Welcome to Impact Factor, your weekly dose of commentary on a new medical study. I'm Dr F Perry Wilson of the Yale School of Medicine.
How much do you feel it is justified to threaten public health officials when they close businesses to slow the transmission of COVID-19 disease?
My reflexive answer to this question, which was posed at multiple pandemic time points to a nationally representative sample, was a quick "never." We shouldn't be threatening anyone, whether or not they are a public health official. But, as you may have guessed, my reflexive answer is not exactly representative of the US population currently, whose antagonism to public health officials has risen — and not entirely among the people you might expect.
We're talking today about this study, appearing in JAMA Network Open.
Researchers from Johns Hopkins, leveraging a longitudinal panel survey known as Amerispeak, asked whether harassment or threats to public health officials are justified. The results are, honestly, pretty depressing. Let me give you the highlights.
In November of 2020 (pre-vaccines) in the thick of the first year of the pandemic, 20% of Americans felt that harassing public health officials for closing businesses was justified, and 15% thought threatening them was. By July and August of 2021 (post-vaccines), when, I will remind you, no public health officials really were closing businesses, those numbers went up even higher — to 25% and 21%, respectively.
Threats against these individuals were common. Anthony Fauci received multiple death threats, one of which led to an arrest. And though I am not a public health official, I suppose I face the public a bit more than most docs, and my inbox is routinely graced with letters like this, which I summarily delete and do my best not to think about again.
The characteristics of those who felt threats were justified were fairly revealing. In November of 2020, in the Trump era, more Democrats than Republicans felt it was OK to threaten public health officials. These results largely flipped by August of 2021, 8 months into the Biden presidency.
This is intriguing, as many of the public health officials that one could consider threatening haven't actually changed over time. Sure, we have fewer Scott Atlases right now, but we have just as many Anthony Faucis.
This speaks to the overt politicization of public health in the pandemic era — an incredibly frustrating development, one that we seem to have been completely unprepared for, and one that I'm not sure we can recover from.
Of course, in terms of single traits predicting support for threatening public health officials, the single most powerful factor was "trust in science." By 2021, nearly 50% of individuals who, when asked whether they trusted science, reported "not much" or "not at all" said that threatening public health officials was justified.
I have to take a bit of an aside here to say that I personally don't really like the question, "Do you trust science?" It's the type of question that sounds totally clear when you ask it — sure, I trust science — and then the more you think about the more you're not sure exactly what it means. I trust the scientific method, certainly — the practice of discovering new knowledge through experimentation and unbiased observation. But nowadays, I think the idea of "trusting science" has been conflated with the idea of trusting experts, and so of course those who say they don't trust science would be more tolerant of threats against public health officials.
To be clear, I'm not saying we shouldn't trust experts. Experts are, you know, experts. They are good people to ask when you have a question that is in their area of expertise. All I'm saying is that science is bigger than experts.
Concerningly, even those who reported that they trust science a lot were much more likely to say that threats were justified in 2021 compared with 2020.
To be fair, some of this increased tolerance for threats may reflect broader societal trends. The percentage of people who said that threatening politicians was ok jumped between 2020 and 2021 as well.
It's hard to look at numbers like this and not feel that we are witnessing some sort of social breakdown. When do we resort to harassment and threats? When we feel we have no other recourse — when the people who run our lives, whether they are politicians, or, in a pandemic, maybe public health officials — don't seem to be responding to our needs.
No doubt this will be analyzed to pieces in the future, when "pandemic studies" becomes a college major.
And perhaps at that future date, threatening public officials will be considered the best way to express your personal political beliefs.
But I hope not.
F. Perry Wilson, MD, MSCE, is an associate professor of medicine and director of Yale's Clinical and Translational Research Accelerator. His science communication work can be found in the Huffington Post, on NPR, and here on Medscape. He tweets @fperrywilson and hosts a repository of his communication work at www.methodsman.com.
Image 1: JAMA Network Open
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Cite this: F. Perry Wilson. When Did It Become Acceptable to Threaten Public Health Officials? - Medscape - Aug 01, 2022.