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Dan Rodricks: In pandemic, doctors treat patients for both COVID-19 and for misinformation | COMMENTARY

In August, the CDC reported that hospitalizations of COVID-19 patients reached their highest level since the start of the pandemic for all age groups under 50 years old.
In August, the CDC reported that hospitalizations of COVID-19 patients reached their highest level since the start of the pandemic for all age groups under 50 years old. (JEFF PACHOUD // Getty Images)

The U.S. death toll from COVID-19 is at least 645,000 and climbing. Just 61.7% of Americans age 12 or older are fully vaccinated, according to the Centers for Disease Control and Prevention, and the rest still refuse to get their second shots or any shots at all. Thousands are in hospital beds. People who were famously against vaccination have died from the virus. Some unvaccinated people are sick with the disease and taking horse dewormer for it.

The pandemic has been a showcase of America at its best — doctors, nurses, first responders trying to save lives; vaccines produced in record time — and its worst: governors ignoring medical advice and endangering their citizens, distrust of public health officials forged by right-wing media that pushed conspiracy theories and quack cures.

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On a recent show, Tucker Carlson, the sneering Fox News host, had the gall to blame the nation’s medical establishment for its public trust problem when Carlson and his colleagues have been relentless in their attacks on that very establishment.

As I noted in Wednesday’s column, Carlson’s guest that evening was Marty Makary, a surgeon, author and professor at Johns Hopkins University School of Medicine. Makary joined Carlson in criticizing the push for mass vaccinations and what he characterized as dishonesty in the medical establishment about the value of natural immunity — that is, the ability of the body to fight off the virus, without vaccination, after infection.

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Makary has publicly opposed the mandatory masking of schoolchildren. He predicted that the nation would achieve herd immunity months ago, and he was wrong. More recently, he wrote a piece for the Fox News website accusing President Joe Biden of announcing a plan for vaccine booster shots to distract from news of the U.S. withdrawal from Afghanistan. Such conflation of issues is the stuff of cheap talk radio.

Makary has chosen to reinforce messaging from Fox, a cable channel whose hosts have sowed doubt about the need for vaccination and masking and ridiculed the nation’s medical leadership. Other doctors at Hopkins are not happy about it. “Appalled” was how one professor at the Bloomberg School of Public Health put it during a conversation last week.

“Marty is a bit of a contrarian,” said another doctor, Kelly Gebo, a Hopkins infectious disease specialist who has treated hundreds of patients with COVID-19 over the past year. “He pushes against regular medical thought, and there’s a place for that in the world. But, during a pandemic, when we’re trying to protect the majority of Americans, we need to be careful with the words we use.”

Gebo says she recently received a letter from a woman whose employer required her to be vaccinated. The woman cited a statement by Makary that people who have survived the virus need not be vaccinated. (This was the point of Makary’s segment on Carlson’s show — that people who were infected and have antibodies are sufficiently immune to the virus. Carlson called it “insane” that health officials recommend that people who’ve survived infection still get the shots.)

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“I told her that while Dr. Makary is entitled to his opinion, he does not speak for all the faculty at Hopkins,” Gebo said. “Just because you have been infected with COVID doesn’t mean you can’t be reinfected.”

Indeed, Ravens quarterback Lamar Jackson had COVID once, got it a second time, and only then said he was thinking about getting vaccinated.

During the pandemic, the public has had access to a bounty of evolving information. That has presented a huge challenge for those of us who do not work in lab coats. It often looks like medical science can’t make up its mind when, in fact, that’s exactly what it’s trying to do. But too many Americans are impatient, lazy about reading, skeptical of government and professional expertise. Add to that a layer of political polarization, and you have the perfect storm of a lingering pandemic.

Marty Makary is entitled to his opinions, but I don’t see how anything he’s written or said over the last several months will bring us closer to the end of the crisis. He says he supports vaccination, but he takes part in a Fox show that raises doubts about it.

“Ad hominem attacks against public health officials undermine trust of the group actually charged with [responding to the pandemic] for the U.S. government,” says Dr. Stuart Ray, a professor in the Hopkins Division of Infectious Diseases who, like Gebo, has treated hundreds of COVID patients. “It’s uniformed members of the [U.S.] Public Health Service that Makary’s attacking.”

Ray’s main issue with Makary is his repeated claim that public health officials refuse to include natural immunity against the virus in favor of mass vaccination. But a strategy built on natural immunity would require proof via testing of antibodies in the millions of Americans who have survived COVID. Makary, says Ray, provides no plan for making that feasible given the resources available.

While Makary says he favors one dose of vaccine for people who have recovered from COVID, Ray says full vaccination is better than partial vaccination and partial immunity. “We don’t want people thinking they have protection they don’t have,” he says. “In addition, that person who is partially immune could be bad for controlling the evolution of new variants. You need to be all in to fight it effectively.”

And there’s the problem. We’re not all in. And so the pandemic continues.

“We all have to do our part,” Gebo says. “People who are vaccinated but who can’t mount a response — they’re on a variety of different medications or have [chemotherapy] or have an immune system that doesn’t work normally — those people need the rest of us to help them out. By doing our part, that’s how we help to make sure everyone else can stay safe.”

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