Dr. Levine Says the Quiet Parts Out Loud

America’s Tallest Health Commissioner* stepped out on a limb earlier this week by agreeing to a long-form interview with David Goodman of WDEV and VTDigger. David is an accomplished journalist and skilled interviewer, and the results were predictable: the good doctor kinda spilled the beans.

*Citation needed –Ed.

Dr. Mark Levine acknowledged that the Scott administration’s Covid policies are not based on public health science. He used the word “hope” an uncomfortable number of times He implied that the administration welcomes a spike in Covid cases because it would build immunity in the population. He actually said that the admin is trying to “distract people from case numbers.” He admitted that the long Covid consequences of the Omicron variant are unknown. And he said his own behavior is substantially more cautious than the administration line.

Let’s start with “hope.” He said “hope” or “hopefully” a total of eight times. That’s an awful lot of conditional optimism for a set of policies that’s drawn heavy criticism from many experts, including Levine’s two immediate predecessors.

Levine was hopeful of a smooth transition from pandemic to endemic. He was hopeful that more people will get vaccinated. He hopes to “minimize serious illness and death.” He hopes that widespread shortages of test kits will be a thing of the past. He hopes that long Covid won’t be a major issue because of our high vax rate, and he hopes long Covid will be less of a problem after the Omicron wave than it’s been for other variants.

All that hope validates my view that the administration is taking substantial risks, essentially betting they can get through the pandemic without too much damage.

Other points…

The first thing that struck me was Levine’s acknowledgment that science does not, in fact, reign supreme in decision-making — and that if it did, adminstration policy would be much different. “Public health doesn’t call all the shots. Public health doesn’t make a unilateral decision, and everyone falls into place. Otherwise, we’d have a whole country that had mask mandates.”

He later ticked off the other factors involved: Mental health and substance abuse, the economy, the education system, and a vaguely defined “impacts of severely regulating people’s lives.”

That is, in fact, a reasonable approach to public policy — but the devil is in the details. How big a role does the science play? Not much, not lately, it seems. Also, this makes it clear that Governor Scott is talking out his ass when he asserts that all his decisions are based on science and data. He needs to stop saying that.

But here’s my biggest concern. I don’t doubt that mental health has been affected and that some are tired of government mandates. But as a person at elevated risk, my mental health is being greatly affected by the raging fire of Omicron. I’m worried, man. All the time. I’m back to staying home except for tightly targeted errands, usually carried out in the morning right after opening time. It’s been almost two years since I saw anyone in my family. My mother died in March 2020 (not of Covid) and we have yet to scatter her ashes as she wished. And I see no light at the end of this tunnel.

This is true of people over 65, anyone who suffers from one of a variety of medical conditions, children too young to be vaccinated (<5 years) or boosted (<16 years), and all those who work in service industries, especially health care workers. And I haven’t mentioned the people whose surgeries have been indefinitely postponed so we can accommodate a spike in Covid hospitalizations. How about the mental health impact on someone with a debilitating but correctable injury, or those waiting for cancer surgery or gender reassignment surgery?

This all smacks of the Great Barrington Declaration, the infamous petition that offers a bleak Malthusian worldview. It says we should be letting the virus burn through the population rather than trying to limit its spread, claiming the same harms that Levine ticks off and promising the benefits of “herd immunity.” The World Health Organization calls the declaration dangerous and lacking scientific foundation. It’s been slammed by 14 separate professional public health groups including the American Public Health Association.

Oh, and the declaration was sponsored by the American Institute for Economic Research, a libertarian free market think tank associated with climate change denial.

You’ll be known by the company you keep.

There’s another strong Barringtonian strain in Levine’s presentation. The good doctor believes (hopes?) that the Omicron variant will be milder than other types of Covid, so the collateral damage will be limited and widespread infection will help us get to “a level of immunity where this will become… part of the background, just like a common cold.”

The problem with that cold calculation is that immunity via infection is a temporary thing. You don’t just get a little sick, recover, and you’re set for life. No amount of Omicron cases will advance us to the point where Covid is “just like a common cold.”

As for long Covid, Levine offers no absolutes and a whole bunch of “hope.” He has said that 10-30% of Covid patients will suffer from long Covid, but he hopes that number will be lower because of Vermont’s high vaccination rate and the presumed milder effects of the Omicron variant. “The hope is, again, with something like Omicron, if it truly produces less severe illness and if it occurs in vaccinated people with a very mild and short illness, that the sequela of long Covid will not be occurring in those individuals.”

For those scoring at home, that’s one “hope” and two big “ifs” in a single sentence, plus the specious notion that long Covid “will not be occurring” in Omicron patients. I wouldn’t be surprised if long Covid is less prevalent after Omicron, but I absolutely don’t believe that it won’t occur at all.

Levine’s own behavior is not too dissimilar from mine, and I’m extremely cautious. His holiday gatherings involved no more than four or five people at a time. He canceled a holiday flight to visit family in another state. He doesn’t patronize restaurants except for takeout. He wears a mask whenever he’s out in public. Levine may think it’s be okay if a lot of people contract Covid, but he’s sure trying to avoid it himself.

One more thing. Levine throws shade at the news media and others obsessed with the daily case counts that, he said, “makes it look like some wildfire’s wildly out of control.”

Maybe. But case counts aren’t meaningless, either. The Dow Jones is a very imperfect measure of our prosperity, but if it plunges by 1,000 points in a week, it’s Code Red. If the media ignored the case counts, it’d be doing a disservice to the truth. It might make Levine’s life easier, but that’s not the point.

In sum, the Levine interview makes it clear that if administration officials are closely questioned, their assertions fall apart. That rarely, if ever, happens in the weekly briefings. Levine’s experience is a warning to administration officials: Keep away from open-ended, uncontrolled venues. Especially those involving a single smart questioner who can ask follow-ups as often as needed.

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