HomeMy WebLinkAbout2021_12_16 KGould_Response to BoH Meeting_1From:Kincaid Gould
To:Board of Health; jeffbocc
Subject:Response to 12/16/2021 BOH Meeting
Date:Thursday, December 16, 2021 10:21:53 PM
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Dear Board of Health,
In wake of today's Board of Health meeting, I feel compelled to respond to what was said inresponse to my comment.
First, I would like to clarify that I arrived under the impression that I would have three minutes
to make comment, not just two. This resulted in me editing my prepared document in theminutes before I was given my turn to speak. I understand that the Board has the discretion to
limit the amount of time dedicated to public comment, but I do not understand why it wasdecided that that would happen at this meeting. With only four comments, a maximum of 12
minutes would have been allocated for comments. Cutting out four minutes (assumingeverybody used their full three minutes, which apparently would not have happened, as some
people didn't even use their full two minutes) would not save all that much time. There wasclearly not an unprecedentedly large number of commenters at the meeting, and given that you
as panelists could see who was providing public comment, it felt to me as though the intentionwas to limit certain types of comments that were anticipated. Of course, this impression cannot
be substantiated, but seeing as you saved perhaps two minutes of time by limiting commentstoday, that seems to be the most plausible conclusion I can draw. If this is the case, it is
understandably disturbing.
Second, Denis Stearns responded to the fact that I brought up that MMWR articles are notfrom a peer-reviewed journal. Thank you, Vice-Chair Stearns, for taking the time to respond
to at least part of what I mentioned during my comment.
The fact that MMWR is not a peer-reviewed publication, as was acknowledged, is commonknowledge. As was stated, this does not mean that the data that comes from these publications
are necessarily flawed or unusable. (I would have qualified the statement I made today had Ihad the full three minutes I anticipated to reflect this.)
However, it is ironic that these are the only types of articles (in addition to one JAMA
Cardiology study mentioned at Monday's BOCC meeting) that Dr. Berry has (at least recently)cited publicly, when she makes it clear that studies should be peer-reviewed when we talk
about COVID-19. (And to be clear, I do not agree with this statement; all peer-reviewedstudies lacked a peer review at some point, and the fact that a study has not been peer-
reviewed should not mean it cannot be looked at it.) And while not all MMWR publicationsare of poor quality, it should be noted that not all MMWR publications are very good sources
of information, either.
Take, for example, the MMWR article about two hairstylists which claimed to show thatmasks are an effective tool to combat COVID-19. Perhaps this claim is true; the study does
not offer that evidence, despite the article's claims and the CDC's endorsement of the study as
evidence for that claim. The study is riddled with fatal design flaws, flaws which bear astriking resemblance to those found in the "study" (for lack of a better word) that I focused on
during my public comment.
Here are some of the problems I've identified with that particular MMWR study:
“An investigation of a high-exposure event, in which 2 symptomatically ill hair stylistsinteracted for an average of 15 minutes with each of 139 clients during an 8-dayperiod. Found that none of the 67 clients who subsequently consented to an interviewand testing developed infection. The stylists and all clients universally wore masks inthe salon as required by local ordinance and company policy at the time.”
The CDC’s summary of this case (above) showing “evidence of mask effectiveness”already has serious problems. First of all, we see the sample size is significantly under-powered with only 139 people total. However, that’s being generous as fewer than halfof them, only 48.2% or 67 people, consented to being tested for COVID-19 infection.Whether or not the other half of people present contracted COVID-19 (perhapsasymptomatically) was not identified in the study. All of those who were tested weregiven PCR tests. The authors of the study note: “With a viral incubation of 2-14 days,any COVID-19 PCR tests obtained from clients too early in their course of infectioncould return false-negative results.” Along with this comes the problem of falsepositives, which are possible in the two hair stylists.
The study goes on to say that about one month after the study started, the researchersattempted to interview all of the clients at the hair salon. Of the 139, only 104 (74.8%)consented to be interviewed. Any information about the other 25.2% of people isunknown.
According to the study, two of these 104 interviewees said that they were not wearingtheir mask the entire time—possibly suggesting that masks had no effect on whether ornot one contracted COVID-19 (though of course, this is hardly evidence to suggest thatmasks don’t work). This brings up the issue of the lack of a control group to measureagainst; if everybody was universally masking as the study claims (and then laterrefutes by saying that at least 2 of the clients were not masked the entire time), there’sno way to tell if the masks were effective in preventing the spread of COVID-19 ornot. It’s possible that if all of the clients were unmasked, none of them would havebeen infected with COVID-19 either.
Another complication arises when we consider that 17 of the interviewees (16.3%) saidthat they had had “respiratory symptoms in the 90 days preceding their appointment”and that “none reported testing for or diagnosis of COVID-19.” It is therefore quitepossible that at least 17 of these individuals had already had and recovered fromCOVID-19 in the past. Because COVID-19 can be asymptomatic in people, it’s alsopossible that some or all of the people who didn’t report respiratory symptoms couldalso have developed natural immunity to the virus. The fact that the clients were notinterviewed until more than a month had passed since their visit to the hair salon raisesthe question of how well these individuals were able to remember 90 days prior to theirappointment. It’s quite possible that some of the individuals who said that they hadn’thad symptoms actually may have had symptoms that were so minor that they forgotabout them; conducting these interviews more promptly would have been betterpractice.
The study goes on to say that masks were not the only preventive strategy employed bythe hair salon. Indeed, there was a “citywide ordinance [that] reduced maximumbuilding waiting area seating to 25% of normal capacity and recommended the use offace coverings… where physical distancing was not possible.” The study
acknowledges that additional precautions “were likely important factors in preventingthe spread of SARS-CoV-2 during these interactions between clients and stylists.”
The researchers conclude that “A policy mandating the use of face coverings waslikely a contributing factor in preventing transmission of SARS-CoV-2 during theclose-contact interactions between stylists and clients.” Of course, given the aboveconstraints on this study, it’s difficult to consider this study very weighty when weconsider the criteria that Dr. Berry uses for evaluating scientific discourse.
You are all entitled to your own opinions, just as I am mine. But while you can "have Dr.Berry's back," as so many of you put it, you can at the same time hold her accountable forwhat she says. I am actually quite surprised by her failure to defend the science supporting thevaccine passports at today's meeting, as she has on several occasions over the past weeksvaunted this single instance as proof that the segregative system we have in place is a reasonthat "we are doing so well" in Jefferson County. This claim continues to remain incongruouswith Chair Dean's statement that local policy is not based on local data. I am similarlydisappointed that yet again nobody on the Board thought it appropriate to ask Dr. Berry todefend these claims after she chose not to respond.
Do the problems I have raised not merit concern? If they do, why has nobody asked Dr. Berryfor clarification about them, despite multiple chances to have done so? If they don't, whyhasn't Dr. Berry or anybody on the Board of Health responded to me with the reason(s) thatthey are not valid concerns?
Accountability seems to have flown out the window, and while I can't honestly say that I'msurprised, I am disillusioned.
Sincerely,
Kincaid Gould