We Want Them Infected
When Prominent People Suddenly Become 'Contrarian Doctors’
Jonathan Howard's book, “We Want Them Infected,” provides one of the first documentary overviews of the greatest health catastrophe in the United States in over a century. While the book addresses structural causes, the author focuses on the actions of individual persons who, due to their reputation, possessed a special power of discourse. They received much attention in major newspapers and renowned news channels, actively seeking the limelight. Taking a closer look at these individuals is worthwhile to better immunize ourselves against the actions of such “contrarian doctors” in the future. The book offers valuable insights that go far beyond the topic of science communication and dealing with disinformation in pandemic control.
Recently published by Redhawk Publications, the book is subtitled “How the failed quest for herd immunity led doctors to embrace the anti-vaccine movement and blinded Americans to the threat of COVID.” The author, Jonathan Howard, is an associate professor of neurology and psychiatry at NYU Langone Health and Chief of Neurology at Bellevue Hospital.
It is unusual for a book to begin with the following disclaimer: ”I regret any errors that inevitably slipped through.” However, this note demonstrates an important intellectual humility that was apparently lacking in many of the individuals discussed in the book during the pandemic. Jonathan Howard acknowledges his own mistakes in his ten-chapter work.
The title “We Want Them Infected” may initially sound conspiratorial but is taken directly from Paul Alexander, a scientific advisor in the White House under Trump, who wrote in July 2020,
“Infants, kids, teens, young people, young adults, middle aged with no conditions etc. have zero to little risk….so we use them to develop herd…we want them infected…”
This early commitment to achieving natural herd immunity through infections may have led the protagonists discussed in the book to systematically sow doubts about the effectiveness of COVID-19 vaccines, especially in children and adolescents.
Is this the real life...?
Howard worked in a hospital during the first and most severe wave of COVID-19 in New York. He describes the suffering he witnessed there: the constant sound of sirens in the streets, refrigerated trucks carrying bodies, mental and physical exhaustion, but also the strong sense of solidarity during that time. He also talks about difficult medical decisions that continue to haunt him.
Jonathan Howard discussed his experiences during the pandemic in an interview with the American YouTuber "Debunk the Funk," where he talked about a division between two worlds. On the one hand, there is the real world where human suffering and the tragic consequences of the pandemic are evident. On the other hand, there exists a “fantasy world” where this suffering was and continues to be denied. This is the world of vaccine opponents and “contrarian doctors,” as Howard calls them.
This division also reflects Howard's own development. Even before the pandemic, his former classmate Kelly Brogan spread false claims about vaccines. This led him to engage with this movement and its narratives. In one of his earlier publications, he already explored cognitive perceptual errors and their impact on medicine.
Through this engagement, Howard developed a keen sense for the narratives of vaccine opponents. However, during the pandemic, he noticed that these narratives suddenly became mainstream in the United States. The disseminators were no longer just fringe figures but also respected individuals from prestigious universities such as Stanford, Oxford, or Harvard. Their words carried weight in the public sphere.
Too Keen a Sense?
Critics will likely accuse Howard of having too keen a sense or committing his own perceptual error. However, this is initially countered by the prominent support that Howard's book has received. Among others, vaccine researcher Peter Hotez, who recently received an award from the prestigious American Association for the Advancement of Science (AAAS), has supported the book. Martin McKee, President of the British Medical Association, writes about the book,
“Everyone who has suffered from COVID-19, losing friends and relatives or experiencing Long COVID, or who cared for them, owes a debt of gratitude to Jonathan Howard.”
The renowned blog Science-Based Medicine, which has provided invaluable service to the public during the pandemic, also supports Howard. Through the website, I myself recently came across a worthwhile post by Howard.
Reputation is not always everything, as Howard himself acknowledges. In addition to the pure argument from authority, Howard's intellectual humility and meticulous work with sources speak to his perception. In his book, he lets the quotes speak and organizes them in a comprehensible manner to demonstrate the argumentative overlap with the anti-vaccine movement.
In his book, he succeeds in convincing readers with a variety of quotes from different phases of the pandemic. This makes it clear that the problematic statements are not isolated incidents but a systematic problem. His careful research and analysis leave no doubt that misleading narratives were also spread.
Communication Style: Opium for the Masses
It is almost inevitable to wonder what drives people to spread unscientific doubts about vaccines. Jonathan Howard does not provide a clear answer to this and does not attribute individual motives to anyone. Some of them repeatedly predicted or suggested the end of the pandemic too early, some as early as spring 2020. Howard believes that these repeated and premature public predictions have harmed the discourse. However, they have provided a platform in leading media for the doctors who like to portray themselves as victims of censorship.
However, Howard has developed a personal way of characterizing the possible thinking and feeling of these doctors. He sees in them a deep need for grandiosity, the desire to be someone special. This attitude leaves little room for mistakes and hinders socially responsible action. At the end of his book, Howard draws the fitting conclusion:
“When the emperor has no clothes, we are obligated to tell him he is naked.”
However, he also knows that it will be difficult to provide direct evidence of the negative impact of this poor science communication. He writes, in essence, that we will probably never know the impact this communication had. Unlike some of those “contrarians,” Howard is not interested in a reexamination of past events in show trials. Rather, he expresses the desire to immunize ourselves against such dynamics in the future.
Immune to Fear?
During the pandemic, the theme of “fear” dominated. Regardless of whether it was actually present or not, terms like “Coronaphobia” or “Fear of Normal (FONO)” were coined, which were also used to stigmatize people who simply wanted to protect themselves from COVID based on their own risk assessment. Howard points out a paradox that is not entirely unfounded. Although many of these doctors claimed to detect excessive fear, they were often the ones fueling scientifically and socio-politically irrational fear of the measures. For example, oncologist Vinay Prasad wrote in October 2021,
“COVID19 policy shows a (potential) path to the end of America.”
However, Howard also emphasizes that not every criticism of the measures should automatically be understood as part of such a dynamic. A differentiated view is still important. The distinction between pseudo- contrarianism and genuine contrarianism is the biggest challenge, but one that is worthwhile, as the book proves.
Immune to criticism?
One could and probably will criticize Jonathan Howard for noting the number of people who have died from Corona in the US since each statement was made in some of his quotes. However, I never get the impression that he directly holds these individual statements responsible for the number of deaths. Rather, Howard emphasizes how far these statements were from the pandemic reality. In most cases, Howard also manages to demonstrate that these statements were in blatant contradiction to helpful and comprehensive science communication.
However, this approach has its limits in a 25-page overview with a wealth of passages. Historically, these are certainly not irrelevant, but as a reader, I sometimes missed Howard's otherwise demonstrated ability to directly classify individual narratives. I didn't always get the impression that they spoke for themselves. I wondered if some of the quotes could also be explained with a more benevolent interpretation.
The book by Howard would certainly have benefited from expanded proofreading in some places, especially with regard to individual oversights in formatting. However, these are overall negligible issues in an otherwise successful book. There is always room for improvement in hopefully future editions.
“Perfection is the enemy of the good when it comes to emergency management. Speed trumps perfection … The greatest error is not to move. The greatest error is to be paralyzed by the fear of failure. If you need to be right before you move, you will never win.”
(Michael Ryan, WHO Heatlh Emergencies Programme, at a press conference of the organization on March 19, 2020)
Coming to Terms with the Pandemic
In the book, Jonathan Howard also provides concrete assistance. In one section, he presents 27 arguments used by “contrarian” doctors during the pandemic against vaccinating children. In doing so, he also points out that these arguments not only resemble old and well-known arguments from the anti-vaccination movement but also share similar argumentative structures.
Beyond Howard's recommendations for dealing with such arguments and doctors, the book serves as a gateway to discourse. It offers a narrative without fiction, a presentation based on verifiable statements with journalistic aspirations about the pandemic in the United States. It is a possible entry point into the societal examination of COVID-19, which ultimately, despite its focus on individual persons, should also be considered structurally.
This book is not only interesting for an American audience. The influence of many of these doctors extends far beyond the Atlantic. Therefore, interested readers in Europe will also benefit from reading it.
For those interested in failed science communication in times of crisis – here I also think of communication about the climate crisis – “We Want Them Infected” may be worth a try.
The book does not replace scientific analysis and certainly not a much-needed debate on structural causes. Jonathan Howard never claims this as his intention throughout the 445 pages.
“We Want Them Infected” by Jonathan Howard (Redhawk Publication) is available for 25 US-Dollars. Currently, the book is only available in an English-language edition.
“Every time we see or hear such mistruths we need to combat them and call them out. They are used to play down the seriousness and consequences of covid-19 and undermine health protection efforts.”
(David Oliver: Mistruths and misunderstandings about covid-19 death numbers, in BMJ)
* I have neither requested nor received any compensation or a free review copy for this review.
** ChatGPT was used to support and translate this post.