In a recent article in The Atlantic, Emily Oster proposed a “Pandemic Amnesty” for the things that people got wrong during the worst parts of COVID. This evoked strong feelings on both sides. Those who fought lockdowns and vaccine mandates mocked the idea and called for justice while those still fearful of COVID scoffed at the idea of need amnesty at all. These two groups could not be more opposite and yet they both scoffed at the idea. In my return to this forum, I will seek to answer two questions:
Is the article accurate in its claims of “not knowing”?
To what degree is the medical community responsible for the most egregious errors of the pandemic?
Setting the Stage
I want to start by laying out my view from the inside. Those that know me or have heard my thoughts on the subject know that I give everyone a pass for the first few weeks. The havoc that the SARS-CoV-2 virus wrought on Italy was a flashing red light to the medical community in the US. When COVID finally arrived at our doorsteps in took New York City by storm. Their health system was under strain prior to the pandemic, and it revealed itself to be uniquely unprepared for the influx of critically ill patients that presented to their hospitals. That was the thing about COVID in the early days, there was a disproportionate number of people that needed an ICU compared to the rest of the hospital. That strain on the ICUs resulted in cancellation of elective surgical procedures. People were also scared to go to the hospital. This combination of events resulted in the horrible optics of empty ER waiting rooms and largely empty hospital wards. Then came the Tik Toks.
The first great error of COVID was not 2 weeks to flatten the curve. I would hope that rational people can look back and see the uncertainty of the time and the worst-case scenarios being forecast and realize that a brief semi-lockdown could be justified (in a utilitarian sense). The problem was that the medical community forgot optics. While telling people that they had to protect the hospitals from being overwhelmed, doctors and nurses were dancing around empty hospital wards to pop songs. It undermined the whole premise and was the first big hit to the credibility of the medical field during COVID. At the risk of repeating myself too often, it is difficult to find a group that has more completely squandered public goodwill than the medical community during COVID. But God forbid you question the actions of the brave men and women of the medical community. We were “Healthcare Heroes” after all. The debate rapidly descended into tribalism and that stage was set for the culture war to come.
We Didn’t Know!
I think that the first step is to address the arguments in the article itself, to see if there is any validity to them. Unfortunately for the author, they start with an anecdote that reveals a lot about how they approached COVID. They tell a story of April 2020, a time when very little was known about SARS-CoV-2 transmission, when they would go for hikes outside. If someone got too close, they had instilled such a fear in their 4-year-old that the child would yell “social distancing” at those getting too close. The author claims that they didn’t know that outdoor transmission was, in their words, “vanishingly rare”. A more honest explanation would state that brief, passing, outdoor exposure to someone else has never been reported to result in COVID transmission. The problem? We knew this but people didn’t want to listen.
Outdoor transmission of respiratory infections has never, before COVID, been considered a significant risk. Despite this fact, public health officials closed outdoor spaces to “stop the spread”. This closure of outdoor spaces, driving people indoors, likely was counterproductive (although there will be no studies to support his assertion). I, myself, was the target of outdoor COVID zealotry on more than one occasion. I recall one run where a person yelled “Six Feet” at me multiple times as I ran past on a public sidewalk, motioning for me to run into the street so that they weren’t with the made-up radius that would result in transmission. On a separate occasion, I was on a hike on a logging road (more than six feed away) as I passed a person who yelled at me to “Mask up, buddy”. The desire to scold instead of pass by and avoid exposure reveals that the desire was not to prevent transmission but instead to exert a degree of control on others that had not previously been available. These were petty tyrants revealing themselves and they were just getting started.
School Closures
Following the hiking anecdote, the author moves on to a discussion of school closure. This again, reveals their purposeful ignorance on the topic at the time. They claim that there were reasonable people on both sides of the argument regarding school closure but neglect to mention how vilified those that argued, correctly, that learning loss was a problem. If you even questioned the risks of learning loss you were shouted down as a “COVID denier” or someone that didn’t care about teachers. Problem is, we had data by fall of 2020 and it supported keeping schools open.
Most of Europe, despite its early disasters, realized that children were low risk for serious illness or death and were also not significant vectors of transmission by the summer of 2020. Despite this fact, schools in many states in the US remained closed into 2021, with teachers’ unions initially not wanting to open up until vaccines were available and then resisting even after the vaccines. At the same time, plastic barriers were being put up and kids were being told that they couldn’t socialize during lunch breaks. It was always theater to anyone willing to look at the data critically.
Vaccine Effectiveness
“Safe and Effective”. That was the claim from the first emergency use authorization. Never mind that the original study couldn’t make either of these claims (see my post on the pfizer study). They author of this article tries to distract by discussing the mRNA vaccines vs the J&J vaccine. Reality is, that is not the real issue. Those in charge misled the public regarding what the studies showed and what the effectiveness was. They also didn’t have adequate data to comment on safety. Yet, a public that had previously been taught to distrust big pharma companies as the money-grabbing corporate entities that they are, bought this hook, line, and sinker. Why? They were scared. At the time of the initial vaccines, there weren’t really any great therapies. There were some monoclonal antibodies that had been used and a few therapeutics that showed some promise (I’ll get into the demonization of certain therapies in part 2).
The vaccines were a light on a hill. Mass vaccination had eradicated smallpox and essentially rid the US of measles and polio. A credulous public was ready to believe. The data, however, was there to read and those that questioned the narrative were disparaged as “antivaxxers” or “anti-science”. Never mind the fact that science is a process of discovery that includes disproving prior dogmas. The modern science is rigid and cannot be questioned.
Where’s the Apology?
The article finishes with a rhetorical flair about well-meaning individuals. Everyone was right about some things and wrong about others so shouldn’t we all just let bygones be bygones? There is not acceptance of responsibility, just the excuse that “we didn’t know”. I’m tempted to say that ignorance is no excuse because the data was available. But do I really expect most lay people to dive into the data? Is that fair? Or is there something to a degree of amnesty for most people who were simply scared of infecting their elderly parent or grandparent? To be clear, I’m not speaking of those that excommunicated family or friends for being supposed charlatans. I’m speaking more on a global sense about those individuals who were focused on living their lives and keeping their family safe. They outsourced the synthesis of data to medical professions and public health officials who should have known better. Maybe they should apologize for their zealotry but, in my opinion, that is not where the true blame lies.
Maybe I’m biased and think too highly of my field, but I think the medical field is responsible for the greatest excesses of COVID policy. COVID is a tale of the failure of the institutions of modern medicine that were built to prevent things like this from happening. It reveals the continued issues with modern healthcare in the US that, if not fixed, will result in the same events happing in the future. That will be the focus of part 2.
Nothing in this article should be viewed as medical advice. Everyone is an individual and risk/benefit of therapies is always an individual decision. I hope you have a doctor that will discuss this with you prior to any treatment. As always, I welcome your input both on this article and topics to address in the future.