HJNO Nov/Dec 2024

HEALTHCARE JOURNAL OF NEW ORLEANS I  NOV / DEC 2024 27 Editor’s Note: This Q&A is in response to testimony given at the Louisiana House Select Committee on Homeland Security COVID response inquiry this September. The Journal source was granted anonymity to speak candidly, preferring to be identified as “a physician who was deeply involved in caring for COVID-19 patients in a Louisiana hospital.” Dianne Hartley, Editor Thank you for talk- ing to the Journal about the recent tes- timony given to the Louisiana House Select Committee on Homeland Security a few days ago. I don’t really understand why COVID has turned political, do you? Physician It’s a good question, and it’s one that I’ve been pondering a lot, too. Pan- demic is traumatic and in traumatic times, I think people are vulnerable, and you have someone come in and say, “This is why you’re unhealthy, this is who’s the blame,” that’s an easy snake oil to sell. Everyone is traumatized by the pandemic, and, in that trauma, you’ve got charlatans that see a win. For guys like RFK Jr., this was his big shot, and he took it. To me, that’s what it comes down to. Editor But what it’s doing, and what I’m seeing, is it’s eroding all trust that we have in experts that have been studying diseases and potential pandemics their whole careers. And when the next one comes, the people that have been told they’ve been lied to by these organiza- tions are not going to trust the informa- tion coming out of them. Physician Without question. And the next one doesn’t have to mean the next pan- demic. The next one can mean when your family member gets cancer and you’re meeting with the oncologist. The next one can mean when you have a hurricane and there are serious health ramifications, and the public doesn’t trust institutions that are there to protect us and provide for us. The next thing doesn’t necessarily mean COVID. It extends to all types of health and well- ness. It’s one of the things that was most, above all else, troubling to me about Ralph’s comments. Whom does sowing mistrust in our collective health infrastructure serve? Does it serve the public’s well-being, or does it serve his political aspirations? That’s the bottom line. Editor I keep hearing Fauci lied to us, lied to congress. Will you please share your thoughts on that? Physician I’ve heard a couple iterations of this. One relates to his statement to con- gress that NIH was not funding gain of function research inWuhan. There is a very technical definition NIH applied to this type of research that apparently what we funded did not cross. But it doesn’t seem that tech- nical definition aligns 100% with the more pedestrian understanding of the term. So, as best I can tell, he gave a politician’s answer of sorts — technically correct but skirting the broader implications. The other iteration I’ve heard relates to his statements early in the pandemic that masks were not neces- sary. This is 100% unfair. In the very early days, it was CDC’s well documented under- standing that COVID behaved like “drop- let transmission” style pathogens and not “airborne transmission.” Under the droplet transmission model, beyond 6 feet from the source, masks are not necessary. The drop- let/airborne frame of reference is a classical model of transmission we all learned inmed school. A fewmonths into the pandemic, the CDC revised its understanding of COVID and stated it is likely to behave more like airborne. This is when Fauci reversed course and said masks were advisable. He did what all scientists do — make the best call with available data at hand, then revise as more data becomes available. It should also be noted that one of the things we learned through COVID is the old droplet versus airborne model is actually quite antiquated, and it’s much more of a gradual spectrum. Editor I was at a healthcare journalism conference this spring in New York. Mandy Cohen, MD, MPH, director of CDC, was asking 200-plus healthcare reporters to help CDC get their credibil- ity back with the public. And, of course, we all looked at each other saying, “Well, that’s not really our job to help you get credibility back with the public.” But at the same time, you listen to what’s said in the Louisiana State Capitol, and by whom … I’m bewildered by some of the statements made during that session. Would you mind going point-by-point on what struck you during that two-day event? Physician Yeah, I’m happy to. I’m so glad that you transcribed it. I saw the readout from Mandy Cohen, the CDC director’s talk that I think you’re referring to. You’re right, it’s not reporters’ jobs to do that work, but it is reporters’ jobs to report on what’s happen- ing. There were a couple of [media] pieces that came out after this testimony and they fact-checked a little bit, but to preserve his [Ralph Abraham, MD, surgeon general of Louisiana] words, it was really impor- tant because I don’t think people, certainly people in the legislature, appreciated how much of a wild and violent departure what he said is from the establishment of what public health is and how it helps protect people whether they realize it or not. And to document that, be able to chart it, I think is incredibly important, particularly of how dangerous it is. I’m really happy that you did that. I think it’s really important. Editor Thank you.