I’ve written several times about the Great Barrington Declaration (GBD), a statement released by three COVID-19-minimizing scientists, Dr. Sunetra Gupta (University of Oxford), Dr. Martin Kulldorff (Harvard University) and Dr. Jay Bhattacharya (Stanford University). Named after the Massachusetts town where the American Institute of Economic Research (AIER, the libertarian “free market” think tank that birthed the declaration) is based, the Great Barrington Declaration, which, it should be noted, was published two months before any COVID-19 vaccines received emergency use authorizations (EUAs) from the FDA, advocated basically letting COVID-19 rip through the “healthy population” to achieve “natural herd immunity” while using “focused protection” to keep those at high risk of severe disease and death from the virus (e.g., the elderly and those with chronic health conditions that put them at high risk) safe from COVID-19. Unfortunately, what was meant by “focused protection” was never really defined, and the GBD totally ignored the impossibility of “focused protection” of those at high risk from an infectious disease that was spreading unchecked through the rest of the population. As I said at the time, the entire idea struck me as not-so-thinly disguised eugenics that would let the “unhealthy” suffer and die in the name of getting the business of business rolling again, while the AIER’s likening GBD adherents to abolitionists was risible in the extreme. All of this is simply a lead-up, however, to a story from yesterday, in which Governor Ron DeSantis announced that Dr. Joseph Ladapo would be Florida’s new Surgeon General and Secretary of the Florida Department of Health:
I intentionally included that reply because, unsurprisingly, it turns out that Dr. Ladapo is an antimasker and signatory of the GBD:
That is, of course, a common talking point among antimaskers, those opposing “lockdowns” of even the most mild variety, and in general other science-based interventions to slow the spread of COVID-19 and thereby mitigate its damage to public health and save lives. Unfortunately, it’s a message that seems to resonate, as it portrays those opposed to public health interventions as “courageous,” as opposed to those advocating for a more science-based approach, who are portrayed as cowering in irrational fear of the virus rather than wanting to rationally devise a strategy that slows the spread of the virus and prevents as many people as possible from becoming critically ill and dying while minimizing social and economic disruption as much as feasible. Of course, one can’t help but note the hypocrisy, given how often antimaskers, antivaxxers, and those opposed to other public health interventions love to try to spread fear of their own. It’s just fear of things other than the virus, mainly bogus fears of adverse health effects of masks and, of course, “tyranny” from public health officials.
Worse, in addition to parroting antimask tropes about public health interventions to combat COVID-19, Dr. Ladapo appears to be flirting with “soft” antivaccinationism:
Whenever you hear someone compare vaccination to a religion, you’re hearing an antivaccine message, whether the one making the comparison realizes it or not. One might wonder whether Dr. Ladapo does realize that he is promoting an antivaccine message or not (I suspect that he knows exactly what he is doing by parroting that message, just as Gov. DeSantis does), but he is. Antivaxxers love to harp on the false notion that vaccine advocates are irrational zealots and bullies regarding vaccination—and, of course, cowering in fear of disease—and that “belief” in vaccination is more akin to religion (and that vaccine advocates also engage in “vaccine exceptionalism“) than anything else.
The other part of Dr. Ladapo’s statement, in which he says that the “state should be promoting good health” and that “vaccination isn’t the only path for that,” is a message right out of the quack playbook that echoes what I like to call the central dogma of alternative medicine. That dogma is basically The Secret: Wishing for healing heals. Alternatively, it can be stated somewhat more accurately as: You attract health to yourself. Note that this is just like The Secret, only for health. The central dogma of many, if not most (if not all) alternative medical systems seems to be that, if you wish for healing hard enough, your mind/spirit/energy can heal you of almost anything, just as, according to the Law of Attraction from The Secret, you “attract” things to you from the universe according to your thoughts, intents, and desires.
What Dr. Ladapo is saying is, at its core, very similar to what quacks say about COVID-19 in order to minimize the severity and effect of the disease and attack public health interventions, including vaccines, as strategies to combat it, namely that if you make yourself “healthy enough” you will be less likely to get really sick from the virus or even die. Of course, it is trivially true and has been known since early in the pandemic that those with chronic health conditions, such as obesity, diabetes, heart disease, and chronic lung disease, are more likely to land in an ICU or even die if they contracts COVID-19, but is the converse true? If you, for instance, lose a lot of weight, exercise, and improve your diet, will it make you less likely to die of COVID-19. That’s what Dr. Ladapo was clearly implying, if not outright arguing, yesterday when you put him in context:
In the press conference Tuesday, Ladapo declined to say that he would promote vaccines and downplayed their role in helping bring an end to the pandemic.
“The state should be promoting good health, and vaccination isn’t the only path to that,” Ladapo said. “It’s been treated almost like a religion, and that’s just senseless. There’s a lot of good pathways to health, and vaccination is not the only one. So, we support measures for good health—that’s vaccination, losing weight, it’s exercising more, it’s eating more fruits and vegetables, everything. We support it all.”
To be clear, while losing weight, exercising, and eating fruits and vegetables are generally good for health, they will not prevent SARS-CoV-2 infection or transmission.
I left that last paragraph in the quote intentionally, because it’s spot on correct. To it I would also add that it’s not at all clear that adopting a healthy lifestyle will dramatically lower your risk of dying from COVID-19, but let’s for the moment consider the possibility that it might. Arguing that we should not be prioritizing vaccination as much as we do and instead should be increasing emphasis on lifestyle changes that lead to better health is folly in the middle of a pandemic. Why do I say that? Because, in the middle of a pandemic, lifestyle changes, even if they do work as Dr. Ladapo implies, take too much time.
Let me briefly recount again a personal anecdote. Last year I finished losing over 50 lbs through a combination of fanatical calorie counting coupled with increasing exercise, primarily riding my bicycle. The effects on my health were definitely salutary. My blood pressure improved markedly, allowing me to drastically reduce the dose of anti-hypertensive medicine that I had been taking, and I might even be able to get off of medications altogether. I can now ride over 25 miles (and do so a couple of times a week). My resting heart rate, once in the 80s, is now in the 60s. My cholesterol and lipid levels have declined into the normal range. Let’s imagine, though, that the pandemic had hit three years ago, when I was obese and my weight was trending steadily upward. Even if losing 50 lbs would have decreased my risk of death from COVID-19, lifestyle interventions are too damned slow in the middle of a pandemic, even for an individual. Moreover, if lifestyle interventions are too slow for an individual, at a population level they are even slower and more unreliable, given how difficult it is to get people to change their habits to improve their health.
I often like to observe that I don’t know what clicked in my head three or four years ago that finally got me off of my ever-expanding posterior to do something about my weight and cardiovascular fitness, but I’m glad it did. I now weigh only a little more than what I weighed 30 years ago. I also realize that I’m incredibly privileged. I have money to afford healthy food and time to invest in a physical fitness regimen. Not everyone can pull this off. Worse, this shifting emphasis to “other ways” of promoting health risks turning into victim shaming and blaming of the sort that antivax activist Del Bigtree engaged in when he blamed those at high risk of COVID-19 for having made themselves vulnerable to severe disease through their prior lifestyle choices and urged his followers to “catch that cold” in order to achieve “natural herd immunity.” And what about the elderly? It’s not as though you have any control at all over how old you were when the pandemic hit.
Whenever I see someone like Dr. Ladapo advocate “other measures” to improve health, I can’t help but wonder: What does he mean by that? After all, there’s a lot that the government could do to decrease obesity and chronic health conditions, even if it will take years. Florida could implement laws and policies that discourage the consumption of, for instance, large quantities of sugary drinks, such as taxes and limits on portion sizes sold. It could institute measures to discourage alcohol and tobacco use. It could pump money into free programs to assure that the poor living in “food deserts” have access to healthy food at an affordable price, instead of having to purchase cheap, calorie- and fat-dense food. Somehow, though, I doubt that Dr. Ladapo will advocate for such measures once he takes charge of Florida’s public health apparatus. (Just a hunch.)
Who is Dr. Ladapo, anyway? When I learned of his appointment, I didn’t remember ever having encountered him or written about him; so I searched my blogs and my Twitter feed. There was only one mention of him. I was very surprised, because the more I did Google searches for him, the more I saw Dr. Ladapo as someone very much deserving of much more not-so-Respectful Insolence than he had received in the brief mention of him on this blog. Indeed, I hadn’t even known that Dr. Ladapo had signed the GBD or that he was a regular contributor to the Wall Street Journal opinion page, his most recent contribution being from last week and entitled Vaccine Mandates Can’t Stop Covid’s Spread. Common COVID-19 contrarian talking points dominate Dr. Ladapo’s editorials in the WSJ and elsewhere, such as claims that we are “overreacting” to the virus; COVID-19 vaccines are “riskier than advertised“; masks have been “oversold“; it was “too late“—in March 2020!—for lockdowns to save us; and “universal vaccination” is unrealistic and dangerous.
I also found out that Dr. Ladapo is—surprise! surprise!—a member of “America’s Frontline Doctors”:
Dr. Joseph Ladapo: An associate professor of medicine and clinical researcher at University of California – Los Angeles (who states explicitly during the press conference that he is speaking for himself “and not for UCLA”), Ladapo has become an ardent proponent for the “open the economy back up” school of thought. At the start of the pandemic, he penned an op-ed for USA Todaydownplaying the lethality of the virus and advocating for the economy to stay open in lieu of lengthy shutdowns: “Can you imagine a United States in which children are forced to forgo proper schooling, unemployment and poverty decimate millions more lives, and our economy is strangled into a persistent depression? And all for a virus that, when all is said and done, most people will recover from — even the elderly,” he wrote. In a Wall Street Journal op-ed, he accused Democratic political leaders of politicizing the response to COVID-19 in order to further their own agenda, accusing them of invoking “‘science’ to justify decisions manifestly guided by their personal preferences.”
That last bit strikes me as projection of the most obvious sort.
Does anyone remember America’s Frontline Doctors, though? During the first summer of the pandemic, they were pushing the unproven (and now disproven) drug hydroxychloroquine as a COVID-19 cure. A year later, they were suing over “deaths from COVID-19 vaccines.” These days, they’re pushing ivermectin, as is Dr. Ladapo. Indeed, Dr. Ladapo even appeared in that infamous video from July 2020 in which America’s Frontline Doctors promoted hydroxychloroquine as they rejected other public health interventions:
Joseph Ladapo—the doctor appointed on Tuesday as Florida’s new surgeon general by Republican Governor Ron DeSantis—once appeared in a COVID-19 conspiracy video featuring Dr. Stella Immanuel. Immanuel, a pediatrician and religious minister, gained notoriety in 2020 for her bizarre theories, including that “demonic seed” causes endometriosis and ovarian cysts.
In July 2020, Ladapo appeared in a 43-minute viral video as part of a group called America’s Frontline Doctors. None of the doctors in the video were epidemiologists or immunologists best qualified to speak on infectious diseases, Rolling Stone reported at the time. The doctors’ recorded speech was organized by the Tea Party Patriots, a right-wing group backed by wealthy Republican donors.
The video promoted hydroxychloroquine as a “cure” for COVID-19, even though studies haven’t substantiated that claim. The video also said that masks do not slow the virus’ spread and that COVID-19 is less deadly than the flu. Both claims are untrue.
In fairness, though, I haven’t been able to find out much else about Dr. Ladapo’s connection to American’s Frontline Doctors (none of whom were ever really “frontline” and most of whom are COVID-19 grifters), at least not recently; so it’s possible that Dr. Ladapo realized that being associated with the “demon sperm” doc wasn’t a good look for him and disassociated himself from this group of cranks. Any mention of him does appear to have been removed from the group’s website. Fortunately, the almighty Wayback Machine at Archive.org shows him in the physician leadership of America’s Frontline Doctors as “policy liaison” in July 2020:
None of that stopped Dr. Ladapo from opining at his press conference yesterday:
In addition to being done with fear, Ladapo also said he was done with misinformation. Over the past year, “people have been taking the science, and they’ve been misrepresenting it,” Ladapo said. With DeSantis standing behind him, Ladapo vowed: “That will never be a problem here.”
There is only one appropriate reaction to that statement.
The appointment of Dr. Ladapo by Gov. DeSantis to take over the State of Florida’s entire medical and public health bureaucracy represents a dangerous new step in the evolution of the government response to COVID-19. I can only hope that the Florida Senate fails to confirm him, but I am not optimistic that this will happen because, on paper at least, Dr. Ladapo appears qualified.
That’s the danger of doctors like Dr. Ladapo, the three academics behind the GBD, and all the other “respectable” doctors promoting COVID-19 misinformation. By embracing bad science and COVID-19 contrarianism, they serve as either willing accomplices or useful idiots used by ideologues like Gov. DeSantis, who appears far more interested in the economy than in preventing his constituents from suffering and dying in droves. Dr. Ladapo, the main signatories of the GBD, and others doctors and academics like them, serve the same role as tobacco scientists did a half century ago in that they provide a patina of seeming scientific rational for ideology-based policies rooted in bad science and are thus essential tools of the disinformation machine promoting resistance to public health interventions.