New Trump pandemic adviser pushes controversial ‘herd immunity’
strategy, worrying public health officials
Scott Atlas, senior fellow at the Hoover Institution, speaks with
President Trump during a coronavirus briefing on Aug 12.
Scott Atlas, senior fellow at the Hoover Institution, speaks with
President Trump during a coronavirus briefing on Aug 12. (Jabin
Botsford/The Washington Post)
By
Yasmeen Abutaleb
<https://www.washingtonpost.com/people/yasmeen-abutaleb/>and
Josh Dawsey <https://www.washingtonpost.com/people/josh-dawsey/>
Washington Post, August 31, 2020 at 6:00 a.m. EDT
Add to list
One of President Trump’s top medical advisers is urging the White House
to embrace a controversial “herd immunity” strategy to combat the
pandemic, which would entail allowing thecoronavirus
<https://www.washingtonpost.com/health/2020/02/28/what-you-need-know-about-coronavirus/?itid=lk_inline_manual_1>to
spread through most of the population to quickly build resistance to the
virus, while taking steps to protect those in nursing homes and other
vulnerable populations, according to five people familiar with the
discussions.
The administration has already begun to implement some policies along
these lines, according to current and former officials as well as
experts, particularlywith regard to testing
<https://www.washingtonpost.com/health/cdc-testing-guidelines-coronavirus/2020/08/26/eb653028-e7af-11ea-97e0-94d2e46e759b_story.html?itid=lk_inline_manual_3>.
The approach’s chief proponent is Scott Atlas, a neuroradiologist from
Stanford’s conservativeHoover Institution
<https://www.hoover.org/profiles/scott-w-atlas>, who joined the White
House earlier this month as a pandemic adviser. He has advocated that
the United States adopt the model Sweden has used to respond tothe virus
outbreak
<https://www.washingtonpost.com/coronavirus/?hpid=hp__%3A&itid=hp__%3A&itid=lk_inline_manual_4>,
according to these officials, which relies on lifting restrictions so
the healthy can build up immunity to the disease rather than limiting
social and business interactions to prevent the virus from spreading.
AD
ADVERTISING
Sweden’s handling of the pandemic has been heavily criticized by public
health officials and infectious-disease experts as reckless — the
country has among the highest infection and death rates in the world. It
also hasn’t escaped the deepeconomic problems
<https://www.washingtonpost.com/business/2020/06/24/imf-global-economy-coronavirus/?itid=lk_inline_manual_7>resulting
from the pandemic.
But Sweden’s approach has gained support among some conservatives who
argue that social distancing restrictions are crushing the economy and
infringing on people’s liberties.
How does immunity against coronavirus work? New research shows how
antibodies can block infection.
<https://www.washingtonpost.com/health/2020/08/21/how-does-immunity-against-coronavirus-work-new-research-shows-how-antibodies-can-block-it/?itid=lk_interstitial_manual_9>
That this approach is even being discussed inside the White House is
drawing concern from experts inside and outside the government who note
that a herd immunity strategy could lead to the country suffering
hundreds of thousands, if not millions, of lost lives.
“The administration faces some pretty serious hurdles in making this
argument. One is a lot of people will die, even if you can protect
people in nursing homes,” said Paul Romer, a professor at New York
University who won the Nobel Prize in economics in 2018. “Once it’s out
in the community, we’ve seen over and over again, it ends up spreading
everywhere.”
AD
Atlas, who does not have a background in infectious diseases or
epidemiology, has expanded his influence inside the White House by
advocating policies that appeal to Trump’s desire to move past the
pandemic and get the economy going, distressing health officials on the
White House coronavirus task force and throughout the administration who
worry that their advice is being followed less and less.
Atlas declined an interview request. White House spokesman Judd Deere
did not respond to specific questions for this story and instead said in
a statement that Atlas is a “world renowned physician and scholar of
advanced medical care and health care policy” and criticized the media
for reporting on the topic.
White House officials said Trump has asked questions about herd immunity
but has not formally embraced the strategy. The president, however, has
made public comments that advocate a similar approach.
AD
“We are aggressively sheltering those at highest risk, especially the
elderly, while allowing lower-risk Americans to safely return to work
and to school, and we want to see so many of those great states be
open,” he said during hisaddress to the Republican National Convention
<https://www.washingtonpost.com/elections/2020/08/27/republican-national-convention-live-updates/?itid=ap_philiprucker&itid=lk_inline_manual_19>Thursday
night. “We want them to be open. They have to be open. They have to get
back to work.”
Coronavirus update: U.S. death toll approaches 180,000
<https://www.washingtonpost.com/nation/2020/08/30/coronavirus-covid-updates/?hpid=hp_hp-banner-low_coronavirus-203pm%3Ahomepage%2Fstory-ans&itid=lk_interstitial_manual_20>
Atlas has fashioned himself as the “anti-Dr. Fauci,” one senior
administration official said, referring to Anthony S. Fauci, the
nation’s top infectious-disease official, who has repeatedly been at
odds with the president over his public comments about the threat posed
by the virus. He has clashed with Fauci as well as Deborah Birx, the
White House coronavirus response coordinator, over the administration’s
pandemic response.
Atlas has argued both internally and in public that an increased case
count will move the nation more quickly to herd immunity and won’t lead
to more deaths if the vulnerable are protected. But infectious-disease
experts strongly dispute that, noting that more than 25,000 people
younger than 65 have died of the virus in the United States. In
addition, the United States has a higher number of vulnerable people of
all ages because of high rates of heart and lung disease and obesity,
and millions of vulnerable people live outside nursing homes — many in
the same households with children, whom Atlas believes should return to
school.
AD
“When younger, healthier people get the disease, they don’t have a
problem with the disease. I’m not sure why that’s so difficult for
everyone to acknowledge,” Atlas said in an interview with Fox News’s
Brian Kilmeade in July. “These people getting the infection is not
really a problem and in fact, as we said months ago, when you isolate
everyone, including all the healthy people, you’re prolonging the
problem because you’re preventing population immunity. Low-risk groups
getting the infection is not a problem.”
Atlas has said that lockdowns and social distancing restrictions during
the pandemic have had a health cost as well, noting the problems
associated with unemployment and people forgoing health care because
they are afraid to visit a doctor.
“From personal communications with neurosurgery colleagues, about half
of their patients have not appeared for treatment of disease which, left
untreated, risks brain hemorrhage, paralysis or death,”he wrote
<https://thehill.com/opinion/healthcare/499394-the-covid-19-shutdown-will-cost-americans-millions-of-years-of-life>in
The Hill newspaper in May
AD
The White House has left many of the day-to-day decisions regarding the
pandemic to governors and local officials, many of whom have disregarded
Trump’s advice, making it unclear how many states would embrace the
Swedish model, or elements of it, if Trump begins to aggressively push
for it to be adopted.
But two senior administration officials and one former official, as well
as medical experts, noted that the administration is already taking
steps to move the country in this direction.
Inside Trump’s pressure campaign on federal scientists over a covid-19
treatment
<https://www.washingtonpost.com/health/convalescent-plasma-treatment-covid19-fda/2020/08/29/e39a75ec-e935-11ea-bc79-834454439a44_story.html?itid=lk_interstitial_manual_32>
The Department of Health and Human Services, for instance, invoked the
Defense Production Act earlier this month to expedite the shipment of
tests to nursing homes — but the administration has not significantly
ramped up spending on testing elsewhere, despite persistent shortages.
Trump and top White House aides, including Atlas, have also repeatedly
pushed to reopen schools and lift lockdown orders, despite outbreaks in
several schools that attempted to resume in-person classes.
AD
The Centers for Disease Control and Prevention also updated its testing
guidance last week to say that those who are asymptomatic do not
necessarily have to be tested. That prompted an outcry from medical
groups, infectious-disease experts and local health officials, who said
the change meant that asymptomatic people who had contact with an
infected person would not be tested. The CDC estimates that about
40 percent of people infected with covid-19, the disease caused by the
coronavirus, are asymptomatic, and experts said much of the summer surge
in infections was due to asymptomatic spread among young, healthy people.
Trump has previously floated “going herd” before being convinced by
Fauci and others that it was not a good idea, according to one official.
The discussions come as at least 5.9 million infections have been
reported andat least 179,000 have died
<https://www.washingtonpost.com/graphics/2020/national/coronavirus-us-cases-deaths/?hpid=hp_hp-top-table-low_gfx-virus-tracker%3Ahomepage%2Fstory-ans&itid=hp_hp-top-table-low_gfx-virus-tracker%3Ahomepage%2Fstory-ans&itid=lk_inline_manual_38>from
the virus this year and as public opinion polls show that Trump’s
biggest liability with voters in his contest against Democratic
nomineeJoe Biden
<https://www.washingtonpost.com/elections/candidates/joe-biden/?itid=lk_inline_manual_38>is
his handling of the pandemic. The United States leads the world in
coronavirus cases and deaths, with far more casualties and infections
than any other developed nation.
AD
The nations that have most successfully managed the coronavirus outbreak
imposed stringent lockdown measures that a vast majority of the country
abided by, quickly ramped up testing and contact tracing, and imposed
mask mandates.
Atlas meets with Trump almost every day, far more than any other health
official, and inside the White House is viewed as aligned with the
president and White House Chief of Staff Mark Meadows on how to handle
the outbreak, according to three senior administration officials.
The lost days of summer: How Trump fell short in containing the virus
<https://www.washingtonpost.com/politics/trump-struggled-summer-coronavirus/2020/08/08/e12ceace-d80a-11ea-aff6-220dd3a14741_story.html?itid=lk_interstitial_manual_43>
In meetings, Atlas has argued that metropolitan areas such as New York,
Chicago and New Orleans have already reached herd immunity, according to
two senior administration officials. But Birx and Fauci have disputed
that, arguing that even cities that peaked to potential herd immunity
levels experience similar levels of infection if they reopen too
quickly, the officials said.
AD
Trump asked Birx in a meeting last month whether New York and New Jersey
had reached herd immunity, according to a senior administration
official. Birx told the president there was not enough data to support
that conclusion.
Atlas has supporters who argue that his presence in the White House is a
good thing and that he brings a new perspective.
“Epidemiology is not the only discipline that matters for public policy
here. That is a fundamentally wrong way to think about this whole
situation,” said Avik Roy, president of the Foundation for Research on
Equal Opportunity, a think tank that researches market-based solutions
to help low-income Americans. “You have to think about what are the
costs of lockdowns, what are the trade-offs, and those are fundamentally
subjective judgments policymakers have to make.”
It remains unclear how large a percentage of the population must become
infected to achieve “herd immunity,” which is when enough people become
immune to a disease that it slows its spread, even among those who have
not been infected. That can occur either through mass vaccination
efforts, or when enough people in the population become infected with
coronavirus and develop antibodies that protect them against future
infection.
Estimates have ranged from 20 percent to 70 percent for how much of a
population would need to be infected. Soumya Swaminathan, the World
Health Organization’s chief scientist, said given the transmissibility
of the novel coronavirus, it is likely that about 65 to 70 percent of
the population would need to become infected for there to be herd immunity.
With a population of 328 million in the United States, it may require
2.13 million deaths to reach a 65 percent threshold of herd immunity,
assuming the virus has a 1 percent fatality rate, according to an
analysis by The Washington Post.
It also remains unclear whether people who recover from covid-19 have
long-term immunity to the virus or can become reinfected, and scientists
are still learning who is vulnerable to the disease. From a practical
standpoint, it is also nearly impossible to sufficiently isolate people
at most risk of dying due to the virus from the younger, healthier
population, according to public health experts.
Atlas has argued that the country should only be testing people with
symptoms, despite the fact that asymptomatic carriers spread the virus.
He has also repeatedly pushed to reopen schools and advocated for
college sports to resume. Atlas has said, without evidence, that
children do not spread the virus and do not have any real risk from
covid-19, arguing that more children die of influenza — an argument he
has made in television and radio interviews.
Atlas’s appointment comes after Trump earlier this summer encouraged his
White House advisers to find a new doctor who would argue an alternative
point of view from Birx and Fauci, whom the president has grown
increasingly annoyed with for public comments that he believes
contradict his own assertions that the threat of the virus is receding.
Advisers sought a doctor with Ivy League or top university credentials
who could make the case on television that the virus is a receding threat.
Atlas caught Trump’s attention with a spate of Fox News appearances in
recent months, and the president has found a more simpatico figure in
the Stanford doctor for his push to reopen the country so he can focus
on his reelection. Atlas now often sits in the briefing room with Trump
during his coronavirus news conferences, even as other doctors do not.
He has given the president somewhat of a medical imprimatur for his
statements and regularly helps draft the administration’s coronavirus
talking points from his West Wing office as well as the slides that
Trump often relies on for his argument of a diminishing threat.
Atlas has also said he is unsure “scientifically” whether masks make
sense, despite broad consensus among scientists that they are effective.
He has selectively presented research and findings that support his
argument for herd immunity and his other ideas, two senior
administration officials said.
Fauci and Birx have both said the virus is a threat in every part of the
country. They have also put forward policy recommendations that the
president views as too draconian, including mask mandates and partial
lockdowns in areas experiencing surges of the virus.
Birx has been at odds with Atlas on several occasions, with one
disagreement growing so heated at a coronavirus meeting earlier this
month that other administration officials grew uncomfortable, according
to a senior administration official.
One of the main points of tension between the two is over school
reopenings. Atlas has pushed to reopen schools and Birx is more cautious.
“This is really unfortunate to have this fellow Scott Atlas, who was
basically recruited to crowd out Tony Fauci and the voice of reason,”
said Eric Topol, a cardiologist and head of the Scripps Research
Translational Institute in San Diego. “Not only do we not embrace the
science, but we repudiate the science by our president, and that has
extended by bringing in another unreliable misinformation vector.”
-=-=-=-=-=-=-=-=-=-=-=-
Groups.io Links: You receive all messages sent to this group.
View/Reply Online (#1029): https://groups.io/g/marxmail/message/1029
Mute This Topic: https://groups.io/mt/76532472/21656
-=-=-
POSTING RULES & NOTES<br />#1 YOU MUST clip all extraneous text when replying to a
message.<br />#2 This mail-list, like most, is publicly & permanently archived.<br
/>#3 Subscribe and post under an alias if #2 is a concern.
-=-=-
Group Owner: [email protected]
Unsubscribe: https://groups.io/g/marxmail/leave/8674936/1316126222/xyzzy
[[email protected]]
-=-=-=-=-=-=-=-=-=-=-=-
