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'Do No Harm': An Open Letter From Stanford Medical Faculty

In an unusual and blunt rebuttal of a former colleague, 99 Stanford medical experts reject the "falsehoods and misrepresentations of science" concerning Covid 19 by Dr. Scott Atlas, a Trump advisor, warning of "immense avoidable harm."

September 9, 2020

Dear Colleagues,

As infectious diseases physicians and researchers, microbiologist and immunologists, epidemiologists and health policy leaders, we stand united in efforts to develop and promote science-based solutions that advance human health and prevent suffering from the coronavirus pandemic. In this pursuit, we share a commitment to a basic principle derived from the Hippocratic Oath: Primum Non Nocere (First, Do No Harm).

To prevent harm to the public’s health, we also have both a moral and an ethical responsibility to call attention to the falsehoods and misrepresentations of science recently fostered by Dr. Scott Atlas, a former Stanford Medical School colleague and current senior fellow at the Hoover Institute at Stanford University. Many of his opinions and statements run counter to established science and, by doing so, undermine public-health authorities and the credible science that guides effective public health policy. The preponderance of data, accrued from around the world, currently supports each of the following statements: 

  • The use of face masks, social distancing, handwashing and hygiene have been shown to substantially reduce the spread of Covid-19. Crowded indoor spaces are settings that significantly increase the risk of community spread of SARS-CoV-2.
  • Transmission of SARS-CoV-2 frequently occurs from asymptomatic people, including children and young adults, to family members and others. Therefore, testing asymptomatic individuals, especially those with probable Covid-19 exposure is important to break the chain of ongoing transmission. 
  • Children of all ages can be infected with SARS-CoV-2.While infection is less common in children than in adults, serious short-term and long-term consequences of Covid-19 are increasingly described in children and young people.
  • The pandemic will be controlled when a large proportion of a population has developed immunity (referred to as herd immunity) and that the safest path to herd immunity is through deployment of rigorously evaluated, effective vaccines that have been approved by regulatory agencies.
  • In contrast, encouraging herd immunity through unchecked community transmission is not a safe public health strategy. In fact, this approach would do the opposite, causing a significant increase in preventable cases, suffering and deaths, especially among vulnerable populations, such as older individuals and essential workers.

Commitment to science-based decision-making is a fundamental obligation of public health policy. The rates of SARS-CoV-2 infection in the US, with consequent morbidity and mortality, are among the highest in the world. The policy response to this pandemic must reinforce the science, including that evidence-based prevention and the safe development, testing and delivery of efficacious therapies and preventive measures, including vaccines, represent the safest path forward. Failure to follow the science -- or deliberately misrepresenting the science – will lead to immense avoidable harm. 

We believe that social and economic activity can reopen safely, if we follow policies that are consistent with science. In fact, the countries that have reopened businesses and schools safely are those that have implemented the science-based strategies outlined above.

As Stanford faculty with expertise in infectious diseases, epidemiology and health policy, our signatures support this statement with the hope that our voices affirm scientific, medical and public health approaches that promote the safety of our communities and nation.

(Signed)

 

Philip A. Pizzo, MD

Upi Singh, MD

Bonnie Maldonado, MD

Lucy Shapiro, PhD 

Melissa Bondy, PhD

Michele Barry, MD

Charles Prober, MD

Julie Parsonnet, MD

Steve Goodman, MD, 

David Relman, MD

Lee M. Sanders, MD, MPH

Steve Luby, MD

Harry Greenberg, MD

Ann Arvin, MD 

Edward S Mocarski, Jr, PhD

John Boothroyd, PhD

John Carette, PhD

Dylan Dodd, MD, PhD

Jason Andrews, MD, SM, DTM&H

David Studdert, LLB, MPH, ScD

Michelle Mello, JD, PhD

Joshua Salomon, PhD

Manuel Ricardo Amieva, MD, PhD

Lorene Nelson, PhD, MA

Abraham Verghese MD, MACP, FRCP(Edin)

ArunaSubramanian, MD

Dean L. Winslow, MD, FACP, FIDSA, FPIDS

Stephen J Galli, MD

Helen M Blau, PhD

Jason Wang, MD, PhD

Ann Hsing, PhD, MPH

Steve Asch, MD, MPH

Esther John, PhD, MSP

Thomas C Merigan, MD

David A. Stevens, MD, FACP, FAAM, FIDSA 

Gary K. Schoolnik, MD

Jack Remington, MD

Cornelia L. Dekker, MD

Denise Monack, PhD

Stan Deresinski, MD, FIDSA

Shirit Einav, MD

Robert Shafer, MD

Holden Terry Maecker, PhD

Wah Chiu, PhD

Doug K Owens, MD, MS

Cybele A. Renault, MD, DTM&H

Jake Scott, MD

Justin Sonnenburg, PhD

Hector Bonilla, MD

Dora Ho, MD, PhD

Marisa Holubar, MDMS

Sharon Chen, MD, MS

Roshni Matthew, MD

Elizabeth S. Egan, MD, PhD

Jenny R. Aronson, MD

Catherine Blish, MD, PhD

Paul L. Bollyky, MD, D. Phil

Talal Seddick, MD

Clea Sarnquist, MD

Sruti Nadimpalli, MD

Allison W. Kurian, MD, M.Sc. 

Tim Stearns, PhD

Kerwyn Casey Huang, PhD

Michael Fischbach, PhD

Maya Adam, MD

Samantha Johnson, MD, MP

Philip M. Grant, MD

Joanna Nelson, MD

A.C. Matin, PhD

Taia T. Wang, MD, PhD, MSCI

Peter Sarnow, PhD

Hayley Gans

Michael Baiocchi, PhD

Glenn M. Chertow, MD, MPH

Paul Graham Fisher, MD

Lisa Goldman-Rosas, PhD, MPH

Bonnie Halpern-Felsher, PhD, FSAHM

Victor Henderson, MD

Tina Hernandez-Boussard, PhD, MPH, MS

Abby King, PhD

Allison W. Kurian, MD, M.Sc. 

Lianne Kurina, PhD

Mitchell R. Lunn, MD, MAS, FACP, FASN

Kari Nadeau, MD, PhD

Lorene Nelson, PhD, MS

Mindie H. Nguyen, MD, MAS, AGAF, FAASLD

Michelle C. Odden, PhD

Juno Obedin-Maliver, MD, MPH, MAS

Latha Palaniappan, MD, MS, FAHA, FACC, FACP

Lesley S. Park, PhD, MPH

Rita A. Popat, PhD

David H Rehkopf, ScD, MPH

Thomas N. Robinson, MD, MPH

Kristin Sainani, PhD

Gary M. Shaw, DrPH

Julia F Simard, ScD

Marcia L. Stefanick, PhD

Holly Tabor, PhD

Alice S. Whittemore, PhD 

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