I like to think that I'm plugged into social media at least about the topics that I care about, such as medicine, quackery, vaccines, and COVID-19. I realized that I was not when I saw a link to an article from Dr. Lucy McBride on the Tweet from outspoken Yale epidemiologist Gregg Gonsalves.
& you misunderstand one of the central tenets of harm reduction: meeting people where they’re at. I work on HIV & substance use. Have for a long time. Would never shame someone in public as a coronaphobe or anything else. Imagine your patient reading this.
— Gregg Gonsalves (@gregggonsalves) May 15, 2022
The article was published in The Huffington Post. Here is what you need to know. I noticed that the date was over a year ago. I responded.
For whatever reason, an awful article by @drlucymcbride about "coronaphobia" from March 2021 has resurfaced on social media to make the rounds. The depressing thing is that this article could have been written today, which is perhaps why it's making the rounds again. https://t.co/YKmmVopMNx
— David Gorski, MD, PhD (@gorskon) May 15, 2022
Several people pointed out to me that the reason this article was making the rounds again was because of Dr. McBride, who doubled down on her words on Saturday.
I’m finding that the “cure” for some of my patients’ outsize fear of COVID is … COVID.
“Coronaphobia” can be defined as an exaggerated fear of COVID that’s rooted in the rational anxiety of the very real threat of COVID.
(I wrote this a year ago.)
https://t.co/c8Nhh1Brlr
— Lucy McBride, MD (@drlucymcbride) May 14, 2022
Dr. Social Media didn't notice that Dr. McBride was responsible for the reappearance of her old article. I apologize.
The Washington Post published an article by her titled "I've been longing for an end to the Pandemic" a week later. I'm a little afraid now that it's here. One can note how Dr. Marty Makary was the one who declared that the pandemic would be over in April 2021. Her labeling her patients afraid of the virus as having "coronaphobia" or "fear of normal" has not aged very well. It was vile because by the beginning of March 2021, most of her patients had not been vaccinations.
Because it was BEFORE almost all of her patients had been vaccinated and AFTER she was. Let this sink in.
— Gregg Gonsalves (@gregggonsalves) May 15, 2022
The EUA for the Pfizer COVID-19 vaccine was issued in December. After that, healthcare and other frontline workers were first in line, followed by those over 65 and then the rest of the population. The first dose of the Pfizer vaccine was given to frontline workers in March of 2021, but most of the US population was still not up to date.
The reappearance of this article provided me with a convenient excuse to address another example of how, during the Pandemic, everything old is new again and antivaccine talking points keep popping up again and again. It's the pathologizing of the fear of infectious disease, representing it as an anxiety disorder, that might even need treatment. You could be mentally ill if you are afraid of a vaccine.
There are people who are suffering from anxiety and depression due to the effects of the COVID-19 epidemic, and some of them may need treatment. There are. I am going to point out how similar the messaging is to what I have come to expect from the antivaccine movement. An old antivax trope that seeks to shame those who fear vaccine-preventable diseases is what Dr. McBride is doing. She denies it all the time. She wrote about it in her HuffPo article.
When anxiety takes on a life of its own — that is, when the cognitive, emotional, physical and behavioral manifestations of anxiety are rooted in reality but out of proportion to the actual threat — it’s time to see a doctor. After all, mental health isn’t something that we can opt out of like we can a feature on our iPhone.
Her message was that anything that she doesn't consider to be a rational fear is potentially pathological, and INRDeals INRDeals INRDeals INRDeals INRDeals INRDeals INRDeals INRDeals INRDeals INRDeals INRDeals INRDeals INRDeals INRDeals INRDeals INRDeals INRDeals INRDeals INRDeals INRDeals INRDeals INRDeals INRDeals INRDeals INRDeals INRDeals INRDeals INRDeals INRDeals INRDeals INRDeals INRDeals INRDeals INRDeals INRDeals INRDeals INRDeals Jonathan Howard mentioned in February that her public appearances have been all about minimizing the threat of COVID-19 and helping patients deal with their anxiety.
The messages from Dr. Lucy McBride have been consistent.
It's time to go back to a time before the epidemic.
I know that I've mentioned this before, but it's time to do it again. When the antivaccine movement was at its peak, it was the fear of the MMR vaccine that was the main terror. For purposes of messaging about vaccines and the pathogens targeted by them, there are two. The first was to portray the vaccine as dangerous and/or ineffective, and the second was to portray the vaccine as normal and not dangerous. Measles is more dangerous than had been thought. The same two messages are being applied to COVID-19 and the vaccines against it, but back in the day, these messages were mostly about childhood illnesses.
I used to refer to it as the Brady Bunch ruse, in which old sitcoms from the 1950s and 1960s where kids getting measles was played for laughs. The Brady Bunch is a classic sitcom that antivaxxers were referencing. The episode first aired in 1969 and featured hijinks when Brady kids caught the measles in rapid succession, a situation that was mostly handled humorously. Brady Bunch is a 52 year old episode that features natural immunity. When Mike Brady and his wife Carol were exposed to the disease, it was revealed that they had never had it as children, but that Carol was immune to it as an adult.
The reality was different from the fuzzy-headed nostalgic thinking of comedy writers in the 1960s, all of whom likely suffered from survivorship bias. According to the CDC, before the vaccine, 48,000 people a year were hospitalized for the Measles, 4,000 developed Measles-associated encephalitis, and 400 to 500 people died. The introduction of the measles vaccine in 1963, followed by the MMR in 1971, made it less of a public health problem. In his response 13 years ago, Dr. John Snyder reminded us that the vaccine book written by Dr. Sears was the same one that promoted an alternative vaccine schedule. Recent data shows that a severe complication of the disease, subacute sclerosing panencephalitis, is more common than we used to think. 13 years ago, Dr. Sears claimed that the risk of death from the disease was close to zero.
It's obvious how such things can contribute to a message that you should be more afraid of the vaccine. In the comments section of an antivaccine blog that I have often referred to as a "wretched hive of scum and antivaccine quackery", a pro-vaccine commenter named "Curt Watkins" wrote. He left the door open after realizing the futility.
I guess I’m tilting at windmills by posting here, but it really gets my goat when someone claims that measles is this benign illness, shrugging off a one in 3,000 (or 1 in 10,000) case fatality rate for developed countries. In the third world the fatality rate is far higher. I challenge you to find a pediatrician with pre-vaccine experience and ask them about treating measles. If anyone cares to argue that measles is not occasionally a very serious disease, then I would be happy to engage in a discussion. I’ll check back.
Grace Green portrayed Dr. Watkins as having a fear of heights.
Curt Watkins, I’m very sorry for your phobia of risk-taking. I have survived measles, mumps. rubella, chickenpox and even scarlet fever! I must have been at much greater risk walking out of my front door, as a slate could have fallen on my head, and as for getting into a vehicle, the risk is huge. Come to think of it, most accidents happen in the home, so it’s not even safe to stay there! I have on the other hand lived with “mild” vaccine injury for 64 years, and it’s total misery, prevented me from working, or socializing. So I’ve seen both sides of this debate, including my sons having measles, chickenpox (twice) and whooping cough. People who haven’t had these experiences are being lead astray by fear-mongering into needlessly poisoning their children. The writers here are simply trying to warn others, from our own experiences.
The idea is that if you are afraid of something and not dangerous, you must have a fear of it. Another antivaxxer explicitly says this.
From the 1950 Merck manual on Diseases:
Prognosis
Measles usually is a benign infection with a low mortality rate and one attack apparently confers lifelong immunity. However, the disease may be followed, particularly in infants, by bronchopneumonia and other bacterial infections which may be fatal. Postmeaslcs encephalitis, which also may be fatal, occurs only about once in 1,200 to 1,500 cas
Benign doesn’t imply innocuous. Most parents I know who have elected by informed consent to decline the MMR vaccine, have an alternative medical philosophy in place on how they would support a child’s immune system, as they succumb to measles and other infections.
I laughed because benign actually means innocuous. How can a disease be benign if it is not innocuous?
In this antivaccine article, A Very Brady Meas, it was said that the fear of measles was due to physicians, public health officials, and the media.
Things are so different today. Illness is a bad word. What used to be called a common childhood disease is now viewed as impending doom. Fevers, rashes and sicknesses that last longer than a few hours are treated like the plague. Anything that can be passed from one person to another is a death sentence. These types of exaggerations fill many news stories.
And:
Catching a disease can be scary. But as we saw in the clip, the Bradys survived the measles in America. In that clip, we’re given a peek at how a TV family, likely modeled after hundreds of real-life families, treated and managed the measles with common sense. Instead falling for scare tactics and being filled with doom and gloom, we saw that the parents used good judgment. We saw that the kids rode out the illness. They rested, they got better, and they survived. And God love her, Alice did too.
In a fictional idealized late 1960s suburban Los Angeles upper middle class white neighborhood, the kids all did well when they got the measles, as did the two adults who had never had it. It was not the case for many thousands of others every year before the vaccine, at which time 500 would die.
It wasn't just antivaxxers. The fear of the disease was portrayed by some physicians as irrational by the media. The Vaccine Book: Making the Right Decision for Your Child was written by Dr. Bob Sears, who complained about parents asking him if they should.
Should she see this, she will bristle at the comparison. She has advocated for adults to bevaccinated. She helped to found the astroturf effort to open up schools.
In addition to ending mask mandates in schools, she [Dr. McBride] told me, she wants required quarantines to end, as well as testing for asymptomatic children. “The problem right now is we’re isolating and quarantining healthy kids,” she said, arguing that the decision to quarantine a child who is exposed to the virus should be up to parents and pediatricians. (Public health experts have told me this policy would likely lead to further spread, since people are highly infectious before they ever show symptoms. This could be particularly problematic if masks are not required in classrooms.)
In fairness, Dr. Sears complains about his patients because their children were mostly unvaccinated.
This year there will be more than usual, the way it’s looking so far, but it’s not a reason to panic. Make your choice – do vaccine, or don’t do the vaccine.
So, when SHOULD someone worry? If an actual direct exposure has occurred from a known case, then you might be at risk. This doesn’t mean a case in the county in which you live: it means that you’ve actually been in the same room with someone who has had measles. Or, at the most, maybe the same building. But transmission almost always requires close proximity (same room). There have been a handful of cases over the decades in which someone sitting across a stadium has caught it, but that is almost unheard of. You have to be in the same room, people. If THAT happens, call me. If not, then just relax and go about your life as usual.
IF we see more cases, I’ll let you know. Actually, just to give you a heads up, we probably WILL see a few more cases. But virtually all measles outbreaks are limited to 10 to 20 cases in any given county. So, the chance that any one of your unvaccinated children is going to be a case is very very very very very small. I love you all, and love caring for you all. But just chill out. Measles will never go away – it’s always going to be a very small risk. If you aren’t comfortable with that, get the vaccine. If you don’t want the vaccine, accept the risk.
The reason why most measles outbreaks were small back then can be observed even eight years later. Can you tell me what it was? It was because of high vaccine take-up in the communities in which the outbreaks occurred that the pockets of unvaccinated children were limited.
The message that Dr. Sears and other COVID-19 minimizers have been promoting is that COVID-19 will never go away. How much risk you are willing to take is up to you. Don't expect anyone else to do the same if you're worried, even if you're exposed to something. Let's chill out.
The only difference is that Dr. McBride takes the narrative that people are afraid because of the media and government promoting fear-based messages, and kicks it up a notch.
… and to recognize the very real physical, emotional, and behavioral effects that anxiety-laden headlines/messaging can have on people, particularly those who are *already* vulnerable to fear & anxiety.
COVID is an ongoing, real threat. And some degree of anxiety is normal..
— Lucy McBride, MD (@drlucymcbride) May 14, 2022
This fear and anxiety should be invoked during Mental Health Awareness month.
The challenge is *calibrating* our public health & personal responses to C19 to the level of actual risk…to protect against C10 & the harms of living in a constant state of fear.
It’s #MentalHealthAwarenessMonth
Instead of dismissing ppl w anxiety about COVID, let’s name it.
— Lucy McBride, MD (@drlucymcbride) May 14, 2022
There is little doubt that the swine flu has caused a lot of anxiety and depression. It is correct that some anxiety over a potentially deadly illness is normal and expected. She is, contrary to what she thinks she is doing, by calling it anxiety. She is pathologizing this anxiety while providing no real solution other than her anti-anxiety regimen.
To mitigate the expected anxiety — rational or irrational — we assemble a kit of coping tools. I commonly recommend breathing techniques, guided meditation, regular exercise, prioritizing sleep and spending time in nature, all of which tamp down stress hormones.
One would expect a concierge doctor in an affluent DC neighborhood who doesn't have any contracts with health insurance companies or maintain Medicare assignment to tell her patients who have anxiety over COVID-19. She has a degree of privilege in that her well-off patients can do these sorts of things more easily than those who are less well-off.
Dr. McBride parrots antivaccine messaging about childhood diseases, even if she doesn't realize it or will admit it.
I will admit that she is smart enough to be self-deprecating about her first invitation to a gathering.
With a mix of reticence and relief, I click “RSVP YES!” to my colleagues’ party and take my first step toward reentry. The next step? Buttoning my pants.
She goes out of her way to claim that she is bringing up mental health issues because of her incredible empathy for her patients.
I feel particularly sad for my more anxious elderly patients who, bc of age, are indeed at highest risk for serious outcomes from C19 and who suffer from social isolation. Obviously my job is to help ppl manage risk but C19 is only one threat to their health & wellbeing.
— Lucy McBride, MD (@drlucymcbride) May 14, 2022
Dr. Gonsalves had a great response.
I test because I care about other people. I know my risk for serious acute complications may be low, but if testing can help me avoid exposing others who might be at higher risk, it is worth it. Living my life is not just about myself.
— Gregg Gonsalves (@gregggonsalves) May 14, 2022
All of which is true, but hasn't stopped Dr. McBride from self-deprecatingly portraying herself as just trying to work it all out.
And instead of shaming ppl for living their lives w a different risk tolerance than our own, let’s give each other a little latitude & grace.
This is not a sermon.
I’m trying to take my own advice as I help others navigate the art & science of living with risk all around us.
— Lucy McBride, MD (@drlucymcbride) May 14, 2022
I can cite something that antivaxxer Del Bigtree said over two years ago, before vaccines and when the virus was new.
I would argue that coronaphobia is similar to what Bigtree said in another context.
The problem is that, regardless of what Dr. McBride says to her own patients in the privacy of her clinic exam rooms, her public utterances do amount to a shaming of those who remain. Her coronaphobia label contributes to that.
The mockery of patients. The assumption that fear is fear for themselves. The refusal to see the larger problem: climate change and the future pandemics it predicts. Show me someone who diagnoses Coronaphobia, & I'll show you someone who doesn't think beyond their own nose.
— Loretta Torrago (@Loretta_Torrago) May 15, 2022
In the age of the Pandemic, everything old is new again. The antivaccine and disease minimizing narrative and trope that I have seen thus far about COVID-19 existed long before the epidemic. In the age of the Pandemic, it has been disturbing to see how many doctors consider themselves to be very reasonable. It's not unusual for people with an overwrought fear of a vaccine to have a diagnosable mental health condition.
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