likely to completely revise my considered opinions, but I’ve stated for a long time that the primary failing of public health professionals over the last 4 years has been in our communication methods and presentation. For the most part, PH personnel could intercommunicate but we did not meet the public’s needs.

Of course, we also had to contend with he whole public world looking over our collective shoulder as we attempted to understand and interpret data and create recommended policy, with critiques of the process sometimes happening in real time. So, we were fielding questions and criticism from the public and participating in the sometimes cantankerous process of determining what we thought we knew.

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One of the points Kellie is making is that many PH policies were wrong - which is something more than just a communications problem.

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We had policy recommendations, especially early, that could have been better if we'd had more/better information but we were working from a pandemic/outbreak plan that was predicated on an H5 influenza outbreak, misunderstood aerosol transmission dynamics, had been abandoned by the administration at the outset and seen the appropriate planners scattered to different agencies or completely ousted, and were trying to reassemble a plan for an airborne, apparently respiratory viral agent we knew nothing about. Those policies were ONLY wrong in retrospect. That said, PH made recommendations, politicians derived policies but made sure PH was prominently mentioned as the origins of said policies even if we had not phrased things as the politicians did.

So, in a lot of ways, yes, we made errors but were doing the best we could with the tools we had available at the time. I've said it here, and on other forums: I had days where my professional opinion could change more than once in a 24 hour period as new data and articles came in that were evaluated to be meaningful and trustworthy. My recommendations initially were not "wrong" but could be superceded by new information and knowledge.

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Yep, a lot of people listen but cling to their narrative. I did for several years.

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But shouldn’t that “learning” go both ways? Because if only one person is “learning” (however you want to define it), then it’s not much of a discussion- more of a lecture.

Discussion to me implies both parties take away or learn something.- I’d like to know what Kelley took away from discussion that may have changed her perceptions/thoughts/opinions.

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This is a really good instance of constructive engagement. I salute Kelley for being willing to reach out, and for being blunt but not offensive. I salute Katelyn for her restraint in sharing Kelley's views without a point-by-point rebuttal.

For me, the most telling comment is the last, about the disconnect between citizen experience and health-provider reality. Statistical thinking is not how we humans naturally assess risk. This comes up in many contexts, including seatbelt wearing. (Hardly any of us knows someone who died when hurled through their windshield in a crash, and no one who drives without a seatbelt ever experiences that ... until they do.) One of the coronavirus's adaptive advantages was that its fatality rate was high enough to overburden hospitals to the breaking point but low enough that more than 99% of people survived more-or-less unscathed. That's practically an invisible crisis. And yet, I *know* hospital workers who worked close to double-time through the pandemic and lost patient after patient -- nearly all of them unvaccinated.

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And many healthcare workers died from Covid. 2020 was a terrible year for those on the frontline

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We didn’t see a 1% case fatality rate early in the outbreak. Initial CFRs were much higher, estimated at >5%, which is a significant problem. In fact, 1% is a significant CFR, but it appears small to someone when one looks at a percentage, but not at the effect of other viral diseases.

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I am amazed that CDC and other leaders did not emphasize that they were feeling their way with a novel virus. "This is the best we can recommend today. As more information is available, we will change our guidance."

I was locked down outside the US. They followed the pandemic response playbook by the letter. Political leaders deferred all comment to the Pandemic Response Team. That team was strict, much more repressive than in the US. But they were given the authority to act in the name of public health, and stepped up to take charge.

When the public became weary, watching the US refuse to shut down, there was some push-back. That is, until the politicians in the US started taking charge and spouting nonsense. When a US governor explained that we were just going to have to accept that the old people would die, the population in Latin America settled down immediately. No one wanted to risk their parents or grandparents by an accidental infection.

Sometimes, if you can't be a good example, you can lead by being a rotten example and a warning of the worst that can happen. At least in this, the US served the purpose of scaring the rest of the world into careful deliberation and listening to the folks better prepared to offer recommendations than we.

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"Amazed" -- not really. The reason this was a "novel" virus is that it was not evolved, but GENETICALLY DESIGNED to be harmful. This is the core truth that all the authorities were trying to cover up. That's why they couldn't talk about why this was a "novel" situation.

In a naturally evolved virus, the spike protein would be simply an entry (through ACE-2 receptor) into the cell. But in the COVID virus, the spike protein was engineered to cause blood clots and nerve damage. If the CDC admitted this, then people would have asked, "so why is the spike protein the epitope of choice for the vaccines?"

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I still have not seen real evidence this was an engineered virus, but lots of speculation. Sorry, I have to disagree with your statement.

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What kind of evidence are you conversant with? Do you understand how genomes are edited, and what kinds of clues are left in the genome? Do you understand redundancy in the genetic code, and can you trace patterns of which codes are used by most viruses and which are used in SARS-CoV-2? Do you know what a furin cleavage site is?

Or are you just trusting summaries of the original literature that are paid to assure you, "nothing to see here...move along"?

At least you could read Jeffrey Sachs's story of being snookered by Daszak.

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I was rusty when the pandemic started but came back up to speed pretty quickly. I'm, indeed, familiar with genomic sequencing and CRISPER editing. And the furin cleavage discussions, which are now mostly settled in favor of a natural origin rather than engineered, was interesting, and required me to revisit a fair bit of the science to follow appropriately. I've also become more than passingly familiar with the codes and variants substitutions/deletions we've seen. So, no, I'm not solely relying on literature but conversations with a variety of virologists, vaccinologists, translational medicine experts and geneticists to make sure I'm able to keep up on my own.

I am familiar with Sachs' changes of opinion regarding the lab leak theory. I disagree with his final position but have no real understanding of why he changed his mind, based on evidence I've seen.

So: Yes, as a career scientist, I'm conversant with the material you've questioned, and have formed my own opinions based on evidence I've been exposed to, and additional research I've done.

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Thanks, Gerry. I'd like to keep this conversation open, to look at the evidence that convinced you that the virus was more likely to have evolved spontaneously. Here is some of the evidence that convinced me of the opposite:

1) The earliest known strains of SARS-CoV-2 were incapable of infecting a bat. Adaptation to humans was already complete.

2) The spike protein is particularly toxic to nerves, epithelial tissue, and heart muscles. This offers no selective advantage to the virus -- quite the opposite. But it is what you would expect from an engineered bioweapon.

3) There are published papers describing coronavirus gain-of-function, including specifically addition of a furin cleavage site, focusing on the spike protein. There is a Moderna patent on a portion of the spike protein too long to be a chance coincidence.

As for "mostly settled science", I have come to suspect that there is political bias in what is published on this topic. If indeed it is proven that the emergence of the pandemic was the result of bioweapons research, some very powerful people will have hell to pay.

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re:(1), I've not seen those references. If you've got them please share. THe sequences I've seen were consistent with a zoonotic virus that had varied to allow binding to the ACE2 site, and compatibility with human cells, but just barely. Recall that the first sequences were derived from humans, and not from bats, and after the hosts had been infected for several days.

re:(2): there are elements of the virus, not necessarily S1, that have been found in endothelium, brain, bone (esp., skull) and muscle tissue, as well as most solid organs, but this is, we're finding now, consistent with other viruses from different families. We'd simply not had the tools, nor the cluse to find these issues before. What we are seeing are viral reservoirs, which do post a competitive advantage.

re:(3), all the GoF testing with coronavirus strains have been on other strains. I could have missed these, but all I've seen had been on other coronaviridiae. On the other hand, GoF is a standard tool in virology to understand how a virus functions, and what tools can be used to produce antiviral agents. The original identification of the furin cleavage was noted with suspicion but that cleavage is not solely artificially produced and can/does appear in nature.

I'm still not convinced this was an engineered virus, but if it was and it was designed at WIV, the net effect on China was more severe than on the western states in terms of local casualties. In other words, it was a failure for them.

I've seen politicization of the pandemic, its origins and mitigations/therapeutics. I've not seen much of that in the research, save a few folks who wanted to support "alternative" approaches for fame or profit; I've no interest in working with them ever, nor in supporting a discussion where they might gain any publicity.

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If you have patience, listen to this interview -- which has been suppressed and shadow banned: https://open.spotify.com/playlist/0ZCLBEbktYqp1lSheZS81E

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Thank you for posting this. Very helpful point of view!

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Mar 14Liked by Katelyn Jetelina

I applaud the courage of both women and echo comments already made. And I appreciate Katelyn's restraint and not inserting rebuttals in Kelley's summary. There are times when those of us in Public Health just need to listen. I think the expression is that "no one is going to change their minds unless they feel they have been heard."

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“ While some people did get very sick from Covid, and many doctors were indeed traumatized by this, many people knew few, if any, people who were hospitalized or died from Covid.”

Over 1.1 million Americans died from Covid-19. I do believe the majority of Americans knew someone who was hospitalized or died from Covid.

The share of Americans who were killed by the coronavirus was at least 63 percent higher than in any other large, wealthy nation, according to a New York Times analysis of mortality figures. This is because our nation was at the bottom of the list regarding vaccination rates.

It is sad and unacceptable that so many of my fellow Americans died needlessly because of the fear of getting vaccinated. What a catastrophic failure of healthcare messaging—with blame to go around everywhere.

Covid vaccines are incredibly safe and effective in preventing death from this disease. Instead of rejoicing, like when we developed the polio vaccine, it is beyond comprehension that so many refused this lifesaving inoculation.

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we have no clinical trials that show a mortality benefit for any of the covid shots, so I'm not sure how you conclude with any certainty that the shots saved lives. Also, everything vaccine or covid-related needs to be broken down by age. The shots may have had a mortality benefit for a 70 year-old diabetic, but not for a healthy 30 year-old. But they were relentlessly pushed on everyone with no nuance.

Many people died from covid, but when you are running PCR tests at 40 cycles and counting every positive as a covid death, your numbers are inflated.

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Your opinion, your choice.

As a highly educated healthcare provider, I choose to vaccinate my family (including kids in their 20’s) as often as recommended. This decision for me and the wellbeing of my own family was based on analysis of the sound scientific data showing the safety and efficacy of the Covid-19 vaccines.

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Are they safe? Those of use with terrible reactions to the vaccines really question that. Safe for most is more likely the story.

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This statement demonstrates a lack of understanding of how deaths are certified by health care professionals. There is a clear differentiation between dying WITH Covid, and dying OF Covid. If you have ever seen a death certificate, you understand this. Every factor in the death is predicated with “due to, or as a consequence of”. And no, we didn’t get “kickbacks” for over-counting Covid deaths.

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Can’t count the number of times I’ve given that same explanation. Well stated.

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PCR tests at 40 cycles when even the manufacturer / designer of the test says that it is useless at that level and all you're reading is noise. Reminds me of how the president of Tanzania submitted samples of goat and papaya and they came back as positive PCR tests for covid.

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Well, considering that we are still in the pandemic… your verb tense is wrong (among other things).

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Mar 14Liked by Katelyn Jetelina

Very, very classy to publish her comments. Good for you! YLE is the best!

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Just a plain old scientist/mom here who took it for granted that COVID (in the height of the emergency) was relatively easy for me to navigate without relying on media/government noise. And I still believe one the greatest barriers to trust in scientists is people accepting that we don't have all the answers immediately and that as our understanding grows, recommendations can change. I also think public health messaging over-corrected out of desperation, because people were shutting down and the emergency was real. Then it was just a vicious cycle where the fear contributed to even less cooperation. People could not fathom a world where this kind of pandemic was truly possible and in a country that is so individualistic, there appeared to be little incentive to simply look out for each other (ie, the most vulnerable). Beyond the poor communication and potentially exaggerated claims, we have cultural, educational, and socioeconomic crises in the US and other countries that made collective action virtually impossible.

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