Data, disease and division: Osterholm returns to Gustavus' Nobel Conference

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Oct. 6—ST PETER — In 2006, epidemiologist Michael Osterholm spoke at Gustavus Adolphus College's Nobel Conference, discussing the likelihood of another influenza pandemic and predicting the consequences.

"Economic and social disruption will be great. Every country must be prepared," Osterholm said 15 years ago. "... And non-pharmaceutical intervention such as quarantine, infection control, social distancing are going to have a limited impact. ... Our hospitals are already overstressed. We're going to hear more about that. ... It's not a matter of if, just when and where. ... Planning is not an option. Yet we keep postponing it."

On Tuesday, Osterholm had a return engagement at the Nobel Conference. Although this year's conference was online due to the COVID-19 pandemic, his speech wasn't entitled "I Told You So." Instead, he talked about data science in the current health crisis as part of the Nobel Conference theme for 2021: Big Data Revolution.

Much of his presentation was a concession that scientists still have little understanding of the course an epidemic will take. Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, showed charts of the waves of new infections in previous pandemics and in the current one as it devastated different parts of the globe at different times.

In most cases, the ebb and flow didn't appear to be related to public health policies or government dictates.

"We have no real understanding of why," he said. "It cannot be attributed to human behavior no matter how much we wish it were so. ... As I've said over and over, 'We're riding this tiger, we're not driving it.'"

As to whether quarantining, masking and social distancing make a meaningful difference, there's little hard data, according to Osterholm: "I will tell you today, it's very unclear."

Osterholm wasn't particularly complimentary about pandemic modeling, either. He showed the forecasts from Britain's Imperial College, from the University of Washington and from the Minnesota Department of Health/University of Minnesota and was particularly disdainful of the University of Washington's predictions for as much as six months in the future, complete with huge ranges of possible daily death totals.

He compared it to forecasting the weather now for a particular day in January: "If I said it would probably be between 60 below and 60 above, I'd probably be right. But what good is it?"

Then he showed a model by the Centers for Disease Control, which combines the forecasts of multiple other models and never projects more than four weeks into the future.

"Now this is responsible modeling," Osterholm said.

The effectiveness of mask-wearing in slowing the spread of COVID-19 is a much more complex question than most media stories imply. Properly fitted hospital-grade masks can be extraordinarily effective in preventing exposure when worn by both an infected person and by an uninfected person in close proximity, he said. "Simply putting a cloth face covering on your face doesn't do that."

That lack of understanding — about the difference between the aerosol-spread of the COVID-19 virus versus a disease that travels through droplets coughed or sneezed by an infected person — was also responsible for the largely pointless "hygiene drama" where public places were repeatedly disinfected and plexiglass barriers were placed in stores, according to Osterholm.

In some instances, though, the available data is rock solid. The safety of the vaccines is crystal clear, according to Osterholm. It may not be known yet how long the protection lasts or the most effective number and spacing of doses, but they are safe and effective.

He talked about the misuse of the Vaccine Adverse Event Reporting System by vaccine opponents. The database, created in 1990 by the CDC and the Food and Drug Administration, collects information on all major health problems that occur after someone is vaccinated. VAERS doesn't distinguish between health issues that were caused by a vaccination and those that happened coincidentally. Its purpose is to spot trends and then begin an investigation of a possible correlation if a trend pops up.

For example, Osterholm said, in a group of one million men between the ages of 55 and 64 who do not receive a vaccine, 79 would suffer a fatal heart attack and 74 would have a stroke in a typical week. If that same million-man group received the vaccine, those reports of heart attacks and strokes would show up in the VAERS system.

Some people, including unscrupulous politicians, are using those statistics to imply the adverse health effects were caused by the vaccine, he said.

The vaccines have undergone rigorous study and extensive clinical trials, and their safety has been verified in hundreds of millions of doses administered this year, but 70 million Americans are still refusing to get the shot, Osterholm said. Many of the people most antagonistic to the vaccines are willing, by contrast, to use an anti-parasitic drug most commonly used in horses. The largest study suggesting possible positive benefits of using that drug, Ivervectin, has been found to be fraudulent. And there's plenty of evidence that Ivervectin is causing harm to many people taking it.

Nonetheless, hospitals are being sued for refusing to prescribe Ivervectin for COVID patients.

"Imagine family members who wouldn't vaccinate loved ones now in court trying to get Ivervectin used," he said.

After nearly a half-century working in public health and infectious disease control, including leading the response to the 1995 meningitis outbreak in Mankato, Osterholm appeared to be at a bit of a loss when it comes to America's current partisan divisions. A common guest on television news programs, Osterholm said he's faced more invective, even death threats, in the past 18 months than in all of his previous years. And that's despite advising both Republican and Democratic presidents and governors, and keeping his party preferences closely guarded.

"This country has never been like this before," he said. "Our country is ripping apart."

Despite that, public health professionals and scientists have no choice but to continue their efforts to inform the public and provide evidence-based advice to policymakers.

"I liken it to trying to plant petunias in a category 5 hurricane," Osterholm said. "It's going to be tough."