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The Anti-vaccine Con Job Is Becoming Untenable

The Anti-vaccine Con Job Is Becoming Untenable

When I was in my early twenties, I discovered The Atlantic magazine. Soon, I decided it was one of the best all around magazines available for general reading about news events, culture, art and a grab bag of other editorial focused articles.

Today, deciding if The Atlantic skews one way or the other for the sake of building a pro or con case to reading it, is as much a waste of time as assessing any other magazine or periodical.
Where humans are involved, skews follow. What matters here, and everywhere else, is the quality of writers, research sources, and the presence and verification of facts, where applicable.
 
The Atlantic deserves a read for intelligently thought out perspective, and novel coverage like the article that follows below… >MB


https://www.theatlantic.com/ideas/archive/2021/08/vaccine-refusers-dont-want-blue-americas-respect/619627/

Full article pasted in for those who can not access the link. Courtesy of The Atlantic magazine.

The Anti-vaccine Con Job Is Becoming Untenable

Why targets of deliberate deception often hesitate to admit they’ve been deceived

By Brooke Harrington
AUGUST 1, 2021

Something very strange has been happening in Missouri: A hospital in the state, Ozarks Healthcare, had to create a “private setting” for patients afraid of being seen getting vaccinated against COVID-19. In a video produced by the hospital, the physician Priscilla Frase says, “Several people come in to get vaccinated who have tried to sort of disguise their appearance and even went so far as to say, ‘Please, please, please don’t let anybody know that I got this vaccine.’” Although they want to protect themselves from the coronavirus and its variants, these patients are desperate to ensure that their vaccine-skeptical friends and family never find out what they have done.

Missouri is suffering one of the worst COVID-19 surges in the country. Some hospitals are rapidly running out of ICU beds. To Americans who rushed to get vaccinated at the earliest opportunity, some Missourians’ desire for secrecy is difficult to understand. It’s also difficult to square with the common narrative that vaccine refusal, at least in conservative areas of the country, is driven by a lack of respect or empathy from liberals along the coasts. “Proponents of the vaccine are unwilling or unable to understand the thinking of vaccine skeptics—or even admit that skeptics may be thinking at all,” lamented a recent article in the conservative National Review. Writers across the political spectrum have urged deference and sympathy toward holdouts’ concerns about vaccine side effects and the botched CDC messaging about masking and airborne transmission early in the pandemic. But these takes can’t explain why holdouts who receive respect, empathy, and information directly from reliable sources remain unmoved—or why some people are afraid to tell their loved ones about being vaccinated.

What is going on here? Sociology suggests that pundits and policy makers have been looking at vaccine refusal all wrong: It’s not an individual problem, but a social one. That’s why individual information outreach and individual incentives—such as Ohio’s Vax-a-Million program, intended to increase vaccine uptake with cash prizes and college scholarships—haven’t worked. Pandemics, by definition, are collective problems. They propagate and kill because people live in communities. As a result, addressing pandemics requires understanding interpersonal dynamics—not just what promotes trust among people, but which behaviors convey status or lead to ostracism.

Shifting from an individual to a relational perspective helps us understand why people are seeking vaccination in disguise. They want to save face within the very specific set of social ties that sociologists call “reference groups”—the neighborhoods, churches, workplaces, and friendship networks that help people obtain the income, information, companionship, mutual aid, and other resources they need to live. The price of access to those resources is conformity to group norms. That’s why nobody strives for the good opinion of everyone; most people primarily seek the approval of people in their own reference groups.

In Missouri and other red states, vaccine refusal on partisan grounds has become a defining marker of community affiliation. Acceptance within some circles is contingent on refusal to cooperate with the Biden administration’s public-health campaign. Getting vaccinated is a betrayal of that group norm, and those who get the shot can legitimately fear losing their job or incurring the wrath of their families and other reference groups.

Sociology solves mysteries like these by zeroing in on problematic relationships, not the decisions that individuals make in isolation. Many of the people refusing safe, effective vaccination amid a deadly pandemic are enmeshed in a very distinctive type of relationship that sociologists have been studying for more than 70 years: the con job. Con artists gain social or financial advantage by convincing their marks to believe highly dubious claims—and to block out all information to the contrary.

COVID-19-related cons have become big business, not just for right-wing media outlets that have gained viewers while purveying vaccine disinformation but also for small-time social-media grifters and enterprising professionals. The New York Times recently profiled Joseph Mercola, a Florida osteopath whom the paper described as “The Most Influential Spreader of Coronavirus Misinformation.” Four years ago, the Federal Trade Commission forced Mercola to pay nearly $3 million in settlements for false advertising claims about indoor tanning beds that he had sold. In February of this year, Mercola told his millions of followers on Facebook that the vaccine would “alter your genetic coding,” and promoted his line of vitamin supplements as an alternative to ward off COVID-19.

To outsiders, the social dynamics of the con appear peculiar and irrational. Those caught up in it can seem self-destructive and, frankly, clueless. But to sociologists, including me, who study fraud, such behaviors obey a predictable logic.

The seminal text in the field—Erving Goffman’s 1952 essay “On Cooling the Mark Out”—observes that all targets of con artists eventually come to understand that they have been defrauded, yet they almost never complain or report the crime to authorities. Why? Because, Goffman argues, admitting that one has been conned is so deeply shameful that marks experience it as a kind of social death. The victim, he writes,

has defined himself as a shrewd man and must face the fact that he is only another easy mark. He has defined himself as possessing a certain set of qualities and then proven to himself that he is miserably lacking in them. This is a process of self-destruction of the self.

Goffman notes that other life events, such as being fired or dumped, can evoke similar feelings of humiliation. But people targeted by con jobs can save their pride by denying the con as long as possible—or claiming they were in on it the whole time. This saves face and cheats social death, but allows the con to continue unchecked, entrapping others. In doing so, marks prioritize their self-image over the common good.

This behavior—which Goffman doesn’t shrink from calling a “moral failure”—is embodied in figures such as the Louisiana man who attained national fame recently with a defiant rant from his ICU bed, refusing to get vaccinated even after a life-threatening bout with COVID-19. After being hospitalized with the disease, or losing loved ones to it, some former vaccine refusers own up to their misjudgment. But not all do.

Framing vaccine refusal in terms of sociological theory isn’t just an intellectual exercise. On the contrary, it can help public-health experts and government officials figure out how to react when marks collide with the reality that COVID-19 is serious, the vaccines work, and not getting vaccinated is dangerous. Goffman points out that con artists employ specialists to “cool” marks down when the deception is finally revealed. A cooler, he writes, “has the job of handling persons caught out on a limb—persons whose expectations and self-conceptions have been built up and then shattered.” Coolers prevent blowback from angry marks—encouraging them to blame themselves, not the con artist. They help marks rebuild their social identity, retain their self-respect, and preserve their affiliations with their reference groups.

In this light, the recent volte-face of many prominent conservatives toward enthusiastic endorsement of vaccination is great news for everyone who wants to see an end to the pandemic. Representative Steve Scalise, a high-ranking House Republican from Louisiana, recently got vaccinated on camera. Sarah Huckabee Sanders, a press secretary in the Trump White House now running for governor of Arkansas, published an op-ed disclosing that she and her family had gotten vaccinated. On Tuesday, Senator Roy Blunt used the Republican leadership’s weekly press conference to urge his constituents in Missouri to get vaccinated—presumably without resorting to disguises.

Some commentators have mocked these efforts—particularly those of Republican Governors Ron DeSantis of Florida and Kay Ivey of Alabama. DeSantis recently declared, “Vaccines are saving lives.” “It’s the unvaccinated folks that are letting us down,” Ivey recently said, adding, “These folks are choosing a horrible lifestyle of self-inflicted pain.” Both had previously taken vocal stands against certain pandemic-mitigation measures; in May, for example, each signed legislation banning organizations in their states from requiring proof of vaccination for employees and customers.

But those who see only hypocrisy and bad faith in these moves misunderstand the social dynamics of the con. Cooling out the marks—which is what all these right-wing efforts to push vaccination represent—works only when the marks perceive the coolers as members in good standing of the same reference groups. Having expressed doubts about COVID-19 vaccination or other pandemic mitigation likely makes Ivey and DeSantis more effective in persuading other conservatives: Their previous positions signify authenticity and in-group loyalty, making them more trustworthy, not less. High-status leaders such as Scalise, Ivey, Blunt, and DeSantis can expand the range of acceptable behavior for other group members through the example of their own actions.

This is reason for optimism: The conservative coolers are finally on the case, and only they have a chance of transforming partisan vaccine refusers into vaccine adopters. Whether these efforts will improve vaccination rates in red states remains to be seen, but it should come as a relief to those weary of being nice to vaccine holdouts. Blue-staters’ approval probably never mattered in the first place.


Brooke Harrington is a sociology professor at Dartmouth College. She is the author of Pop Finance and Capital Without Borders: Wealth Management and the One Percent. Her site is brookeharrington.com.

The Dangerous Delays in U.S. Coronavirus Testing Haven’t Stopped

The Dangerous Delays in U.S. Coronavirus Testing Haven’t Stopped

Without adequate testing, people with coronavirus symptoms are left to agonize over the right course of action on their own.


 


Editor’s Note: The Atlantic is making vital coverage of the coronavirus available to all readers. Find the collection here.


After surveying local data from across the country, we can only verify that 4,384 people have been tested for the coronavirus nationwide, as of Monday at 4 p.m. eastern time. These data are as comprehensive a compilation of official statistics as currently possible.

The lack of testing means that it is almost impossible to know how many Americans are infected with the coronavirus and suffering from COVID-19, the disease it causes. While our analysis has tracked state and local announcements that more than 570 people in 36 states are infected, experts say that number is almost certainly too small to reflect the full extent of the disease’s spread in the U.S. Not enough Americans have been tested for officials to know how many people are ill, they say.

When researchers have used statistical and genetic techniques to estimate the true size of the outbreak, they have concluded that thousands of Americans may have already been infected by the beginning of the month. Health officials have attributed 26 deaths to COVID-19 in the United States, as of today.

The sluggish rollout of the tests has become a debilitating weakness in America’s response to the spread of the coronavirus. By this point in its outbreak, South Korea had tested more than 100,000 people for the disease, and it was testing roughly 15,000 people every day. The United Kingdom, where three people have died of COVID-19, has already tested more than 24,900 people.The Atlantic reached its new estimate through an ongoing collaboration with the data scientist Jeffrey Hammerbacher and a team of volunteers recruited for their experience with data collection, and after consulting data published by all 50 states and the District of Columbia. States vary widely in their reporting standards. All provide positive case reports. But many do not provide negative or pending case reports, which provide crucial context for both the progression of the virus and the government response to it.Our effort is necessary because the Centers for Disease Control and Prevention is not regularly providing data on the full scope of American testing. On its website, the federal agency now provides a number (1,707 as of Sunday) that reflects only the number of people tested at the CDC’s laboratory, even though state and private laboratories provide the bulk of testing. (The CDC did not immediately respond to a request for comment.)

When the CDC has provided data, it has been slow and incomplete.

On Saturday, Stephen Hahn, the commissioner of the Food and Drug Administration, told reporters that 5,861 specimens—not people—had been tested for the coronavirus by the end of the week. As a rule of thumb, it takes about two specimens to deliver results for a single patient, which would make this equivalent to about 2,900 people tested through Saturday.

Last week, The Atlantic reported that it could only verify that 1,895 people had been tested for the coronavirus as of Friday morning.

Testing capacity still varies enormously across the country. Many states, including some of the country’s most populous, are not reporting how many tests they have conducted overall. Texas, which now has 24 positive cases, has not posted on its website how many people it has tested overall. A spokesman for the state said it had tested 150 people as of last week, but “with private labs coming online now, I don’t think we’re going to have a definitive number for the entire state going forward.” Nevada has not reported any new data at all on its health-department website since March 3.

Massachusetts, which has 41 presumptive cases, has not released its total number of people tested. Neither has Pennsylvania, which has 10 presumptive cases. Last week, a Pennsylvania official told us that the state could test only a dozen or so people a day, suggesting that it has a high rate of positives.

On Friday, California also stopped reporting how many tests it has conducted, switching to releasing only the number of positive cases.  The California Department of Public Health told us that the state had tested 778 people as of Saturday, and that the state has 114 positive cases. It now has 15 labs doing tests across the state.

North Carolina, which has two positive cases, and Indiana, which has two, have also never said how many overall tests they have conducted.

LabCorp and Quest, two companies that run routine medical tests for doctors’ offices, have both announced that they can now test samples for COVID-19. The two companies can test a combined 2,500 patients a day, according to a tally assembled by Scott Gottlieb, the former FDA commissioner, and published by the American Enterprise Institute.

Altogether, the country can test a maximum of 7,840 people a day, according to Gottlieb’s preliminary tally. His count is another example of the kinds of data tabulation that a federal agency might usually take responsibility for.

The testing situation is so bad that Marc Lipsitch, an epidemiology professor at Harvard, says that health officials and journalists should stop reporting the number of positive cases in the United States as “new cases.” Instead, he wrote by email, “they should refer to them as ‘newly discovered cases,’ in order to remove the impression that the number of cases reported has any bearing on the actual number.”

The ponderous rollout of tests—and the stringent criteria that the CDC has imposed on them—has hamstrung doctors and injected anxiety into the lives of ordinary Americans. Are their symptoms pneumonia, the flu, or something worse?

“I have no clue if we could have already or could be now spreading this to others,” a 38-year-old woman who lives near Austin, Texas, who asked not to be identified for privacy reasons, told us.

After returning from Western Europe in late January, the woman and her husband came down with a mysterious illness, which sent them in and out of week-long fevers. She and her husband would wake up coughing in the middle of the night, their ribs aching so badly that they needed to vomit. She has tested negative for the flu, twice, and also tested negative for strep. She has been diagnosed with pneumonia.

On her trip, she had frequently been in large, international crowds, where she could easily have been exposed to the coronavirus. But despite having all the symptoms, she has not been tested for it. When she called Austin’s public-health department to ask for guidance, she was told that unless she was hospitalized or had traveled to China, she could not be tested for COVID-19.

“The woman who I talked to said, ‘There aren’t any cases here [in Travis County],’” she told us. “And I said, ‘There hasn’t been any testing, so how do you know?’”

Without a firm answer about whether she has the virus, she has agonized over how to act responsibly. When is she overreacting? When is she being reckless? She and her husband have stayed home since they became ill, but their son and daughter, both younger than 5, attended school until her daughter ran a fever last week.“There’s no guidelines out there, even at the urgent care today,” she said. She now plans to keep both kids at home for the next two weeks.But that’s only one of many arenas where there is currently no firm guidance for people who think they may have the virus, but who cannot get tested for it.

“Am I supposed to tell my team [at work]? Am I supposed to tell my kids’ school? Am I supposed to tell everyone I interacted with for the last four weeks?” she asked. “I don’t want to start a crisis, because I don’t know if I actually have this thing.”

Doctors have expressed similar frustration in getting patients tested. “The Georgia Department of Public Health has basically thrown up their hands when it comes to testing patients who do not require hospitalization,” Josh Hargraves, an emergency-room doctor in Georgia, told us. “On Friday we were told, ‘If the patient doesn’t have a travel history and doesn’t need to be admitted to the hospital, don’t bother calling; we’re not going to test.’” By Saturday evening, when Hargraves saw four prospective coronavirus patients, he managed to get one of them tested, but only after filling out onerous and unusual paperwork.

“We’re still restricting usage and asking thoughtful, knowledgeable medical professionals to jump through hoops to get a test they know a patient needs,” Hargraves said.

The outbreak is not at the same stage in every state. If public-health officials can quickly increase testing, it might be possible to have a much more comprehensive view before community transmission worsens.

We know the virus is here and spreading in many places. Restrictive testing policies—especially ones focused on travel outside the United States—clearly don’t make sense anymore. There are sick people in this country whose doctors think they need testing and who still cannot be tested. Every day that this epidemic continues without adequate testing, the country’s ability to slow the outbreak will deteriorate.