I continue to really appreciate what you are both doing here but when taking a step back some of the dynamics are really strange, aren't they? For example, the idea that we must show "public health" officialdom that those with dissenting views were data driven and not bent on destruction or whatever (similarly, Dr. Jetelina's statement in the original piece that she was initially surprised she could have a civil and productive dialog with you (!))... I mean, is public health a serious profession and field of study? Or some kind of insular and emotionally fragile club?
Because in most serious professions / fields of study the ability to consider and incorporate alternate views is pretty baseline. As their reflection continues (at its glacial pace) I hope they will consider there might be something fundamentally awry in the epistemological state of either the field itself, or the majority of its contemporary practictioners.
One of the biggest issues I had was the outright lying.
To pretend that they knew more than they actually knew, they lied about it. Lied about trade-offs, lied about data, just lied.
But it wasn't just the deceptions, but that they tried to otherize the people who were trying to dig into what was actually going on. In some cases, these other people may have been incorrect, but they were trying their best. In some cases, they turned out to be correct. But no, they wanted grandma to die, you see.
They are going to have a difficult time rebuilding trust if it's not just that they say, "Sorry, we were wrong, we shouldn't have done that" (they're still making excuses -- some won't go that far), but that they say, "We won't do it next time." -- some may say the first, but not the second. We can't trust it won't happen again. They'll lie again if they feel they want to wield that power. It's for our own good, you see.
Even if they're wrong. Again. Because they're the experts.
Thank you for having a discussion with Katelyn. These conversations need to happen and be free of emotion. I worked in public health from May 2020- April 2021. It was a very eye opening and frustrating time as there was no concern for improving how we reported infection data to the public, and how we interfaced with people, especially alleviating fears by conveying what symptoms to watch for. As a physician I found this a bit shocking. The drive was to collect numbers of cases, contacts and outbreaks. Despite my urging we never took the symptom data collected and stratified it into mild moderate severe categories. That could have showed us how the virus and our response to it was changing. Public health decision making was too concrete, unyielding and followed a cookie cutter approach.
When the vaccines rolled out we were told to push people to take them. What the media, “experts” and politicians were saying was based upon hope and conjecture and not rigorous data as the RCTs did not measure transmission. By February we started seeing breakthrough infections among HCWs, the first tranche vaccinated. It was not just a few cases. When another physician and I discussed this with our supervisor we were told to just collect the information as usual. Breakthrough infection data was minimized because it hurt a non-evidence based narrative that the vaccines blocked transmission. I quit not long after that.
The response to the pandemic has soured my view of public health, the CDC, the media and the “experts.” There were no experts, no one had experience in dealing with a pandemic from with a novel virus much less a widespread vaccination program using a novel vaccine platform during an active pandemic.
It was a sad time for those of us who practiced evidence based medicine.
There has definitely been a failure by the some on the left to acknowledge that the Democratic Party was improperly politicizing the reopening of schools, including with the distribution of gruesome videos exaggerating the impact of Covid on children and misleadingly suggesting that schools were exceptionally dangerous environments. I would like to see some recognition from those involved with this campaign -- you link to an article about it in your piece -- that it was inappropriate.
Great article Kelley. I'd like to add to something you mention at the end: Sudden embrace of lockdowns in March 2020 based on data from China. One of the most Orwellian things to me was the rapid change from lockdown is authoritarian and doesn't work anyway, to lockdown is a basic public health measure and you're a science denying killer if you don't go along. From CNN, 1/24/2020:
"Unprecedented lockdown on 10 cities and 30 million people" - UNPRECEDENTED. That means by definition no one could've known if it was going to work, *because it was unprecedented.* Yet we were told in soon afterwards that locking down the entire US was a basic public health measure and The Science.
In the same article, Fauci is quoted: "Fauci said that China's decision to shut down travel may not have a huge impact on containing the spread, but “it’s their judgment that this is something that in fact is going to help.”
“That’s something that I don’t think we could possibly do in the United States, I can’t imagine shutting down New York or Los Angeles, but the judgement on the part of the Chinese health authorities is that given the fact that it’s spreading throughout the provinces... it’s their judgement that this is something that in fact is going to help in containing it. Whether or not it does or does not is really open to question because historically when you shut things down it doesn’t have a major effect.”
So shutting things down historically doesn't work, and it had never been done at this scale. Then just 6-7 weeks later, we had to do it at 10x greater scale, and Fauci and every state and local public health dept were calling it a basic public health measure and demonizing anyone who disagreed.
It's not just about whether lockdown worked, it's about the Orwellian change from all the evidence showing this doesn't work and was a mass authoritarian experiment at scale on unwilling human subjects, to "this is just basic science, you bigot!"
One possible action that public health could do that hasn't yet been mentioned: openly and thoughtfully reset the relationship with the press. If you are a government public health official and you are texting journalists on your personal cell phone and getting together for drinks outside of work with journalists, you are a) violating federal records preservation laws, b) making it look like your professional decisions are being driven by how they will look in the press, and c) making the press no longer objective and independent. We usually put the onus here on journalists, but I would be in favor of a law where every single conversation between a government official and a journalist is recorded and published online 30 days after it occurs, no exceptions.
Edit: This isn't a problem unique to public health. The relationship between the press and government employees at all levels of government (state, local, regional, tribal, etc.) has become massively unhealthy over the last 15 years. If you are a government employee, you are in a position of public trust, and you need to act like it.
Politics. It's not controversial to say progressives are more willing than conservatives to use the coercive power of government to pursue policy goals. Sadly, it's a short leap to imagine there is a "deep-state" conspiracy to deprive you of your liberty and "control" you (whatever that means). It's important for some people to believe that latter which precludes a more charitable assessment of the COVID response. That is, well-meaning officials acted out of an abundance of caution, absent much data about the disease. In retrospect, many of those policies were useless and some did more harm than good. Personally, I lived with a morgue trailer parked at the end of my block for a few months so I cut officials some slack.
I would like to add a point to your list of reasons why some of us do not trust (and likely never will trust) public health.
Medical exemptions to mask mandates were not honored. In fact, those of us who have legitimate reasons for not using face covers were often bullied, accused of being "selfish liars" and denied services and medical care.
All that while the official "on-paper" policy from the governors called for medical exemptions.
It was beyond inexcusable and it showed that those in power were really motivated by a desire to control the masses.
I agree with, "The level of restrictions required to control Covid while waiting for vaccines was massive, and frankly, not compatible with American values and freedoms" but probably not in the way it was meant. Those restrictions were not compatible with American individualism (which are NOT all American's values nor interpretation of what freedom is. So I appreciate the attempts of defining "freedom" as it's clear many of us view it differently). I felt and still feel a lot of grief for our inability to protect those who were more vulnerable. I wish we could be a country that would just agree to take precautions as small as wearing a mask so others could continue to be in the world. Today, I still have immune compromised friends who live highly restricted and isolated ways of life due to the risks that exist. That said, there are still small businesses and people who accommodate and care about the well fare of their fellow countrymen and women which is heartening. But I acknowledge, the conversation of caring for the "we" or the "I" is something we struggle to make time for. I think both are important and on the ends of the political spectrum, the "I" is more valued on one end, and the "we" on the other. I hope the rest of us outside of the extremes can find time to have conversations to make space for all of us.
My sister lives in New Zealand and my mother became ill (and subsequently died) during the pandemic. There was a period of time we though my sister wouldn't be able to come to the United States in time due to the heavy restrictions on travel. Fortunately, my mom hung on until those restrictions were loosened (New Zealand's vaccination rate reached a level where they could loosen restrictions on travel). This is all to say, I truly felt the weight of these restrictions. They came at a time that was highly painful and difficult for me. However, New Zealand's death rate (as reported by the Guardian) was 80% lower than in the US. So to say these countries had "all had a huge wave of Covid later on" is a bit misleading without naming the impact of those policies. The wave was inevitable, the loss of life was not.
In a Dilbert comic from ~30 years ago someone says: "I've decided to become a doctor. People have to suck up to doctors, otherwise they stick big needles into your body for practically no reason at all."
Maybe doctors are no more or less arrogant than in the early '90s, but the "stick big needles into your body" factor has only grown. The apparently absolute faith that nearly all doctors and public health workers have in vaccines is a problem.
Kelly, I have looked to you and others on SubStack to see open discussions on Covid and rebuttals to “experts”. It is disconcerting the attacks on different ideas as opposed to having reasonable disagreements and discussions. Along these lines, Roger Pielke has an excellent article: What a COVID-19 Food Fight Says About Scientific Discourse (https://rogerpielkejr.substack.com/p/what-a-covid-19-food-fight-says-about) that I recommend. The fact that scientists are trying to silence ideas leads to further public distrust. I would hope at some point the government would do a review of its actions on Covid, but I doubt an objective review can be done anytime soon. Thanks for all your hard work.
There's also the war on covid treatments, which was willful, deliberate and plain evil
Govt/public health went above and beyond to the utmost to sabotage every effective covid treatment, including career assassinations for the few doctors who were treating covid
Also they ran a bunch of high profile studies that were fraudulently conducted for the purpose of "refuting" the efficacy of effective covid treatments like HCQ or Ivermectin
I continue to really appreciate what you are both doing here but when taking a step back some of the dynamics are really strange, aren't they? For example, the idea that we must show "public health" officialdom that those with dissenting views were data driven and not bent on destruction or whatever (similarly, Dr. Jetelina's statement in the original piece that she was initially surprised she could have a civil and productive dialog with you (!))... I mean, is public health a serious profession and field of study? Or some kind of insular and emotionally fragile club?
Because in most serious professions / fields of study the ability to consider and incorporate alternate views is pretty baseline. As their reflection continues (at its glacial pace) I hope they will consider there might be something fundamentally awry in the epistemological state of either the field itself, or the majority of its contemporary practictioners.
One of the biggest issues I had was the outright lying.
To pretend that they knew more than they actually knew, they lied about it. Lied about trade-offs, lied about data, just lied.
But it wasn't just the deceptions, but that they tried to otherize the people who were trying to dig into what was actually going on. In some cases, these other people may have been incorrect, but they were trying their best. In some cases, they turned out to be correct. But no, they wanted grandma to die, you see.
They are going to have a difficult time rebuilding trust if it's not just that they say, "Sorry, we were wrong, we shouldn't have done that" (they're still making excuses -- some won't go that far), but that they say, "We won't do it next time." -- some may say the first, but not the second. We can't trust it won't happen again. They'll lie again if they feel they want to wield that power. It's for our own good, you see.
Even if they're wrong. Again. Because they're the experts.
Thank you for having a discussion with Katelyn. These conversations need to happen and be free of emotion. I worked in public health from May 2020- April 2021. It was a very eye opening and frustrating time as there was no concern for improving how we reported infection data to the public, and how we interfaced with people, especially alleviating fears by conveying what symptoms to watch for. As a physician I found this a bit shocking. The drive was to collect numbers of cases, contacts and outbreaks. Despite my urging we never took the symptom data collected and stratified it into mild moderate severe categories. That could have showed us how the virus and our response to it was changing. Public health decision making was too concrete, unyielding and followed a cookie cutter approach.
When the vaccines rolled out we were told to push people to take them. What the media, “experts” and politicians were saying was based upon hope and conjecture and not rigorous data as the RCTs did not measure transmission. By February we started seeing breakthrough infections among HCWs, the first tranche vaccinated. It was not just a few cases. When another physician and I discussed this with our supervisor we were told to just collect the information as usual. Breakthrough infection data was minimized because it hurt a non-evidence based narrative that the vaccines blocked transmission. I quit not long after that.
The response to the pandemic has soured my view of public health, the CDC, the media and the “experts.” There were no experts, no one had experience in dealing with a pandemic from with a novel virus much less a widespread vaccination program using a novel vaccine platform during an active pandemic.
It was a sad time for those of us who practiced evidence based medicine.
There has definitely been a failure by the some on the left to acknowledge that the Democratic Party was improperly politicizing the reopening of schools, including with the distribution of gruesome videos exaggerating the impact of Covid on children and misleadingly suggesting that schools were exceptionally dangerous environments. I would like to see some recognition from those involved with this campaign -- you link to an article about it in your piece -- that it was inappropriate.
Great article Kelley. I'd like to add to something you mention at the end: Sudden embrace of lockdowns in March 2020 based on data from China. One of the most Orwellian things to me was the rapid change from lockdown is authoritarian and doesn't work anyway, to lockdown is a basic public health measure and you're a science denying killer if you don't go along. From CNN, 1/24/2020:
"Unprecedented lockdown on 10 cities and 30 million people" - UNPRECEDENTED. That means by definition no one could've known if it was going to work, *because it was unprecedented.* Yet we were told in soon afterwards that locking down the entire US was a basic public health measure and The Science.
In the same article, Fauci is quoted: "Fauci said that China's decision to shut down travel may not have a huge impact on containing the spread, but “it’s their judgment that this is something that in fact is going to help.”
“That’s something that I don’t think we could possibly do in the United States, I can’t imagine shutting down New York or Los Angeles, but the judgement on the part of the Chinese health authorities is that given the fact that it’s spreading throughout the provinces... it’s their judgement that this is something that in fact is going to help in containing it. Whether or not it does or does not is really open to question because historically when you shut things down it doesn’t have a major effect.”
So shutting things down historically doesn't work, and it had never been done at this scale. Then just 6-7 weeks later, we had to do it at 10x greater scale, and Fauci and every state and local public health dept were calling it a basic public health measure and demonizing anyone who disagreed.
It's not just about whether lockdown worked, it's about the Orwellian change from all the evidence showing this doesn't work and was a mass authoritarian experiment at scale on unwilling human subjects, to "this is just basic science, you bigot!"
Link to the CNN piece is here: https://www.cnn.com/asia/live-news/coronavirus-outbreak-hnk-intl-01-24-20/index.html
One possible action that public health could do that hasn't yet been mentioned: openly and thoughtfully reset the relationship with the press. If you are a government public health official and you are texting journalists on your personal cell phone and getting together for drinks outside of work with journalists, you are a) violating federal records preservation laws, b) making it look like your professional decisions are being driven by how they will look in the press, and c) making the press no longer objective and independent. We usually put the onus here on journalists, but I would be in favor of a law where every single conversation between a government official and a journalist is recorded and published online 30 days after it occurs, no exceptions.
Edit: This isn't a problem unique to public health. The relationship between the press and government employees at all levels of government (state, local, regional, tribal, etc.) has become massively unhealthy over the last 15 years. If you are a government employee, you are in a position of public trust, and you need to act like it.
Politics. It's not controversial to say progressives are more willing than conservatives to use the coercive power of government to pursue policy goals. Sadly, it's a short leap to imagine there is a "deep-state" conspiracy to deprive you of your liberty and "control" you (whatever that means). It's important for some people to believe that latter which precludes a more charitable assessment of the COVID response. That is, well-meaning officials acted out of an abundance of caution, absent much data about the disease. In retrospect, many of those policies were useless and some did more harm than good. Personally, I lived with a morgue trailer parked at the end of my block for a few months so I cut officials some slack.
I would like to add a point to your list of reasons why some of us do not trust (and likely never will trust) public health.
Medical exemptions to mask mandates were not honored. In fact, those of us who have legitimate reasons for not using face covers were often bullied, accused of being "selfish liars" and denied services and medical care.
All that while the official "on-paper" policy from the governors called for medical exemptions.
It was beyond inexcusable and it showed that those in power were really motivated by a desire to control the masses.
I agree with, "The level of restrictions required to control Covid while waiting for vaccines was massive, and frankly, not compatible with American values and freedoms" but probably not in the way it was meant. Those restrictions were not compatible with American individualism (which are NOT all American's values nor interpretation of what freedom is. So I appreciate the attempts of defining "freedom" as it's clear many of us view it differently). I felt and still feel a lot of grief for our inability to protect those who were more vulnerable. I wish we could be a country that would just agree to take precautions as small as wearing a mask so others could continue to be in the world. Today, I still have immune compromised friends who live highly restricted and isolated ways of life due to the risks that exist. That said, there are still small businesses and people who accommodate and care about the well fare of their fellow countrymen and women which is heartening. But I acknowledge, the conversation of caring for the "we" or the "I" is something we struggle to make time for. I think both are important and on the ends of the political spectrum, the "I" is more valued on one end, and the "we" on the other. I hope the rest of us outside of the extremes can find time to have conversations to make space for all of us.
My sister lives in New Zealand and my mother became ill (and subsequently died) during the pandemic. There was a period of time we though my sister wouldn't be able to come to the United States in time due to the heavy restrictions on travel. Fortunately, my mom hung on until those restrictions were loosened (New Zealand's vaccination rate reached a level where they could loosen restrictions on travel). This is all to say, I truly felt the weight of these restrictions. They came at a time that was highly painful and difficult for me. However, New Zealand's death rate (as reported by the Guardian) was 80% lower than in the US. So to say these countries had "all had a huge wave of Covid later on" is a bit misleading without naming the impact of those policies. The wave was inevitable, the loss of life was not.
In a Dilbert comic from ~30 years ago someone says: "I've decided to become a doctor. People have to suck up to doctors, otherwise they stick big needles into your body for practically no reason at all."
Maybe doctors are no more or less arrogant than in the early '90s, but the "stick big needles into your body" factor has only grown. The apparently absolute faith that nearly all doctors and public health workers have in vaccines is a problem.
Kelly, I have looked to you and others on SubStack to see open discussions on Covid and rebuttals to “experts”. It is disconcerting the attacks on different ideas as opposed to having reasonable disagreements and discussions. Along these lines, Roger Pielke has an excellent article: What a COVID-19 Food Fight Says About Scientific Discourse (https://rogerpielkejr.substack.com/p/what-a-covid-19-food-fight-says-about) that I recommend. The fact that scientists are trying to silence ideas leads to further public distrust. I would hope at some point the government would do a review of its actions on Covid, but I doubt an objective review can be done anytime soon. Thanks for all your hard work.
There's also the war on covid treatments, which was willful, deliberate and plain evil
Govt/public health went above and beyond to the utmost to sabotage every effective covid treatment, including career assassinations for the few doctors who were treating covid
Also they ran a bunch of high profile studies that were fraudulently conducted for the purpose of "refuting" the efficacy of effective covid treatments like HCQ or Ivermectin