Tuesday, September 1, 2020
Meet the New Yes Man on Trump’s COVID Task Force: Dr. Scott Atlas Wants U.S. to Adopt Herd Immunity
https://www.democracynow.org/2020/9/1/trump_coronavirus_scott_atlas_herd_immunity
As the number of confirmed COVID-19 cases in the United States passes 6 million, with a death toll of over 183,000, the Trump administration is loosening coronavirus restrictions, fast-tracking vaccine approval and disregarding safety tests, and now one of Trump’s top medical advisers is pushing for the country to adopt a controversial “herd immunity” strategy, raising alarm among public health officials. Washington Post health reporter Yasmeen Abutaleb says Dr. Scott Atlas is not an epidemiologist and was brought on specifically because he would back President Trump’s position “about how the pandemic was going, that the threat was receding, that the country should reopen.” We also speak with Yale epidemiologist Gregg Gonsalves, who argues the U.S. is already following an “implicit” herd immunity policy. “They realize it’s politically toxic, so they don’t want to use the phrase, but if it walks like a duck and quacks like a duck, it is a duck,” he says.
Transcript
This is a rush transcript. Copy may not be in its final form.
AMY GOODMAN: The number of confirmed COVID-19 cases in the United States has topped 6 million, with a death toll of over 183,000. More than a million people tested positive over the past three weeks in the United States, and over 4,000 Americans died of COVID-19 just during last week’s Republican National Convention alone. That’s more than the total number of people killed in the 9/11 attacks.
This comes as the Food and Drug Administration has approved the use of remdesivir for all patients hospitalized with COVID-19, despite a lack of published scientific support. Meanwhile, the FDA has ousted its top spokeswoman and a PR consultant, just days after FDA Commissioner Stephen Hahn apologized for overstating the positive results of using blood plasma as a treatment for COVID-19. Under enormous pressure from President Trump, who called the FDA part of the “deep state,” the FDA recently gave emergency use authorization for the plasma treatment. The FDA chief is now admitting the agency may also consider emergency use approval for a COVID-19 vaccine before Phase 3 trials are complete.
Meanwhile, the Centers for Disease Control and Prevention has quietly dropped its recommendation that people quarantine for 14 days after traveling from an area with a high rate of infection, even though public health experts say the move will undermine efforts to control the spread of the disease. The decision was reportedly made by the White House Coronavirus Task Force while top public health expert Dr. Anthony Fauci was undergoing surgery and recovering. The changes were backed by the task force’s newest member, Dr. Scott Atlas, a Fox News contributor and neuroradiologist from Stanford’s conservative Hoover Institution with no expertise in epidemiology or infectious disease. Atlas is the focus of a damning new report by The Washington Post headlined “New Trump pandemic adviser pushes controversial 'herd immunity' strategy, worrying public health officials.”
For more, we’re joined by one of the lead authors, Yasmeen Abutaleb, national health reporter for The Washington Post. Also with us, professor Gregg Gonsalves, assistant professor of epidemiology of microbial diseases at the Yale School of Public Health and co-director of the Global Health Justice Partnership.
We welcome you both to Democracy Now! Yasmeen, let’s begin with you. Why don’t you lay out what you found about the president’s new addition to the coronavirus task force, who he recently introduced. Tell us about Dr. Scott Atlas and what he’s pushing.
YASMEEN ABUTALEB: So, the president announced earlier in August that Scott Atlas was joining as a pandemic adviser. We know that he meets with the president almost every day. The administration brought him on because earlier this summer Trump had encouraged his advisers to look for a doctor or some sort of medical adviser with Ivy League or top university credentials who basically would argue what he wanted to hear about how the pandemic was going, that the threat was receding, that the country should reopen — basically, take the opposite tack of Dr. Birx and Dr. Fauci, who are two of the top doctors on the task force and who have said the pandemic is a threat in every part of the country. They’ve urged partial lockdowns in areas experiencing surges. They’ve encouraged state mask mandates. And those aren’t things the president really wants to hear. So, Scott Atlas is more in line with what the president wants to do and wants to hear on the pandemic. So, he’s said things like kids don’t get COVID, which there is no evidence for, and that they don’t spread it. He’s said that schools should reopen no matter what, that college sports should resume.
He’s also pushing this herd immunity strategy, which basically says that you let the coronavirus spread through most of the population, and you protect the most vulnerable populations, so nursing homes, prisons, you know, tightly congregated places. That’s impractical, because vulnerable people live with healthy people. And there also — the science on coronavirus is still evolving, so there are plenty of young, healthy people who get coronavirus and die or who develop long-term complications. So almost every public health expert we spoke with very much argued against this strategy, saying it was dangerous, and some of the dangers could even be unknown.
AMY GOODMAN: During a COVID-19 news conference on Monday in Tampa Bay, Florida, Dr. Scott Atlas of the White House Coronavirus Task Force was asked about your report that he’s pushing the herd immunity strategy.
DR. SCOTT ATLAS: Twenty-five-plus percent of our young adults, 18 to 25, have contemplated suicide in the past 30 days. This has really got to end. And we know the president here has a strategic and appropriate policy, which is protecting the vulnerable. We know who’s at risk here. It’s not everybody. It’s not about all the cases that’s the most important metric. It’s about saving lives by protecting the vulnerable, by preventing hospital overcrowding — which we are really doing well — and by opening the economy, opening the schools, because American lives are being destroyed.
AMY GOODMAN: Yasmeen Abutaleb, if you could respond? That was him speaking on Fox News.
YASMEEN ABUTALEB: Yeah, I mean, he is essentially advocating a herd immunity strategy there. He’s maybe not saying it explicitly, but he’s saying, you know, plenty of people are not vulnerable to this, just protect the most vulnerable — you know, the elderly, people with underlying health conditions. So, he’s not saying it explicitly, but those are the tenets of the strategy, that it’s not a big deal if it gets into the general population, and you just sort of want to sequester off the most vulnerable people and make sure they are protected. He also talks about preventing hospital overcrowding, but that’s really difficult to do if you’re letting the virus spread unchecked through the population.
JUAN GONZÁLEZ: And, Yasmeen Abutaleb, the issue here of herd immunity, I mean, Sweden is the biggest example that is held up in terms of a deliberate policy of a government to develop herd immunity. But could you talk about your understanding of how harmful it could be in the U.S., given the high percentage of Americans who have chronic conditions, whether it’s asthma, diabetes, obesity and so forth?
YASMEEN ABUTALEB: Right. I mean, I think one of the important things is Sweden has about a 10 million-person population, and the U.S. has 330 million people. The U.S. also has extraordinarily high rates of underlying health conditions that are known risk factors for coronavirus, so, like you laid out, obesity, heart disease, diabetes. All of these make people much more vulnerable for severe effects of coronavirus or more susceptible to dying from the disease. So, you know, this idea that you can separate the vulnerable from the healthy is just impractical. I mean, someone with diabetes lives in the same household as someone who’s otherwise healthy. Not every vulnerable person lives in a nursing home.
JUAN GONZÁLEZ: And in terms —
AMY GOODMAN: And, Gregg Gonsalves — oh, go ahead, Juan.
JUAN GONZÁLEZ: In terms of the CDC recommendation recently, the change against quarantining for 14 days if you’ve come from an area that has a high incidence rate of COVID-19?
YASMEEN ABUTALEB: Right. So, the CDC last week changed its testing guidance to say that asymptomatic people who come in contact with a confirmed infection don’t necessarily need to get tested. And we lay out in the article that there — you know, while the White House hasn’t formally embraced the strategy, there are policies that start to fall in line with the tenets of a herd immunity strategy.
So, unlike countries that are ramping up testing and contact tracing, and have been for some time, the U.S. seems to be moving in a direction of testing fewer people. So, this testing change last week saying you don’t need to test — or don’t necessarily need to test asymptomatic people who came into contact with a confirmed infection, the CDC estimates that up to 40% of cases are asymptomatic. And we know that the surge that we saw this summer in many parts of the country was largely driven by young, healthy people asymptomatically spreading the disease.
You know, we also laid out that they invoked the Defense Production Act to ramp up tests to nursing homes, but you haven’t seen them significantly ramp up testing in other parts of the country, whether for schools, businesses, just the general population. So you already see this strategy of let’s test and aggressively test these vulnerable populations that we know are most at risk, and just sort of not worry as much about the more general population. And at a roundtable yesterday that Scott Atlas was at, he said young, healthy people don’t need to get tested. He was still reiterating aspects of this.
AMY GOODMAN: So, I want to go to that response of Scott Atlas, directly responding to your report, Yasmeen.
DR. SCOTT ATLAS: I was shocked to see the story, because they never asked me for a comment, first of all. That’s — you know, there’s news, there’s opinion, and then there’s overt lie. And that was never a strategy that was advocated by me and the administration. The president does not have a strategy like that. I’ve never advocated that strategy. So, that whole discussion in The Washington Post was just really sort of irresponsible to write an article like that.
AMY GOODMAN: So, can you respond, Yasmeen Abutaleb? Did you reach out to Scott Atlas?
YASMEEN ABUTALEB: We did, and we updated the article to include it. We reached out through the White House three different times to give him a chance to comment, to ask for an interview. I think it was August 21st, 28th and 29th, both through email and through phone. So there was plenty of time and plenty of opportunity to comment.
And we know from several sources that he’s pushing this strategy. And if you just look at the public statements, I mean, he advocated a herd immunity strategy in an appearance on Fox that we also quoted in the article. At that event yesterday in Florida, he was also advocating tenets of a herd immunity strategy. So, you know, there was plenty of time to comment. He did comment after the fact. So, you know, that’s just not true that we didn’t reach out. And I think the policies and his public position speak for themselves.
AMY GOODMAN: I want to bring Gregg Gonsalves into this conversation, with the Yale School of Public Health. Professor Gonsalves, if you can respond to this issue of herd immunity and then go on to all the messages that are being changed right now, and then particularly talk about what Dr. Hahn, the head of the FDA, has just floated, the idea that the vaccine Phase 3 trial will not be done before they move ahead with making it available to the public? What’s happening here?
GREGG GONSALVES: So, a couple of things on herd immunity. I think Yasmeen’s article in The Washington Post deserves a Pulitzer. It was meticulously researched, thoroughly documented. And any attempt to suggest that it was filled with any kind of falsehood is not true.
I mean, many people in the public health community have watched this with horror, the sort of implicit herd immunity strategy, downplaying asymptomatic testing, now the withdrawal of the 14-day quarantine period for people moving from one part of the country to the other, which might be a red zone or hot zone, the still sort of inability to get the amount of PPE we need for our healthcare workers, let alone teachers and others who are going to be in high contact, close contact, high-frequency interactions with people.
So, herd immunity is the implicit policy of the United States. And I think they realize it’s politically toxic, and so they don’t want to use the phrase, but if it walks like a duck and quacks like a duck, it is a duck. And this is essentially a herd immunity strategy.
And it’s entirely risky for many of the reasons you mentioned. One is because we have many more people with underlying conditions in the United States. We also don’t have the social safety net or the healthcare infrastructure that many of the Nordic countries have. So, we won’t even be able to deal with the sort of impact of the deaths and suffering we’d see by a continuation of the White House’s strategy.
What Dr. Hahn has been doing at the FDA, first with the hydroxychloroquine emergency use authorization, now with the convalescent plasma emergency use authorization, is to do the bidding of the White House based on scanty data about treatments for coronavirus.
The danger about the vaccine EUA before Phase 3 trial results are out is much more dire, because we give treatments to the sick and, in this case, to many people who are hospitalized. Vaccines go to millions of people. We depend on them to be effective, so people don’t get the wrong impression about what they should be doing in terms of social distancing and other behavior because they’re vaccinated. And we depend on them to be safe. A vaccine is going to be an important long-term way to control the virus, and we need a public confidence in vaccines. Remember, pre-COVID, half of Americans don’t get vaccinated against seasonal flu. We’ve had outbreaks of measles and diphtheria and other childhood diseases because we have pockets of people who have skepticism about vaccines. And Dr. Hahn’s sort of willingness to play fast and loose with the data, when vaccine developers, researchers, immunologists, virologists are terrified that they’re going to sort of get out ahead of the data, again, because the president wants something by the end of October so he can bring it into the election week with him hoping for victory.
But, you know, this is three strikes for the FDA: hydroxychloroquine, convalescent plasma and a potential vaccine EUA. Harold Varmus, former NIH director, today, and Rajiv Shah, who’s head of the Rockefeller Foundation, have said, “Stop listening to the CDC,” because of their asymptomatic testing language, because of the stuff about quarantines. Now what are we going to do about the FDA? They’re not giving us reliable information about the things we put in our bodies, drugs and vaccines. It’s their basic statutory mandate, and they’re failing us right now.
JUAN GONZÁLEZ: And, Professor Gonsalves, what about this whole issue that even countries that did practice sharp lockdowns early on in the pandemic, like Spain, are now seeing a second wave of increasing infections? Your assessment of what should be the right policy here in the United States?
GREGG GONSALVES: So, one is, nobody said there was never going to be a second wave. And, in fact, many people, like Marc Lipsitch at Harvard and others, have talked about how this is going to sort of be a rolling pandemic around the world. Remember, Spain and Italy were later to lock down than some other countries in Europe and had very, very substantial epidemics.
The point is, we need to scale up testing. And as Yasmeen is saying, asymptomatics are key to that. Of course we’re going to diagnose people who are sick in the hospitals, but we need to know where the virus is spreading in communities. And then we can think about targeted lockdowns.
If we had done this in March and April, so lock down as we were supposed to, provide social and economic support so people could isolate at home without economic fears and without social fears, and scale up testing, contact tracing and isolation, we would be in a situation today where we wouldn’t be saying, “God, should I send my kids to school? Is there going to be an outbreak there?” Or I’m sitting at a university campus. Are we worrying about an outbreak of 100, 200, 500 student here on campus?
We never did the right thing. We can still turn around, but it really means scaling up testing among asymptomatics; getting this third relief bill out of Congress, and not a skinny bill, as Mitch McConnell is suggesting, but one that really provides support for the local and state governments, economic and social support for individuals to isolate and to social distance if they can; and a rapid scale-up of testing and PPE, and the things that we’ve been talking about left and right. You know, Scott Gottlieb is no flaming liberal. He has talked about this explicitly since March. People like Andy Slavitt, sort of on the liberal side, have done the same. This is not a bipartisan — this is a bipartisan sort of strategy that’s been articulated really since March and April. And the White House keeps turning a blind eye to it, sort of adopting conspiracy theories, finding people who will tell them what they want to hear rather than what really needs to be done.
AMY GOODMAN: Gregg Gonsalves, in one of a long series of tweets Monday, you wrote, “Dr. Atlas, a radiologist, has no training or expertise in infectious diseases, but what he does have are the words the President wants to hear: you can let the virus spread widely throughout the US if you just try to keep the elderly safe, open up everything and let ’er rip.” Talk more about who Scott Atlas is, why he’s now got the ear of the president, meeting with him almost every day, as Dr. Fauci is recovering from throat surgery, and what this means at a time — especially the asymptomatic issue. For so long we’ve been told people must be tested because asymptomatics can spread COVID-19. Kids are now gathering together all over the country to go to school. And this is exactly the point when the testing is becoming more and more difficult to get, and when he is talking about opening things up. Talk about who he is.
GREGG GONSALVES: So, look, Dr. Atlas has medical training. He’s a neuroradiologist. There are plenty of people who have general medical expertise who have been fine public health and agency leaders in the United States. You don’t have to be an infectious disease clinician or an infectious disease epidemiologist to do the right thing, but you should know when you’re getting out ahead of your skis.
And, you know, Dr. Atlas’s comments are so far from the mainstream of thinking in public health and clinical medicine on infectious diseases, it’s astounding. You know, he could have engaged experts, tried to figure out what the consensus view was, what we needed to do, and to advise the president in that way. But what he’s done instead is to sort of think about what the president wants to hear: “We’re doing great. We don’t need to do more tests. We can open up the economy, open up businesses, open up schools, open up universities. And we can sort of get through the epidemic in that way.”
And so, because of his appearances on Fox News, he caught the president’s and the White House’s attention, and that’s why he’s sitting in the place that he is, not because he has any specific expertise. He’s not edgy. He’s not contrarian. He’s just simply wrong, foolish and dangerous.
JUAN GONZÁLEZ: I wanted to ask you if you could put yourself in the shoes of a political leader in the United States or some of these other countries that are dealing with this situation and are finding small but significant portions of their populations actively resisting basic public health suggestions or recommendations by their governments about how to prevent the spread of the disease. What do you do with these folks that are — in Germany, for instance, there was a protest outside the German parliament of right-wing folks who are opposed to the lockdown measures in Germany. Could you talk about what you recommend political leaders do in this situation?
GREGG GONSALVES: Well, first of all, people like Angela Merkel have been actually pretty good at sort of rallying their country to do the right thing around social distancing, around understanding the risks presented by the pandemic. And so, her and Jacinda Ardern in New Zealand have been very good about rallying their countries around a sort of united, comprehensive response.
Of course there are always going to be people who don’t believe what they’re being told by their governments or, for some other reason, don’t want to comply with public health recommendations. Think, again, back to vaccination, about childhood vaccinations and what we see. And what you have to do is not to shame them and not to go after them in that way. You need to meet them where they’re at, try to figure out what’s going on. You need to build incentives into the system that helps them get to a better place than they were yesterday.
And so, yeah, I think there’s always going to be a minority of people in any given country who are resisting public health orders, who see public health as sort of an imposition on their sort of liberties. But even in the United States, remember, we did some great things this spring. We did beat down the virus in many places in this country because we took care of each other. We all stayed at home. We all social distanced. And so, we’ve shown alive that generosity and solidarity, that we even saw in this country, even though the president would be loath to admit it.
AMY GOODMAN: We want to thank you so much, Gregg Gonsalves, for joining us, a professor at the Yale School of Public Health, an epidemiologist. And thank you to Yasmeen Abutaleb, The Washington Post reporter who broke the story on Dr. Scott Atlas, the new adviser to President Trump on the coronavirus task force.
This is Democracy Now! When we come back, President Trump heads to Kenosha, Wisconsin, today, despite fierce opposition from the Wisconsin leadership. We’re going to look at a case that implicates the very local authorities who will be dealing with the Jacob Blake case. Stay with us.
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