When Measles Met COVID

How the anti-vaxers unintentionally blew up the COVID minimizers

As RFK Jr assembles his band of quacks to run HHS, scientific fiction seems to be the order of the day. His favorite myth, that vaccines cause autism, has us on course to see the worst year for measles in more than 30 years. Meanwhile, his cabal of COVID minimizers is frantically rewriting the history of the pandemic, prominently insisting that lockdowns and other non-pharmaceutical interventions (NPI’s) were ineffective against COVID. In an ironic twist, the data documenting the damage done by attacks on the measles vaccine also demonstrate that those who attacked the public health response to COVID, particularly NIH director, Jay Bhattacharya, were dangerously wrong.

Measles is the most contagious human virus, 5-10 times more contagious than COVID. We have witnessed that incredible transmissibility over the past few months as measles spread explosively in the United States with 935 cases⁴ in just the first four months of this year.

CDC surveillance data shows how measles, a disease at least 5 times more contagious than COVID, almost disappeared when public health interventions to control the pandemic were in place.

Just 25 years ago, measles was declared eliminated in the United States reaching a low of just 44 cases in 2004, all of them traceable to infections acquired during foreign travel. In subsequent years, as vaccination levels dropped, primarily in response to concerns about autism based on a fraudulent paper, measles made a resurgence to the point where, in 2019, there were 1314 cases. Then, in 2020, the incidence of measles suddenly dropped to the lowest level ever recorded. During the first year of the pandemic, there were just 13 cases.

COVID minimizers will argue that measles was simply underreported because of the pandemic, but reduced ascertainment of a disease as easily diagnosed as measles can’t begin to explain a 99% drop from the previous year, a 96% drop from the average for the preceding ten years, or a 70% drop from the lowest rate ever recorded. The only plausible explanation is that the lockdowns and other NPI’s introduced to control the spread of COVID were so effective at limiting the spread of airborne infections that they almost eliminated the most contagious human disease.

It should be noted that we also saw a dramatic drop in influenza mortality during COVID. (I have a forthcoming paper on this currently available as a preprint). The difference is that the 2019-2020 flu season was ending when COVID hit. We only have the 2020-21 flu season, so we don't have a good measure of 2020. Measles shows how dramatic the effect was during that year.

One of the perils of doing public health interventions right is that we make the consequences of inaction invisible. There is no control planet where we did not intervene. However, the unprecedented reduction in measles incidence is as compelling a piece of evidence as we are likely to find that COVID NPI’s were extremely effective. There is certainly room for discussions of the tradeoff between the economic and social consequences of NPI’s and their benefits in terms of reduced morbidity and mortality, but any notion that they were not effective in controlling COVID should be buried forever.