scott atlas covid
© Carlos Barria / Reuters
Scott Atlas, Senior advisor to the President
Freddie Sayers caught up with Scott Atlas, a healthcare policy academic from the Hoover Institute at Stanford, who has become the latest lightning rod for the controversy around Covid-19 policy and his support for a more targeted response.

Speaking from inside the White House, where he is now Senior advisor to the President and a member of the Coronavirus task force, he does not hold back. He tells us that he is disgusted and dismayed at the media and public policy establishment, sad that it has come to this, cynical about their intentions, and angry that lockdown policies have been allowed to go on so long.

He won't be rushing back to Stanford, where his colleagues have rounded on him, if the President loses in November.


Key quotes:
Why him?
"I'm a healthcare policy person — I have a background in medical science, but my role really is to translate medial science into public policy. That's very different from being an epidemiologist or a virologist with a single, limited view on things."

Dr Fauci
"He's just one person on the task force — there are several people on the task force. His background is virology, immunology and infectious disease. It's a very different background, it's a more limited approach, and I don't speak for him."

Herd immunity policy?
"No. It's a repeated distortion, lie, or whatever you want to call it... What they mean by 'herd immunity strategy' is survival of the fittest, let the infection spread through the community and develop a population immunity. That's never been the policy that I have advised. It's never even been discussed inside the White House, not even for a single minute. And that's never been the policy of the President of the United States or anybody else here. I've said that many many times... and yet it persists like so many other things, hence the term that the President is fond of using called fake news."

On herd immunity
"Population immunity is a biological phenomenon that occurs. It's sort of like if you're building something in your basement: it's down on the ground because gravity puts it there. It's not a 'strategy' to say that herd immunity exists — it is obtained when a certain percentage of the population becomes resistant or immune to an infection, whether that is by getting infected or getting a vaccine or by a combination of both. In fact, if you don't that believe herd immunity exists as a way to block the pathways to the vulnerable in an infection, then you would never advocate or believe in giving widespread vaccination — that's the whole point of it... I've explained it to people who seemingly didn't understand it; I've mentioned this radioactive word called herd immunity. But that's not a strategy that anyone is pursuing."

What is his policy?
"My advice is exactly this. It's a three-pronged strategy. Number one: aggressive protection of high risk individuals and the vulnerable (typically the elderly and those with co-morbidities). Number two: allocate resources so that we prevent hospital overcrowding, so that people can be treated for this virus and get the other serious medical care that is needed. Number three: open schools, society and businesses because keeping them closed is enormously harmful — in fact it kills people."

Has the policy changed?
"It is the White House policy on Coronavirus, but it always was. The President started this with an observation that was overlooked by most people in the world: he said in the third week of March that the cure cannot be worse than the disease... In April the White House released a formal 'opening up America' document, which included extreme protection of the vulnerable and opening up society... It's not been a shift."

Effect of lockdowns
"We must open up because we're killing people. In the US, 46% of the six most common cancers were not diagnosed during the shutdown... These are people who will present to the hospital or their doctor with later stage disease — many of these people will die. 650,000 Americans are on chemotherapy ­ — half of them didn't come in for their chemo because they were afraid. Two-thirds of screenings for cancer were not done; half of childhood immunisations did not get done; 85% of living organ transplants did not get done. And then we see the other harms: 200,000 cases plus of child abuse in the US during the two months of spring school closures were not reported because schools are the number one agency where abuse is noticed; we have one out of four American young adults, college age, who thought of killing themselves in the month of June...

All of these harms are massive for the working class and the lower socioeconomic groups. The people who are upper class, who can work from home, the people who can sip their latte and complain that their children are underfoot or that they have to come up with extra money to hire a tutor privately — these are people who are not impacted by the lockdowns.

This is the topic, this is why you open up. A secondary gain might be population immunity, but this is the reason to open up."

On short-term immunity
"We don't know how long someone's immunity lasts to this, but this is a coronavirus, this is not a completely novel disease... Coronavirus exposure typically has a year, or even a few years, of immunity — we can make a first guess that probably there's a good chance that will happen... Yes, we know that antibodies disappear... but that's true for every infection, that's a typical scenario and not a cause for panic. Why? Because we know there is resistance to infection that seems to be coming out in the literature that is not purely due to antibodies, there are other components of the immune system. Suffice to say this: do we know that people have immunity? You don't need to be a scientist to understand that when you hundreds of millions of cases... do you know how many cases of reinfection there are? At the most, five in the world... It is not true that there is no immunity to this, that would be a bizarre conclusion."

Climate of fear
"This is one of the biggest failures of the voices of public health in the United States and in the world — they specifically instilled fear with their proclamations and statements... And the models that were put forward that were worst case scenarios and were just hideously wrong, and the media that has hyped up these rare exceptions like multi-system inflammation in children even though we know the overwhelming evidence is that this disease is absolutely not high risk for children. All the hyperbole, the sensationalising and the failure of public health officials to articulate what we know instead of what we don't know... The fear is due to what was said by the so-called experts, by the media and by a failure to understand or care that they were instilling fear... I just heard a famous epidemiologist from Harvard the other day say that to have the idea of herd immunity even being discussed is 'mass murder' — these kinds of statements are hideously outrageous.

It's never appropriate to have fear. There is no such thing as a government leader who is competent who instils fear."

How to protect old people
"We have not been perfect at it, there's no question — it's very challenging. The first is to educate people: put forward the guidelines. I think our society has learned — no-one knew what social distancing meant... that was a foreign concept and we now understand that — but there are more specific measures. We have shipped every single nursing home point of care rapid testing — we have mandated weekly testing of every staff that enters a nursing home, but when there is community increase we recommend going up to... four times a week.

We cannot guarantee that we can protect everybody — there is not such thing as zero risk in life..."

But
"I have a 93 year old mother in law, and she said to me 2 months ago, "I'm not interested in being confined in my home. I am not interested in living if that's the life... I'm old enough to take a risk, I understand social distancing. I'm going to function, otherwise there's no reason to live." This sort of bizarre, maybe well-intentioned but misguided idea that we are going to eliminate all risk from life, we are going to stop people from taking any risk that they are well aware of, we're going to close down businesses, we're going to stop schools — these are inappropriate and destructive policies.

There are between 30,000 and 90,000 people a year that die — that are high risk elderly — in the United States every flu season. We don't shut down schools in response to that..."

Is it politics?
"I see that there is a different philosophy in life. In my own family we have different views on things. But we need to start by looking at the data.

One thing that's been really shocking to me is that in the US and I think all over the world, we have a really contaminated media. Their politics has really distorted truth... I think that has now contaminated public policy and science. There's been a massive distortion — a complete almost disregard for objectivity, including in some of what were the world's best journals like Lancet, New England Journal, Nature, Science: these people feel compelled to be politically visible, and that's contaminated the discussion."

On test and trace
"Now, there are 7 million registered cases in the US but even the CDC says that it's probably tenfold that, that's 70 million people at least; if we look at the world's cases, maybe 40 million cases but we know that it's probably 10 to 20 times that. So it's not possible to do things like contact tracing and isolating asymptomatic people.

A lot of these people who have very fancy CVs have engaged in very sloppy thinking. And now, partly because it's a political year in the US with a massively polarised electorate, the politics have entered the scene and there's a massive amount of digging in to the original beliefs even though they are completely wrong..."

On his own reputation
"My position here is not political — zero politics. My motivation was that the President of the United States asked me, a public health policy person who understands medical science, to help in the biggest healthcare crisis of the century. There would be something wrong with you if you would say no to that, no matter what your politics...

When I did that though, I knew I would be vilified, because in the US there are a lot of people who think that this President is radioactive, so there is a massive destruction that ensues immediately when you associate with this President. It's a very sad statement on America, on American culture, on the world — these people are blinded, even scientists, to the data because they despise the political side of this. And they have a massive ego, and can't admit they're wrong. Ok I'm a contrarian, I'm used to being a contrarian, I'm proud to be an outlier when the inliers are wrong.

I've gone through various levels of being angry. I'm not angry but I'm sort of disgusted and dismayed at the state of things... It's just sad to me. I'm cynical about the state we're in right now and the future... I'm disturbed. I have children of my own who are in their twenties, and I wonder what the future is if we have lost truth in the media, to a great extent, and we are now starting to lose truth in science...

I am angry at the people who were wrong and who insist on prolonging these policies that are killing people, particularly people who are not in their socioeconomic class. It's no problem for a person who has a high level job in government, or an academic job, to sit there and pontificate when the average guy is being destroyed. That I am angry about and I think history will record these people very harshly — it is an epic failure of massive proportion that they have abandoned regular people here with their own hubris and political agenda. In that sense - yeah I'm angry."

On masks
"Things like universal mask wearing — honestly that is contrary to the science as well as common sense, to think that you need to wear a mask when you're in the middle of the desert, when you're in the car on your own, when you're bicycling through St James's Park. This kind of stuff is nonsense. There is no science to support universal masking.

You can look at LA County, Miami-Dade county, many states in the US, the Philippines, Spain, France, the UK, all over the world mandating masks does not stop for the population does not stop cases. That is just super naïve, wrong, and that's just garbage science really. The WHO does not recommend widespread mandatory masks, the NIH does not recommend that, the CDC data itself shows that that doesn't work. That's bordering on wearing a copper bracelet as far as I am concerned.

I do think masks have a role... in medicine we wear masks for surgical procedures. The reason you wear a mask is when you're very close to somebody, or a sterile environment like an open incision, you want to stop a cough or droplets from getting in there and infecting something. That's very different from breathing... If you're socially distanced, there's no reason to wear a mask."

On the Stanford letter
"They expose themselves for who they were when they wrote that letter... It's preposterous what was said. But I have a lot of support inside Hoover Institution, a lot of support in faculty... I certainly have lost some friends, there's no question about that — would I do it again? Absolutely. It's the most important thing I've ever done.

I'm disgusted by politics - completely disgusted and it's a sad statement. People were exposed when someone came into power who they didn't agree with it — they were exposed for who they were. That's a gross embarrassment, and its sad.. There's a tremendous amount of emotion rather than rational thought."