Thinning the Herd: COVID-19 and the Rhetoric of Trumpian Catastrophe

As COVID-19 infections spread in early 2020, the term herd immunity drew the Trump administration's attention as a remedy for redressing the pandemic. However, scientific experts warned the Trump administration against adopting herd immunity as a pandemic response. The Trump administration was unmoved. I argue that understanding the Trump administration's incongruous pandemic response is impossible without theorizing the deeper catastrophic formations uniting herd immunity and the political Right. Drawing evidence from the Trump administration and its allies, I analyze herd immunity as a reflection of a catastrophic form of social Darwinism emerging from the Trump administration's coronavirus messaging. By exploring the Trump administration's general enthusiasm for catastrophe, I offer a fresh scholarly contribution at the intersection of rhetorical studies, public address, and health, political, and scientific communication, ultimately illuminating larger theoretical and political lessons for the discipline and beyond.

Was the 1889-1891 Russian Flu Really Coronavirus?

The authors presented an extensive and masterful review of clinical and pathological literature showing contemporary case descriptions from the pandemic of 1889-1891, which included descriptions of cases with features remarkably similar to what has been observed since human cases of SARS-CoV-2 began appearing in 2019. Common clinical observations that suggest coronavirus infection rather than influenza included: relatively mild illness in adolescents;higher mortality in men, elderly individuals, and those with comorbidities;“long hauler” persistence of symptoms;pathologic evidence of inflammation and thrombosis;multisystem disease (with frequent gastrointestinal and neurological symptoms);presymptomatic transmission of infection;occasional symptomatic reinfection;and lack of protection by previous infection with influenza. Just a few years ago, I heard a brilliant lecture from a French doctor who carefully documented how rapidly the Russian flu spread throughout Europe and the United Kingdom via rail lines and then to North America in just a couple of weeks via transatlantic steamship, and subsequently by railroads in the United States and Canada.1 We now know conclusively that the 1918-1919 influenza was caused by infection with a particularly virulent strain of influenza A H1N1, based on molecular reconstruction of the virus from individuals who died of flu and whose remains were preserved in Arctic permafrost.2 The most commonly accepted theory of the etiologic agent of the 1889-1891 Russian flu is that this was Influenza A H3N2, based on serologic analysis of blood obtained in the 1950s and 1960s from individuals born before vs. after 1890.3,4 We do not have frozen specimens from Russian flu patients to examine to demonstrate conclusively the etiology of this pandemic, so the Brussow paper postulating trans-species infection with a bovine coronavirus as the cause remains speculative.

Reduced Incidence of Kawasaki Disease During the Time of COVID-19

The finding of decreased KD incidence seen in this study is parallel to the findings of Hatoun et al for common respiratory and enteric viral and some bacterial infection diagnoses during the months of mitigation.1 Thus, this finding supports the hypothesis that KD is triggered by a common childhood infectious respiratory agent.2,3 Shulman et al also looked at the possibility that the decreased number of KD cases during the April to December 2020 mitigation period was the result of parents not bringing their ill children to clinics for care. Hatoun et al reported that COVID-19-related childhood mitigation social distancing measures, including the closure of schools, a stay-at-home advisory, and the use of masks, coincided with a marked reduction in diagnoses of many common infectious diseases in children.1 The most pronounced declines were observed in infections transmitted by the respiratory route, with influenza, croup, and bronchiolitis essentially disappearing during the social distancing period.1 Shulman et al found that the number of cases of KD in early 2020 (January to March) was comparable to the number in the same months during the eight previous years, but that the number of KD diagnoses during the 2020 social distancing era (April to December) was very significantly lower than in the comparable period of 2012 to 2019 — less than one-third of the number previously observed (P = 0.008). Since last year, my colleagues have cared for a small number of children with COVID-19-related multisystem inflammatory syndrome in children (MIS-C) at Lucille Packard Children’s Hospital, and our Medicine service has cared for several adults at Stanford Hospital with MIS-A.