The newest member of the coronavirus task force is giving out terrible advice

Why shouldn’t we trust the advice of an M.D. from Stanford University? Because he’s unqualified, that’s why.

As everyone with a pulse knows, the U.S. has handled the coronavirus pandemic very, very badly. Tragically, over 220,000 people have died, and our rate of deaths per capita is higher than any other country in the world.

The Trump administration established a coronavirus task force back in the spring, supposedly led by VP Mike Pence. For a long time, the task force included Dr. Anthony Fauci, a world-renowned expert on viruses who is also the Director of the NIH’s infectious disease institute, where he has worked for 40 years. Despite the frequently erroneous and misleading statements by President Trump, Dr. Fauci consistently gave the public advice that was both scientifically and medically accurate. He never promised that the virus would simply disappear, and he urged everyone to wear masks and avoid unnecessary contact with others. He also warned against re-opening businesses too quickly.

Trump didn’t like that, so he pushed Fauci to the sidelines in favor of someone whose advice matched what he wanted to hear.

Enter Scott Atlas. Atlas is a Fellow at the right-wing Hoover Institute at Stanford University, where he studies health care policy. He’s also an M.D., a radiologist who specializes in MRIs. Notably, he has no special expertise on viruses, vaccines, or epidemiology.

Atlas has pushed for schools to reopen and for college sports to resume, against the advice of public health experts. Just last week, he tweeted that masks don’t work, a claim that was so outrageous and dangerous that Twitter took it down. (To be precise, Atlas’s tweet was “Masks work? NO”.) Another coronavirus task force member, Dr. Deborah Birx, said she felt “relief” that Atlas’s tweet was removed.

Perhaps Atlas is so convinced of his own brilliance–after all, Stanford is one of the world’s top universities, and he wason the faculty there–that he thinks he’s an expert on everything. But a good scientist would pay attention to the recommendations of others who are clearly more qualified, and Atlas has not done that. For example, he has argued, against the evidence of experts, that “low-risk groups getting the infection is not a problem” (wrong–they can spread the infection to high-risk groups) and that only people with symptoms should get tested (very bad idea, given that many people are asymptomatic).

Alarmed at the harm that Atlas’s advice has been causing, a group of more than 70 of his Stanford colleagues, including world-renowned experts in infectious diseases, epidemiology, and health policy, published an open letter decrying Atlas’s bad science. Their statement read, in part:

“... we have both a moral and an ethical responsibility to call attention to the falsehoods and misrepresentations of science recently fostered by Dr. Scott Atlas, a former Stanford Medical School colleague. Many of his opinions and statements run counter to established science and, by doing so, undermine public-health authorities and the credible science that guides effective public health policy.”

Atlas responded by threatening to sue his Stanford colleagues over their letter, and in response to that, an even larger group of Stanford professors released a statement saying they wouldn’t be intimidated. The second letter, with over 100 signatories, stated:

“We believe that his [Atlas’s] statements and the advice he has been giving fosters misunderstandings of established science and risks undermining critical public health efforts.”

My bottom line: Atlas is a bad scientist, apparently far more interested in power and influence than in public health. I’m not commenting on his skills as a radiologist, which are irrelevant here. (He might be an outstanding radiologist.) However, he’s providing advice to the U.S. government that contradicts the advice of scientists who are far more qualified than he is, and when they pointed that out, rather than buttressing his arguments with data, he threatened to sue. That is not the behavior of a good scientist.

To those who think that this disagreement means there are two sides to the issue, I urge you to think again. Science and medicine are highly specialized. Just as you wouldn’t want a virologist to read your MRI scan, you wouldn’t want a radiologist (Atlas) to decide on the best way to treat the Covid-19 virus. So when a radiologist (Atlas) disagrees with a virologist (Fauci) over a virus, guess who’s most likely to be right?

It’s unfortunate that the current administration has chosen to heed the advice of someone who tells them what they want to hear, rather than someone who truly has the qualifications to advise them.

Can the SARS-CoV-2 virus damage the brain?

A certain very famous politician came down with Covid-19 recently, and has been acting even more erratically than usual. This has led a number of pundits (and some doctors) to speculate that this politician’s behavior might be a symptom of his ongoing infection. Could this be true?

Well, maybe. Most of the attention around Covid-19 has been focused on the damage that the SARS-CoV-2 virus causes in the lungs, which can lead to difficulty breathing, the need for a respirator, and even death. The virus has the ability to replicate explosively in a person’s lungs, not only causing serious damage but also triggering an over-reaction by the immune system, a so-called “cytokine storm” that itself can kill you, even if the virus doesn’t.

However, numerous reports have shown that the virus gets into many other tissues besides the lungs, including the brain. Just this week, a new study out of Northwestern University School of Medicine found that over 80% of patients with Covid-19 had at least some neurological symptoms. 80% is a startlingly high number.

While that sounds alarming, let’s look at the details. The new study looked at 509 Covid-19 patients, all of them admitted to hospitals in Chicago. These were “consecutive” patients, meaning that the investigators didn’t cherry-pick their subjects, but just took 509 in a row. That seems sound.

Most of the symptoms, although definitely affecting the brain, were mild. 38% of the symptoms were headaches, and 44% were “myalgias”, which refers to aches and pains throughout the body. (Note that some patients had more than one type of symptom, so the numbers in the study add up to more than 100%.)

However, 32% of the patients had encephalopathy, which can be much more serious than a simple headache. According to NIH, encephalopathy can involve:

“loss of memory and cognitive ability, subtle personality changes, inability to concentrate, lethargy, and progressive loss of consciousness.”

Does this sound like any of the behaviors we’ve seen in our most famous infected politician?

The new study is not the first one to report neurological symptoms caused by Covid-19. Back in July, a research team from University College London reported multiple cases of neurological problems in their cohort of 43 patients. They observed not only encephalopathy (in 10 patients), but also encephalitis in 12 other patients and strokes in 8 more. Some of the patients in that study were reported as experiencing “delirium/psychosis,” and strokes often cause permanent brain damage. Clearly, the SARS-CoV-2 virus can cause serious health problems, and disturbing behavioral changes, if it gets into the brain.

None of this means that any current political leader is experiencing an altered mental state. We don’t have a direct test that measures whether the virus is present in a person’s brain, so all we can do is observe symptoms and make inferences from those. The best available evidence today, though, shows that for anyone with Covid-19, neurological problems are definitely something we should be worried about.