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January 05, 2023

Coronavirus week 131: Problems with the People's CDC

First, yes, there is an organization billing themselves as such, the People's CDC, complete with website.

I came across them via a New Yorker story by Emma Green. As she narrates it and I interpret it, they're the other hand, or other pole, of the twosiderism and tribalism on this issue that I work to avoid.

Her Twitter thread is worth reading not only for the highlights of the story, assuming you hit a New Yorker paywall, but also for the degree of vitriol she gets from the one of the two sides, which has definitely lost me.

As far as main points?

  • The CDC as eugenicist is laughable, and sounds like something the other half of the tribalism says about Big Pharma's mRNA vaccines
  • That's only amplified by it being mainly White folks attacking Green
  • Taking money from the Robert Wood Johnson Foundation would be hypocritical.
  • Their claims about risk levels on Long COVID haven't been scientifically tested. (In addition, there's no scientifically agreed definition of Long COVID, which of course makes it "easier" to claim whatever you want. More on that below.)

There you go.

Let's look at the Long COVID issue. Here, first on their side:

More grievances: the People’s C.D.C. believes that the C.D.C. downplays the risk of long COVID, a post-viral syndrome that can follow the initial infection. The People’s C.D.C. matter-of-factly reports that getting COVID more than once increases your risk of death and hospitalization, and of developing chronic conditions affecting your lungs, heart, brain, and other organs. No amount of COVID is safe, and no number of shots can protect you: “We want to say plainly that you can have a mild infection and still get Long COVID,” the organization wrote, in a Weather Report in June. “Vaccinated people can also get Long COVID.” They frequently cite the figure that one in five cases may lead to long-COVID symptoms, based on a C.D.C. study of data gathered, in part, before vaccines were widely available. All of this is an argument against treating COVID like any other inevitable seasonal yuck, the People’s C.D.C. argues—instead, we should think about it as a “mass-disabling event.”

Then, the response:

Leana Wen, a professor at George Washington University’s school of public health and the former health commissioner of Baltimore, told me that there’s a distinction between patients who have trouble recovering from a bad COVID case or who experience lingering symptoms and those who are truly debilitated afterward. “That’s not one in five patients,” she said, of the latter group.

If these folks are really claiming "one in five," they're fucking laughable. They're probably also goalpost-shifting on just what Long COVID is, which also wouldn't surprise me. I also wonder exactly what they mean by "immunocompromised." Is it cancer patients, organ transplant persons and some other narrow group? I agree with those concerns. But, is it defined broadly and vaguely?

Another way of looking at this is via "anecdotal math." Let's say that half of all adult Americans have gotten COVID. I don't think that's wild-eyed and could be conservative. If one in five has Long COVID, that would mean that 10 percent of adult Americans have Long COVID. Does that describe your social world? Including yourself, are 1 in 10 people in your circles afflicted with Long COVID?

I think some want "masks forever." You can do that — as individuals. But, even in Japan, where pre-COVID individual mask-wearing was a deal, it's not happening nationwide.

That said, I'm not totally unsympathetic to them, either. Nor is Green, for that matter:

Among the people I spoke with who have actually led public-health agencies, all were sympathetic to some of the critiques that the People’s C.D.C. makes. “The pandemic has opened what were cracks in our health-care system and exposed them as large chasms,” [Anne Zink, Alaska's chief medical officer], said. “The systems that we have built have failed America and failed us individually.” But these experts also found it hard to take the group seriously because of its strident analysis. “To make claims that C.D.C. is beholden to big business—this is just nonsense, frankly,” [Tom] Frieden, the agency’s former leader, said. “Once you’re sitting at C.D.C., your goal is not to say the thing that makes you feel best or sounds most politically correct or radical.” 
The C.D.C. has become “the punching bag of our country,” Zink told me. She recognizes that the pandemic has been scary, sad, and frustrating for many people. Her reaction to “hearing those criticisms, particularly the eugenics comment—it’s just more sadness.”

There you go. And, it's why I called this a "semi-crappy takedown," not a "crappy" one. (More on the "semi" below, though.)

Related to that is the People's CDC saying the CDC et al are getting this that and the other wrong, but not only not offering, rather, actively refusing to offer, anything in the way of ideas to do things differently, beyond "masks forever."

I've talked myself about some of this before. I've talked hard about my wondering why we don't have non-mRNA boosters. And, the likes of Walker Bragman, who is at least a fellow traveler to the People's CDC? Crickets. But not crickets on the piece, calling it, via a retweet of Gregg Gonsalves, a "hit piece." And, the People's CDC has nothing about this on their website. And, I think that's deliberate, especially if current as well as former CDC are involved. They're not going to criticize the government on vaccines, period, which is sad.

Contra Green, and some of her "other side" interviewees, I think there IS room to criticize capitalist capture of more then FDA than the CDC, and specifically Big Pharma. Bragman, who should know better, has never gone there. I think they're all afraid of looking like MAGAts. Tough shit. The lack of better boosters is an issue, and the mRNA jabs, while not ineffective, are of relatively limited effectiveness.

So, to put it in tribalist terms, until it starts pushing for non-mRNA boosters, it can pretty much fuck off. That's even as daily cases so far this winter show but a mild uptick and daily deaths remain flat, per the latest info from Worldometers. Per Worldometers, the P-CDC claim that 2,000 people a week are dying is too high by one-third right now. (Carl Zimmer also makes this not-totally-true claim.) And, even if true, that is NOT worse than at least a more severe flu season. Oh, and you can stop the alarmism, likes of The Fed Up Chef, over Omicron SUBvariants. (And is Rob Wallace of the People's CDC actually looking for variants in wastewater, or subvariants?)

Anyway, shadowtweeting about the likes of these people:

But Emma Green can fuck off to some degree herself, and deserves some the vitriol. This IS a schtick by her and I first called her out SEVEN years ago. It, and this, were both two-dimensional strawmanning.

There's an actual piece to be written about the problems with the People's CDC, one with more nuance than this. Sadly, it will now never be written; Emma Green's made those waters too toxic.

One side note: The venue kind of surprises me at first glance. I could easily see The Atlantic, where Green did her schtick seven years ago, doing a piece like this. But the New Yorker? This seems at first glance like eating their own. But, really, not so much. It's left-neoliberal, not leftist, so just a few steps away from Atlantic on the spectrum.

==

Related: STAT talks about lessons from COVID so far. One is how public health measures have both been imposed, and to some degree, opposed, without nuance either way. Something else the People's  CDC could take to heart — but probably won't. It also notes the rapid dropoff of mRNA effectiveness, something which, as noted above, the People's CDC and fellow travelers don't discuss, at least not from what I could tell browsing their website.

In that piece, re the one big issue above, Nancy Messionier notes there's still no accepted definition of Long COVID. That's one of many science-tentative issues around COVID, she says.

This:

“I’ve been sort of repeatedly surprised by how often I see statements in the press attributable to scientists that have an unwarranted level of confidence associated with them,” [Paul Bieniasz, a virologist at Rockefeller University] said, suggesting this has contributed to a decline in trust in science and in public health experts over the course of the pandemic. 
Bieniasz thinks scientists should have started most statements with “I don’t know, but my best guess is …”

Is big. But, again, the People's CDC half of twosiderism won't be listening. Nor will many of the science experts who may not be twosiderists but are unwittingly fueling the problem.

==

Update: Related issue? Zeynep Tufekci tells you what Bragman and the People's CDC won't — RSV and flu cases have both sharply dropped again after their initial surge. I suspect two years of masking and isolation lessened natural immunity, which is a thing, even if misinterpreted by the denialists and minimalists. (And, she's been attacked on Twitter herself.)

Update 2: The Nation decides to go "all in" on the left hand  of tribalism, with a piece by People's CDC fellow traveler Gregg Gonsalves (you ARE a "fellow traveler," Gregg) that's as much a hit piece if not more than Green's original. He has no substantive engagement with Green on Long COVID and other issues. I also find it "interesting" that the likes of a Zeynep Tufekci aren't interviewed.

The piece has other strawmanning. No, we don't have a memorial to COVID dead, unlike 9/11. And? As I wrote in a newspaper column 20 years ago, we also don't have a memorial to dead diabetics and other things.

Finally, Gregg? Show your homework. Worldometers doesn't show 4,000 US dead in the past week. Even a full week of 500-death days (which we don't have) would be 3,500.

Update 3 (as we get material enough for a new post): Former Pro Publica editorial top cheese Dick Tofel also suggests it's time to move from pandemic to endemic, in terms of journalism coverage, and how we should get beyond twosiderism:

The answer seems not to be to pretend that COVID has disappeared, but rather to integrate what we have learned these last three years into public life, urging (and making it feasible) for those who are ill to stay home, taking special precautions around those at highest risk, varying our own behavior at times and in places where illnesses are more prevalent, acknowledging that those who choose to avoid or delay available vaccines are assuming risks for which they must bear at least some of the consequences.

Sounds pretty sensical.

Update 4, mainly as a bookmark for me when I start that new thread: Leana Wen, a professor of public health like Gonsalves, and one of the experts mentioned in Green's story, wonders if we're not overcounting COVID deaths and talks about deaths "from" vs deaths "with." And, she actually interviews two people, which is two more than Gonsalves. Both the people she interviewed are infectious disease physicians. Both have themselves been attacked as COVID minimalists.

Wen has the advantage of having been, pre-COVID, on the ground lines of public health as the city of Baltimore's health commissioner, too.

Update 5: A Dutch immunologist says there's a bunch of clear evidence COVID is moving in the direction of seasonal waves.

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