‘If we don’t, others will’: White House Covid adviser calls on doctors to combat a vacuum of medical information

WALTHAM, Mass. — The coordinator of the Biden administration’s Covid-19 response team called on doctors to take a leadership role with patients to battle medical misinformation and disinformation, linking the continuing death toll in part to such erroneous messaging.

Speaking to an audience of physicians at a conference near Boston Friday, Ashish Jha reminded them they are skilled at dealing with uncertainty, just as when they explain to a patient they don’t know whether what a medical scan shows will be terrible or not, but that they will guide them through it. The uncertainty of the pandemic is no different, he said, but since people have so many different sources of information to consult now, doctors need to step up.

“What we have seen is the widespread propagation of misinformation and disinformation. And the reason it has taken root is because there was an information vacuum,” Jha said to the group, convened by the Massachusetts Medical Society with support from the New England Journal of Medicine Group. “I come back to our role as physicians. It is critical that we fill that vacuum because if we don’t, others will.”

Over the last year in the White House, Jha has seen an average of 250 to 500 people dying of Covid every day, despite plentiful free vaccines and treatments.

“If you are up to date on your vaccines and you get treated with Paxlovid, if you get an infection, you just don’t die of this virus. Almost no one dies of this virus,” he said. “Almost every one of those deaths is preventable. And yet people are still dying. And that is the power of misinformation. That is the power of disinformation that we all have to work on countering.”

Jha also blamed misinformation and disinformation for death threats that require security teams to protect CDC Director Rochelle Walensky and former NIAID Director Anthony Fauci, perhaps the best-known examples of people in health and public health who’ve been targeted.

Jha also warned that a revisionist history of the early pandemic is taking hold. When the novel coronavirus was first spreading, the only tools at hand were countermeasures like social distancing and masking, followed by lessons learned in hospitals that led to administering dexamethasone, a better understanding of who needed a ventilator and who didn’t, and the role of proning to help patients breathe. “Our hospitals were overwhelmed. People were dying in extraordinary numbers,” he said. “We did not overdo it.”

Those tools bought us time, Jha said, from April 2020 when hospitalized patients had a 50% chance of dying to when a vaccine authorized in December 2020. Now the set of tools enabled by the Public Health Emergency will end. Two of the provisions he mentioned: allowing hospitals to set up beds in parking lots and changing rules around supervision so residents could do what only attending physicians were authorized to do before. “We no longer felt like that was critical at this moment in where we are with this pandemic,” he said. “Not to say that Covid is over.”

Jha also acknowledged that long Covid is not over for millions of Americans who are suffering or debilitated by it. It’s also “not totally surprising” because of other post-viral syndromes. But “we think that SARS-CoV-2 is probably worse. … And long Covid is not one condition.”

As horrendous as the pandemic has been, it has also created innovations worth sustaining, he said. Telehealth is an obvious one, along with home testing for Covid, flu, or other illnesses, and test-to-treat, a one-stop model of health care. Further behind is better building ventilation, which Jha calls a passion of his.

Improving air quality can reduce infection by 80%, he said, citing an Italian study that said influenza and RSV were lowered that much by changing the air. And it’s doable, “not super expensive,” and important for hospitals overwhelmed by infection-intensive winters, he said. “You’re not asking people to change behavior, right? You’re not saying everybody has to wear a mask indoors for the next four months.”

Speaking more broadly, Jha said the ongoing crisis has exposed the need for leadership. “We’re talking about the important role of political leaders, people who marshal resources and bring the country together. We have not always been blessed with such leaders, but we’ve had some great ones,” he said. “We’ve also needed a different type of leader. Physicians are particularly well-poised to play this role.”