Noble lies are a public health hazard

The United States' COVID pandemic performance is among the worst in the world — particularly given our unparalleled advantages. We lead the planet in confirmed infections and deaths, and while India probably has had more of both that went uncounted, that's cold comfort when its population is more than four times larger than ours.

One reason for this tragic failure is the dishonesty of American public health bureaucrats. They have repeatedly lied to the public, playing politics with the pandemic, and in the process undermined both the fight against COVID-19 and confidence in their own credibility. Their deception almost certainly got people killed, and it continues to do so this month, as the Omicron variant spreads and booster shots go unused.

This practice of shading the truth or telling straight-up falsehoods in service of some half-baked political end started from the first moments of the pandemic. Back in February and March 2020, National Institute of Allergy and Infectious Diseases (NIAID) chief Anthony Fauci was all over the media downplaying masks. "If you look at the masks that you buy in a drug store, the leakage around that doesn't really do much to protect you," he told USA Today that spring. "Now, in the United States, there is absolutely no reason whatsoever to wear a mask." In an interview with 60 Minutes in March, he said, "Right now in the United States, people should not be walking around with masks."

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It turns out Fauci almost certainly didn't believe what he was saying. In an interview with InStyle several months later, he admitted that trying to preserve the mask supply for doctors and nurses was his first motivation. "We were told in our task force meetings that we have a serious problem with the lack of PPEs and masks for the health providers," he said.

Moreover, studies going back years have found consistently that face masks cut down on the transmission of aerosol viruses. Most were focused on influenza, because of the 1918 flu pandemic, but much of the research was simulations that would apply to any virus spread through the air. The findings (from 2007, 2008, 2009, and 2013, just for starters) were consistent: Masks help. Cloth ones help a little bit, surgical ones a bit more, and N95 respirators or better best of all. And this makes perfect sense — of course putting some fabric in front of your face would help prevent transmission of a virus spread by people breathing particles on each other. There's no way Fauci — who has been head of NIAID for the last 38 years — wasn't aware of this science.

His claim, from around the same time, that public health experts didn't know "the infection could be spread by asymptomatic carriers who don't know they're infected" is also incredible. Evidence suggesting this happened with COVID was published in late January and early February of 2020. And besides, given how common asymptomatic transmission is in other diseases, any prudent public health authority would have recommended masks just in case.

Fauci didn't do that. He didn't even say something like, "Yes, masks work, but you shouldn't buy the professional-grade ones so we can save them for doctors and nurses. Use a makeshift cloth mask for the time being, and here's how to make one." Instead, he dishonestly cast doubt on the effectiveness of masks in service of a goal he failed to achieve. Despite the lies, medical workers dealt with PPE shortages for months; public mask adoption was delayed and depressed; and pandemic cranks and contrarians got a perfect talking point.

Fauci didn't learn his lesson. Not only did he lie more, but he exposed his own deception once again. Last December, he told The New York Times he'd also been lying about how many people would have to get vaccinated to reach herd immunity (moving from 60 to 90 percent). The shift, he said, was based on his random guess of how people would react: "He is doing so, he said, partly based on new science, and partly on his gut feeling that the country is finally ready to hear what he really thinks." Comments like this are functionally anti-vaxx, suggesting public health recommendations are based more on bureaucrats' feelings than rigorious scientific data.

A year later, other public health officials seem to have replicated Fauci's deception on the subject of booster shots — and the consequences here may be graver still. By August of this year, the Biden administration was extremely alarmed about reports of waning immunity among the vaccinated, and in September, officials started plans to recommend booster shots to all adults.

But key bureaucrats and scientists dragged their feet. The Food and Drug Administration vaccine advisory panel refused to endorse an emergency use authorization, with panel members citing a series of bizarre objections in an interview with CNN. "The stated goal of this vaccine has been to protect against serious illness," Dr. Paul Offit said. This is false — the point of any vaccine is to reduce negative health outcomes of any kind as far as possible, ideally by stamping out transmission entirely through herd immunity. It's good that two doses of mRNA vaccine likely still protect against severe COVID from the Omicron variant, but it's even better to cut the risk of symptomatic infection by about 40 percentage points with a booster.

FDA officials Dr. Philip Krause and Marion Gruber complained they didn't have enough science to back boosters yet, which is total nonsense. By September at the latest there was strong initial data from Israel and the U.S. itself. Dr. Cody Meissner of Tufts University School of Medicine argued unvaccinated people should get priority, which is just a non sequitur — those two goals don't trade off at all, because America has had plenty of vaccine supply for months.

Perhaps these arguments aren't compelling because they aren't honest. A more plausible motivation comes through in August comments from infectious disease specialist Céline Gounder, who was a pandemic adviser for Biden. "It's really inequitable and it's not in our interest because you're leaving much of the world unprotected, where you're going to have the emergence of other variants," she told Politico, pushing to send vaccine supplies overseas instead of giving boosters to Americans. "I feel like this is very short-term thinking. It's very individualistic, nationalist thinking."

This makes much more sense. Just like Fauci told a noble lie to conserve PPE, officials overseeing booster decisions almost certainly fudged the science in the service of an ulterior motive: getting vaccines to poorer countries.

Just like saving PPE for doctors and nurses, this is a legitimately good goal. Poorer countries should have been getting a larger share of vaccines from the start. But it's not the business of public health bureaucrats to decide where vaccines are allocated (that's for elected officials to decide), and it's especially not their business to try to steer policy by lying to the public.

Fudging the science did not, in fact, help poorer countries get more doses — but it certainly delayed booster distribution here. After weeks of argument and pressure, the CDC finally approved boosters for all adults in late November, yet it only recommended them for people over 50, ignoring research which recommends their universal use.

Now, thanks to the FDA and CDC spreading what amounts to misinformation to manipulate U.S. policy, tens of millions of people have decided boosters aren't an urgent priority, and only about 55 million people have been boosted. The ones who have belatedly realized their mistake are finding pharmacy appointments booked up for weeks (supply is plentiful, but health care workers are not).

Noble lies have set us up for a needlessly grim winter.