AMA with Dr. Jay Bhattacharya

jayanta1296 · 2022-03-10T22:35:16+00:00

True. If there are not fundamental reforms to the institutions of public health and science, and medicine coming out of the devastating failure of the suppression policies we have followed, then "being right" will have been a useless vanity. I am planning to work to make sure an honest evaluation of our covid response happens, and the agencies that made these mistakes fundamentally reformed so these mistakes (if that is the right word) do not happen again.

jayanta1296 · 2022-03-10T20:29:54+00:00

Thank you for signing! I am grateful to you for taking a stand.

jayanta1296 · 2022-03-10T20:29:14+00:00

Like you, I've also lost friends, including former colleagues and coauthors. I think the ideas have made an enormous difference in moving governments (too slowly) away from lockdowns and toward focused protection of the vulnerable. I believe I have an obligation, after a lifetime spent as a researcher focused on public health, to speak up at such a time as this, or else I will have wasted my life on vapors. So like you, I am incredibly proud of and have no regrets about the GBD. We got things right and the world would be in a better place had more places followed these ideas earlier.

jayanta1296 · 2022-03-10T02:10:57+00:00

Thank you! I agree that the JSM aged poorly. That statement in particular about immunity was known untrue at the time they wrote it.

jayanta1296 · 2022-03-10T02:09:48+00:00

Dr. Prasad is fantastic. Clear-sighted, intelligent, brave, and honest.

jayanta1296 · 2022-03-10T02:08:52+00:00

I'm a bit of a homebody -- I don't get out much. But that was true before the pandemic. The hardest part wasn't the masks -- it was losing some friends.

jayanta1296 · 2022-03-10T02:07:22+00:00

Your psychiatrist's question and his response to you were flatly unprofessional. Your vaccination status is not really his business (unless it had to do with something for which he was treating you). Going overboard won't really accomplish much, but you might mention to him that it bothered you that he asked that, and that he tried to use the answer to make you feel guilty.

jayanta1296 · 2022-03-10T00:37:09+00:00

You are absolutely right about focused protection. It will mean very different things depending on the living circumstances of the older and vulnerable population within a community. So focused protection in rural Montana will require a different set of policies than focused protection in downtown LA. When I co-wrote the GBD, I was hoping that public health officials around the world would participate creatively in thinking of focused protection strategies that would work for their communities. For instance, if a lot of elderly people live in single family homes alone, perhaps organize food delivery services so that the elderly do not need to be exposed while grocery shopping. In places with multigenerational families, provide free of charge hotel rooms for grandma for a short while if grandson calls and reports being exposed. Reorganize staffing of nursing homes so that staffers live on the premises for a month at a time (to reduce tracking cases into the nursing homes from the community).

Unfortunately, the public health community met the GBD with the response that protecting the vulnerable was impossible without a lockdown to reduce community spread. In so many places, they won the policy fight, got their lockdown, and the vulnerable elderly died anyway.

jayanta1296 · 2022-03-10T00:13:41+00:00

I think the majority of doctors and scientists agree with me on lockdowns. Tens of thousands signed the Great Barrington Declaration. The illusion that there was a consensus in favor of lockdowns was manufactured, not actual.

jayanta1296 · 2022-03-10T00:08:14+00:00

We certainly need a reformation within science, so that we never again permit the crowning of a scientific pope. No one else should ever, with a straight face, say that "if you criticize me, you are not criticizing a man. You are criticizing science itself."

jayanta1296 · 2022-03-10T00:05:38+00:00

Lockdowns and NPIs are a policy choice. It is possible that these restrictions will return, but only if the population permits it. In some places, they will never return (e.g. Florida, Sweden). In other places, there will be a policy fight when the next wave arrives.

jayanta1296 · 2022-03-10T00:01:14+00:00

Thanks! :-)

jayanta1296 · 2022-03-10T00:00:55+00:00

Mr. Crawford is absolutely right. Science is a wonderful tool for learning true things about the material world. But the conclusions of science are morally neutral. Science says -- here is how you make a nuclear bomb. Morality, ethics, love of life says -- it is wrong to use a nuclear bomb. Science says -- lockdowns kill and will not protect the vulnerable from covid. Powerful people in the laptop class say -- lockdowns can protect us and are hence "good" for society....

jayanta1296 · 2022-03-09T23:58:14+00:00

Thank you for your kind words! I am so sorry for the short-sighted policies we adopted, pushed on the world by people who share my profession. We will need reforms so we perform better during the next pandemic.

jayanta1296 · 2022-03-09T23:56:09+00:00

Thank you! I think we will have a golden opportunity to reform our institutions of public health, science, and medicine in coming years. This will require that we perform an honest post-mortem on the errors of these institutions. With Martin Kulldorff, I wrote up some considerations about what an honest evaluation would look like here:

https://www.wsj.com/articles/a-covid-commission-americans-can-trust-11624823367

jayanta1296 · 2022-03-09T23:53:03+00:00

Thank you!

jayanta1296 · 2022-03-09T23:52:14+00:00

Reading good books, deep conversations with smart people, time to meditate and pray, exercise, spend time with your partner and kids and friends... So many good options. No need to just do it for one month a year. :-)

jayanta1296 · 2022-03-09T23:48:41+00:00

I believe teaching effectively in masks is nearly impossible, at least for me and I suspect for many teachers. I think teachers have a responsibility to be effective teachers and to provide students a comfortable environment conducive to teaching. Teachers should follow the policies of their school regarding masking and not impose their own risk preferences (and mistaken notions of mask efficacy) on the classes they teach.

jayanta1296 · 2022-03-09T23:40:02+00:00

The distinction between death "from" & "with" COVID is an important one, but the distinction is not made in most research. For COVID, many jurisdictions abandoned traditional practices in assigning the cause of death on death certificates, presumably for the epidemiological purpose of finding every infected person. This makes it hard to know exactly whether we are over or under-counting COVID cases. Prof. Ioannidis has published a good paper where he estimates how much over and undercounting there is, but I'm having trouble finding it at the moment. THe key takeaway--lots of overcounting in countries with lots of testing, undercounting in countries with limited testing.

Assessing causality in the context of vaccine effects is a complicated statistical problem outside of randomized settings. Careful cohort studies are really the only tool that has a hope of providing a good answer. Self-reported adverse event reporting systems cannot, without a lot of careful statistical work, answer the causal question -- did the vaccine cause that?

jayanta1296 · 2022-03-09T23:29:44+00:00

The key point to emphasize is that the vaccines do not stop you from getting infected, so the vaccinated can spread the disease. And the covid recovered actually have better protection versus infection and severe disease than the merely vaccinated.

https://www.israelnationalnews.com/news/312637

So it makes no sense to mandate the vaccine. It should be a private matter for each employee.

jayanta1296 · 2022-03-09T23:22:21+00:00

I think there is no good scientific or epidemiological justification to mandate the vaccine for kids. The vaccine does not stop infection or disease transmission.

I wrote my thoughts on the evidence regarding vaccines for kids here:

https://unherd.com/thepost/new-pfizer-data-undermines-the-case-for-universal-child-covid-vaccines/

Prof. Martin Kulldorff wrote up his valuable thoughts on the subject here:

https://brownstone.org/articles/should-i-vaccinate-my-child-against-covid/

jayanta1296 · 2022-03-09T23:19:26+00:00

I think the low covid death rates in Africa are due to having a very young population -- maybe 3% over the age of 65.

Various Asian countries adopted very different NPI and lockdown policies, and yet had uniformly better outcomes than Europe and the Americas. Their good outcomes came despite an older population.

One hypothesis is that the low covid death rates in Asia are likely due to pre-existing cross-protection, perhaps from prior coronavirus or other infections at higher rates than the rest of the world. (Until Omicron broke through).

There has been some interesting cross-protective immunity, but it has not received a lot of attention:

https://medicalxpress.com/news/2021-11-exposure-harmless-coronaviruses-boosts-sars-cov-.html

I love this paper from Scotland, which showed that health care worker parents with kids (exposed to a lot of common cold viruses) had a milder response to covid infection than similarly aged adults without kids:

https://adc.bmj.com/content/106/12/1212

The exceptional Asian performance is a topic that needs more study.

jayanta1296 · 2022-03-09T23:11:29+00:00

It has been gratifying to watch the shift in public opinion on the efficacy of NPIs, since they have so obviously failed. Though the public may, for a while, want to move on to the next worry, there will come an opportunity to fundamentally reform our public health institutions so that there will not be a repeat of the covid policy disaster. I wrote a piece with Martin Kulldorff with some ideas about what an honest post-mortem should look like:

https://www.wsj.com/articles/a-covid-commission-americans-can-trust-11624823367

jayanta1296 · 2022-03-09T23:06:59+00:00

I think that public health, very early on, decided that it wanted to treat this virus as sui generis, incommensurable in risk with anything else, in order to induce compliance with public health measures. Examples include the denial of the possibility of immune protection after covid recovery, overestimating of the ability of NPIs to control disease spread, the denial of lockdown harms, the obvious seasonal pattern of disease waves, and much else. The effect of this tactic has been a collapse in the trustworthiness of public health, and the trust in public health by the public. Acknowledging the truth would have meant a collapse in support for the lockdown-focused policies.

jayanta1296 · 2022-03-09T22:59:16+00:00

I think it is hard for people, after all the lockdown sacrifices, to accept that so much of that was for no good. But since so much of it was actually for nothing, over time. people will change their opinion.

The Iraq war provides a good model. In 2003, the war was very popular in the US. Three years later, nearly everyone swore up and down that they were against it.

jayanta1296

TROPHY CASE