Yesterday I wrote about the racist origins of the philosophy of natural childbirth.

The idea that “primitive” women feel no pain in childbirth and that the pain that Western women experience can be attributed to the “fear-tension-pain cycle” originated with obstetrician Grantly Dick-Read. If you doubt that his fabricated claims were based on racism, you only have to read his own words:

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Natural childbirth philosophy is fundamentally and ineradicably racist.[/perfectpullquote]

The primitive knows that she will have little trouble when her child is born… Natural birth is all that she looks for; there are no fears in her mind; …she has no knowledge of the tragedies of sepsis, infection and hemorrhage. To have conceived is her joy; the ultimate result of her conception is her ambition…

…Two, three or four percent of some tribes [died] without any sadness . . . realizing if they were not competent to produce children for the spirits of their fathers and for the tribe, they had no place in the tribe.

While contemporary natural childbirth advocates are either ignorant of or choose to ignore the racist origins of their philosophy, academic feminists have been studying how the racialization of pregnant bodies lies at the heart of natural childbirth philosophy, from its beginnings to the present day.

Rachelle Chadwick explores the racist and classist assumptions in her book Bodies that Birth: Vitalizing Birth Politics.

In the present day, racist and imperialist prejudices about women’s birthing bodies continue to underpin contemporary rhetoric about biomedicalization, ‘natural childbirth’ and rights-based discourse advocating for women’s right to choice and control. These underlying assumptions are rarely recognized or acknowledged. Colonial ideas about indigenous and black women’s bodies as primitive and animal-like and thus primed to give birth (and breastfeed) easily and without pain or the need for medical assistance, are rooted in ideologies of racial difference and Social Darwinism

Grantly Dick-Read’s racist beliefs persist among leaders and laypeople in the natural childbirth movement:

Colonial myths about easy and painless birth for so-called ‘primitive’ women also continue to frame and are used to legitimize the (largely middle-class and Euro-American) ‘natural birth’ movement and meta-narrative…

These racist myths play an outsize role in homebirth and freebirths:

These racist assumptions continue to resonate in contemporary discourse about homebirth, natural birth and unassisted birth or what has become known as ‘free birth’ in the form of the caricature of the ‘Third World,’ rural or ‘primitive’ woman who does not require biomedical assistance but gives birth alone and without medical intervention… [T]he ‘primitive’ woman, “haunts western women’s birth stories” as a romanticized, racist ideal that valorizes the power of the instinctive, pure or ‘natural’ birthing body …

The trope of the primitive woman who approaches the birth of her baby in an ‘uncomplicated’ fashion, with a “built-in knowledge of childbirth” and “without fear” has been found to inspire and embolden women’s decisions to birth outside the medical system (i.e. homebirth or unassisted birth) and pervade the talk of women planning homebirths.

Chadwick argues that the philosophy of natural childbirth continues to be fundamentally racist:

The call to return to ‘authentic’ birth and “natural selves” while ostensibly neutral, is actually an implicitly racially marked project aimed at predominantly white and privileged women.

This ongoing racism has real and deadly consequences for black women in industrialized countries. The natural childbirth movement, having conjured a racialized pregnant body as inherently “perfectly designed” for birth, elides the fact that black women are much more likely to die in childbirth than white women. To the extent that the tragedies of black pregnant women have been recognized by white women, it is to exploit those tragedies to argue – falsely and disingenuously – that black women need more of what white women want: intervention-free unmedicated vaginal birth, midwives and doulas.

But black women in industrialized countries are not dying because of too many interventions. They are dying because they don’t have access to the very interventions that white natural childbirth advocates deride. Black women die preventable deaths during pregnancy and childbirth because they need more high tech care — medical specialists, perinatologists, ICUs — not less.

The bottom line is that the contemporary philosophy of natural childbirth is fundamentally and ineradicably racist. It is long past time that the natural childbirth movement acknowledge its racist underpinnings and excise its racist assumptions about “unhindered,” “instinctual”, “natural” birth.

I’m not holding my breath. The racist trope of “the primitive woman who approaches the birth of her baby … without fear” is central to natural childbirth and beloved of privileged white natural childbirth advocates; racism be damned.

Sadly, there is an ugly history of racism in medicine. What’s less well known is the history of racism in natural childbirth advocacy and breastfeeding promotion.

As Alison Phipps explains in‘The New Reproductive Regimes of Truth,’ a chapter in the book The Politics of the Body: Gender in a Neoliberal and Neoconservative Age, natural childbirth advocates and lactivists promote an exoticized view the poor indigenous mothers of color while portraying mothers of color from their own societies as “uneducated” and lazy.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]NCB and lactivism promote exoticized views of indigenous mothers of color while portraying mothers of color from their own societies as “uneducated” and lazy.[/perfectpullquote]

Complementing this focus on the ‘natural’, there is a tendency to search for authenticity and origins in the discussion of alternative birth practices. This … often involves the Orientalizing of ‘traditional’ cultures, whether prehistoric or from developing countries. American childbirth educator Judith Lothian describes her Lamaze class as modelling ‘traditional ways of passing information about birth from generation to generation’, and advice to mothers to pursue on-demand or extended breastfeeding often makes reference to the fact that these practices are common outside the West, but without highlighting pertinent differences in culture and lifestyle.

In other words, both natural childbirth and breastfeeding advocates mobilize the myth of the “noble savage.”

According to Rational Wiki:

The noble savage stereotype is generally considered racist, ethnocentric, or culturally insensitive at the very least due to its association with a long history of imperialism, colonialism, and scientific racism …

A good deal of colonial histories and perceptions of indigenous people were based on myths, legends, and pseudohistory…

The racist myth of the “noble savage” is often used to promote pseudoscience:

Noble savage stereotypes are often used to sell woo, especially nature woo due to the perception that indigenous people are more “in tune” with nature or have some ancient and secret knowledge.

Natural childbirth and breastfeeding advocates often channel Grantly Dick-Read’s racist, sexist notions of “primitive” women. According to Dick-Read, “primitive” women have painless childbirth because they are content with their lot of being restricted to childbearing and childrearing. Of course, Dick-Read made it up and his invocation of a tension-fear-pain cycle was the result of his racist assumptions.

As Phipps notes:

… Like the claims of many contemporary activists, however, Dick-Read’s points were made despite the fact that he had not spent extensive time in non-western countries. The lack of an evidence base to corroborate such assertions is particularly problematic when non-western birthing practices are appropriated in the service of authenticity rather than effectiveness.

Contrast that with the view of poor, non-white women in their own countries:

… [W]omen who choose childbirth interventions or formula feed (who are largely from working-class and minority ethnic groups) [are] presented as ignorant and lazy or at best in need of education (which feeds racist and classist stereotypes). A generous formulation is that women lack the confidence to give birth without technology and need to be educated to trust themselves …

The surprising paradox is that natural childbirth and breastfeeding advocates claim to emulate indigenous mothers of color, whom they view as authentic and close to nature, while simultaneously demonizing mothers of color in their own countries whom they view as too ignorant to recognize the birth and breastfeeding “regimes of truth,” and too lazy to employ them when they learn of them.

The notion that women who have different preferences in childbirth and infant feeding are both ignorant and slothful justifies the beloved preoccupation of natural childbirth and breastfeeding advocates with the coercion of “informed choice.”

Within this framework of compulsory empowerment through ‘informed choice’, deviant behaviours are positioned as being a product of ignorance or weak-mindedness, rather than affirmative choices in favour of an alternative. This is clear in Lothian’s question: ‘why are women seemingly uninterested in choosing normal birth, in spite of our best efforts?’

Phipps concludes:

… [A]lthough birth and breastfeeding activists have a tendency to present themselves as counter-cultural, and identify themselves with global Others in their appropriation of ‘traditional’ practices, there is little attention paid to the stigmatizing effect this might have upon our own social Others, the working-class and minority ethnic women who may choose birth interventions or infant formula for a variety of structural reasons.

It makes you wonder: where would natural childbirth and breastfeeding advocates be without racist portrayals of mothers of color.

Imagine a study that compared in hospital blood transfusion rates to death rates. What would you conclude if that study found that people who received blood transfusions were more likely to die than those who did not?

Would you postulate that blood transfusions caused deaths? Would you recommend that blood transfusions be withheld? Of course not!

You would almost certainly recognize the obvious: people who received blood transfusions are likely sicker those who did not and therefore the two groups can’t be compared directly. You would understand that withholding blood transfusions from those who need them would lead to more deaths not fewer.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]A new study claiming to show that in hospital formula supplementation reduces breastfeeding duration is a joke.[/perfectpullquote]

That’s why a new study that claims to show that in hospital formula supplementation reduces breastfeeding duration is such a joke. It’s yet another example that breastfeeding research sucks.

The paper is In-Hospital Formula Feeding and Breastfeeding Duration by Marcia Burton McCoy, MPH, IBCLC, Pamela Heggie, MD, IBCLC.

Here’s what the authors think they found:

Hazard ratios (HR) for weaning increased across time. In the first analysis, the HR across the first year was 6.1 (95% confidence interval [CI] 4.9–7.5), with HRs increasing with age (first month: HR = 4.1 [95% CI 3.5–4.7]; 1–6 months: HR = 8.2 [95% CI 5.6–12.1]; .6 months: HR = 14.6 [95% CI 8.9–24.0]). The second, more conservative analysis revealed that infants exposed to IHFF had 2.5 times the hazard of weaning compared with infants who were exclusively breastfed (HR = 2.5; 95% CI 1.9–3.4).

CONCLUSIONS: IHFF was associated with earlier weaning, with infants exposed to IHFF at 2.5 to 6 times higher risk in the first year than infants exclusively breastfed. Strategies to reduce IHFF include prenatal education, peer counseling, hospital staff and physician education, and skin-to-skin contact.

Here’s what they actually found: absolutely NOTHING!

Why is the study a joke? Because it fails to fully account for the fact that mothers whose babies need in hospital supplementation may have insufficient breastmilk. The two groups of infants being compared are not comparable and therefore no conclusions can be drawn.

The authors did recognize that — contrary to the beliefs of many lactation professionals — insufficient breastmilk is both real and common. But they did not adequately take that reality into account.

The authors made four assumptions:

1. On the basis of early weight loss nomograms for exclusively breastfed newborns, a maximum of 5% of infants experienced weight loss ≥ 10% because of primary lactation failure.

2. All cases of primary lactation failure were detected by excess weight loss.

3. All infants with excess weight loss were given formula rather than the mother’s expressed milk or pasteurized donor human milk.

4. Those with excess weight loss had the shortest durations of breastfeeding of all infants exposed to IHFF.

Therefore:

In this analysis, we excluded the 5% of IHFF infants with the shortest breastfeeding durations before matching.

Using those assumptions, the “risk” of in hospital formula supplementation leading to weaning was cut dramatically from 6.1 to 2.5.

But most cases of insufficient breastmilk are NOT diagnosed immediately. It can take days or even weeks for insufficient breastmilk to become apparent.

Furthermore, the incidence of insufficient breastmilk in the first week or so after birth is up to 15%, much higher than the 5% that the authors assumed. As a result, they failed to fully account for breastfeeding complications. Therefore, their results are worse than meaningless.

That’s hardly surprising because most breastfeeding research is like bad drug company research; it is impaired by conflicts of interest. It uses statistically illiterate methods to demonstrate meaningless ”benefits” and reach the predetermined conclusion that we should be buying more of whatever the breastfeeding industry is currently selling.

At first it seems confusing and out of place; they weren’t celebrating their heritage, real or imagined. So why did protesters in Michigan — as far north from the Deep South as you can possibly be and still be in the US — wear Confederate garb and carry Confederate flags?

Because COVID denialism is primarily an expression of white identity. It is partly wishful thinking that white, rural people are immune, but it also includes a willingness to die to conserve a superior “place” in a purported racial hierarchy.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Many poor white people are willing to die to conserve their “place” in a purported racial hierarchy.[/perfectpullquote]

When these protestors die, and too many of them will, they will be dying of whiteness.

How did we get here?

It’s just an extension of the politics of racial resentment that have been roiling the country for a generation.

COVID-19 started in China and brought massive suffering to Italy, literally shutting the country down. But the first major flares in the US occurred in cities known for liberalism, tolerance and population density. And because it disproportionately kills people of color, many white people erroneously believe that they are immune.

But even as they find they are not immune — consider the stories circulating about COVID deniers who dropped their denialism when they became desperately ill — denialism is growing as a political force.

Homemade placards reading ‘give me liberty or give me covid’, and ‘live free or die’, feel frighteningly close to the truth, as protestors defy crucial social distancing guidelines, and demand the lifting of necessary measures which would see a sharp spike in fatalities…

As physician Jonathan Metzl explained in Dying of Whiteness: How the Politics of Racial Resentment is Killing America’s Heartland, poor, rural white people often favor beliefs and policies that literally kill them.

As Metzl noted in an interview last year:

…What I was trying to do was first explore how racial tensions shaped policies in particular states. And I found very clear evidence of the ways that fears of immigrants, fears that minority people were usurping resources, were shaping policy agendas in these regions.

In Kansas [where voters have supported massive cuts to public services], for example, a number of very far-right people told me that they felt like minority school districts were taking all the state taxpayer money and buying party buses and having parties. And those tensions shaped policies that defunded schools or blocked immigration or cut health care services. So were the individual people racist? I don’t know. But the policy itself was shaped by racial tensions, and that, ultimately, dictated health outcomes across the board.

This isn’t merely people failing to understand how the policies they support will hurt them. It’s people willing to be hurt in order to preserve racial hierarchies. When COVID deniers declare they want to live free or die, they mean that they don’t want to live if they have to live in a world where people of color are accepted as equal.

But what about COVID deniers on the Left, the anti-vaxxers and purveyors of the nonsense “documentary” Plandemic? Although they will deny it vigorously, their views rest on racism, too.

Anti-vax has long been an expression of white privilege. As sociologist Jennifer Reich writes in the paper Neoliberal Mothering and Vaccine Refusal: Imagined Gated Communities and the Privilege of Choice:

[Anti-vax mothers] … envision disease risk to lie in “foreign” bodies outside their networks, and, therefore, individually manageable …

Anti-vaxxers claim to be empowered by their decisions:

Yet, they do so by claiming their power through dominant feminine tropes of maternal expertise over the family and by mobilizing their privilege in the symbolic gated communities in which they live and parent…

At its heart — both on the Right and the Left — COVID denialism is an expression of racism. It is the belief that white people, by virtue of being superior, are immune to the scourge. And if it doesn’t actually make them immune, they will settle for displaying their supposed superiority by campaigning against measures they view as benefiting poor people of color.

It’s not difficult to recognize that this husband is abusive:

My daughter, 10 months old has recently started biting during breastfeeding… [M]y breasts kind of look like a war zone- I’m bleeding and sore because of the biting and simply cannot take it anymore.

… My husband does not like this. He was okay with me pumping and feeding our daughter until I started supplementing with formula. He believes that breastmilk is best and formula is the devil because it’s not “natural” or something…

It reached the tipping point yesterday when he hid the formula so I’d have “no choice” but to breastfeed our daughter.

I ask him why he’s doing this, and he simply says he doesn’t think I’m not trying hard enough because I stopped simply because she’s biting me, and that a good mother wouldn’t stop doing what’s best for her child simply because she’s in pain.

Most of the comments on the Reddit thread are supportive of the mother. For example:

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]What’s the difference between this abusive behavior and the typical behavior of many lactivists?[/perfectpullquote]

… How fucking dare he. I am filled with righteous indignation on your behalf. A good husband wouldn’t gaslight his wife into thinking that she is somehow doing her child wrong by making certain her child gets the nutrients she needs while make certain that her own body isn’t relegated to the status of a chew toy… [I]f my husband did this to me (hid formula to try to force me to breast feed; doubled down by accusing me of being a bad mother if I didn’t follow his command) I would tell him I’d see the formula back immediately, or I’d see him in court.

So here’s my question: is there any difference between this abusive behavior and the typical behavior of many lactivists* and lactation professionals?

A foundational document of contemporary lactivism, Diane Weissinger’s Watch Your Language, is a veritable primer on emotional abuse. It explains in detail how to use fear, obligation and guilt to force women to breastfeed.

What are the tactics employed by both the abusive husband and by lactivists?

1. Thought policing:

This is the key tactic:

When we … say that breastfeeding is the best possible way to feed babies because it provides their ideal food, perfectly balanced for optimal infant nutrition, the logical response is, “So what?” Our own experience tells us that optimal is not necessary. Normal is fine, and implied in this language is the absolute normalcy and thus safety and adequacy-of artificial feeding… Artificial feeding, which is neither the same nor superior, is therefore deficient, incomplete, and inferior. Those are difficult words, but they have an appropriate place in our vocabulary.

What better way to ensure fear, obligation and guilt than to insist that infant formula is “deficient, incomplete, and inferior”? The abusive husband employs the same tactic when he tells his wife that breastfeeding is “what good mothers do.”

2. Lying: Lactivists lie routinely in promoting breastfeeding. Yes, breastfeeding can be beneficial, but in first world countries with access to clean water the benefits for term babies are trivial. Honesty is unlikely to promote the fear, obligation and guilt desired by lactivists so they lie instead. This deprives women of the opportunity to make informed decisions about breastfeeding since the information they are given is proganda, not scientific evidence. The abusive husband employs the same tactic when he implies that the baby will suffer by being weaned at 10 months of age.

3. Invalidation: In the world of lactivism, women’s thoughts, needs and values are dismissed out of hand. Maternal exhaustion? Who cares. Maternal need to return to work? Just pump. A history of maternal sexual abuse that leads a woman to avoid anyone touching her breasts? She should just get over it. Mothers’ feelings aren’t simply irrelevant; they are invalid.

4. Gaslighting: This is a specialized form of invalidation that involves denying reality. A mother says her baby is hungry? Tell her all babies scream like that. A mother finds breastfeeding agonizing? Tell her her pain doesn’t matter. A mother needs medication incompatible with breastfeeding? Tell her she doesn’t really need it. In other words, lactivists — like the abusive husband — refuse to accept the lived reality of breastfeeding for many women, substituting preferred beliefs instead.

These are not the only emotionally abusive tactics used to promote breastfeeding, but they are among the most prominent. Rather then treating women respectfully as individuals with their own needs and desires, emotional abusers treat women as existing merely to be manipulated to satisfy the abuser’s needs. This husband “needs” his wife to breastfeed their child so he abuses her in an attempt to force the issue. Lactivists “need” other women to breastfeed so they abuse women in an attempt to force the issue.

Like this husband, lactivists deploy thought control, lying, invalidating and gaslighting to exert control. If it’s abusive behavior when a husband does it, it’s abusive behavior when lactivists and lactation professionals do it. In both cases, it must stop!

* I am not suggesting that the emotional abuse meted out by lactivists has anywhere near the destructive effects of the emotional abuse that can occur within personal relationships.

The lactivist community is obsessed with the idea that breastmilk might contain antibodies against the virus that causes COVID-19.

[Rebecca] Powell is an assistant professor of medicine and infectious diseases at Mount Sinai’s Icahn School of Medicine who studies the immune properties of human breast milk.

Her lab is hoping to pin down whether breast milk has antibodies specific to COVID-19, whether they might protect babies from COVID-19, and ultimately, whether they can be spun into a therapy against the illness for adults.

They’ve released their results as a pre-print, Evidence of a significant secretory-IgA-dominant SARS-CoV-2 immune response in human milk following recovery from COVID-19, a paper that has NOT been reviewed by other scientists:

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]There’s not much practical significance to a breastmilk antibody that reduces the risk of an already rare disease by only 8%.[/perfectpullquote]

In this preliminary report, 15 milk samples obtained from donors previously-infected with SARS-CoV-2 as well as 10 negative control samples obtained prior to December 2019 were tested for reactivity to the Receptor Binding Domain (RBD) of the SARS-CoV-2 Spike protein by ELISAs measuring IgA, IgG, IgM, and secretory Ab. Eighty percent of samples obtained post-COVID-19 exhibited IgA reactivity, and all these samples were also positive for secretory Ab reactivity, suggesting the IgA is predominantly sIgA. COVID-19 group mean OD values of undiluted milk were significantly greater for IgA (p<0.0001), secretory-type Abs (p<0.0001), and IgG (p=0.017), but not for IgM, compared to pre-pandemic group mean values. Overall, these data indicate that there is strong sIgA-dominant SARS-CoV-2 immune response in human milk after infection in the majority of individuals, and that a comprehensive study of this response is highly warranted.

Or as a pediatrician opined on Facebook:

Not only does the act of breastfeeding likely protect baby, but a potent antibody response within the breast milk could be even more effective than plasma or immunoglobulin infusions as a therapy for active COVID-19 infection!

Let’s assume for the moment that the results are true and breastmilk contains secretory IgA against COVID-19. What does it really mean? Not much!

We already know that breastmilk contains secretory IgA against respiratory and diarrheal illnesses. And we know that the secretory IgA reduces those illnesses by a — wait for it — only 8%! That’s not especially meaningful for the common cold; the antibodies DON’T prevent babies from getting the common cold (as any breastfeeding mother could tell you). They simply reduce the incidence by only 8%.

For an illness like COVID-19, where the incidence among infants is already low, the impact is likely to be negligible or even unmeasurable.

Why?

Because IgA is a subtype of antibody and not a particularly effective one. It is very different from what most people think about when they think about antibodies.

The most powerful antibodies against disease — the antibodies that you make if you are infected or vaccinated against the majority of childhood diseases — are IgM and IgG. IgM and IgG circulate in the bloodstream and seek out a specific virus or bacterium to tag it for destruction by white blood cells. These antibodies are so effective that they can be harvested in the plasma of people who have recovered from a disease in order to passively protect people who can’t make enough antibody on their own.

Secretory IgA, in contrast, acts on internal surfaces of the body like the respiratory and gastrointestinal tracts.

Secretory IgA (SIgA) plays an important role in the protection and homeostatic regulation of intestinal, respiratory, and urogenital mucosal epithelia separating the outside environment from the inside of the body. This primary function of SIgA is referred to as immune exclusion, a process that limits the access of numerous microorganisms and mucosal antigens to these thin and vulnerable mucosal barriers.

Secretory IgA reduces the risk that a virus or bacterium will gain entry to the body, but doesn’t act in the bloodstream where the organism wreaks its havoc. To use an analogy, if IgG and IgM are guns then secretory IgA is a fence. Fences are useful but they don’t do much to protect you once the invader has scaled the fence and dropped over the other side. Only a weapon could possibly protect you then.

That’s also why breastmilk is not protective against the majority of childhood diseases. While IgG can be transferred to a baby across the placenta, (hence vaccinations for mothers in the last trimester of pregnancy) it can’t be effectively transmitted in breastmilk because it will be digested in the baby’s stomach.

Moreover, to my knowledge, unlike IgM and IgG — which can be used to provide passive immunity in someone who can’t make or hasn’t yet made their own antibodies — IgA has NEVER been used effectively to provide passive immunity to anyone for anything. To put it another way, if secretory IgA were a useful therapy, we already would have used it to prevent the common cold and that hasn’t happened.

The bottom line is this: even if breastmilk contains antibodies to COVID-19, the practical significance is likely to be low and the possibility of using it as a therapy is vanishingly small. It’s just another example of breastfeeding researchers touting ever more arcane theoretical benefits of breastfeeding that make no difference in reality.

When the Japanese bombed Pearl Harbor on December 7, 1941, killing thousands of Americans, the “Greatest Generation” recognized we had been attacked, rallied to enlist in the defense of our country, willingly accepted privation and worked tirelessly for victory.

Can you imagine what would have happened if the Left denied we were attacked or if the Right insisted that Hawaii wasn’t really part of the US so there was no need to respond? We would have been invaded and conquered and we would have deserved the destruction that followed.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Instead of the “Greatest Generation,” we are the Gullible Generation. [/perfectpullquote]

Faced with our Pearl Harbor, a pandemic that has already killed tens of thousands of Americans, many in our generation — the Gullible Generation — deny that there is a deadly threat, refuse to participate in the defense of our country, won’t even tolerate wearing masks in public and refuse to believe in the existence of the enemy let alone work to defeat it.

And they’re proud of their gullibility!

They tell themselves that they’re the ones who see the lies, and the rest of us are sheep. But believing that everybody’s lying is just another kind of gullibility.

Slate writer William Saletan was talking about JFK assassination conspiracists, but he could just as easily have been talking about coronavirus conspiracists. They, too, are absolutely sure that there is giant conspiracy, a conspiracy that encompasses the entire world, designed to falsely convince people that we are in the midst of a pandemic. Ironically, instead of being the only people who see the conspiracy, they are the the very “sheeple” that they purport to despise.

From the alt-right to the loony left, thousands of people have created and then clung to conspiracy theories that feel to their believers like a child’s fuzzy blanket — offering comfort from the big, scary world. They are so psychologically immature that they are incapable of dealing with reality, a pandemic that could kill them and their family members, so they escape into fantasy.

Why?

Unlike the “Greatest Generation” that came to maturity in the 1930s and 1940s forced to endure the reality of the Depression and World War II, the current generation of conspiracy sheeple came to maturity in the age of social media, able to recuse themselves from reality.

Social media allows us to:

… customize our surroundings, and accustom us to regulating and controlling the information that comes our way. This has several effects: an expanded sense of what falls under our personal social domain, an increased expectation of control over that domain, and a greater sensitivity to input that deviates from our preferences.

If reality is too hard or too frightening, we don’t work harder or mature to handle our difficulties. Instead, we seek out like minded sheeple on Facebook and Twitter to bond around fables that leave us simultaneously victims of malevolent forces AND heroes who recognize the true source of our peril. The sheeple on the Left soothe themselves by pretending that the pandemic was planned by the government and corporations; the sheeple on the Right soothe themselves by pretending that it doesn’t even exist.

The Greatest Generation was blessed with extraordinary leaders like Franklin Roosevelt and Winston Churchill. The Gullible Generation is cursed by Donald Trump, the apotheosis of recusing yourself from reality. He constantly vomits forth a barrage of lies, nearly all of which involve simple, but wrong explanations for complex problems and advocate simple, but wrong solutions that never work.

Both the alt-right and the looney left may cling to their conspiracy theories, but they cannot recuse themselves from reality for long. Countries like Germany, which relied on scientists and epidemiologists, quickly brought the pandemic under control, have experienced far less economic and social disruption (not to mention far fewer cases of illness and deaths), while countries like the US, which ignored (and continues to ignore) scientists and epidemiologists has seen the pandemic accelerate with no end in sight. The massive economic and social disruption we have experienced will continue because we don’t have the disease under control.

The COVID-19 pandemic is another national Pearl Harbor and unlike the Greatest Generation, we are not rising to the challenge. The Gullible Generation, in the grip of conspiracy theories, is failing spectacularly.

George Santayana’s most famous quote is used so often that it has become a cliche:

Those who do not remember the past are condemned to repeat it.

It’s just as true in epidemiology as it is in history. That’s why this graph may save your life.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Beware the second wave![/perfectpullquote]

It’s a graph of the US death rate during the Spanish Flu epidemic of 1918-1919. It illustrates what happens when you stop social distancing and open up the economy too soon.

Like many pandemics, the disease and death of the Spanish flu pandemic did not occur all at once. It happened in three distinct waves.

Back in 1918 there were no medical or pharmacological tools to mitigate the severity of the disease; there were no anti-virals and no vaccines for influenza. Public health officials had only natural methods at their disposal: they implemented social distancing to reduce the spread of the disease and the number of deaths.

And it mostly worked.

Most of the social distancing measures used today were well known and implemented with mixed severity and mixed outcomes in 1918. Total isolation, if implemented early, is effective…

The effectiveness of social distancing … is considered to depend on how well and how soon it implemented. In 1918, St Louis implemented these early and well, but Philadelphia did not, including allowing a WWI parade. Philadelphia had a greater rate of infection. However, when St Louis later started cutting back on social distancing restrictions, influenza cases spiked, and the city had to reinstate the measures.

But people chafed at the restrictions and suffered from the resulting economic devastation. Cases and deaths were dropping and politicians were declaring that the worst was over. Sound familiar?

There was tremendous political pressure to lift the restrictions. At first the predictions of the protesters seemed to be confirmed. Cases of the flu continued to drop and it nearly disappeared during the summer months. But it hadn’t been eliminated because social distancing measures were ended too soon. In the fall, it came roaring back.

Lifting control measures when a population is still in the exponential part of the curve, and before any external factors that can limit a wave take effect (eg, a vaccine or antiviral), allows that population to regress to the point before controls were implemented. However, by that time, a much higher number of individuals will be infected. If doubling time reaches 3 days early in the wave, 10 infected persons will increase to 20 in 3 days. If the doubling time when controls are lifted is still 3 days, but the number of infected persons is 1000, then the number will go from 1000 to 2000 infected persons in 3 days, and then to 4000 in another 3 days.

This is especially true when, as in the case of COVID-19, the virus can spread asymptomatically. Moreover, the virus can continue to mutate as it spreads, possibly becoming more virulent.

When the Spanish flu returned in the fall, cases and death rates exploded. Ultimately 675,000 American died of the flu and — as the graph demonstrates — the majority of deaths occurred in the second wave.

There are a lot of reasons to believe that COVID-19 may behave like the Spanish flu and similar pandemics. Indeed, nearly every prediction made by doctors and scientists about the COVID-19 pandemic has come to pass; those predictions were based directly on the Spanish flu experience. That means that the worst of this pandemic still lies ahead.

Where are we now? I added the green arrow to the graph to show that we appear to be cresting the first wave. It seems to those who are protesting the restrictions that there is no reason to continue them. That’s what those who protested the 1918 restrictions thought, too.

They were dead wrong! For every person who died in the first wave of the Spanish flu, up to 10 died in the second and third waves. That means that if 60,000 Americans have died thus far, we can expect as many as 600,000 more to die in the coming 12-18 months if we lift restrictions prematurely.

That doesn’t have to happen. We can keep restrictions in place, only gradually easing them to be sure that the disease does not come roaring back. If the graph convinces politicians to move slowly, hundreds of thousands of lives (including YOURS!) may be saved. Even if politicians choose to behave irresponsibly, you can still heed the lessons of the graph and keep practicing social distancing as far as you are able, continuing to wear masks and avoiding large gatherings of people as much as you can.

Those who refuse to learn from the past are condemned to repeat it. Just because the protesters are determined to ignore the lessons of 1918 and kill themselves, their relatives and their friends doesn’t mean the rest of us have to follow them into the abyss.

Remember this graph; it could save your life and the lives of those you love.

Faced with the pandemic of COVID-19 the Trump administration has done everything wrong and tens of thousands of people have died as a result.

• Trump suppressed information about the threat of the pandemic.
• He lied about the dangers of the virus.
• He refused to allow use of the test that would have identified early cases.
• He failed to provide protective equipment for medical staff.
• He seized tools states had ordered to fight the disease.
• He promotes ineffective and dangerous treatments.
• He is inciting his followers to resist the only measures that have protected them: social distancing, masks and economic shutdowns.

Every action Trump has taken has killed or will kill more people. So why is he doing it? Because Trump doesn’t care about the threat of the virus; he only cares about the perception of the virus. Given the choice between preventing people from getting sick or falsely assuring people they won’t get sick he picks lying every time.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]I OPPOSE any effort to develop a vaccine “at warp speed.”[/perfectpullquote]

But all that may pale in comparison to the next effort Trump is touting — developing a vaccine “at warp speed.” We could develop a safe vaccine for COVID-19 slowly or we could quickly develop a vaccine that might be deadly.

It’s not a theoretical risk. It has happened before. In 1976, faced with the looming threat of a particularly virulent form of swine flu, President Gerald Ford rushed a vaccine into production and insisted on releasing it immediately. The result: more people were harmed by complications from the vaccine than from the flu.

Emergency legislation for the “National Swine Flu Immunization Program” was signed … on April 15th, 1976 and six months later high profile photos of celebrities and political figures receiving the flu jab appeared in the media. Even President Ford himself was photographed in his office receiving his shot from the White House doctor.

Within 10 months, nearly 25% of the US population, or 45 million citizens were vaccinated …

But the vaccine wasn’t safe. Over 450 people were paralyzed temporarily or permanently by reactions to the vaccine. The worst part was that the swine flu turned out to be less of a threat than the vaccine designed to prevent it.

Why did the debacle occur?

Ford was facing a tough re-election campaign that fall (one he subsequently lost) and he feared the impact of an epidemic on his electoral prospects. He was more concerned with producing a vaccine quickly than producing it safely.

Sound familiar?

I am a passionate advocate of vaccines and I know that the only solution to the current pandemic is a vaccine. Nonetheless, I OPPOSE any effort to develop a vaccine “at warp speed.” We MUST ensure the vaccine is safe and the ONLY way to do that is to test it over time.

We can have a safe vaccine or a rapidly developed vaccine. We can’t have both. We must demand a safe vaccine!

Anti-elitism killed John McDaniel.

On social media McDaniel publicly disparaged efforts to slow the spread of COVID-19.

One screenshot of a post dated March 13 included an accusation that the virus was a “political ploy.”

“If you’re paranoid about getting sick, just don’t go out,” another post allegedly said. “It shouldn’t keep those of us from Living Our Lives. The Madness has to stop.”

A month later he was dead. The proximate cause was coronavirus. The real cause was anti-elitism.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Do Trump supporters love themselves as much as they hate elites?[/perfectpullquote]

I’m old enough to remember when doctors and scientists were respected. That was before a political party weaponized anti-elitism in the effort to win elections.

It started by encouraging distrust of government. President Ronald Reagan famously declared:

The nine most terrifying words in the English language are: I’m from the Government, and I’m here to help.

Over time it expanded to include the people who might support activist government, the “elites.” Instead of responding to the threats identified by “elites” in science and medicine, anti-elitists began condemning those who brought them any news they didn’t want to hear.

Anti-vaxxers didn’t like vaccines so they publicly vilified the doctors and scientists who created them. They attack any effort to maintain one of the greatest public health advances of all time.

Oil and coal interests didn’t want to hear about climate change so they publicly vilified the scientists who raised the alarm. They and their followers attack any effort to protect us from the environmental tragedy that we have been racing toward.

Our current President and his followers didn’t want to hear about the dangers of coronavirus so they publicly vilified the “elitist” doctors who warned about it.

Instead of taking measures to head off the pandemic, Trump and his supporters discounted the frantic calls to action of “elitist” epidemiologists and insisted it wouldn’t arrive.

Instead of quickly mobilizing social distancing to prevent spread of the virus, they derided those measures (they were recommended by elitists!) and insisted they were unnecessary efforts designed to socially control populations for nefarious ends.

Instead of quickly implementing the testing developed by the hated elitists at the World Health Organization, the Federal government insisted on developing its own test that was an embarrassing failure.

Instead of providing protective equipment for “elitist” health professionals, they have instead confiscated protective equipment that states managed to source for doctors and nurses.

At every step of the way, the Federal government has openly disparaged “elitist” scientists and callously risked the lives of “elitist” doctors and nurses.

Anti-elitism has become such a knee jerk reaction that instead of doing everything possible to avert economic disaster, Trump supporters including Senate Majority Leader Mitch McConnell have labeled rescue measures as “Blue State bailouts” designed to protect hated Democratic elites.

Anti-elitism has become such a reflexive response that instead of staying far away from others who might be carrying the virus, Trump supporters are holding rallies to show their contempt for safety measures.

But the anti-elitists have a big problem: the hated elites could have reduced the scale of this massive tragedy and they are the ONLY people who can bring it to an end.

Thus far nearly every prediction that “elites” have made about COVID-19 has come to pass. Nearly every prediction made by anti-elitists has been wrong, often spectacularly wrong.

So there’s only one question left for anti-elitists:

Do they love themselves and their families more or, like John McDaniel, do they hate “elites” so much that they’re willing to die for no better reason than to demonstrate their contempt?