On April 29th, 2020 as the College was beginning its discussion of whether it should reopen for in-person classes in the fall of that same year, I submitted the following post to the Faculty Listserv.
I thought some of you might be interested in yesterday’s statistics from the CDC regarding total Covid fatalities for various age tranches of the US population to date.
The 15-24 age cohort—which presumably includes most of our students— and is made up of 42,970,800 individuals has seen 33 Covid deaths.
So, based on these numbers, the chances of someone in this age group dying from Covid are, if my feeble arithmetic skills are accurate, is:
0.00007679%
In the 25-34 group there have been:
233 deaths out of a cohort of 45,697,774 people
In the 35-44 group there have been:
599 deaths out of a cohort of 41,277,888 people
In the 45-54 group there have been:
1,649 deaths out of a cohort of 41,631,699 people
In the 55-64 group there have been:
3,970 deaths out of a cohort of 42,272,636 people
So, when we take all the numbers of people between 15 and 64 in the US, which presumably includes almost all those who might find themselves working in and around a college campus, we get:
6,484 deaths out of a total number of 213,850,797 people
So again, if my feeble math skills are correct, then the following is the current death rate from Covid for all people from 15-64
0.003%
The figures here were taken last evening from this page.
No one on the Listserv challenged my statistics. However, a number did try to reframe this seemingly straightforward matter. One stated by saying that lethality was the wrong measure to be talking about as there are other damages from exposure.
However, this person provided no facts or even anecdotes to back up the claim.
Another told us about a friend who is a nurse in New York who said lots of people were dying there. Again, however, no statistics were adduced.
Finally, another said lethality in the general population was not the right measure as we should be talking about deaths among the infected. When I responded that since we don’t know who is infected, we cannot determine that number and thus this was the best we could do, no response was forthcoming.
Later that same day, I sent the following note to the Listserv in response to a colleague who, after referencing the statistics from the Diamond Princess and the Santa Clara study, and admitting that the levels of infections and fatalities were quite low in that ship of mostly senior citizens but concluded, without providing any evidence, that this meant that the testing must be faulty. In other words, he just somehow knew—media conditioning is indeed a powerful thing—that the virus had to be much more lethal than the Diamond Princess and Santa Clara studies had shown it to be. Here is my response.
Dear XXX
Fine. But you can’t have it both ways. Either, as has been suggested, we are all in danger because the virus has not spread and will eventually get to everybody and we thus need to be vigilant for the coming wave of sickness is produced.
Or as the cruise ship numbers—derived from what which is I presume is a pretty ideal venue for infection— demonstrate, and the Santa Clara study you mention also shows, that infection does not necessarily spread as rapidly or as extensively as once thought.
So, which assumption are we working with?
In the end, given the heavy reliance on differing, but as yet unproven assumptions regarding the extent and rate of spread of the disease in the absence of testing, the most stable indicator would appear to be deaths caused over time.
On another note, both Spain and Italy are generally viewed as being considerably ahead of the US in terms of the development of the epidemic and well ahead of the US in deaths per million.
Or to use ZZZZ’s metaphor, they are in March or April or June of the car driving accident season.
And yet, in their death numbers by age group, in their tendencies in the 0-60 age cohort line up pretty nicely with the CDC ones I cited earlier.
Italy (28 April)
0-9 years, 2 deaths
10-19 years, 0 deaths
20-29 years 7 deaths
30-39 years, 48 deaths
40-49 years 203 deaths
50-59 years 869 deaths
60-69 years 2,376 deaths
Spain (21 April)
0-9 years 2 deaths
10-19 years 3 deaths
20-29 years 24 deaths
30-39 years 48 deaths
40-49 years 138 deaths
50-59 years 388 deaths
60-69 years 1,119 deaths
Worth pondering?
The next day I chimed in with the following note in response to the email of the same colleague who had mentioned the Santa Clara and Diamond Princess statistics
Thanks XXX.
You have, I think, nudged us toward what I believe is, or should be, a key subject of discussion.
It is not incumbent on me as a faculty member with an unspecialized knowledge of medicine and public health to advance or refute one or the other assumption-based models out there regarding the mortal danger from the virus.Why?
Because I am not advocating for the need to close the institution in the name of preventing a loss of life.
But for those who are making the decision to possibly do so, a decision that will significantly interrupt the normal functioning of this institution and undeniably bring with it enormous economic and social costs, I think it very much incumbent on them to provide very clear reasons—reasons that transcend this or that speculative theory about the lethality or rate of spread of the virus—for breaking with the age-old ideal of “First do no harm.”For example, it would seem to be incumbent on them, not on me or anyone else, to demonstrate clearly, and on the basis of available statistics from around the world, that this virus has shown itself to be a greatly enhanced mortal threat to the 0-50 (or even 0-60) age cohort, a group which I presume covers the vast majority of people studying and working on college campuses in this country.
I have looked at various sets of figures from various countries and have found that, several months into the epidemic, none remotely support this idea.If someone has hard data that suggests something else, please send it along.
No such comparative statistical information was shared by anyone. However, one colleague responded to this by arguing that we should be thinking, in addition to the problems of death and sickness, about the possible strain on the general health care system. I responded in the following manner.
Sure. But this begs the question of what age group of people overwhelmingly stress the system. And it is clearly not college students nor, for that matter, most people in the first five or six decades of their lives.
So, presuming you can keep those in their 70s and 80s, and if you want to be real safe, 60s, in a situation where they are shielded from the young, why can’t the rest of the people, infected or uninfected, go about their business?Is it more efficient to shut down an entire economy or to undertake special, very targeted measures to ensure the safety of those who are truly in danger and in need of intensive care?
A colleague responded that he found it ironic and thus improper that I should use the usually medicine-related phrase “Do no harm” to talk about damage in the social and economic realms. I can only conclude that he believed that significant harms cannot be generated by policy decisions in these areas. He also said that focusing on mortality was not productive as this obviates the overall stresses placed on the healthcare system by the crisis.
I replied in the following manner:
I was fully aware of the irony as I used it as I think it is very important to look beyond the frame that implies that the preeminent social harm of all that is going on in relationship to this crisis is necessarily related to the virus itself.
In my view, we need to be open to the possibility that this might not be so and to think accordingly.
I agree that a focus on mortality is counterproductive. This has always been primarily a health care provision crisis that, however, has become conflated in many minds through the media’s handling of it as an unprecedented mortality or mortality threat crisis which it is not, especially for the young and most under 50. This needs to be cleared up to frame our response correctly.
On May 19th a colleague posted an article titled “Who Is Responsible if a University Reopens and a Student Dies from Covid-19?” on the listserv. A half hour later I responded with the following message.
According to the CDC, as of May 13th there were 59 Covid deaths in the US out of a 15-24 age cohort comprised of some 43,000,000 individuals.
Is there anyone else out there interested in seeing some level of proportionality brought to the current discussions on the levels of mortal danger this virus poses to young people?
Tom
This was followed by a colleague in her late fifties who, despite not contesting the mortality figures for her age group I had shared earlier, admitted that she was concerned for her own health and believed we could not trust students to be responsible and thus we needed to restrain them to keep people like her safe. She then “refuted” my age stratification statistics by mentioning that our local hospital had Covid patients ranging in age for 31 to 83 and several people on ventilators. More of the same: ostensibly intelligent people under the influence of fear, substituting hearsay anecdotes for rather straightforward health statistics.
On September 9th 2020, after the college had established that mask-wearing was obligatory for all on campus almost all the time, I wrote the following missive to my colleagues on the Faculty Listserv.
It is not uncommon for there to be rather sizable divergences between the pronouncements of “fact” made by people at the top of an organization (and from there, the political figures with whom they often commingle), and what the experts in their charge know or believe to be the truth on a given matter.
It appears that this might be the case on mask-wearing and its putative role in preventing the spread of Covid,
Buried in a note in the CDC’s 31 July publication on “Public Health Guidance for Community-Related Exposure” is the following passage (the italics are mine):
“Data to inform the definition of close contact are limited. Factors to consider when defining close contact include proximity, the duration of exposure (e.g., longer exposure time likely increases exposure risk), and whether the exposure was to a person with symptoms (e.g., coughing likely increases exposure risk). While research indicates masks may help those who are infected from spreading the infection, there is less information regarding whether masks offer any protection for a contact exposed to a symptomatic or asymptomatic patient. Therefore, the determination of close contact should be made irrespective of whether the person with COVID-19 or the contact was wearing a mask.”
Not exactly a ringing endorsement for the all-important role of masks. In fact, it clearly implies the they should be viewed as a non-factor when sizing up situations of potential risk.
In fact, if you go to the document in question, you will see it does not put mask-wearing in any of its front-page recommendations as to how to combat the spread of the virus.
And in the sub-section of the same page where different risk scenarios are outlined, the one dealing with “All U.S. residents, other than those with a known risk exposure” who might be in danger of “Possible unrecognized COVID-19 exposures in U.S. communities”, the authors suggest that people should “Practice social distancing and other personal prevention strategies, Be alert for symptoms, Watch for fever, cough, or shortness of breath, or other symptoms of COVID-19, Check temperature if symptoms develop, Follow CDC guidance if symptoms develop”
No, mention of the role of masks at all.
True, there is contradictory guidance in other parts of their website regarding masks.
But what does seem evident is that the people on the ground at the CDC, being aware of the very inconclusive science regarding the effectiveness of masks in preventing the spread of respiratory viruses in the general public, carefully avoid making any full-fledged endorsement of their effectiveness in this realm.
Which leads us to the WHO’s 5 July publication on “Advice on the Use of Masks in the Context of COVID-19.” In it we find the following:
“There is limited evidence that wearing a medical mask by healthy individuals in households, in particular those who share a house with a sick person, or among attendees of mass gatherings may be beneficial as a measure preventing transmission. (41, 56-61). And later on the same page:
“Results from cluster randomized controlled trials on the use of masks among young adults living in university residences in the United States of America indicate that face masks may reduce the rate of influenza-like illness, but showed no impact on risk of laboratory-confirmed influenza.(62, 63) At present, there is no direct evidence (from studies on COVID- 19 and in healthy people in the community) on the effectiveness of universal masking of healthy people in the community to prevent infection with respiratory viruses, including COVID-19.”
And they conclude:
“Many countries have recommended the use of fabric masks/face coverings for the general public. At the present time, the widespread use of masks by healthy people in the community setting is not yet supported by high quality or direct scientific evidence and there are potential benefits and harms to consider (see below).”
Just following the publication of this document, the WHO reversed itself on the matter of masks and began calling for their more generalized use among the public.
On 10 July, Deborah Cohen from BBC’s News Night reported:
“That the World Health Organization’s committee that reviewed the evidence on the use of face-coverings in public, didn’t back them. But after political lobbying, the WHO now recommends them”.
In a tweet published two days later, Cohen said the following
“We had been told by various sources WHO committee reviewing the evidence had not backed masks but they recommended them due to political lobbying. This point was put to the WHO, which it did not deny”
Interestingly, the WHO document from which I quoted above disappeared from the organization’s website sometime between 1 September and now. Glad to provide a copy to anyone interested in reading it.
It is also interesting to note that in the version of the WHO’s COVID Q and A section, available on 1 September the answer to question “ What can I do to protect myself and prevent the spread of the disease?” did not contain any guidance regarding masks.
At some point between then and now, however, it was added.
In the same Q and A section, the query “Does WHO recommend wearing medical masks to prevent the spread of COVID-19?“ garners the following response:
“Currently, there is not enough evidence for or against the use of masks (medical or other) in healthy individuals in the wider community. However, WHO is actively studying the rapidly evolving science on masks and continuously updates its guidance.
Medical masks are recommended primarily in health care settings but can be considered in other circumstances (see below).”
And the “other circumstances” mentioned below are: for healthcare workers, People who are sick and exhibiting symptoms of Covid-19, or Anyone taking care of a person at home who is sick with Covid-19.
Finally, in the response to the question about “How to properly wear a medical mask?” the authors, after giving several points of technical advice on that matter, conclude with:
“Remember that masks are not a substitute for other, more effective ways to protect yourself and others against COVID-19 such as frequently washing your hands, covering your cough with the bend of elbow or tissue and maintain a distance of at least 1 meter from others.”
On 18 July Carl Heneghan of the Oxford Centre for Evidence-Based
Medicine (CEBM) said: “By all means people can wear masks but they can’t say it’s an evidence-based decision…there is a real separation between an evidence-based
decision and the opaque term that ‘we are being led by the science,’ which isn’t the evidence”.
Did my colleagues express gratitude to me for this rather extensive review of the existing state of the “the Science” on the effectiveness of masks? Hardly. Rather, with the exception of one colleague who thanked me for the information and another who earnestly traded a contrasting position based largely on the pronouncements of Fauci, I was met by a storm of hostile comments and about my person and my character.
To that earnest person who depended heavily on the pronouncements of Fauci regarding masks, I responded in this way.
Dear XXX:
Which Fauci are we talking about?
Are we talking about the Fauci who said wearing a mask was unnecessary in March as we were galloping toward the peak of the outbreak as measured by hospitalizations and deaths?Or about the Fauci who reversed himself 180 degrees later on when the time of great virulence, again as measured by the above criteria, had passed ?
Here is a video of Fauci in March, during the one of the more dangerous moments of the epidemic, speaking on the need to wear masks
His advice here sounds quite similar to what I quote from the CDC and WHO.
No?But your comment raises another interesting point.
Is good science about sound processes of experimentation and correction occurring among a community of committed scholars seeking some type of working consensus? Or following the personal dictates of allegedly “Great Men” within the field, well, because they are great.It seems you are suggesting the latter.
The informants in the official documents I quoted were simply expressing what they understand to be the evidence-based state of the question as established by published science.
Are you suggesting that a broad-based assessment like this should be overridden by the say-so of one illustrious man, who just happened to say exactly the opposite a few months before?
Best: Tom
The same person then suggested that difference in our positions regarding masks might have to do with the fact that the science is rapidly changing, that Fauci may have learned new things between March and the present moment, to which I responded:
Sure.
But one more question.Are you suggesting that the scientific consensus as evidenced by studies and/or meta-studies has changed since that time?
That seems an odd thing to suggest given that the oldest of the two advice documents I quoted from is only a few days more than two months old (5 July, the other being from 31 July)This, and the fact that WHO Q and A document I quoted and which says “Currently, there is not enough evidence for or against the use of masks (medical or other) in healthy individuals in the wider community.” is still there on the organization’s website.
Surely if there had been a seismic shift on the matter in the scientific community, the WHO of all places would know about it and want to trumpet it.
Glad to see any studies you might have that show that there is now a solid scientific consensus now on the efficacy of using masks in the general population to curb the spread of respiratory viruses.
Best: Tom
To his credit he sent me a restatement on the advisability of wearing masks for the CDC and seven studies, none of which, however, explicitly addressed the matter of mask effectiveness, but rather explored questions related to the mechanics of viral transmission between people.
I responded to him with this:
Dear XXX:
Thanks for the info from the CDC.However, this falls far short of anything that countermands the belief, stated in the other parts of the website that there is not enough evidence to say they are effective. This is a small number of studies (7 of the list you sent) that suggest that masks may be effective in doing so.
That is not the same as a clear scientific consensus on the matter, something you will notice they fall well short of suggesting or stating in the document. And as they say they make this recommendation based ”what we know about the role respiratory droplets play in the spread of the virus that causes Covid-19, paired with emerging evidence from clinical and laboratory studies that shows masks reduce the spray of droplets when worn over the nose and mouth.”
Emerging evidence is not a strong consensus in a scientific community, at least as I understand it.
Why is consensually strong scientific important in such a matter?
Because governments and other institutions are fundamentally altering long-established patterns of human life by suggesting that mask-wearing is all-important.
And it seems to me a matter of simple logic that in the matter of forced disruptions like this it is incumbent on the disrupter or disrupters to:
a) Do so only on the basis of well-established “iron clad” scientific consensuses
b) Do so only through legislation of policy that cites that strong consensus.
Don’t you agree?
Tom
You might be interested in some of these studies:
1. A May 2020 meta-study on pandemic influenza published by the US CDC found that face masks had no effect, neither as personal protective equipment nor as a source control. (
2. A July 2020 review by the Oxford Centre for Evidence-Based Medicine found that there is no evidence for the effectiveness of cloth masks against virus infection or transmission.
3. A Covid-19 cross-country study by the University of East Anglia found that a mask requirement was of no benefit and could even increase the risk of infection.
4. An article in the New England Journal of Medicine from May 2020 came to the conclusion that cloth face masks offer little to no protection in everyday life.
5. An April 2020 Cochrane review (preprint) found that face masks in the general population or health care workers didn’t reduce influenza-like illness (ILI) cases.
6. An April 2020 review by the Norwich School of Medicine (preprint) found that “the evidence is not sufficiently strong to support widespread use of facemasks”, but supports the use of masks by “particularly vulnerable individuals when in transient higher risk situations.”
7. A July 2020 study by Japanese researchers found that cloth masks “offer zero protection against coronavirus” due to their large pore size and generally poor fit.
8. A 2015 study in the British Medical Journal BMJ Open found that cloth masks were penetrated by 97% of particles and may increase infection risk by retaining moisture or repeated use.
Then came the imprecations. Seeing me not fold before what “everyone knows” and doing it with much more solid science than they had at their disposal clearly enraged a number of the people on the listserv. As it happens, I was at home because I was on leave. But one guy who had clearly been watching too many TikTok videos positing the heroism of those who ventured out to do their jobs in the midst of a plague that, according to Ioannides, miraculously left 99.77% of all those infected (and a much higher percentage of those under 70) fully alive, decided to play tough guy with me.
He asked whether I was on the campus braving it like him and all the other self-canonized heroes. Surprised by the question given its lack of relation to what we had been discussing, I first said “Huh?” But then I followed that up with, “ I’m not teaching this semester. But if I were, I’d be teaching in person, preferably without a mask.” Well that was enough to set of another self-identified front line hero apparently offended by my lack of fear and actually possession, beyond sound bites, of scientific studies on mask effectiveness told me to buzz off, saying “Stop wasting people’s time.” Brave hero that he was, he told me to buzz off, saying ‘stop wasting people’s time.’ To which I responded:
Delightful, XXX. Where did you hone your Socratic skills? Is that how you handle differences of opinion in class?
Interesting how a conversation that was proceeding along more or less evidentiary lines, became somehow personal, and about being here or there, as if that that had anything to with the strength or weakness of the scientific case for mask-wearing.
In the absence of any reprimand from the more veteran faculty in defense of my right to express my opinions, the younger faculty perceived the road as having been cleared for my cancellation. One then called me a troll and encouraged everyone to “stop feeding the troll.” This led to a long letter from another young faculty member in which she accused me of hounding people and lacking compassion for the difficult positions people are in.
I responded to it with this.
Thanks XXXX for your comments.
If I understand you right, you are telling me that at moments like this it behooves us as academics to subordinate our analytical abilities, which by the way are the very skills that have delivered us to nice jobs with extraordinary protections that few in society have, to the greater goal of compassion, and that within that general frame of understanding some of us must mute ourselves in order to show deference to what is presumed to be the greater angst of others.
There are, in my view, a few problems with the argument as you lay it out. Who is to be the arbiter as to whose level of angst is most acute? Is it going to be you, XXX, XXXX or someone else? What do you know about me or the level of angst I may or may not be living through, or may have lived through in the past and how it may affect me now? And yet here you are suggesting, in effect, that you and some otherwise unspecified collective of profs are going through something that I can’t imagine or possibly access and that therefore my duty, as it were, is to shut my mouth and defer to those who have declared themselves to be frontline heroes in a way I am not and cannot be right now. You even go so far as to suggest that discussing issues with obvious bearing on all of our lives in a decidedly and quite consciously non-personal way is tantamount to personally “hounding” others. This, despite the obvious fact that it was clearly others sought to make this about me and my person.
Can you not see the levels of extreme presumptuousness and psychological projection in that, and indeed, its none too disguised authoritarianism?
Then there is the question of the sources of the angst itself. There are a number of ways to deal with anxiety. One is to accept it at face value as the environment around you effectively “serves” it to you and reacts defensively according to its implied imperatives while making sure through small and large acts of social coercion, like the always classy “Stop wasting people’s time” that no dissonant strains of thought break the collective spell of anxiety, or provide new, and possibly liberating perspectives on what you are subjectively feeling.
Another approach is to ask hard questions about what one “knows” to be true in a given situation and subject it to analytical reasoning. In your note, you suggest that compassion and analysis are in effect two mutually exclusive modes of thought and that in times of perceived crisis the latter must inevitably cede to the former. There are many people, however, like me, who see rigorous analysis and compassion as perfectly compatible modes of living and acting, who believe that the more they know about the true dimensions of the fears they face and/or the remedies being proffered by others to combat them, the calmer and more compassionate they can be. Anxiety grows best in the dark and frightening spaces of uncertainty. Conversely, it diminishes when the actual facts are known. We also know that anxious people are notoriously poor caregivers, aka deliverers of compassion. What you and others seem to be suggesting, however, is that your current anxiety is a moral badge of honor and that all must get in line to salute it….or else, regardless of the fact that one of the obvious factors in generating and reifying the overall ambience of anxiety, mask-wearing, may itself rest on rather questionable scientific grounds.
Then there is the none-too-small matter of freedom of speech. The extraordinary protections that we as academics enjoy, and to which I alluded above, were designed precisely to protect minority thought from being run out of the public square for moments like these. But, of course, community standards and ideals are only as good as the majority in that community’s will to uphold them. The invocation of the need to maintain “decorum,” along with unfounded imputations of Ill will (e.g. a desire to “hound”) to those dissenting from majority opinion are two of the oldest and most assiduously used ways of undermining those lofty ideals without actually having to take frontal responsibility for failing to live up to their often demanding imperatives. I would suggest that is something worth bearing in mind.
I don’t know about you, but I see and read many things each day that I consider misguided, offensive, or downright stupid. But unlike you and apparently others I feel little or no compunction to ask those generating these speech acts to muffle their thoughts or simply shut up. Perhaps it is because I trust in the discerning capabilities of other people and that I am quite sure that I have no monopoly on the truth. This, and the fact that I in no way believe that I have a position of emotional privilege that empowers me to qualify other people’s reactions to the world as intrinsically less legitimate than my own.
As an academic, I believe that the truth will come out in the end. This is what I thought we all believed. Apparently, however, some now believe we should push for truth, only insofar as it doesn’t threaten or disturb what one or people invested with power over that same individual, have already decided is right and good.
If, in the end, legitimate scientific inquiry proves, in a way it has clearly not up until now according to both the CDC and the WHO, that masks are an essential and highly effective way of mitigating the transfer of respiratory viruses among the general population, I’ll be the first to recognize that. And you can then enjoy telling stories about the crank on the faculty who really didn’t “get it” and spewed nonsense in the midst of the pandemic.
Until that time comes (sorry Mr. “Stop wasting people’s time”), I’m not going anywhere.Tom
Communication with the Administration on the College’s Testing and Vaccine Policies
On December 2, 2020 I wrote to the spokesperson who had been posting the college’s policy of testing and masking asking for clarification on those policies.
Dear XXX:
The FDA allows PCR testing up to 40 cycles of magnification, but Dr. Fauci has said that anything done above 34 cycles is completely unreliable, could you please confirm for me that level at which the firm doing testing at the college does their magnification of genetic material? (see video of Fauci at minute 4:22)
Indeed, in a recent study on the matter (Fauci was only speaking ex-cathedra) published at Oxford Scientific the threshold for PCR accuracy in detecting Covid was placed at much lower level than this.
Still another group of scientists has recently challenged the accuracy of the Corman Drosten which, in the eyes of many, heralded the use the RT-PCR test as an accurate measure for the presence of active Covid in a person.
Given testing through this method is the driving force behind all sorts of policies altering the fundamental nature of student and faculty life at the College, I think you would agree that this is not a trivial issue.
I look forward to hearing from you soon
Sincerely:
Tom Harrington
This person looped in her superior who was actually in charge of setting the policy and told me of how much confidence they had in the organization they had chosen to lead the testing operation—the Broad Institute at Harvard—and that the operative threshold in the protocol was indeed 40 ct, but that several student infections had been flagged at as low as 25ct. On December 7th 2020 I responded in the following fashion
Thanks for this XXX
So, if I understand your answer correctly, you are saying that the Broad Institute is doing tests at Ct 40.
Could you please confirm that my impression is correct?
Thanks: Tom
Later in that same day, the person in charge of implementing the policy on campus wrote and confirmed that the college does indeed consider positives obtained at 40 ct to mean that someone is infected and thus subject to the policies relevant to infected people on campus.
On January 19th, just as the second semester was beginning, I wrote to the spokesperson and architect of the campus testing once again.
Dear XXXX and XXX:
I have another question regarding protocols.
Given that a recent publication by the CDC, and numerous other studies have shown that those infected by the Sars-Covid virus gain rather robust immunity form the experience, what allowance for this fact do you plan to introduce to the protocols for the upcoming semester?
Surely you cannot continue to place such people under a one-size-fits-all paradigm of risk.
Thanks: Tom
I was tersely told a few days later that they college was not contemplating making any changes to the testing protocols, something to which I responded in the following fashion on January 22nd 2021
Hi XXXX and XX:
Thanks so much for the quick response.
So, can I take that to mean that our health partners do not recognize, or are not interested in, the emerging science on post-infection immunity, even though this matter has potentially very important effects on the freedom of movement of many members of the College community?
Also, I was wondering if the College was planning to take the WHO’s new guidance on the use of RT-PCR test into account moving forward?
As you can see in this document, that organization makes clear that, in and of themselves, such tests cannot be used to determine the presence of disease. Rather, such diagnoses can only be made when combining that result with several other analytical processes.
Will all of these other processes be employed before making a judgment on removing people from the normal flow of life on campus? Will the college follow the WHO’s advice about retesting those for whom the “positive” does not correspond with clinical presentation while also withholding judgment about that person’s disease status in the interim?
Finally, you will note that the same document shows concern about the reliability any “positives” achieved at high ct levels.
Since the college is already using the tests at cycle levels considered by Dr. Fauci and numerous other scientists to be completely unreliable in terms of their results, is the college at all concerned about a potential legal or social backlash down the road against such testing practices, and their use as a justification for policies that restrict heretofore basic individual and communal prerogatives on campus?
Best, Tom
After receiving no reply to that message, I sent the following note to XXXX and XXX on January 26th 2021
Dear XXXX and XXX:
Hope all is well with both of you.
I thought you might be interested in the following study on the efficacy of different Covid tests that, citing the CDC’s publication “Common Investigation Protocol for Investigating Suspected SARS-CoV-2 Reinfection of the Centers for Disease Control,” states that that organization’s top accepted threshold for receiving reliable results from RT-PCR tests is 33 ct.
As the aforementioned study says: “Ct > 33 have been considered negative according to the Common Investigation Protocol for Investigating Suspected SARS-CoV-2 Reinfection of the Centers for Disease Control and Prevention.”
In light of this guidance, does the college have any plans to notify those who might have tested positive above this threshold that their diagnosis was not licit according to the CDC’s own current guidelines, and that the consequent restrictions placed on their freedom of movement resulting from this finding were probably not justified?
Will the college continue to label those testing positive above this threshold as Covid “cases” in the absence of any clinical findings indicating disease?
Best, Tom
After receiving another note in which the spokesperson simply reaffirmed that they were fully confident in the correctness and appropriateness of the advice being provided to them by their health partners at the Broad Institute, I wrote the following message on January 28th 2021.
Dear XXX:
Thanks for your reply.
In the interest of maintaining the principle of informed consent in relation to medical procedures and health rules to which a person is subject, could you kindly ask the experts with whom you are consulting to provide a brief bibliography of the peer-reviewed scientific papers they which they are basing their policy prescriptions regarding Ct levels in Covid testing?
Also, could you ask them to do the same regarding the mask mandates on campus?
I am aware that last summer the CDC suddenly changed its longstanding policy on the use of masks, but without, to my knowledge, adducing any new science to bolster its new enthusiasm for their use.
Up until that time the CDC, adhering to the extant science on the matter, had held that there was no robust proof to back up the notion that masks are effective at inhibiting the spread of respiratory viruses (In fact, one of the studies they cited before their about-face on the matter dealt with the spread of respiratory ailments in college dormitories).
But since the experts with whom you consult have apparently embraced the idea that masks are, in fact, important inhibitors of the spread of respiratory viruses, it would be nice to actually see that science that has guided them in this matter, and if, in fact, it actually constitutes the predominant view within the extant literature.
Thanks again:
Tom
Realizing that I was being completely stonewalled by XXXX and XXX, I decided to escalate my concerns to a higher administrative level. On February 21, 2021, I wrote the following message to YYY and YYYY, people quite high in the leadership hierarchy of the college.
Dear YYY and YYYY:
I have received your recent communications, and those of other members of the College Community, regarding the college’s testing program. And I must say I am a bit surprised by what I have seen.In recent months, one of the recurrent mantras at the College and in our country at large has been about need to “follow the science”. And more often than not, the science guidance adduced by those using this refrain has centered on guidelines produced or enunciated by some combination of the WHO, the CDC and Dr. Fauci.
It would appear that the college’s current testing processes deviate in significant ways from the latest practices recommended of these two health policy bodies and the nation’s acknowledged medical leader in the fight against Covid.
As XXXX and XXX confirmed to me, the College currently conducts its RT-PCR tests up to a 40 Ct threshold. While this permitted by the FDA guidelines regulating the use of such tests, numerous scientists, including Dr. Fauci (see video starting at 4:22) have stated that anything “found” by such a test over the level of 34 Ct is completely unreliable. This basic premise was upheld by an article published in the European Journal of Clinical Microbiology & Infectious Diseases in August of 2020. And, Dr. Michael Mina at Harvard has said that the level at which the test should be set in order to avoid numerous false positives should probably be at no more than 30Ct.
Apparently, the professionals at the CDC have “been listening to the science” on this. On October 27th of last year, that organization published new guidance that said that in least in the case of suspected Covid reinfections, anything found over a level of 33Ct should be treated as a negative.
Why is this important? Because the college is, it seems, using these tests to de facto abridge the basic freedoms of movement of faculty and workers at the college.
Sounds exaggerated?
Well, not to the judges of Portugal’s highest appeals court who found that depriving people of their freedom of movement on the basis of a highly unreliable test that throws off abundant false positives at higher Ct levels was a form of arbitrary detention.
However, that was not the Portuguese court’s only objection to the practice of using unreliable RT-PCR tests to restrict citizen freedoms. There was also the matter of what a medical “case” is, and who is empowered to certify its existence.
As you may or may not know, up until the late winter of 2020, a medical “case” could only and ever be said to exist following a full examination of symptoms by a licensed medical doctor.
However, in the late winter of 2020 both the WHO and the CDC suddenly changed this decades-long, if not centuries-long, practice on their own initiative.
However, in recent months they have, perhaps aware of the Portuguese legal finding and other similar legal efforts being pursued in Germany, both backtracked on this radical redefinition of long-standing medical practice.
In its new guidance, published on 14 December 2020 and updated in late January 2021, the WHO strongly reaffirms the role of the professional diagnostician in determining the existence of illness and infection saying, “Most PCR assays are indicated as an aid for diagnosis, therefore, health care providers must consider any result in combination with timing of sampling, specimen type, assay specifics, clinical observations, patient history, confirmed status of any contacts, and epidemiological information.”
The CDC has similarly walked back its endorsement of the RT-PCR test as a stand-alone diagnostic tool. In its new testing guidance published on 21 October 2020 it advises that people who have no symptoms and have not been in a proximity of less than six feet for over 15 minutes with a person known to be infected, should not be tested.
In fact, the same document states that even people with mild symptoms need not be tested and that, moreover, that anyone who was symptomatic and has recovered need not be tested for another three months.
In short, it reaffirms that symptomology as determined by a licensed physician, rather than the results of an often-faulty test, are to once again be on the leading edge of suggested mitigation efforts.
Perhaps, I am wrong, but it would appear that the College’s current practices are not in compliance with important elements of the recent scientific findings and CDC guidance referenced above.
To the best of my knowledge, the current Ct threshold of the College testing program remains at 40ct, thus guaranteeing the creation of many false positives, and from there, the unwarranted restriction of movement on numerous perfectly healthy people.
Is the college’s testing program currently classifying apparently matching viral material identified at over 33 or 34 Ct. as a “positive”?
If so, will the college continue to do this? Or will embrace the emerging scientific consensus which holds that anything found over 33Ct is probably dead viral material and thus should be classified as a negative?
If it decides keep things as they are, on what on the basis of what published science or CDC guidance will it be so doing?
Also, now that the CDC has reaffirmed that symptomology should lead testing, and not vice-versa, will the College do the same?
In short, will it thus discontinue the extant practice—correct me if I am wrong on this—of often using the test results in the absence of a full symptomological review by a physician, as the basis for restricting the movements and the normal privileges of the members of our community?
And on another slightly different if equally significant note, the CDC now says, as we have seen, that there is no need to re-test a person who previously tested positive for three months after that initial finding.
Can I now assume that the College will now follow this guidance and exempt such people from testing during a 90 period? If not, why not?
Finally, in the new testing procedures announced yesterday, you have stated that those testing “inconclusive” will nonetheless be treated, presumptively, in the same way at those testing positive until a second “negative” test can be produced. Could you explain the legal and medical basis for doing so?
In an American legal system that prizes individual freedom over the collective prerogatives of the government and corporate entities, ambiguities regarding guilt or innocence—whose clear correlates in this case are “infected with restricted freedoms” and “uninfected with freedom of movement”—are to be resolved in favor of the non-restriction of individual rights.
Similarly, the famous medical injunction from the Hippocratic Oath “to do no harm” comes down clearly on the side of hands-off prudence over the strident use of diagnoses and therapies of uncertain empirical basis when doubts arise.
I look forward to hearing from you soon.
Best: Tom
In his response two days later YYY simply re-stated his belief that the college was getting the best medical advice possible and that its policies were similar to those being pursued at peer institutions, and hence, that nothing would change. He did, however, acknowledge that the college had implemented the 90-day delay for retesting people who had tested positive and that they had, in fact, been following that policy since August of 2020.
I responded to his note in the following way on February 24th 2021:
Dear YYYY and YYY
Thanks for the note.
Glad to hear that re-testing is not taking place on previously positive people.
£Can I take that to mean that such people have full mobility and access to all areas on campus during that time?
Does the same apply to people with antibody tests and/or T-Cell tests showing previous infection with the virus?
I am also glad to hear that you are comparing notes with other colleges and universities in the Connecticut and the rest of the US.
However, that does not answer a number of the specific questions I asked.
Could you please respond to them in the interest of transparency?
Here they are.
1) Is the College currently treating RT-PCR positives obtained above 33 Ct as a positive? If so, on what scientific basis is this being done?
2) Is the College currently testing people in the absence of symptoms and a without a previous one-on-one examination of the person by a licensed physician? If so, on the basis of what scientific guidance is it so doing?
3) On what medical and legal basis will people showing “inconclusive” RT-PCR test be prevented from having full freedom of movement on campus?
Finally,
4) The EEOC has determined that testing in workplaces should only be done with tests that are “accurate and reliable”. Given that all RT-PCR tests are currently operating under Emergency Use Authorizations (EUA), meaning, as I understand it, that there is little if any double-blind scientific literature available to support their presumed efficacy, how can claims of accuracy and reliability be verified?
I look forward to hearing from you soon.
Best: Tom
After receiving no reply to my queries, I sent the following message to YYYY and YYY on March 2nd, 2021
Dear YYYY and YYY:
I thought you might be interested in seeing what Dr. Michaela Mina of Harvard is saying in the leading British medical journal The Lancet about the reliability of PCR tests.
The particular reliability concern analyzed in the piece is different than the Ct-level problem I have referred to in earlier emails.
In light of these doubts expressed by qualified professionals in leading journals, are you sure that it is wise for the college to continue to restrict citizen freedom of movement on this basis?
Here’s the link: https://www.thelancet.com/action/showPdf?pii=S0140-6736%2821%2900425-6
Best: Tom
I received a boilerplate-type “thanks for your concern” letter that ended with YYY simply restating that nothing I had sent would have any effect on existing policies. A day later, I followed up with the following note.
Dear YYY:
I am glad to see you have great confidence in the Covid mitigation methods currently being employed at the college.
I will only point out something that sometimes gets overlooked by policymakers: people and communities often work with flawed methodologies when living through moments of perceived duress, especially when they are given little or no say in their application.
However, this acquiescence does not prove that those methodologies are/were necessarily fully legal or backed by good science.
It seems rather clear, to take an example referenced in one of my earlier communications, that the Azorean Regional Health authorities in Portugal were convinced that their mitigation methods were legally acceptable and rooted in settled science.
That was, of course, before a panel of judges reminded them that a) basic citizen rights and rules of medical practice are not vaporized in times of perceived crisis and b) what is presented as the unquestioned “gold standard” of science in popular parlance and TV talking heads might not necessarily be so.
I can only hope for the College’s sake that, when the current bout of angst clears, there won’t be too many people taking hard-headed second looks at the proportionality, scientifically proven effectiveness, and strict legality of its current mitigation methods.
Best: Tom
I received no response to this message.
On April 19th, 2021 YYYY announced to the college community that the administration had concluded an agreement with a health provider to furnish vaccination for all enrolled students. He added that all students were expected to be vaccinated by the May 16th when they return home for the summer.
That same day I wrote the following message to him.
Hi YYYY:
Thanks for your recent note on the administration of vaccines to students at the College.I was just wondering if in the process of making vaccines available to students if you and the other members of the administration were planning—in compliance with both the spirit and the laws of informed consent—to:
1) Inform students that these vaccines have not been approved by the FDA owing to the fact that they have not undergone a full cycle of testing, and that they are thus being used under and Emergency Use Authorization (EUA), which is another way of saying students are de facto part of a large clinical experiment (something explicitly evinced in the some of the documents cited below).
2) That the companies producing the vaccines have full immunity from damages should these experimental products injure or kill those who receive them.
3) That according to the CDC’s latest best estimates people in the age group of 0-17 have a 20 out of 1 million chance of dying (99.998% survivability rate or .002% mortality rate) if infected with the SARS-CV2 virus, while people in the 18-49 cohort, which includes all, if not most of our students as well as a good percentage of others on campus, have a 500 in a million chance of dying (99.95% chance of surviving or a .05% chance of dying). And if they are in generally good health the chances are even smaller than that.And as you are well aware, the cohort of those “infected”, even with the numerous false positives certainly being generated by an RT-PCR being run, as is the case at the College, at 40ct, is still a relatively small part of the population in any given age band.
I think you would have to agree that being informed of the statistically known consequences of not taking a medical treatment, never mind an experimental one, is an absolutely necessary element of any regime of informed consent.
If for example, I have a benign or extremely slow-moving cancerous tumor would it necessarily be wise to submit to a form of complex and possibly dangerous surgery to get rid of it? And would not the doctor be compelled to inform me, in contrast, of the probable fairly positive outcomes were I to elect to do nothing? And would he or she be liable were he or she not to inform me of this? I think these questions answer themselves.
Another important question is whether to “strongly encourage” the taking of vaccines within the student body might be seen as a form of coercion, which is not allowed under most interpretations of the doctrine of informed consent.
4) That according to the applications for Emergency Use Authorization for the three major vaccines, none claims to immunize those that take them from infection or, perhaps more importantly, to inhibit asymptomatic transmission.
In the briefing document published by the FDA on the Pfizer vaccine it says:
“Data are limited to assess the effect of the vaccine against asymptomatic infection as measured by detection of the virus and/or detection of antibodies against non-vaccine antigens that would indicate infection rather than an immune response induced by the vaccine. Additional evaluations will be needed to assess the effect of the vaccine in preventing asymptomatic infection, including data from clinical trials and from the vaccine’s use post-authorization.”
The FDA briefing document on the Moderna vaccine states:
“Data are limited to assess the effect of the vaccine in preventing asymptomatic infection as measured by detection of the virus and/or detection of antibodies against non-vaccine antigens that would indicate infection rather than an immune response induced by the vaccine. Additional evaluations will be needed to assess the effect of the vaccine in preventing asymptomatic infection, including data from clinical trials and from the vaccine’s use post-authorization.”
In the document published in December by by the CDC Advisory Committee on Immunization Practices’ Interim Recommendation for Use of Moderna COVID-19 Vaccine, the authors characterized the differing levels of certainty they had about the various capabilities of the vaccine in the following manner:
“From the GRADE evidence assessment, the level of certainty for the benefits of the Moderna COVID-19 vaccine was type 1 (high certainty) for the prevention of symptomatic COVID-19. Evidence was type 2 (moderate certainty) for the estimate of prevention of COVID-19–associated hospitalization and type 4 (very low certainty) for the estimates of prevention of asymptomatic SARS-CoV-2 infection and all-cause death”.
The FDA briefing document on the Jansen vaccine states in the section titled Vaccine effectiveness against asymptomatic infection that:
“Available Day 71 N-serology data from a small subset of participants in the study, with infrequent evaluations of serological and virological measurements, are limited to assess the effect of the vaccine in preventing asymptomatic infection. There is uncertainty about the interpretation of these data and definitive conclusions cannot be drawn at this time. Additional evaluations will be needed to assess the effect of the vaccine in preventing asymptomatic infection, including data from clinical trials and from the vaccine’s use post authorization and including additional data to support the sensitivity of serologic and virologic surveillance methods.”
I am under the impression—of course I could be wrong—that many people at the College are taking the vaccine on the premise that doing so will help curb transmission of the virus.
Can I assume that, in the interest of complying with the obligation to ensure informed consent in the taking of experimental medicines, you and your staff will be actively informing all being vaccinated of the fact that that none of the three major vaccine makers claim, nor do they adduce any clear evidence to support the proposition, that these vaccines will reduce asymptomatic transmission?
I look forward to hearing from you soon.
Thanks: Tom
YYYY responded to this message not by answering and of my queries and then saying that according to their surveys 94% of the student had expressed an intention to get fully vaccinated. This, as if the opinion of a highly propagandized crowd, effectively trumps scientific data. He stated that if the College’s students do not like these requirements, they can go elsewhere. I guess he though this meant all the things I had asked about were thus moot issues. He then added, contrary to all available evidence, that since the college was not engaging in “human trials” he felt no need to address my raising of this matter.
On April 23rd, 2021, I responded in the following manner.
Thanks YYYY
It seems there might be a problem of communication here.
It’s not that the College is conducting an experiment per se. Rather it’s that the vaccines themselves are experimental. An EUA is not approval. And these three vaccines cannot be approved fully precisely because they have not gone through the full cycle of safety testing which will be completed, at the very earliest, in 2023.
Therefore, all those involved in giving and taking them are engaged in an experimental process. This, regardless of whether you and the College see yourself as doing so.
Are you aware of the guidelines regarding coercion in experimental processes that grew out of the Nuremberg principles?
While I am not a lawyer, it would seem that making the full participation in campus life dependent on the receipt of an experimental and unapproved medical product is pretty clearly coercive.
By the way, as nice as it is to have on your side now, history often shows that popularity for a given measure as demonstrated in opinion research in a given moment is not always the most durable indicator of either the moral or the legal correctness of a measure.
Best: Tom
On April 27th later, after not hearing anything in response to my previous note, I sent the following message to YYYY and YYY
Dear XXXX and XXX:
This morning I received the following message from a student.
“Yesterday I received the second dose of the Pfizer vaccine. Although I hoped to be able to attend class today, I am experiencing extreme symptoms: nausea, intense joint pain, and as I tried to begin moving around today, I lost consciousness, leaving my roommates to deal with my mess! Because of the degree of the reaction, I’m going to go to the health center.”
This would seem to have all the markings of an “adverse event” following the taking of a vaccine.
I was wondering if the College, which is actively encouraging students to take these still not fully approved vaccines, plans to report such incidents to Vaccine Adverse Event Reporting System (VAERS) run in cooperation with the CDC?
If not, why not?
I was also wondering if you plan to announce these adverse events to the community with the same assiduousness with which your regularly announced to us the advent of new “cases” which were in fact not cases by any previous definition of the term (which was always anchored in the diagnosis of symptoms by a licensed physician), and were used, moreover, to deprive students—most of whom to my understanding were symptom-free– of their basic freedoms of movement and assembly?
It seems that if was considered licit community news to report on how perfectly healthy people tested positive on a notably inaccurate test being run at CT levels guaranteed to produce false positives (tests, moreover, that both the CDC and WHO have said that cannot in and of themselves diagnose anything), then these adverse events should also be similarly publicized.
Don’t you agree?
I look forward to hearing from you soon.
Best: Tom
That was the end of my back and forth with my colleagues and college administrators during Covid.
Well, kind of. During the summer of 2021, the college announced that all faculty members would either need to be vaccinated or to submit to daily testing to be on campus. As I had been studying the vaccines, their capabilities and their risks for some time now, I believed strongly in the principal of bodily autonomy, I had no intention of getting vaccinated.
So, in mid-July I applied for a medical exemption on the basis of the still very strong antibody levels and T-Cell levels I had from previous infection(s). A doctor attested to this fact and said in my exemption request form that “Patient has no indication to receive a Covid-19 vaccine. After recovering from having the Covid-19 virus, patient has long-standing immunity as evidenced by present antibody response on a lab report obtained on 5/17/21.
Two weeks later I received the following message from Human resources. “
Dear Thomas,
Your request for medical exemption from the COVID19 vaccine has been denied by the Health Center.
Reason: Vaccine after illness is required.
And with that, my academic career was done for all intents and purposes. I was, however, able to work out a deal with the administration to teach the classes I had scheduled for the fall of 2021 and the winter session of 2022 from home, after which I would have to say good-bye to it all. I suspect that this was granted, as much as anything else, because finding a qualified substitute for my classes at the end of the summer would be more trouble than just letting me finish this last round of teaching from home.
The Comically Grotesque Coda at the End of It All
In the middle of the Spring 2022 semester, I received a note saying the department would be having a celebration of me and my career. I immediately wrote back that I was out of the country and would not be back on the date they proposed for the celebration. A short time later, they wrote back and said that the celebration would go on without me. And a report from a colleague confirmed that it did, which only goes to show that there is a subset of people that always manage to remain classy right up until the bitter end.
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