When to Be Skeptical of the Experts

As the “reopen” movement forges blindly ahead, we are seeing more and more health experts coming out of the woodwork to support the drive back to work and school. Contrary to their own recent arguments in support of social distancing and sheltering-in-place (SIP), many are now claiming it is safe, though nothing has changed to make it so. Their messaging is irrational, inconsistent and risks undermining people’s trust in science at a time when evidence-based decision making is most critical, and at a time when people have already lost trust in so many other social institutions.

I am not talking about the quacks and snake oil peddlers whom I discussed in my piece, Careful Which Health Experts You Follow. Here I’m talking about well-respected experts in the fields of epidemiology, infectious disease and pandemics, like Dr. Thomas Frieden, former head of the CDC, one of the most trusted scientific institutions in the U.S., and Dr. Scott Morrow, Health Officer for the County of San Mateo, California, (the epicenter of the region’s biotechnology industry).

Rule #1: Be Skeptical of Science in the Service of Capital

Dr. Morrow, who is a physician with degrees in Public Health and Business, is reopening San Mateo County with the express purpose of “increasing the immunity of the population” [and to] “minimize economic damage." This move is in complete disregard for the lack of scientific evidence to support the efficacy of a Herd Immunity policy and, worse, in complete disregard for the lives of all the higher-risk people who will die as a result. But it is clearly in service of capital, as his stated goal is to diminish the economic damage caused by the SIP.

Scientists do NOT know whether individuals who’ve been infected with Covid-19 gain a robust or lasting immunity, drawing into question whether herd immunity is even possible. According to the CDC, “it remains uncertain whether individuals with antibodies (neutralizing or total) are protected against reinfection with SARS-CoV-2, and if so, what concentration of antibodies is needed to confer protection.” If our immune response to Covid-19 is similar to seasonal coronaviruses, the prognosis is not good, since there is evidence of people being reinfected by seasonal coronaviruses in as little as 80 days.

Even if herd immunity was possible, it might not be achievable through deliberate social mixing. Most experts believe we would need 70-80% of a population to have been infected. Nowhere on the planet have we come close. Even in New York City, the hardest hit region to date, less than 20% of the population has been infected, suggesting that the city could suffer more severe outbreaks in the coming months. London is estimated to have a 17.5% infection rate and Madrid has a 11.3% rate. But we do know that encouraging direct social interactions (e.g., work and school) will cause a surge of infections and deaths, which is highly unethical and contrary to the concept of “do no harm.” In New York City, there have been 16,877 deaths to date from Covid-19, and this is with an outbreak so severe that the healthcare system was on the verge of collapse, with people dying because of a lack of ventilators and ICU beds.

Rule #2: Be Skeptical of Scientists Who are “Woke”

As the protests over police violence continue, numerous health experts have come forward saying things like social justice matters more than social distancing and that it’s okay to for large groups to gather, if they’re fighting for a good cause. For example, Dr. Thomas Frieden (former head of the CDC) said the threat to Covid control from protesting outside is tiny compared to the threat to Covid control created when governments act in ways that lose community trust. And Jennifer Nuzzo, an epidemiologist at Johns Hopkins, said that in this moment the public health risks of not protesting to demand an end to systemic racism greatly exceed the harms of the virus.

However, if being in crowds was dangerous for gun-toting Republicans at the Michigan statehouse, how can it suddenly be safe for progressives to mass protest against police violence now? The risks of mass gatherings do not physically change based on the motivation of the participants. If anything, the anti-police brutality protests might be more dangerous than other mass gatherings, since the use of tear gas by the police could exacerbate the spread of droplets containing Covid-19, while also damaging people’s respiratory systems and making them more vulnerable to infection. Furthermore, while Frieden thinks the benefits of the protests outweigh the risks, the current CDC chief thinks the protests will spur new outbreaks and that all protesters should get tested.

The argument that social justice matters more than social distancing is not a binary choice, nor necessarily true. You can fight for social justice in dozens of ways that are consistent with social distancing. But if we don’t continue to socially distance, there will be a surge of new infections and deaths which, based on recent trends, will disproportionately affect poor people and people of color, thus worsening social injustice. Plus, social distancing provides immediate protection against a deadly disease, including immediate benefits for people of color, whereas social protesting does not necessarily result in any social change or improved health outcomes, let alone immediate ones. 

Contrary to Nuzzo’s claim, the health consequences of not protesting cannot be worse than the health consequences of the virus. If the health of people of color was compromised by racism before the pandemic, it continues to be so now, but with the additional risk of illness or death from Covid-19. Unless the protests somehow caused an immediate reduction in the illness and death caused by racism, which they can’t, we are likely to see an increase in mortality for poor people and people of color precisely because the large gatherings could increase the infection rate of Covid-19. Interestingly, Black Lives Matters, Seattle, has explicitly cautioned against attending mass protests for this reason.

Yet, even if we take a more long-term view and presume that the protests will result in significant changes in policing and race relations, how much will that improve the health and longevity of African Americans? Consider that the cops kill around 225 African Americans a year, but Covid has already killed around 25,000 African Americans in just three months (roughly 23% of Covid deaths in the U.S. are among African Americans). Thomas Frieden suggests that the protests will somehow help in Covid control (presumably by reducing the racism that causes a disproportionate number of African American Covid deaths), but it’s hard to see how. The high rate of black covid deaths are happening primarily in poor communities and may be due as much to poverty as systemic racism. The same is true of police murders, which occur overwhelmingly in poor communities. Indeed, roughly the same percentage of African Americans die at the hands of cops as live in the poorest communities in America.

It is understandable that doctors and scientists, like most of the rest of the country, are outraged by the daily police murders in this country; the persistence of institutional and overt racism; the government’s complete disregard for our health, safety and social wellbeing in the face of the pandemic; the mass economic suffering; the anxiety and fear about the future; and should want to express that outrage in the streets. However, they’ve known for some time that racism, poverty, and other social inequities have serious negative impacts on life expectancy, heart disease, cancer, and diabetes, not just from the obvious reasons (e.g., less access to good healthcare, healthy diets, clean environments), but from the long-term destructive effects of cortisol, which is overproduced in people who are subjected to chronic stress. (For an excellent explanation of the biology of stress and the effects of cortisol, watch the PBS Documentary: Unnatural Causes: Is Inequality Making Us Sick).

If this is what Frieden and Nuzzo are talking about, why weren’t they leading or calling for social protests for each of the 1,004 people fatally shot by the police in 2019, or the hundreds killed by police in 2020, prior to George Lloyd? Why haven’t they been leading or calling for protests for the 275 people a day who die from their work-related injuries? Or the 120,000 people who die each year from workplace stress? Or the 90,000-360,000 who die yearly from air pollution?

None or this is to say people shouldn't protest. There are plenty of excellent reasons to do it, including the hope it will inspire positive changes, but the scientists should be honest and let people know that doing so increases their risk of contracting coronavirus, and the risk of intensifying community spread. It is great that they are starting to identify racism as a cause of the disproportionately poorer health outcomes in African Americans, instead of the tired and scientifically unsubstantiated notion that it is genetics. But it's time for them to do the same with class.