JANUARY 10, 2021 (counterpunch.org)
Image by: Felipe Esquivel Reed (CC BY 2.0)
It is easy for progressives to blame the staggering calamity of U.S. COVID-19 deaths solely on Trump. Yes, Donald Trump is a self-serving liar, and his vice president, Mike Pence, as chair of the President’s Coronavirus Task Force and Trump henchman, has blocked life-saving guidance from scientific authorities. There is smoking-gun evidence (some of which I will discuss) that convicts Trump and Pence, but if progressives blame only the Trump administration and not politically-intimidated scientific authorities, they will be guilty of failing to prevent another disastrous response to the next pandemic.
While anti-authoritarian progressives should have expected nothing less from Trump and Pence, cavalier clowns from the theocratic/pre-Enlightenment wing of the corporatocracy, they should have expected more from scientists at the Centers for Disease Control (CDC), whose compromising of science was chronicled by ProPublica (“Inside the Fall of the CDC”) and noted by the Center for Infectious Disease and Research Policy (CIDRAP). Both the ProPublica and the CIDRAP reports will be discussed here.
For most of 2020, confused, anxious, and terrified Americans simply have had no idea as to which authority to trust, and such confusion, anxiety, and terror obliterated critical thinking. Now, with the arrival of vaccines—hopefully as effective as claimed—along with other good news that I will report, perhaps some Americans are re-energized to think critically. For those who have regained their strength, the goal of this article is to provide information for critical thinking about the CDC fiasco and the increasingly failed state called the United States—failed if your criteria includes how a society treats its elder citizens (according to the December 20, 2020 AARP Bulletin, the COVID-19 fatality rate in U.S. nursing home/long-term care facilities is 16% compared to the Battle of the Bulge fatality rate of 4%).
First, that piece of good news. Unlike CDC director Robert Redfield (a Trump appointee), CIDRAP director Michael Osterholm, in spite of heavy political pressure, has valiantly NOT made scientific proclamations without scientific evidence; and last November, Osterholm was named to Biden’s 13-member COVID-19 Advisory Board.
From the beginning of the COVID-19 pandemic, there has been widespread confusion in the general public concerning scientific truths about stopping its spread. Genuine scientists recognized what was truly known and not known, and those with courage, such as Osterholm, attempted to make this clear. However, because scientific proclamations have had such huge economic implications—which translated into huge political implications—scientific authorities experienced great pressure, and the CDC caved to that pressure. Before discussing that CDC capitulation, some facts:
(1) The United States has, by far, more COVID-19 fatalities than any other nation. As of December 29, 2020, the United States had approximately 335,000 deaths; Brazil was second at 191,000; New Zealand had 25 deaths. On one day alone, December 29, there were 3,725 U.S. COVID-19 deaths, at that time, the highest U.S. daily total. As of December 16, 2020, while there were eight other nations with higher fatality rates than the United States, the U.S. fatality rate of 921 deaths per million was 250% greater than Canada’s rate of 364 deaths per million. New Zealand had a fatality rate of 5 deaths per million. While the Trump slogan may have been “Make America Great Again,” U.S. government policy has resulted in “Made Americans Dead.”
(2) Trump’s only agenda with regard to COVID-19 has been to keep it from derailing the economy, especially the stock market, which he believed would derail his re-election. In November 2020, the Atlantic (“All the President’s Lies About the Coronavirus”) documented over 50 Trump lies in key areas, including the nature of the outbreak, its seriousness, testing, and treatment.
(3) The CDC, pressured by the Trump administration, compromised its scientific mission, resulting in lost respect and credibility for the CDC from scientists inside the CDC and from scientists outside of the CDC.
In ProPublica’s lengthy exposé, “Inside the Fall of the CDC” (October 15, 2020), journalists James Bandler, Patricia Callahan, Sebastian Rotella and Kirsten Berg conclude: “When the next history of the CDC is written, 2020 will emerge as perhaps the darkest chapter in its 74 years, rivaled only by its involvement in the infamous Tuskegee experiment. . .”
The ProPublica story begins with an ugly example of the nature of the Trump administration’s assault on the CDC. Propublica recounts that in mid-May 2020: “the CDC had published its investigation of an outbreak at an Arkansas church that had resulted in four deaths. The agency’s scientific journal recently had detailed a superspreader event in which 52 of the 61 singers at a 2½-hour choir practice developed COVID-19. Two died.”
Jay Butler, the CDC Deputy Director for Infectious Diseases who was directing the CDC’s COVID-19 response, was tasked with crafting CDC guidance for religious organizations’ activities. Butler, Propublica points out, is “an infectious disease specialist with more than three decades of experience . . . . one of the CDC’s elite disease detectives, he’d helped the FBI investigate the anthrax attacks, and he’d led the distribution of vaccines during the H1N1 flu pandemic when demand far outstripped supply.”
Just prior to Memorial Day, Trump publicly insisted that churches reopen and accused Democratic governors of disrespecting houses of worship, which he proclaimed should be deemed as “essential services.” Trump announced that the CDC would “very soon” release safety guidelines for places of worship. Butler’s team rushed to finalize this guidance—recommendations that earlier in April, Trump’s aides had rejected. Butler’s team reviewed “a raft of last-minute edits from the White House,” Propublica reports, and the team rejected those White House edits that conflicted with CDC research, including rejecting a White House suggestion to delete a line in Butler’s team’s guidance that urged congregations to consider suspending or at least decreasing the use of choirs.
After these rejections by Butler’s team of the White House “suggestions,” Mike Pence, chair of the President’s Coronavirus Task Force, made the White House position clear. Propublica recounts: “The next day, a furious call came from the office of the vice president: The White House suggestions were not optional. The CDC’s failure to use them was insubordinate, according to emails at the time.” In sum, 52 of the 61 singers at a 2½-hour choir practice developed COVID-19 with two dying, but the self-identified evangelical Mike Pence declared it to be insubordination should the CDC retain its guidance to consider suspending or at least decreasing the use of choirs.
Sadly, almost immediately, a Butler deputy replaced their team’s guidance with the White House version, and the choir dangers went unmentioned. On the Sunday morning of the Memorial Day weekend, Propublica reports, “Butler, a churchgoer himself, poured his anguish and anger into an email to a few colleagues,” his email reading: “I am very troubled on this Sunday morning that there will be people who will get sick and perhaps die because of what we were forced to do.”
To give you the flavor of the detailed Propublica exposé on the CDC, below are a few quotes from it:
• “A vaunted agency that was once the global gold standard of public health has, with breathtaking speed, become a target of anger, scorn and even pity.”
• “Agency insiders lost faith that CDC director Dr. Robert Redfield, a Trump appointee who’d been at the agency only two years, would, or could, hold the line on science.”
• “People interviewed for this story asked to remain anonymous because they feared retaliation against themselves or their agency.”
• “Longtime CDC employees confess that they have lost trust in what their own agency tells the public.”
Not reported in the Propublica exposé is another CDC tragedy, an extremely important CDC flip flop.
On March 18, 2020, the CDC put out the video “Answering 20 Questions about COVID-19,” in which Jay Butler is asked about CDC recommendations regarding cloth masks. He responds (at the 52:12 mark): “CDC does not recommend use of masks in the general community, and that’s not a new recommendation. That’s been a standing recommendation for some time, primarily because there’s not a lot of evidence that there is benefit. We are also concerned about the exposure of hands to the face. . . . Just [an] anecdotal observation—not true scientific data—I’ve watched people in public who are wearing the mask and how often they put their hand to their face to adjust the mask . . . . It really makes me wonder if it actually might have a negative benefit on the risk of infection. . .”
In addition to the lack of evidence for cloth masks’ positive benefits and the possible negative effects of face-touching caused by mask use, there is another hugely important reason why public health officials did not want to recommend them. Specifically, they feared that mask recommendations would result in a false sense of security; in the words of a CIDRAP commentary published on April 1, 2020, “Masks-For-All for COVID-19 Not Based on Sound Data”: “Their use may result in those wearing the masks to relax other distancing efforts because they have a sense of protection.” This CIDRAP review of the scientific research is authored by Lisa Brosseau and Margaret Sietsema (their mini-bios state: “Dr. Brosseau is a national expert on respiratory protection and infectious diseases and professor, retired, University of Illinois at Chicago. Dr. Sietsema is also an expert on respiratory protection and an assistant professor at the University of Illinois at Chicago”).
On July 16, Brosseau and Sietsema added a statement to their review which began: “The authors and CIDRAP have received requests in recent weeks to remove this article from the CIDRAP website.” CIDRAP director Osterholm refused to be intimidated by these “requests,” and he instead provided Brosseau and Sietsema with an opportunity to respond to criticism; and they made it clear that they are not “anti-maskers,” and that they only were conveying what is known about mask protection. If you are interested in what scientists know and do not know about the protection provided by various types of masks—including N-95 respirators, surgical, and cloth ones—I strongly recommend that you read Brosseau and Sietsema’s careful review.
Prior to the CDC flip flop on cloth mask recommendations, the phrase repeatedly used by public health officials, not just those at CIDRAP, about why they did not recommend such mask use was “a false sense of security.” It was believed that if people were told that cloth masks were protective that—even if they were also told of the greater importance of social distancing (“physical distancing,” notes CIDRAP’s director Michael Osterholm, is the better term)—then many people would be lax about physical distancing.
This nightmare of public health authorities came true. One glaring example was that after the CDC told Americans not to travel on Thanksgiving, many Americans simply blew that recommendation off, and there were airport scenes throughout the nation with everybody masked up awaiting boarding—inches from one another—and most likely majorly spreading the virus.
Between March 18, when Jay Butler told the American people that the CDC does not recommend the use of masks “primarily because there’s not a lot of evidence that there is benefit,” and early April, when the CDC reversed this recommendation, there was no new mask research to justify such a reversal, a fact documented by CIDRAP director Michael Osterholm (more later on this).
To say that Michael Osterholm’s scientific credentials in the areas of infectious diseases and epidemiology are impressive is an understatement (see bio), and the Des Moines Register gives us some insight into the fiber of this Iowa native: “He has described his father as a bullying alcoholic who left the family after Osterholm stood up to him during his senior year of high school.”
Osterholm has a history of accepting unpopularity if that was the cost of saving lives. In 1984, following Secretary of Health and Human Services Margaret Heckler’s announcement that we would have an HIV vaccine within three years, Osterholm responded to the media, “Until we have a ‘beam me up Scotty machine,’ or some kind of new breakthrough technology, I didn’t understand how this vaccine would work.” Osterholm recalls, “My critical concern was that we couldn’t let our guard down; we had to maintain all the efforts we were promoting to support people not to become infected through their personal choices of behavior.” Soon after Osterholm’s 1984 buzzkilling remarks, he spoke at a meeting in which a group of gay businessmen were in attendance, and he recounts,“When I was asked a question about the prospects for a vaccine, some of them got up and left in a very public display of their disagreement with my answer. Today I sit here in 2020, some 36 years later, and we’re not close to having an HIV vaccine.I take no comfort in having been right about that.”
On June 2, 2020, in Special Episode: Masks and Science, in an interview with Chris Dall (click here for transcript), Osterholm attempts to clear up the mask confusion. Osterholm recounts that on April 3, 2020, the CDC reversed its earlier mask recommendation, with the CDC proclaiming: “In light of this new evidence, CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g. grocery stores and pharmacies) especially in areas of significant community-based transmission.” This “new evidence,” Osterholm explains, was not at all evidence of mask effectiveness but studies demonstrating presymptomatic or asymptomatic transmission. Osterholm explains the following about the CDC flip flop: “The recommendation was published without a single scientific paper or other information provided to support that cloth masks actually provide any respiratory protection. There were seven reports or papers listed as ‘Recent Studies’ that detailed the risk of presymptomatic or asymptomatic transmission. There was nothing about how well such masks protect against virus transmission, particularly from aerosol-related transmission.”
Osterholm could not hide his disappointment and anguish: “Never before in my 45 year career have I seen such a far-reaching public recommendation issued by any governmental agency without a single source of data or information to support it. This is an extremely worrisome precedent of implementing policies not based on science-based data. . . . If these cloth masks do little to reduce virus transmission due in large part to their lack of protection against aerosol inhalation or exhalation, do we not have an obligation to tell the public of this potential limitation? How many cases of COVID-19 will occur when people using cloth masks and not understanding the limitations of their effectiveness participate in activities with others where virus transmission does occur?”
He continued, “I believe this cloth mask recommendation situation represented the other low point in CDC’s response to COVID-19 with the other being the failed testing situation [a major CDC debacle discussed in depth in the Propublica article]. I have talked to close friends and colleagues who work at CDC and who were involved on the periphery with this issue. They universally disagreed with the publication of this recommendation based on the lack of information supporting that cloth masks actually reduced the risk of virus transmission to or from someone wearing a cloth mask.”
Directing listeners to the CDC website, Osterholm noted, “You’ll not find one piece of information supporting that cloth masks are effective in reducing respiratory virus transmission. Ironically, what you will find is that the National Institute for Occupational Safety and Health [NIOSH], an institute that is part of CDC, states on the CDC site the following; ‘A surgical mask does NOT provide the wearer with a reliable level of protection from inhaling smaller airborne particles and is not considered respiratory protection’. . . . And remember that NIOSH is recognized as one of the world’s leading authorities on respiratory protection. Frankly, I believe that this issue of CDC recommending the use of cloth masks without any substantial scientific evidence that they provide such protection, and in conflict with their own expertise in NIOSH, has helped create the immense confusion that exists around this issue. In short, I believe that CDC has failed the public by creating this confusion.”
In the 2020 climate of tribal attacks on critically-thinking truth tellers, in order for CIDRAP to survive and continue to disseminate only scientific truths, Osterholm needed that same kind of strength required to stand up to a bullying alcoholic father. He reports, “In all my years in public health, I’ve never experienced this blowback, even with the influenza vaccine or HIV vaccine related issues. We’ve actually had people who’ve contacted funders of CIDRAP, demanding that they defund us, because of my position on cloth masking.” While CIDRAP, unlike the CDC, is not a U.S. governmental institution that has to answer to Trump, its survival within the auspices of the University of Minnesota depends on the funding of various foundations.
Osterholm, Brosseau, and Sietsema make clear that they are not “anti-maskers.” Osterholm repeats that “masks may provide some benefit in reducing the risk of virus transmission.” However, the key word is may, and the critical point is that if in fact there proves to be some mask benefit, “at best it can only be anticipated to be limited.” He regularly notes the following scientific truth: “Distancing remains the most important risk reduction action. . . . I understand why many would argue that some benefit is better than none, but I believe that we must approach this assumption with caution. The messaging that dominates our COVID-19 discussions right now makes it seem that if we are wearing cloth masks you’re not going to infect me and I’m not going to infect you. I worry that many people highly vulnerable to life-threatening COVID-19 will hear this message and make decisions that they otherwise wouldn’t have made about distancing because of an unproven sense of cloth mask security.”
Science and basic math dictated that the life-saving response to COVID-19 should consist in, as it was called in New Zealand, “going early and go hard.” In “Lessons from New Zealand’s COVID-19 Outbreak Response,” published by the prestigious medical journal the Lancet (October 13, 2020), there is no mention of masks; rather it concludes: “The lockdown implemented in New Zealand was remarkable for its stringency and its brevity. . . [relying on] early decisive reactions from health authorities, performant surveillance systems, and targeted testing strategies as much as stringency.” Prime Minister Jacinda Ardern and the New Zealand government took seriously scientific truths; and they implemented policies based on what science told them clearly mattered. Honesty with the pubic by New Zealand governmental and public health authorities provided them with credibility, resulting in New Zealanders’ trust that financial and social sacrifices early on caused by a stringent lockdown would reap great benefits later. Ardern, like Trump, was also up for re-election, but she focused solely on the lives of New Zealanders, who rewarded her for her policies that resulted in New Zealand suffering only 25 COVID-19 deaths. On October 17, 2020, the BBC headline read: “Jacinda Ardern’s Labour Party Scores Landslide Win.”
New Zealand authorities, similar to scientists Osterholm, Brosseau, and Sietsema, are not anti-maskers—while studies with poor-to-no science have been used to promote masks, this same lack of science also exists in anti-mask studies, including the most loudly trumpeted one, commonly called DANMASK-19, conducted in Denmark during April and May 2020 (published in November 2020 as “Effectiveness of Adding a Mask Recommendation to Other Public Health Measures to Prevent SARS-CoV-2 Infection in Danish Mask Wearers”). In DANMASK-19, 3030 participants were randomly assigned to the recommendation to wear masks, and 2994 were assigned to control; 4862 completed the study. Infection occurred in 42 participants recommended masks (1.8%) and 53 control participants (2.1%). This was trumpeted by anti-maskers to “prove” that masks have little value. However, as Noah Haber, a leading critic of this study pointed out, “This wasn’t a trial about mask-wearing; it was a trial about messages to wear masks . . . . Any protective effect those masks may have had was dampened by the fact that many of the participants didn’t actually use them: In the end, less than half the people in the intervention group reported having worn the masks as recommended.” (Haber and colleagues registered all their concerns about the study design in September 2020 before the study was published). Science does not proclaim that cloth masks do not work but rather that they may or may not work, and that to the extent that they do work, they may not provide much benefit. In contrast, the science is clear that physical distancing is effective.
Finally, before submitting this article to CounterPunch, I rechecked the CDC website to see if they finally found credible scientific evidence for mask effectiveness. Had an amazing research team actually conducted a randomized controlled trial (RCT) on a large number of subjects in which relevant variables were truly controlled so that the comparison of subject infection rates could provide at least a modicum of evidence concerning mask effectiveness? No, not even close to that.
Specifically, updated on November 20, 2020, the CDC posted Scientific Brief: Community Use of Cloth Masks to Control the Spread of SARS-CoV-2. In the section “Human Studies of Masking and SARS-CoV-2 Transmission,” the CDC did acknowledge: “Data regarding the ‘real-world’ effectiveness of community masking are limited to observational and epidemiological studies.” In other words, they had no RCT studies. Then the CDC described their first—which is likely what they consider their strongest—of five non-RCT studies: “An investigation of a high-exposure event, in which 2 symptomatically ill hair stylists interacted for an average of 15 minutes with each of 139 clients during an 8-day period, found that none of the 67 clients who subsequently consented to an interview and testing developed infection. The stylists and all clients universally wore masks in the salon as required by local ordinance and company policy at the time.”
This hair stylist report might be interesting to many in the public, but for scientists, this is closer to an anecdote than a scientific study; and for scientists, anecdotal evidence is not scientific evidence. Specifically, this is an observational, non-RCT report with two hair stylists in which more than half of their clients are omitted from the results. If you read the author’s report (“Absence of Apparent Transmission of SARS-CoV-2 from Two Stylists After Exposure at a Hair Salon with a Universal Face Covering Policy), it states: “Overall, 67 (48.2%) clients volunteered to be tested, and 72 (51.8%) refused.” The authors themselves tell us that their study has “at least four limitations”: (1) only a subset of the clients were tested; (2) no information was collected regarding use of other personal protective measures; (3) clients who interacted with the stylists immediately before the stylists became symptomatic were not recruited for contact tracing; and (4) the mode of interaction between stylist and client might have limited the potential for exposure to the virus.
The CDC posting of this study as its top human-study evidence for mask effectiveness, for me, appeared so pathetic that I had a second reaction that was darkly hopeful. Perhaps some terrified CDC scientist—afraid of retaliation but wanting to signal that the CDC’s scientific evidence of cloth mask effectiveness falls somewhere between nada and bupkis—posted this study to both survive and signal the truth that they have nothing, and that everybody should focus on physical distancing. Maybe that CDC employee was doing what Sigmund Freud did in order to be allowed to exit Austria in 1938.
According to Freud’s biographer Ernest Jones (The Life and Works of Sigmund Freud), in order for him to be permitted to leave Austria, the Gestapo demanded that Freud, who was by then world famous, sign a document stating: “I have been treated by the German authorities and particularly by the Gestapo with all the respect and consideration due my scientific reputation, that I could live and work in full freedom, that I could continue to pursue my activities in every way I desired. . .” The clever Freud, gaging the Gestapo’s inability to distinguish between a true compliment and sly sarcasm, told them that he had no compunction about signing the document but asked if he could add this sentence to it: “I can heartily recommend the Gestapo to anyone.”
I wonder if Jay Butler and his team at the CDC, forced by Trump and Pence to delete guidance that could have saved lives, now wish that they would have imitated Freud’s tactic by asking if they could add this sentence to their coerced guidance statement: “I can heartily recommend Donald Trump and Mike Pence to anyone.”
Bruce E. Levine, a practicing clinical psychologist often at odds with the mainstream of his profession, writes and speaks about how society, culture, politics and psychology intersect. His most recent book is Resisting Illegitimate Authority: A Thinking Person’s Guide to Being an Anti-Authoritarian―Strategies, Tools, and Models (AK Press, September, 2018). His Web site is brucelevine.net