Dr. Deborah Birx
You may still vaguely remember Deborah Birx.

If not. In March 2020, Dr. Birx became the "response coordinator" for the White House task force on Covid, a job she held until Donald Trump left office.

Birx has now written a book about her time at the White House, Silent Invasion. It came out in April to resounding indifference. Its biggest audience seems to be me and other lockdown skeptics, who want to understand how Birx and her public health colleagues so overreacted and mismanaged the response to Sars-Cov-2.

On that front, Silent Invasion is very revealing.

Birx is obsessed with asymptomatic transmission - the theory that people who are not showing symptoms of illness are very important spreaders of Covid.

Before Covid, scientists agreed people who did not have symptoms of respiratory viruses like influenza did not spread illness. ("The driver of respiratory outbreaks is symptomatic people, not asymptomatic carriers," Dr. Anthony Fauci famously said on January 28, 2020.)

But if asymptomatic transmission is rare, the Covid mitigation measures Birx favored - including mask mandates, lockdowns, and widespread testing of asymptomatic people - are impossible to justify.

Thus Birx spends much of Silent Invasion insisting Covid is unlike other respiratory viruses, that what it is driven by what she likes to call "silent spread." Silent spread must be stopped by any means necessary, and especially by mass testing of young healthy people like college students.

Birx likes lockdowns and masks, but she loves forced testing of asymptomatic people for Covid. The less risk the coronavirus poses a person, the more necessary it is to test that person weekly, if not daily! Because silent spread. All those frat boys doing community service at nursing homes, or something.

The cost, intrusiveness, and civil liberties concerns of forced testing mean not a whit to Dr. Birx.

Nor does the fact that in the real world, testing - of either symptomatic or asymptomatic people - failed completely as a way to halt the spread of Covid.

The number of tests the United States and other countries conducted made absolutely no difference to the course of the epidemic. The practical obstacles to using testing as a way to contain Covid are simply impossible to overcome. PCR testing usually takes days to give an answer, making it too slow to matter, unless people are going to be forced to quarantine while they wait. At-home antigen testing is a slightly better alternative. But it will miss many early infections, as viral loads are rising - just as people are becoming more infectious.

Birx comes by her obsession with asymptomatic transmission and testing of healthy people honesty. Before Covid, she spent most of her career fighting HIV, which is mostly transmitted by people without symptoms.

Still, her fixation on testing is a perfect example of Santayana's definition of fanaticism: redoubling your effort when you have forgotten your aim. Testing is controllable and measurable, it is proof that the public health authorities are doing something, even if that something makes no difference.

And, as Dr. Birx tells us on page 33 of Silent Invasion, she likes to do things. ("I prefer doing things rather than talking about them.")

Testing is doing things!

But Birx's testing obsession is not the most disturbing part of Silent Invasion.

No, that moment comes near the end, on page 409, in what is basically an aside as Birx discusses the Covid vaccine rollout. She writes:
Historically, flu vaccination rates in America have been nowhere near high enough for the population to develop herd immunity[emphasis added]...

The CDC should have worked to understand vaccine hesitancy and, more important, how that hesitancy could be overcome. If we had increased annual flu vaccinations over time, we could have been very near or have exceeded the number of people needed to achieve vaccine-based immunity [emphasis added].
(I didn't make this up. I couldn't make this up.)

Birx quote
How do I put this politely?

If Deborah Birx believes the United States could reach "vaccine-based immunity" to influenza by increasing the number of flu shots it administers, she lacks even the most basic understanding of epidemiology.

Flu vaccines are at best marginally effective against reducing influenza infection. The Centers for Disease Control puts the effectiveness of a flu shot at roughly 40 to 60 percent most years - 50 percent, give or take.

That 50 percent estimate is probably high (if 50 percent sounds like a nice round made-up number, that's because it is), but no matter. A vaccine that reduces infection rates by only 50 percent cannot possibly produce "vaccine-based immunity" to any illness with pandemic potential, even if everyone in the world is vaccinated.

Our real-world experience with the flu and flu vaccines bears out this fact. The United States increased the number of flu shots it administered 15-fold between 1980 and 2020, to almost 200 million doses - including about 75 percent of adults over 65...

flu vaccine doses

...while the number of flu deaths rose roughly six-fold during the same 40-year period, from 3,650 to 20,000.

To be clear, this unfortunate correlation does not prove that flu shots cause more flu deaths. But it hardly shows that flu shots work, or that "vaccine-based immunity" to influenza is anything but a pipe dream.

In fact, an excellent 2020 paper that examined 14 years of British data covering 170 million suggested that flu shots have precisely no impact on flu deaths: no evidence indicated that vaccination reduced hospitalizations or mortality among elderly persons.

Lately, Birx has been pretending that she was skeptical of the Covid vaccines from the first. Last month, she told Fox News, "I knew these vaccines were not going to protect against infection. I think we overplayed the vaccines."

In reality, Birx's enthusiasm for flu shots, which have always been far less effective than the early clinical trial results suggested the mRNA Covid vaccines would be, suggests exactly the opposite.

On page 410, Birx makes an equally bizarre statement about those clinical trials for the Covid vaccines, attributing their strong results to the fact that the trials consisted of "volunteer participants [who] are motivated to contribute to a historic breakthrough."

Oh. That makes sense. That's why clinical trials for cancer medicines fail so often! People have cancer aren't motivated to beat it at all, so the trials don't work.

The point of a randomized, controlled, double-blinded clinical trial is to eliminate any placebo effect or other biases in its participants, by keeping them from knowing if they have received the real treatment or a placebo. That way, only the actual biological effect of the drug will have an impact.

The 94-95 percent effectiveness that Pfizer and Moderna reported in the mRNA clinical trials proved to be a lie for many different reasons. Birx managed to come up with about the only one that didn't matter. Her basic scientific ignorance is stunning.

And so - for all the wrong reasons - Silent Invasion does indeed go a long way to help explaining what happened in 2020.

Fauci's memoir's gonna be a doozy.