There are two extreme approaches to the Covid epidemic: shut down everything, or ignore the whole thing.  Of course neither position is defensible, but finding the golden mean between the two strategies requires an understanding of nuance and a respect for complexity.  Thoughtful, well informed people can disagree on where to land on the spectrum, but looking at the quality of our national dialogue on Covid issues, you might believe there is no middle ground.

Members of school boards all over the country are facing threats for their stances on Covid mitigation strategies for students.  Legislators are subject to vituperative communications and demonstrations regarding policies to try to get Covid under control.  Patrons at restaurants excoriate employees who are trying to enforce masking and vaccination mandates.  Demonstrators gather outside of hospitals to demand unproven drugs like ivermectin be given to Covid patients.  And it goes on and on.

Public Figures Pile On

The mindlessness of events like these reflect a startling lack of appreciation of the complexity of the issues surrounding the Covid pandemic, and the obliviousness is not confined to the masses.  Public figures in the media and politicians also build on the stupefying avalanche of disinformation, sometimes with explicit mistruths, often with selective use of data.

• A Houston physician blames the Covid surge in Texas on vaccinated individuals
• A US senator claims that masks are completely ineffective in protecting against Covid infection
• A major news network edits a piece to “prove” that the director of the CDC states that comorbidities, not lack of vaccination, were responsible for the killing 75% of unvaccinated people. Hosts of a major cable “news” show seize on this, asserting this is further evidence of the government’s dissembling about the efficacy of vaccination.  
• One commentator asserts that current vaccines have no effect against the Omicron variant

Fact Based Responses

Some of these assertions are too ridiculous to comment upon.  Others gloss over the truth. 

Masks may not be as effective as we would like, but they do reduce Covid infection in people who wear them conscientiously and correctly.  

The CDC director was referring  to a population of vaccinated people who died, three quarters of whom had four or more comorbidities (the study looked at 1.2 million vaccinated individuals, 36 of whom died).  

Vaccines have failed to reliably prevent Covid infection, but continue to confer a high level of protection against severe disease, hospitalization, and death.

Ignoring Facts to Make a Point

Selective citation of facts without additional acknowledgement of information that muddies a cherished position is another, more subtle way of purveying disinformation.  This is perhaps the most pernicious brand of truth twisting, as facts, limited though they may be, are often presented accurately. Here is an example.

A prominent surgeon from Johns Hopkins medical school, is a strident opponent of requiring children to be vaccinated.  He points out, accurately, that there are very few deaths in children from Covid and plays up the exceedingly rare vaccine complication of myocarditis in children.  But he is silent about the broader societal impact of asymptomatic infection in children.  Are they important vectors to spread the disease to a population more vulnerable to serious complications of Covid infection?  They are.  Are hospitalizations of children for Covid infections at an all time high?  Yes.  Do children suffer long term complications of Covid such as the “long haul” syndrome?  

We don’t know, and this physician’s analysis is an example of making a point without a comprehensive look at important possibilities.  A study out of Italy found that one third of 129 children aged 6 to 16 had two or more lingering symptoms for at least four months after infection.  Symptoms included insomnia, fatigue, muscle pain, and persistent cold-like symptoms.  Even though preliminary, these findings deserve to be part of any responsible analysis on whether children should be vaccinated. 

Consequences

Disinformation comes in many forms, including outright untruths, tendentious manipulation of data, and willful simplification of complicated issues. In a simpering interview in November, the above physician repeatedly used words like “crazy” to characterize policies with which he disagrees.  This smug assuredness, characteristic of so much of the rhetoric on Covid challenges, compromises credibility,* and probably retards progress on meaningful solutions to the epidemic.  

I may be a bit out of my lane in this blog entry–the commentary is more sociological than medical.  However, It is not hard to connect the rhetorical dots and feel that, if we had a reasonable and productive national discussion on the pandemic issues, hundreds of thousands of deaths attributable to Covid infections could have been prevented..

*This same physician, in a simpering interview in November of 2021, confidently predicted the epidemic would be over in December.  Early in 2021, he predicted that the US would achieve herd immunity by April of that year. 

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