For the Record, I’m not an Epidemiologist

Hello, friends.

A guy named Adam Graham writes a column for “Caffeinated Thoughts.” Couple days ago, Mr. Graham publicly accused me of impersonating an epidemiologist and misquoting a famous doctor. I wish to object. What follows are my responses to Adam’s accusations, and one more attempt to explain my decision to return to my job as a “non-essential worker” in the age of coronavirus. It’s long, but, it’s the weekend, and the topic impacts all workers – essential and otherwise. So, pour some coffee, and settle in…

AG: In his eight seasons of hosting Dirty Jobs, Mike Rowe has done numerous grimy difficult jobs. However, after a recent Facebook post, it’s clear there’s one job Rowe should avoid: epidemiologist. His attempts to do the job have misrepresented the work and advice of one of America’s leading infectious experts.

MR: Hi there, Adam. Mike Rowe here. For the record, I’m not an epidemiologist. I have never claimed to be an epidemiologist, nor have I tried to do the job of an epidemiologist. I’ve never even played an epidemiologist on on TV. As for your accusation of misrepresentation, let’s see what you’ve got.

AG: A fan challenged Rowe over his decision to film his TV program and make speeches in COVID hotspots such as Georgia and Tennessee. To be fair to Rowe, his travels and work are not in violation of state health orders, and he’s taking precautions such as social distancing and wearing a mask. If Rowe had provided this answer, he would have been fine. However, Rowe had to go further than that.

MR: I chose to answer a question from a fan named Darlene Gabon, as honestly as I could – not as an epidemiologist, but as guy working in what she called a “non-essential job.” I went as far as I had to go to explain my rationale for going back to work.

AG: Beyond his TV show, Rowe has a reputation as an Internet folk philosopher.

MR: I do?

AG: Rowe offered his philosophical approach to COVID using a notable epidemiologist as the basis for his decision. He cites Dr. Michael Osterholm. He says Osterholm is “the only expert I know of who hasn’t walked back his numbers, reconsidered his position, or moved the goalposts with regard to what we must do, what we can do, and what he expects to happen next. I say all of this because Dr. Osterholm also publicly predicted – in early March – that we could conservatively see over 100 million COVID cases in this country, with a very strong possibility of 480,000 fatalities – even if we successfully ‘flattened the curve…’” Rowe’s philosophical conclusion is: “By late April, I had come to accept Dr. Osterholm’s predictions as a matter of fact. Since then, I’ve had three full months to come to terms with the fact that, a) I am probably going to get COVID-19 at some point, b), I am almost certainly going to survive it, and c), I might very well give it to someone else.”

MR: True, those were my words, and I can see how they might sound glib, especially taken out of context. But I can’t very well accept the possibility of 100 million infections in a country of 330 million people, and not accept the possibility that I might be among those who get it and spread it. This “acceptance,” however, of Dr. Osterholm’s admittedly grim prediction, did not led me to a “philosophical” conclusion. It led me to a practical conclusion, based on his belief that COVID-19 is a highly transmissible disease that simply isn’t going away anytime soon. This was the crux of Dr. Osterholm’s message in March. Today, his fundamental message hasn’t changed. Here he is again, from an interview with Market Watch, published August 1st, just two days ago.

“We will be dealing with this virus forever. Effective and safe vaccines and hopefully ones with some durability will be very important, but the whole world is going to be experiencing COVID-19 ‘til the end of time.”

This is what I’ve accepted. Coronavirus is here to stay, and we must find a way to live our lives in its presence. That was the essence of my reply to Darlene, and the reason I chose to return to work, albeit as safely as possible.

AG: The problem according to Rowe is that millions of Americans haven’t accepted the reality of death, disease, and infections and that we need to get on with it and just accept our eventual infection with COVID-19, hope for our survival, and live with the results of our spreading the virus to others.

MR: I’m not nearly as blasé as your summation makes me sound. This thing is deadly serious, and I don’t take it lightly – especially with two elderly parents in a high-risk category. But I do think a little perspective might be in order. This coronavirus may be “novel,” but in spite of what cable news would have us believe, the risk it poses to the species is nothing new, and neither is the fear that comes with it. As C.S. Lewis famously said in 1948, in his attempts to calm a paralyzed America in the advent of the atomic age, “Let us NOT begin by exaggerating the novelty of our situation. We were already sentenced to death long before the atomic bomb was invented.”

On the positive side, the overwhelming majority of people who contract the virus are not going to die from it. That too, is a simple fact that no epidemiologist disputes, and pointing that out doesn’t mean I’m trying to “downplaying the danger.” Dismissing it however, robs us of all perspective, and leaves people irrationally fearful. The real risk of dying from COVID should neither be ignored nor exaggerated.

AG: In all fairness to Rowe, he’s not reckless, as evidenced by his incorporation of masks and social distancing.

MR: Thanks. For the record, I also buckle up, look before changing lanes, obey the speed limits, keep my car well maintained, and drive sober. Then, in spite of six million accidents and 40,000 annual fatalities, I drive anyway. This is why most rational people are able to operate an automobile in spite of the obvious danger – they first assess the risk, then they adapt their behavior, and then, they proceed with caution. This is also how people will live their lives in the age of coronavirus. What choice do we have?

AG: The question isn’t whether he’s a horrible person, but whether he’s accurately represented the science as explained by Dr. Osterholm.

MR: We can certainly discuss my relative “horribleness,” the accuracy Dr. Osterholm’s predictions, or the accuracy of my representation of his position, but if you make that question “the” question, then you’re avoiding the whole point of my answer – i.e, to suggest to Darlene that she and many other Americans are grieving, and that grieving is a process – a process that ends with acceptance, but requires us to first pass through four other stages – denial, anger, bargaining, and depression. Osterholm’s predictions in March, accurate or not, sent me hurtling through that process. His projection of 100 million cases got my attention, and his prediction of a long term event helped me come to terms with the seriousness of the disease. Thus, I’m not shocked today by the announcement of 4.5 million cases in America. I’ve been expecting them. Nor am I paralyzed by the possibility of contracting a virus that probably won’t kill me.

Again, I don’t want to spread COVID anymore than I want to cause a car wreck. But like I said, I can’t very well accept the prospect of being among the hundred million who might become infected, without accepting the possibility that I might give it to someone else. And so, I have accepted both eventualities as possible, and gone about the business of trying to protect myself from getting it and spreading it while getting back to my life.

AG: Rowe stated what Osterholm said in March of this year. The most likely source for that was Osterholm’s appearance on the Joe Rogan Experience.

MR: That’s funny, Adam. The Joe Rogan Experience is the “most likely” source because I provided the link to the interview in my original answer to Darlene. What you did, Adam, was click on it. You’re welcome!

AG: Reviewing the transcript, there are some critical differences between what Osterholm said and what Rowe thinks he said. Early in the transcript, Osterholm states, “I brought some numbers. We conservatively estimate that this could require 48 million hospitalizations, 96 million cases actually occurring, over 480,000 deaths that can occur over the next three to seven months with this situation.” However, more than thirty-eight minutes in, Osterholm mentions that the projection comes from the American Hospital Association. The transcriptionist should have put quotations marks around the information quoted, starting with the phrase, “We conservatively estimate.” That it’s a quotation from someone else would also explain why Osterholm read “48 million” hospitalizations rather than the 4.8 million listed in the actual report. These were not numbers he produced.

MR: “Critical differences?” With respect, Adam, do you really suppose a highly respected epidemiologist like Dr. Osterholm would have shared numbers he disagreed with from a source he didn’t trust? His whole purpose in appearing on Rogan’s podcast was to articulate the seriousness of the virus, which he did with great success. (Obviously, “48 million hospitalizations” was a simple mistake – a misreading that he later corrected.)

AG: Rowe spent quite a bit of time in his posting touting Osterholm’s credentials as a basis for deciding to accept Dr. Osterholm’s prediction, which wasn’t his. The whole tenor of Osterholm’s message was not to say that COVID-19 had 480,000 inevitable deaths. Instead, he mentioned this potential death count to tell us, “this is not one to take lightly.”

MR: Again, the source of Osterholm’s numbers is not relevant. The fact that HE shared them is what makes the numbers credible. That’s why I took some time to make sure people understood that Dr. Osterholm is a leading scientist and highly respected epidemiologist. Right now, he appears to be the most respected scientist in his field. Obviously, a man like that wouldn’t share numbers from a source he didn’t trust.

AG: The 480,000 figure also was not a final bottom line score for COVID deaths. The estimate, as stated originally in the show, was over a three-to-seven-month period. Later, Osterholm said between six and twelve months. In the latter case, the death rate would have to accelerate considerably from the 150,000 we’ve seen in the five months for there to be 480,000 deaths on February 26, 2021, 12 months after the presentation. In the former case, it would have to escalate catastrophically for us to have another 330,000 additional deaths by September 26. So, the prediction, as Rowe explained it, isn’t the actual prediction. It wasn’t predicted by the person whose authority he’s relying on, and it’s probably going to be proved inaccurate.

MR: I never claimed that Dr. Osterholm’s predictions would be correct, or incorrect. I simply said that I accepted his prediction as credible and persuasive, just as I’ve accepted the likelihood of six million traffic accidents and 40,000 fatalities. Time will tell if he’s right or wrong. As for the time frame, yes, he did say the spread could happen over the next seven months. But he also said the disease itself would be with us for a very long time. Which begs the obvious question – if we flatten the curve without eliminating the virus, (which we’ve done,) and if we can’t remain locked down indefinitely, (which we can’t,) how then, are we to live our lives in the presence of COVID?

Seems to me that the first step is to accept the fact that COVID is here to stay. The second step is to accept the fact that COVID is going to infect a lot of people. The next step is to either proceed with caution, or abandon your former life.

AG: Rowe credits Osterholm for consistency in the advice, prescriptions, and numbers he’s shared. But how consistent has Osterholm been? In the Joe Rogan interview, like most of the medical community, Osterholm was down on the idea of masks. He said, “People wear them, they look like they’re doing something, they’re not.” However, Osterholm’s view has changed: “I want to make it very clear that I support the use of cloth face coverings by the general public. I wear one myself on the limited occasions I’m out in public. In areas where face coverings are mandated, I expect the public to follow the mandate and wear them.” He does take a more nuanced view than some and worries about members of the public “using masks to excuse decreasing other crucial, likely more effective, protective steps, like physical distancing.”

MR: Fair enough. I shouldn’t have implied that the doctor hasn’t reconsidered ANY of his COVID-related positions. I only meant to say he hasn’t walked back any of his initial predictions. As far as I can tell, Dr. Osterholm still believes that we could see upwards of a hundred million cases in this country. If it turns out those numbers are way too high, fantastic! I’ll be genuinely relieved. Just like I’ll be genuinely relieved if automobile accidents come in under the six million we anticipate, and fatalities wind up under the 40,000 we’ve been told to expect. Regardless, I’ll still continue to drive with caution, just as I’ll continue to work with caution.

AG: Osterholm has also provided different death numbers. In a June interview with NPR quoted in the Iowa Press-Citizen, he stated, “about 200 million Americans would be infected and between 800,000 and 1.6 million Americans would die from COVID-19 in the next 18 months if we don’t have a successful vaccine or take preventative measures.”

MR: I’m not sure I understand the point of predicting infection rates and fatalities if we take no preventative measures…since we ARE in fact, taking all sorts of preventative measures. That’s a bit like saying, “if everyone refuses to wear safety belts and starts driving a hundred miles an hour while drinking gin, we could see a million traffic deaths!” Respectfully, I’d file a prediction like that under, “Obviously!”

Also, back in March, Osterholm’s numbers weren’t presented as a warning about what could happen if we did nothing; they were presented as a warning of what could happen in spite of what we do. “This is not a coronavirus blizzard,” Osterholm said. “This is a coronavirus winter. It’s going to be with us for a very long time.”

He was also clear that until we reach herd immunity or develop an effective vaccine, we’d have to find a way to live with the virus, presumably with new and ever-evolving safety protocols and medicines to lessen the severity of the inevitable infections. To accept it, in other words, even as we fight it.

AG: Additionally, during the Joe Rogan interview, he often compared COVID-19 to the flu. However, in an interview with CBS in July he admitted a shift stating: “This is a coronavirus that is not acting like a flu virus.” Osterholm hasn’t been saying the same thing over the last four months, nor should he have been. COVID-19 was unknown to mankind until last year. Until six months ago, all the information we had on it came from a totalitarian regime in China that can’t be trusted. Scientists talking about COVID-19 in the same way they were in March aren’t being consistent, they’re being bad scientists.

MR: Clearly, Dr. Osterholm has refined a few of his opinions over the last few months, as any sensible scientist would do in the face of new data. Again, I was simply trying to tell people that Dr. Osterholm hasn’t backed off his core belief that COVID-19 is a highly transmissible disease that’s here for the long term, and will likely kill a fraction of a percent of the population. On that score, he’s been very consistent, as his most recent interview, attached, demonstrates.

AG: Part of the problem goes back to the politicization of science, with many activists (particularly among progressives) treating science as a religion and claiming, “You have to agree to my agenda because science says so.” This isn’t how real science works. Science isn’t a religion with a creed. As Osterholm said in his piece on masks, “Science, when done well, can be messy, imperfect, and slower than we wish… Public health policy—including COVID-19 response—should always be informed by the best data available and should evolve with scientific knowledge.” Watching science in action is frustrating for the public, and there should be more humility in scientific pronouncements. Reasonable people should understand that real scientists aren’t trying to pull the rug out from under citizens. Rowe takes an approach of whoever’s going to get sick is going to get sick, and whoever’s going to die is going to die.

MR: I agree that science is indeed frustrating, and rarely as “settled” as we wish. But you’re mistaken to suggest I’m blasé about my own mortality, or anyone else’s. I don’t want this disease, Adam, and I don’t want to spread it. But if the virus is here to stay, as Osterholm clearly believes it is, I’m not inclined to spend the rest of my life hiding from a pestilence that has very little chance of killing me. That’s why I decided to get back to work, cautiously. But you’ve twisted my position into a fatalistic interpretation that’s leaves everything up to chance. We can’t be in a world where people are forced to choose between locking down till the virus is gone, and throwing caution to the wind because we’re all gonna die anyway! I reject both of those options. I believe we should instead accept the things we cannot change, understand the risk at hand, and then proceed with caution.

AG: On the other hand, Osterholm is far from shrugging and singing Que Sera, Sera about COVID-19.

MR: Neither am I. I’ve never once shrugged my shoulders, sung Que Sera Sera, or made any reference to Doris Day, (who’s terrific, btw.) Nor have I ever downplayed the severity of the virus or tried to minimize the danger it poses. As you kindly acknowledged above, I am not a reckless person. I take precautions. I hedge my bets. And I encourage others to do the same.

AG: In an interview on July 28 with NPR, Osterholm called for “a kind of second lockdown. And this time let’s get it right.” This is far from the first time that Osterholm has hinted at a second lockdown. He cites European Countries as evidence for this: “Those countries that were on fire last spring and then did a lockdown are now the ones that have been successfully reopening. Their economies are back, they’re enjoying life — and they’re still maintaining control over the virus.”

MR: Are you sure about that? The latest news from Europe is not so rosy. Check it out. But second waves in Europe notwithstanding, a national lockdown here will have deadly consequences that many experts believe will be more devastating than COVID, especially among children. Experts like the director of the CDC, According to Robert Redfield, “We’re seeing far greater suicides now than we are deaths from COVID. We’re seeing far greater deaths from drug overdose than we are seeing deaths from COVID.”

As for, “a kind of second lockdown,” I’m all in favor of treating hot spots differently than cold spots. There will certainly be parts of the country where the curve will need more flattening, in order not to overrun the hospitals. On the other hand, we shouldn’t assume that most hospitals are already overrun or nearing their capacity. The vast majority are not. Mostly though, we have to remain cognizant of the unintended consequences that come from locking down the country and keeping our schools closed. That’s not living with COVID – that’s hiding from it.

AG: Outside of Europe, New Zealand had less than two dozen deaths and has so successfully contained the virus; it’s news when they have one positive test among quarantined international travelers. The country has not had a single case of community spread in months and has been enjoying things like six thousand people attending concerts.

MR: Good for them! I’m happy for the Kiwis, sincerely. But New Zealand, as you may have heard, is an island with the population of Kentucky. We’re a country of over 330 million people, spread across 48 interlocking states, each with a porous border and an autonomous governor. It’s simply not a sensible comparison.

AG: Americans will have a lot of COVID-related deaths over the next six months and a lot of hardships and frustrations, much of it preventable.

MR: You’re probably right. We could probably delay many COVID fatalities over the next six months by shutting everything down. Just as we could delay additional fatalities by keeping our cars in the driveway, our ships in the harbor, and our planes on the tarmac. But if you believe we can wipe this thing out by staying inside, you’re not only disagreeing with me, your disagreeing with Dr. Osterholm. His most recent words are worth repeating:

“We’re not going to be vaccinating our way out of this. We’ve really got to come to grips with actually living with this virus.”

AG: Mike Rowe illustrates a big part of why we have this problem.

MR: Why, exactly? Is it because I’m skeptical of our media? Is it because I’m skeptical of those running for office? Is it because I dared to legally venture out into the world to earn a living while exercising every recommended precaution? Sorry Adam, but no reasonable person today can be blamed for adapting a measure of healthy skepticism. We the People have been overwhelmed with a mind-boggling amount of contradictory information and mixed messages from every front. And yet, this endless flood of incongruous information continues to be served up with an appalling level of certainty, only to be walked back again and again without a shred of humility. How exactly do you propose we make sense of it all?

AG: Rowe managed to use Dr. Osterholm’s authority to support a prediction that Ostherholm quoted rather than made. Based on that prediction and a misstatement of Osterholm’s positions, Rowe reached a conclusion totally at odds with Osterholm’s actual view on COVID-19 and how to manage it.

MR: Obviously, we disagree. I hold Dr. Osterholm in the highest regard, and I used his comments to explain my rationale for getting back to work. Nowhere has the doctor discouraged healthy people who take the recommended precautions from legally traveling around the country to make an honest living. To suggest otherwise is simply bizarre.

AG: A flawed argument by a Cable TV host wouldn’t be important except he shared it with 5.7 million followers on Facebook, and, as of this writing, they have shared this nearly 170,000 times. It’s very probable that thanks in part to Mr. Rowe, more people are aware of his characterization of Osterholm’s views than of Osterholm’s actual views.

MR: I don’t know how to break it to you, Adam, but it’s worse than that. My “flawed argument” has now reached over 15 million people! (Crazy right?) On the positive side, your trenchant rebuttal has now been shared with that very same audience. You’re welcome!

AG: Rowe would do well to consider King David’s wisdom, who didn’t concern himself with matters too profound for him. (Psalm 131:1)

MR: Ah, yes. King David. Smart fella. Humble. Didn’t he also send a man into battle so he could sleep with his wife? Oh well, nobody’s perfect, right?

AG: Americans should be sure the people they listen to know what they’re they’re talking about.

MR: Agreed. But again, how do you propose we Americans do that? If you want us to listen to the experts, which experts? If you want us to listen to journalists, which journalists? If you want us to listen to politicians, which politicians? I know I’m just a guy on the tee-vee, and I realize you think the topic at hand is beyond my grasp. But with respect, is it really within yours? I visited your page, Adam, and read about your failed bid for elected office, your prior working relationship with Rick Santorum, and your long-term tenure as a professional Sunday School teacher. Nothing wrong with any of that. But what is it about your background that qualifies you to weigh in on such important matters, and what is about mine that doesn’t?

AG: Rowe has excellent thoughts on education and the need to help kids find blue-collar careers rather than pushing everyone off to college. He knows what he’s talking about on that topic. However, with COVID-19, not so much.

MR: Hmm…It’s tempting to conclude from this that that my thoughts are “excellent” when they mirror your own, but when they don’t, I’m “part of the problem.” Would that be a fair conclusion?

AG: A study showed New Zealand defeated COVID-19 by its people following guidelines and listening to their health experts. America is losing its battle with COVID-19 by its people rebelliously ignoring the advice from experts. Instead, people use whatever arguments they find to do whatever they want, even if it means relying on the host of Dirty Jobs for guidance.

MR: So…that’s your advice to the world? “Don’t listen to the Dirty Jobs Guy?” You couldn’t have said that without accusing me of impersonating an epidemiologist and misquoting a famous doctor? Obviously, I believe your accusations to be unfair and unfounded, but I’m willing to turn the other cheek. (Matthew, right? 5:39:41?) Seems a magnanimous thing to do, in these unforgiving times. I will say however, that you sound very much like a man who’s still in denial…

I wish you well on your journey to acceptance.


Dr. Osterholm: Americans will be living with the coronavirus for decades
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