Black In Public Health

Who would be excited to see a #BlkDEHEM next month for Black History Month? Black Disabled people in higher education deserve a Black Disabled Empowerment In Higher Education Month Higher education leaders need to follow & learn from the stories to be told - @nolan_syreeta

Lots of action items this week! We must expand COVID wastewater collection and analysis! The deadline to send a public comment to the @CDCgov via the Federal Register is tomorrow. Instructions can be found below. peoplescdc.substack.com/p/we-must-expa….

I would like to talk about the dangers of following the crowd. “Would you jump off a bridge just because your friends did?” Most of us heard a version of this question as children. It was intended to encourage us to think for ourselves, but it turns out very few people do. Most people feel peer pressure very intensely and it’s not limited to the public, who might have an excuse for being less informed about the risks of SARS-CoV-2. Academic peer pressure is real, and in some ways can be more harmful, because it can lead to important ideas being excluded from the scientific discourse. I have written before about my work on Fas-L, and early in the pandemic I published this paper: frontiersin.org/articles/10.33… The mechanism I proposed based on my expertise in the field was later proven in vivo: ncbi.nlm.nih.gov/pmc/articles/P… nature.com/articles/s4141… In summer 2020, I started work on a paper on the long-term risks of COVID-19 with Marc Desforges, @dgurdasani1 and @adamhamdy which was published in 2021: ncbi.nlm.nih.gov/pmc/articles/P… You can judge for yourself how accurate our concerns were. I published an explanation of why I expect reinfection to be a net harm to human health, with a feed forward mechanism that will have attritional effects with each infection: frontiersin.org/articles/10.33… I presented considered views that were intended to contribute to the scientific discourse. Views that are grounded in evidence, based on my experience conducting research at the NIH and elsewhere. My reward for sharing these views was to be labeled a ‘crank’ and a ‘grifter’ by a small but very vocal community of scientists and COVID commentators on Twitter like Marc Veldhoen and Zeynep Tufekci. I don’t have my own lab. I’m not in receipt of grants and my work on COVID has not benefited my career whatsoever. In fact, it has cost me. I have privately paid for the journal publication fees, and have suffered harm to my reputation because of how this vocal group chose to engage with me, attacking me as a person, rather than engaging with and refuting the science. What started as a small group quickly grew. I know members of this group reached out to other scientists privately to discredit me as an alarmist. They felt that the broad stimulation and hyperactivation of T cells was only valid during 1) severe disease and 2) acutely Little did they know the mechanism of T cell aging and death would behave in an "as above, so below" instance. What I mean is, that if you have a continuous broad stimulation, you have continuous broad turnover of cells. This is how in part people with Long Covid are missing unactivated naive T cells. There is a broad stimulation, which happens acutely, happening chronically as well. So they dismissed my alarm of 'kiss your naive T cells goodbye' when I wrote it in 2020 I know that some of the people they reached out to listened and distanced themselves from me and joined in the process of discrediting me. I know of arguments behind my back in DM groups and individually by people who weren’t qualified to understand the immunology and who were basing their decisions on whether to disavow me on my tone and junior status. But what would their tone and persona have been like if they’d been the subject of a campaign to isolate them and present their views as ‘fringe,’ as Brian Hjele had said? From my perspective, we had everyone else commenting on immunology and T cell death that were not in a qualified position to do so whatsoever. Brian Hjele worked on some viruses. Marc Veldhoen on T cell metabolism. Bertoletti on patents for supplementing Hep specific cells with Car-t Soon, what had started with a handful of people became a large, concerted campaign. Even people I previously respected like Dr Rupert Beale joined the crowd and described me publicly as a crank. I was so upset by this, I wrote to Dr Beale’s supervisor, who said he would remind Dr Beale about the good conduct policy for social media None of these people attempted to refute my science. None of them reached out to me to find out whether the unsubstantiated rumors doing the rounds – that I was unemployed and unemployable – were true. In fact, as I’ve written before, I was at medical and working at the NIH conducting cancer research during my vacations. I suspect many of the people caught up in this bullying campaign didn’t even bother to read my papers, which outlined the mechanisms I suspected were at play. Mechanisms that have subsequently been proven, like Fas apoptosis in severe disease, and sweeping losses of naive T cells. Imagine if, instead of devoting so much time and effort to discrediting me because they were so insecure about themselves and their understanding of the world, they had instead engaged on the science. I warned about T cell differentiation, activation, and depletion in 2020. I warned about persistent infection in 2020. Now we see persistent T cell activation and persistent infection and we have no idea of the long-term harms involved. I think I have some idea, but you will indeed call me an "information terrorist" as Mel Symeonides has done. We can hazard a guess based on our existing understanding of a persistently activated immune system. We can expect an increase in autoimmunity, like I said which was confirmed.. We can expect a decrease in immune function as the immune system continually diverts resources to fighting a persistent infection. We can expect immunosenescence because of chronic inflammation. We need to be mindful of the effects of rapid T cell turnover and what that might mean for future health. In short, many of the things I was concerned about have come to pass. I tried to warn people, but like many COVID cautious people, I was fighting the weight of a society that just wants to get back to normal. The emergence of this pathogen ended the old normal. The choice we now face is whether to continue the pretense we can return to 2019 or whether we accept our new reality and adapt to live with the virus. The price of pretense will be sustained increases in morbidity and mortality, individuals suffering sudden unexplained incidences of cardiovascular disease, autoimmune disease, kidney disease and so on. I’ve written about this before, but early harm to the immune system doesn’t necessarily manifest as an exponential and endless rise in fungal or bacterial infection (although strep tonsillitis risk increases after Covid according to the BMJ). It expresses as a rise in all cause morbidity and mortality as the body becomes dysregulated in its ability to fight harms across the board. The John Snow Project has written about what ‘textbook immunity’ tells us to expect: johnsnowproject.org/insights/textb… And in a related piece has called on governments to urgently answer some of the key questions that surround the harms that are likely to be caused by repeat infections: johnsnowproject.org/insights/admis… To all the COVID cautious people out there still masking and keeping themselves and their loved ones safe, thank you. Each infection prevented is a transmission chain ended and a series of harms avoided. You aren’t just doing good for yourselves, you are benefiting society, and I believe there will come a time when people who spread SARS-CoV-2 are regarded with the same or greater disapproval than smokers who inflicted the harms of passive smoking on others. To the COVID cautious I say the weight of evidence is on your side. The science tells us infection and reinfection are net harms. And not only the science: the NIH, WHO and HHS are among a growing number of organizations advising people to avoid reinfections because they increase the risk of harmful outcomes. To all the people like Dr Beale and Mel, who got swept up in the gaggle that thought it cool to bully and abuse me for a while, I would ask you to take a deeper look at the science and really question whether you believe the vaccines alone are enough to protect human health from the harms being caused by this virus. I don’t think we have learnt anything about this virus that was better than the mainstream consensus was expecting. From asymptomatic infection to airborne transmission, from reinfection to viral persistence, from T cell activation to infection of the bone marrow, this virus has confounded the expectations of optimists and it is likely to continue to do so. If upon reflection you decide I was right to vocally warn people to take care, please add your voice to the cause and demonstrate what you believe in your actions. Wear a respirator mask, advocate for cleaner air, and encourage colleagues to do likewise. SARS-CoV-2 represents an unprecedented challenge and I believe we will only rise to meet it by working together. This means putting aside personalities and not getting swept along with the crowd because it is the easy thing to do. It means standing up for what is right and encouraging people to protect themselves, and most importantly their children. My pinned tweet is a letter a sent to a school board because I think one of our fundamental responsibilities as human beings is to safeguard those who cannot look after themselves. Children depend on adults to protect them, and right now the adults are gambling that repeat infections by SARS-CoV-2 will not violate that trust. The stakes could not be higher: we risk failing in our profound duty to make the world a safe place for the next generation. History will judge. Don’t follow the crowd. Even if it’s difficult and there is a cost to be paid, do what is right