Politics. Never mind that in the end, the FDA’s guidance requiring two months of follow-on surveillance data was ultimately approved, thus pushing consideration for the EUA past the November 2020 election. The House Select Committee on the Coronavirus Crisis dedicated much of its most recent report to the White House meddling in the vaccine approval process. It was an massive unforced error by the Trump White House which managed to take a celebration of American ingenuity and turn it into a political hot potato.
Like the obsession with Dr. Scott Atlas in the first report, this one seems designed to change the narrative; to resurrect the talking point from spring 2020 that asserted the Trump administration could not be trusted with vaccine approval.
Rep. Jim Clyburn, the Committee Chairman, is probably just piling on to the current political priority to halt a return of Donald Trump to the White House. In isolation, that is probably a reasonable strategy.
However, excess mortality, largely unexplained, is making its way into the mainstream. Some, like the Telegraph in the U.K. have put the finger on lockdowns, delayed treatment, and an overwhelmed National Health Service.
That explanation gets more and more unsatisfying the farther genuine “lockdowns” recede in the rearview.
So, it is also possible, whether the Committee intended it or not, that the political setup will be to blame the Trump administration for poor approval oversight and procurement practices that delivered a potentially faulty product.
Seems like a stretch right now, but mortality data remains persistently and uncomfortably high for facile explanations.
Policy. You would think that during a time of national crisis that the Civil War was, no one would consider selling the Union Army lame mules and munitions boxes full of sawdust.
But they did.
You would also think that the Union Army’s procurement officers would have been a bit more savvy when dealing with commercial interests.
But they weren’t.
That was all before Bretton Woods, central banks and other instruments of moral hazard that at least limited the number of three-legged mules the Union Army purchased.
Imagine the extent to which such wartime profiteering can go today. Ok, don’t imagine. Just consider that the U.S. government, with support from Congress, has been purchasing billions of dollars’ worth of COVID vaccines with little durability and no effect on transmission, the latter admittedly a misguided policy goal from the start.
Along the way, federal health officials have told themselves stories – or repeated the ones they were told - to justify the ongoing federal expenditures. COVID cases rose in spring 2021, prompting mandates, because of the epidemic of the unvaccinated. Breakthrough infections were recognized as “rare,” then they weren’t. The latest argument is that COVID vaccines protect against severe illness and hospitalizations.
Maybe that is true but also possible, given the limited durability of boosters and the rapidly declining administration of same, is Omicron and all its variants is much milder than the original wild type that caused so much death in early 2020.
Under normal circumstances, like in the post-Cold War period when the Defense Department was buying $600 coffee pots, such poor procurement processes would not escape the oversight of Congress, the Justice Department, the Office of the Inspector General.
These days, you are either all right (the majority party) or all wrong (the minority party) and there is little impetus for agency introspection. The False Claims Act, passed by Congress in 1863 in response to the purchase of those beasts of burden that were not up for the business of war, recognizes that political paralysis means taxpayers are on their own in protecting their interests.
The device from English common law known as Qui Tam allows individual citizens to sue on behalf of the U.S. government, as Brook Jackson has done in United States in ex rel. Brooke Jackson v. Ventavia Research Group, Pfizer et al.
For the time being the case is being ignored because, at least in part, it is hard to fathom how or why any American company would resort to such profiteering in a national crisis.
But maybe they did.
Power. Dr. Anthony Fauci, a federal government employee for 50 years, announced his retirement last week to cheers and jeers. Conservatives have been more outspoken in their distaste for the good doctor, but it is fair to say his reputation has suffered across the medical and scientific communities, politics notwithstanding.
The main charge against Dr. Fauci is that he may bear some responsibility for risky coronavirus research that paved the way for a pandemic. Let the dead bury the dead on that one because we may never know for certain.
He is also blamed for many of the missteps in the COVID response that has wrought economic damage the world over.
The caricature of Dr. Fauci that emerges from these accusations is a bureaucratic version of Mike Myers’s Dr. Evil. It is comforting to find blame in one prosecutable human being.
It is also wrong.
Not to defend Dr. Fauci because his role in the COVID response is not flattering, as was the case in his early work on AIDS/HIV. Not because he was some evil mastermind but because he was a loyal sycophant.
Lockdowns, masks and mass testing were driven mostly by Dr. Deborah Birx, according to her memoir. She dragged Dr. Fauci along because, to use her description, he did not like confrontation. The vaccine push originated with Alex Azar, according to Jared Kushner’s book, “Breaking History.” Dr. Fauci appears to be mostly guilty of being a media hog and being conned into funding really bad ideas.
You do not manage to survive over 40 years in high positions in Washington without being agreeable, preferably malleable. Dr. Fauci is both. His departure, however, which was accelerated from the end of Biden's term to the end of December, probably means the future is not a bright one for the NIH, biosecurity funding and perhaps pandemic response.
Have a great rest of the weekend.
Emily Evans
Managing Director – Health Policy
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