Covid Contrarians Are Poised To Lead Trump’s Health Agencies. Here’s How Their Critiques Have Aged.

The Covid wars are still raging in 2024, and now the Covid contrarians are in charge.

President-elect Donald Trump has rounded out his roster of health agency nominees by picking Jay Bhattacharya, a Stanford University physician and economist who criticized lockdowns, school closures and health agency leadership during the pandemic, to lead the National Institutes of Health.

Bhattacharya joins a cohort of Trump nominees who made claims during the pandemic that were derided by health officials like Anthony Fauci and Francis Collins as they led the Covid response. Those nominees include Marty Makary, a Johns Hopkins surgeon who criticized the Biden administration’s Covid response and is Trump’s choice to lead the Food and Drug Administration.

Trump’s picks speak to a larger sentiment among many Americans that health officials got some of the pandemic response wrong — particularly on school closures and lockdowns.

Some experts say creating a binary of who got the pandemic right and wrong is unhelpful. Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security, warned against what he called “false alternatives” of one side versus another on Covid policy.

“Most of the time during the pandemic, nuance was not allowed,” he said.

But the strictest Covid policies may have gone too far, some experts say, and resentment over them has fueled contrarians’ rise to power.

“In retrospect, we probably shut down businesses and shuttered schools and restricted travel more than we needed to,” Paul Offit, a vaccine inventor and pediatric infectious disease specialist at the Children’s Hospital of Philadelphia, told POLITICO.

“We are paying the price for that. That was seen by many as government overreach and I think it largely contributed to the distrust we have now in public health agencies. To take it a step further, I think that distrust, in many ways, opened the door for people like Makary and Bhattacharya and RFK Jr.”

But the public is using a binary framework to assess the pandemic, even if health experts wish they weren’t. In some cases, Bhattacharya and Makary’s views, thought to be fringe at the time, held up. In other instances, experts say, their views remain controversial or even dangerous.

Here’s how experts view five of the contrarian claims Bhattacharya and Makary made during the pandemic, given what is known today:

1. Keeping students out of school was “a grave injustice”

Who made the claim: Bhattacharya, October 2020

What happened: The pandemic caused unprecedented disruption in the lives of children, their families and their schools.

The halt to regular classroom life starting in March 2020 and the uneven return to in-person learning that followed contributed to sharp declines in test scores while some mental health providers and parents blame it for a spike in social and emotional damage to young people.

Teacher unions and their leaders resisted pressure to quickly reopen K-12 schools. But even evangelists for reopening — which by the summer of 2020 included the American Academy of Pediatrics — could not overcome widespread fear that a rush back to regular classes would put children, teachers and their communities at risk.

The reopening debate also became inextricably linked to partisan politics and broader arguments over masks, social distancing and eventually vaccines.

Colleges and universities with older students, dormitories, plus active nightlife scenes confronted different considerations than daycares or elementary schools. In reopening for the 2020-2021 school year, many imposed stringent social distancing and quarantine rules that remained in place even after vaccines became widely available. Most schools reopened with some form of in-person learning by the spring of 2021, but families from communities hit hardest by the disease often chose to keep their children at home.

What the evidence shows: Lengthy school closures likely did not make a significant dent in slowing the virus’ spread, despite great cost to students, and schools could have operated more normally with basic safeguards, studies have found.

But fundamental disagreements remain between infectious disease specialists and politicians who believe keeping schools open — especially without adequate safety measures — would have led to more spread and death in surrounding communities, and those who believe far more should have been done to keep schools operating normally.

2. Natural immunity from prior infection could end the pandemic

Who made the claim: Makary, February 2021

What happened: A drop in new Covid cases of 77 percent over six weeks was evidence, Makary said, that herd immunity was imminent, at which point vaccination and prior infection would cause a dramatic decline in disease spread.

“At the current trajectory, I expect Covid will be mostly gone by April, allowing Americans to resume normal life,” Makary wrote. “When the chain of virus transmission has been broken in multiple places, it’s harder for it to spread — and that includes the new strains.”

Makary acknowledged that new variants would mean that Covid-19 would “persist for decades” but noted that countries with new variants were seeing significant declines in new cases. He said that reinfections were generally mild.

“As we encourage everyone to get a vaccine, we also need to reopen schools and society to limit the damage of closures and prolonged isolation. Contingency planning for an open economy by April can deliver hope to those in despair and to those who have made large personal sacrifices,” Makary said.

What the evidence shows: If the virus had not mutated, Makary may have been correct that Covid would have been “mostly gone” by April 2021 — though we’ll never know for sure. Many virologists expected mutation was inevitable.

Covid case growth did slow significantly as vaccinations ramped up in the spring of 2021. Initial data on vaccines showed they were highly effective at preventing transmission of the disease, not just reducing the severity of illness, which led many experts to proclaim that the end of Covid dominating daily life was near.

President Joe Biden even celebrated independence from Covid in a July 4, 2021 address.

But even as Biden declared that America had “gained the upper hand” on the virus, the Delta variant that summer led to a major spike in cases and increase in severity. That signaled that herd immunity had not been reached, despite a significant portion of the population having either received a vaccine or endured an infection. The highly transmissible Omicron variant took hold at the end of 2021 and led to record levels of cases nationwide, and deaths spiked near their 2020 winter peak.

Studies suggest that Covid reinfections likely have similar levels of severity.

“Natural immunity is a factor. It’s not necessarily the way you want to become immune to Covid,” Adalja said.

Others also wrongly predicted herd immunity was possible, including Fauci, who said it would come when most Americans had received vaccines.

Herd immunity “was a bad idea then and a bad idea now,” said Georges Benjamin, director of the American Public Health Association. “You have a higher risk of complications from an acute [Covid] infection.”

There’s a misconception that achieving herd immunity was ever possible, according to Offit.

“You’ll never have herd immunity for this kind of virus,” he said of viruses like flu, RSV and coronaviruses. “If the entire world were vaccinated or infected naturally, those viruses would still circulate.”

3. Mandatory masking was a mistake, especially for kids

Who made the claim: Makary, November 2021

What happened: Some states and cities, particularly in Democratic-controlled areas, mandated the wearing of masks into early 2022. Some schools in those areas required them for children until the summer of that year. A federal judge in Florida ordered the end of a mask mandate for airplanes, subways and other forms of public transit in April 2022. A federal judge in Louisiana ended a mask mandate for pre-kindergarten students in the federal government’s Head Start program in September 2022.

Makary, who recommended universal masking in May 2020, had decided that was unnecessary by the fall of 2021.

“If you use universal masking as a heavy hand beyond its utility, you alienate the authority of public health,” Makary told Free Press founder Bari Weiss, even as he continued to recommend the practice for elderly and other high-risk people.

Kids’ learning and language acquisition were harmed due to “using an indiscriminate mask policy at times,” according to Makary, adding that “it may not even be working, and we don’t have any data that it is.”

What the evidence shows: Many public health officials say that masking made good sense.

“Masking was a good idea,” Offit said. According to Offit, masks don’t provide perfect protection, especially the cloth masks recommended early in the pandemic when medical grade ones were in short supply, but quality masks work. Doctors have long worn masks while working to prevent infections.

However, hard evidence that they work is thin. The Cochrane Library, a London-based organization that assesses randomized control trials, reviewed mask studies and reported in 2023 that the studies “did not show a clear reduction in respiratory viral infection.” But Cochrane said the relatively low quality of the studies meant they couldn’t come to any conclusive result about whether masks work.

In retrospect, Offit said more nuanced guidance on masking might have made more sense than recommending them for everyone, all the time.

The case for masking is especially strong, he said, for people who are sick and cannot stay home.

4. Vaccine mandates and guidance for young, healthy people were unscientific

Who made the claim: Makary, June 2021, and Bhattacharya, November 2021

What happened: Biden moved to mandate Covid vaccines for employees at companies with more than 100 workers in November 2021, along with most civil servants, government contractors and health care workers.

The Defense Department that summer had mandated the shots for its personnel.

Thousands of people who refused lost their jobs.

By the summer of 2021, an outbreak of the disease among vaccinated people in Provincetown, Massachusetts, demonstrated that vaccinated people could carry the disease, despite claims from Biden and then-CDC Director Rochelle Walensky that they could not.

Because the vaccines did not prevent infection, Bhattacharya argued that mandating the shots was unethical.

Makary also made the case that vaccine guidance, that everyone gets two doses of the vaccines, was overbroad.

He pointed to a Johns Hopkins analysis he was a part of, which found that the mortality rate of Covid among children without preexisting conditions was zero. He also alleged that the CDC was undercounting potential vaccine complications.

The Supreme Court struck down the private-sector vaccine mandate in January 2022, finding the administration didn’t have the power to impose it. Biden ended the vaccine mandate for federal workers in May 2021.

Most European countries no longer recommend additional annual doses to healthy young people. The U.S. still recommends them for everyone age 6 months and up.

What the evidence shows: There’s near-universal agreement among public health officials that most people are well served by getting the initial two shots. There’s less about boosters.

“It is true that as the pandemic went on, we knew the risk to kids was less than we originally thought,” Benjamin told POLITICO.

In recent years, the CDC has shifted much of its public health messaging around updated Covid vaccination to target vulnerable groups, including older Americans and people who are immunocompromised, to acknowledge their higher risk of severe complications.

Benjamin noted that the benefits of vaccinating young, healthy people is also about protecting vulnerable populations, including family members, people undergoing cancer treatment and people with compromised immune systems, as the shots provide some protection against infection.

“We also know that a primary Covid infection puts you at higher risk of long Covid,” he added. “People who are infected and not vaccinated have a higher risk.”

Offit said Makary’s notion that children were an “invulnerable group” against Covid was wrong.

“There are about 1,800 children who died of Covid. Not all of them had medical problems. So you could be a healthy child and die from Covid. So children needed a vaccine. You would much rather get your immunity from the vaccine than from a wild-type infection,” he said.

Offit initially advised his own son not to get a third dose, saying he felt two doses were sufficient against severe illness, but later changed his mind.

5. Lockdown costs outweighed their benefits

Who made the claim: Bhattacharya, October 2020

What happened: Most states issued stay-at-home orders in the spring of 2020 as Covid started to spread. But the restrictions they imposed were not as onerous as those in Europe, where countries barred people from leaving their homes or required them to stay within a certain perimeter, or in China, where they were even more onerous.

The most restrictive state orders closed non-essential workplaces and schools, but Americans could move about.

Bhattacharya laid out an alternative strategy in his Great Barrington Declaration, an open letter published in October 2020 and signed by thousands of public health experts. It argued against lockdown measures and in favor of letting low-risk people build up herd immunity.

“Current lockdown policies are producing devastating effects on short and long-term public health,” according to the declaration, listing lower childhood vaccination rates, fewer cancer screenings and worse mental health among the consequences of keeping schools and businesses closed.

Bhattacharya and his cosigners said young people and underprivileged people were disproportionately harmed. “Our goal should therefore be to minimize mortality and social harm until we reach herd immunity.”

What the evidence shows: Some infectious disease experts think Bhattacharya had a point about the costs and benefits of at least some of the restrictions.

“We didn’t need to close schools nearly as long as we did,” Offit said. “Children suffered from decreased education, decreased socialization. That was a mistake. We probably didn’t need to close businesses as long as we closed them, either.”

Others think the jury may still be out about the impact of social distancing.

“We know now that the intent of social distancing was to stop the spread of infection before we had the vaccine,” Benjamin said. “We had to bend the curve to decompress our health systems. Those health systems that got overwhelmed with Covid had worse clinical outcomes than hospitals that did not get overwhelmed.”

Adalja said the Great Barrington Declaration also failed to consider other ways out of the pandemic, like adopting stringent testing policies or increased ventilation.

“Lockdowns aren’t a treatment of choice,” he said. “They’re a last resort.”