“We should have studied whether social distancing works.”
In a previous article I discussed how doctors performatively fetishized randomized-controlled trials (RCTs) not to advance medical research, but rather to spread doubt and mistrust about unwanted mitigation measures. In that article, I wrote the following:
Pro-infection doctors didn’t honestly question whether mitigation measures slowed the spread of the virus, they sought to undermine them precisely because they slowed the spread of the virus.
It’s worth expanding on this because it shows how utterly disingenuous much of our COVID discourse really was. For example, consider the article How to Save Science From Covid Politics by Dr. Vinay Prasad. He wrote:
Let’s say we want to find out if a particular policy—say, mask mandates—actually helps. A randomized trial is a tool that allows us to separate the biases of the world—some states are blue, some people take more precautions, some places have higher vaccine rates—and lets us figure out the actual value of an intervention. By randomly assigning groups to either have the intervention or not, you balance out the variables and isolate the effect of the mandate.
Many experts have called for more randomized trials during the pandemic. But they were ignored. We should have studied whether social distancing works, and how much distance is ideal. We should know a lot more about who to test, why we’re testing, and how often to test. Even school closure and reopening could have been studied. Randomized trials could have turned political fights into scientific questions. Not running them was a huge failure.
This seems straightforward, but it raises a very basic question. What exactly does Dr. Prasad mean by the words “helps” and “works”? He seems to be saying, “We should have done RCTs to investigate whether or not mitigations measures slowed the spread of COVID.” He seems to further imply that if only we had solid evidence from RCTs that mitigation measures “helped” and “worked”, then we would be perfectly justified in using them and nobody would object to them, as if we all shared the same goal.
But we didn’t all share the same goal.
“It is reckless to let children age into a more serious encounter with a disease best dealt with while younger… Shielding kids from exposure only increases their future risk… For children, getting sick and recovering is part of a natural and healthy life… Exposures are how we best protect our children against the variants of the future… Immunity is built through illness.”
Indeed, slowing the virus was not Dr. Prasad’s goal for most of the pandemic, especially for children. Quite the opposite actually. His article Should We Let Children Get Omicron?, written during the deadliest part of the pandemic for children and just two weeks before the article discussed above, was crystal clear about his intentions. He wrote:
These measures are premised on the idea that America’s children must be shielded from exposure to Covid-19. What kids really need, however, is a return to normal. When it comes to infectious disease, normality means a world where they are routinely exposed to, and overcome, viral illness. For children, getting sick and recovering is part of a natural and healthy life…
Parents must consider that exposures are how we best protect our children against the variants of the future. In fact, it is reckless to let children age into a more serious encounter with a disease best dealt with while younger.
He proposed using sick, unvaccinated children as human shields to theoretically protect more vulnerable adults. He said:
Shielding kids from exposure only increases their future risk. This is partly why the UK does not vaccinate against chickenpox. Serious complications from the disease are rare among children, and the circulating virus allows adults to be naturally boosted against reactivation-driven shingles. By rebuilding population immunity among the least at-risk, moreover, we help buffer risk for those most vulnerable.
He favorably quoted Professor Francois Balloux who said:
I’m not sure how to convey this message in a half-acceptable way. But, if the objective were to send SARCoV2 into endemicity, then healthy kids have to be exposed to the virus, ideally earlier than later. This is not ‘eugenism’; it is bog-standard infection disease epidemiology.
He similarly quoted an editorial in the BMJ that said:
Once most adults are vaccinated, circulation of SARS-CoV-2 may in fact be desirable, as it is likely to lead to primary infection early in life when disease is mild, followed by booster re-exposures throughout adulthood… This would keep reinfections mild and immunity up to date.
Dr. Prasad urged his readers to accept pediatric fatalities “as a matter of course”, writing:
While the death of any child is a tragedy, Covid-19 is less deadly to children than many other risks we accept as a matter of course.
“Schools are not sterile, nor should they be. Immunity is built through illness,” he concluded.
“Dropping masks, quarantines, distancing, and all other mitigations will allow children to develop the kind of broad immunity gained by living a normal life.”
So let’s image a fantasy world where it was possible to have run every RCT Dr. Prasad dreamt of. Let’s further pretend that these pristine RCTs unambiguously showed that mitigation measures meaningfully slowed the spread of COVID. Would Dr. Prasad then say these measures “helped” or “worked”? Would he have come out guns blazing advocating for these mitigations?
Of course not. His mind was already made up. He didn’t need any RCTs to say it was “reckless” to even try to prevent COVID in children. When Dr. Prasad asked the question should we let children get Omicron?, he answered not by calling for any RCTs, but by saying “restrictions in schools must never return”. He added this:
It is important to emphasise that a more laissez-faire approach to kids and Covid makes public health sense, too. Dropping masks, quarantines, distancing, and all other mitigations will allow children to develop the kind of broad immunity gained by living a normal life.
And there it is. Pro-infection doctors didn’t honestly question whether mitigation measures slowed the spread of the virus, they sought to undermine them precisely because they slowed the spread of the virus. Almost no one, not even Dr. Prasad, sincerely doubted that mitigation measures limited the spread of the virus. However, some doctors feigned ignorance about their impact because they felt that “shielding kids from exposure only increases their future risk.” In this upside-down mirror world, by definition, the only policies that “helped” or “worked” were those that “allowed” unvaccinated children to be repeatedly exposed to SARS-CoV-2.
It only makes sense when you remember this- they wanted them infected.