Declining Credibility of Public Health Officials

In a healthcare crisis, who do you look to for sound medical advice? Your primary care doctor is a good start, but he or she needs help from public health officials who have vast amounts of information from which to draw important conclusions. As a doctor, you expect to receive sound advice from these officials, which you can pass on to your patients.

In the past that system has worked fairly well. Such cooperation between public health officials and primary care physicians led to defeating such healthcare scourges as polio, tuberculosis, and the measles. But what if those same public healthcare officials are controlled by the politicians and the media? Now you have a real crisis – a crisis of credibility.

Soon after the Biden administration took office, Dr. Rochelle Walensky became the new Director of the Center for Disease Control and Prevention (CDC). The former CDC Director, Dr. Robert Redfield, was dismissed by the new administration in the usual transfer of power. This move might have been questioned in the middle of a pandemic, but the Biden administration wanted to appoint their own new director. Now we know why – they wanted someone they could control.

On February 21, 2021, I published a blog called CDC Director Caves to Politics. In that post, I discussed how Dr. Walensky first came out with a statement that schools could be reopened without teachers getting vaccinated, but then changed her position after the White House let her know that was contrary to their support of the teachers unions. Her scientific, medical opinion had to take a back seat to their political agenda.

The same thing is happening to the Food and Drug Administration (FDA). The first hint of this came in September, 2021, when two top FDA officials quit the agency complaining of undue pressure to authorize boosters. Marion Gruber, former director of the Office of Vaccine Research and Review, and her deputy, Philip Krause, later wrote about the lack of data to support a broad booster authorization.

Now it is happening again, this time over debate about a second booster, or fourth Covid shot. Dr. Marty Makary, Johns Hopkins professor of medicine, writes in The Wall Street Journal that the FDA last week authorized Americans 50 and over to get a fourth Covid vaccine dose. Yet some of the FDA’s own experts disagree with the decision, but the agency is simply ignoring them. The agency will convene its advisory committee this week to discuss future vaccine needs. Dr. Makary says this is like having lawyers present arguments to a judge who’s already issued a verdict. (see Fourth Covid Shot?)

Opposition to this move by the FDA comes from their own advisory committee. Eric Rubin, editor in chief of the New England Journal of Medicine and an advisory committee member, told CNN last month he hadn’t seen enough data to determine whether anyone needs a fourth dose whose immune system isn’t seriously deficient. Cody Meissner, chief of pediatric infectious diseases at Tufts Children’s Hospital, agrees. He said, “The fourth dose is an unanswered scientific question for people with normal immune systems.” Paul Offit of Children’s Hospital of Philadelphia told The Atlantic he advised his 20-something son to forgo the third shot, which the FDA recommends for everyone 12 and over.

Dr. Makary believes the crux of the board opposition to second boosters is the recognition of B and T cells, which public health officials have long ignored. They are focused only on antibody levels, which tend to decline in the months after vaccination, forgetting the significance of cellular immunity. B and T cells, once activated by the primary vaccine series or an infection (and augmented by a single booster in older patients), are highly and durably effective at preventing serious illness from Covid. An additional vaccine dose induces a fleeting increase in antibody levels, offering only mild and short-lived protection.

In keeping with the collusion between public health officials and the Biden administration, the CDC gave its formal approval to the FDA authorization only hours later – without convening its external vaccine experts.

Dr. Makary is also asking questions about the failure of the FDA to move forward with approval of two new Covid vaccines. Novavax and Covaxin are two vaccines made with traditional vaccine technology, rather than the new mRNA vaccines of Pfizer and Moderna. It is believed these vaccines may provide broader protection against variants, and both shots could overcome some Americans’ hesitancy about using a novel technology. Yet the FDA has still not acted on their emergency use authorizations which were applied for in January. Both have been approved by the World Health Organization and other countries.

Dr. Makary concludes, “Trust in public health is at an all-time low. When agencies bypass their own experts, it only reinforces the perception that health policy is driven by groupthink and politics.”  I couldn’t have said it better, especially when Big Tech stifles dissent from other health experts by controlling social media.

Update on the Omicron BA.2 Variant

It’s been almost two months since I first told you about the latest Covid variant, called Omicron BA.2 (Omicron Variant 2.0). What more do we know now than we knew then?

The Omicron BA.2 variant now represents more than half (55%) of new Covid-19 cases in the U.S., according to the CDC. Most of these cases are found in the Northeast. The region has the highest BA.2 concentration, including more than 70% in an area including New York and New Jersey.

U.S. data remains a mix of positive signs, including counts of hospitalized patients near record lows, and some evidence of new pressure as BA.2 spreads. As BA.1 cases decline, the percentage of BA.2 cases is rising. Some epidemiologists are hopefull that built-up immunity in the U.S. population from the winter surge can help mute the BA.2 variant’s impact.

What do we know now about the BA.2 variant?

The BA.2 variant of Covid-19 is a relation of the original Omicron variant, known as BA.1, according to Theodora Hatziioannou, an associate professor of virology at Rockefeller University. The two variants arose around the same time and come from the same ancestor strain. Viruses mutate all the time and diversification within a variant is normal. The earlier Delta variant comprised more than 200 sublineages before it was replaced by Omicron, according to Francois Balloux, director of the University College London Genetics Institute.

Renee Onque and Denise Roland, reporting for The Wall Street Journal, say it still isn’t known whether the BA.2 variant behaves in materially different ways than the original BA.1 variant. Some research suggests it may be more infectious, but like the original, it is less likely to lead to severe disease. Studies in Denmark showed no differences in hospitalization rates when comparing the two. A South African analysis also concluded that the odds of hospitalization and developing severe disease were about the same.

How is the BA.2 variant responding to treatment and vaccinations?

The BA.2 variant may be better at evading monoclonal antibody drugs developed to fight Covid-19, according to New York University virologist Nathaniel Landau. The antibody treatment sotrovimab, which was effective against BA.1, may be less effective against BA.2. The FDA is no longer recommending its use for this newer variant. However, other monoclonal antibody drugs such as remdesivir and molnupiravir, along with the oral treatment pill Paxlovid, have all shown effectiveness against the BA.2 variant.

Vaccines remain effective against both variants. An analysis by the U.K. Health Security Agency found similar vaccine effectiveness against symptomatic disease from both BA.1 and BA.2. Further studies are currently under way.

Where else in the world has the BA.2 variant been detected?

At least 40 countries have detected the BA.2 variant, including the U.K., Denmark, India, Sweden, Singapore, and the Philippines. It appears the BA.2 variant is displacing the BA.1  variant as the original Omicron wave abates and this new wave gathers steam. However, the large number of BA.1 variant cases has left the world with many people who have developed natural immunity, so the BA.2 variant is less likely to be as wide spread. The BA.2 variant has notbeen designated a “variant of concern” by the World Health Organization.