If you read or watch nothing else about Covid-19 today or this weekend, make sure you watch Margery Smelkinson’s 4-minute testimony.
It’s here.
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May 13 2023
If you read or watch nothing else about Covid-19 today or this weekend, make sure you watch Margery Smelkinson's 4-minute testimony. It's here.
READER COMMENTS
Monte
May 13 2023 at 1:55pm
What the CDC, Fauci, Lewinsky, Weingarten et al, backed by the Biden Administration, did by ignoring the REAL science behind natural immunity and the obvious impact of prolonged school closures amounts to criminal negligence, IMO. And that they now distance themselves from their own policy failures and offer no apology to the American people is an outrage.
A body of men holding themselves accountable to nobody ought not to be trusted by anybody. – Thomas Paine
Thomas L Hutcheson
May 13 2023 at 5:59pm
Nothing much new. Dr. Smelkinson points to just one area in which CDC failed to provide individuals and public officials with up to date and changing scientific information with which _they_ could take actions and craft policies to limit the costs of the disease at minimum cost on other dimensions. And the blame must extend to FDA for failing to permit development and deployment of tests to screen for asymptomatic infection and thereby foreclosing multiple ways interrupt the chain of infection at lower cost than closure of schools and other venues.
As for vaccine hesitance, I place more blame there on CDC for over-hyping the “safety” of vaccines instead of there effectiveness and politicians and media personalities who saw personal utility in fomenting distrust of vaccines.
Michael Rulle
May 14 2023 at 7:21am
What politician would have been more inclined to believe Ms.Smelkinson’s review— Trump or Biden——-(just an example)——does not mean either would have been right or wrong for the right reason——-still—-we know the answer.
Nature magazine ———perhaps fraud is too strong a description of that journal—-but I will go with it. They produce more essays and studies that do not follow scientific protocol then seems plausible.——-they certainly quack like a hack. I particularly find their essays on climate change remarkable. It does not surprise me they follow the same method on Covid.
David Henderson
May 14 2023 at 11:17am
I literally (and yes, I’m using the word correctly) don’t understand your first sentence. Can you clarify?
Michael Rulle
May 16 2023 at 9:53am
What I meant to communicate were 2 basic points.
1. My guess is Trump would have agreed with the author , even if his reasoning was not correct (not saying it would have been incorrect). Biden would not have agreed.
2. Nature Magazine is overrated. See essay by Nobel Prize winner Randy Schekman’s harsh critique of Nature. He believes they distort science and he will not publish any essay in Nature.
Scott Sumner
May 14 2023 at 12:19pm
Excellent. This is just one of many examples where policymakers ignored the science.
Thomas L Hutcheson
May 14 2023 at 10:39pm
More specifically did not use to make or facilitate making decisions that pass cost-benefit tests.
steve
May 14 2023 at 1:19pm
She is right about a few things, wrong about some others and is so wrong about some she has to be lying. Maybe she is just arrogant and is one of those people who thinks stuff is “proved” if you have one paper to support your preconceived ideas.
She is sort of correct about schools. Some places maintained their school policies too long, however we didnt have really good evidence until later than she claims. We had a couple of papers but we still didnt know long term effects. (How could we after only a few months?) So we conducted our own natural experiment with some schools going back much sooner than others. Since schools are locally run what each school did largely reflected their own appetite for risk.
She is wrong about us not knowing or that it was not published that natural immunity was recognized early. However, there are a couple of problems. One, you have to get the virus in order to be immune, meaning you could get sick or spread it to others. Second, we didnt know for quite a while how long the immunity lasts. In fact it took several months for repeat cases to show and at first they were hard to identify since many of those people were diagnosed clinically and were not tested due to shortages of tests.
Once we did figure out you could be re-infected and started to get a handle on how long immunity could last the virus was mutating and the variants were even more infectious. So first, we have a history of working with viruses and we know from other viruses that sometimes natural immunity lasts longer, but sometimes vaccine immunity lasts longer/works better. Next, we had a moving target. After that, she doesnt mention that the literature at one point more strongly supported vaccines. In particular, natural immunity seemed to be related to how severely sick you were. So if you nearly died you had good immunity. Vaccines more consistently provided immunity.
At present, we live in the present, hybrid immunity appears to be best. Maybe I missed it but I didnt hear her mention that. Makes me think she is present a POV and not literature based science. Many other things about which she was wrong but takes too long. You can lie and spin things in a matter of seconds but it takes a long time to explain what really happened.
Steve
Monte
May 15 2023 at 12:48am
Your first paragraph applies with equal measure to the rest of your comment, but unlike you, I’ll concede the benefit of the doubt about lying.
We had the intuitive sense that the costs of prolonged school closures would far outweigh the benefits. That intuition proved 100% correct based on the fact that we had solid evidence early on that the risks to school-aged children were virtually non-existent.
Her point was that natural immunity was given little, if any, consideration by the mainstream medical community. Almost without exception, “no jab, no job” became a standing policy for most businesses. This was politics at its ugliest, not science.
Which turned out to be true of the vaccinated, as well. Walensky touted CDC data suggesting the vaccinated almost never carry the virus. I’m hesitant to give the benefit of the doubt about lying here.
And less deadly. “No jab, no job” became a standing policy for most businesses and a highly unethical justification for violating an individual’s autonomy by mandating a medical intervention.
Not true. Having SARS-CoV-2 confers much greater immunity than a vaccine.
This is a bigger indictment of those individuals I mentioned in my original comment than it is of Ms. Smelkinson.
steve
May 15 2023 at 11:15am
“We had the intuitive sense that the costs of prolonged school closures would far outweigh the benefits. That intuition proved 100% correct based on the fact that we had solid evidence early on that the risks to school-aged children were virtually non-existent.”
Intuitive sense is not evidence. We did not have solid evidence early. We figured out by the fall that kids were at low risk of death but we did not know if there were long term effects. It also took a while to figure out the risks of kids spreading disease to adults.
“Her point was that natural immunity was given little, if any, consideration by the mainstream medical community. ”
Totally wrong. We were obsessed with natural immunity and trying to figure out how long it lasted. As I noted above for the first few months we thought it might be possible the immunity was permanent. No jab, no job recognized that with he early variants the vaccines stopped spread with 70%-90% effectiveness, plus it kept people out of the hospital. If businesses were concerned about insurance costs or just having people at work it made sense.
“Which turned out to be true of the vaccinated, as well.
Wrong again. As i said above, early on it reduced risk and reduced spread. As the pandemic went on vaccines and natural immunity equalized, meaning some studies showed natural immunity better, the ones she cites, and other showed vaccines better, the ones she ignores. At present, it looks like the combo of vaccine and having been infected is best.
““No jab, no job” became a standing policy for most businesses”
As noted, when the vaccines first came out they were very effective at stopping both spread and severe illness. It made sense to require the shot. Over time they became less effective at stopping spread, dropping to 50% and with the latest variants it is lower.
“Not true.” The Israeli study was dealing with Delta. The earlier variants responded better to vaccines. There are several issues with the Israeli study but it should be noted that it was one of the early ones to note that the combination of vaccine and infection was superior to either alone. If your goal was to either prevent spread or reduce severe illness you needed to require the vaccine.
“This is a bigger indictment of those individuals I mentioned”
You seem to be concentrating on people to blame. I am concentrating on both what the literature said/says and living through the experience managing pts and the response to covid. I dont particularly care who Smelkinson is, but I do know what literature she chooses to ignore and what she chooses to reach her conclusions. It is especially egregious on her part to make the claim that the mainstream medical community ignored the idea of natural immunity. We were very aware of it.
Steve
robc
May 15 2023 at 12:21pm
April is in the fall now?
We knew almost immediately the age-based risk.
From the earliest stats, it was clear that the virus was not a risk to young and healthy individuals.
steve
May 15 2023 at 2:55pm
No we did not. In April we had no idea about morbidities and long term follow up effects. Was covid going to act like ARDS and leave a lot fo people as pulmonary cripples even if they didnt die? In April we still weren’t even sure about all of the pathophysiology that lead to death and morbidities. It took a while to recognize how much clotting was an issue. That also meant we didnt know if there was long term vascular damage that would show up in delayed vascular and cardiac morbidities or death.
Also remember that in March and April the death rates for hospitalized pts was about 30%-50% higher than what it was 6 months later. So what people constantly do is look at what we did two years later, what we knew two years later, when we were dealing with a much different variant later, and try to apply that to what was going on in the first 6 months or year of the pandemic.
Steve
robc
May 15 2023 at 5:22pm
What I said is accurate: In April we knew the age-based risk. I wrote an article on it in April 2020, the economic analysis in the article is pretty bad, but the data analysis holds up.
Closing schools for the rest of the school year in spring of 2020 made sense. Any school that didnt open in the Fall of 2020 was insanely stupid.
Monte
May 15 2023 at 8:19pm
In the absence of hard evidence, an intuitive sense of what policies to implement is the next best alternative. We certainly knew what the educational, emotional, and other physical effects of long-term school closures would likely be. And there WAS an emerging body of evidence early on that indicated kids were at very low risk:
“Early data from K-12 schools do not confirm fears that bringing students together in classrooms inevitably creates COVID-19 petri dishes — although the absence of a standardized national database of school cases makes it impossible to know for sure. University researchers have partly filled the void with a plethora of data analyses from selected schools and grades. One of the largest studies, led by Brown University economist Emily Oster, PhD, analyzed in-school infection data from 47 states over the last two weeks of September. Among more than 200,000 students and 63,000 staff who had returned to school, Oster reported an infection rate of 0.13% among students and 0.24% among staff.” (Association of American Medical Colleges, November 5, 2020).
“School closures were an unnecessary response to the SARS-CoV-2 virus. Simply put, children were not in danger of severe illness nor death from COVID-19″ according to Dr. Tracy Hoeg, an epidemiologist from the University of California at San Francisco. “The school closure policies recommended by the CDC and adopted in most states throughout the nation were not based on scientific data and were among the “worst” public health decisions of our lifetimes.”
If the experts were obsessed with it, they certainly didn’t promote it. In fact, based on CDC recommendations, the policies enforced by the administration, schools, and many businesses dismissed it out of hand and allowed few, if any, exemptions:
“On the evidence available, Such policies should have recognised proof of natural immunity as a sufficient basis for exemption to vaccination requirements. While we clearly cannot settle the scientific debates on this point, we lack clear and convincing scientific evidence that vaccine-induced immunity has a significantly higher protective effect than natural immunity. Since vaccine requirements represent a substantial infringement of individual liberty, as well as imposing other significant costs, they can only be justified if they are necessary for achieving a proportionate public health benefit. Without compelling evidence for the superiority of vaccine-induced immunity, it cannot be deemed necessary to require vaccination for those with natural immunity.” (Journal of Medical Ethics, Volume 48, Issue 6).
Please cite evidence for that level of effectiveness (other than the CDC, which has demonstrated itself to be unreliable and highly politicized). While the vaccines helped attenuate the severity of the Delta and Omicron variants, there were vast numbers of fully vaccinated people that suffered break-through infections and spread the virus to others, which doesn’t strengthen the case for a “no jab, no job” policy.
If the experts were obsessed with it, they certainly didn’t promote it. In fact, based on CDC recommendations, the policies enforced by the administration, schools, and many businesses dismissed it out of hand and allowed few, if any, exemptions:
“On the evidence available, Such policies should have recognised proof of natural immunity as a sufficient basis for exemption to vaccination requirements. While we clearly cannot settle the scientific debates on this point, we lack clear and convincing scientific evidence that vaccine-induced immunity has a significantly higher protective effect than natural immunity. Since vaccine requirements represent a substantial infringement of individual liberty, as well as imposing other significant costs, they can only be justified if they are necessary for achieving a proportionate public health benefit. Without compelling evidence for the superiority of vaccine-induced immunity, it cannot be deemed necessary to require vaccination for those with natural immunity.” (Journal of Medical Ethics, Volume 48, Issue 6).
Please cite evidence for that level of effectiveness (other than the CDC, which has demonstrated itself to be unreliable and highly politicized). While the vaccines helped attenuate the severity of the Delta and Omicron variants, there were vast numbers of fully vaccinated people that suffered break-through infections and spread the virus to others.
I disagree. Businesses should have carried out detailed risk assessments showing whether or not compulsory vaccination was the best way of dealing with the risk of COVID-19 in the workplace. Instead, most followed in lock-step with the CDC and the Biden administration by foregoing the time and costs associated with a proper risk assessment and implemented “no jab, no job” indiscriminately.
No. The vaccines reduced the risk of severe illness or hospitalization for the elderly and those with co-morbidities, but were not very effective at reducing the spread:
“Most papers to date indicate vaccines are holding up against admission to hospital and mortality, says Linda Bauld, professor of public health at the University of Edinburgh, “but not so much against transmission.”
Previously addressed as inaccurate.
This shouldn’t have been a nationwide policy applied to every individual without exception. The focus should have been on those most at risk. It’s already been demonstrated that the vaccines failed to prevent the spread. Extended lock-downs, school closures, and vaccine coercion proved to be extremely counter-productive and costly policies.
You set the tone of this discussion by disparaging Ms. Smelkinson’s credibility and character. That’s an odd way for a doctor presumably concerned with only the literature and lived experience to respond to a staff scientist at the National Institute for Allergy and Infectious Diseases. I challenge you to point out specifically where she lied about any of the claims she made in the video. And based on our discussion (which includes a number of opposing views by scientists based on several studies), I wonder what literature you chose to ignore in order to reach your conclusions?
steve
May 16 2023 at 10:52am
Will do bullet form
Read my second paragraph. I will say it again. I said she was sort of right about schools. We can debate about definition of “early” but I would agree that in the fall we had pretty good mortality numbers for schools (Oster paper and a couple of others). However, we didnt have much about long term effects, if any, on kids. Once again, economists and people who comment on their blogs focus solely on death. Its as if you guys wouldn’t care if your kids got polio because the risk of death was low and who cares if people are paralyzed. That said, in the fall I think I can safely say that among those caring for kids we had a sense that the risk of long term morbidity was low, but there wasnt much literature to support that belief.
I have no idea what you mean by promote natural immunity. If you mean that people should go get covid to develop immunity that is a high risk approach. That was actually talked about quite a bit. Within the medical community, which is her initial claim, we were well aware of natural immunity. As I said before at first we weren’t sure it was possible to be re-infected. Also again, the sequence needs to be remembered. At first we did not know how long natural immunity would last. Once we had vaccines at first it looked like vaccines were better. With time and different variants natural immunity looked to be as good, slightly better in some studies. At present, hybrid immunity is clearly superior. https://www.nebraskamed.com/COVID/covid-19-studies-natural-immunity-versus-vaccination
Only one cite per post. Will try to do it later but I have provided this link probably a dozen times at Cowen’s site.
Nope. Literature suports.
First, it wasnt applied everywhere as lots of places ignored it. Second, early the vaccines were pretty effective against spread. If people had actually gotten vaccinated we might have had a lot less spread and fewer illnesses.
Easy. I listened to her again. She said that the medical community failed to recognize the protection from natural immunity. While she is not a clinician she is a proclaimed expert and must have access to medical literature. It is impossible that she would not know about the debates we had over whether re-infection was even possible. If she is not lying sh tis so ill-informed she should be ignored. Next, notice that she said that natural infection “could” provide immunity, not that it always did. She does not lay out the time course. I guess we could call that spinning. Last, she omits the finding in the Israeli paper you cited and several others (at the link above) that show the combination of vaccine plus natural immunity, at present, seem to be the most effective. This seems to my like lying by omission, the kind of thing someone who is trying to project a POV rather than science based data would do.
My biases? When I was young I believed the first “good” paper that comes out. Now I like to see stuff replicated before I believe it and preferably by a source I think has a good track record. I also think long term. While my clinical practice is oriented toward crisis I chair a department and realize that we too often ignore the long term effects of illnesses. I am very skeptical of literature form 3rd world sources. They have a much higher rate of poor methods and are not screened well compared with first world lit. I run a private practice group in an academic setting, but I have a lot of skepticism, bordering on disdain at times for the pure academics. Thie work is important but sometimes they dont know what they dont know since they have little contact with real, live patients.
Steve
Monte
May 15 2023 at 10:23pm
One final comment. Our public health agencies are going to be hard-pressed to restore the public trust in the aftermath of this pandemic. Aside from their mixed messaging and suppression of information, when you force an experimental drug on people and exempt pharmaceutical companies from any liability for potential adverse effects, that’s egregious.
Speaking of which, this study revealed that “Serious and severe harms of the COVID-19 vaccines have been downplayed or deliberately excluded by the study sponsors in high impact medical journals.” It has yet to be peer-reviewed, but, prima facie, it does little to convince us of vaccine safety and efficacy.
steve
May 16 2023 at 9:51am
robs=Please provide a link to your paper. I would love to see how you reached conclusions about the long term effects so early. At that point all most of were aware of were crude mortality rates. Since I do critical care I would especially be interested on your data on readmissions to the ICU and the effects of prior illness but also the long term follow up, preferably at least 3 months out. Also, since we weren’t really sure we were dealing with uniform variants throughout the US, more or less the entire world, how did you determine how many variants were extent, the rate of mutation and whether or not the new mutations were more or less deadly? It’s a real shame your paper wasn’t more widely known.
robc
May 16 2023 at 11:56am
I think you have fundamental reading issues.
First, its robc, not robs, but that might just be a typo, they are sort of near each other, but combined with other reading issues, I question it being a typo (I am in the never ascribe to incompetence that that can be explained by malice camp).
Second, it wasnt a paper, it was an article. A quick one off for a libertarian site. it had no scientific basis, it was a quick look at the data as existed in April 2020.
Three, as I already said, in April we knew the age-based risk (of mortality). I didn’t consider long term effects, and I was right not to. The article was called “The Calculus of Death – A Love Story” (hopefully from the title you can guess the tone of the article). It focused on mortality, because, IMO, at the time it was clear that people who survived didnt have long term effects. The assumption (which could have turned out wrong, but didnt) was that it was bad flu, not new polio.
I would link it, but the site that hosts it has been having server issues the last 12 or so hours, so its down right now. Will link later.
robc
May 16 2023 at 12:32pm
https://www.glibertarians.com/2020/04/calculus-of-death-a-love-story/
steve
May 16 2023 at 4:03pm
What I specifically said was “No we did not. In April we had no idea about morbidities and long term follow up effects. Was covid going to act like ARDS and leave a lot fo people as pulmonary cripples even if they didnt die? In April we still weren’t even sure about all of the pathophysiology that lead to death and morbidities. It took a while to recognize how much clotting was an issue.”
I said nothing about mortality. You replied.
“What I said is accurate: In April we knew the age-based risk.”
You didnt mention mortality either. Since you were responding to my comment I took you at your word that you had age based risks for all of the things, or at least some, that I mentioned. So good, we have clarified that. In April we had no idea of the long term age-based risks of covid. As I noted, we didnt fully understand the pathophysiology at that point.
Steve
steve
May 16 2023 at 10:59am
https://www.cdc.gov/media/releases/2021/p0607-mrna-reduce-risks.html
Monte
May 16 2023 at 12:50pm
I had to chuckle at this. If you’ll recall, I asked for you to cite evidence for that level of effectiveness “other than the CDC, which has demonstrated itself to be unreliable and highly politicized”. Do you have other sources from which you can cite evidence to corroborate this study? If not, I remain more persuaded by the studies already mentioned disputing covid vaccine efficacy on transmission.
Seriously?
Really?
“Not only were children overwhelmingly spared the threat of severe illness and death, previously published European and international data likewise confirmed Hoeg’s testimony that when European schools reopened in 2020, there was no increase in community transmission. A British Royal Society study, for example, observed that “the lower susceptibility of schoolchildren substantially limited the effectiveness of school closure in reducing COVID-19 transmissibility.”
What I mean is that public health agencies like the CDC ignored NI as a mitigating factor in formulating a policy recommendation of compulsory vaccination. This recommendation influenced the administration, school boards, and businesses to completely disregard any appeals for exemption on that basis.
A counter-factual unsupported by the evidence. Pure supposition and conjecture.
Once again, she is referring to what I just alluded to. The CDC and other public health agencies disregarded NI as a request for exemption from compulsory vaccination. This is indisputable.
You’re wading into semantics here that are irrelevant. The use of the word “Could” doesn’t diminish the point she was trying to make. And just because she omits certain studies that might either substantiate or corroborate her POV doesn’t constitute lying by omission.
We should be critical of all forms of literature, including that which you and I have been referencing. But 3rd world literature can also provide accurate and insightful data and shouldn’t be dismissed out of hand as such.
steve
May 16 2023 at 4:34pm
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8099312/
Seriously? Seriously. If you address morbidity you will be one of the very few commenters at an econ site I will ever see address them. Might even be a first at this site.
Really?- Your quote does not address long term effects among children. Severe, but not fatal infections in adults often to lead to longer term pulmonary dysfunction. What was that incidence in kids? Were there long term vascular issues? We didnt know and sounds like you didnt either.
“What I mean is that public health agencies like the CDC ignored NI ”
I will partially agree if that is what you meant, but this is mostly based upon a desire to avoid being vaccinated when the vaccines are safe and as noted in the Israeli study you cited, the best option almost always included being vaccinated. My concerns, another bias I guess, is to choose the best treatment options based upon the best literature. How much liberty one should have to infect others is a separate topic I think.
“Pure supposition” No, we knew the R values for every variant. A vaccine that was 90% effective, as shown in the Israeli cite, would get us down to a rate where transmission dies out.
“Once again, she is referring to what I just alluded to. ”
You are interpreting for her. I am telling you what she actually said. After she said what I quoted she went into a somewhat lengthy, simplified, definition of natural immunity. She was establishing herself as the superior in expertise over the general medical community. It is only later on that she refers to messaging. Note that she is reading off of written notes. If this were extemporaneous maybe its OK for you to interpret for her, but that is not the case.
“her POV doesn’t constitute lying by omission.”
Seriously? Say you go to your doctor and ask which of two drugs is better for your diagnosis. He says they are both about the same but one is a little bit better. In fact, the medical literature suggests you do much better if you are them both. If your doc doesnt tell you that he is lying by omission and you would have to suspect there is some reason for doing that.
And I forgot one. Her claim about losing medical staff is misleading. Becker’s has followed that pretty extensively and I know what all of the hospitals in our area did. The percentage of people who left the medical profession was tiny. First, most hospitals offered generous exemptions. he legal standard in most states is just having a sincere belief so it was easily met. Second, of those who left any specific place of employment with most hospitals reporting in the 2% or less range, most of those went to work elsewhere joining the traveling nurses group to make more money.
“shouldn’t be dismissed out of hand as such.” Agreed, but I have seen much higher error rates and poorly done studies in that group so they bear, I believe, closer scrutiny.
Steve
Monte
May 16 2023 at 9:13pm
That lack of evidence in no way justifies a nationwide school closure for over a year. To defend this policy is to completely ignore the preliminary evidence that was available to reasonably assess the risks of re-opening schools and to accept the hugely detrimental effects we knew would result from a prolonged shutdown. In this Evidence Summary of Pediatric Covid-19 Literature dated 3/20, morbidity studies focused on Pediatric Multi-System Inflammatory Syndrome (PMIS) indicated incidence was rare. By fall of 2020, there was no justification for keeping schools closed based on the remote possibility of those issues you mention occurring. Evidence on post-acute COVID-19 syndrome is still limited, particularly for children and adolescents. To have continued with the recommendations by our public health officials on that basis, and that you seem to be defending, was just bad policy. OTOH, we’re beginning to see more long-term adverse effects related to certain covid vaccines in the study I cited earlier. That’s rather disturbing, don’t you think?
The experience in our local hospitals (and I would argue most everywhere else) was different. Exemptions were very rare. I would also argue that the percentage of people who left the medical profession or other jobs was relatively small because their jobs were being held hostage by employers who were enforcing vaccinations. Most people couldn’t afford NOT to get the jab or risk losing their jobs.
I think we’re at an impasse here. There are opposing views backed by credible scientific evidence on both sides of this issue, but I’m still convinced that we made bad decisions with respect to prolonged school closures and compulsory vaccinations and that people should be held accountable. As to whether Ms. Smilkinson is the scoundrel that you’re making her out to be, I guess that’s up to the readers on this forum to decide.
Thank you for the discussion, continued success in your capacity as a health care professional, and I give you the last word.
Comments are closed.