Three Masks, New York City, March, 2016. Copyright, Gerald S. Feldman, 2024
Part II
by Gerald S. Feldman
Abandoned on a hilltop and raised by wolves – or so he imagined and sometimes wished.
Suckled with fear and weaned on hate. Behind a mask that thrummed a mantra of “positive thinking.” That hid his true face from all who might read it – smarter, surer and more powerful than he. Happy and serene in this fearful and unlucky world.
In adolescence he was taught to kill. Because being a ‘killer’ was the highest office to which one could aspire – at least according to his father. His father killed daily and tutored young Donald in the craft – not with guns or knives or poison, or hatchets. Or anything the law could detail in a forensic report. There were no ridges of a fingerprint that could be lifted from a glass, No ballistic rifling on a discarded shell casing, nor anything else that could put an end to his life-long spree.
Because his father killed without resource to common weapons of art, his victims succumbed with discretion to cutting remarks that were sharp and sliced deep into where they were most vulnerable and tender, draining their last drop of self-worth into darkening pools. (Some say he killed his eldest son, Don’s older brother, in just this way.)
In business he grew rich by killing his competitors. He killed them by bribing officials to win prized contracts. And with bended knee he swept floors of the minutest remains of projects completed – to turn them to use in ones upcoming, and finish with a cost cutting coup de gras that none other could match.
So that by the time his father was long in his grave, his son and apprentice had bested him by gathering victims from venues he’d never have ventured. They included: defrauding the elderly of their life’s worth of savings; collecting millions in charitable monies he used for himself; divorced two wives, married a third, cheated on each, and molested scores more – to later be held to account for one he’d raped. And then Donald Trump bested his father even further by defrauding the citizens of this country into electing him as their forty-fifth president.
So when the nation (and the world) confronted the most deadly medical crisis in over a century, with Donald Trump as president and Anthony Fauci, the director of NIAID and our country’s foremost expert on infectious diseases — the cast of the two main adversaries in our national (and personal) melodrama was complete. Natural foils – who were each to the other an opposite in every conceivable way.
Funny how opposites can at first seem so alike.
Before Covid both Fauci and Trump had a natural camaraderie. Both New York boys born in the 1940s who jived to a familiar patois – . Trump’s a hybrid of Fifth Avenue/Queens meander and Fauci’s a softening of Kings County swagger. They were two in the know, who could huddle and laugh at the white bread D.C ers who knew nothing from a bagel, nor a pizza slice held folded straight down the middle. Fauci liked Trump whom he found charming and funny. And Trump liked Fauci because he was a famous Harvard educated doctor and scientist. He talked like a guy from the neighborhood, who knew his ass from his elbow.
But then came the great disillusionment when Covid arrived and hammered down its stake.
Fauci noted, “Trump was always looking for someone to tell him what he wanted to hear.” Which was far from what fauci was telling him – that they would be in for a long, brutal trial, that would test them to the brink.
So Trump’s wishful thinking (which had just surfaced during the first lock-down in March 2020 when he guaranteed unrealistic openings by upcoming Easter) found its avatar in a self proclaimed ‘expert’ he’d seen as a frequent guest on Fox News,
Dr. Scott Atlas, a former Professor and Chief of Neuroradiology at Stanford University Medical Center in California, advocated for an alternative natural “herd immunity” approach to the one of the Centers for Disease Control (CDC) – which he called a “massive overreaction” to a disease that would “cause only about 10,000 deaths.”
To Trump, Scott Atlas’s extraordinarily optimistic projections — which varied wildly from almost every other health organization’s worldwide, depended on a strategy that the overwhelming medical consensus opposed – was his answer.
And adding to his appeal for Trump, Scott Atlas was a senior fellow at a conservative public policy think-tank, the Hoover Institution, and his public health care recommendations followed politically conservative strategies for parsing and delivering healthcare coverage.
Like most conservatives, Atlas opposed Medicaid expansion (for those unable to afford insurance, but not receiving public assistance) under the Affordable Care Act (ACA); he lobbied for the elimination of the ACA altogether (to be replaced by tax incentives and deductions). And along the same lines, he was against a public health care option or a single payer health care system.
Rational arguments can be made for and against the kind of system conservatives favor that refrain from altering that which has had proven success. A restraint that leaves in place a traditionally vertical structure, which starts with a top tier that optimizes care for those who can pay the price the medical industry demands – in order to provide an indispensable engine for funding research and development of new, more effective diagnostics, treatments and cures. Developments that over time become absorbed into general practice and make their way down to those less financially able, but who remain at risk because of the delays in availability of what is new, regardless of need.
Similarly, arguments for and against a more progressive system organized horizontally that attempts to provide a high degree of coverage and quality of care for all – but can result in increased service delays, and potentially decreased rates of innovation.
Some protested that Atlas’ scheme was political. His natural “herd immunity” strategy did depend on a certain hierarchical division, in which the virus was allowed to spread unchecked among the young and healthy, while the elderly and infirm remained segregated and therefore protected. For the majority younger and potentially healthier, this meant: No quarantines, no masking, no social-distancing, no repeated hand washing. No business closings, no testing. And since, according to Atlas, children were basically immune, no school closings, so parents could continue to work, leaving businesses uneffected. And like his healthcare coverage recommendations, it had a conservative restraint – of leaving things to essentially go on as they were among a majority, that had a financial benefit of preserving the economy. It depended, however, on a large degree of added risk.
What Scott seemed not to consider – for the young and healthy with greater resistance who would not succumb to the virus, but develop milder cases, retaining an immunity shared by the similarly young and healthy members of the “herd” – was that this recently acquired immunity was sure to stimulate something difficult (if not impossible) to overcome –natural selection. Over their infinitely brief lives, countless generations of the virus could evolve new strains in order evade their host’s newly acquired immunity, eliminating any advantage gained by encouraging this strategy, that on the contrary, stimulated a more diverse virus population of potentially greater virulence and geometrically enhanced spread. (Which is why even with vaccines — the safer and controlled way of achieving the goal of herd immunity — periodic boosters are needed to defeat the inevitable evolutionary process that creates new resistant strains that ensure the virus’s survival.)
If that was not enough Atlas seemed also not to consider that the younger and presumably healthier population responsible for achieving herd immunity included a large contingent of those at the lower end of the economic scale, comprising a mix of racial minorities, low-wage unskilled labor, and those on the fringes who lived less secure lives with additional stresses of often living in areas of elevated crime, in inferior, sometimes multi-generational housing (that could be unsanitary), further undermined by poor nutrition, and limited healthcare access. All of which led to a compromised resistance to disease, leaving them especially vulnerable to Covid, that could result in an engine of further contagion, deaths, and spread throughout the entire working community and beyond.
Whether by ignorance, or delusion individually — or together, by design – omitting these well established (and other similar) objections and severe warnings by the medical community to his calculus of establishing natural herd immunity, it seemed Atlas was attempting to shoehorn a political philosophy that placed protecting the economy at the utmost tier, above human lives, as his prescription for what was needed in the face of the pandemic.
Further, because he was as a physician, who now had a real influence with the president to establish a national strategy – he was doing so with the knowledge that he was trespassing onto a field in which he had no known training or experience, a field that opposed his strategy – which potentially made him guilty of a severe abrogation of his oath “to do no harm.”
As Fauci later commented: “I have real problems with that guy. He’s a smart guy who’s talking about things that I believe he doesn’t have any real insight or knowledge or experience in. He keeps talking about things that when you dissect it out and parse it out, it doesn’t make any sense.”
Regardless, on August 20, 2020, Trump officially appointed Atlas as an advisor to the Corona Virus Task Force, on an equal footing with accredited experts: Dr. Anthony Fauci, Director of NIAID; Dr. Deborag Birx, former Assistant Chief of the Walter Reed Allergy/Immunology Service; and Dr. Robert Redfield, Virologist and Director of the CDC.
Three weeks later, September 9, 2020, seventy eight infectious disease physicians and research microbiologists and immunologist epidemiologists and health policy leaders – all former colleagues of Scott Atlas at the Stanford University Medical Center – wrote an open letter protesting Trump’s appointment of Atlas as advisor to the president’s Corona Virus Task Force. They stressed their “moral and ethical responsibility to call attention to falsehoods and misrepresentation of science recently fostered by Dr. Scott Atlas.” And that because “many of his opinions and statements run counter to established science… [could]… undermine public health authorities and credible science that guides effective public-health policy.”
And they listed “the preponderance of data accrued from around the world that supported the effectiveness of approaches opposed by Atlas.”
From the use of face masks, hand washing and hygiene that effectively reduced the spread of covid.. They emphasized the necessity for testing asymptomatic individuals exposed to the disease because they were shown to be just as likely to spread the disease (perhaps even more so because they can more easily evade precautionary measures) , that “children of all ages can be infected” while less common could spread it to others, and that “serious short-term and long-term consequences of covid-19 are increasingly described in children and young people, [Over five-hundred children have died.]”.
And that “encouraging herd immunity through unchecked community transmission … would cause a significant increase in preventable cases, suffering and deaths.”
Their conclusion was emphatic: “The policy response to this pandemic must reinforce the science, including evidence based prevention and safe development, testing and delivery of efficacious therapies and preventive measures, including vaccines, represent the safest path forward. Failure to follow the science – or deliberately misrepresenting the science – will lead to immense avoidable harm.”
On November 30, 2020, Atlas resigned. Yet Trump continued to praise him as “one of the world’s great experts.”
Special issue. Tuesday, November 5, 2024 (Part III will follow)
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