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6-foot rule, Fauci, and the bigger picture

Pandemic revisionism at its finest

KATELYN JETELINA

JUN 11, 2024

(Reprinted with permission)

Last week, Fauci testified before a special House subcommittee.

While the subcommittee’s main focus was Covid-19 origins, other topics snuck in, including the 6-foot social distancing policy during the pandemic. This was a key measure taken to slow down spread, including at schools, businesses, and places of worship.

A level-headed evaluation of decisions and policies made during the pandemic is helpful and needed, but that’s not at all what happened here. Instead, there were empty, unhelpful questions lacking nuance and depth, and at worst, unhinged harassment of public servants.

The result? A dangerous wave of “pandemic revisionism”—headlines and viral social media accounts taking soundbites of the hearing and concluding that pandemic policies were worthless or that public health officials just made stuff up.

Americans deserve (and need) so much better.

6-foot rule: Where did it come from?

Last week, the subcommittee blamed Fauci for the 6-foot policy. Fauci responded saying he was unaware of studies supporting the 6-foot social distancing guidelines. He then clarified that it wasn’t based on randomized control trials.

There are a few problems with this exchange:

1. This wasn’t a Fauci decision. The 6-foot guideline was decided by CDC.
2. This policy wasn’t pulled out of thin air. During the Bush administration, this key strategy was put into the pandemic playbook in 2007 and again in 2017. It was based on our knowledge of flu at the time, which showed droplets as a main form of transmission (rather than aerosols). Given that Covid-19 was a novel virus, pulling from a pandemic playbook was the right decision.
3. Even though 6 feet was not the “perfect distance,” it still helped prevent transmission.

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4. The mistake was not updating the policy quickly enough. It turns out Covid-19 has droplets, but its main mode of transmission is aerosols (i.e., airborne). In the summer of 2020, more than 200 scientists sent a letter to the WHO urging them to recognize this, as it would impact policy decisions. However, it took over a year for the CDC and WHO to officially recognize it. Why? And why did the U.S. go with 6 feet while the WHO went with 1 meter? Now, these are questions that would be useful to answer.
5. You won’t get a randomized control trial in times of an emergency. We were losing thousands of people per day. We have to move quickly and with suboptimal information. This is why preparedness is so important. Even so, some questions we ethically can’t answer with an RCT.
6. It ignores what we learned. When the world works on one thing, we learn leaps and bounds. One example is how much we learned about the power of air ventilation and filtration.

But these points are coming far too late.

Millions this week received the wrong and dangerous message that the 6-foot rule was based on no science thanks to this botched exchange, erroneous headlines and viral tweets. Clawing back the narrative for the next response—such as bird flu where droplets may be an important driver of a disease — will be incredibly difficult. (!–Editor’s Note)

Attacking scientists is also not the answer.

It’s reasonable to ask Fauci why he made certain decisions, what conversations he was a part of, or what his thinking was at the time. After all, he was one of the key decision-makers.

However, vilifying, attacking, and ripping apart public servants is unacceptable, undeserved, and certainly unhelpful in propelling us forward. Some tweets, like the one below by Elon Musk, was viewed more than 44 million times.

Public health leaders stepped up during a time of great uncertainty using systems too old to succeed while losing, at its peak, 3,500 people a day.

They had to make incredibly difficult decisions, often with incomplete information, many of which were valid decisions based on the data at the time.

Yes, they made mistakes, but their service was heroic and patriotic, too.

We can live with these two truths.

If not, we risk losing public health leaders — why would someone step up when this is how they’re treated?

We need a far better approach.

A proper diagnosis with the breadth, depth, and fairness the Covid-19 emergency deserves, driven by critical thinking and diverse perspectives:

• Why weren’t we prepared?
• What decisions were made, when, why, and by whom?
• What mistakes were unavoidable and avoidable?
• What could have saved more lives?
• How could we have a better balanced, holistic view of health?
• What tangible steps will be taken to do better in the future?

There is precedent for such an approach: the 9/11 Commission. However, a united, national diagnosis seems less likely as the months pass.

Thankfully, some groups have taken it upon themselves to start patching together answers:

• State-level diagnoses, like New Jersey
• Books like Lessons from the Covid-19 War: An investigative report
• Reports from independent organizations, like American Democracy & Health Security: Lighting a Path Forward Amid Pandemic Polarization

Will this be enough for the future? Especially with no funding to make the changes needed?

Time will tell, but this is a gamble given that health threats are coming faster.

Bottom line

The United States lost more than 1 million lives—worse per capita than any other developed nation. We deserve to know why and what steps are needed to ensure this doesn’t happen again. However, resorting to unhinged attacks and disingenuous waves of pandemic revisionism will only hurt us in the end.

Love, YLE

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WPCNR THE LETTER TICKER. From The People’s CDC. www.peoplescdc@substack.com JUNE 11, 2024:

 

The comment portal is still open until 11:59 pm EDT! Tell the Centers for Medicare and Medicaid (CMS) that hospitals must report COVID infections and they should give us care, not COVID. Although the text indicates an earlier deadline of 5pm “to be assured consideration,” the comment portal is still open for submissions. If you haven’t already commented, submit one now! CMS is one of the primary funders of US hospitals. 94% of hospitals have at least half of their admissions paid for by Medicare or Medicaid. The CDC recently stopped mandating that healthcare systems report COVID hospitalizations. Since the end of the public health emergency in May 2023, COVID hospitalizations have remained one of the few remaining data indicators. Without this information, the public health and general community will not understand the severity of COVID infections in the US. To address this, CMS has proposed mandatory reporting of COVID infections among hospitalizations beginning October 1, 2024. They need to hear overwhelming public support for this measure. SEE OUR GUIDE BELOW ⬇️ for submitting a public comment, with a sample template to help make your voice heard on this vital patient safety issue. Please submit your comment directly on the Federal Register. In your comment, we recommend telling CMS to allocate financial resources to create capacity for collecting and reporting COVID infections among hospitalized patients. While we remain concerned with the gap in the current reporting period between now and October 1, this is a necessary proposed change to our public health system. We also are advocating for data reporting on demographic, socioeconomic, and disability status to better understand differences in population outcomes. Further, we continue to urge CMS to adopt an approach that deters healthcare-acquired COVID infections. Currently, CMS penalizes hospitals that fail to keep patients safe from other hospital-acquired infections through the Hospital Acquired Condition Reduction (HAC) program. But COVID is not on the list of infections that CMS tries to get hospitals to prevent, unlike, for example, surgical site infections and MRSA blood infections. Hospital-acquired COVID-19 has a mortality rate of 5 to 10% — between a 1-in-10 and 1-in-20 chance of dying if you catch COVID in the hospital! Healthcare systems and other healthcare settings can and should prevent COVID. Join us in also telling CMS to add COVID to the list of infections in the Hospital Acquired Condition Reduction (HAC) program. When the CDC stopped requiring hospitals to maintain crucial COVID-infection control measures like COVID testing upon hospital admission and before elective procedures, we saw hospital outbreaks as a result. Without COVID-19 infection control, hospitals have become high-risk zones for COVID transmission, where people getting care for COVID-19 are very likely to encounter vulnerable patients who could be harmed by COVID. You have nearly a 40% chance of catching COVID-19 if your hospital roommate has it. Who wants to go to the hospital for a heart attack, giving birth, or routine surgery and end up catching COVID? It is especially concerning that hospitals are incentivized to ignore positive COVID cases—which would reduce income from carrying out elective procedures—especially during a “crushing” financial crisis. CMS thus must make the hospitals put patient safety first.  Preventing hospital-acquired COVID is an equity issue. CMS says they want to hear from multiple stakeholders and they are concerned about equity.  Over the course of the pandemic, we have seen marginalized communities. like low-income communities, disabled people, and people of color continue to be disproportionately harmed. These harms continue to persist and are further compounded by the fact that these groups are less likely to have access to boosters and treatment.” Together we can urge CMS to mandate reporting of COVID infections and protect us while making our hospitals safer! SUBMIT YOUR COMMENT How to Comment:  Unique comments in your own words have the greatest impact and are counted with more weight. Select “Healthcare industry” in the “What is your comment about?” dropdown menu. Begin your letter with something personal, stating a fact that informs your interest such as: “I am concerned about this issue because I have lost family members to COVID” or “I am at high risk for severe illness,” or “I am concerned about Long COVID.” If you have a health condition or disability and you feel comfortable sharing, or if you’re a health worker or public health researcher, mention those. Feel free to use and include our sample letter text, references, edited, in part or full, with your public comment, as you see fit. If you prefer you can upload your comment as a PDF. If you have the time and energy, please, upload any supporting references as PDFs. They are required to  read every document uploaded! Here are a few suggestions. Below is a sample template letter you can copy-paste all or in parts for your public comment (but please customize for achieving higher impact).    SUBMIT YOUR COMMENT   Sample template letter: (The hyperlinks below will not transfer to the plain-text box. If you prefer to upload a fully cited version, please save everything below as a PDF and submit as an attachment). To the Leadership of the Centers for Medicare and Medicaid: To reduce the spread of COVID inside healthcare settings, the Centers for Medicare and Medicaid (CMS) must 1) mandate hospitals report COVID infections and 2) include healthcare-acquired COVID infections as part of the Hospital Acquired Condition Reduction Program, CMS-1808-P. The following proposals and changes should be implemented: Hospitals must separately report total COVID, Flu, and RSV infections in healthcare settings on a weekly basis as part of this proposal as part of routine reporting of “respiratory illnesses.” Financial support should be provided to healthcare systems to ensure robust reporting capability. I support the reporting of demographics including additional characteristics such as socioeconomics and disability data. These data should be reported separately by facility name and aggregated at the state level with public access through HealthData.gov. CMS must include COVID in its Hospital-Acquired Condition (HAC) HAC Reduction Program and/or its Value-Based Purchasing Program, to create financial incentives for COVID prevention in inpatient care. CMS should require hospitals to report and decrease hospital-onset COVID, using layered protections, such as universal mask wearing, universal screening testing, and improved air quality to promote patient and staff safety and health equity.  Hospitals should be required to report all hospital-onset COVID cases to CMS and the CDC. These data should be made available through HealthData.gov. Hospital-onset COVID should be defined as infections diagnosed after 5+ days of admission. The CDC currently defines hospital-onset COVID as only those cases diagnosed in people who are still in the hospital after 14 days of hospitalization. This vastly underestimates hospital-acquired COVID, as current variants of COVID only take 2-3 days from exposure to developing symptoms.1,2 Since the average hospital stay is 5.4 days,3 the current criteria of 14-day hospitalization miscount most people. Additional Information and References for the Comment Letter: During the first three months of 2023, US hospitals reported an average of 1231 patients per week that had caught COVID during their stay, with a high of 2287 patients with hospital-acquired COVID in the first week of January 2023 (using the current CDC 14-day definition).4  The UK has documented even higher rates,5 but the UK defines hospital-onset COVID as cases diagnosed after 7 days of hospitalization. The Biden administration never released data showing how prevalent COVID spread has been inside individual hospitals,6 and the CDC stopped requiring hospitals to report hospital-onset COVID in April 2023.7  COVID remains a major cause of death in the US since 2020,8,9 and many of those deaths were likely due to hospital-acquired COVID, which has a 5-10% mortality rate. 10,11 This is significantly higher than several of the other infections CMS includes in its HAC Reduction Program. Catheter-Associated Urinary Tract Infection has a mortality rate of 2.3%,12 Surgical Site Infections for Abdominal Hysterectomy and Colon Procedures have a mortality rate of 3%,13 and Clostridium-difficile infection has a mortality rate of 7.9%.14 Thus, hospital-onset COVID requires more preventive effort. Nearly half of all US residents are concerned about COVID outbreaks.15 Preventing COVID in the hospital is an equity issue. People of color continue to suffer high rates of COVID deaths.16 Amid huge health worker shortages, half of health workers go to work with COVID symptoms.17 CMS needs to protect both patients and health workers. Even when community transmission is low, healthcare settings are the most likely place where people receiving COVID care could encounter vulnerable patients who could be harmed by COVID. COVID outbreaks are already happening in hospitals that stopped requiring masks.18 If your hospital roommate has COVID, you have a 4 in 10 chance of catching it from them.19 No one should be endangered for going to the hospital for a heart attack, elective surgery, or delivering a baby.    Hospitals should be protecting patients under their care from COVID. But since hospitals previously faced a financial crisis23 and positive COVID cases mean loss of income from elective procedures, we are concerned that hospitals are placing priority over profits over patient safety.  Please protect vulnerable patients, prevent health worker shortages, and promote health equity by requiring hospitals to report COVID infections and protect patients from hospital-acquired COVID.

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Hudson River Beaches Reopen Today;
Health Department Advisory Lifted

Swimming can safely resume at Croton Point Park Beach and Philipse Manor Beach Club, and boaters can resume recreational activities in the Hudson River, as the Westchester County Department of Health has lifted its Hudson River advisory.

The advisory was put in place during sewer main repairs on a force main in Ossining, which were completed Friday evening. The advisory was lifted today so that ample tidal movement would allow the partially treated sewage that had been released into the river to be adequately diluted.

For more information on water quality go to https://health.westchestergov.com.

en Español

Las Playas del Río Hudson Reabren Hoy;
Aviso del Departamento de Salud Levantado

Se puede volver a nadar de manera segura en la playa de Croton Point Park y en el Club de Playa de Philipse Manor, y los navegantes pueden reanudar las actividades recreativas en el Río Hudson, ya que el Departamento de Salud del Condado de Westchester ha levantado su advertencia sobre el Río Hudson.

La advertencia se había puesto en lugar durante las reparaciones de la tubería principal de alcantarillado en una tubería de fuerza en Ossining, que se completaron el viernes por la tarde. La advertencia se levantó hoy para que el movimiento de las mareas pudiera permitir que las aguas residuales parcialmente tratadas que se habían liberado en el río se diluyeran adecuadamente.

Para más información sobre la calidad del agua, visite https://health.westchestergov.com.

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WPCNR THE LETTER TICKER. June 8, 2024

Hello Everyone –

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WPCNR WESTCHESTER LAW JOURNAL. By John F. Bailey. June 6, 2024:

The Westchester League of Women Voters District Attorney Forum held on zoom Tuesday was described in the words of civil rights lawyer William Wagstaff, candidate in his closing statement, when he described it as “A contrast and choice.”

You can view the complete Forum at

The choices  are:  Susan Cacase, retired judge with 30 years experience; Adeel Mirza a pro bono defense lawyer and former prosecutor in New Rochelle; and William Wagstaff, a civil rights lawyer.

Ms. Cacase said she has 30 years experience in the Westchester justice system, recently retired as a judge,  she has a “passion” for protecting children, continuing to confront and diminish the opioid crisis, gun violence  diminish fentanyl deaths, explore alternatives to incarceration and protect reproductive choice

The other two candidates in the June 25 primary are a seasoned prosecutor, Mr. Mirza formerly prosecutor with the City of New Rochelle and recently a pro bono defense lawyer; and William Wagstaff, a civil rights lawyer.

The contrast between the candidates being the veteran experience of  judge and former prosecutor, Ms. Cacase and two persons, veteran litigators,  familiar with the practices in Westchester courts where D.A. policies on decisions playout.

Mr. Mirza and Mr. Wagstaff  feel there should be change in treatment of those charged in the Westchester justice system with emphasis on prosecution practices, more preventive community programs to influence positive behavior, more assistant D.A.s hired to speed prosecutions; less incarceration, and cutting back the alleged practice of  delaying trials in domestic violence cases when divorce proceedings are going on simultaneously.  The two court-seasoned opponents say the justice practices in Westchester need more programs in the communities, and working with the police, especially in the cities.

Here is a summary of positions and answers to the questions asked in the forum Tuesday night. Again you can see the candidates saying what I have truncated here in my notes at

Opening Statements:

MS CACACE: 30 Years experience. Passion for protecting children. Stopping gun violence.   Addressing stopping sharp rise in opioid and fentanyl deaths, trafficking. Increase alternatives to incarceration, 100% endorsed by Pro Choice

1. MIRZA: Address mental health factor in those committing crimes and intervention in paths that lead to crime: poverty and addiction, and crimes against tenants.
2. WAGSTAFF: Has personal experience with crime. Father robbed at own gas station. Mother was also assaulted. Strong on expanding prosecution of hate crime violence. Action to intervene in mental health issues that can cut down on inevitable turn to crime.

3 MOST IMPORTANT HOT ISSUES IN COUNTY JUSTICE:

1. CACASE: GUNS, GUN TRAFFICKING, OPIODS, SEX CRIMES
2. MIRZA: GET GUNS OFF STREET, MORE GUN BUYBACKS
3. WAGSTAFF: GUN VIOLENCE, DOMESTIC VIOLENCE, RELIEF FROM PROSECUTIONS LEADING TO INCARCERATION

INEQUALITY OF TREATMENT

1. CACASE: ANALYZE CRIME STATS TO SEE HOW PEOPLE OF COLOR, HISPANICS ARE HELD TO SAME STANDARDS. CONCERNED ABOUT INCARCERATION PROPORTIONS BASED ON ETHNICITY. WOULD NOT NAMES, RACE, OF PERSONS CASES TO PUBLIC. WOULD RELEASE CRIME NUMBERS TO PUBLIC.

Mr. MIRZA: “I SAW IT EVER DAY”…MINORTY DEFENDENTS TALKED INTO GUILTY PLEAS TO GET OUT OF THE SYSTEM. ASSISTAN D.A.’S NEED MORE EXPLICIT INSTRUCTIONS. WE NEED STATS ABOUT HOW DIFFERENT RACES ARE TREATED WHAT IS BEING DONE. AT THE IVORY TOWER IN WHITE PLAINS (CITY COURTS), I SEE THIS HAPPEN.

1. WAGSTAFF: I AM A CIVIL RIGHTS LAWYER. I HAVE BEEN THE RECIPIENT OF IT (INQUALITY OF TREATMENT).

GUN VIOLENCE

1. CACASE: CONTROLLING GUN VIOLENCE REQUIRES COOPERATION WITH VARIOUS AGENCIES (STATE, LOCAL, FEDERAL), COORDINATING INVESTIGATIONS AND PROSECUTION. (FAMILIAR WITH HOW THESE INVESTIGATIONS WORK.)
2. MIRZA: TOO MANY GUNS IN WESTCHESTER. I WOULD GO AFTER GUNS TRAFFICKING. PROVIDE MORE “GUN BUYBACKS.” REVISIT THOSE (PEOPLE, INSTITUTIONS) WHO SHOULD HAVE HELPED YOU (TO SEE HOW TREATMENTS AWARENESS COULD BE IMPROVED)
3. WAGSTAFF: INVESTIGATE THINGS THAT TARGET BEHAVIOR IN COMMUNITIES. ESTABLISH MORE JOBS. MODEL HOW TO BE A CONTRIBUTOR TO THE COMMUNITY

RELEASE OF PRISONERS (BAIL)

1. CACASE: EARLIER RELEASE DEPENDS ON THE CRIME. SEX OFFENDERS NEED MORE TIME THAN ANY OTHER CONVICTED OFFENDER. (MOST RECIDIVIST)
2. MIRZA: SHORTENED SENTENCES SHOULD ONLY APPLY TO NON-VIOLENT CONVICTIONS. VICTIMS OF THE CRIME MUST AGREE TO A SHORTENED SENTENCE.
3. WAGSTAFF: AGREES TO LIMIT SENTENCES . ADVOCATES FOR IT.

SEX CRIMES:

1. CACASE: I WILL WORK TO HIRE MORE PROSECUTORS
2. MIRZA: PROSECUTORS NEED HELP. THERE ARE NOT ENOUGH PEOPLE TO INVESTIGATE ALL THE SEX CASES
3. WAGSTAFF: I WILL WORK TO REDUCE PROSECUTING DELAYS BROUGHT BY TWO PARTIES BECAUSE THEY ARE GOING THROUGH A DIVORCE AND ASK FOR DELAYS (IN GOING TO COURT) TO LEVERAGE DIVORCE NEGOTIATIONS

FINAL STATEMENTS (From Transcripts):

1. CACASE:

I referenced earlier I’ve spent my life my career pursuing criminal justice as a judge of 19 years a criminal court judge of 19 years an assistant district attorney in the office office that I seek to lead for 15 years and a criminal defense attorney all here in Westchester County my experience combined actually is more than both of my opponents put together.

The position of district attorney is the chief law enforcement officer of the county it’s an important position it’s not one for someone to learn on the job figure it out once they get in there my Triad of experience makes me the most qualified for the position.

 I’ve worked with the office in the office I’ve worked with law enforcement across the county. I have the respect of law enforcement I commit to work with law enforcement as the chief law enforcement officer of the county my commitment will be to take guns off the streets tackle the opioid crisis in the county protect victims of crimes especially the most vulnerable children and the elderly and add more resources to the biased crimes unit in light of the uptick of biased crimes across the county I want to use my experience to make Westchester a safer place to live for everyone and with your support I can get there and get this job done 

1. MIRZA:

 You know what the reality is Ms. Cacace is right the DA’s office is not a job you can learn on the Fly no way no how the ADAs (Assistant District Attorneys)  who have been in that office some of them are fantastic Adas great trial lawyers and they’ve been there and they’ve dedicated their careers to Public Safety and they need someone who’s done their job someone who has stood in the trenches with them somebody who has handled the criminal courts of Westchester with them it’s not that they’re looking for, you know, someone to come in and save them because the system is not a complete and total disaster. Criminal justice in New York Works.

 Does it need fixes of course it needs fixes.  The reality is it’s not something you want to just toss out though because we have good ADAs, have good judges we have good investigators we have good police departments 42 of them some of the Westchester police departments are some of the best in the country and we are not going to just throw take a a flamethrower to the whole place because we need them and a combination of all of us will make Westchester a better place but what are the fixes we can make to the system right—

There’s some crimes that are over prosecuted and there’s some crimes that don’t get enough attention right 18 years as a prosecutor I’ve learned that there’s people that belong in jail and there’s people that don’t belong in jail because of mental illness addiction poverty so let’s focus the time efforts of the D.A.s who are there right now some of who are great lawyers right and let them — for morale for expediency– for time let them focus on the crimes against Community, crimes against Reproductive Rights crimes against tenants gun crimes shootings homicides and the office will be a better place.

1. WAGSTAFF:

This primary is about contrast in choice if you think that the justice system and its current iteration is working fine then you have two candidates that have been a cog in the wheel of Injustice that you can vote for but if you’re looking for someone who is going to be that breath of fresh air who’s going to bring a unique perspective and has a different background somebody that is proven that they are a transformational leader if you look at the obstacles that I’ve overcome to get to this point now is not the time to bet against me and I submit to you that if we are going to be serious about safety it takes somebody that has a combination of Education experience and passion to get us to the place that we all deserve to be if you want to continue the rut of succession politics which is an indictment on our democracy then you can go that pathway but I don’t suggest it and I implore you that the next district attorney should not be somebody that is trying to package entitlement as experience or looking for their old job back but should be somebody that is a transformational leader that has proven that they can overcome obstacles and solve intractable problems because we’re trying to solve generational issues and it’s going to take a generational Talent William Wagstaff is that talent.