Science Denounces Trump
Two leading scientific journals have taken the historic step of weighing in on the Presidential race, deeming President Trump’s handling of public health a crisis that demanded their voice.
NYT (“In a First, New England Journal of Medicine Joins Never-Trumpers“):
Throughout its 208-year history, The New England Journal of Medicine has remained staunchly nonpartisan. The world’s most prestigious medical journal has never supported or condemned a political candidate.
Until now.
In an editorial signed by 34 editors who are United States citizens (one editor is not) and published on Wednesday, the journal said the Trump administration had responded so poorly to the coronavirus pandemic that they “have taken a crisis and turned it into a tragedy.”
The journal did not explicitly endorse Joseph R. Biden Jr., the Democratic nominee, but that was the only possible inference, other scientists noted.
The editor in chief, Dr. Eric Rubin, said the scathing editorial was one of only four in the journal’s history that were signed by all of the editors. The N.E.J.M.’s editors join those of another influential publication, Scientific American, who last month endorsed Mr. Biden, the former vice president.
The JAMA editorial (“Dying in a Leadership Vacuum“*) is harsh:
The magnitude of this failure is astonishing. According to the Johns Hopkins Center for Systems Science and Engineering,1 the United States leads the world in Covid-19 cases and in deaths due to the disease, far exceeding the numbers in much larger countries, such as China. The death rate in this country is more than double that of Canada, exceeds that of Japan, a country with a vulnerable and elderly population, by a factor of almost 50, and even dwarfs the rates in lower-middle-income countries, such as Vietnam, by a factor of almost 2000. Covid-19 is an overwhelming challenge, and many factors contribute to its severity. But the one we can control is how we behave. And in the United States we have consistently behaved poorly.
[…]
Why has the United States handled this pandemic so badly? We have failed at almost every step. We had ample warning, but when the disease first arrived, we were incapable of testing effectively and couldn’t provide even the most basic personal protective equipment to health care workers and the general public. And we continue to be way behind the curve in testing. While the absolute numbers of tests have increased substantially, the more useful metric is the number of tests performed per infected person, a rate that puts us far down the international list, below such places as Kazakhstan, Zimbabwe, and Ethiopia, countries that cannot boast the biomedical infrastructure or the manufacturing capacity that we have.2 Moreover, a lack of emphasis on developing capacity has meant that U.S. test results are often long delayed, rendering the results useless for disease control.
The United States came into this crisis with enormous advantages. Along with tremendous manufacturing capacity, we have a biomedical research system that is the envy of the world. We have enormous expertise in public health, health policy, and basic biology and have consistently been able to turn that expertise into new therapies and preventive measures. And much of that national expertise resides in government institutions. Yet our leaders have largely chosen to ignore and even denigrate experts.
The response of our nation’s leaders has been consistently inadequate. The federal government has largely abandoned disease control to the states. Governors have varied in their responses, not so much by party as by competence. But whatever their competence, governors do not have the tools that Washington controls. Instead of using those tools, the federal government has undermined them. The Centers for Disease Control and Prevention, which was the world’s leading disease response organization, has been eviscerated and has suffered dramatic testing and policy failures. The National Institutes of Health have played a key role in vaccine development but have been excluded from much crucial government decision making. And the Food and Drug Administration has been shamefully politicized,3 appearing to respond to pressure from the administration rather than scientific evidence. Our current leaders have undercut trust in science and in government,4 causing damage that will certainly outlast them. Instead of relying on expertise, the administration has turned to uninformed “opinion leaders” and charlatans who obscure the truth and facilitate the promulgation of outright lies.
Scientific American went even further, explicitly endorsing Biden even in its headline (“Scientific American Endorses Joe Biden“):
Scientific American has never endorsed a presidential candidate in its 175-year history. This year we are compelled to do so. We do not do this lightly.
The evidence and the science show that Donald Trump has badly damaged the U.S. and its people—because he rejects evidence and science. The most devastating example is his dishonest and inept response to the COVID-19 pandemic, which cost more than 190,000 Americans their lives by the middle of September. He has also attacked environmental protections, medical care, and the researchers and public science agencies that help this country prepare for its greatest challenges. That is why we urge you to vote for Joe Biden, who is offering fact-based plans to protect our health, our economy and the environment. These and other proposals he has put forth can set the country back on course for a safer, more prosperous and more equitable future.
The pandemic would strain any nation and system, but Trump’s rejection of evidence and public health measures have been catastrophic in the U.S. He was warned many times in January and February about the onrushing disease, yet he did not develop a national strategy to provide protective equipment, coronavirus testing or clear health guidelines. Testing people for the virus, and tracing those they may have infected, is how countries in Europe and Asia have gained control over their outbreaks, saved lives, and successfully reopened businesses and schools. But in the U.S., Trump claimed, falsely, that “anybody that wants a test can get a test.” That was untrue in March and remained untrue through the summer. Trump opposed $25 billion for increased testing and tracing that was in a pandemic relief bill as late as July. These lapses accelerated the spread of disease through the country—particularly in highly vulnerable communities that include people of color, where deaths climbed disproportionately to those in the rest of the population.
While I would have assumed physicians, because of their income bracket and social status, lean Republican, that’s been decreasingly true over the last two decades. Mostly, this is a function of women making up a much larger percentage of the profession and thus counter-balancing the Republican skew of the once male-dominated field. Additionally, the decreasing percentage of doctors who are in solo and small practice has declined precipitously.
Regardless, there’s a reason these institutions have always stayed out of partisan politics: if they’re seen as taking sides, they will inevitably lose their prestige as impartial experts. They have, rightly, decided that the situation is so dire that they have to take that risk.
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*This was trending two days ago but I only saw the headline, not the origin, and didn’t make much of it.
The GOP, and everything that it stands for, has long ago decided that it doesn’t care about evidence and expertise – in any field whatsoever, economics included.
So what do these scientific publications have to lose?
Colbert’s joke “reality has a well known liberal bias” worked because, underneath the inversion, it spoke (and speaks) truth.
Ron Suskind quoted a W Bush official, believed to be Karl Rove, as saying their faith based approach would beat the opposition’s reality based approach. I think Democrats should embrace that view now that the Rs faith based approach is so visibly failing. It’s conventional wisdom that people vote on perceived tribal identities. Republicans have defined themselves as the Regular White People tribe and Democrats have largely acquiesced, allowing themselves to be defined by default as the Non-White, non Regular People tribe, in the eyes of Republicans the tribe of the poor, the takers, Romney’s 47%, the people who want to come for my stuff.
In my mind, Trump, and particularly his non-response to COVID, gives Dems an opportunity to redefine the tribes. We can define ourselves as the Reality Based Tribe, the tribe that embraces the world as it is and moves confidently toward a shiny future. Let the Rs define themselves in opposition to that. This post shows the medical and scientific communities being driven to the Democrats. Run with it.
Historically it is true the physicians skewed to being Rs but another factor beyond the entry of women into the field is the milieu that physicians work in has changed dramatically. 50 years ago, most physicians worked independently or in a small group private practice, today most physicians are employees of large medical conglomerates often owned by private equity concerns. While some specialties are highly paid, the typical GP or family practice physician is around $225K, a nice but not outstanding income, plus today they see more patients today and must conform to the strictures of the corporation.
That’s enough to make you a socialist, forget about a Dem.
Thanks for the updated information, last time I saw a breakdown was at least a decade ago and it said doctors were about 90% R. Since then, in addition to the above:
– Having a chunk of your income come from Medicare, Medicaid, and government employee insurance probably affects your attitude toward the dreaded socialized medicine.
– There must be some feelings of relief that Obamacare means turning away from treating fewer people because of poor or no insurance, expecting they’ll actually get the meds you prescribe, and your hospital not eating such large losses in the ER.
– The COVID crisis aside, Rs have dismissed science and expertise wholesale.
– I suspect the medical population skews heavily urban.
– Fear the gubmit might dictate care has, I suspect, largely been displaced by insurance companies and corporate management actually dictating care.
– Educated people are moving D generally.
@gVOR08:
Except for in the Southeast, college-educated whites are strongly Democrat.
Ouchies.
As far as physicians trending less GOP over time, you have to think that the GOP being relentlessly against actual health care for most people would tend to take the bloom off the rose, no matter how mercenary you were… The GOP’s pro-pandemic stance is only the latest and most extreme example of them being in favor of libertarian approaches to public health, which work about as well as libertarian approaches to sanitation.
@gVOR08: I expect you and I would have very few meaningful disagreements regarding what is ‘reality based’ policy and how to effect it. But I have to point out that much of the appeal of the typical AM Ranter is that what they say seems like such common sense to their audience. When they pronounce that generous unemployment benefits keep recipients from trying to find work (to pick one), that seems completely reasonable and obvious on it’s face. It’s wrong in the real world but seems so reasonable that it becomes ‘truth’ that leftists deny.
@JohnMcC:
Of course — but that’s exactly what science is: a systematic way to learn that your common sense is wrong. The earth is not flat, bad smells do not cause disease, light waves do not require a medium in which to propagate, air and water (much less earth and fire) are not elemental, etc. And (for example) companies that implement paid sick leave on average become more profitable even as their employees become more healthy and prosperous. Who’d a thunk it?
More reliable, I think, sources like Beckers have tracked physician affiliation for years by looking at voter registration numbers. At this point there may be a slight Democratic tilt. In general, the high paying specialties like orthopedics go GOP and the lower paying ones like pediatrics vote Dem. Also linked to gender.
Steve
@Sleeping Dog:
There is also debt from undergrad and med school. Even if you don’t borrow for your bachelor’s, medical school is expensive.
Getting in-state tuition helps, but you’re still looking at 100k in tuition over four years at the least expensive schools. Add the opportunity cost of four years out of the workforce and middling pay for post-graduate residency/fellowships, and the cost of becoming a physician is massive.
@DrDaveT:
A friend of mine was an English major. He was hanging out with some other students in the same program when one of them brought up the difficulty of reading Gravity’s Rainbow.
Another student in the group rolled her eyes and read aloud the few sentences of the novel. She put it down and said, “see? That’s easy! How could someone not understand that?”
Some people just don’t want to accept that the world isn’t as straightforward as their brain expects it to be.