COVID misinformation from infectious disease experts

Last update: Saturday 2/4/23 

Now that the COVID pandemic has morphed into an endemic, neither the conservative MAGA media nor the liberal/progressive mainstream pays much attention to COVID developments. This only leaves U.S. infectious disease experts as a significant potential source of COVID misinformation. 

A. Broad guidance contradicted by facts

Broad guidance provides a framework that facilitates acceptance of more specific guidance. As consequence, erroneous broad guidance facilitates erroneous specific guidance. 

Arguably the most important example of erroneous broad guidance is the notion that "We are all in this together." This sentiment should have meant that COVID might pose greater risks to some persons than to others, but posed unacceptable levels of risk to everyone ... but it didn't.

Unfortunately, the disproportionate risks that COVID poses to older persons and to others who have health co-morbidities dwarf the risks it poses to younger persons.  Indeed, COVID deaths and hospitalizations in ICUs of persons under 18 have been rare events, even among young persons who were unvaccinated. The exceptional victims, of course, have been young persons afflicted with co-morbidities. These facts have been documented by data on the CDC's Website since 2020.

• For example, see the CDC's eye-popping chart of death rates by age groups "COVID-19 Weekly Cases and Deaths per 100,000 Population by Age, Race/Ethnicity, and Sex -- Deaths, All Age Groups" ... Microsoft Power B1 -- Slide #8 "COVID-19 Weekly Deaths per 100,000 by Age Group"  

Accepting the notion that we are all in this together makes it easier to accept the notion that all of us should therefore receive the same guidance, i.e., one size fits all. Consider the following examples: 

1) Guidance that advised lock downs in all fifty states at the same time in the spring of 2020. This recommendation from the Trump Task Force and the CDC initiated the politicization of the pandemic. 

• The one-size-fits-all recommendation to lockdown all states yielded high compliance in New York, California, and other populous coastal states because a high percentage of their residents had friends and workplace associates, or had friends of friends and associates of associates who knew persons who had been infected, hospitalized, or died.
  
  However, lockdown guidance in states wherein the virus did not attain substantial presence until the summer of 2020 yielded limited compliance because their residents had few if any members of their broader social and workplace networks who had been infected, hospitalized, or died. Nevertheless, low levels of compliance had outsized negative impacts on local economies and local  schools systems. The mismatched impact of COVID itself vs. the economic and educational impact of limited lockdowns is well described in the following NY Time article. This mismatch triggered widespread doubt in low/no COVID states about the dangers posed by COVID. Indeed, many residents of those states thought that COVID was a hoax. 
  -- "A Striking Disconnect on the Virus: Economic Pain With Little Illness", Michael H. Keller, Steve Eder and Karl Russell, NY Times, 6/6/20
  
  As it happened, the high impact/high compliance states were "blue" states; wheres the low impact/low compliance states were "red" states. Unfortunately, this initial political coincidence was reinforced again and again long after the residents of red states suffered substantial levels of COVID infections, hospitalizations, and deaths

2) Guidance that recommended that non-vulnerable persons receive booster shots in the Fall 2021. The Biden administration pushed the FDA and the CDC to issue a one-size-fits-all recommendation that booster shots be given to everyone, despite the fact that the data available at that time did not support boosters, except for older and/or health compromised persons. The Biden administration's political interference received pushback and resignations from some FDA experts

• "Two Top F.D.A. Vaccine Regulators Are Set to Depart During a Crucial Period", Noah Weiland and Sharon LaFraniere, NY Times, 8/31/21 

Nevertheless the FDA and the CDC eventually approved booster shots for millions of Americans who were not older or health compromised. Here's an excerpt from a NY Times article that places their compliance in context: 

" [The CDC Director's] approval of recommendations made by a scientific advisory committee brings the country closer to fulfilling President Biden’s promise in August to offer boosters to all adults ... That pledge angered many experts, including some advising the Food and Drug Administration and the C.D.C., who said that scientists had not yet had a chance to determine whether boosters were actually necessary."

 --  "C.D.C. Recommends Covid Booster Shots for Millions of Americans", Apoorva Mandavilli, NY Times, 10/22/21  

Ironically, in February 2022, the CDC reported that boosters had only provided substantial additional protection for older recipients, i.e., one size did not provide benefits to all.

• "Younger Americans Benefited Less From Booster Shots Than Older People", Apoorva Mandavilli,  NY Times, 2/4/22 ... Note: Mostly Delta infections were analyzed, very little Omicron  

B. Our divided nation could not be "all in this together"

In the years immediately proceeding the pandemic and throughout the pandemic our nation has been more divided than at any time since the years immediately preceding the Civil War. The January 6, 2021 insurrection in the nation's capitol was the most violent manifestation of our divisions. Accordingly, it was incredibly naive for the CDC and other public health officials to expect everyone to pull together. 

The next few bullets provide selected highlights from the report "National Exit Polls: How Different Groups Voted" that was published by the NY Times on 11/3/20 after the 2020 elections. The bullets denote the party affiliations of the percentage of voters who agreed with three statements.  (Note: The designation 'Dems" for Democrats or "GOP" for Republican merely indicates how a person voted, not their party registration.)

• Which is more important? 
  Containing the coronavirus now, even if it hurts the economy ==> Dems (79%), GOP( 19%)
  ... or ...
  Rebuilding the economy now, even if it hurts efforts to contain the coronavirus ==> Dems (20%), GOP (78%)
  
  
• Wearing face masks in public is a personal choice ==> Dems (24%), GOP (73%)
  
  
• Wearing face masks in public is a public health responsibility ==> Dems (64%), GOP (35%)

This November 2020 poll provided succinct and scary documentation of the depth of the politicization of the pandemic. Republican voters were far more risk tolerant than Democratic voters with regards to COVID. 

As consequence, the CDC and other public health agencies were not getting through to most GOP voters. Nevertheless public health officials continued their repetition of the same messages ==> "We're all in this together. I wear my mask to protect you; you wear your mask to protect me. One size guidance fits all". 

When faced with evidence of their failure to resolve "red" state rejection of their guidance, public health experts from the CDC and from other agencies rolled their eyes and threw up their hands in pained exasperation. Unfortunately, eye rolls and hand throws do not resolve political conflicts, nor is it effective medical practice to do so. Faced with recalcitrant patients who refuse to submit to prescribed treatments, effective doctors don't roll their eyes and throw up their hands; they look for other treatments that their patients might find more acceptable. 

C. Risk tolerant messages that were more acceptable to GOP voters

Our states have been called "laboratories of democracy". So it's reasonable to wonder: Was any GOP governor of any "red" state able to use CDC data to provide effective public health initiatives that limited severe illness and death from the virus? A correct answer to this question would be "Yes, Governor Ron DeSantis of Florida". 

Let's pause a moment to acknowledge that many readers are now rolling their eyes and throwing up their hands with pained exasperation on their faces. DeSantis? DeSantis!!!  He's a ruthless, racist culture warrior! He's a MAGA-hatted, Trump successor wannabe? No! No!!! He flagrantly rejected every pandemic mitigation and vaccination guidance and thereby inflicted thousands of unnecessary cases of severe illness and death on Florida, right?

Wrong. The governor may indeed be a ruthless, racist culture warrior and a MAGA-hatted, Trump successor wannabe. But his successful management of COVID in Florida is what Vice President Al Gore might call "an inconvenient truth", a truth about which the mainstream media deliberately misinformed their liberal/progressive readers by ignoring it. Yes, the Times published articles about surges of infections in Florida and articles about the governor's opposition to COVID mandates; but the Times never published stories about severe illness overwhelming Florida's hospitals or surges in deaths overwhelming Florida's morgues ... because these dire expectations did not occur. 

Question #1 -- How did he do it? 

Answer #1 -- He gave highest priority to vaccinating Florida's oldest residents. To this end he mobilized state resources to provide residents who were 65+ and their caregivers with extensive opportunities to become vaccinated ... opportunities, not mandates

• "Governor Ron DeSantis Announces His “Florida Leads” Budget Proposal for FY 2021-2022", Press Release, Governor Ron DeSantis, 1/28/21
  -- "The cornerstone of my mission has been to protect our most vulnerable residents and put Florida’s Seniors First, while ensuring that every Floridian can go to school, go to work, and provide for themselves and their families."
  

... and, oh yes, the governor assumed that his constituents throughout 2021/2022 would be more like GOP voters in November 2020 than Democratic voters. In other words he assumed that they would agree that a large increase in mild to moderate infections followed by a modest increase in death rates would be an acceptable price to pay for enabling the vast majority of his electorate to live in a normal economy and send their kids to normal schools.

His assumption proved to be correct. He was first elected governor in 2018 in a close election that required a recount; but his reelection in 2022 was a landslide triumph that reflected the appreciation of the overwhelming majority of Florida's electorate for the protection from COVID that the governor had provided without disrupting Florida's economy or its school systems.

Question #2 -- What CDC data might have guided the governor in his rejection of mandates?

Answer #2: 

1. CDC data that showed that vast majority of COVID deaths had been inflicted on his state's oldest residents; 
2. CDC data that showed that young people rarely died from COVID, even when they were not vaccinated; and 
3. FDA and CDC acceptance of the results of clinical trials published in late 2020 that showed that the new mRNA vaccines were about 95 percent effective in preventing infections against the original coronavirus variants.

Caveat
The COVID data savvy Governor DeSantis masterminded Florida's pandemic management from 2020 to late summer 2022, while acting as one of the nation's most energetic supporters of COVID vaccines. He is obviously not the same guy as the COVID data dummy "Governor DeSantis" who was recently satirized by a look-alike comedian on Saturday Night Live in a skit that was not broadcast on a Saturday night, as described in the following articles. 

• "Gov. DeSantis Incorrectly Claims Covid-19 Booster Makes You ‘More Likely To Get Infected’",  Bruce Y. Lee, Forbes, 1/19/23
• "Fact check: DeSantis says newest booster increases chances of COVID infection. Not true", Yacob Reyes, Miami Herald, 1/26/23

In order to avoid confusing our two DeSanti, the DeSantis who made vaccines the cornerstone of Florida's pandemic management will hereafter be referred to as the old Governor DeSantis.

Editor's note -- My eyes are rolled, my arms thrown high, and my face is filled with pained exasperation ... :-(

D. COVID deaths in Florida vs California

So how well did the old Governor DeSantis do from the beginning of the pandemic until the summer of 2022? And compared to what? 

Florida is the third most populous state in the Union, so it's reasonable to compare COVID death rates in Florida with COVID death rates in California, California being the most populous state and the bluest of blue states with regards to strict adherence to the CDC's risk averse pandemic guidance. (Note: The second most populous state is Texas, whose governor is another risk tolerant Republican)

• Table 1 (below) shows that Florida vaccinated about the same percent of its 65+ population as California
• Table 2 (subsequent) shows that Florida's death rate per 100,000 for persons in the 65+ population group was about the same as California's

Table 1. Fully Vaccinated % of Age Groups by State

			Vax_65+	Pop_65+		Percent Vax_65+
California			5,298,788	5,838,115		90.8
Florida			4,106,078	4,497,337		91.3

Table 2. Deaths per 100,000 in Ages 65+ by State

	California	Florida
TotDeaths65plus	66,944	51,942
TotPop65plus	5,644,497	4,347,912
DeathsPer100K65plus	1,186	1,195

The editor of this blog extracted data for COVID deaths by age groups from the CDC's Provisional COVID-19 Deaths by Sex and Age dataset in June 2022. Populations of the 65+ age groups were obtained from the U.S. Census Bureau's NST_EST2021_POP table. His complete analysis was included in the following note on this blog:

• "Elections 2024 ... Risk averse Democrats vs. risk tolerant Republicans ... Part 2 (Age groups and vaccinations)", Last update: 6/8/22

E. Estimate of Lives Lost, i.e., Lives that might have been saved by CDC guidance

The old DeSantis vaccinated the about same percentage of seniors as did the  governor or California, so the death rates among seniors was about the same in both states. But what about the lives that were lost in other age groups as result of his rejection of all guidance for those groups, e.g., vaccines, face masks, remote K-12 classes instead of in-person, quarantines, lockdowns, etc, etc, etc.??? How many lives were lost in younger age groups?

The editor of this blog derived a rough estimate of the number of lives that were lost in Florida as a result of its governor's rejection of mitigation mandates. His complete analysis was included in the following note on this blog. 

• "Florida's Governor Ron DeSantis: COVID Rebel or Pioneer??? (Part B)", Last update: 7/3/22

The next few bullets summarize his most important findings from the beginning of the pandemic until the summer of 2022.

• California -- 26.6 percent of all deaths were middle aged, i..e, 40 to 64; 70.3 percent were 65+. So the two oldest age groups accounted for 96.9 percent of deaths; all younger age groups, i.e., all under 40, only accounted for 3.1 percent of deaths; and school age, under 18, only accounted for 0.1 percent. 
  
  
• Florida -- 23.3 percent of deaths were middle aged, i.e., 40 to 65; 74 percent were 65+. So the two oldest age groups accounted for 97.3 percent of deaths; all younger age groups, all under 40, only accounted for 3.1 percent of deaths; and school age, under 18, only accounted for 0.1 percent.

Now for the editor's analysis of these findings:

• Deaths of school age children in both states was only 0.1 percent. COVID deaths among school age children were rare events in both states, regardless of vaccinations. Had death rates among school age children not been rare, their parents would have demanded remote classes. Had the old Governor DeSantis refused their demand, he probably would not have been re-elected.
  
  
• Second, deaths for persons under 40 were the same in both states, i.e., 3.1 percent. So the only lives lost would be in the middle age group, i.e., 40 to 64.
  
  
• California's middle age COVID death rate was found to be 208 per 100,000; Florida's was 240. So the lives "lost", i.e., the lives that might have been "saved" had Florida implemented the CDC's guidance = 32 per 100,000 from the start of the pandemic until the summer of 2022.
  
  
• Florida's middle age population was 5,516,131, so the number of lives lost/saved = 5,516,131 * (32 / 100,000) = 1,765 over the course of the pandemic's 2.5 years ... or 1,765  / 2.5 = 706 deaths per year
  

The overwhelming majority of Florida's voters regarded an additional 706 deaths per year as a modest and acceptable increase in COVID deaths each year, i.e. as an acceptable price to pay for enabling the rest of its 21,477,737 residents to return to normal living and send their kids to normal schools. So they reelected the old Governor DeSantis in a landslide in November 2022.

F.  What the new Governor DeSantis may have misinterpreted

On 11/18/22, the CDC posted a new dataset on its Website called "Rates of COVID-19 Cases or Deaths by Age Group and Updated (Bivalent) Booster Status". As per its name, the dataset reports the number of COVID infections and deaths by age group and primary vaccination or bivalent booster status. The editor of this blog has not yet tabulated this data for the following reasons:

• During the late spring and summer of 2022, the CDC, the FDA, and other public health agencies encouraged everyone to receive the forthcoming bivalent booster that would be more effective than the original booster shots because they also targeted the Omicron family 
  
  
• The messaging sometimes implied that the new booster would increase a recipient's resistance to infection. But Omicron continued to produce new sub-variants that were not covered by the testing procedures for the new booster. By the time the new booster was made available in the fall of 2022, its primary advantage proved to be substantially increased resistance to hospitalization and death against the latest Omicron sub-variants, but recipients could could still become infected.
  
  
• Now let's consider the context of the arrival of this new booster. It's generally recognized that most COVID tests are now self-tests whose results are not reported to public health agencies, so they are not included in the CDC's infection datasets, including the new dataset that reports the bivalent booster status of infected persons.
  
  By now there have been so many infections and reinfections of persons who had received previous boosters, that infected boosted persons who test themselves don't pay much attention to asymptomatic, mild, or even moderate infections.
  
  
• One can anticipate an important exception to these generalizations ==> people who received bivalent boosters with the expectation that the booster would either make them immune to new infection or substantially decrease their chances of getting infected. These folks would be more likely to seek a PCR test from a professional facility to confirm a home positive test, especially if they experienced substantial symptoms that might be caused by COVID. The professional test site would report their infection. Therefore infected persons who had just received the new bivalent boosters might be overrepresented in the CDC's new dataset for a while.
  
  
• This overrepresentation might continue until most people get used to the idea that one can receive a bivalent booster and still become infected ... but the infection will probably be asymptomatic or mild or even moderate ... Paxlovid or other medical treatments are probably not required ... so they should just wait a few days to see if the symptoms go away ... the same as they did after receiving previous boosters.

Bottom line:  The new Governor DeSantis may have drawn a sweeping, incorrect conclusion from a dataset that may be inadvertently misleading ... for a while. 

As per the "Caveat" in a preceding section of this note about the governor's latest COVID pronouncements, he is a very imperfect messenger for a policy that might have been more acceptable to GOP voters in red states than the "We're all in this together, one size fits all" dogma propounded by the CDC and the mainstream liberal/progressive media. A forthcoming note on this blog will estimate the number of lives that might have been saved in Texas had the GOP governor of that red state adopted the DeSantis pandemic management policy. 

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Links to related notes on this blog:  

• "COVID FAQs Nov22", Last update:  11/23/22