Jay Bhattacharya Tells Me Why He Should Not Lead NIH
Or, perhaps, why he is the perfect man to preside over the decline of the world's leading life sciences research institutions
There is little chance that a Republican controlled Senate, so in thrall of Trump they would confirm a nutjob like RFK Jr, will fail to confirm Jay Bhattacharya as NIH director. As a Stanford professor with an MD and a PhD, he certainly looks the part. However, in just a few interactions with me, he demonstrated that he has neither the character nor the integrity to lead the world’s preeminent institution for life sciences research. Consider the three faces of Jay Bhattacharya.
The “Epidemiologist”
Bhattacharya is a health economist but suddenly became an epidemiologist with the arrival of COVID and continues to present himself as one. This seems to have started when he conducted one the most influential and deeply flawed epidemiological studies of COVID in April of 2020. In brief, the study purported to estimate the total number of infections that had occurred in Santa Clara County prior through mid-March by testing blood samples for antibodies and used that estimate to predict the risk of dying from COVID.
This type of study, known as a seroprevalence study, is deceptively difficult to conduct because it requires a random sample of blood, something people are understandably reluctant to provide. No one on the team had ever done a seroprevalence study before and it showed. Epidemiologists argued from the outset that the study was flawed. It would take the virus to show us how flawed.
The Santa Clara study estimated that only 0.17% of unvaccinated people infected with COVID would die, roughly on par with seasonal flu. If Bhattacharya had been right, COVID would have killed less than 300,000 Americans.[1] With more than 1.2 million deaths, SARS-COV2 has shown that study to be off by a factor of four or more.
Bhattacharya had taken the unusual step of declaring what he expected to find in a Wall Street Journal op-ed before conducting the study. Prior to meeting him last summer, I was inclined to believe that he was well intentioned but had unwittingly fallen into the trap of letting those prior beliefs guide the many small decisions that go into conducting a study and produced biased results. We all make mistakes. A true test of scientific character lies in our response to those errors. In the summer of 2024, I had the opportunity to apply that test when I met Bhattacharya at a conference.
When I laid out the facts described above, I expected Bhattacharya to explain why he felt I was overstating the error. Perhaps he would suggest that Santa Clara was radically different from the rest of country. Certainly, he would acknowledge some level of error.
His response shocked me.
Skepticism is central to science. Self-skepticism defines a good scientist. Bhattacharya exhibited none. His study, he insisted, had gotten things “exactly right”. Self-skepticism does not seem to be in his repertoire.
The Public Health Strategist
In 2020, the Santa Clara study gave rise to the line that COVID was no worse than the flu and played a central role in launching an unprecedented assault on the public health community. Its apparent minimization of the COVID risk helped make him an advisor on Trump’s pandemic response. That fall, a conservative economic thinktank invited him to join a team of three with no experience managing a local disease outbreak or even caring for a single COVID patient to develop a response strategy for a global pandemic. They produced a rambling, one-page document that came to be known as the Great Barrington Declaration (GBD). It advocated a strategy of “focused protection” for “those at highest risk”.
The authors did not bother to define exactly who was at highest risk or how we should protect them but made it clear that everyone else should “live their lives normally to build up immunity to the virus through natural infection”. In other words, the best way to manage a novel infectious disease with no knowledge of its potential chronic or latent effects, was to let almost everyone get the disease.
This strategy of “focused protection” had been championed by Sweden and went on to be embraced by conservative governments in the US and UK. A year into the pandemic, all three countries had dramatically higher COVID death rates than countries with more aggressive public health measures and/or more compliant populations.
The Victim of “Censorship”
As the superficially appealing public health minimalism espoused in the GBD gained traction, public health officials grew alarmed. NIH Director, Francis Collins, called Bhattacharya a “fringe epidemiologist” and federal scientists made a desperate, but ill-advised effort to limit its reach.
In Bhattacharya’s prepared remarks for today’s confirmation hearing, he asserts that NIH officials exhibited “lack of tolerance for ideas that differed from theirs”. This appears to be a direct reference to the “censorship” of his own ideas.
If what Bhattacharya experienced was censorship, who needs PR. The preprint describing his Santa Clara Study was downloaded over 300,000 times, picked up by 451 News outlets and eventually published. A search of FOX News alone finds he made more than forty appearances on the network. Many of those appearances were prompted by the revelation that social media platforms had limited his reach, hoping to control the spread of misinformation.
The reality is that no serious scientist has a problem with ideas that differ from their own. Scientists must constantly test their own beliefs and adapt them to new, high-quality research. The problem comes when poorly conducted research and unsupported ideas like Bhattacharya’s are presented as truth to people unable to assess their validity.
When it comes to medicine and public health, misinformation kills. That is why there are many laws that limit what one can say in a public forum, such as those that regulate the content of pharmaceutical ads. Controlling the spread of misinformation in a modern media environments was a daunting challenge for public health officials in the early phase of the pandemic. At the conference mentioned above, I posed this question to Bhattacharya:
If you are certain that belief in scientific misinformation is causing people to take actions that endangered their health and/or the health of those around them, how should we, as a society control or counter its dissemination on conventional and social media?
I had just watched a panel discussion in which Bhattacharya had decried efforts to limit the spread of his research and opinions on COVID. The other member of the panel, the Marin County Health Commissioner described his struggles to counter that misinformation in his efforts to save lives in Marin County. When I posed the question, Bhattacharya responded with a rambling non-answer in which he seemed to insist that the free flow of information supersedes other concerns.
Once again, the virus poked huge holes in the Bhattacharya’s strategy for COVID. The GBD was released on October 4, 2020. What followed was the deadliest wave of COVID in the entire pandemic, particularly among those countries most receptive to its “focused protection” strategy.
Is stopping someone from shouting fire in a crowded theater, censorship? Or more aptly, should we allow someone to stand in that proverbial theater as fire grows in its basement and shout that people need not to worry about the smoke. Bhattacharya seems to want us to hand that person a megaphone.
Bhattacharya’s preprepared remarks for his confirmation hearing state that, as NIH director, he would
“encourage different perspectives and create an environment where scientists … can express disagreement respectfully.”
To suggests this is a needed innovation implies an unfamiliarity with a tradition almost as old as science itself. Scientists routinely attend scientific conferences that are built around respectful disagreement. Furthermore, another interaction with Bhattacharya, suggests he has a different definition of respectful disagreement than I do.
Last fall, I responded to a post by one of the three authors of the GBD asserting that time had proven their strategy to be correct.
This, it seemed to me, was respectful disagreement. When Kyle Lamb, an economist and former adviser to Ron DeSantis, insisted that I simply didn’t understand the epidemiology, Bhattacharya cheered him on, posting that I was incapable of basic logic.
He then blocked me.
This does not make me special. He routinely insults and/or blocks people who disagree with him, including scientists and physicians .
Bhattacharya seems to understand neither censorship nor science and is an utterly inappropriate choice to lead the world’s preeminent biomedical science institution. However, as noted above, none of this will prevent his confirmation. Given the ethos of this administration, his hypocrisy and self-righteousness will fit right in. In fact, it may well be fitting for him to preside over the decline of US preeminence in life sciences research in collaboration with an anti-science President and his chainsaw wielding sidekick.
[1] This takes into account the impact of vaccines in reducing the mortality rates associated with COVID.