It’s possible that I shall make an ass of myself. But in that case one can always get out of it with a little dialectic. I have, of course, so worded my proposition as to be right either way (K.Marx, Letter to F.Engels on the Indian Mutiny)
Mosquito-borne illnesses are a growing concern in Northeastern states, with health officials monitoring cases and advising residents to avoid outdoor activities near standing water and other environments prone to mosquito spread.
Of particular concern is eastern equine encephalitis, a rare disease that can lead to serious and fatal illness, caused by mosquitoes carrying the virus.
Known as EEE or “triple E,” the virus can cause disease in humans and animals such as horses and birds. It doesn’t spread from human to human, but is transmitted through the bite of an infected mosquito.
While most people don’t develop symptoms or serious illness, 1 in 3 people who become seriously ill from the virus die, and about half of those who recover from severe cases will still experience long-term physical and cognitive effects, according to the federal Centers for Disease Control and Prevention. Symptoms can include fever, headache, vomiting and drowsiness. Encephalitis is a rare and serious complication in which the infection causes inflammation in the brain.
Eight states — Massachusetts, New Hampshire, New Jersey, New York, North Carolina, Rhode Island, Vermont and Wisconsin — have reported human cases of the virus this year, for a total of 16 cases, according to the latest CDC data. Other states have seen cases in animals only. In Maine this year, triple E was found in two emus and one wild bird. Tuberculosis cases rise, but public health agencies say they lack the resources to keep up
In August, Massachusetts officials said they would begin spraying for mosquitoes in two counties after a man in his 80s contracted the virus, four years after the state last saw an outbreak that led to 17 confirmed cases and seven deaths.
Also in August, New Hampshire confirmed its first EEE death this year; it was the first infection the state had seen in a decade, according to state health officials. So far this year, the state has confirmed five total cases in humans, and the disease has been detected in one horse and seven mosquito batches. The state last saw infections in 2014, when three people were infected and two of them died.
Preventive steps
In recent weeks, New York confirmed its first case and death since 2015. The death in Ulster County, about 100 miles north of New York City, prompted Democratic Gov. Kathy Hochul to issue a declaration of imminent threat to public health, and to provide state resources to local health agencies to take preventive action, including mosquito spraying.
The state also is making insect repellent available at state parks and campgrounds; posting signs to raise awareness of EEE; consulting with local health officials about limiting park hours and camping availability during dawn and dusk, the hours of peak mosquito activity; and using social media to educate New Yorkers on how to avoid mosquito bites.
State officials said the person who died in Ulster County was an older adult, but wouldn’t share details as they investigate factors around the case.
Bryon Backenson, epidemiologist and director of the New York State Department of Health’s Bureau of Communicable Disease Control, said about a dozen counties throughout the state take part in mosquito surveillance, but rural Ulster County wasn’t one of them.
While the virus doesn’t spread from horses to humans, researchers keep track of EEE cases in horses to determine how prevalent the virus is in a particular area.
Horses, in many ways, can act as sentinels for us. We can oftentimes use horses as an indication that triple E may be in a particular area at a particular time.
– Bryon Backenson, epidemiologist and director of the New York State Department of Health’s Bureau of Communicable Disease Control
This year, there were 20 cases of EEE reported in horses across about a dozen New York counties. The state has never had so many cases, nor in so many counties, in a single year, Backenson said.
“Horses, in many ways, can act as sentinels for us,” Backenson said. “We can oftentimes use horses as an indication that triple E may be in a particular area at a particular time. If a horse tests positive, we know that there are mammal-biting mosquitoes that are out there and active.”
Ulster County did have a horse case that preceded the human case, but that horse wasn’t in close proximity to where the individual lived, Backenson noted.
Philip Armstrong, chief scientist at the Center for Vector Biology & Zoonotic Diseases at the Connecticut Agricultural Experiment Station, said while his state hasn’t seen cases, the regional clusters are cause for vigilance.
“This is definitely one of the more active years,” he said. “I would say, about every four or five years, we see these sort of regional outbreaks that occur.”
Armstrong said his team is still collecting and testing mosquitoes.
“So far, we are lucky in Connecticut in that we have not had a human case,” he said. “But sometimes these things come out of the woodwork later in the season — you just don’t know. I’m not ready to declare victory yet.” Climate change’s impact
There is no human vaccine or medicine for triple E. Experts say residents can protect themselves by using insect repellent and wearing long sleeves and pants when going outside; avoiding the outdoors at dusk and dawn when mosquitoes are most active or taking extra precautions when outside at those times; and draining sources of standing water, such as bird baths and wheelbarrows, a prime environment for mosquito egg-laying.
Dr. Erin Staples, a physician and medical epidemiologist with the CDC’s Division of Vector-Borne Diseases in Fort Collins, Colorado, told Stateline the U.S. typically sees an average of seven cases annually. In 2019, the nation saw 38 cases — the highest number of cases ever reported in a year.
Climate change can increase risk of vector-borne diseases, including those from mosquitoes, as increased rainfall and warmer temperatures create favorable conditions that can boost their populations.
While it’s not unusual to see sporadic infections of triple E or West Nile virus from year to year, Staples said, changes in bird and mosquito populations and weather patterns can affect the number of cases.
“Climate is one of many factors that can impact vector-borne diseases. Changes in climate lead to changes in the environment, which can change where and how often vector-borne diseases, like EEE and West Nile, occur,” Staples wrote in an email, noting that flooding can also change where cases are seen.
Sen Pei, an assistant professor of environmental health sciences at Columbia University’s Mailman School of Public Health, said along with rising temperatures that can cause expansion of mosquito habitats, climate change-related disasters such as hurricanes can alter how and where people live. Officials should monitor for vector-borne diseases after disasters.
“It’s a systematic impact. Vector-borne disease is such a complicated ecosystem,” he said.
Stateline is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Stateline maintains editorial independence. Contact Editor Scott S. Greenberger for questions: info@stateline.org. Follow Stateline on Facebook and X.
Thursday, September 26, 2024
ZOONOSIS
Pigs may be transmission route of rat hepatitis E to humans
Study shows viral strain infects, circulates among swine
Ohio State University
COLUMBUS, Ohio – New research suggests that pigs may function as a transmission vehicle for a strain of the hepatitis E virus (HEV) common in rats that has recently been found to infect humans.
The Rocahepevirus ratti strain is called “rat HEV” because rats are the primary reservoir of the virus. Since the first human case was reported in a person with a suppressed immune system in Hong Kong in 2018, at least 20 total human cases have been reported – including in people with normal immune function.
People infected with rat HEV did not report exposure to rats, leaving the cause of infection undefined. The suspected cause during other human HEV infections, in many cases, is consumption of raw pork – making it a potential route for rat HEV as well.
Researchers at The Ohio State University found that a strain of rat HEV isolated from humans could infect pigs and was transmitted among co-housed animals in farm-like conditions. Rats are common pests in swine barns – suggesting that the pork production industry may be a setting in which rat HEV could make its way to humans.
Hepatitis E is the leading cause of the acute viral liver infection in humans worldwide, mostly in developing regions where sanitation is poor. The virus is also endemic in pigs in the United States – though it is present mostly in liver rather than muscle, and is killed when the meat is cooked.
Past studies testing the cross-species infectiousness of rat HEV showed the strain used in experiments did not infect non-human primates.
“It dropped off the radar for six or seven years because it was thought not to be a human pathogen. And now it’s infecting humans, so we need to figure out why,” Kenney said.
One strain linked to human disease is known as LCK-3110. First author Kush Yadav, who completed this work as a PhD student in the Center for Food Animal Health, used the viral genomic sequence to construct an infectious clone of LCK-3110.
The team first showed the cloned virus could replicate in multiple types of human and mammal cell cultures and in pigs. Researchers then injected pigs with an infectious solution containing the LCK-3110 strain or another HEV strain present in pigs in the U.S., as well as saline as a control condition.
Viral particles in the blood and feces were detected one week later in both groups receiving HEV strains, but levels were higher in pigs infected with rat HEV. Two weeks later, co-housed pigs that received no inoculations also began to shed rat HEV virus in their feces – an indication the virus had spread through the fecal-oral route.
Though infected pigs’ organs and bodily fluids were also positive for viral RNA, the animals did not show signs of feeling sick. Previous research suggests rats don’t have clinical symptoms, either.
Even so, the rat HEV virus was detected in cerebrospinal fluid of infected pigs – a finding that aligns with growing concern that various strains of HEV that infect humans can harm the brain. One human death linked to rat HEV was caused by meningoencephalitis.
“HEV is gaining importance for neurological disorders, and a lot of the research now points toward how neuropathology is caused by the hepatitis E virus,” Yadav said. “And even though we have a small number of known human cases, a high percentage of them are immunosuppressed. That means transplant recipients in the United States could be at risk of infection by general HEV as well as rat HEV.
“Research could now focus on whether pork liver products contain rat HEV and explore food safety procedures to block the disease.”
Yadav is now a postdoctoral researcher in the Virginia-Maryland College of Veterinary Medicine at Virginia Tech. Co-authors of the study, all from Ohio State, were Patricia Boley, Carolyn Lee, Saroj Khatiwada, Kwonil Jung, Thamonpan Laocharoensuk, Jake Hofstetter, Ronna Wood and Juliette Hanson.
Stanford University promotes disastrous “natural herd immunity” approaches to the pandemic
A week and a half ago, Stanford University announced a conference on pandemic policy that features several of the usual suspects who spread misinformation during the COVID-19 pandemic. Truly, Stanford has become the “respectable” academic face of efforts to undermine public health.
Stanford University School of Medicine Center for Academic Medicine.
If there was one thing that I would not have predicted—but, arguably, should have been able to predict—regarding the COVID-19 pandemic, it’s the degree to which my fellow academics, particularly physicians and scientists, would contribute to public fear, misunderstanding, and doubt about public health interventions utilized to mitigate the worst of the pandemic. If I had been able to predict the level of complicity of my fellow academics in advocating for just letting the disease rip in a futile bid to achieve “natural herd immunity,” opposing tried-and-true interventions to slow the spread of respiratory diseases (e.g., masking) using a narrow fundamentalist interpretation of evidence-based medicine (EBM), promoting unproven “repurposed drugs” as near miracle cures, and even fear mongering about vaccines, I might have been able to predict that Stanford University would end up being the epicenter of such activities, if only because of its tight affiliation with the right wing think tank, The Hoover Institution. If that weren’t enough, then the fact that one of the authors of the Great Barrington Declaration, the document advocating a “let ‘er rip” approach to the pandemic promising “natural herd immunity” in six months, Dr. Jay Bhattacharya, is Stanford faculty should have helped. So should the fact that Dr. John Ioannidis, formerly the greatest EBM guru (whom I once admired) who very early in the pandemic took a heel turn in favor of minimizing how dangerous COVID-19 was and advocating—you guessed it—”natural herd immunity” approaches to the pandemic.
That background is why, while I was disappointed, I wasn’t entirely surprised to start seeing posts like this on social media:
Sweet Jesus. Vinay Prasad and Monica Ghandi the two people who have literally not once been correct? The very people who have disabled and killed ppl with their misinformation?
— CleanTheAir #CleanTheAirInSchools (@ProHealth4MyKid) August 25, 2024
Vinay Prasad and Monica Ghandi are only two of the participants in this conference and, arguably, not even the worst ones.
Of course, four years later, I’ve become all too familiar with the dismal track record of certain prominent Stanford University faculty with respect to promoting bad science, pseudoscience, and misinformation about the pandemic. For example, look what happened to Renée DiResta, who was the technical research manager at Stanford Internet Observatory, a cross-disciplinary program of research, teaching and policy engagement for the study of adversarial abuse in current information technologies. Unfortunately, the example of DiResta is just another example of why Stanford has gotten even more problematic. The mission of the Stanford Internet Observatory has been “refocused,” with Stanford having having ended the Election Integrity Partnership’s rapid-response election observation work designed to analyze and counter election misinformation. As a result of Republican pressure, the Stanford Internet Observatory is in essence being dismantled right before the election, and Stanford didn’t renew DiResta’s contract or the contracts of several other employees.
Naturally, I was intrigued. So let’s take a look at this one-day conference, who is participating, and how these participants have “distinguished themselves” as—alas!—highly influential (mostly) academic pandemic minimizers and COVID-19 misinformation spreaders.
Pandemic Policy: Planning the Future, Assessing the Past?
The title of the conference is Pandemic Policy: Planning the Future, Assessing the Past, which should tell you a lot. For example, knowing who the speakers and panelists are, I know that “assessing the past” will likely consist of highly revisionist history of the COVID-19 pandemic presented through the lens of claiming that public health interventions didn’t work and then justifying a “plan” for the future in which all those pesky public health measures that interfered with “freedom” be minimized or not used at all. Let’s take a look at how the conference is being advertised:
Bringing together esteemed academics, public health practitioners, journalists, and government officials from all sides of the COVID-19 policy debate in conversation with one another with an eye toward reforms in science and public health to better serve the public.
With millions of lives lost, the COVID-19 pandemic wrought havoc on the world. Despite decades of planning for the “next” pandemic, public health systems faced tremendous stress and often buckled and failed. Universities served as centers for valuable scientific work but failed to support their academic freedom mission by sponsoring vigorous discussion and debate on matters of pandemic policy. To do better in the next pandemic, we need to learn the lessons of the COVID-19 era.
“Esteemed academics, public health practitioners, journalists, and government officials from all sides of the COVID-19 policy debate”? My first reaction was to laugh derisively. No, far from “all sides” are represented. The best that could be said is that the truly radical “infect the all to reach ‘natural herd immunity’ faster” contingent—e.g., Scott Atlas (yes, that Scot Atlas!)— is “balanced” by those who think that it was acceptable to do some public health interventions and try to save some lives, as long as the interventions weren’t too “onerous” (by their definition) and didn’t disrupt business or school too much (again, by their definition). It’s like the line from the 1980 movie The Blues Brothers in which the owner of a bar where the Blues Brothers had been booked to play answers their question about what kind of music the bar features: “We got both kinds. We got country and western!”
Declaration, which was signed on October 4, 2020 and then released to the world the following day. I have a hard time believing that the selection of this particular date for this particular Stanford conference was not entirely intentional, given the involvement of a signatory of the Great Barrington Declaration (Sunetra Gupta) and GBD-adjacent faculty as panelists. I could be wrong—and maybe I am wrong—but it’s hard not to see the choice of date as very intentional. Another oddity is that October 4 is during Rosh Hashanah, one of the most important Jewish holidays, with the site even noting this thusly, “We are aware that the conference date coincides with Rosh Hashanah. We deeply appreciate the significance of this holiday and regret the overlap.” I guess lining the conference up with the fourth anniversary of the signing of the GBD was too important to schedule the conference on a day when Jewish faculty could attend.
OK, I’ll stop, as I know I’m risking starting to sound as conspiratorial as some of the faculty recruited as panelists for this conference!
Still, it’s worth a brief reminder. The Great Barrington Declaration (GBD) was a “scientific” declaration facilitated by the right-wing “free market” think tank, the American Institute for Economic Research (AIER). Named for the location of AIER’s headquarters in Great Barrington, Massachusetts, the GBD called for what was, in essence, a “let ‘er rip” approach to the pandemic to achieve “natural herd immunity” in six months by letting the young and healthy just get COVID and using “focused protection” to keep those at high risk of death and complications from COVID safe. It’s a tactic that never would have worked—and didn’t work—and was profoundly social Darwinist at its heart. Of particular note, how “focused protection” would work was never really spelled out in sufficient detail to determine just how the GBD signatories would keep those most at risk for death and severe disease due to COVID-19 safe.
Also, adding to the imprimatur of Stanford University being placed on this conference, Stanford President Jonathan Levin will be providing the opening remarks to introduce the day’s proceedings. Of note, he became President of Stanford on August 1, 2024; so he’s new in the job. I also note that the Wayback Machine shows that the conference’s webpage first went live on or around August 2, a placeholder that described the conference, but left all the speakers and panelists to be “announced later.” I guess “later” means a week and a half ago.) Most likely, this conference was being organized before Levin officially became Stanford University president, but it is disturbing that he would basically agree to participate, even in the ceremonial manner that most university presidents giving opening remarks at a university-hosted conference do.
Levin, of course, is not a public health scientist or physician. Rather, he is an economist who was elevated to university president after having served before that as the Dean of the Stanford Graduate School of Business. He’s also a collaborator who has published with Dr. Jay Bhattacharya before in economics journals. Even though Bhattacharya is not a speaker or panelist, it makes sense that Levin would be amenable to participating by introducing the conference, especially since Bhattacharya has stated on X, the hellsite formerly known as Twitter, that he is the main organizer of the conference:
please name the individuals you are referring to rather than subtweeting
Quelle surprise that Dr. Bhattacharya is the main organizer. It is actually surprising that he isn’t a speaker or panelist in the conference he’s organizing, given his ego.
Let’s look at the various sessions of this conference.
“Evidence-Based Decision Making During a Pandemic”?
Session 1 is entitled Evidence-Based Decision Making During a Pandemic. The blurb describing it seems benign enough; that is, if you are unfamiliar with the participants:
The interventions undertaken to control the COVID-19 pandemic – lockdowns, extended school closures, social distancing, mask mandates, vaccine mandates – were unprecedented in their scope and global impact. How well did these policies work to protect the public from COVID-19 and what were their collateral harms? How can scientists better inform pandemic policy in real time during the next pandemic?
Of course, the key aspect of the GBD and pandemic minimizers is that they always underplay the harm of the virus and overplay the “collateral damage” from public health policy designed to address the pandemic. One of the key giveaways here is the choice of “language,” particularly “lockdowns.” Basically, “lockdowns” has turned into one of those right-wing dog whistles that the “freedom über alles” contingent always uses—usually with a sneer—to describe business and school closures and shelter-in-place orders. While it is true that there were business and school closures, there was never anything in terms of policy that approached the sorts of real “lockdowns” that one saw in some authoritarian regimes, in particular China. Moreover, again, the GBD was never about protecting the public from COVID-19. It was about opening up the country for business as fast as possible without regard for harms that the “young and healthy” might suffer from the virus, and only a passing nod to protecting those who were actually the most vulnerable to severe disease and death from COVID-19. Again, as I like to point out, “natural herd immunity” was always a pipe dream for SARS-CoV-2, the virus that causes COVID-19, given that natural herd immunity requires lifelong—or at least very long-lasting—postinfection immunity. It had long been known by 2020 that postinfection immunity from coronaviruses tends to be relatively brief and that coronaviruses are very good at evolving variants that can bypass preexisting immunity due to infection with prior variants. Even in October 2020 (or March 2020, when some of the earliest versions of a “natural herd immunity” approach to the pandemic started popping up among certain academics, such as John Ioannidis), one would have had to ignore everything that was known about coronaviruses, including SARS-CoV-1, to think that “natural herd immunity” was even a possibility, much less the truly fantastical belief that such population immunity could be achieved in six months through mass infection.
But let’s look at the participants in this session:
Drs. Marty Makary and Monica Gandhi have been discussed a number times here. Makary, you might remember, was one of the originators of the false claim turned into an all-too-commonly repeated fake factoid that’s treated as true that medical errors are the third leading cause of death in the US, a claim based on ridiculous extrapolation from relatively small studies that doesn’t pass even a basic “smell test.” What I mean by that is that 250K-400K deaths from medical errors would translate to up to 15% of all deaths and over half of the deaths of hospitalized patients in the US that occur every single year. The real number, although still too high, is likely 10- to 20-fold lower. As embarrassed as I was then that Dr. Makary shares my specialty (surgical oncology), I was even more embarrassed at how he quickly became a COVID-19 minimizer starting very early in the pandemic, repeatedly proclaiming an “end to the pandemic” because we’ll have herd immunity” by this date or other and repeatedly being wrong about the pandemic being over.
Monica Gandhi probably represents one of the “both kinds” of COVID-19 minimization in that throughout the pandemic she presented herself as the “reasonable” middle ground between “let ‘er rip” ideologues like Makary and Atlas and conventional public health science recommending standard public health interventions to mitigate the pandemic, viewing the latter as too strict, all the while polluting the COVID-19 information landscape with obvious misinformation and falsely pacified people the worst was over, when in fact the worst was yet to come. Basically, she tried to have it both ways, as Dr. Howard described:
Those last few links are excellent summaries of why Dr. Gandhi has been so problematic.
But what about the other two? I’m less familiar with Eran Bendavid other than that he, too, is Stanford faculty, but he has been featured on this blog before. For example, he was coauthor with Drs. Jay Bhattacharya and John Ioanndis of an early infamous study that vastly overestimated the seroprevalence of COVID-19 in Santa Clara county and was widely used to argue that the infection fatality rate (IFR) was so low that we didn’t really need to do anything—hint: “lockdowns,” masking, and social distancing—to address COVID-19. He also co-authored a March 2020 op-ed with Bhattacharya in the conservative Wall Street Journal asking, Is the Coronavirus as Deadly as They Say? (You can guess their answer.) As I like to remind my readers, pretty much everything Jay Bhattacharya has said about the pandemic has turned out to be spectacularly wrong, particularly his predictions. As for Bendavid, as he decried the “Faustian bargain” that made pandemic scientists media figures in 2021, he also revealed a bit too much of an open mind, to the point of being open enough to allow one’s brains to fall out:
The ideal scientist comes into her trade with a sense of wonder, curiosity, openness, and marvel at what nature has to show us. The corruption of scientific norms is a collective manifestation of the erosion of many scientists’ spirits. Many—I would venture most—scientists hold that spirit as a personal ideal. Its erosion happens when science gets blended with social, economic, and psychological forces that exploit the human being inside the scientist, and none more strongly than the media with its fondness for conflict, strife, and black-or-white-ism.
This all sounds lovely, if you don’t know the actual context and the veritable cottage industry of contrarian scientists who stoked fear, uncertainty, and doubt about public health—and continue to do so—and that Bendavid collaborated willingly with scientists who are experts at the very dark arts he self-righteously decries.
As for Anders Tegnell, those who sought to minimize the severity of COVID-19 and advocate a “let ‘er rip” approach loved Sweden because, supposedly, its policies were not so restrictive, while falsely representing Sweden’s COVID-19 results as being as good or better than its neighbors. (And, yes, Sweden did close schools.) Tegnell was a central figure in this and has represented himself as some sort of truth-teller who stood up to conventional wisdom (and was right). Let’s just say that GBD author Martin Kulldorff thanked Tegnell in March 2020 for his “wise epidemiological sane Covid-19 work.” What did he mean by that? Pursuing a “natural herd immunity” approach to the pandemic, of course! He also declared in March 2020, “Herd immunity before vaccine is inevitable, basically no matter what we do to prevent it.” By April 2020, he was voicing the delusion that there “may be herd immunity in Stockholm by May.” (How did that work out?) Again, the Pandemic Accountability Index has a roundup of Tegnell’s actions and quotes that demonstrate clearly that he was solidly in the “natural herd immunity” camp, as well as a deconstruction of the “Swedish myth” that Sweden did well because of that approach and evidence of how much of a fanboy Tegnell was of one of the most notorious social media influencers pushing COVID-19 misinformation, Ivor Cummins, a.k.a. The Fat Emperor.
Truly, a “fair and balanced” panel. I’m sure they’ll express a moderate, evidence-based take on the successes and failures of public health interventions for COVID-19. (Yes, that’s sarcasm, in case it wasn’t obvious.)
Onward to Session #2, which is even cringier.
Pandemic Policy from a Global Perspective?
The second session is entitled Pandemic Policy from a Global Perspective. It is represented thusly:
Because the world economy is global in scope, pandemic policy decisions made by Western governments had profound impacts on the health and economic prospects of people worldwide, including the collapse of global markets, severe supply chain disruptions, large-scale government borrowing to finance pandemic policies, and global inflation. How can the interests of the world’s poor be better represented in the decisions of Western government during the next pandemic?
Yes, you can guess what this will be about. It will likely misrepresent real concerns and debates about disparities in pandemic response, access to vaccines, and health care capacity in poor nations compared to rich nations being exacerbated by the responses of wealthy Western governments as reasons that we should have just pursued a “natural herd immunity” approach. Yes, I’ve seen this movie before. The basic argument is that, because the populations of less developed, poorer nations tend to be on average younger than the populations of more developed nations, letting the virus rip in such countries can achieve “natural herd immunity” faster and with less potential suffering and death than in developed countries (although this fact never stopped that GBD-adjacent from arguing that we should pursue “natural herd immunity” in developed countries too). Never mind that the crowding, the poorer health and nutrition, and the much less robust healthcare infrastructure in such countries would likely obviate any “advantage” in terms of lower morbidity and mortality when a younger population undergoes mass infection.
Let’s look at the participants:
Kevin Bardosh, Applied Medical Anthropologist, University of Washington
Sunetra Gupta, Professor of Theoretical Epidemiology, Oxford University
Anup Malani, Professor of Law, University of Chicago
I won’t say much more about Sunetra Gupta, given that she was one of the authors of the GBD and remains an advocate of “natural herd immunity.” Nor do I find it necessary to say a lot about Dr. Vinay Prasad, given that he’s been one of the most prolific social media influencers promoting COVID-19 minimization, antimask misinformation, and even fear-mongering about the COVID-19 vaccines that has expanded to echoing old antivax tropes about the childhood vaccine schedule. Suffice to say that Dr. Prasad opposed the COVID-19 vaccine for children even before it was approved for children; has portrayed concern about the virus as “irrational” fear; embraced the antivax message of “do not comply”; frequently misrepresented studies as demonstrating the COVID-19 vaccine is dangerous; approved of reporting parents who want to vaccinate their children against COVID-19 to child protective services; has repeatedly denied that virus mitigation measures work; and echoed antivaxxer Robert F. Kennedy, Jr.’s misleading claim that most of the childhood vaccination schedule has never been tested against saline placebo controls in RCTs.
I’m not as familiar with Kevin Bardosh and Anup Malani as perhaps I should be. Bardosh is Director and Head of Research at Collateral Global, a research institute and educational charity based in the UK. He is also affiliated with the School of Public Health, University of Washington and Edinburgh Medical School, and a perusal of his X (Twitter) feed shows that he is very much on the side of emphasizing the harms of the world’s COVID-19 response compared to any benefits. Collateral Global is anything but a pro-public health organization, too. Basically, it’s a GBD-adjacent, anti-“lockdown” org formed by GBD author Gupta and others:
Collateral Global is founded and directed by Sunetra Gupta and her partner Alexander Caccia, a UK Ministry of Defence contractor with ties to Canadian government fossil fuel investments, who had secretly drafted the GBD document. He had also secured PR support for Gupta’s claims about herd immunity from an agency linked to the Cabinet Office ‘Nudge Unit’. OpenDemocracy has now revealed that Gupta personally received funding for her discredited research on herd immunity from a Tory billionaire.
Indeed, it appears to have been formed by all three GBD authors, as discussed in this email:
From the depth of our hearts, a belated thank you for signing the Great Barrington Declaration. With over 850,000 signatures, together we opened up the pandemic debate. While many governments continued with their failed lockdown and other restrictive policies, things have moved in the right direction. For example, most schools have re-opened, most countries prioritized older people for vaccination and Florida rejected restrictions in favor of focused protection without the negative consequencesthat lockdowners predicted.
While occasionally censored, we have not been silenced. Since authoring the Declaration in October 2020, the three of us have actively advocated for focused protection through social media, op-eds and interviews on, for example, vaccine passports and natural immunity.
We have also launched Collateral Global, a charity staffed with academics from across the world to document and disseminate information about the collateral damage of the restrictive measures so that we don’t repeat the mistakes of this pandemic and are able to inform future policy with evidence and analysis. Collateral Global is crowdfunding so that this work can be done to the highest possible standards. You are welcome to join us and help us in those efforts at www.collateralglobal.org, as well as follow us on Twitter, etc. We are also planning an initiative on scientific freedom soon.
As for Anup Malani, he’s an Indian economist and lawyer, faculty at the University of Chicago, not a public health scientist or physician. He seems to think that because economists are good at statistics they are also good at analyzing COVID-19:
On this I disagree.
1/ Empirical economists are good at…stats. And stats are useful for analyzing Covid data. See eg recent AER-I paper on selection bias in COVID surveillance.
2/ Fields (including economics!) often get trapped in particular ways of thinking about things.… https://t.co/FWBmjcAOza
While I don’t disagree that sometimes an “outsider” can bring a new perspective to investigations, I also note that often “outsiders” lack deep subject knowledge that is possessed by actual subject experts. Perusing Malani’s publication record, I find less to object to from him, other than his being interviewed by the COVID-19 minimizers at Collateral Global. Perhaps he’s one of the “both” country and western, as well. (If anyone is more familiar with his work than I could become Googling him, perusing his publications, and looking at his social media feeds, please weigh in down in the comments.) It will also be interesting to see how he responds to the virus minimization blather of the other panelists and the borderline antivax bleatings of Dr. Prasad. If he is one of the reasonable panelists, he will likely turn out to be the token skeptic on the panel.
Onward to Session #3.
Misinformation, Censorship, and Academic Freedom?
Session #3, Misinformation, Censorship, and Academic Freedom, is the one that produced the biggest “WTF?” reaction from me, for obvious reasons, namely the panel participants. Its description is full of false dichotomies:
The pandemic saw the conflict of two clashing approaches to informing the public and protecting it against rumors and harmful falsehoods. On the one hand, governments censored information contrary to public health pronouncements in social media settings and heavily influenced traditional media sources to convey those pronouncements. On the other hand, dissident scientists and university professors sought means to reach the public with their message despite censorship and suppression. Does the suspension of free speech rights during a pandemic help keep the population better informed or does it permit the perpetuation of false ideas by governments?
“Dissident scientists”? More like “brave maverick doctors,” COVID-19 minimizers, and outright cranks, many of whom started out as one or the other of the first two and, as the pandemic progressed, evolved into the third. (Martin Kulldorff and Vinay Prasad immediately come to mind.) Also, although I wasn’t (initially) familiar with the moderator (George Tidmarsh), get a load of the panelists:
Jenin Younes, Litigation Council, New Civil Liberties Alliance
Yikes! Hosting a panel on misinformation, censorship, and academic freedom with Scott Atlas and Jenin Younes as the sole panels is a lot like having a discussion panel on childhood vaccines and autism consisting of Andrew Wakefield (godfather of the 21st century antivax movement) and Aaron Siri (a lawyer who frequently works with antivaxxers like RFK Jr. and Del Bigtree)! Also, why just two on the panel? It’s not as though the conference lineup isn’t packed with COVID-19 cranks bemoaning how they’ve supposedly been “canceled” and “censored.” Surely one or two of them could have done double-duty and appeared on two panels.
Dr. Scott Atlas, you might remember, is a neuroradiologist and, so it seems, a formerly well-respected one, having served as the chief of the neuroradiology section at Stanford University. Unfortunately, Dr. Atlas became a right-wing hack at The Hoover Institution at Stanford, a conservative think tank that’s been a font of bad takes on COVID-19, where the organizer of the conference, Dr. Jay Bhattacharya, is also a senior fellow. In 2020, he improbably (and briefly) served as a key advisor to President Donald Trump about the government pandemic response, despite his utter lack of expertise in any relevant medical or scientific discipline to do so. Atlas, of course, has featured here before and a fairly frequent topic on my not-so-super-secret other blog, given all the misinformation he has spewed (and continues to spew). Dr. Howard, who’s kept a careful log of his statements, most recently last month. Unsurprisingly, Dr. Atlas was entirely on board with the GBD, and, as a result, in October 2020 the Trump administration was seriously considering a herd immunity-based strategy before there was even a vaccine.
By November 2020, Stanford was distancing itself from Dr. Atlas because he had urged resistance to public health policies and mandates:
Stanford University on Monday evening distanced itself from White House coronavirus task force member Dr. Scott Atlas, a senior fellow at the school’s Hoover Institution, after he urged Michigan residents to “rise up” against new public health measures.
“Stanford’s position on managing the pandemic in our community is clear. We support using masks, social distancing, and conducting surveillance and diagnostic testing. We also believe in the importance of strictly following the guidance of local and state health authorities,” the university said in a tweet.
“Dr. Atlas has expressed views that are inconsistent with the university’s approach in response to the pandemic. Dr. Atlas’s statements reflect his personal views, not those of the Hoover Institution or the university.”
In particular, this now deleted Tweet caused an uproar, and this is personal to me because Atlas’ Tweet was in response to pandemic restrictions in Michigan:
Atlas later tried to take it back, but no one believed him:
I remember that in April 2020, armed militia menaced legislators in Michigan because they disapproved of the “lockdowns” and public health mandates that Gov. Gretchen Whitmer had ordered. I highly doubt that Dr. Atlas was unaware of that history when he urged people to “rise up.” His reaction to the criticism of his Tweet was very disingenuous. I could go on and on about Dr. Atlas, but just use the search box on this blog or my not-so-super-secret other blog, and peruse Dr. Howard’s recent post about him.
As for Jenin Younes, yikes again! First, note that she is a lawyer who has been closely associated with AIER, under whose auspices Bhattacharya, Kuldorff, and Gupta wrote the GBD and whose Twitter handle used to be @leftylockdowns1. A brief perusal of her articles and social media feeds demonstrates that she’s all about opposing any mandatory public health response to COVID-19, including “lockdowns” and mask and vaccine mandates. Her New Civil Liberties Alliance also sued to enjoin California’s law penalizing doctors for disseminating so-called misinformation about COVID-19 to patients. So, she’s pro-quack, too.
I’m sensing a theme here for this conference. On to Session #4!
COVID-19 Origins and the Regulation of Virology?
The last session is entitled COVID-19 Origins and the Regulation of Virology. Given what’s come before, I’m sure you can guess what the focus will be here, but let’s see what the organizers say:
The stakes in the debate about the origin of the pandemic could not be higher. If the pandemic started from an inadequately regulated wildlife trade or zoonoses, reforms to reduce the likelihood of human contact with wild species is vital. On the other hand, if the pandemic started due to dangerous laboratory experiments and inadequate protocols to prevent leaks, then more stringent regulation of such experimentation is warranted. What is the evidence on these topics, and what is the path forward?
This sounds reasonable enough, particularly the first part. Note, however, the false equivalency between a zoonotic origin for the pandemic and “lab leak.” Also note the only person on this panel, which makes me wonder if they plan on adding someone else or if this will just be a talk. And who is this sole panelist? It’s Laura Kahn, Co-Founder, One Health Initiative.
I must confess that I wasn’t very familiar with Kahn, who is a physician and biosafety researcher with a book coming out in early October (surely another coincidence?) entitled One Health and the Politics of COVID-19. Some of the reviews suggest to me where she is coming from:
This book challenges One Health’s most pernicious dogma—that nature is necessarily deadlier than the consequences of human hubris. The book is especially courageous as it criticizes leading contemporary scientific powerholders who support unnecessarily risky virological work. Trust in science requires ethics and transparency.
Some of her social media posts suggest that, although she does emphasize zoonosis and how to prevent zoonotic spillover whenever possible, she is also rather open to lab lake conspiracy theories. I mean, Tweeting:
Let’s just say that treating anything Rand Paul says about COVID-19 as serious is not a good look for someone who purports to be evidence-based. Nor is credulously publicizing something like this from an anti-GMO group known for promoting lab leak conspiracy theories:
This is that anti-gmo group, right? I knew I had seen these authors before.
In addition, Googling found an article that she wrote for the Bulletin of the Atomic Scientists in March 2022, The origins of SARS-CoV-2: still to be determined, in which she makes “lab leak”-adjacent arguments if not outright arguments for lab leak, denigrating two of the key papers published in 2022 that supported a zoonotic origin from the Wuhan animal markets, which both Steven Novella and I wrote about at the time.
Her take:
Two recent papers, Worobey et al. and Pekar et al., present geospacial analysis of animal stalls in the Huanan market and viral phylogenetic analysis but do not provide convincing evidence of natural spillover. The data and analyses discussed by Worobey are equally consistent with both hypotheses: (1) that SARS-CoV-2 first entered humans at the Huanan Seafood Market in Wuhan, and (2) that SARS-CoV-2 first entered humans at another location and was subsequently brought to the market and then amplified in the market by humans. The authors’ assertion that the data and analyses support only the natural spillover hypothesis is false.
Perhaps, but not really. The evidence in those papers is far more consistent with a SARS-CoV-2 spillover event at the Huanan Seafood Market, as Steve and I discussed. I also note that she wrote about the preprints, given that her article was published in March 2022 and the final versions of the papers were published in July 2022, honing in on one phrase that lab leak proponents really hated, to the point that they gloated over its removal in the final version of, first raging that the “hypothesis that SARS-CoV-2 originated from a laboratory-related spillover—for example, from a laboratory-acquired infection—remains a viable possibility” before proclaiming:
Science is the objective pursuit of truth. Preventing future COVID-19 pandemics requires finding the truth. Premature, false declarations of “dispositive evidence” or “proof” does not generate public trust in science and does not protect public health.
That sure sounds like a lab leak proponent argument. As I pointed out, the use of that word in the preprint really ticked off lab leakers, to the point where they responded to its removal by gloating:
Those preprints from a while ago, arguing for wet market spillover (against e.g. lab leak followed by market super-spreading), are now published.
This horrible NYT op-ed by Alina Chan (called “important” by Kahn) was full-on lab leak conspiracy theory, and I discussed why soon after it was published. It’s not for nothing that I’ve referred to Chan as the queen of lab leak conspiracy theories.
I’ve changed my mind. Kahn appears to be at least lab leak-adjacent. I’ve long argued that the current version of lab leak is primarily a conspiracy theory far more than it is a useful or valid scientific hypothesis (most recently three weeks ago), but on what can be gleaned from some Googling I don’t think Kahn is a hard core lab leak proponent. She does, however, seem, at minimum, a little too receptive to the idea given how little the actual scientific evidence supports it.
Stanford should be ashamed, but won’t be
Wrapping it all up is another Stanford Professor, Dr. John Ioannidis, because of course he is. Before the pandemic, Ioannidis was someone whom I admired. Unfortunately, since the pandemic, my opinion—and that of a lot of Ioannidis’ former admirers—soured. Why? Early in the pandemic Ioannidis was quick to embrace “natural herd immunity” approaches to COVID-19 that later became the basis of the Great Barrington Declaration. Again, the GBD was a strategy that never would have worked—and didn’t work—and was profoundly social Darwinist. Although Ioannidis was not an author—indeed, in fairness he refused to sign it, although not based on disagreeing with the GBD’s premise but because of his opposition to “signing petitions” as a means of settling “questions of scientific fact”—his call early in the pandemic for what sure sounded like a variation on the idea of “focused protection” was all over the GBD. He was also a co-author, along with GBD co-author Jay Bhattacharya of the infamous Santa Clara seroprevalence study that misleadingly claimed that over 80 times more people had been exposed to COVID-19 than previously thought (and therefore the infection fatality rate, or IFR, was way lower than was being claimed, meaning COVID was not nearly as dangerous as claimed and therefore all those public health interventions were unnecessary). Ioannidis also made a vile evidence-free accusation that ICU doctors were inadvertently killing COVID patients by intubating them willy-nilly when the patients really didn’t need mechanical ventilation. And don’t even get me started on Ioannidis’ infamous “Kardashian index” paper, in which he smeared scientific critics and opponents of the GBD as “science Kardashians” using risibly bad methodology based on what was originally published as a satirical index to comment on scientists with more social media influence than influence in the scientific literature. Through it all, Ioannidis continues to treat theoretical death from a vaccine as being of more concern than actual death from COVID-19 and to falsely accuse expert panels whose conclusions he doesn’t like of “panel stacking.”
Sadly, it sounds like a very appropriate wrap-up for a conference so loaded with COVID-19 misinformers.
So what happened to Stanford? At the risk of comparing apples to oranges (although I don’t think I am), I liken it to the case of the Cleveland Clinic, an institution that is generally science- and evidence-based, but through ideology allowed in whole centers and institutes that support “integrating” quackery like “functional medicine,” acupuncture, reiki, and others into conventional medicine. How that ideology got entrenched, I don’t know, but it remains so. As for Stanford, my best guess is that it is the right-wing libertarian/conservative influence of The Hoover Institution that attracts COVID-19 contrarians opposed to anything that can be cast as a “lockdown” or any other public health mandate.
The sad thing is, whatever good public health faculty there are at Stanford, their voices do not dominate. Rather, it is the voices of the worst of the worst contrarians, like Jay Bhattacharya, Eran Bendavid, John Ioannidis, and Scott Atlas who dominate the public discourse regarding public health science coming out of Stanford. This is a propaganda-fest masquerading as a legitimate conference on public health responses during a pandemic, and Stanford University ought to be ashamed for putting its imprimatur on the whole affair.
By Orac
Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.
That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)
DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.
