A Return to Reason

The current administration endangers our health. With the arrival of Covid-19, it was inevitable that this administration, this political party, would begin to attack the work of public health. The denigration of the work of scientists in government agencies had already happened to climate- and pollution-related research over the past four years. But after the events of the past few weeks every American with an interest in public health and medical investigation, and with an interest in truth, now swings between indignation and anguish.

When the commissioner of the Food and Drug Administration (FDA), a political appointee, stated last week that blood plasma containing high concentration of antibodies, if given to hospitalized Covid-19 patients, would save “35 out of 100” patients treated, he misrepresented the data, knowingly or unknowingly. His exaggeration of lives saved was not off by only a little. The actual number was three out of 100, not 35 – one-tenth the announced effect – and was derived from a subset of patients severely ill with Covid-19.

With this falsehood, we entered a now-common scenario: a federal agency head who makes a public statement is discovered to have made false claims to support a partisan position. Perhaps he was pressured to do so – his job under threat – or perhaps he was trying to please the administration he works for, or both. He sacrifices his credibility, but more importantly, he undermines the mission of his agency. In the end, he is attacked by his superiors for mishandling his job – in this case, for being too slow to approve new drugs altogether – and by the public for lying and later contradicting himself, and for his complicity in politicizing his position. Another agency that citizens depend on for independent evaluation has presented imagined results.

After the FDA misstatement, we immediately entered again the second phase of our new public health politics. Those who knew the actual plasma data asked for a public correction, asked for accuracy and the true effect size of the new treatment. Non-governmental scientists called for rigorous trials and made an impassioned defense of the need for evidence and peer review, for the sanctity of science; government-employed scientists kept their heads down while truth became an incidental victim.

The undermining of the Centers for Disease Control and Prevention (CDC) came next. The leadership there was pressured to make the nonsensical announcement that people exposed to Covid-19 but who were not symptomatic may not need to be tested. Of course exposed persons need to be tested; this is at the core of limiting disease spread. The reversal of the agency’s previous position recommending testing for all close contacts of people diagnosed with Covid-19 was obviously politically motivated. Unlike the CDC under the direction of other political parties, there was no attempt at scientific basis for this decision. Indeed, at the Republican Convention, Covid-19 was referred to in the past tense.

With this falsehood, we entered a now-common scenario: a federal agency head who makes a public statement is discovered to have made false claims to support a partisan position.

There is no functional Covid-19 Task Force anymore, when in fact we need a new one if  Covid-19 killed no one ever again, if only to address the mental health effects on a nation where 180,000 men, women and children are dead. Going forward, only good news about Covid-19 will be permitted. But what happens if there is a new spate of children who die of Covid-19 at the start of this school year. How will that be good news? Who will be blamed? Teacher unions probably. What if we learn there are persistent cardiac problems among infected college students who were never symptomatic? Blame the administrators and the students who don’t do the right things. But who would issue the public warning?

Our health is in jeopardy. When we can’t imagine another politico-scientific trespass, one appears. We are almost used to it. We have been force-fed lies of vast proportion – hydroxychloroquine, sunlight, bleach. A toxic nutritional supplement as a cure for Covid-19.

Science is a reliable method for creating knowledge. Scientists do not present the conjectural as definitive. Rules apply. Our current leaders do not know what it is to know something. Desperate, many citizens are more credulous than ever. The endangerment will worsen.

A vaccine is coming. Our country is split; half data-driven, half driven by vested interests believing they know the answer in advance. Whatever the clinical trial results, the disruption of government workings over the past four years will leave half the populace disbelieving any announcement. We are all in a rush to hear the data. Who will be holding the microphones?

The job of everyone in public health is to communicate true information. Melodrama is not truth. We in public health work the realm of attempted truth, not fabrication that serves powerful, partisan interest. The job of every public health and medical researcher, every public health worker and clinician is to learn the data, the vaccine and any treatment data, and when it rolls out, to inform friends, colleagues, and anyone who will listen, and to grab every microphone available that can return us to reason.