On the Current Covid "Surge": Misinformation from the Media and the Experts

A recent rise in Covid prevalence highlights an ongoing problem of hypocrisy around public health misinformation.

“What the New Covid Surge Really Means,” Politico promised to tell readers on July 31; “Covid Didn’t Take a Summer Vacation: it’s time for a refresher on how to protect yourself and others,” the Times ordered on August 8; last week, on August 18, CBS News asked, “Covid cases are rising, but should you be worried this time?” On August 3, CNN published a piece titled “What You Should Know About the Latest Covid-19 Surge.”

Dr. Bob Wachter, the Chair of the Department of Medicine at the University of California, San Francisco—who has appeared in the New York Times, the Washington Post, San Francisco Chronicle, CNN, NPR, CBS, NBC, and so on—also weighed in on the recent “surge” on August 18, on Twitter, where he has cultivated a large following. Of the rise in Covid, Wachter said he would tell his audience “what that means and how you might choose to alter your behavior in response.”

For both news outlets and a cottage industry of public health professionals-come-media-darlings like Wachter, the cyclical waxing and waning of Covid continues to deliver a gift of reliable, recurrent source material. The populace can be kept in a state of repeated anxiety, and the “experts” can maintain their relevance by regularly telling us how we should feel and what we should do.

Like many media outlets and some fellow doctors who seek a public profile, Wachter has repeatedly positioned himself as a truth-telling antidote to misinformation. These doctors, including Wachter, and legacy media outlets often do convey accurate and helpful content. But their messaging is also often, at best, dubious, and at worst itself misinformation. Coverage of the recent “surge” is a powerful case study on this point, and a telling example of the establishment’s hypocrisy.

To start, a broad Exhibit 1 is the image below, in which I identified the “surge” that the headlines keep scaring the public about.

CDC graph. Text and arrow added by Dave

If a tiny bump in the rate of new weekly Covid hospital admissions—that still is among the lowest rates over the last three years—relates to a surge, then what is an actual large rise called? The use of this hyperbolic language by so many media outlets that over-dramatizes risk skirts very close to misinformation.

But the “surge” and “wave” headlines are far less egregious than Exhibit 2, Dr. Wachter’s Twitter thread from a few days ago:

The thread begins with the heading: Covid Chronicles, Day 1249. Wachter’s folksy “chronicles” of his life since the onset of Covid—where he gives anecdotes of his personal experiences, observations of the current situation regarding the virus, and his advice on how people should conduct themselves based on their personal risk assessment, often in 20-plus-part threads—have garnered him more than 270,000 followers.

Between that audience and his frequent appearances in major media outlets, Wachter’s statements carry a lot of influence. When he makes misleading claims, it matters.

Unlike Twitter-famous alarmists like Eric Feigl-Ding, Wachter generally takes a more measured tone with his threads, suggesting different degrees of concern for different populations, and different actions they may or may not want to take depending on one’s priorities. This is an important distinction that he should be commended for.

With that said, the mere existence of a “Covid Chronicles” gives an indication of how much this virus consumes Wachter’s life. Wachter often describes in exquisite detail the elaborate calculations he makes to decide whether and how to venture into various social situations.

Wachter’s thread starts off promisingly, where he said he purposefully describes the recent rise in Covid as an “uptick,” rather than a surge. And he included the above CDC graph (minus my “surge” indicator) to illustrate the definite but mild upward trend.

But then things take a bad turn.

“Why the uptick?” Wachter writes. It’s not the new variant, he says. Rather, “more likely, it’s the same reason we’ve seen this roller coaster for two years: after a 6-12 month lull in Covid, most folks have let down their guard.”

“The virus lurks, waiting to find less immune & more unmasked hosts. It’s now finding them,” he writes. “This pattern will likely repeat 2-3 times yearly for the foreseeable future.”

Let me be candid: this is complete nonsense. And, as I’ll explain later, this type of misinformation causes harm.

There is no evidence that the recent uptick is because people “have let down their guard.” Nor is there any quality evidence that the roller coaster of Covid prevalence to which he refers, and that is visible in the graph that he tweeted, is a result of people letting their guard down. Nor is there evidence that this pattern, which he expects will be repeated 2-3 times yearly, will be due to people letting their guard down.

I replied to Wachter on Twitter, asking him what evidence supported his statement that the uptick was from people letting “their guard down.” Did he actually think that from 12/31/22 to 6/24/23 people had their guards up, then let them down on 6/25? He did not respond.

Further, does Wachter actually think the roller coaster epi curve of Covid over several years is due to rhythmic changes in personal behaviors at a population level? (And that these behaviors have this strong of an impact on transmission?)

I corresponded with two infectious diseases specialists about Wachter’s thread to make sure I wasn’t mistaken. “Absolutely false,” one said of Wachter’s claim. (Both asked to remain anonymous since they did not receive permission from their institutions to talk with the press.) The other also outright dismissed the notion that the rise was related to people letting their guard down, and said that “waning immunity since the last time we had high levels was the most compelling reason” for the rise in cases.

But one needn’t be an infectious diseases expert to see the absurdity of Wachter’s claim. The empirical reality is that pretty much every major facet of society has been operating without restrictions for a year or more. Schools have run normally and at capacity since at least fall 2022. Stadiums and arenas have been packed with sports and music fans, parties have been thrown, kids have slept over friends’ houses, and so on—this all has been happening for a long, long time, through the various ups and downs of Covid prevalence.

To put a fine point on it, below, I have illustrated what Dr. Wachter is suggesting:

Author’s diagram of Bob Wachter’s epidemiological theory of Covid prevalence.

Wachter is not the only “expert” with a wild claim about the recent rise in cases. In the August CNN article on the “surge,” Dr. Leana Wen said it was possible that cases were rising because it was hot outside and more people may have been gathering indoors. Another health professional frequently in the press, and with a strong social media presence, Katelyn Jetelina, who calls herself Your Local Epidemiologist, also said, in an August 3 PBS segment that, among other reasons, the rise was occuring because people were “moving inside because of the heat.”

Are Wen and Jetelina not aware that over the last three winters—a time of year when people also congregate indoors—cases both rose and then fell off a cliff? 

The people-let-their-guard-down claim is only the latest in plenty of dubious posts by Wachter, including him tweeting a widely-mocked CDC graph purporting to show effectiveness rates of different masks that was based on atrocious research methods.

Yet the frustrating irony is that many medical professionals often in the media, and in particular Wachter, have cast themselves as the defenders against misinformation.

In May 2020, Wachter was featured in a Wall Street Journal article about doctors on Twitter, where he referred to himself as one of the “good guys” putting out information “as correct as it can be.” In a July 2022 editorial in the journal Science, Wachter lectured readers about how crucial it is to message the public with “scientifically accurate and nuanced communication that tells people what the latest numbers mean and how they should influence behavior.” In February of this year, Wachter moderated a Grand Rounds about combating misinformation in medicine.

Wachter’s profile header on Twitter.

As recently as this summer, Wachter was still banging the drum. On July 31 he wrote that “dis/misinformation” was “perhaps our greatest threat to health.” And on August 15, he uncritically retweeted a study on doctors supposedly spreading misinformation that was rife with its own misinformation, as I reported last week.

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Along with the indoor gathering theory of Wen and Jatelina, the main problem with Wachter’s claim about people letting their guard down as the cause of the rise in Covid is that it is based in hubris, on a belief that our behavior and interventions have more influence over the world than they actually do.

This false belief—be it for masking or gathering or other actions—encourages behaviors that can increase transmission. For example, I know people who have been infected and, nevertheless, got on transatlantic and cross-country flights thinking they wouldn’t infect anyone else because they wore a mask. Conversely, untold numbers of people confidently gathered with others, unwittingly exposing themselves to the virus, because they wore a mask, thinking it would protect them. (The endless social media posts from people who got infected even though they “did everything right” attests to this.) And this false belief encourages policies that unnecessarily cause harm without clear benefit. Politicians closed schools saying that would reduce transmission, even though case rates around the country bore no correlation with school closure policies.

Just this week, Dr. Carlos del Rio, the interim Dean of Emory University School of Medicine, tweeted an article that claimed a rise in Covid cases in Georgia is, in part, due to kids going back to school. Yet cases and hospitalizations are up in New York, and many other states, where schools remain closed for the summer.

Overstating the effect of human actions on transmission reduction—such as claiming that Covid prevalence rises and falls based on the extent that people “let their guard down”—exacerbates division among the populace. It erroneously, even if at times implicitly, assigns blame or praise to people, depending on whether circumstances are unfavorable or favorable. This type of misinformation is less easy to spot than, for example, outlandish claims about vaccines, but it may ultimately prove to be no less harmful.