Hippocampal lesions

Probably the most famous single patient of the past 100 years was an unfortunate man named Henry Molaison, more commonly known by his initials HM. Mr. Molaison suffered from epilepsy, and in an attempt to cure him of the condition, surgeons removed both of his hippocampi. Mr. Molaison stopped having seizures but was tragically unable to form new memories for more than a few minutes. He lived over 50 years, but was forever stuck in 1953, when he had his operation.

I’ve never seen someone this permanently disabled, fortunately, but I’ve met multiple patients with identical deficits due to treatable or transient disorders, namely limbic encephalitis and transient global amnesia. It’s fascinating but unnerving to talk to people whose consciousness is fixed in a moment in time, unable to process that the world around them is changing. They keep saying the same thing over and over again and can’t retain any new information. It feels a bit like Bill Murray’s experience in Groundhog Day.

“…the extraordinary measures being carried out in cities and states around the country are surely justified”

With this is mind, let’s examine a statement made on March 20, 2020.

If it’s true that the novel coronavirus would kill millions without shelter-in-place orders and quarantines, then the extraordinary measures being carried out in cities and states around the country are surely justified.

This eminently reasonable justification for lockdowns came from an article titled Is the Coronavirus as Deadly as They Say? by Drs. Eran Bendavid and Jay Bhattacharya. Dr. Bhattacharya is well known as one of the authors of the Great Barrington Declaration (GBD), which advocated that healthy, young people magically separate from older, vulnerable people to create herd immunity by getting infected with a virus that seems to mutate enough not to provide lasting immunity. I previously likened the sophistication of this plan to my childhood idea of eliminating crime by “locking up all the bad guys”.

Beyond this, Dr. Bhattacharya famously said that Florida “protected the vulnerable” in the summer of 2020. Six weeks later, the headlines declared “Florida breaks COVID-19 deaths record fifth week in a row“. He wrote self-pitying editorials in international newspapers claiming that he’d been muzzled. He said that vaccine mandates spread the virus. After COVID-19 killed hundreds of children and the flu just one child, Dr. Bhattacharya said that more children died from the flu. That statement is as honest as someone saying a cat weighs more than an elephant.

In an essay titled “The ill-advised push to vaccinate the young“, Dr. Bhattacharya and Dr. Martin Kulldorff, a co-author of the GBD, claimed that,

The idea that everyone must be vaccinated against COVID-19 is as misguided as the anti-vax idea that no one should. The former is more dangerous for public health.

I’ve read this line 100 times, and I still find it jaw dropping. In the middle of the worst pandemic in 100 years, they feel it is more dangerous to vaccinate young adults and children than to vaccinate no one at all. That’s certainly a fringe idea, is it not? If a genie granted them the wish to vaccinate everyone in the world or no one at all, all indications are that they would choose to vaccinate no one at all. It’s no wonder congressmen and judges ridicule him and repeatedly deem his testimony unreliable.

Dr. Bhattacharya also said, “The emergency phase of the disease is over… We should be treating covid as one of 200 diseases that affect people.” I’d personally love it if COVID-19 occupied 1/200th of his attention. However, Dr. Bhattacharya clearly doesn’t think we should be treating covid as one of 200 diseases that affect people. COVID-19 is the only disease he speaks about, and he does so constantly.

Dr. Bhattacharya disagreeing with Dr. Bhattacharya will be a recurring theme of this essay.

“A 20,000-40,000-Death epidemic is a far less severe problem than one that kills two million”

Dr. Bhattacharya’s early statement that lockdowns would be justified to save millions of lives seems uncontroversial today, and indeed most of us accepted lockdowns at that time to avoid hospitals being overwhelmed and to buy time for vaccines. However, Dr. Bhattacharya was not in favor of lockdowns when he made that statement.

Though he was clear that mass death would justify lockdowns, at the time he felt “there’s little evidence to confirm that premise” that COVID-19 could kill millions and that “projections of the death toll could plausibly be orders of magnitude too high.” He wrote that “if we’re right about the limited scale of the epidemic, then…A universal quarantine may not be worth the costs it imposes on the economy, community and individual mental and physical health.” Simply put, Dr. Bhattacharya was against lockdowns at the start of the pandemic because he didn’t feel COVID-19 would be that bad. He wrote, that “a 20,000-40,000-death epidemic is a far less severe problem than one that kills two million”, and that early estimates of mass death were “deeply flawed.”

As the USA inexorably marches towards the devastating milestone of a million COVID-19 deaths, these early estimates don’t seem “deeply flawed” at all, especially considering that “extraordinary measures” were taken and that highly effective vaccines were widely available a year after the first wave. One might reasonably expect Dr. Bhattacharya to reflect on his early optimistic prediction and concede he was wrong about the “the limited scale of the epidemic”. One might further expect he would conclude that the “the extraordinary measures” taken at the start of the pandemic were indeed justified. After all, he wrote that the death of millions would warrant such measures and he was absolutely right about one thing – a million-death epidemic is a far more severe problem than one that kills 20,000-40,000.

However, as Dr. Bhattacharya is generally incapable of acknowledging basic facts much less admitting error, exactly one year after saying lockdowns were justified to prevent mass death, he pivoted and said that COVID-19 lockdowns were the “biggest public health mistake we’ve ever made…The harm to people is catastrophic“. In March 2021, he said “the lockdowns themselves impose great harm on people. Lockdowns are not a natural normal way to live”. Of course, there were no lockdowns when he made this statement, though he spoke about them in the present tense.

This is why I opened this essay discussing people with hippocampal injuries, frozen in time, unable to learn new information.

Lockdowns

Debating lockdowns today is kind of like debating prohibition. That era has long passed. No place in the USA has been locked down since the first few months of the pandemic, and the lockdowns here were much less stringent here than in many other countries. Even as the omicron variant spread widely, politicians from across the political spectrum resisted further lockdowns.

In an essay titled “We’re All Trying to Find the Guy Policing Our Behavior“, Alex Pareene described his normal family routine and noted that:

Elsewhere, Disney World was officially full on New Year’s Eve. For $107 I could book a flight to Bermuda this weekend. The Knicks lost at home yesterday; a fan was spotted at the game watching The Office on mute. Vietnamese restaurant Que Viet, a Minneapolis mainstay famous for the giant egg rolls on a stick it sells each year at the Minnesota State Fair, is opening a St. Paul location. The number one movie in the country is Scream.

It all seems very normal. It seems a bit uncannily normal, really, happening against a backdrop of hundreds and hundreds of thousands of new Covid-19 infections across the nation, and months of Americans dying by the thousands. And yet! To hear some people, this is a country where panicky scolds refuse to allow children to go back to school, or, in some vague sense, let people have their normal lives back.

He continued, “This is why I find the tenor of discussion around Covid-19 restrictions genuinely bewildering. There basically aren’t any.” He’s right.

It’s January 2022

Though lockdowns are a relic from the pandemic’s first days, Dr. Bhattacharya and his GBD coauthors still talk about lockdowns constantly. The whole sad spectacle is exactly what it’s like to talk to patients with hippocampal injuries.

Like them, Dr. Bhattacharya seems stuck in time, unable to process that the world has changed. His consciousness is fixed in March 2020, when politicians shuttered businesses and schools. He desperately wants them all open, and of course, most are. Yet, Dr. Bhattacharya seems blissfully unaware that nearly two years have passed, the lockdowns ended long ago, and that the virus will soon kill a million Americans, a situation for which he said lockdowns were “surely justified”. Even as late as October 2021, in an interview that mentioned lockdowns over 40 times, he said to help children we should “End the lockdown, because the lockdown is causing devastating harm for them“.

I have good news for Dr. Bhattacharya on that front. It’s January 2022.The lockdowns ended long ago. Politicians aren’t closing schools You can go to restaurants, concerts, museums, and basketball games. I’ve done all this right here in liberal New York City. Yet, not everything is open. The virus is closing schools, canceling concerts, and shutting down Broadway shows.

Not only is Dr. Bhattacharya stuck in March 2020, like patients with hippocampal injuries, he has not demonstrated that he can learn certain facts. As far I know, he’s never acknowledged that over 1,200 children have died of COVID-19 and that around 100,000 children have been hospitalized. He’s never recognized that the vaccine has proven extremely effective at preventing these rare but severe harms in adolescents. He seems unable to retain the fact that schools closed or used the National Guard as babysitters this winter because so many students and teachers contracted the virus, not because politicians closed schools. His “plan” to open schools by saying “open schools” was nothing more than empty virtue signaling given that he also undermined every effort to contain the virus in children.

I’d love for Dr. Bhattacharya to demonstrate the power of his hippocampi and share information on how the virus has hurt children and how the vaccine can protect them. He has a much larger platform than I do. However, for contrarian doctors, bad facts about the virus and good facts about the vaccine suffer the same ultimate fate as facts told to brain-injured patients. Though one group can’t remember them and the other group refuses to acknowledge them, they are never spoken.

Of course, Dr. Bhattacharya’s hippocampi are fully intact. He knows children are dying of COVID-19 every day. He knows the vaccine can prevent this. Dr. Bhattacharya simply chooses not to acknowledge these basic facts. He also knows nowhere in America has been locked down since the start of the pandemic. Repeatedly discussing distant lockdowns as if they are an ongoing threat is also a very purposeful decision on his part. The imagined specter of dreaded lockdowns serves as a boogeyman to disparage any and all means to limit COVID-19 infections in young people, including vaccines, masks, and testing. Any attempt to control the virus is labeled “draconian” by sheltered, histrionic doctors who don’t work in COVID-19 ICUs. Even a simple statement that children should get vaccinated will sometimes be met with accusations of “lockdowner” by the financial backers of the GBD.

The vaccine isn’t perfect, but it’s much safer than the virus for young people. If you’re confused why someone would try to obscure this important information, you’re not alone. I certainly don’t understand why so many doctors spread misinformation about a potentially life saving vaccine for children. But here’s how I’ve come to think about things.

Dr. Bhattacharya hopes that by linking effective, generally benign measures to control the virus to the most draconian, loathed measures, he can better achieve his fabled goal of “focused protection” through mass infection of children and young people. His constant protests against imagined lockdowns and his anti-vaccine position towards young people make perfect sense only when one remembers a disturbing fact – he wants young people to be infected with the virus. The whole premise of the GBD was that young people should “live their lives normally to build up immunity to the virus through natural infection”. It was clear that herd immunity “can be assisted by (but is not dependent upon) a vaccine”. In other words, for the vast majority of children and young people, this really was a “let er rip” strategy. There’s no pretending otherwise.

Effective vaccines are a direct challenge to his pro-virus ideology, and so he opposes vaccines for young people. In a statement that might have come from the mouth of Andrew Wakefield, Dr. Bhattacharya said,

I don’t think if there’s any good reason to vaccinate kids that young did for kids [sic], they face a vanishingly small risk from COVID itself, near zero from mortality from COVID… I think that it is a mistake to think about this as good for kids. It’s not good for kids.

Dr. Bhattacharya and other contrarian doctors can take a lot of credit for the fact that many parents fear the vaccine more than more than the virus. They’ve all spread many myths about COVID-19 and children, always minimizing the dangers of the virus and always overstating the dangers of the vaccine. The very real harms children have suffered are dismissed with obviously false statements that the flu has killed more children than COVID-19 and empty bromides that children have a “quite small” risk from COVID-19. I doubt that will be much comfort to the families of the 27 children who died just last week.

The GBD won

We are largely living in the world envisioned by the GBD. Except for the fact that millions of children are safely vaccinated, they basically won. The lockdowns ended long ago and pediatric infection rates are at an all time high. According to the American Academy of Pediatrics, 1,150,543 children contracted the virus last week alone. Meanwhile, as Dr. Bhattacharya hoped, overall childhood vaccination rates are abysmal. The GBD authors have every right to take a victory lap. Infected children have been their goal all along. I’m serious about this. The GBD authors should be boasting that a record number of children are contracting the virus now. Everything they’ve worked for has led to this moment.

Yet, they’ve been curiously silent about their success. It seems they’re afraid that people also know that a record number of children are going to the hospital now. Some of these children are very sick, needing ICU-level care. One news report said:

“I sorry, Mommy. Mommy hugs, I scared. I don’t like it. Mommy!” Those were the last words 3-year-old Justin Lee Francis spoke to his mother, Yvonne, before he was sedated and put on a ventilator at Primary Children’s Hospital last week, when he was diagnosed with COVID-19, asthma, pneumonia and other illnesses.

Some children are dying, including those who were eligible to be vaccinated.

Dr. Bhattacharya and his GBD co-authors are smart enough to know normal people don’t view sick, dying children as a good thing. So instead of loudly taking credit for millions of infected children as they should, the authors of the GBD are consumed by self-pity, furious that those who prefer vaccines to the virus for children view them as “fringe“. They feel compelled to constantly defend what matters most to them, their reputations, often with comical results. If I ever feel the need to make a video saying a movement I started “is NOT Koch Funded Eugenics,” I will take a real hard look at what choices led me to that point in my life.

“The lockdowns just postponed the inevitable”

Even though it’s only of historical interest, an honest broker would approach the question of lockdowns differently than Dr. Bhattacharya. They would try to honestly understand their benefits and harms. Did lockdowns stop the spread of the virus? Did they save lives? What were their costs?

From my vantage point, lockdowns clearly saved lives, at least here in New York City. COVID-19 hit us like a bomb. Our first case was confirmed on March 1, 2020. When we locked down three weeks later, an average of 16 people were dying per day. Three weeks after that, 829 people were dying daily, and hospitals were deluged. Some hospitals needed forklifts to move the bodies and refrigerated trucks were needed to store the bodies. Every other disease vanished from the hospital.

Then, the deluge receded. The refrigerated trucks left. Gradually, the hospital returned to normal. By the middle of May, the daily death toll fell below 100 people daily, still a large number of people. Thanks to vaccines, viral-induced immunity, and our behavior, our ICUs were never again overwhelmed with COVID-19 patients even during the recent omicron surge. Something abruptly stopped the spread of the virus here, and those who feel the lockdowns deserve no credit are obligated to provide a better explanation. What does Dr. Bhattacharya think stopped the virus so suddenly in the spring of 2020 in New York City? I don’t think I’ve ever heard him try to answer that. But I could have easily missed it. The man has made an inordinate number of YouTube videos.

Much of the evidence that lockdowns slowed the virus is common sense, of course. The virus couldn’t easily spread when people were separated. Formal studies support the obvious observation that lockdowns saved lives. One study, found that “36,000 fewer people would have died if social distancing measures had been put in place across the U.S. just one week earlier”.

Dr. Bhattacharya knows all this of course, which is why he reasonably said shelter-in-place orders and quarantines would be justified for a virus that could kill millions. Dr. Kulldorff also recognizes that lockdowns slowed the spread of the virus, though he disparaged them by saying that “lockdowns just postponed the inevitable“. This seems true to me. I honestly think few of us will avoid the virus the rest of our lives. That’s just a sad fact. The lockdowns just postponed the inevitable for a lot of us.

But this is not a bad thing! Dr. Kulldorff and other pro-virus doctors overlook two obvious points; 1) all of medicine is just postponing the inevitable and 2) there is often great value in postponing the inevitable. Dr. Kulldorff confirms this anytime he puts on a seat belt. The same is true with COVID-19. Someone who encountered the virus after being triple-vaccinated was much better off than an unvaccinated person who encountered the virus during the first wave when hospitals were deluged. Unless doctors make no progress in treating COVID-19, someone who encounters the virus in 2030 will be better off than someone who encounters it today.

Dr. Bhattacharya clearly saw the value in postponing the inevitable. Even though he instructed others to “resume life as normal” early in the pandemic, he wisely managed to avoid the virus until August 2021, several months after he had been vaccinated. Healthcare workers who worked with COVID-19 patients instead of making YouTube videos were often not so lucky. Around the world 180,000 healthcare workers may have died of COVID-19, including several of my friends.

The city I love became a ghost town

Of course, recognizing that lockdowns slowed the spread of the virus doesn’t mean I liked them. My children’s schooling was totally interrupted, and the city I love became a ghost town. Once the initial COVID-19 surge abated, I had it relatively easy. I never missed a paycheck, and my kids are old enough to mostly take care of themselves. It was summer, not winter. We were able to move a lot of our lives outside. Outdoor dining has permanently changed the streets of New York City for the better. On warm nights, it’s like there’s an outdoor party. I’m mostly too old, but I like seeing young people outside enjoying themselves. Similarly, Central Park turned into a chapel with dozens of outside weddings. Many people adapted to the lockdown. We all tried to be resilient. Aside from the predictable anti-vaccine sociopaths, most people in New York City looked out for one another.

Still, this is the silver lining of a dark cloud. The economic and social harms of the lockdowns were very real for a lot of people, and they were not distributed evenly. I know I was among the very fortunate. I have many reasons to be grateful. Some healthcare workers were driven to despair by what they went through. Recognizing that the lockdown saved a lot of lives doesn’t mean I don’t realize they had serious costs, and if robust studies undercut my observations and the studies thus far, I will accept the results.

Repeatedly this pandemic, Dr. Bhattacharya has contradicted Dr. Bhattacharya

In contrast, Dr. Bhattacharya is not dedicated to a method of inquiry, but rather to a result. He started with the belief that lockdowns were useless and harmful, and now struggles to retrofit data to validate his initial premise. This is easy for him to do. Dr. Bhattacharya will never treat a young person with COVID-19, or any person with any disease for that matter. Like most contrarian doctors, he experienced the pandemic from behind a computer screen, completely sheltered from the consequences of his words. He had the privilege to oppose lockdowns when he thought COVID-19 would not cause mass death, and to oppose lockdowns after COVID-19 had already caused mass death, including the deaths of thousands of people younger than 30 years.

Did Dr. Bhattacharya forget his initial claim that “shelter-in-place orders and quarantines” would be “surely justified” if “the novel coronavirus would kill millions”? Of course not. His hippocampi work just fine. He remembers what he said. He just hopes you’ll forget. But my hippocampi remembered that early essay and the compelling case it made for lockdowns. Now, so will yours.

I also noticed an interesting pattern. Repeatedly this pandemic, Dr. Bhattacharya has contradicted Dr. Bhattacharya. And given that Dr. Bhattacharya doesn’t take the ideas of Dr. Bhattacharya seriously, why should anybody else?

Author

  • Dr. Jonathan Howard is a neurologist and psychiatrist based in New York City who has been interested in vaccines since long before COVID-19.

Posted by Jonathan Howard

Dr. Jonathan Howard is a neurologist and psychiatrist based in New York City who has been interested in vaccines since long before COVID-19.