FOR A MEDICAL DOCTOR, SENATOR RAND PAUL DOESN’T SEEM TO BELIEVE IN SCIENCE

 

                                                   …Senator Rand Paul (R-KY)

 

Senator Paul seems to enjoy arguing with Dr. Anthony Fauci

 

Senator Rand Paul (R-ky) began practicing ophthalmology in 1993.  But he has positioned himself as the Senate’s foremost skeptic of coronavirus expert Anthony Fauci. The two have argued repeatedly about the coronavirus and its need for wearing masks.  Paul says that using masks is “theater”.

Paul recently brought it up again, while Fauci again made it clear he has little patience for Paul’s non-expert theories about the outbreak, and Paul’s so called “studies about it”.

At a Senate hearing, Paul pressed Fauci on health experts’ continued recommendation of masks, even for people who have contracted the virus or who have been vaccinated.  Paul repeatedly suggested wearing masks in those cases was “theater”, pointing at Fauci’s wearing of masks, even though he has been vaccinated.

“You’re telling everybody to wear a mask, whether they’ve had an infection or a vaccine,” Paul said. “What I’m saying is: They have immunity, and everybody agrees they have immunity. What studies do you have that people that have had the vaccine or have had the infection are spreading the infection? If we’re not spreading the infection, isn’t it just theater? … You’ve had the vaccine, and you’re wearing two masks. Isn’t that just theater?”

The real fact is, not everyone, if they had the vaccine agrees that they have full immunity and/or they can’t spread the virus.  The experts haven’t come to that conclusion….as yet.

Fauci said that, despite the lack of re-infections thus far, we don’t have significant data in two very relevant areas: Whether people who get the vaccine or who have contracted the virus can still spread it, and whether all those variants of the coronavirus might override any existing immunity. Fauci  bristled at the idea that his personal use of masks was “theater.”

“No it’s not,” Fauci said before suggesting, as he previously had, that the true “theater” was being promulgated by Senator Paul. “Here we go again with [Paul’s] theater.”

Fauci went on to address the specific study Paul had cited that supposedly indicated “everybody agrees they have immunity.” He noted it was not as conclusive as Paul suggested when it came to protection. The study was from, among others, Shane Crotty and Alessandro Sette at the La Jolla Institute for Immunology, whom Fauci referenced.

“Let’s get down to the facts,” Fauci said. “The studies that you quote from Crotty and Sette look at in vitro examination of memory immunity, which in their paper, they specifically say this does not necessarily pertain to the actual protection. It’s in vitro.”

Indeed, the study says exactly that.

“Although immune memory is the source of long-term protective immunity, direct conclusions about protective immunity cannot be made on the basis of quantifying SARS-CoV-2 circulating antibodies,” the study says, “ … because mechanisms of protective immunity against SARS-CoV-2 or COVID-19 are not defined in humans.”

Fauci’s point wasn’t that people definitely can’t spread the virus after infection or vaccination but that it’s hardly as certain as Paul suggested.

Perhaps sensing this hole in his argument, Paul began interrupting Fauci. He went back and forth between arguing that people were definitively immune and asking Fauci to prove that they weren’t, which is a much higher standard.

Fauci, though, noted that we simply don’t have enough information (Data) to be able to draw the kind of firm conclusion that Paul had.  Also, in the absence of that, mitigation is still the name of the game.   And mitigation can be achieved by wearing masks.

“I agree with you that you very likely would have protection from wild type for at least six months if you’ve been infected,” Fauci conceded, referring to today’s prevalent strain of the coronavirus. “But we in our country now have variants that are circulating.”

Fauci added that this was, “because we don’t have a prevalence of a variant yet. We’re having one … that’s becoming more dominant.”

Paul again cut in, accusing Fauci of making “policy based on conjecture.” Fauci responded that the policy was based not on conjecture but rather on unknowns.  Things that weren’t nearly as certain as Paul suggested.

Paul responded by accusing Fauci: “You parade around in two masks for show.”

After the exchange, the chairwoman of the committee, Sen. Patty Murray (D-Wash.), gave Fauci more of a chance to respond at length.

Fauci responded:

When you have a variant, you have an immunity that you get … against a wild type, you get a certain level of antibody that’s specific for a particular viral strain. If there’s a circulating variant, you don’t necessarily have it. You have some spillover immunity, to be sure, but you diminish by anywhere from two- to eightfold, the protection. So the point I’m saying is that there are variants now circulating.

The point that Senator Paul was making was that if you look at wild type only, there is some clear-cut credence to what he’s saying. But we are living right now in a situation where we’re having a dominance of ... the original U.K. [variant]. We have a very troublesome variant in New York City. ... We’ve got two variants in California. ... And we have a number of others. So we’re not dealing with a static situation of the same virus. That was the only point I’m making.

This illustrates the tension between Paul and his conservative allies and health officials. Paul’s allies, when they aren’t questioning the effectiveness of masks or vaccines, have criticized health officials for saying masks are necessary even after vaccination. Paul is saying: “Why get vaccinated if you still have to wear a mask?”

The answer is pretty obvious, from a health standpoint: They both reduce your chances of getting or spreading the virus. To the extent Paul has a point, it’s that people who are fed up with masks might get vaccinated to rid themselves of that recommendation.  But that doesn’t mean masks aren’t still a good idea when it comes to truly getting beyond the pandemic, which is obviously Fauci’s focus. 

It’s a difference in philosophy: “How do you truly tamp this down [Fauci] versus, how do you mitigate it without too much inconvenience [Paul]. (And, to the mind of Paul’s GOP allies, subservience to health officials).”

If there’s perhaps one big takeaway for Republicans from Paul’s presentation, though, it might be what he said to those who are skeptical about vaccines.  (That’s a group that skews strongly Republican.)

“In fact, I don’t think we have a hospitalization in the United States after the two-week period after the second vaccination,” Paul said while arguing masks weren’t necessary.

Paul’s statement about no hospitalizations after two weeks after the second vaccination, that is correct about the original strain of the virus.  But there is no proof as yet, if that’s the case for some of the variant strains.  The experts just don’t have any data to support that statement.  In that case, Fauci is correct to suggest that wearing a mask is extra insurance until they have the data that can support Paul’s assumptions regarding the variant strains.

For a medical doctor, Rand Paul is not following appropriately the way most medical personnel would believe in the science of the virus, especially the variants.

Copyright G. Ater 2021