Epistemic chaos and the Delta variant, Part IV

How many people can a single anti-vaxxer kill?

By Claire Berlinski

This is the last essay in our series about the spread of the anti-vaccination movement on the Internet. Here are the first three parts:

Part I: Catastrophic risks: The Internet as threat multiplier

Part II: Confusing claims about vaccines: An epistemic map

Part III: Old anti-vax arguments and new mutants

If you’re a new reader, welcome. This month,¹ the Cosmopolitan Globalists have been exploring global catastrophic and existential risks. We’ve already had a look at nuclear near-misses, the risks of biotechnology, and threats from space such as solar flares. We’ve taken a detour, this week, to explore the spread of the anti-vaccination movement; we’ve done so both because the subject is topical—and urgent—and to demonstrate the way the Internet serves as a catastrophic risk multiplier.

A small handful of activists have used the Internet to persuade a very significant proportion of the public the world around—roughly one in every five people²—that contrary to overwhelming evidence, vaccines are not the safest, most effective and most consequential invention in medical history, but rather a sinister and dangerous menace that should be eschewed. It is an achievement on a par with persuading people to mix their drinking water with their sewage.

It should not be possible to convince so many people to believe something that is at once so unfounded in any evidence and so contrary to the most fundamental of human drives: staying alive. What does it mean that it’s possible? It strongly suggests that so long as social media is configured the way it is, anything is possible. The Internet, as it’s now structured, may be used to persuade at least one in five people that up is down, black is white, and if you leap off the top of a skyscraper, you’ll fly.

For open societies in particular, this is a massive vulnerability. It is trivially easy for hostile states and sociopaths to exploit this, and they do exploit it. They’ll continue to exploit it this way until one of two things happens: We find a more rational way to organize the Internet, or we’re destroyed by it.

If you think this an exaggeration, turn it over again in your mind. A recent study of the anti-vaccination movement found that 73 percent of the anti-vax propaganda on Facebook originates among the same twelve people.³ They are superspreaders. Other studies have come to similar conclusions. Here, for example, is Newsguard’s data sheet. Russia boosts these accounts—heavily—but the phenomenon is not of Russian origin.

What this suggests is that it’s not only theoretically possible for a dozen-odd people, mostly Americans and Europeans, to persuade a fifth of the world to join a death cult, it has happened already. So this is unlikely to be a rare event. These figures are well-known to researchers. The superspreaders include both physicians and alternative health entrepreneurs. They tend to be in it for the money. They promote “natural health” cures. They sell books and supplements. They run multiple accounts across different platforms. When taken off a social media platform, they pop up under other names and guises, but they’re the same people.

The impact of their activity isn’t a massive imponderable. It can be quantified and measured. Last February, Sahil Loomba et al. published the results of research on vaccine misinformation in an article in Nature titled, Measuring the impact of COVID-19 vaccine misinformation on vaccination intent in the UK and USA. The experiment was randomized; the sample large; the results significant. In both the US and the UK, exposure to anti-vaccination propaganda induced an immediate 6.2-6.4 percent decline in willingness to be vaccinated.

“Scientific-sounding” misinformation, they found, was more strongly associated with a decline in intent to be vaccinated. And once people have been exposed to this garbage, it’s damned near impossible to reverse the effects. Telling people they should not take seriously reports that “an eight-year-old who got the vaccine was found dead in his bed ten hours later” has exactly the effect it will now have on you when I tell you not to think about yellow elephants.

It requires years of study to master complex and difficult questions in medicine. Bad ideas and superstition, however, are accessible to all. Pastor Chris Oyakhilome lives in Lagos. It is immensely unlikely that he independently arrived upon the thesis that 5G technology causes Covid19. He believes this because a handful of lunatics in the West have been spreading this idea—all the way to Nigeria. They’ve done so much faster than anyone could spread useful medical knowledge, because acquiring a body of useful medical knowledge takes years of study, much of it hands-on.

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Following his meeting with Vladimir Putin, Joe Biden said, “I made it very clear to him that the United States expects, when a ransomware operation is coming from his soil—even though it’s not sponsored by the state—we expect them to act, if we give them enough information [about the author of the attack.]”

His statement expresses a principle most of us intuitively find sound. If Russian citizens, living in Russia, attack the United States, it’s the responsibility of the Russian government to stop them, even if these Russians have never set foot in the United States. We accept the idea that in the Internet age, crimes may be committed at a great distance. We accept, too, that it is the responsibility of the governments where these criminals reside to prevent their citizens from committing transnational crimes.

Does this mean the government of Nigeria is entitled to ask our governments to crack down on our anti-vaxxers? Obviously, it doesn’t. Not by law, not by custom, not by our initial moral instinct. But these laws, customs, and instincts evolved over centuries in which it wasn’t possible to do this much harm, at a distance, this quickly. It’s tricky to explain why, precisely, these cases are vastly unalike. Our anti-vaxxers are, in a meaningful sense, killing people in Nigeria.

The anti-vaccination movement isn’t native to Africa. Particularly in countries without an advanced health infrastructure, vaccination is the only hope, for many, of making it to adulthood. There’s no hospital in South Kivu with equipment and trained personnel sufficient to bring people back from the verge of death from common infectious diseases that vaccination would prevent entirely. However harmful the anti-vaccination movement is in the West, it is even more harmful to the world’s most vulnerable people.

We can’t—or won’t—deprive our own citizens of their First Amendment rights because their ideas lead to outbreaks of epidemic disease in Africa. Still, this doesn’t mean that the statement, “These ideas cause epidemic disease in Africa” is false. Obviously, ideas don’t cause disease in the way that viruses, bacteria, or cigarettes cause disease. But it isn’t meaningless to say that ideas both cause and cure diseases. In 1945, Stockholm awarded the Nobel Prize in medicine to Andrew Fleming. They did not give the award to penicillin. If it made sense to award the Nobel Prize to Fleming, why doesn’t it make sense to say that anti-vaccination activists caused this?

The suspension of vaccination against polio in Nigeria sparked a global polio outbreak that quickly spread to 20 countries in Africa, the Middle East and Southeast Asia, causing 80 percent of the world’s cases of paralytic poliomyelitis. Beyond delaying the eradication of polio, the outbreak that started in Nigeria also resulted in a cost of over US$500 million for immunization campaigns and public-awareness initiatives.

The simple answer—at least from the American perspective—is that the US Constitution specifies that Congress shall make no law abridging the freedom of speech, and that’s that. Because of our commitment to freedom of speech, we can’t silence our anti-vaxxers through criminal law.

But this doesn’t mean that what they’re doing is of no moral concern to the rest of us, and it certainly doesn’t mean any of us have an obligation to promote their ideas or hand them the keys to the platforms by which they spread their ideas overseas. To the contrary. It’s immoral to do so. Their ideas are, in a meaningful sense, an immediate danger to human life.

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How many people can a single anti-vaxxer kill?

The Cosmopolitan Globalists are liberal democrats. We are deeply attached to the idea that censoring controversial speech is wrong. Debates about Covid19 have also shown the value, not just the risk, of a free market of ideas in which even fools, cranks, and heretics may sell their wares. One orthodoxy about the pandemic after another been challenged, even toppled, as fringe ideas have moved to the mainstream. Among them: You don’t need masks. Aerosol transmission is rare. Scientists have shown the virus could not have emerged from a lab.

Thomas Kuhn, in The Structure of Scientific Revolutions, described the sociological process by which scientific knowledge is acquired and our scientific paradigms change. It’s not uncommon for figures on the margins of the scientific establishment, even those condemned by it, to do important work in bringing what Kuhn called focal anomalies to light. The sociologist Zeynep Tüfekci, for example, in an influential article in The New York Times, changed public discourse, and probably public policy, toward masks. No doubt public health authorities found her criticism unwelcome and embarrassing at the time.

But the statement, “Cranks and quacks are sometimes right and should not be censored” does not entail, “Cranks and quacks are always right and must be given equal access to social media platforms.”

Nor does it entail, “Cranks and quacks can do no harm.” They can do immense harm. They should be discouraged from doing so. What cranks and quacks who discourage vaccination are doing is not brave; it is not useful; we should not celebrate them just because YouTube takes down their videos and cranks are sometimes right. That’s idiotic.

If you’ve leapt up to defend, say, Bret Weinstein’s ability to make money as the guru of a pseudoscientific death cult—why? What’s your thinking? “Weinstein is on the verge of becoming one of the more prominent casualties to a censorship movement that it’s hard not to see as part of a wider Evergreening of America,” writes Matt Taibbi. He continues: “Whether or not one agrees with Weinstein about the efficacy of ivermectin, or the idea that the Covid-19 vaccines carry unreported dangers, anyone who follows his show recognizes that his is nearly the opposite of an Alex Jones act.”

This is sloppy reasoning. This is nothing like the Evergreening of America. Weinstein is the very same kind of problem as Alex Jones. The truth value of the claims Weinstein asserts are enormously relevant; they can’t be dismissed with the words, “whether or not you believe.”

Taibbi is, rightly, uneasy about the role and power of Big Tech and its ability to delimit the boundaries of acceptable speech. But anti-vax propaganda is the worst imaginable test case. Does he accept that Big Tech should censor, say, ISIS recruitment propaganda? If he has, he’s conceded the point. Now we’re just arguing about the limits. In the entire universe of ideas, few are as demonstrably and immediately harmful as those endorsed by the most prominent anti-vaccination advocates. ISIS recruitment propaganda is almost certainly not as deadly.

Weinstein seems to have attracted the sympathy of a number of journalists who disliked the students at Evergreen and who see, in the legacy media, a bunch of self-righteous and partisan hacks who take it upon themselves to lecture their fellow citizens without cease about what they should and shouldn’t think. These criticisms of the students at Evergreen and the legacy media are so obviously condign we may treat them as truisms, but it’s completely illogical to imagine a truism of any kind would entail that Weinstein is right—intellectually or morally—to advocate rejecting the entire edifice of the Enlightenment, empiricism, modern science, and medicine.

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The Cosmopolitan Globalist has done its best to do what liberal democrats are supposed to do in the face of an argument that displeases them—we’ve offered a better argument. We hope our readers have been persuaded that common arguments against vaccination generally, and Weinstein’s in particular, are entirely without merit. If you’re still unsure, send us your questions. We’ll answer them.

But Weinstein is a prominent public figure. YouTube has Streisand-effected his claims to the stratosphere. Despite his protestations of censorship, he’s spread his lies about the dangers of Covid19 vaccines to a vast audience. In the past, his podcasts have been downloaded as many as five millions times. Since he began promoting this anti-vax quackery, he’s been invited to spread it further on Joe Rogan’s podcast. He’s been interviewed by Megyn Kelly and Tucker Carlson. He has reached millions of people with this message.

Anyone who follows these debates on social media can track his influence semantically. The claims he’s made are unique and bizarre enough that when people repeat them, it’s clear they originated with him. It defies plausibility that so many people would independently come up with exactly the same nonsense phrases. There is no doubt in my mind that he has persuaded many previously uncertain people not to be vaccinated.

Most people don’t make medical decisions by studying the relevant scientific literature themselves, but by listening to authorities they trust. It’s no secret that once-lustrous chains of epistemic authority in the United States—the academy, the FDA, the CDC, the media—have frayed.

We spare no odium for those who have, in causing them to fray, brought us to this impasse. But here we are. If you can’t or won’t read all the studies and meta-studies on ivermectin and safety of the mRNA vaccines, you’ll find an authority who seems to you credible and trust what he or she says. Ten million people, I’d wager—as a conservative estimate—have now directly heard what Weinstein has to say about vaccines. Thanks to Tucker Carlson, some have heard him through broadcast media. But most have heard him through social media.

Sahil Loomba’s research suggests that about 6 or 7 percent of these people, particularly if they were already inclined to be dubious of vaccines, are now significantly less likely to be vaccinated against Covid19. He has told them ivermectin is an excellent prophylaxis against Covid19—so much so that if you’re taking it, you don’t need to be vaccinated. He has told them mRNA vaccines are extremely dangerous, causing terrible side effects in vast numbers of the people who take them; he has told them they endanger their fertility and there is good reason to worry they cause cancer and strokes. He and his guests have strongly insisted children should not be vaccinated, and nor should people who’ve had the disease, even though it is, clearly, possible to have Covid19 more than once. Someone who had not read the literature on these vaccines would be scared witless by what he’s said.

So it seems reasonable to speculate that at least 300,000 people, because they trust him, will decline to be vaccinated entirely or delay getting their second dose. Obviously, this is an imprecise estimate. But I’m low-balling it. What will happen to those people?

The number who will be infected by Covid19 will depend how many other people around them are vaccinated. This would, obviously, be a lower number if people were widely to take his words to heart. If they’re the only unvaccinated people in their locality, they may be able to free ride on everyone else’s immunity. But in the US, at least, people who are reluctant to be vaccinated are clustered geographically. Those communities are not a bulwark of immunity.

The Delta variant has at least a dozen mutations that make it more contagious, and possibly more lethal, than other strains. French epidemiologists have said plainly that they believe its virulence so great that everyone in France will be exposed to it. They’re probably right. Perhaps if you live in an Antarctic village, this doesn’t apply. But if you have any kind of social relationship with the rest of the world, it is likely that you will be exposed. The Delta variant will quickly become dominant everywhere, as it has in India and the UK. In the UK, the vast majority of Delta-variant cases have been in people under 50—the people less likely to have been vaccinated.

The mRNA vaccines, thank God, are effective against this variant, as they have been against all the other variants, but only if you get both doses. One dose confers some protection (enough dramatically to reduce the risk of hospitalization and death) but not enough to prevent symptomatic illness. The mRNA vaccines seem to be more effective against this variant than our other vaccines.

Half of Americans have been fully vaccinated, and more have some immunity from having previously contracted the disease. This will slow the spread. But already, in communities where vaccination rates are low, we’re seeing major spikes, especially in younger, unvaccinated people. The risk is gravely heightened because people are done with social distancing and masking. States with low vaccination rates have been open for weeks. In some states in the South and rural West, only a third of the public has been fully vaccinated. Already, big differences in the death toll are apparent: In counties and states with higher vaccination rates, cases, hospitalizations, and deaths have plummeted. Where rates of vaccination are low, people continue to sicken and die.

If the French government is right, all 300,000 of the people persuaded not to be vaccinated will be infected with Covid19 in the course of their lifetimes. Assuming the case fatality rate in the United States remains what it has been—1.8 percent—this means at least 3,180 of Weinstein’s listeners will die because they took his advice to heart.

Many more will be permanently crippled. Covid19 is a terrible disease. No trivial number of its victims suffer permanent damage to their lungs, their hearts, their kidneys, their brains. Surviving the initial infection doesn’t mean you’ll be okay. People are left with brain damage, psychiatric disorders, ophthalmic sequelae; some people need limb amputations. Even the treatment for Covid19 can cause permanent damage, psychiatric and physical. Artificial ventilation can cause barotrauma—burst lungs. A stay in the ICU is a massive trauma of its own right.

So-called minor cases are often not minor at all. Ask anyone who is suffering from long Covid. Most people who develop long Covid are between the ages of 20-50. The risk of developing it does not appear to be linked to the severity of the initial illness. People with mild Covid19, even those without initial symptoms, can develop lasting disability. That we have no idea how long this syndrome might last is reason enough not to dream of exposing children to it. If a year of missed classroom time has set kids back, what do you imagine this much cognitive damage—which may be permanent—will do to them?

And what of the long-term effects of SARS-CoV-2? No one knows. We do know that other coronaviruses have terrifying properties. I recently lost my beloved cat, Daisy, to Feline Infectious Peritonitis, which is caused by the coronavirus FeCV. It is often acquired in kittenhood. After the initial infection, the virus often lies dormant. But about ten percent of the time, the virus—which is not itself deadly—acquires a lethal mutation. This is what happened to Daisy. Her immune system was weakened by age. Out of nowhere, the virus suddenly, swiftly, and agonizingly killed her. There’s no evidence that SARS-CoV-2 will do that to humans. But there’s also no evidence it won’t.

A full quarter of the people who are infected develop long Covid.⁴ No one knows how long it might last. If we stick with my estimate—300,000 people will be infected because they put their faith in Bret Weinstein—then we wind up with 75,000 people who will be severely, and perhaps permanently, impaired. That’s a hell of a lot of human suffering, and it’s suffering that doesn’t just affect the victims, but everyone who loves them.⁵

But it doesn’t stop there. Not at all. It doesn’t stop because—also according to French epidemiological estimates—every infected person passes it on to six more.

And every person infected with anti-vaccination propaganda passes that on, too. We don’t know how many more, but it’s probably a lot more than six.

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The angels of death

If you believe it makes sense to award a Nobel Prize in medicine to people—for their groundbreaking ideas—rather than awarding it directly to the medicines and treatments they discover, then you must also believe it makes sense to say that Bret Weinstein and other anti-vaxxers will be responsible for these deaths and this suffering. Yes, it is true that these deaths would not happen without the virus. But it is also true that the deaths would not happen without the anti-vaxxers.

No one is responsible for deaths we do not know how to prevent, or for deaths we do not yet have enough doses of vaccine to prevent. But we now know how to stop almost every death from Covid19 in the developed world. We have more than enough vaccines to do it. With rare and unlucky exceptions, every further death from Covid19 in the West will be the anti-vaxxers’ fault. They will kill the vaccinated along with the unvaccinated, because the vaccines’ protection, though excellent, is not ironclad. So long as the virus is circulating, we are all at risk. We are at risk not just from the variants of Covid19 already circulating, but new variants.

Once manufacturing capacity ramps up and there are enough vaccines for everyone in the world, along with the logistical infrastructure required to deliver them, these people—and again, they number about twenty—will be responsible for almost every death from Covid19. Some blame, too, should be assigned to the Russian bots and trolls who boost their message, as well as to everyone who refuses to confront them. Some blame should be assigned to public health agencies who have been incompetent in combating them. And of course, at the end of the rope, is individual agency. People who are credulous enough to believe them are, ultimately, the authors of their own fate.

But there is no reason on God’s good earth, apart from this propaganda, for people to fear a vaccination that can not only save their lives, but prevent them from becoming angels of death to their families, their communities, and their countries. The reluctance to be vaccinated is purely a product of these lies. It’s not a natural phenomenon. Anti-vax sentiment was not widespread in the modern world before the advent of the Internet and the rise of these ghoulish entrepreneurs. There is no other good explanation for it.

No one in his right mind would decline safe, effective vaccinations against diseases that have long been the scourge of mankind, or against a deadly new pandemic. No one in his right mind would want an unnecessary risk of contracting a deadly or disabling disease, or, worse still, giving that disease to someone he loves. Declining to be vaccinated only makes sense in the context of the belief that the vaccines themselves are deadly. The notion that vaccines are deadly is a lie. The risks are so small they can barely be disambiguated from the risk of being alive.

The people who spread this lie are not spreading an offensive but harmless opinion. The anti-vax movement is an authentic modern death cult. Internet platforms are entirely justified in saying they won’t be party to its spread, just as they were entirely justified in saying they would not host ISIS recruitment propaganda. No private citizen or entity should be forced to spread any view he or she doesn’t feel like spreading; to suggest a private citizen or entity be forced to spread the views of a death cult—one that directly threatens them and their families—is contrary to reason, established law, and any normal moral instinct.

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So what do we do about this?

If people can so easily be led to think that vaccines—achievements that represents the height of scientific achievement and the power of modern medicine—are deadlier than a virus that has caused their own local morgues to overflow, we have a problem that goes well beyond the issue of vaccines. Social media censorship, while justified, is a completely inadequate remedy. The problem is the incentive structure of social media itself.

Here is what won’t work:

It won’t work for Tony Fauci to say, “What’s that all about?” We know what it’s about. The people who are cheering believe the vaccines are dangerous. They will not be dissuaded from this view upon being told, “Dr. Fauci is horrified.”

The marketplace of ideas only works to sort good ideas from bad ones if people have the opportunity to hear the other side of a bad argument. Otherwise, it serves to reinforce bad ideas and create pockets of medieval superstition in the heart of the world’s most scientifically advanced democracies.

Here’s one suggestion. I don’t know if it would work, but what we’re doing isn’t working, so why not try it? Why don’t we give prominent anti-vaxxers the public platform they so crave contingent upon their willingness to debate Dr. Fauci? The full debate could be the first thing people see when they look at anti-vaxxers’ accounts. If Fauci’s not up for it (and I suspect he isn’t), find someone who is. Nominate him, or her, our designated National Debater against Anti-Vax Lunatics. Make it a full-time job. Create a new federal bureau, even. Put the head of this department in the Cabinet. But the anti-vaxxers must be countered, publicly, in a way such that everyone can hear the debate.

Instead of censorship, debate. At every turn. We can’t ignore this phenomenon anymore. Nor can we pretend that the words, “The CDC says,” or “Scientists say,” have sufficient persuasive power. They don’t. We’ll be living with this pandemic forever—and all of our freedoms and rights, including our right to life, will be threatened by it—until we defeat the anti-vaxxers. We can’t pretend this is a fringe movement that won’t have an effect on our ability to end the pandemic. It isn’t. It will.

The anti-vax superspreaders must be shamed. They must be shamed not by calling them evil—although they are—but by exposing all of their arguments, one by one, as worthless, and exposing them as profiteering frauds.

Honest people who are simply confused, however, should not be shamed. We must acknowledge how profoundly difficult it is for people who feel let down by the government and the academy—often for good reason—to know who to trust.

They’ve been let down by us. In democracies, the government is We, the People, and we’ve let them down, first, by failing to provide them with a basic education that leaves them literate and conversant with science and mathematics. We’ve let them down by failing to modernize our dinosaur public health agencies, who seem to be incompetent, when push comes to shove, staffed by men and women who don’t seem to realize the year is 2021, who have not adapted to the new technology that drives public discourse, and do not understand the culture of the people with whom they’re trying to communicate.

We’ve let them down by doing nothing to rein in the tech giants, who have transformed their platforms into dystopian engines of misinformation and brainwashing—products incompatible with liberal democracy and the culture required to maintain an advanced, scientific society.

We’ve let them down by offering them a dangerous and addictive product, one of which humanity has no experience, one that is is capable of scrambling human brains and persuading people that up is down, black is white, wrong is right, and vaccines are deadly rather than lifesaving. We need to get our hands around this problem, fast. We need to squeeze the necks of Big Tech until they redesign these faulty and dangerous products so that they’re no longer an existential risk to advanced societies. If they don’t do it fast, they should be broken up. And the rest of us should have the right to sue them for every bit of harmful content they publish.

How should they redesign them? I don’t know and don’t care. That’s their problem. But they need to do it, fast, because their product itself is a catastrophic risk.

1. Yes, we admit it. It’s a month, not a week.

2. An imprecise estimate based on YouGov polls in the US.

3. They list Joseph Mercola, Robert F. Kennedy, Jr., Ty and Charlene Bollinger, Sherri Tenpenny, Rizza Islam, Rashid Buttar, Erin Elizabeth, Sayer Ji, Kelly Brogan, Christiane Northrup, Ben Tapper, and Kevin Jenkins. The report antedated the recent contributions of Alex Berenson, Bret Weinstein, Robert Malone, Steve Kirsch, and Tess Lawrie.

4. A Detailed Study of Patients with Long-Haul COVID.

5. Weinstein’s new book is now the top release in evolutionary psychology on Amazon, however.