Saturday, September 12, 2020

Politics and medicine, at Stanford and in Washington--an open letter from Stanford docs about corona virus policies

 Politics and medicine can combine poorly, particularly in a politicized pandemic.

Here's an open letter from over a hundred faculty at Stanford's Medical school, disowning the positions about pandemic policies taken by one of their former colleagues, now in Washington, by way of Fox News. (Here's the letter in full; to see the signatories click on the link...)

An Open Letter from Stanford Doctors [Update: the letter has been taken down from the Stanford medicine website, but here is another copy...]

"As infectious diseases physicians and researchers, microbiologists and immunologists, epidemiologists and health policy leaders, we stand united in efforts to develop and promote science-based solutions that advance human health and prevent suffering from the coronavirus pandemic. In this pursuit, we share a commitment to a basic principle derived from the Hippocratic Oath: Primum Non Nocere (First, Do No Harm).

"To prevent harm to the public’s health, we also have both a moral and an ethical responsibility to call attention to the falsehoods and misrepresentations of science recently fostered by Dr. Scott Atlas, a former Stanford Medical School colleague and current senior fellow at the Hoover Institute at Stanford University. Many of his opinions and statements run counter to established science and, by doing so, undermine public-health authorities and the credible science that guides effective public health policy. The preponderance of data, accrued from around the world, currently supports each of the following statements:

●  The use of face masks, social distancing, handwashing and hygiene have been shown to substantially reduce the spread of Covid-19. Crowded indoor spaces are settings that significantly increase the risk of community spread of SARS-CoV-2.

●  Transmission of SARS-CoV-2 frequently occurs from asymptomatic people, including children and young adults, to family members and others. Therefore, testing asymptomatic individuals, especially those with probable Covid-19 exposure is important to break the chain of ongoing transmission.

●  Children of all ages can be infected with SARS-CoV-2. While infection is less common in children than in adults, serious short-term and long-term consequences of Covid-19 are increasingly described in children and young people.

●  The pandemic will be controlled when a large proportion of a population has developed immunity (referred to as herd immunity) and that the safest path to herd immunity is through deployment of rigorously evaluated, effective vaccines that have been approved by regulatory agencies.

●  In contrast, encouraging herd immunity through unchecked community transmission is not a safe public health strategy. In fact, this approach would do the opposite, causing a significant increase in preventable cases, suffering and deaths, especially among vulnerable populations, such as older individuals and essential workers.

"Commitment to science-based decision-making is a fundamental obligation of public health policy. The rates of SARS-CoV-2 infection in the US, with consequent morbidity and mortality, are among the highest in the world. The policy response to this pandemic must reinforce the science, including that evidence-based prevention and the safe development, testing and delivery of efficacious therapies and preventive measures, including vaccines, represent the safest path forward. Failure to follow the science -- or deliberately misrepresenting the science – will lead to immense avoidable harm.

"We believe that social and economic activity can reopen safely, if we follow policies that are consistent with science. In fact, the countries that have reopened businesses and schools safely are those that have implemented the science-based strategies outlined above.

"As Stanford faculty with expertise in infectious diseases, epidemiology and health policy, our signatures support this statement with the hope that our voices affirm scientific, medical and public health approaches that promote the safety of our communities and nation."


Here's a recent NY Times story on Dr. Atlas, a radiologist:

A New Coronavirus Adviser Roils the White House With Unorthodox Ideas

Dr. Scott Atlas arrived at the White House as a coronavirus contrarian, questioning controls like masks. He has angered top health officials while pushing a suite of disputed policy prescriptions.

By Noah Weiland, Sheryl Gay Stolberg, Michael D. Shear and Jim Tankersley,  Sept. 2, 2020

"Before joining the task force, Dr. Atlas pitched his ideas as a health commentator on Fox News, which is in part how he attracted Mr. Trump’s attention. His arrival at the White House has coincided with less visible roles for Dr. Birx and Dr. Fauci, the director of the National Institute for Allergy and Infectious Diseases."


Of course, medicine isn't the only kind of science that has been caught up in Washington lately. (I write this from smoky California, where climate change seems quite real).

Nor is it the only part of medicine that has been caught up in politics around the world: I'm reminded of yesterday's post about the politics of global health care.  Science seems to be slowly gaining on politics there, and so I'm hopeful that's a general trend, although sometimes slow and uneven, with a high ratio of heat to light.

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