Covid and the war on medical expertise

31 December 2021 (Desdemona Despair) – If you’ve been on the internet for a few years, you may have encountered a skirmish with climate denialists or evolution “skeptics”. Frequently, these threads start with a “concern troll” who questions some aspect of science and insinuates corruption or deception on the part of scientists. The accusations are made up whole cloth or based on intentional misreadings of scientific discourse, e.g., the infamous “hide the decline” attack on UK climate scientists known as “Climategate“. Fact is beside the point; these attacks on expertise are launched by provocateurs with the intent of manufacturing doubt.

In the case of biological evolution, attacks on the science by “skeptics” may have only an academic effect – the daily life of humans doesn’t depend on whether Earth is six thousand or four billion years old. Attacks on climate science do affect humans and most life on Earth, but the chain of causation is diffuse and the destructive results are distant both in space and time.

The war on expertise

The conservative war on expertise has been documented and lamented for many years. The word agnotology was coined in 1995 by Stanford University professor Robert N. Proctor and linguist Iain Boal to describe the study of deliberate, culturally-induced ignorance.

As amply documented by Tom Nichols in his book, The Death of Expertise: The Campaign Against Established Knowledge and Why it Matters, “The United States is now a country obsessed with the worship of its own ignorance. It’s not just that people don’t know a lot about science or politics or geography; they don’t, but that’s an old problem. […] The bigger problem is that we’re proud of not knowing things. Americans have reached a point where ignorance, especially of anything related to public policy, is an actual virtue. To reject the advice of experts is to assert autonomy, a way for Americans to insulate their increasingly fragile egos from ever being told they’re wrong about anything. It is a new Declaration of Independence: no longer do we hold these truths to be self-evident, we hold all truths to be self-evident, even the ones that aren’t true. All things are knowable and every opinion on any subject is as good as any other.”

The COVID-19 pandemic has driven a new escalation in antiscience: the war on medical expertise. Unlike the attacks on knowledge of climate and evolution, the assault on medical science has immediate and deadly effects. Manufacturing doubt about the efficacy of vaccination exposes millions of people to dangerous pathogens. Worse, it encourages vigilantes to take violent action against healthcare providers.

Violence against healthcare workers (HCWs) was already prevalent before COVID-19, with healthcare workers at hugely increased risk (4x) for workplace violence relative to other industries, like retail and construction.

The risk of violence against healthcare workers has increased sharply during the pandemic, and it’s a global phenomenon, from Wuhan to Cleveland.

In November 2020, a National Nurses United survey found “about 20 percent of nurses report facing increased workplace violence on the job”. NNU put the survey results in context:

“NNU’s first survey in March focused on hospitals’ lack of preparedness for Covid-19; the second survey in May highlighted government and employers’ disregard for nurse and patient safety; and the third survey in July revealed the devastating impact of reopening too soon. This fourth survey demonstrates clearly the continuing disregard that hospitals and health care employers show for the safety of nurses and health care workers.”

In Pakistan, healthcare workers also experience police violence when they protest for better working conditions:

“A total of 29 incidents were identified, with perpetrators of violence most commonly being relatives of COVID-19 patients. Most frequent reasons included mistrust in HCWs, belief in conspiracy theories, hospitals’ refusal to admit COVID-19 patients due to limited space, COVID-19 hospital policies, and the death of the COVID-19 patients. Protests by doctors and other HCWs for provision of adequate PPE, better quarantine conditions for doctors with suspected COVID-19, and better compensation for doctors on COVID-19 patient duty resulted in police violence towards HCWs.” 

In Egypt, nearly ten percent of surveyed healthcare workers reported suffering physical violence:

“Workplace violence (WPV) is a serious endemic phenomenon in healthcare settings, and it has been escalating during the COVID-19 pandemic. In this cross-sectional study, healthcare workers (HCWs) (105 physicians and 104 nurses) working at two public hospitals accepting patients with COVID-19 in Egypt were included. Using a self-administered questionnaire distributed in January 2021, data about HCWs’ sociodemographic and occupational characteristics and their exposure to psychological and physical WPV during the past six months were collected. The results showed that the prevalence of psychological and physical WPV was 42.6% and 9.6%, respectively. Relatives of patients were the perpetrators in most WPV incidents. HCWs did not report 57.3% of psychological and 10.0% of physical WPV incidents. Female sex, having physical contact with patients, and working rotational shifts were associated with the increased exposure to psychological and physical WPV. In conclusion, this study showed a high prevalence of WPV against HCWs in Egyptian public hospitals during the COVID-19 pandemic.”

In India, violence against doctors has been called the “The Forgotten Pandemic”:

“Often labelled ‘The Forgotten Pandemic’, violence against doctors has become an increasingly common occurrence.[3] Studies suggest that up to 75% of doctors have faced some kind of violence at work, which is similar to the rates from other countries in the continent.[4] This violence may comprise telephonic threats, intimidation, verbal abuse, physical but noninjurious assault, physical assault causing simple or grievous injury, murder, vandalism, and arson. Medical professionals who faced violence have been known to develop psychological issues leading to absenteeism, and having drastic consequences on community health. […]

“One would think, at a time where healthcare workers are the frontline warriors, the violence would subside. This, however, is far from the truth with doctors being denied dignity even in death.[9,10,11] India has witnessed numerous cases of physical and verbal abuse, stone pelting, and damage to hospital property even during the pandemic while doctors are working as frontline warriors. While analyzing the status of violence against doctors during the pandemic, it was noted that majority of such incidents occurred in community settings, the perpetrators ranging from family members to famous personalities, and modes of violence spanning a vast variety—from verbal to physical. On further assessment, it was realized that even during screening and quarantine procedures, doctors were not safe, putting primary care physicians at greater risk. [Medicine or martyrdom? A peek into the rising violence against doctors during times of COVID 19 (nih.gov)]

In a preprint paper by Saverio Bellizzi, Emergency Department lead with the World Health Organization, and others, WHO reports preliminary numbers for casualties among healthcare workers:

“A 3-year analysis released in August 2021 by the WHO indicated that more than 700 healthcare workers and patients have died (2,000 injured) as a result of attacks against health facilities since 2017. The COVID-19 pandemic has made the risks even worse for doctors, nurses, and support staff, unfortunately. According to the latest figures from the International Committee of the Red Cross, 848 COVID-19-related violent incidents were recorded in 2020, and this is likely an underrepresentation of a much more widespread phenomenon.”

Violence against abortion providers

Some cases of violence against healthcare workers may be attributable to grieving relatives, but in the U.S., many attacks are explicitly political. The National Abortion Federation has tracked violence against abortion providers and clinics since 1977, and in 2019 the group reported “a dramatic increase in violence and disruption against clinics, beyond anything we’ve ever seen before.” In a 2019 story, CBS News reported:

“In 2017, violent acts against abortion providers more than doubled from the year prior, according to data compiled by NAF. The group recorded 1,081 violent acts, the most since the group began tracking these incidents. 

“Last year, the group recorded another new record high: 1,369 reported violent acts, including 15 instances of assault and battery, 13 burglaries, 14 counts of stalking and over a thousand episodes of illegal trespassing.

“In interviews with nearly one dozen clinics, including McNicholas’s St. Louis Planned Parenthood, providers say the situation is getting worse. In August alone, three young men were arrested for threatening mass shootings against Planned Parenthood facilities. At the home of one of the suspects, authorities seized 15 rifles, 10 semi-automatic pistols, and 10,000 rounds of ammunition during a raid.”

Attacks on women’s healthcare providers escalated in 2021 as NAF reports:

“It is no surprise given the political climate and the increase in hate incidents throughout the country in 2020 that we saw an escalation of actions meant to disrupt, intimidate, and harass abortion providers and their patients.

“These activities continued despite the onset of the COVID-19 pandemic. At a time when many of us were complying with public health guidance and practicing social distancing to help limit the spread of COVID-19 and keep our families and communities safe, it’s alarming that anti-abortion protesters used this time to target and threaten abortion providers. Throughout 2020, anti-abortion protesters defied stay-at-home orders and gathered outside clinics without masks where they approached and yelled at patients as they entered health care facilities.

• Abortion providers reported an increase in death threats and threats of harm, rising from 92 in 2019 to 200 in 2020.
• We saw a 125% increase in reports of assault and battery outside clinics with members reporting 54 incidents, rising from 24 in 2019.
• Internet harassment and hate mail and harassing phone calls rose once again this year. Providers reported 3,413 targeted incidents of hate mail and harassing phone calls, rising from 3,123 in 2019.
• There was a slight decrease in the reported number of picketing incidents in 2019, which is likely due to a decrease in anti-abortion protester activity in some locations at the very beginning of the COVID-19 pandemic. Providers still reported 115,517 incidents in 2020—which far exceeds any other year since we began tracking these statistics in 1977 except for 2019 when there were 123,228 incidents reported. Picketing is also an area where we expect there was underreporting in our 2020 data.
• NAF members reported an escalation in aggressive behavior from protesters during 2020 so although there was a slight decrease in picketing, the activities were often more intense and disruptive.”

Anti-vaxxer threats

Anti-vaccine protesters have adopted the methods of anti-abortion provocateurs, causing a mobile vaccination clinic in Georgia to shut down by harassing health care workers who were administering COVID-19 shots, harassing parents and children in Massachusetts outside of a COVID-19 vaccination clinic held at a school, and following and intimidating people at a vaccination clinic in Prince George, British Columbia.

In the environment of a deadly pandemic and escalating violence against healthcare workers, you might expect responsible people with large public microphones to moderate their language. Instead, we find unscrupulous actors pouring gasoline on the fire with increasingly violent rhetoric.

At an anti-vaxxer rally in Trafalgar Square on 24 July 2021, Kate Shemirani, a former nurse who was removed from the UK Nursing and Midwifery Council in June 2021 for spreading COVID-19 disinformation, addressed the crowd: “Get their names [of doctors and nurses]. Email them to me. With a group of lawyers, we are collecting all that. At the Nuremberg Trials, the doctors and nurses stood trial, and they hung. If you are a doctor or a nurse, now is the time to get off that bus… and stand with us, the people,”

On 29 July 2021, Rep. Marjorie Taylor Greene (R-GA) was invited to a fundraising event sponsored by the Alabama Federation of Republican Women. Speaking at the lectern, Rep. Greene hinted at using guns to shoot door-to-door vaccinators: “Joe Biden is sending one of his police-state friends to your front door. … Yeah, well, what they don’t know is in the South, we all love our Second Amendment rights. [crowd cheers] We’re big on our Second Amendment rights, and we’re not big on strangers showing up at our front door, are we?”

Trump lawyer Lin Wood, who has more than 800,000 followers on Telegram, accused doctors of killing South Carolina Republican Party executive committeeman Pressley Stutts, who died from coronavirus on 19 August 2021.

“This is criminal,” Wood wrote. “How many people have to suffer and die before We The People demand proper medical care and treatment and the recognition of patients’ rights?” He told his followers to “avoid hospitals at all costs.”

Later in the year, he championed Veronica Wolski, a popular QAnon advocate, when she was critically ill with COVID-19. Wood announced her death on 13 September 2021 in a Telegram post and added: “It is our responsibility to ensure that these medical murders stop NOW and the perpetrators be brought to justice.” Wood had organized a harassment campaign against healthcare workers at the hospital, exhorting his followers: “TELL THEM WHAT YOU THINK OF COMMUNISTS WHO VIOLATE NUREMBERG! AND TELL THEM WHATS COMING FOR THEM!” The harassment campaign led to the hospital receiving hundreds of calls from QAnon supporters, some of which threatened violence.

On 29 December 2021, UK anti-vaxxers stormed a test-and-trace center in the Milton Keynes Theatre in Buckinghamshire. Dozens of people entered the facility and were seen damaging and removing equipment in videos they shared on social media.

Matthew Barber, Police and Crime Commissioner for Thames Valley, said it was “appalling” to see the protest “escalate into something much uglier.”

Joe Harrison, CEO of Milton Keynes University Hospital, said: “I am very sorry and angry to see NHS colleagues at Milton Keynes Covid testing centre harassed and intimidated at their place of work. Our staff having to deal with increasing aggression and violence for simply doing their job. It’s abhorrent, unacceptable and we will not stand for it.”

On the same day, anti-vaxx attackers set fire to Australia’s Old Parliament House in Canberra, damaging the entrance to the historic building and clashing with police and journalists. A group known as MMAMV Australia, for Millions March Against Mandatory Vaccination, live-streamed the fire on Facebook. It had posted from Old Parliament House the previous day, vowing to return “until the job is done”.

Bringing the sedition and antiscience caucuses together is Simone Gold, a Beverly Hills doctor who founded the antiscience group America’s Frontline Doctors and was arrested during the insurrection at the U.S. Capitol. She was indicted for participating in the coup attempt but remains free on her own recognizance and tours the U.S., spreading disinformation about the pandemic. On 6 December 2021, members of her group stalked and confronted Kristina Lawson, the president of California’s medical board, which issues medical licenses and disciplines doctors. Ms. Lawson said in a statement:

“I was concerned when I saw someone flying a drone over my house and saw a mysterious white truck parked outside my home. Later that day, my concern turned to terror. I arrived in the dark parking garage behind my office and experienced four men unexpectedly rush towards me, jumping out of the same white truck that had been parked outside my house. I then realized that these four men had been surreptitiously stalking me.”

The nadir of antiscience scapegoating in 2021 came from Fox News host Jesse Watters, who told young people at a Turning Point USA conference to “ambush” Dr. Anthony Fauci and “go in for the kill shot” to get famous. Fox News defended the violent language as taken out of context, and Snopes bought the “just a metaphor” interpretation, labeling the claim false that Watters demanded the literal assassination of America’s most prominent infectious disease specialist. But there are so many other metaphors for inspiring youth to pursue legitimate journalism, why describe an interview in the language of political murder?

In the environment of escalating violence against healthcare workers, one answer stands out: stochastic terrorism.