350 “The Most Egregious Failure”

     

In 1841 Charles Mackay, an English journalist, published a three-volume treatise entitled Extraordinary Popular Delusions and the Madness of Crowds, examining dozens of hysterical, irrational phenomena such as the South Sea Bubble, Tulipomania, the Witch Mania, etc.  These books are not particularly worth reading today, but the title is both memorable and prescient, for the reactions to the COVID19 pandemic can only be called understood as “extraordinary popular delusions and the madness of crowds!”  Still more:  Mackay’s advice for his readers clearly applies to us:  “Men, it has been well said, think in herds; it will be seen that they go mad in herds, while they only recover their senses slowly, and one by one.”

Could I get all Americans to read a book that would help us recover our senses by providing accurate insight into what’s happened in the past two years, I’d probably commend Scott W. Atlas’s A Plague Upon Our House: My Fight at the Trump White House to Stop COVID from Destroying America (New York:  Bombardier Books. Kindle Edition, c. 2021).  Atlas provides persuasive personal information inasmuch as he served for four months in the White House, advising President Trump.  And he writes with the precision and truth-commitment one rightfully expects of a highly-trained and compulsively meticulous scientist.  With Winston Churchill, he insists:  “Truth is incontrovertible.  Panic may resent it.  Ignorance may deride it.  Malice may distort it.  But there it is.”  Reading the  book, weighing its evidence and argument, one can only conclude:  “there it is.”

Atlas is the Robert Wesson Senior Fellow in health care policy at the Hoover Institution and served as a “senior advisor for health care” to presidential candidates in several elections.  He has advised world leaders and frequently testified in Congress providing perspectives on public health.  The author of many scholarly articles and books, he has been interviewed by scores of media from around the world.  He’s received many awards and served as an ad hoc member of the nominating committee for the Nobel prize in medicine and physiology and has routinely been listed in The Best Doctors in America.  He spent years caring for patients, doing research and training leaders in neuroradiology and MRI and wrote a “standard book in a revolutionary field, MRI of the Brain and Spine.”

Now he’s written a book for the general public to provide an accurate history of his role in addressing what he considers “the greatest health care care crisis in the past century.”  He also seeks to accurately “clarify the facts underlying the pandemic, free from the filter of government bureaucrats, academics, and scientists with political and other biases.”  He also wants to help us “address future crises” which could “threaten the very principles of freedom and order that we often take for granted” (p. 16-17).  He’s “shocked at the enormous power of government officials to unilaterally decree a sudden and severe shutdown of society—to simply close businesses and schools by edict, restrict personal movements, mandate behavior, regulate interactions with our family members, and eliminate our most basic freedoms, without any defined end and with little accountability.”  And he’s “stunned at the acceptance by the American people of draconian rules, restrictions, and unprecedented mandates, even those that are arbitrary, destructive, and wholly unscientific.  The acquiescence of the citizenry to such extraordinary and ill-conceived restrictions in a nation that was founded on the principles of freedom from an overbearing government, in a country that stands as the world’s beacon for independence and liberty, is nothing less than shocking” (p. 17).  In addition, he is distressed by “the overt bias of the media, the lack of diverse viewpoints on campuses, the absence of neutrality in controlling social media, and now more visibly than ever the intrusion of politics into science. Ultimately, the freedom to seek the truth and openly state it is at risk” (p. 18).

When the pandemic hit America Atlas was deeply involved in academic research, but as he read the pronouncements concerning it he became concerned by the quality of the evidence and the wisdom of the proposals coming forth  from organizations such as the World Health Organization, the National Institute of Health, the Centers for Disease Control and the White House Coronavirus Task Force.  Anthony Fauci (allegedly the “nation’s expert in infectious diseases”), Deborah Birx and Robert Redpath are all bureaucrats rather than research scientists.  For many years the three had studied HIV/AIDS, an illness quite different from COVID-19, and had focused “on the development of a vaccine, rather than treatment . . . —a vaccine that still does not exist” (p. 24).  Given their positions, Fauci and Birx spoke for the federal government and called for “a total societal shutdown,” devastating the country.  “As a health policy researcher for more than fifteen years with decades in medical science and data analysis,” Atlas says,  “I had never seen such flawed thinking.  I was bewildered at the lack of logic, the absence of common sense, and the reliance on fundamentally flawed science” (p. 25).

Consequently, a fog-like culture of fear shrouded the land.  Critical thinking—openly discussing trustworthy data—could hardly be found.  Atlas “began asking myself, ‘Where are the rational scientists?’  I soon found one.  Dr. John Ioannidis, one of the world’s most renowned epidemiologists and a colleague previously unknown to me at Stanford University, authored an amazingly prescient piece in March entitled, ‘A Fiasco in the Making?  As the Coronavirus Pandemic Takes Hold, We Are Making Decisions without Reliable Data.’  His short essay will go down as one of the most important—and most infamously ignored—publications in modern medical science” (p. 26).  Atlas also began daily corresponding with another distinguished Stanford epidemiologist, Dr. Jay Bhattacharya.  They formed a small band of committed scholars began trying to accurately assess the pandemic/panic.  

They also sought to make their views public.  Atlas urged scientists to do science by relying on empirical evidence rather than hypothetical models.  He stressed protecting the elderly—who were dying at an alarming rate despite the lockdowns—“while allowing younger, healthy people with an extremely low risk to function, so that the harms of the lockdown would end.”  He was especially incensed at school closures:  “The most obvious denial of science, the most egregious and inexplicable failure of policy leadership in our country, was indefinitely closing schools” (p. 49).  Unfortunately, teacher unions effectively paralyzed “parents with fear by lying about the danger in schools.”  Kids were not at risk, and most teachers were not in high-risk groups—“92 percent are under sixty.  The bottom line was this:  America was uniquely hysterical in its disregard of actual data on schools and children, more off the rails than almost anywhere in the world” (p. 50).  Sweden, for example, kept its 1.8 million children in school “without subjecting them to testing, masks, physical barriers, or social distancing.  The results?  Exactly zero COVID deaths in kids, while Sweden’s teachers had a COVID risk similar to the average of other professions. Schools were not high-risk settings” (p. 51).

Atlas began making public pronouncements in March 2020, emerging as one the most qualified critics of the lockdowns.  Unexpectedly, he received a call in July 2020 asking him to come to the White House, go through interviews, and perhaps serve as an advisor to President Trump as an expert on public health concerned by the government’s handling of the COVID crisis.  Basically an apolitical research scientist, he neither knew nor particularly supported Trump, but he was anxious to do something to help the country.  Meeting the president, he faced “a rapid-fire series of questions about the pandemic,” ranging from lockdowns to hydroxychloroquine.  Atlas then “went into some detail about harms from the lockdowns—facts about the missed cancer treatments, the skipped organ transplants, the cancers that were never diagnosed.  I told him how the fear had caused people having heart attacks and strokes to avoid calling for an ambulance.”  He noted the harms children suffered as schools closed, and  “was impressed that the president asked the right questions” (p. 74).  

Given the media portrayals of Trump, Atlas “was pleasantly surprised,” seeing how “he was frustrated—not just at how the country was still shut down, but that he had allowed it to happen, against his own intuition.  At one point, he exclaimed with irritation in his voice, but to no one in particular, ‘Why the hell wasn’t this guy here six months ago?’  It was as if he understood that his closest advisors—several standing in that room—had somehow let him down” (p. 74-75).  Trump shared with Atlas an awareness of the lethality of the virus while also realizing that incredible societal harms were being done by various governmental agencies.   As early as March 2020 he had rightly warned:  “The cure cannot be worse than the disease.”  And he also knew what Atlas was soon to discover:  “‘I’m sure you will teach me many things while you’re here.  But there is only one thing you’ll learn from me.  Only one.  You will learn how vicious, how biased, how unfair the media is” (p. 80).  Sure enough, upon arriving in Washington D.C., nothing shocked Atlas more than the national  media, which sought in every way possible to misrepresent the facts and spread fear throughout the country.  They did everything possible to misrepresent him, his scholarly achievements, and his statements.  They slandered him, “engaging in propaganda tactics scarcely different from those used by regimes like the USSR or Communist China to discredit political enemies” (p. 150).  “No opportunity to inflame the voters was going to be missed by what I now believe are the most despicable group of unprincipled liars one could ever imagine—the American media” (p. 149). As soon as he arrived in the White House Atlas began interacting with the COVID Task Force, quickly learning that Deborah Brix dominated the meetings.  She also flew around the country, meeting with governors, university presidents, and health officials, presenting herself as the official spokesman for the Task Force.  She and her associates blithely ignored the president’s directives while promoting their own agenda.   Though most Americans assumed Anthony Fauci was in charge of things, that was due to “his nearly ubiquitous presence and solo interviews on national and international media” (p. 98).  Internally, Birx called the shots, and Atlas quickly discovered her limitations.  For example, when he first met her they discussed masks.  “‘Just curious,’ I asked, ‘what study is the most important one to show masks are effective?’ ‘The hair salon study!’ she replied confidently.’”  He then challenged her, saying it was might be considered a “clinical report” but not “solid science.  I knew the study well, having already dissected it in detail with a few epidemiologists before I set foot in Washington.  My colleagues had all laughed at it.  It was poorly done, and the conclusions were not valid.  It was an embarrassment that it had been published prominently on the CDC website, let alone cited in the media by experts” (p.84).  The “study” Birx claimed  to be “proof” of the need for masks was based upon the experiences of two hair stylists, one of whom had COVID, and their impact on a few clients getting their hair done.  That was it!  Purely anecdotal!

Soon he realized he was an outlier on the Task Force, and he ultimately concluded that attending its meetings was a waste of time.  Since he had come to advise the president, who was supposedly in charge of national policies, he never understood why the president’s wishes were hardly considered by the Task Force.  Trump wanted to reopen schools and the economy, but the Task Force seemed to go its own way, following Birx and Fauci.  As the sole public health policy expert in the White House, however, Atlas was determined to help Trump understand why many of the nation’s leading experts disagreed with Birx and Fauci.  (Thousands had signed the Hartford Declaration!). He wanted to tell him “what I thought, not to be a mouthpiece for what he thought.  I came there to speak on behalf of the American public, especially those who were being destroyed by the lockdowns.  And I could not sit silent and watch this mass destruction” (p. 128).  He also felt morally obligated to speak truthfully to the American people and took advantage of any opportunity to do so, taking “that responsibility more seriously than anything else in my life” (p. 133).  

Birx constantly claimed she was “all about data,” but in her data were frequently flawed and often derived from worldometer and state dashboards—“layman-level websites”—that seriously failed to provide what scholars demand.  Her reasoning was often fallacious—lapsing into circular reasoning, mistaking correlation for causation, tossing off non sequitors, etc.  She and others seemed “incapable of basic logic” and neither she nor Fauci or Redpath—the “experts” on the Task Force—“showed detailed knowledge of ongoing scientific literature on the pandemic” (p. 99).  To Atlas’ amazement, they never “ever brought scientific publications into the meetings that I attended.”  Nor did they demonstrate suitable “familiarity with clinical medicine or had any clinical perspective on medical journal publications” (p. 100).  Birx routinely presided at the meetings, “comfortable speaking to the nonmedical group in the meetings, pushing policies without being challenged, including testing healthy people, quarantining asymptomatic children and adults, and arbitrarily closing restaurants and bars, specifically ‘after 11:00 p.m.’  No one bothered to ask about the science behind that seemingly magical moment.  Why not 9:30 p.m. or 11:30 p.m. or even 2:00 a.m.?  What about the research that showed only a small fraction of cases stemming from bars and restaurants?  Contact tracing data showed that only a tiny percentage of cases originated in restaurants and bars.  That was ignored.  In fact, it seemed completely unknown in the White House until I presented it” (p. 246).

Almost all the meetings he attended in the White House lacked the scientific rigor he’d both anticipated and demanded.  “No contrary evidence was mentioned.  Warnings, broad statements, and assertions were uttered, but never any data or evidence” (p. 206).  The nation was controlled by “experts” who didn’t really know what they were doing!  “The striking uniformity of opinion by Birx, Redfield, Fauci, and Giroir was not anything like what I had seen in my career in academic medicine, and I took that as an absence of independent thought.  And that’s not science” (p. 244).  Birx was extremely defensive and easily angered if anyone questioned her views.  But one thing she knew well:  how politicians work.  And she knew that Vice President Pence, fearing to “rock the boat” would defer to her views.  After all, there was an election to be won!  So too the communications folks in the White House cowered in fear, facing “a relentlessly hostile media.  . . . . They were held hostage by the potential reaction in the press from Fauci and Birx” (p 259).  Hoping to get Trump re-elected they dared not risk even challenging the “experts.”  

While the nation’s governors implemented whatever Birx and Fauci decreed, Atlas tried to get the White House to care for those who were most at risk and dying.  “I kept stressing that locking down, restricting everyone, was extraordinarily harmful, especially to the working class and the poor.  The lockdowns were a luxury of the rich, and it was unconscionable to continue them” (p. 236). He told Birx that no one could stop the virus from spreading.  “‘But,’ he said, ‘we can and must increase the protection of those at risk to die.  Only a narrow group has a significant risk to die, not everyone.  What we can do is minimize the deaths, that’s the entire point—to stop people from dying.  And we should stop sacrificing children and destroying families by locking down healthy, low-risk people.’” (p. 238).  These strategies were clearly not working.  Cases multiplied, deaths mounted, but officials endlessly insisted everyone wear masks and stay home.  The media amplified the narrative and the masses complied.  Atlas began to wonder if those in charge kept doing senseless things because they could not bear to admit they had been wrong.  

He also thinks we should have honestly faced the fact that masks could not stop the virus from spreading.  “The empirical evidence from the US and all over the world already had shown masks failed to stop COVID-19 cases from surging” (p. 332).  In November 2020, the Annals of Internal Medicine published Denmark’s “‘randomized, controlled’ Danmask-19 study.  That seminal study—of the highest scientific quality in clinical trial research—evaluated masks in more than 6,000 adult participants. That study showed there was no statistically significant difference between those who wore masks and those who did not when it came to being infected by the SARS2 coronavirus—nothing different between masks and no masks” (p. 343).  Despite the evidence, the scientists and politicians shaping public policy relentlessly insisted masks could arrest the virus, upholding nothing more than a “dearly held belief” and making a public declaration of both fear and personal righteousness.  Doctors certainly wear masks while doing surgery, as did Atlas when he was in an operating room.  “But the real reason doctors wear masks is to stop large droplets of saliva, coughs, or sneezes from entering the sterile field and contaminating a wound or incision.  They do not wear masks in operating rooms to stop aerosolized viruses emitted via breathing.  This virus primarily spreads by aerosols, invisible with every breath.  That type of spread escapes around a mask” (p. 329).  The COVID virus is significantly smaller than the pores in surgical masks.  “It should not be necessary to explain how absurd it was to even consider that a scarf or bandana would stop the virus” (p. 330).  Though he knows it’s a polarizing issue, and though he wishes masks work, he cannot “endorse a requirement for unscientific, irrational behavior.  I do not choose to wear a copper bracelet for arthritis.  Others may choose to, and that’s fine.  I am in favor of having everyone who wants a mask to wear one” (p. 330).   When caring for symptomatic patients, who often cough or sneeze, wearing masks make sense.  

In a searing summation of his brief experience in D.C, Atlas says:  “It was too much for me.  To sit in that Task Force, to listen to these so-called experts, with such influence, people who denied the data, who were not even critiquing the scientific literature.  People who hadn’t worked with patients for decades, who showed no perspective on clinical medicine.  Public health officials who heinously and consistently disregarded the horrible destruction occurring in the wake of their policies—policies that were undeniably followed throughout the country, no matter what they claimed otherwise, no matter what the president or anyone else tried to say.  The lockdowns—their lockdowns—were at this point, in my mind, reprehensible, totally unforgivable, a crime against humanity” (pp. 239-240).  

Hoping to give the public an alternative perspective, Atlas scheduled a “roundtable meeting with the president” to introduce him to Atlas’ Stanford colleague Jay Bhattacharya, an expert in infectious disease, health policy, and economics” as well as other “nationally recognized academic experts.”  That meeting was cancelled at the last moment when Dr. Birx could not attend—primarily, Atlas thinks, because she “would have suddenly found herself in the minority among a group of respected authorities” (p. 251).  The meeting was rescheduled—and again Birx absented herself.  Undaunted, Atlas persevered and ultimately orchestrated a roundtable in President Trump’s Oval Office.  Trump “eagerly commandeered the meeting” and dove “into the important issues of the pandemic, posing questions to each doctor and listening intently to their responses.”  After the November election, Atlas resigned from his position and later talked with the president, who said:  “‘You did a great job.  We had a great relationship. We got a lot done.  And you worked hard.  You’re a fighter.  I appreciate that.” Atlas thanked him and said he’d done all he could to help the country.  To which Trump said:  “‘You were right; you were right about everything’” (p. 300).  

And Atlas thinks Trump was also right about most everything.  “From his March 23, 2020, statement during the initial fifteen-day lockdown that ‘the cure cannot be worse than the problem,’ President Trump repeatedly stated his overall strategy:  protect the vulnerable, prevent hospital overcrowding, and open schools and businesses.  These principles were stated numerous times throughout the pandemic in the president’s speeches, briefings, and statements issued from inside and outside the White House.”  But the White House Coronavirus Task Force he appointed was “not in synch” with him.  Entrusting the nation’s health to this task force was “a massive error in judgment.  Against his own gut feeling, he delegated authority to medical bureaucrats, and then he failed to correct that mistake” (p. 308).  Its director, Vice President Pence, “was a thoughtful and engaged participant, and he listened to his main doctors,” Drs. Fauci, Birx, and Redfield, who constantly moulded the media and advised the nation’s governors.  They had one simple policy:  lockdowns.  They had one ultimate solution:  a vaccine.  Yet their policies utterly failed.  Indeed it is “likely the most egregious failure in the history of modern health policy” (p. 308).