Part of the Series
Despair and Disparity: The Uneven Burdens of COVID-19
In February 2020, just around one month before the World Health Organization (WHO) declared SARS-CoV-2 a “global pandemic” and as nations scrambled to respond to the novel coronavirus, that same organization declared an infodemic. At the time, the WHO described the infodemic as an “over-abundance of information — some accurate and some not — that makes it hard for people to find trustworthy sources and reliable guidance when they need it.”
Two and a half years later, Peter Hotez –– the Nobel Prize-winning physician-scientist, global health expert, and co-inventor of the patent-free COVID vaccine, Corbevax –– is done with the “infodemic.” Experts overuse that term, he told Truthout this week. But “infodemic” is an obscuring phrase. Even the WHO’s old description reads as naive, it seems to suggest that misinformation and disinformation are random, isolated issues –– a benign overload that leaves the public confused and in the dark.
Hotez is countering this depiction. The movement, he says, is “organized and deliberate.” The problem can’t be solved with small-scale solutions like relying on social media companies to deplatform “repeat offenders” or changing algorithms. That type of reform, warns Hotez, “doesn’t get at the monster. The monster is letting people die unnecessarily from vaccine-preventable disease.” And the monster, Hotez asserts, “has actors, political power, money and nefarious designs.”
Nick Sawyer, an emergency medicine physician and founder of the grassroots organization No License for Disinformation, calls the movement “well-coordinated and well-funded.” Earlier this month, for instance, reports surfaced that a Koch-funded right-wing litigation group had become involved in two separate misinformation-related lawsuits.
When the midterm elections were looming, the monster went into overdrive. Reports from STAT in late October show that “Republicans’ ad buys are now outpacing Democrats’” on COVID-related campaign ads. “GOP candidates have pumped nearly $46 million into COVID-related campaign ads compared to $159 million in the 2020 cycle; Democrats have channeled $17 million toward the topic, a sliver of the $476 million spent during 2020.” And “among deeply conservative and often Trump-backed congressional and gubernatorial candidates, calls to investigate or even jail Anthony Fauci have become regular campaign rallying cries.”
Hotez says that these efforts are all part of the rise of “anti-science aggression” — by now, a “core component” of U.S. politics. In the last decade, Hotez has had a “front row seat” to its rise. (These days, Hotez is known for being public enemy number one in anti-science circles; Robert F. Kennedy Jr. has called him an “OG Villain.”) But as a physician-scientist, Hotez says that he struggles to talk about these issues. Doctors are supposed to be “politically neutral. But what do you do when this is so clearly about a partisan divide?”
In October, a National Bureau of Economic Research study concluded that “significantly more Republicans than Democrats have died from the virus” since the initial vaccine rollout in 2021. Jacob Wallace, an assistant professor of public health at the Yale School of Public Health and one of the study’s co-authors, told Truthout that his group was, to his knowledge, the first to demonstrate the “link between political party affiliation and excess death rates during the COVID-19 pandemic at the individual level. … Our results suggest that political party affiliation only became a risk factor in Ohio and Florida after vaccines were widely available.”
Hotez agreed that deaths are now “overwhelmingly” occurring in red states. “The redder the state,” he said, “the more COVID cases and the more COVID deaths. Where is the horror and the outrage?” Hotez says that even in some of the hardest-hit conservative communities in Texas, folks “don’t connect the dots –– that they were victims of this truly disgusting anti-science aggression.”
Why not?
“Presumably because they’re still in the rabbit hole.”
In a new article –– one that he says was one of the saddest and most difficult he has written in his career –– Hotez draws attention to the effects of “red COVID” in his home state, Texas. The term “reflects the strong anti-vaccine activism promoted by elected officials on the far right and spread on conservative news and social media sites.” This rhetoric originates out of “health freedom” language; in the 2000s and 2010s, so-called health freedom groups were highly organized, both online and offline, partnering with Tea Party organizations to fight state-level school vaccine requirements. Both the “framework and propaganda tool … accelerated in Texas in the 2010s” in connection with childhood vaccination mandates in schools. But in 2020, with the arrival of the pandemic, purported health freedom groups “expanded their vaccine protests to social distancing, masks and other prevention measures.”
In places like Texas, the consequences have been well-documented, and devastating. Texas is “just behind California as the state with the most COVID deaths,” Hotez writes, “but with a Texas population estimated at 29 million compared to 40 million people living in California, the proportion of Texas deaths is far higher.” Although deaths more or less halted in highly vaccinated communities after May 1, 2021 –– when President Biden announced that “any American who wished to take [a COVID ] vaccine could do so” — in places like Texas and other parts of the southern U.S. and mountain West states, “the deaths had just begun.”
Hotez estimates that approximately 40,000 of the 90,000 total COVID deaths in Texas occurred after May 1, 2021. In the first three months of 2022, during the peak of the Omicron wave, the Centers for Disease Control and Prevention found that death rates were “20 times higher among unvaccinated people compared to people who were vaccinated and had received a booster.” Hotez thus concludes that the vast majority of those 40,000 deaths were in unvaccinated Texans.
Some scholars, however, have complicated the narrative about the shift in COVID mortality by party affiliation and race. A Washington Post analysis recently found that the COVID mortality gap “flipped” at the end of 2021; white people are now dying at a higher rate than Black people. But social epidemiologist Nancy Krieger says that this flip “has vastly different implications for public health interventions.” Officials, she says, need to strike a balance between connecting with “communities who are ideologically opposed to the vaccine,” while at the same time contending with “the cumulative impact of injustice” on communities of color.
Elizabeth Wrigley-Field, a demographer and sociologist, concurs. This remains a “pandemic of the disadvantaged,” she says, not just a pandemic of the unvaccinated, as President Biden memorably called it. Indeed, in Wrigley-Field’s research in Minnesota, COVID vaccination rates don’t fully account for mortality rates by race; “white people are less vaccinated,” Wrigley-Field and her co-authors note, “but also less likely to die of COVID.” The authors conclude that these numbers imply an “urgent need to center health equity” in future COVID policy.
Wallace and Hotez, meanwhile, are both concerned that the situation may get worse in places like Texas. “If the well-documented differences in vaccine rates by party affiliation persist,” Wallace said, “we are worried that we may continue to see higher excess death rates among Republican voters through the subsequent stages of the pandemic.”
Hotez worries that “the health sector doesn’t know what to do. Our health sector leaders are fumbling.” But this is a “political problem,” he says –– “with political origins.” And the movement has their “sights set on all vaccines.”
The ramifications are far-reaching; researchers at Rice University’s Baker Institute for Public Policy assert that the future of national vaccine policy runs through Texas. In 2021, Texas lawmakers filed a “trove of anti-COVID-19-vaccination bills.” More anti-vaccination bills were filed in that one year than had been filed in the prior 19 years put together. But the bills that did not pass in the last session will likely be refiled this year: “the 2023 Texas legislative session is expected to be another difficult session” for vaccine policies and their advocates.
Hotez agrees. He says that in the coming months and years, “there is going to be a battle in the Texas state legislature.”