House votes to declassify info about origins of COVID-19
By LISA MASCARO
WASHINGTON (AP) — The House voted unanimously Friday to declassify U.S. intelligence information about the origins of COVID-19, a sweeping show of bipartisan support near the third anniversary of the start of the deadly pandemic.
The 419-0 vote was final congressional approval of the bill, sending it to President Joe Biden’s desk. It’s unclear whether the president will sign the measure into law, and the White House said the matter was under review. … If signed into law, the measure would require within 90 days the declassification of “any and all information relating to potential links between the Wuhan Institute of Virology and the origin of the Coronavirus Disease.”
That includes information about research and other activities at the lab and whether any researchers grew ill.
Almost all of America’s leaders have gradually pulled back their COVID mandates, requirements, and closures—even in states like California, which had imposed the most stringent and longest-lasting restrictions on the public. At the same time, the media has been gradually acknowledging the ongoing release of studies that totally refute the purported reasons behind those restrictions. This overt reversal is falsely portrayed as “learned” or “new evidence.” Little acknowledgement of error is to be found. We have seen no public apology for promulgating false information, or for the vilification and delegitimization of policy experts and medical scientists like myself who spoke out correctly about data, standard knowledge about viral infections and pandemics, and fundamental biology.
The historical record is critical. We have seen a macabre Orwellian attempt to rewrite history and to blame the failure of widespread lockdowns on the lockdowns’ critics, alongside absurd denials of officials’ own incessant demands for them. In the Trump administration, Dr. Deborah Birxwas formally in charge of the medical side of the White House’s coronavirus task force during the pandemic’s first year. In that capacity, she authored all written federal policy recommendations to governors and states and personally advised each state’s public health officials during official visits, often with Vice President Mike Pence, who oversaw the entire task force. Upon the inauguration of President Joe Biden, Dr. Anthony Fauci became chief medical advisor and ran the Biden pandemic response.
We must acknowledge the abject failure of the Birx-Fauci policies. They were enacted, but they failed to stop the dying, failed to stop the infection from spreading, and inflicted massive damage and destruction particularly on lower-income families and on America’s children.
More than 1 million American deaths have been attributed to that virus. Even after draconian measures, including school closures, stoppage of non-COVID medical care, business shutdowns, personal restrictions, and then the continuation of many restrictions and mandates in the presence of a vaccine, there was an undeniable failure—over two presidential administrations—to stop cases from rapidly escalating.
Numerous experts—including John Ioannidis, David Katz, and myself—called for targeted protection, a safer alternative to widespread lockdowns, in national media beginning in March of 2020. That proposal was rejected. History’s biggest public health policy failure came at the hands of those who recommended the lockdowns and those who implemented them, not those who advised otherwise.
WASHINGTON, DC – APRIL 09: White House coronavirus response coordinator Deborah Birx speaks as (L-R) National Institute of Allergy and Infectious Diseases Director Anthony Fauci, U.S. Vice President Mike Pence and Labor Secretary Eugene Scalia listen during the daily coronavirus briefing in the Brady Press Briefing Room at the White House on April 09, 2020 in Washington, DC. U.S. unemployment claims have approached 17 million over the past three weeks amid the COVID-19 pandemic. Alex Wong/Getty Images
The tragicfailure of reckless, unprecedented lockdowns that were contrary to established pandemic science, and the added massive harms of those policies on children, the elderly, and lower-income families, are indisputable and well-documented in numerousstudies. This was the biggest, the most tragic, and the most unethical breakdown of public health leadership in modern history.
In a democracy, indeed in any ethical and free society, the truth is essential. The American people need to hear the truth—the facts, free from the political distortions, misrepresentations, and censorship. The first step is to clearly state the harsh truth in the starkest possible terms. Lies were told. Those lies harmed the public. Those lies were directly contrary to the evidence, to decades of knowledge on viral pandemics, and to long-established fundamental biology.
Here are the 10 biggest falsehoods—known for years to be false, not recently learned or proven to be so—promoted by America’s public health leaders, elected and unelected officials, and now-discredited academics:
1. SARS-CoV-2 coronavirus has a far higher fatality rate than the flu by several orders of magnitude.
2. Everyone is at significant risk to die from this virus.
3. No one has any immunological protection, because this virus is completely new.
4. Asymptomatic people are major drivers of the spread.
5. Locking down—closing schools and businesses, confining people to their homes, stopping non-COVID medical care, and eliminating travel—will stop or eliminate the virus.
6. Masks will protect everyone and stop the spread.
7. The virus is known to be naturally occurring, and claiming it originated in a lab is a conspiracy theory.
8. Teachers are at especially high risk.
9. COVID vaccines stop the spread of the infection.
10. Immune protection only comes from a vaccine.
None of us are so naïve as to expect a direct apology from critics at my employer, Stanford University, or in government, academic public health, and the media. But to ensure that this never happens again, government leaders, power-driven officials, and influential academics and advisors often harboring conflicts of interest must be held accountable. Personally, I remain highly skeptical that any government investigation or commission can avoid politicization. Regardless of their intention, all such government-run inquiries will at least be perceived as politically motivated and their conclusions will be rejected outright by many. Those investigations must proceed, though, if only to seek the truth, to teach our children that truth matters, and to remember G.K. Chesterton’s critical lesson that “Right is right, even if nobody does it. Wrong is wrong, even if everybody is wrong about it.”
Scott W. Atlas, MD is the Robert Wesson Senior Fellow in health policy at Stanford University’s Hoover Institution, Co-Director of the Global Liberty Institute, Founding Fellow of Hillsdale’s Academy for Science & Freedom, and author of A Plague Upon Our House: My Fight at the Trump White House to Stop COVID from Destroying America (Bombardier Press, 2022).
The views expressed in this article are the writer’s own.
Steve Kirsch recently wrote an excellent article highlighting three “scientists” whose guideline recommendations were ultimately responsible for the deaths of nearly a million Americans.
To summarize: It shows that there are dozens of treatments for COVID-19 that have numerous peer reviewed studies demonstrating their efficacy. Despite those existing therapeutics and countless petitions for their usage, the committee responsible for developing the guidelines on what is an appropriate treatment for COVID-19 has only approved remdesivir, which is a toxic drug with no therapeutic value for treating COVID-19. As a result, a dangerous drug has been mandated, while many drugs that would save lives are prohibited in most medical systems.
Evidence based medicine is commonly thought to mean “the best evidence” dictates the standard of care. In reality, it typically means financial interests dictate the standard of care and “evidence” is just used as a smokescreen to justify profiteering. This table that I initially discovered from Kirsch’s article provides clear and unambiguous proof of that contention. See if you can figure out what the circled drugs (those which received an EUA) all have in common!
Because I expected the conflicts of interests of the committee that determined the COVID-19 treatment guidelines to follow the typical pattern, I did some digging and discovered a lovely web of corruption that entangled many of its members. The purpose of this article is to explain the typical pattern and illustrate how it was followed in this case. I am doing this because I believe the first step to moving beyond that pattern is to recognize its existence. For those of you who do not need the context, please skip ahead to the COVID-19 Treatment Guidelines section.
Introduction
There are two ways you can observe most organizational systems:
•As someone trapped inside the system observing their surroundings.
•As an outside observer who sees the entire system as a whole.
Since we typically do not explore or examine systems that are outside our everyday lives, we will typically experience the first type of observation. This occurs after life circumstances force us to become stuck in a system, which happened to many of us who were swept into the maelstrom of COVID-19.
Two of my central principles for understanding the architecture of modern society have been the relentless creation of hierarchal systems and the monopolization of resources that are essential for life.
In regard to the first principle, no matter where you look, a typical pattern is always followed: a hierarchy is established, significant investment is created to establish the importance of the hierarchy, and the top of the hierarchal pyramid is bought out (often through bribes) so that a small investment at the top can be leveraged to control an entire population.
In regard to the second, those with obscene fortunes seem to always find ways to monopolize resources essential for life and transform them from something each person can independently produce to something they must continually work to obtain. For example, it is extremely common after communist revolutions that the independent farmers in the nation will either be prohibited from farming or executed, allowing agriculture to be transitioned to a state-run enterprise. Once this happens, everyone is forced to work for the state or starve, which leads them to becoming obedient subjects that can be easily exploited for their labor.
In most cases when the monopolization of a life essential resource occurs, the new approach is hailed as a technological miracle and this is used to encourage people to let go of their traditional and self-sufficient approach. The new “miraculous” approach is initially deemed “superior” but before long turns out to be worse than the now abandoned initial approach.
The Green revolution is an excellent example of this (more and more fertilizers herbicides and pesticides are needed to produce the same agricultural input). For example, Bill Gates, under the guise of “charity,” has frequently made people in Africa abandon their traditional self-sufficient forms of agriculture and switch to modern chemical-intensive industrial agriculture. Before long, this spikes their price of food and farming supplies (which must be purchased from a multinational corporation like Monsanto). As we are now hitting an unprecedented global wave of fertilizer and food inflation, it is likely that millions who were coaxed into abandoning their traditional forms of agriculture will starve to death.
I have similar reservations about our current transition to green energy technologies. I know of numerous proven effective technologies that could lessen the environmental impact of our energy consumption. However, none of the technologies currently being evaluated meet this fundamental criteria. Instead, each one further centralizes control over this life essential resource, and in the future will likely be used to significantly limit unauthorized consumption of energy or transportation once our existing fossil fuel infrastructure is displaced. For example in light of recent political developments, concerns have begun to be raised over the switches existing in electric cars that can turn them off remotely.
Medical Inflation
Those two principles (rigid hierarchal organization and monopolization of a life essential resource) also happened with the medical industry and really kicked into gear when the Rockefellers (and to some extent Carnegie) bought the AMA and invested a great deal of money into standard medicine (often called “allopathic” or “biomedical” medicine). A variety of competing schools of medicine were removed from the United States, and the practice of medicine was monopolized (those curious to learn more can find more details in this freely available classic).
This proved to be an excellent investment and the effect of this monopolization is striking:
Numerous changes in society emerged to support this medical paradigm. Some of the most important were as follows:
•Society was conditioned to believe that they needed a doctor to be healthy, rather than health being viewed as something each individuals was empowered to seek for themselves. This effectively created an unlimited demand for medical services, and as the above graphs show, an ever-growing need for medical spending. Medical Nemesis by Ivan Illich was the earliest work I was able to locate detailing this change and its consequences.
•Things that genuinely improve public health (and thereby reduce medical expenses) are typically not allowed to emerge, while pointless initiatives that do not improve public health (water fluoridation or annual flu shots) are continually promoted. Likewise, basic health education is not taught to most people, and instead health behaviors developed by corporate interests constitute the majority of “health education” (industry funded nutrition textbooks for example are very common in college courses). In short, there are dozens of simple and obvious policy changes that many have independently identified which could rapidly improve public health and save a lot of money, but despite decades of campaigning to enact them, most have never been adopted.
•Hundreds (or possibly thousands) of highly effective medical treatments for common diseases have been kept off the market to preserve the market for expensive but ineffective treatments that often require lifelong purchasing. For example, prior to the legislative battle to legalize acupuncture, I remember cases where Chinese immigrants were raided at gunpoint for practicing acupuncture in their own community without a license. For those interested, I’ve spent decades tracking those “forgotten cures” down, and while I have found many that for one reason or another were oversold and didn’t really work, I also found many others that were highly effective.
•Every medical service or product is designed to encouraged the consumption of more medical services or products.
•A rigid hierarchy was created to support this monopoly.
Medical Hierarchies
The first hierarchy relates to the right to practice medicine. A large debate exists over whether or not a license should be required to practice medicine. The trade-off is that if no license is required, unqualified practitioners who might harm the public are allowed to practice, while if a license is required, the practice of medicine is monopolized (making medicine much more expensive) and medical practitioners are unable to provide life saving medicines they believe in.
I will now examine a few levels of this hierarchy:
•Medical boards have the power to pull the licenses (and hence careers) of any physician who does something “bad.” Unfortunately, since medical board members are directly appointed by governors, they often end up with crooked and corrupt members (one colleague who served on a midwestern medical board attested to this). Some of the reasons why medical boards exercise their authority are definitely valid, but many others are done to target physicians who step outside the line of what prevailing interests want done. This has happened for a long time. Here are a few examples:
1. After SB 276 was signed in 2019, writing vaccine exemptions was for all practical purposes outlawed in California and I heard of numerous cases where doctors wrote a single justified exemption and then had their license terminated. For this reason, doctors in California will not even write exemptions for patients who nearly died from their first COVID-19 vaccine (ie. from anaphylaxis or a heart attack).
2. The federation of state medical boards put out a statement that publicly promoting any type of COVID “misinformation” (ie. mask efficacy, early treatment options, vaccine safety concerns) could be used to take away a physician’s license.
3. Physicians have had their license suspended for using early treatment options that have FDA approval for other conditions.
The experiences of Robert Malone’s colleague Meryl J. Nass MD is a well known example of the above, but there are many others as well.
As you might imagine, it is quite easy for corporate interests to influence the composition of medical boards (as they are composed of individuals appointed by the governor). In the late 1990s the opioid manufacturers concocted the idea of having present levels of pain be the 5th vital sign and hence measured at every visit.
Since their opioids had “no addictive potential” once this epidemic of “unrecognized” pain emerged (since everyone was encouraged to say they were in pain) the manufacturers managed to lobby the medical boards into taking the position that failing to treat pain with an opioid as malpractice. Once that happened, to protect their licenses, any physicians who had hesitations providing opioids to patients started giving out opioids like candy and this created the current opioid epidemic which has been beyond devastating for many poorer regions of the USA. The problem is massive; hundreds of thousands of people have died from drug overdoses since COVID (which is a figure comparable to the death count from COVID).
•It is very difficult for physicians to work privately in independent practice (a variety of factors have been put in place to force this change over the last 10-20 years). Instead they are required to work at corporate, federal or state jobs where they are largely at the mercy of the institution they work for to follow its policies.
It is for this reason that as soon I was able to, I stopped working for an institution that controlled my practice of medicine.
During the pandemic, many physicians who had serious concerns about the existing approach towards COVID-19 attempted to do things differently, and were frequently shut down by their institution. This led to physicians being fired for not telling their patients the vaccine was “safe and effective” and others such as Paul Marik MD having to sue their hospital in order to be permitted to prescribe a treatment they felt could save the lives of their patients (where no effective treatment was currently available and the patients were frequently expected to die otherwise). Trump’s “Right to Try” law was meant to address this issue, but corporate management has largely superseded it.
•Everyone in medicine is taught to defer to the judgement of a doctor. Hence if you want to do some type of medical treatment and the doctor does not “approve” it, you can’t. In nursing textbooks, it is repeatedly hammered in to always defer to a doctor’s judgement. Nurses typically spend significantly more time with patients where they can see and in their hearts question the human cost of an enforced medical regimen. In contrast, physicians (the ones with authority over the patient), due to their time constraints, typically spend very little time with their patients and are much more detached and isolated from them. This results in bypassing the human connection that should be necessary in medical decision making being bypassed. This type of organizational structure has been used in numerous inhumane systems in the past.
Similarly, many individuals who have found their loved ones in the hospital have been told that unless the supervising doctor approves it, they cannot have any other type of therapy administered. Since many hospitals would not change their policy, numerous lawsuits have been filed to permit patients expected to die to receive ivermectin for example. To my knowledge, in each case where the lawsuit ordered ivermectin to be administered, the drug then saved the patient’s life.
To further illustrate this hierarchy, I know a few physicians with active medical licenses who were hospitalized for COVID-19. Each told me during their hospital stay their that care was continually mismanaged, they had to constantly be on the alert for a fatal medical error, and many of their reasonable requests were not approved by the doctor supervising their hospital care.
•Medical schools to a large extent select for individuals who do not challenge the system, and once in medical school, they rigidly target anyone who is not compliant and obedient to the existing hierarchy to ensure that they will not graduate.
The medical education process is extremely difficult (you have to work brutal hours which break a certain number of medical students and resident physicians each year, and suicide is quite common) and many aspects of the education could be equated to a form of hazing. These types of experiences are known to produce subservience to a system and have been utilized in many fields besides medicine throughout history.
Finally, there is a massive financial cost to become a doctor (most physicians now graduate with between $200,000 to $400,000 of debt at ~7% interest) which leaves many doctors who want to do things differently being completely unable to challenge this system.
The second hierarchy is “medical evidence.” When evidence based medicine was initially introduced, it was a very good and needed paradigm. Many horrific and harmful practices were in wide usage that evidence based medicine had relegated to the dustbins of history. However, medical evidence also follows a hierarchy which rejects foreign or competing ideas, and the upper levels of this hierarchy is bought out by pharmaceutical interests. Here are some examples:
•In order for a study to “matter,” it has to be published in a prestigious journal. The problem is that with the occasional exception of the British Medical Journal, none of the prestigious journals will ever publish studies which go against the existing narrative. “Controversial” studies that merit publication are continually rejected, while bad studies that support mainstream views are regularly published.
One of the better-known recent examples involved The Lancet publishing a study showing hydroxychloroquine was unsafe and ineffective, which was used to end trials of HCQ globally. This study used blatantly fake data and was eventually retracted after readers complained.
The Journal of the American Medical Association appears to be the most biased publication in this regard, and in most cases you can predict what an entire article will say on a topic before you even read it (ie. does the COVID vaccine have any possible harm associated with it…no). The one interesting exception I have seen to this was a recently published study debunking the use of ivermectin. Here the conclusion of the article argued against the use of ivermectin, while the actual data argued for it, raising the possibility the authors phrased the conclusion to say the opposite of their results so that JAMA would publish the study (it is very common for conclusions in journal articles to not be representative of their results).
•In order for a study to be published in most journals, it has to pass “peer review.” In most cases, peer review will hold ideas challenging the existing narrative to either a high standard or an impossible-to-meet standard. Conversely, if an idea agrees with existing narratives, it is held to a very low standard in order to be published. This is an extremely common issue and why much of the most useful research I come across is not published in peer reviewed journals.
•In order for a study to be conducted, it frequently needs approval from the FDA (or an equivalent) and in most settings needs approval from an Institutional Review Board (IRB). In general, it is very difficult to get approval from the FDA to conduct any type of study unless a lot of money is behind the endeavor (for example I was familiar with multiple teams who had safe and effective treatments for COVID with supporting data that nonetheless could not receive FDA approval to begin their human trials). Similarly, despite the fact that extremely unethical human experiments are often conducted under an IRB, IRBs typically will not approve “controversial” research, leading to it not being done.
As a result, I frequently hear of fascinating therapeutic discoveries made outside the normal research process through trial and error that greatly benefit those who receive them, but in most cases these approaches can never be published because no IRB is willing to evaluate them. An excellent 2016 article published by the Association of American Physicians and Surgeons (a group that has also continually advocated for COVID patients) summarizes how many actually useful medical discoveries are made in independent clinical practice, but the recent hierarchal shifts in medicine have made it so this process is becoming continually rarer and rarer.
The accepted practice of medicine is also a hierarchy largely dictated by “medical evidence.” The existing hierarchal structure here makes it so that contrary research that does end up being published nonetheless is prevented from challenging the status quo. I will review some key examples:
•Medical practice is largely determined by “guidelines” that each physician is expected to follow. In most cases if you follow existing guidelines (ie. don’t treat someone with COVID until they have respiratory failure, then put them on a ventilator and give them remdesivir), you get paid and cannot get in trouble. If you do not follow guidelines, it becomes possible for you to be sued for medical malpractice, health care systems will fire you, and medical boards may take your license.
To illustrate physician attachment to guidelines: Throughout the pandemic I have participated in an online forum that approximately 100,000 US healthcare workers use. As you would imagine, the general mentality there is very conventional. One of the more interesting things I noticed in the early days of the pandemic was health care providers desperately asking for and enthusiastically sharing COVID-19 treatment guidelines from various academic institutions, while at the same time aggressively shooting down independent suggestions or ideas raised by individual physicians.
Guidelines are supposed to be made by impartial committees of experts tasked with reviewing the existing evidence in order to determine the most appropriate guidelines. In reality, as pointed out in Steve Kirsch’s article, these committees are extremely biased, and selectively choose evidence supporting the prevailing narrative.
In most cases, the decision of these unelected guideline committees goes unchallenged and even though they should not be (as discussed later), they are in effect the law.
The only exception I know of occurred when the Lyme community sued the Infectious Disease Society of America (which has also published widely cited COVID treatment guidelines I and others strongly disagree with). The lawsuit challenged IDSA’s guidelines that argued against the use of antibiotics for chronic Lyme disease, which was frequently being used by insurers to deny payment for those treatments and as a basis for authorities to crack down on those treatments being administered in private practice.
•Many people can only afford medical care covered by their insurance. In most cases, insurance will only pay for treatments supported by guideline committees and forces providers to spend most of their time fulfilling requirements of the insurance companies rather than treating patients. As you would imagine, significant financial entanglements exist between hospital systems, pharmaceutical companies and insurance companies (for example they often share interlocking board members), which further incentivizes specific therapeutic approaches.
The insurance dynamic creates the unfortunate situation where many people who need help for a condition must depend on word of mouth to identify a physician outside the insurance system who they have to pay for out of pocket. Provided they find the right physician and can afford their care (each of which is often not the case), these individuals often are able to recover from their illness.
•Reciprocally, insurance companies will often pressure health care providers to perform certain services for each patient that “improve quality of care.” If you follow those suggestions (which frequently results in most of the visit being taken up to do so), you are paid more by the insurance companies. Since everyone in health care is tight on money, those incentives result in significant pressure being put on physicians from their administrators to follow those suggestions.
The problem is that many of these suggestions encourage doing things I do not believe help patients and often harm them. For example, one of the reasons doctors aggressively push vaccines to their patients is because insurance companies pay them significantly more for all visits if most of their patients (especially children) are vaccinated. Similarly, one of the reasons why hospitals have been so aggressive in forcing ventilation and remdesivir (to the point they will fight expensive lawsuits to continue doing so), is because Medicare, in accordance with the COVID treatment guidelines, pays them a lot more to manage (and then kill) their patients in this way.
•Federal, state and municipal law enforcement authorities will frequently target those who promote treatments that violate guidelines. In my own experience (and for many others), IV vitamin C has been extremely helpful in certain (but not all) COVID cases. There is also research showing a benefit in COVID from this therapy Nonetheless, the guidelines recommend against it and individuals who publicly promoted IV vitamin C (at a time when no treatment for COVID-19 was available) had their clinics raided and were criminally charged.
•The media will attack any controversial treatment by claiming there is no evidence for it, and simultaneously refuse to report any evidence that emerges in favor of it. Likewise, Big Tech aggressively censors anything that goes against the existing medical narrative. For example, early in the pandemic, a video was posted by a leading researcher who had conducted clinical trials on using IV vitamin C for COVID-19 presenting his data to the NIH. This video was removed by Youtube shortly afterwards for violating their COVID misinformation policy.
How the Hierarchy is Bought Out
As you might imagine, the hierarchy outlined before is immensely susceptible to bribery. As so much money is in health care, this is what always happens.
•When the Affordable Healthcare Act was passed in 2010, its goal was to make health care more affordable. In 2009, total USA healthcare costs were 2.6 trillion dollars. In 2020 it was 4.3 trillion dollars (compared to wages going from $40,711.61 to $55,628.60 per the SSA). As this data shows, Obamacare failed its stated objective. I believe the central problem with Obamacare was that the medical industry is the largest lobbyist in Congress. Because of this, they were able to craft Obamacare to benefit their industry and thereby remove each provision that would have achieved the stated goal of the Affordable Health Care Act, leaving us instead with a variety of highly problematic federal regulations.
•The pharmaceutical industry is the largest sponsor of the mainstream media. For this reason, they prevent stories critical of pharmaceutical products from being discussed and regularly air stories promoting pharmaceuticals. Likewise, they will relentlessly attack anything that opposes mainstream pharmaceutical positions (frequently “cancelling” it and labelling it unscientific and without evidence). During COVID-19 this trend has accelerated following the Biden administration dispensing 1 billion dollars to news outlets across the political spectrum in return for positive coverage of the vaccine. I do not know of any past precedent for this.
Many journalists have complained about their inability to criticize dangerous pharmaceutical products, and to my knowledge, Tucker Carlson is the only individual with a mainstream platform who has (occasionally) spoken out against the industry. In recent times Big Tech and Big Pharma (who during Obama’s presidency became the core sponsors of the Democrat Party) have financially merged with each other, and like the media Big Tech now has a similar commercial interest in protecting Big Pharma’s monopoly.
•Most medical journals are primarily funded by pharmaceutical companies. Because of this, there is a strong bias to publish questionable industry sponsored trials. Conversely, there is also a strong bias to not publish data supporting alternative therapies that challenge their sponsors (an early example of this this is explicitly detailed and can be found within the 2001 book Heart Frauds but I am sure many earlier ones exist). As many of you have noticed, this publication bias has gone into overdrive throughout COVID-19.
•”Large randomized double-blind studies” are typically considered to be the best form of evidence, and many individuals will reflexively dismiss a study unless it fulfills that criteria. The problem is that these types of studies are immensely expensive to conduct, and in most cases can only be done if a pharmaceutical company sponsors them.
As you might expect, numerous studies have shown that when pharmaceutical studies are compared to noncommercial studies, industry studies tend to greatly overestimate the benefits of a drug and understate its harms. This is due to them having a large number of (fraudulent) tricks to create the “scientific” outcome they want. One of the best known recent examples concerned an article in the BMJ discussing a whistleblower who provided proof widespread fraud occurred during Pfizer’s vaccine trials.
While a small benefit can be attributed to the placebo effect (hence suggesting the need for a “placebo controlled trial), in most cases, the bias that emerges from the inherent conflict of interest in a pharmaceutically sponsored trial greatly exceeds the placebo effect. This is extremely important to understand, but rarely understood.
Even in non-blinded studies where a large magnitude of benefit is found (which greatly exceeds any possible placebo effect) those results are typically ignored or dismissed in favor of corporate sponsored research. A sad reality with many scientific publications is that if you read the author conflict of interest disclosures (which intentionally omit key details) and see who sponsored the study of the study, you can typically predict most of what will be written within the publication.
•Most researchers and academic institutions are extremely short on money. Because of this, they are forced to accept pharmaceutical money for any type of research they want to do, and in most cases not ask questions that will upset their sponsors (and even when honest researchers exist, administrators directly concerned with institutional finances will keep them in line). To a lesser extent, they can also function through public grants, but as detailed in “The Real Anthony Fauci” the grant system has been compromised so only researchers who support the mainstream narratives (and have not opposed Anthony Fauci) can get grants. Many respected scientists I have learned a great deal from, believe the corruption of the grant system, which Fauci is largely responsible for, has prevented American science from developing innovative scientific discoveries that were frequently developed in the past.
•In many cases, guideline committees are composed of individuals who have a direct financial conflict of interest over the guidelines they are promoting. The Lyme disease lawsuit for instance was filed on this basis. Malcom Kendrick an English physician who has done an excellent job illustrating many of the scams conducted by the pharmaceutical industry provided one of the best examples for this concept in his book Doctoring Data.
Many physicians are of the opinion statins (which lower cholesterol) have minimal benefit in preventing heart disease and expose patients to frequent and significant adverse effects, but since statins were put on the market, guideline committees have continually lowered the acceptable blood levels of cholesterol, thereby significantly increasing the pool of people who could take statins (leading to the situation that on almost any medical board examination, the correct answer is almost always “give the patient a statin”).
Kendrick’s specific example was that on the guideline committee responsible for determining who needed to receive statins in the United States, every single person who was on the committee (except the chair who was legally barred from it) had a financial conflict of interest with statin manufacturers. As you might guess, one of the quality metrics that administrators have held meetings on and which I was forced to attend regarded not enough “eligible” patients at the clinic being prescribed statin therapy.
•One of Fauci’s major achievements was turning the NIH and NIAID into pharmaceutical production pipelines. This was largely accomplished by allowing federal officials who were involved with the discovery or development of a pharmaceutical that went to market receive royalties for the drug once it was approved that often vastly exceed their salary.
As a result, there is an inherent conflict of interest to push unsafe or ineffective pharmaceuticals through the regulatory process. This frequently happens, whereas non-commercial enterprises focused on public good can almost never receive approval for a medication. Many outside observers believed based on the existing data, remdesivir should not under any circumstances have received an FDA approval, yet it did, largely due to the FDA electing to waive all the required safeguards (such as needing to consult an outside advisory panel) put in place to prevent something like this from occurring.
One of the most interesting aspects of this scheme (detailed in the Real Anthony Fauci) was that Fauci developed a large network of principal investigators (PI’s are needed to run clinical trials) who hold significant sway in getting IRBs around the country to approve ethically questionable trials needed to get unsafe drugs to market. The Real Anthony Fauci also discusses the retaliation faced by honest regulators who raise objections to problems with those trials.
In short, pharmaceutical companies have always bribed regulators, but Fauci had the unique accomplishment of transforming this into being an integral part of the HSS where the regulators would often take it upon themselves to solicit those bribes.
•Lastly, physicians in everyday practice are remarkably susceptible to being bribed, and a cornerstone of the pharmaceutical industry is sending sales reps to convince physicians to prescribe their medications. A small number of physicians refuse to see reps under any circumstances as they feel it is immoral for their own financial self interest to influence their treatment of patients. Typically however, pharmaceutical reps are remarkably effective at accomplishing their goal of selling their chosen medication and many academic physicians who widely promote pharmaceutical products receive immense payouts for doing so.
Revisiting HIV
In my initial post on this substack, I stated I was able to predict much of what has happened with COVID three months before the pandemic started. This was because I have found whenever a formula is discovered which “works” it is typically reused over and over.
The story of HIV, for those interested was originally detailed in Peter Duesberg’s book Inventing the AIDS Virus, and then subsequently further discussed in The Real Anthony Fauci. Fauci’s conduct during this period appeared to have laid the blueprint for what was done with COVID.
At the start of the HIV, there was no cure and many members of the gay community suffered severe disease or died. As time moved forward, independent physicians working in the community discovered a variety of effective treatments for the AIDS patients, some of which were alternative therapies, but most of which utilized repurposed FDA approved drugs. Like the stories shared in those books, a few of my own friends worked in HIV hot spots during this time, and each found they were able to save the lives of their patients if they abandoned government recommendations and tried their own protocols.
Despite endless requests to study these approaches, Anthony Fauci blocked every single one from being studied or adopted into standard of care. In parallel, he pushed along research on a highly toxic drug, AZT. AZT had originally been intended to be used for chemotherapy, but was abandoned as it proved to be too toxic.
While AZT should have never been approved, Fauci was eventually able to manipulate one (terrible) study enough that alongside sufficient pressure being applied to the FDA, earn AZT an FDA approval. Once AZT entered the market, as was obvious from the existing clinical trial data, it significantly worsened the prognosis for AIDS patients, something both reported in each of those books and also reported to me by a few colleagues who observed it enter the market. Despite being responsible for killing many members of the gay community (who at the time protested against Fauci for being a mass murderer), Fauci was hailed a hero, became one of the most influential members of the US government, and made a lot of money in the process.
COVID-19 Treatment Guidelines
At the start of COVID-19, the WHO made the curious announcement that Remdesivir would be the standard of care for COVID-19, despite almost no evidence existing to support this decision. After finding out the drug was a nonspecific viral RNA polymerase inhibitor, I became worried it would likely be somewhat toxic to cells, as broad spectrum antivirals tend to overlap with chemotherapy drugs (AZT being one example).
My initial suspicion was that Remdesivir would also affect cellular RNA polymerases (the classic example you learn in medical school are poisonous wild mushrooms triggering organ failure through this mechanism). As I began hearing of reports of organ failure near the start of the pandemic from physicians in China, I prayed we would not see a repeat of AZT. Since that time, significant evidence against Remdesivir has been uncovered suggesting it should have never been brought to market and to some extent, like AZT, it appears Remdesivir has caused significant harm.
As I observed the trajectory COVID-19 was headed in, I formed the hypothesis that a new lucrative drug needed to be put onto the market which could be theoretically argued to treat COVID-19 (“remdesivir must work since it is a non-specific viral RNA polymerase inhibitor”) but in reality would not be effective and instead would worsen and prolong the pandemic. I suspected this strategy would be adopted since the profit from selling the drug could be channeled into keeping effective therapies off the market long enough for vaccines to enter the market. This sadly appears to be what exactly happened once the COVID-19 Treatment Guidelines Panel of the NIH made remdesivir the standard of care for COVID-19.
On 22–23 June 2001, the Johns Hopkins Center for Civilian Biodefense Strategies, in collaboration with the Center for Strategic and International Studies, the Analytic Services Institute for Homeland Security, and the Oklahoma National Memorial Institute for the Prevention of Terrorism, held a senior-level exercise entitled “Dark Winter” that simulated a covert smallpox attack on the United States. The first such exercise of its kind, Dark Winter was constructed to examine the challenges that senior-level policy makers would face if confronted with a bioterrorist attack that initiated outbreaks of highly contagious disease. The exercise was intended to increase awareness of the scope and character of the threat posed by biological weapons among senior national security experts and to bring about actions that would improve prevention and response strategies.
On 22–23 June 2001, the Johns Hopkins Center for Civilian Biodefense Strategies [1], in collaboration with the Center for Strategic and International Studies (CSIS) [2], the Analytic Services (ANSER) Institute for Homeland Security [3], and the Oklahoma National Memorial Institute for the Prevention of Terrorism [4], held a senior-level exercise entitled “Dark Winter,” which simulated a covert smallpox attack on the United States. Tara O’Toole and Thomas Inglesby of the Johns Hopkins Center for Civilian Biodefense Strategies and Randy Larsen and Mark DeMier of ANSER were the principal designers, authors, and controllers of the Dark Winter exercise. John Hamre of CSIS initiated and conceived of an exercise in which senior former officials would respond to a national security crisis caused by use of a biological weapon. Sue Reingold of CSIS managed administrative and logistical arrangements for the exercise. General Dennis Reimer of the Memorial Institute for the Prevention of Terrorism provided substantial funding for exercise.
The first such exercise of its kind, Dark Winter was undertaken to examine the challenges that senior-level policy makers would face if confronted with a bioterrorist attack that initiated outbreaks of highly contagious disease. The exercise was intended to increase awareness of the scope and character of the threat posed by biological weapons among senior national security experts and to catalyze actions that would improve prevention and response strategies.
Of all potential biological weapons, smallpox is historically the most ominous and feared [5–7]. It is a disfiguring, communicable disease with a case-fatality rate of 30% [8, 9]. There is no effective medical treatment [9]. The World Health Assembly officially declared smallpox eradicated worldwide in 1980 [10]. Since its eradication, smallpox vaccination programs and vaccine production have ceased around the world [6]. The United States stopped its mandatory vaccination program in 1972. Thus, residents of the United States—and indeed, the global population—are now highly susceptible to an inadvertent or deliberate release of smallpox.
It has been argued that the smallpox virus is the organism least accessible to potential bioterrorists. Since its eradication, the only officially existing stocks of the smallpox virus have been stored in 2 World Health Organization reference laboratories located in the United States and Russia [11]. Many experts believe, however, that the smallpox virus is not confined to these 2 official repositories and may be in the possession of states or subnational groups pursuing active biological weapons programs [12]. Of particular importance and concern is the legacy of the former Soviet Union’s biological weapons program. It is widely known that the former Soviet Union maintained a stockpile of 20 tons of smallpox virus in its biological weapons arsenal throughout the 1970s, and that, by 1990, they had a plant capable of producing 80–100 tons of smallpox per year [13].
Exercise Participants
The 12 participants in Dark Winter portrayed members of the National Security Council (NSC). Each is an accomplished individual who serves or has served in high-level government or military positions. Among these, the Honorable Sam Nunn, former US Senator from Georgia, played the President of the United States, and the Honorable Frank Keating, the governor of Oklahoma, portrayed himself. Five senior journalists who currently work for major networks or news organizations observed the deliberations of the simulated NSC and participated in a mock press conference during the exercise (table 1). In addition, ∼50 people with current or former policy or operational responsibilities related to biological weapons preparedness observed the exercise.
Table 1
Roles of key participants in the Dark Winter exercise.
Exercise Design
Dark Winter was a “tabletop” exercise. Decision makers were presented with a fictional scenario and asked to react to the facts and context of the scenario, establish strategies, and make policy decisions. To the extent possible, the decisions made were incorporated into the evolving exercise, so that key decisions affected the evolution and outcomes of the scenario.
Dark Winter was divided into 3 segments and simulated a time span of ∼2 weeks. Each segment portrayed an NSC meeting, which were set several days apart in the story: on 9, 15, and 22 December 2002. The participants began segments 2 and 3 with a review of all events that had taken place in the intervening period since the last meeting. In an effort to mirror the process of NSC meetings, exercise participants received information through a variety of sources. Exercise controllers played the roles of deputies or special assistants, providing briefings of facts and policy options to participants throughout the meetings as needed. Participants were also presented with newspaper summaries and video clips of television news coverage of the epidemic. In addition, specific individuals were given memoranda during the exercise on issues or events that would normally fall within the purview of that individual’s position or agency. Thus, for example, the Director of Central Intelligence was given memos that provided updated intelligence data during the course of the meetings.
Exercise Planning Assumptions
In designing Dark Winter, the authors of the exercise analyzed plausible delivery methods for bioterrorist attacks as well as available scientific and historical data from smallpox outbreaks in the past [14–18]. Numerous factors influence whether a pathogen will successfully invade a host community and how that pathogen will spread once established in that community [19, 20]. Two key assumptions were made that had a direct effect on the scope of the epidemic portrayed in the exercise: the number of people infected in the initial attack and the transmission rate (i.e., the number of people subsequently infected by each person with a case of smallpox). These assumptions were not intended to be definitive mathematical predictors or models and should not be interpreted as such. However, these assumptions were derived from available data and the current understanding of the smallpox virus and, therefore, serve as a foundation for the Dark Winter scenario. These assumptions are further articulated below.
The quantity of available smallpox vaccine also significantly affected the options and outcome of the exercise. The authors posited that the quantity of undiluted vaccine available during the exercise equaled the amount in the US Centers for Disease Control and Prevention (CDC) stockpile at that time: ∼15.4 million doses of vaccine.
Number of persons infected by the initial attack. In the Dark Winter scenario, 3000 people were infected with the smallpox virus during 3 simultaneous attacks in 3 separate shopping malls in Oklahoma City, Philadelphia, and Atlanta. It has been estimated that only a few virions are required to cause human smallpox infection, and thus the total quantity of virus necessary to cause 3000 infections in humans is small [9]. For example, William Patrick, a senior scientist in the US offensive biological weapons program before its termination in 1969, has stated that 1 g of weaponized smallpox would be sufficient to infect 100 people via an aerosol attack [21]. Accordingly, as little as 30 g of smallpox could cause 3000 infections, the number of infections resulting from the initial attack in this exercise. Given the small infectious dose required to cause disease, and considering that the former Soviet Union was able to produce smallpox by the ton, an attack resulting in 3000 infections is scientifically plausible.
Smallpox transmission rate. The transmission rate for smallpox is not a static characteristic of the smallpox virus that can be readily determined, but a complex, dynamic, fluctuating phenomenon contingent on multiple biological (both host and microbial), social, demographic, political, and economic factors [17, 19]. As such, the smallpox transmission rate within any given population is highly context dependent. Therefore, any effort to estimate how smallpox might spread through contemporary societies must account for contextual differences, to the extent possible.
Dark Winter was designed to investigate the challenges following a covert attack with the smallpox virus. As described in the scenario above, the first recognition of a covert attack with smallpox virus will likely occur when people infected in the initial attack begin showing signs of infection and start appearing in emergency departments and doctors’ offices [16]. At this point, those people will have become capable of transmitting smallpox to others. Thus, by the time a covert attack is discovered, the disease will already be spreading to the next generation of cases, known as “second-generation” cases. Given that very few doctors currently practicing medicine have ever seen a case of smallpox, and given that there is currently no widely available, rapid diagnostic test for smallpox, it is likely that the diagnosis of initial smallpox cases will be delayed, further promoting spread of disease. These factors are crucial in estimating the transmission rate in this exercise.
Another important factor in such estimations is the level of national and global susceptibility to smallpox virus infection. Human beings are considered universally susceptible to smallpox virus, unless they have been vaccinated or have been infected previously with an orthopox virus [17]. Given the absence of endemic smallpox in the world and the absence of vaccination programs since the 1970s, the global susceptibility to smallpox virus is higher than it has ever been in modern history [6]. Data from the 2000 US Census indicate that ∼42% of the US population is aged <30 years and, therefore, has never been vaccinated against smallpox [22]. For those who have been vaccinated, the susceptibility to smallpox infection is uncertain, because acquired immunity is known to wane over time. Exactly how long and to what extent smallpox immunity endures is unknown. Epidemiologic data offer some information and insights into the expected duration of immunity and the benefits of past revaccination: “an increased level of protection against smallpox persists for ⩽5 years after primary vaccination and substantial but waning immunity can persist for ⩾10 years….antibody levels after revaccination can remain high longer, conferring a greater period of immunity than occurs after primary vaccination alone” ([23], pp. 3–4).
These findings suggest that those who were vaccinated in the United States before vaccination programs ceased 30 years ago would have waning immunity, although those who were vaccinated ⩾2 times may have maintained higher levels of immunity. A rough estimate of the level of total population herd immunity to smallpox in the United States is 20% (D. A. Henderson, personal communication), a number that will continue to decrease over time. A recent analogous estimate for the United Kingdom is 18% [24]. Thus, an estimated 228 million US citizens would be expected to be highly susceptible to smallpox infection. Some experts have recently argued that immunologic memory in response to vaccination against smallpox may last considerably longer than hypothesized [25] and, consequently, that the level of herd immunity may be higher. However, for now, that remains a matter of conjecture.
The authors of the exercise used a 1 : 10 ratio for the transmission rate of smallpox in Dark Winter, which was based on an analysis of 34 instances of smallpox importation into Europe between 1958 and 1973 [14, 17]. These smallpox importations were instances in which a person contracted smallpox in a country where the disease still occurred naturally and then unknowingly brought the virus back to a country that no longer had endemic smallpox. Ten of those importations occurred in the months June–November, when the smallpox transmission rate is at its seasonal low. These importations were not included in further analysis, because the smallpox attack simulated in Dark Winter took place in December, when the smallpox transmission rate is at its seasonal high. Of the remaining 24 imported cases that occurred during the seasonal high for smallpox transmission (December–May), most were quickly diagnosed and contained [14, 17].
The authors of this exercise determined that 6 of these 24 importations most closely paralleled the conditions and context of the Dark Winter exercise, as well as what should be anticipated and planned for in the event of a smallpox attack on the modern United States. In those 6 importations, health care practitioners were slow to diagnose initial smallpox cases, and infected people had considerable interaction with other people before appropriate infection-control measures were initiated [14]. The number of second-generation cases in those 6 outbreaks ranged from 10 to 19 cases, with an average of 13.3 secondary cases per initial case (95% CI, 9.3–17.3). Gani and Leach [24] have recently analyzed these smallpox importations and have estimated that the transmissibility of smallpox in those outbreaks was 10–12 new infections per infectious person. This estimate may be toward the low error bound, because it does not account for seasonal differences in transmission rates (D. A. Henderson, personal communication).
Of the smallpox importations analyzed, the importation into Yugoslavia in 1972 is particularly instructive because that outbreak encompassed many of the attributes that would be expected if a smallpox outbreak occurred today (e.g., a large number of susceptible people, delayed diagnosis, both hospital and community transmission, wide geographic dispersion of cases, difficulty in contact tracing) [17]. In that outbreak, a man on a religious pilgrimage to Mecca and Medina became infected with smallpox virus while in Iraq and subsequently brought the disease back to Yugoslavia. His infection with smallpox virus went undiagnosed, and he unknowingly infected 11 others, whose infections also went undiagnosed. The smallpox outbreak was not recognized and control measures were not initiated until the advent of the second generation of cases, which comprised 140 new cases (transmission ratio, 1 : 13). Ultimately, a single index case caused 175 cases of smallpox and 35 deaths before the outbreak was brought to an end. Gani and Leach [24] estimated the transmissibility of smallpox in the 1972 Yugoslavia outbreak to be 10.8 new infections per infectious person.
Given the low level of herd immunity to smallpox and the high likelihood of delayed diagnosis and public health intervention, the authors of this exercise used a 1 : 10 transmission rate for Dark Winter and judged that an exercise that used a lower rate of transmission would be unreasonably optimistic, might result in false planning assumptions, and, therefore, would be irresponsible. The authors of this exercise believe that a 1 : 10 transmission rate for a smallpox outbreak prior to public-health intervention may, in fact, be a conservative estimate, given that factors that continue to precipitate the emergence and reemergence of naturally occurring infectious diseases (e.g., the globalization of travel and trade, urban crowding, and deteriorating public health infrastructure) [26, 27] can be expected to exacerbate the transmission rate for smallpox in a bioterrorism event.
Meltzer et al. [28] have reviewed data from a selected series of past smallpox outbreaks and determined that “the average rate of transmission is <2 persons infected per infectious person” ([29], p. v). However, they also conclude that “data suggest that one person can infect many others,” that a “large percentage of the population in the United States is now susceptible” to smallpox, and that “the average transmission rate following a deliberate release of smallpox might be µ2 [persons infected per infectious person]” ([29], p. v). The authors of this article believe that the average past transmission rate calculated by Meltzer et al. [28, 29] does not have significant application to planning for a smallpox attack on the contemporary United States. Their analysis does not adequately account for confounding factors, such as poor herd immunity [24], seasonality, and likelihood of delayed or inadequate vaccination or other public health interventions and, therefore, significantly underestimates the transmission rate that should be anticipated if a smallpox attack occurred today. Gani and Leach [24], on the other hand, incorporated a number of these confounding factors in their mathematical analysis and predicted that the rate of transmission of smallpox in contemporary industrialized societies is 4–6 new infections per infected person, and possibly as high as 10–12 new infections per infected person in the absence of appropriate hospital infection-control procedures.
During Dark Winter, participants were told that the rate of transmission beyond the first-generation to second-generation cases (i.e., to third and fourth generations of cases) would be highly dependent on additional variables (e.g., vaccination and isolation). The Dark Winter exercise ended in the middle of the second generation of cases. However, exercise participants repeatedly requested worst-case scenario predictions for the spread of disease beyond the second generation of cases to guide their key policy decisions. Accordingly, participants were given estimates of the projected number of smallpox cases and deaths, on the assumption that no additional vaccine would become available and no systematic, coordinated isolation procedures could be broadly and effectively enacted—in other words, the worst-case scenario. In these worst-case scenario conditions, it was determined that the transmission rate would continue to be 1 : 10, on average. Therefore, it was estimated that the third generation of cases would comprise 300,000 cases of smallpox and lead to 100,000 deaths, and that the fourth generation of cases could encompass as many as 3,000,000 cases of smallpox and result in as many as 1,000,000 deaths. It was emphasized to participants that these numbers were worst-case projections and could be substantially diminished by institution of large-scale and successful vaccination programs and disease-containment procedures.
Available doses of smallpox vaccine. The United States, through the CDC, maintains a stockpile of 15.4 million doses of smallpox vaccine [30]. Exercise participants were asked to assume that only 12 million doses of vaccine would be available. This estimation was based on practical experience obtained during the smallpox eradication program in the 1960s and 1970s. During the World Health Organization’s smallpox eradication campaign, it was common to lose ∼20% of the available doses of vaccine from any given vial because of unavoidable inefficiencies and waste (D. A. Henderson, personal communication).
Exercise Scenario
The year is 2002 [31]. The Unites States economy is strong. Tensions between Taiwan and the People’s Republic of China are high. A suspected lieutenant of Osama bin Laden has recently been arrested in Russia in a sting operation while attempting to purchase 50 kg of plutonium and biological pathogens that had been weaponized by the former Soviet Union. The United Nation’s sanctions against Iraq are no longer in effect, and Iraq is suspected of reconstituting its biological weapons program. In the past 48 h, Iraqi forces have moved into offensive positions along the Kuwaiti border. In response, the United States is moving an additional aircraft carrier battle group to the Persian Gulf.
NSC Meeting 1
Information presented to NSC members, 9 December 2002. The 12 members of the NSC gather for what initially was to be a meeting to address the developing situation in southwest Asia but are given the news that a smallpox outbreak is occurring in the United States. In Oklahoma, 20 cases have been confirmed by the CDC, with 14 more suspected. There are also reports of suspect cases in Georgia and Pennsylvania. These cases are not yet confirmed. The initial exposure is presumed to have occurred on or about 1 December, given the 9–17-day incubation period for smallpox (figure 1).
Figure 1
Map showing cumulative reported smallpox cases (n = 50) reported to the National Security Council at meeting 1 (9 December 2002) as part of the Dark Winter simulation exercise.
The governor of Oklahoma, who is in Washington, D.C., to deliver a speech, agrees to participate in the NSC meeting to clearly articulate the priorities and needs of his state before rushing home to manage the growing crisis. NSC members are briefed on the status of the outbreak and on smallpox. It is explained that smallpox produces no symptoms at the time of exposure and that fever, malaise, and rash will develop 9–17 days after exposure; that, although vaccination before exposure or up to ∼4–5 days after exposure may prevent or ameliorate disease manifestations, there is no effective treatment once the disease has developed; that the case-fatality rate for smallpox is ∼30%; that smallpox virus is communicable from person to person and is spread at close range by respiratory droplets or, in some instances, at longer range by aerosols (i.e., droplet nuclei) [18]; that although the transmission rate for smallpox virus is a complex dynamic that is dependent on multiple factors, epidemiologic evidence indicates that a single infected person in a highly susceptible population can be expected to infect 10–19 others; and that the US stockpile of smallpox vaccine is 15.4 million doses, but it is estimated that this amount translates to ∼12 million usable doses [8, 9].
The Deputies Committee advises the NSC members on possible disease-containment strategies, including isolation of patients, identification and vaccination of patient contacts, and minimization of public gatherings (e.g., closing schools in affected states). In addition, the Deputies Committee provides the NSC members with 3 vaccine distribution policy options. Policy option 1 is a ring vaccination policy, in which enough vaccine would be distributed to each of the 3 affected states to vaccinate patient contacts and essential personnel, and 2.5 million doses would be set aside for the Department of Defense (DoD). Policy option 2 is a combination ring/mass vaccination policy, in which enough vaccine would be distributed to each of the 3 affected states so that all residents of affected cities could be vaccinated, as well as patient contacts and essential personnel, and 2.5 million doses would be set aside for the DoD. Policy option 3 is a combination ring/mass distribution policy, in which enough vaccine would be distributed to each of the 3 affected states so that all residents of affected cities could be vaccinated, and 2.5 million doses would be set aside for the DoD, and the remaining 47 unaffected states would immediately receive 125,000 doses of vaccine each, to use as they see fit.
Critical debate issues and decisions. The NSC confronts an array of important questions and decisions. With only 12 million doses of vaccine available, what is the best strategy to contain the outbreak? Should there be a national or a state vaccination policy? Is ring vaccination or mass immunization the best policy? How much vaccine, if any, should be held for the DoD? Should health care workers, public safety officials, and elected officials be given priority for vaccination? What about their families? Should vaccine be distributed to all of the states now, or as new cases emerge? What should the size be of the aliquots of vaccine given to each state? Should there be a mandatory or voluntary immunization policy? What is the federal role in emergency response? What are the state roles in emergency response? How are the 2 responses coordinated? Should the National Guard be activated? How best can the Guard be used (under state or under federal control)? What should be done about the developing situation in southwest Asia? What should the public be told? What should our allies be told? Was this a deliberate attack on the United States? If so, who is responsible? Is the nation at war?
The NSC members agree that the public should be fully informed as quickly as possible to maximize public confidence and adherence to disease-containment measures and to minimize the possibility that disease-containment measures would need to be forcibly imposed. NSC members decide to use vaccine distribution policy option 1, which is the ring vaccination policy intended to focus and limit vaccination efforts to those at highest risk of contracting smallpox (e.g., patient contacts and health care and public safety personnel in Oklahoma, Georgia, and Pennsylvania) while preserving as much vaccine as possible for use as the epidemic unfolds. NSC members decide that the same directed vaccination strategy will be followed if additional new cases emerge in other cities or states. In addition, NSC members decide to set aside sufficient doses of vaccine for the DoD to meet its immediate needs, with the expectation that this will be ∼1 million doses and with direction to the DoD to determine those needs. NSC members decide to proceed with the deployment of the additional aircraft carrier battle group to the Persian Gulf but defer other decisions regarding deployments, pending further developments. NSC officials hope that the people of the United States will view these policy decisions as rational and equitable. The meeting closes as the NSC prepares a presidential statement for the press, detailing their decisions and actions.
NSC Meeting 2
Information presented to NSC members, 15 December 2002 (6 days into the epidemic). A total of 2000 smallpox cases have been reported in 15 states, with 300 deaths (figures 2 and 3). The epidemic is now international, with isolated cases in Canada, Mexico, and the United Kingdom. Both Canada and Mexico request that the United States provide them with vaccine. All of the cases appear to be related to the 3 initial outbreaks in Oklahoma, Georgia, and Pennsylvania. The public health investigation points to 3 shopping malls as the initial sites of exposure. Only 1.25 million doses of vaccine remain, and public unrest grows as the vaccine supply dwindles. Vaccine distribution efforts vary from state to state, are often chaotic, and lead to violence in some areas. In affected states, the epidemic has overwhelmed the health care systems, and care suffers. The DoD expresses concern about diverting its critical supplies and personnel to the civilian health care system, given the evolving crisis in the Persian Gulf.
Figure 2
Map showing cumulative reported smallpox cases (n = 2000) reported to the National Security Council at meeting 2 (15 December 2002) as part of the Dark Winter simulation exercise.
Figure 3
Smallpox cases reported to the National Security Council at meeting 2 (15 December 2002) as part of the Dark Winter simulation exercise.
Several international borders are closed to US trade and travelers. Food shortages emerge in affected states as a result of travel problems and store closings. Sporadic violence has been reported against minorities who appear to be of Arab descent. There are no solid leads regarding who may have perpetrated this attack. The government response to the epidemic has been criticized. The media continues its 24-h news coverage of the crisis. Misinformation regarding the smallpox outbreak begins to appear on the Internet and in the media, including false reports of cures for smallpox. Schools are closed nationwide. Public gatherings are limited in affected states. Some states limit travel and nonessential gatherings. The Department of Health and Human Services establishes a National Information Center. Three US drug companies agree to produce new vaccine at the rate of 6 million doses per month, with first deliveries in 5 weeks. Russia offers to provide 4 million doses of vaccine.
Critical debate issues and decisions. NSC officials confront a growing set of challenges and decisions. Given the shortage of vaccine, how can the spread of smallpox be halted? Should patients with smallpox be confined to facilities dedicated to care for them? Should contacts of patients be forced to remain at home or in dedicated facilities until they are proven to be free of smallpox? Should national travel restrictions be imposed? How can disease containment best be balanced against economic disruption and the protection of civil liberties? To what extent can and should the government infringe upon civil liberties? Under what conditions can those powers be exercised? What federal actions can and should be taken to care for the sick? Should the National Guard be federalized (i.e., put under federal control)? What additional assistance can the federal government provide to the states? Should troops continue to deploy overseas to southwest Asia? What should the President tell the people of the United States? Who orchestrated this attack and why? Is the nation at war?
NSC members make a series of important policy decisions. Members decide to leave control of the National Guard as well as decisions on quarantine and isolation in the hands of state officials. Members decide to pursue a crash production program for new smallpox vaccine, despite unresolved liability issues. They also decide to accept smallpox vaccine offered by Russia, provided it passes safety evaluations. In addition, a statement is produced for the President to deliver in a press conference. In the press conference, the President provides an assessment of the gravity of the situation and discusses the government’s response. He appeals to the people of the United States to work together to confront the crisis and to follow the guidance of their elected officials and their public health professionals regarding necessary disease-containment measures.
NSC Meeting 3
Information presented to NSC members, 22 December 2002 (13 days into the epidemic). A total of 16,000 smallpox cases have been reported in 25 states (14,000 within the past 24 h) (figures 4 and 5). One thousand people have died. Ten other countries report cases of smallpox believed to have been caused by international travelers from the United States. It is uncertain whether new smallpox cases have been transmitted by unidentified contacts of initial victims, by contacts who were not vaccinated in time, or by people who received ineffective vaccine, or are due to new smallpox attacks, or some combination of these. Vaccine supplies are depleted, and new vaccine will not be ready for at least 4 weeks. States have restricted nonessential travel. Food shortages are growing in some places, and the national economy is suffering. Residents have fled and are fleeing cities where new cases emerge. Canada and Mexico have closed their borders to the United States. The public demands mandatory isolation of smallpox victims and their contacts, but identifying contacts has become logistically impossible.
Figure 4
Map showing cumulative reported smallpox cases (n = 16,000) reported to the National Security Council at meeting 3 (22 December 2002) as part of the Dark Winter simulation exercise.
Figure 5
Smallpox cases reported to the National Security Council at meeting 3 (22 December 2002) as part of the Dark Winter simulation exercise.
Although speculative, the predictions are extremely grim: an additional 17,000 cases of smallpox are expected to emerge during the next 12 days, bringing the total number of second-generation cases to 30,000. Of these infected persons, approximately one-third, or 10,000, are expected to die. NSC members are advised that administration of new vaccine combined with isolation measures are likely to stem the expansion of the epidemic. NSC members ask for worst-case projections. They are advised that in worst-case conditions, the third generation of cases could comprise 300,000 new cases of smallpox and lead to 100,000 deaths, and that the fourth generation of cases could conceivably comprise as many as 3,000,000 cases of smallpox and lead to as many as 1,000,000 deaths. It is again emphasized to participants that these numbers are worst-case projections and can be substantially diminished by large-scale and successful vaccination programs and disease-containment procedures (figure 6).
Figure 6
Smallpox epidemic projections, worst-case scenario (in the absence of disease-containment measures or new vaccine delivery), reported to the National Security Council meeting 3 (22 December 2002) as part of the Dark Winter simulation exercise. Gen, generation of cases; K, thousand.
No solid leads as to who masterminded the attack have emerged. A prominent Iraqi defector claims that Iraq is behind the biological attack. Although the defector cannot offer proof beyond a reasonable doubt, the intelligence community deems his information highly credible. Polls of US citizens show overwhelming support for retribution when the attacker is identified.
The scenario ends when it is announced that the New York Times, the Washington Post, and USA Today have each received an anonymous letter demanding the removal of all US forces from Saudi Arabia and all warships from the Persian Gulf within 1 week. The letters threaten that failure to comply with the demands will result in new smallpox attacks on the US homeland as well as other attacks with anthrax and plague. To prove the veracity of these claims and the seriousness of their threats, each letter contains a genetic fingerprint that matches the fingerprint of the smallpox strain causing the current epidemic, demonstrating that the author of these letters has access to the smallpox strain.
Critical debate issues. With no vaccine remaining and new vaccine not expected for at least 4 weeks, how can the rapidly expanding epidemic be contained? What measures should the federal and state governments take to stop the epidemic, given the scope of the crisis, the lack of remaining vaccine, and rising stakes? Should the United States pull its forces out of the Gulf in response to the anonymous letters? With no conclusive evidence as to who orchestrated the attack, how and should the United States respond? If the United States discovers who is behind the attack, what is the proper response? Would the American people call for response with nuclear weapons?
Lessons of Dark Winter
The authors of this article have drawn a series of lessons from the Dark Winter exercise. These lessons are based on an analysis of comments and decisions made by exercise participants during the exercise, subsequent Congressional testimony by exercise participants, and public interviews given by participants in the months after the exercise [32]. The lessons learned reflect the analysis and conclusions of the authors from the Johns Hopkins Center for Civilian Biodefense Strategies and do not necessarily reflect the views of the exercise participants or collaborating organizations.
In this section, these lessons are listed, each accompanied by a short explanatory note and quotations from participants in the exercise to illustrate it. The Dark Winter event did not permit attribution of comments without permission from individual participants. Where comments are ascribed to a particular person, permission has been obtained.
Leaders are unfamiliar with the character of bioterrorist attacks, available policy options, and their consequences. The senior decision makers in Dark Winter were largely unfamiliar with the sequence of events that would follow a bioterrorist attack. Important decisions and their implications were dependent on public health strategies and possible mechanisms to care for large numbers of sick people—issues that the national security and defense communities have not typically analyzed in the past.
“We are used to thinking about health problems as naturally occurring problems outside the framework of a malicious actor….If you’re going against someone who is using a tool that you’re not used to having him use—disease—and using it toward—quite rationally and craftily—…an entirely unreasonable and god-awful end—we are in a world we haven’t ever really been in before” (James Woolsey).
“This was very revealing to me—that there is something out there that can cause havoc in my state that I know nothing about—and, for that matter, the federal family doesn’t know a whole lot [about] either” (Frank Keating).
“My feeling here was the biggest deficiency was, how do I think about this? This is not a standard problem that I’m presented in the national security arena. I know how to think about that, I’ve been trained to think about that…a certain amount of what I think went [on] around this table was, ‘I don’t get it. I’m not in gear in terms of how to think about this problem as a decision-maker.’ So then I get very tentative in terms of what to do” (John White).
“This was unique…[you know] that you’re in for a long term problem, and it’s going to get worse and worse and worse and worse and worse” (Sam Nunn).
After a bioterrorist attack, leaders’ decisions would depend on data and expertise from the medical and public health sectors. In Dark Winter, even after the smallpox attack was recognized, decision makers were confronted with many uncertainties and wanted information that was not immediately available. (In fact, they were given more information on locations and numbers of infected people than would likely be available in reality.)
For example, it was difficult to quickly identify the locations of the original attacks; to immediately predict the likely size of the epidemic on the basis of initial cases; to know how many people were exposed; to find out how many were hospitalized and where; or to keep track of how many had been vaccinated. This lack of information, critical for leaders’ situational awareness in Dark Winter, reflects the fact that few systems exist that can provide a rapid flow of the medical and public health information needed in a public health emergency.
“What’s the worst case? To make decisions on how much risk to take…whether to use vaccines, whether to isolate people, whether to quarantine people….I’ve got to know what the worst case is” (Sam Nunn).
“You can’t respond and make decisions unless you have the crispest, most current, and the best information. And that’s what strikes me as a civil leader…that is…clearly missing” (Frank Keating).
The lack of sufficient vaccine or drugs to prevent the spread of disease severely limited management options. In Dark Winter, smallpox vaccine shortages significantly affected the response available to contain the epidemic, as well as the ability of political leaders to offer reassurance to the American people. The increasing scarcity of smallpox vaccine led to great public anxiety and flight by people desperate to get vaccinated, and it had a significant effect on the decisions taken by political leaders.
“We can’t ration….Who do you choose and who do you not choose to get vaccinated?…People are going to go where the vaccine is. And if they know that you’re going to provide the vaccine to my people, they’ll stay to get vaccinated. I think they’ll run if they think the vaccine is somewhere else” (Frank Keating).
“If we had had adequate vaccine supplies…we would have had more strategies to help deal with this thing and help control the epidemic” (Margaret Hamburg).
The US health care system lacks the surge capacity to deal with mass casualties. In Dark Winter, hospital systems across the country were flooded with demands for patient care. The demand was highest in the cities and states directly attacked, but by the time many victims became symptomatic, they were geographically dispersed, with some having traveled far from the original site of attack. The numbers of people flooding into hospitals across the country included people with common illnesses who feared they had smallpox and people who were well but worried. The challenges of distinguishing the sick from the well and rationing scarce resources, combined with shortages of health care staff, who were themselves worried about becoming infected or bringing infection home to their families, imposed a huge burden on the health care system.
“We think an enemy of the United States could attack us with smallpox or with anthrax—whatever—and we really don’t prepare for it, we have no vaccines for it—that’s astonishing. That’s like, for me, in Oklahoma, where we do have tornadoes, to be assiduously studying hurricanes, or not studying tornadoes” (Frank Keating).
“It isn’t just [a matter of] buying more vaccine. It’s a question of how we integrate these [public health and national security communities] in ways that allow us to deal with various facets of the problem” (James Woolsey).
To end a disease outbreak after a bioterrorist attack, decision makers will require ongoing expert advice from senior public health and medical leaders. The leaders in Dark Winter were confronted with rapidly diminishing supply of smallpox vaccine and an expanding smallpox epidemic. Some members advised the imposition of geographic quarantines around affected areas, but the implications of these measures (e.g., interruption of the normal flow of medicines, food and energy supplies, and other critical needs) were not clearly understood at first. In the end, it is not clear whether such draconian measures would have led to a more effective interruption of disease spread.
“A complete quarantine would isolate people so that they would not be able to be fed, and they would not have medical [care]….So we can’t have a complete quarantine. We are, in effect, asking the governors to restrict travel from their states that would be nonessential. We can’t slam down the entire society” (Sam Nunn).
Federal and state priorities may be unclear, differ, or conflict; authorities may be uncertain; and constitutional issues may arise. In Dark Winter, tensions rapidly developed between state and federal authorities in several contexts. State leaders wanted control of decisions regarding the imposition of disease-containment measures (e.g., mandatory vs. voluntary isolation and vaccination), the closure of state borders to all traffic and transportation, and when or whether to close airports. Federal officials argued that such issues were best decided on a national basis to ensure consistency and to give the President maximum control of military and public-safety assets. Leaders in states most affected by smallpox wanted immediate access to smallpox vaccine for all citizens of their states, but the federal government had to balance these requests against military and other national priorities. State leaders were opposed to federalizing the National Guard, which they were relying on to support logistical and public supply needs. A number of federal leaders argued that the National Guard should be federalized.
“My fellow governors are not going to permit you to make our states leper colonies. We’ll determine the nature and extent of the isolation of our citizens….You’re going to say that people can’t gather. That’s not your [the federal government’s] function. That’s the function, if it’s the function of anybody, of state and local officials” (Frank Keating).
“Mr. President, this question got settled at Appomattox. You need to federalize the National Guard” (George Terwilliger).
“We’re going to have absolute chaos if we start having war between the federal government and the state government” (Sam Nunn).
The individual actions of US citizens will be critical to ending the spread of contagious disease; leaders must gain the trust and sustained cooperation of the American people. Dark Winter participants worried that it would not be possible to forcibly impose vaccination or travel restrictions on large groups of the population without their general cooperation. To gain that cooperation, the President and other leaders in Dark Winter recognized the importance of persuading their constituents that there was fairness in the distribution of vaccine and other scarce resources, that the disease-containment measures were for the general good of society, that all possible measures were being taken to prevent the further spread of the disease, and that the government remained firmly in control despite the expanding epidemic.
“The federal government has to have the cooperation from the American people. There is no federal force out there that can require 300,000,000 people to take steps they don’t want to take” (Sam Nunn).
Conclusion
In conducting the Dark Winter exercise, the intention was to inform the debate on the threat posed by biological weapons and to provoke a deeper understanding of the numerous challenges that a covert act of bioterrorism with a contagious agent would present to senior level policy makers and elected officials. Since the Dark Winter exercise, the country has endured the horrific events of 11 September, as well as anthrax attacks through the US postal system. Bioterrorism is no longer just the subject of war games and the source of “futuristic and disturbing topics for…[Congressional] committee meetings” ([33], p. 2454). Many of the challenges and difficulties faced by the Dark Winter participants, unfortunately, have been paralleled in the response to the recent anthrax attacks. The Dark Winter exercise offers instructive insights and lessons for those with responsibility for bioterrorism preparedness in the medical, public health, policy, and national security communities and, accordingly, helps shine light on possible paths forward.
The left is scheming hard to prevent free speech advocate Elon Musk from being able to mount an effort to set social media giant Twitter back on the road to freedom and liberty.
Musk delivered his offer Thursday to buy Twitter out so he can move in and begin restoring free speech there:
On Friday, the social media giant issued a news release stating that the company’s board of directors unanimously adopted a limited duration shareholder rights plan as a direct response to Musk’s offer to buy the tech giant.
“The Rights Plan is similar to other plans adopted by publicly held companies in comparable circumstances,” Twitter insisted in its PR wire.
“Under the Rights Plan, the rights will become exercisable if an entity, person or group acquires beneficial ownership of 15% or more of Twitter’s outstanding common stock in a transaction not approved by the Board,” the message reads. “In the event that the rights become exercisable due to the triggering ownership threshold being crossed, each right will entitle its holder (other than the person, entity or group triggering the Rights Plan, whose rights will become void and will not be exercisable) to purchase, at the then-current exercise price, additional shares of common stock having a then-current market value of twice the exercise price of the right.”
The new rule allows Twitter shareholders to buy up cheap shares which would dilute the commanding stake a buyer such as Musk might hold.
The news released was a long-winded way of saying that Twitter added a “poison pill” to its operating rules to prevent Musk from gaining control of the company.
“The Rights Plan will reduce the likelihood that any entity, person or group gains control of Twitter through open market accumulation without paying all shareholders an appropriate control premium or without providing the Board sufficient time to make informed judgments and take actions that are in the best interests of shareholders,” the company claimed.
The board was scared when the Tesla and SpaceX CEO offered to buy additional shares of the company for $54.20 per share, which would value the company at $41.4 billion. His offer was an 18 percent premium over the closing price of the stock on April 13.
Despite the offer, analysts have questioned how Musk would come up with the cash necessary to make the buy. Despite being one of the richest men in the world, $42 billion in cash is a big ask.
But Musk seems prepared to go the distance. He has related a specific vision for what Twitter should be, and it’s one he thinks the social media giant’s current leadership is not fulfilling.
“I invested in Twitter as I believe in its potential to be the platform for free speech around the globe, and I believe free speech is a societal imperative for a functioning democracy,” Musk said in a letter to Twitter board chair Bret Taylor. “However, since making my investment I now realize the company will neither thrive nor serve this societal imperative in its current form. Twitter needs to be transformed as a private company.
“As a result, I am offering to buy 100% of Twitter for $54.20 per share in cash, a 54% premium over the day before I began investing in Twitter and a 38% premium over the day before my investment was publicly announced. My offer is my best and final offer and if it is not accepted, I would need to reconsider my position as a shareholder.
“Twitter has extraordinary potential,” Musk declared. “I will unlock it.”
Still, he signaled that he has also planned an out if he needs one.
“If the deal doesn’t work, given that I don’t have confidence in management nor do I believe I can drive the necessary change in the public market, I would need to reconsider my position as a stakeholder,” he wrote.
Regardless, in light of the blocking maneuver that Twitter just made, it seems the ball is now in Musk’s court. While he did hint that he has a “plan B” for this Game of Thrones drama, we’ll soon see just how serious he is about righting Twitter’s anti-free speech ship.
If nothing else, this episode of corporate theater has certainly shown just how hard these leftist, Big Tech giants will fight to quash free speech, continue to prevent conservatives from having the freedom to express themselves online, and control the political narrative to keep left-wing Democrats in power.
The gate keepers of the left have been squalling for Musk’s head ever since he announced his interests in preserving free speech. Clinton operative Robert Reich, for instance, was infuriated by Musk’s efforts, calling Musk’s aims “dangerous nonsense.”
Further showing what he thinks of our constitutional right to free speech, Reich added that Musk’s ideas about a free and open Internet is “the dream of every dictator, strongman, and demagogue.”
Then there was wild-eyed never Trumper and neoconservative Max Boot who revealed his inner fascist by quixotically claiming that to save freedom and democracy, we need to curtail free speech.
On Thursday, Boot whined that he is “frightened” by Musk’s free speech advocacy and added, “For democracy to survive, we need more content moderation, not less.”
I am frightened by the impact on society and politics if Elon Musk acquires Twitter. He seems to believe that on social media anything goes. For democracy to survive, we need more content moderation, not less.
Finally, Twitter’s own extremist, left-wing employees also went apoplectic over the idea that conservatives and Trump supporters would be allowed to speak freely on Twitter. According to reports, many of Twitter’s employees jumped to their own Twitter accounts to lament Musk’s intentions.
Whatever Musk does with this Twitter drama, he has fully proven that Democrats, Big Tech, and the left are intent on taking 100 percent control of the media and the Internet to screen out any ideas that might lead to the loss of their political power.
As the addiction and overdose crisis that has gripped the U.S. for two decades turns even deadlier, state governments are scrambling for ways to stem the destruction wrought by fentanyl and other synthetic opioids.
In statehouses across the country, lawmakers have been considering and adopting laws on two fronts:reducing the risk to users and increasing the penalties for dealing fentanyl or mixing it with other drugs. Meanwhile, Republican state attorneys general are calling for more federal action, while some GOP governors are deploying National Guard units with a mission that includes stopping the flow of fentanyl from Mexico.
“It’s a fine line to help people and try to get people clean, and at the same time incarcerate and get the drug dealers off the streets,” said Nathan Manning, a Republican state senator in Ohio who is sponsoring legislation to make it clear that materials used to test drugs for fentanyl are legal.
The recent case of five West Point cadets who overdosed on fentanyl-laced cocaine during spring break in Florida put the dangers and pervasiveness of the fentanyl crisis back in the spotlight.
The chemical precursors to the drugs are being shipped largely from China to Mexico, where much of the illicit fentanyl supply is produced in labs before being smuggled into the U.S.
While users sometimes seek out fentanyl specifically, it and other synthetics with similar properties are often mixed with other drugs or formed into counterfeit pills so users often don’t know they’re taking it.
Advocates say test strips can help prevent accidental overdoses of drugs laced with fentanyl. The strips are given out at needle exchanges and sometimes at concerts or other events where drugs are expected to be sold or used.
Thomas Stuber, chief legislative officer at The LCADA Way, a drug treatment organization in Ohio that serves Lorain County and nearby areas, has been pushing for the test strip legislation. It also would ease access to naloxone, a drug that can be used to revive people when they’re having opioid overdoses.
“This is a harm-reduction approach that has received a lot of acceptance,” he said. “We cannot treat somebody if they’re dead.”
Since last year, at least a half-dozen states have enacted similar laws and at least a dozen others have considered them, according to research by the National Conference of State Legislatures.
In West Virginia, the state hardest hit by opioids per capita, lawmakers passed a bill this month to legalize the testing strips. It now heads to the governor.
The measure was sponsored by Republican lawmakers. But state Delegate Mike Pushkin, a Democrat whose district includes central Charleston, has also been pushing for more access to fentanyl strips. He said the situation got worse last year when a state law tightened regulations on needle exchanges, causing some of them to close.
Pushkin, who also is in long-term addiction recovery, is pleased with the passage of the testing strip bill but upset with another measure passed this month that would increase the penalties for trafficking fentanyl. That bill also would create a new crime of adding fentanyl to another drug.
“Their initial reaction is, ‘We have to do something,’” he said. “It’s not just about doing something, it’s about doing the right thing that actually has results.”
But for many lawmakers, making sure that tough criminal penalties apply to fentanyl is a priority.
California Assemblywoman Janet Nguyen, a Republican, introduced a measure that would make penalties for dealing fentanyl just as harsh as those for selling cocaine or heroin. The Republican represents Orange County, where there were more than 600 reported fentanyl-related deaths last year.
“This is sending messages to those who aren’t afraid of selling these drugs that there’s a longer, bigger penalty than you might think,” said Nguyen, whose bill failed to advance from her chamber’s public safety committee in a 5-2 vote last week. She said after the bill failed that she was considering trying again.
She said committee members stressed compassion for drug users, something she said she agrees with.
The same day her measure failed to advance, a Democratic lawmaker in California announced a different bill to increase fentanyl-dealing penalties.
The National Conference of State Legislatures found 12 states with fentanyl-specific drug trafficking or possession laws as of last year. Similar measures have been introduced or considered since the start of 2021 in at least 19 states, the Associated Press found in an analysis of bills compiled by LegiScan. That does not include measures to add more synthetic opioids to controlled substance lists to mirror federal law; those have been adopted in many states, with bipartisan support.
Fentanyl has been in the spotlight in Colorado since February, when five people were found dead in a suburban Denver apartment from overdoses of fentanyl mixed with cocaine.
Under state law, possession with intent to distribute less than 14 grams of fentanyl is an offense normally punishable by two to four years in prison. But fentanyl is so potent that 14 grams can represent up to 700 lethal doses, under a calculation used by the U.S. Drug Enforcement Agency.
He and a bipartisan group of lawmakers last week unveiled a bill also backed by Democratic Gov. Jared Polis that would increase penalties for dealers with smaller amounts of fentanyl and in cases where the drug leads to a death. The legislation also would increase the accessibility of naloxone and test strips while steering people who possess fentanyl into education and treatment programs.
Maritza Perez, director of national affairs at the Drug Policy Alliance, a group that advocates for harm-reduction measures, is skeptical of the legislation that would increase criminal penalties.
“We have the largest incarceration rate in the entire world and we’re also setting records in terms of overdose deaths,” she said.
Democratic governors are focusing primarily on harm reduction methods. Among them is Illinois Gov. Jay Pritzker, who released a broad overdose action plan last month.
Several Republican governors and attorneys general have responded to the rising death toll with administrative enforcement efforts and by pushing for more federal intervention.
Last year, Texas Gov. Greg Abbott and Arizona Gov. Doug Ducey called for states to help secure the border with Mexico. Along with trying to keep people from entering the U.S., stopping the flow of fentanyl was cited as a reason. Several other Republican governors have sent contingents of state troopers or National Guard units.
The Texas Military Department said that from March 2021 through earlier this month, its troops near the border confiscated more than 1,200 pounds (540 kilograms) of fentanyl. By comparison, federal authorities reported confiscating about 11,000 pounds (4,990 kilograms) in 2021 — still a fraction of what entered the country.Gov. Greg Abbott brags about his border initiative. The evidence doesn’t back him up.
Last year, the U.S. Department of Justice filed about 2,700 cases involving crimes related to the distribution of fentanyl and similar synthetic drugs, up nearly tenfold from 2017. Even so, Republican state officials are critical of federal efforts to stop fentanyl from entering the country.
In January, 16 GOP state attorneys general sent a letter to U.S. Secretary of State Antony Blinken calling on him to exert more pressure on China and Mexico to stop the flow of fentanyl. Those are steps that Dr. Rahul Gupta, the director of National Drug Control Policy, said are already being taken.
In March, West Virginia Attorney General Patrick Morrisey called on U.S. Attorney General Merrick Garland for more enforcement on fentanyl trafficking and harsher penalties.
“Fentanyl is killing Americans of all walks of life in unprecedented numbers,” Morrisey said in a statement emailed to the AP, “and the federal government must respond with full force, across the board, using every tool available to stem the tide of death.”
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