Little Scotty Atlas: Boy Public Health Doctor

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"Either this nation shall kill racism, or racism shall kill this nation." (S. Jonas, August, 2018)

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"Herd immunity" is a public health construct that applies to vaccinated populations, not infected populations. As the Director General of the World Health Organization, Tedros Adhanom Ghebreyesus has said :

" 'Herd immunity is a concept used for vaccination [emphasis added], in which a population can be protected from a certain virus if a threshold of vaccination is reached.' . . . For measles, for instance, it is estimated that if 95% of the population is vaccinated, the remaining 5% will also be protected from the spread of the virus. For polio the threshold is estimated at 80%.

" 'Herd immunity is achieved by protecting people from a virus, not by exposing them to it,' Tedros said. 'Never in the history of public health has herd immunity been used as a strategy for responding to an outbreak, let alone a pandemic.' "

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As is well known, at the most recent Biden-Trump debate, on a day that the U.S. reached an all-time high in reported cases, Trump announced that "we are 'rounding the bend' (or words to that effect)." He continued an argument that he has been making since the "it's all a Democratic hoax designed to win the November election" claim which, with his media enablers at Fox" News", he has been making periodically since then. Oh those enablers. Responsible, with Trump, for so many unnecessary deaths, and economic, social, and educational pain and damage. And here comes another one (see below).

The SARS-Co-V-2 virus that causes the COVID-19 pandemic (or as I call its US version, the Trumpidemic2020Â ©) is a complicated one. It has characteristics, both in terms of the pathology it causes in the sick and how it spread in the population, that are far from completely understood. But it is well-understood, from the experience in those countries that have adopted such measures, that mask-wearing, social distancing, and carefully designed, phased shut-down of certain economic activities as well as the carefully-designed reopening of educational institutions, can significantly, although not entirely, limit its spread.

But for reasons that are not completely understood, the leader of the present world leader in disease, per capita, among the "developed" countries, D.J. Trump, doesn't see it that way. Doesn't like masks (cannot be just because they ruin his make-up, can it?), doesn't like social distancing (see his numerous gatherings, political and governmental, that are described as "super-spreader events,"), and becomes enraged with the thought of targeted shut-downs or what can be, for example, very costly changes in how K-12 education is carried out. (And of course, equipping the U.S. to deal with just such a virus was the task of the Obama-originated Pandemic Diseases Office which was disbanded by Trump.)

In order to advise the President and qualified members of the Administration on how to best deal with the pandemic, the now famous COVID-19 Task Force was assembled. It is (was) comprised mainly of medical, scientific, and public health advisors, with knowledge of the field of infectious disease. Until recently (see below) they happen to have supported the implementation of the measures described above. And those measures, from the beginning, have not fit in either with the President's, shall we say, unique understanding of the virus and the disease or his political/economic imperatives. This led from the beginning to his continually "turning-the-corner/it-will-just-disappear" approach to dealing with it. (Despite what he said on the nature of the disease to Bob Woodward, it is obvious by his actions and policies that he just doesn't get it. He was probably just repeating by rote something he had heard around the White House a time-or-two, which went in one ear and put the other.)

But recently he has found someone, who happens to have an M.D. attached to his name, who supports the President's approach. He is the now well-known Dr. Scott Atlas, whose primary qualifications have nothing to do with the medicine (infectious disease/epidemiology) or the public health (epidemic control) of this plague. No, he is a neuroradiologist --- that is a radiologist who is sub-specialized to look at images of the nervous system. (As a career public health physician myself --- a Professor of Preventive Medicine at StonyBrookMedicine for 43 years, that in itself makes me very nervous. As if this sort of public health problem would show up on an X-ray.) However, for this President, at this time, this man is highly qualified. He works at the far-right wing (and aptly named) Hoover Institution at Stanford University, and makes frequent appearances on Fox"News." And so here comes the suddenly qualified "expert," Little Scotty Atlas, Boy Public Doctor.

And what is Scotty pushing? Why something they call "herd immunity" (which of course as we found out at the beginning of this column, isn't). That is, as Scotty/Donny present it, if lots of people are just allowed to get sick, then eventually the whole population will become immune. Maybe, while we're waiting, an effective-and-safe-and-easy-to-widely-distribute vaccine will come along, and maybe similarly qualified treatments too (or maybe not). But in the meantime, with this disease, doing so, without doing the standard public health measures as well, that means that many people will get sick, and some significant proportion of them will die unnecessarily. But further, even if that weren't all true enough, what Scotty-boy describes as "herd immunity" just ain't (as noted above).

Further on taht point, as I learned, when doing my Master of Public Health degree at Yale back in the 1960s (I don't think that Scotty-boy, self-anointed-public-healther, has one of those), and had heard about before that at Harvard Medical School, "herd immunity" is indeed a concept used for vaccination, [emphasis added]. (No, the WHO General Director of the, WHO didn't just make up the definition of herd immunity he cited.) That is, herd immunity can occur in a population that can thus be protected from a certain virus if a threshold of vaccination is reached.

And why the use of the word "herd?" Because the concept was actually first developed in observing herds of cows in France, about a century ago, which had been immunized against bovine tuberculosis, which infects cow's milk. When enough cows had been given the vaccine, it was found that the whole herd became, pretty much, immune. It applies in modern times to such diseases as measles, which can be vaccinated against. I guess that Scotty-boy-public-healther must have just missed that basic public health course in medical School. But boy, is he is enabling Trump, in actual fact, in creating chaos.

Of course, for the President, Scotty-boy, and such politicians as Gov. Kristi "Sturgis-superspreader" Noem of South Dakota, the big issue on mask-wearing is that of "freedom." People should be free to choose to wear masks or not, even though mask-wearing may be even more important for protecting against infecting others than for protecting oneself from infection. Actually, if the "freedom" issue that Dr. Scotty, and Trump, and many others on the Right keep harping on in relation to mask-wearing, is the most important one, then just like not wearing masks to protect others from the SARS-CoV-2 virus in order to be "free," people who feel like it should have the freedom to move their bowels into a conveniently located public water supply. That is, if so doing would make them feel "free."

Finally, since Scotty-boy can overnight become a public-healther, and Trump's leading public healther to boot, I have been thinking about setting myself up as a neuroradiologist. After all, I did graduate from medical school, still have my license, and did look at some X-rays at the time. And I have thought that if I hooked up with the right politician and became the national leader for re-setting radiology policy, the first thing that I would do would be to have the whole field go back to film for X-rays. They have a real feel that images on a computer screen can never manage.

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Postscript: It turns out that Scotty-boy has been promoted to Trump by a far-right dark money group called the "Job Creators Network." As the cited column in Sludge says: "Atlas was selected by Trump as a science adviser in August after the president asked his advisers to 'find a new doctor who would argue an alternative point of view from Birx and Fauci, with whom the president has grown increasingly annoyed for public comments that he believes contradict his own assertions that the virus's threat is receding,' according to the Washington Post."

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This column is based in part on one that I published on Buzzflash, that in turn was based in part on an earlier column published on OpEdNews.