Serious Questions About Governor Cooper's Chief Health Advisor

The state of North Carolina has a new media darling. It is Dr. Mandy Cohen, the state Health and Human Services Secretary. Dr. Cohen is a physician who initially trained in internal medicine but later went into the field of public health.

The Raleigh News and Observer had a shameless puff piece about Dr. Cohen last week. In fact, they named her Tarheel of the Month. According to the corrupt media's values, she is pushing all the right buttons. And she possesses at least four or five attributes that make her an instant candidate for media hagiography.

But there are some serious questions about Dr. Cohen's handling of this entire situation. 

It turns out that the medical residency I completed had trained a number of physicians to go into the field of public health. Accordingly, I had considerable exposure to the field, including rotations at the state health department and a couple of county health departments; and also a number of other types of educational experiences and exposures in the field. I did not go into the field of public health, however.

The major text that my residency required in the field of public health still sits on my bookshelf. I pulled it out a couple of days ago to review it. It is the Maxcy-Rosenau text edited by John Last (12th edition, copyright 1986). It was represented to us that this was the "bible" in the field; and we used to refer to it as "the Last text". It is fairly hefty, at nearly 2000 pages.

In any case, I will list here the concerns I have based on my review of the relevant portions of the Last text and other considerations.

1. Cooper's health advisor recommended measures that go far beyond the recommended measures for communicable disease control. An entire chapter of the Last text (chapter 4) discusses measures to control the spread of infectious diseases. It discusses isolation of cases and quarantining contacts. It discusses various hygienic measures. Contact tracing is certainly advocated. But there is no discussion of the widespread shutting down of businesses and churches as we have seen in North Carolina. The text also does not recommend placing the entire population under house arrest for a prolonged period of time as we have seen with Cooper's statewide "stay-at-home" order. 

Given the fact that the mortality of COVID-19 has been demonstrated to be similar to some of the more severe flu epidemics, it might  be interesting to see the discussion regarding flu in Chapter 5 of the text: "There may be many reasons to avoid large crowds or known sources of infection when influenza is epidemic, but regulating travel and personal behavior would be impractical, temporizing, and is generally unwarranted." It should be noted that the Last text described and acknowledged previous epidemics, including flu and smallpox, that killed millions of people.

2. Cooper's health advisor violated some of the basic ethics of public health practice. Chapter 65 in the Last text discusses the ethics of public health. It describes, correctly, that public health authorities possess under state law certain police powers-- for instance, the prerogative to require that people with certain infectious diseases be quarantined, and that they reveal their contacts. But the text cautions that public health authorities must be cognizant of the rights of the public; and specifically must respect constitutional rights. It was considered mandatory that public health authorities find the proper balance. Nowhere does the text recommend or advocate suspending the constitutional rights of the general public. Of course, that is not the approach we have seen in North Carolina with COVID-19.

3. A couple of the early representations supporting the necessity of the lockdown turned out not to be true. We were told initially that we would just need a lockdown of a few weeks to "flatten the curve". We were further told that flattening the curve was necessary because hospitals would be over-run and would not have enough ventilators. Neither of these premises turned out to be true. The lockdown was extended for a much lengthier period of time. And the hospitals came nowhere close to reaching their capacity, or running out of ventilators. Inasmuch as these were public health judgments the Governor used to justify his actions, it is reasonable to question whether these represented faulty judgments, or whether the public was not being told the truth.

4. The handling of the COVID-19 epidemic was arguably negligent. Let's accept the premise that the COVID-19 epidemic is so catastrophic and cataclysmic that it justifies suspending the constitutional rights of citizens. That, of course, was Dr. Cohen's recommendation to the Governor. But if it was so bad, then she should have previously recommended a suspension of air travel into the state, and shut down our airports, because that was probably the key means by which the epidemic was seeded in our state. Moreover, given the fact that mass transit spreads the infection like wildfire, she should have recommended shutting  down mass transit. But she did neither of these things.

If we accept the premise that an insufficient supply of ventilators justified the shutdown, then we must reasonably ask whether, during her previous years as health secretary, she assured that we had enough ventilators in the state.  Did she  maintain an adequate stockpile or require that hospitals maintain significant reserves? Apparently not. Moreover, it is quite evident that, because of the massive slowdown among the state's large hospital systems and the overall atmosphere of fear created, many people are not receiving the medical care they need for other conditions. To the extent that the state's response triggered this slowdown, it hurt people medically. Finally, the state's response has triggered massive economic losses. The above factors suggest that the state's public health response, as recommended to the governor, was negligent. This resulted in many innocent people getting hurt unnecessarily, in myriad ways.

5. Cooper's health advisor is a physician who does not appear to be listed on the North Carolina Medical Board website as being licensed in the state of North Carolina. State law requires that physicians practicing here must be licensed in the state of North Carolina. If Dr. Cohen is a physician who is providing medical or public health advice to the governor, then she must be licensed in the state. Public Health physicians must be licensed. The North Carolina Medical Board maintains a database online of physicians licensed in the state that can be searched by the public. She is not found on this database. That raises the question as to whether she is licensed in the state, because if she is not, then she is breaking state law. It is possible, of course, that she might be licensed under her maiden name, but she publicly uses her married name.

6. The law has been broken. I have previously argued here that Governor Cooper has broken the law. I believe that to be true based on his suspension of constitutional rights and his negligence that resulted in harm to many North Carolina citizens. But if that is true of Governor Cooper, then it is also true of his chief public health adviser.

We must keep in mind that the media and their allies on the left insist that public policy regarding COVID-19 is being guided by medical and scientific facts and input. But there is considerable disagreement within the medical and public health communities that the right course is being taken.

In the state of North Carolina, Dr. Mandy Cohen is the personification of the medical input that is guiding public policy. That warrants much scrutiny given the considerations described above.

Comments

[Fred Gregory]

Cooper and Nevada's Governor have one thing in common.

https://www.washingtontimes.com/news/2018/sep/11/ihsan-azzam-nevada-chief-medical-officer-not-licen/

Can the legislature do anything about this >

[Triad Conservative]

Yes, Fred. The legislature can do much, and it ought to. But they are lying supine, acting like cowards and doing everything they can to dodge this situation.

[Fred Gregory]

Some Governors Are Getting Serious About The Cost Of Coronavirus Lockdowns. Some Aren’t

https://thefederalist.com/2020/04/29/some-governors-are-getting-serious-about-the-cost-of-coronavirus-lockdowns-some-arent/

[Triad Conservative]

Fred, the "rubber hits the road" at the state level. And we have horrible people in charge of our state, abusing their power enormously.