Two important reviews were recently released, both casting serious doubts on the scientific basis for many policies rolled out during the COVID-19 pandemic. One, published in the prestigious journal The Lancet, showed that infection-acquired immunity was long lasting and at least as protective, if not more, against symptomatic and severe disease than vaccination alone. The other, a meta-analysis of studies of masking effectiveness, was published by the Cochrane Library, the most respected source of systematic reviews in health care. The Cochrane review concluded that there was no robust evidence showing masks stopped the spread of respiratory viruses, including SARS-CoV-2. To be clear, both these studies were reviews of other studies and neither presented newly collected evidence.
So, given that much of the data supporting a range of policies were never robust, how did, for example, mask and vaccine mandates (especially when it became obvious that vaccines did not stop transmission) become standard in many states? We have no good answers to this question.
The only way to fully understand how and why policies based on weak data were imposed for multiple years on millions of Americans will be through a bipartisan group of experts as part of a congressional commission. Congress has a long history of creating just such bipartisan commissions after events of national importance (the post-9/11 commission, and the commission convened after the financial crisis, to name two) and we have previously pushed for an official congressional commission due to extensive mistakes, and the ensuing loss of public trust, made by the Centers for Disease Control and Prevention (CDC) and other health agencies. Release of these two recent studies, however, should galvanize every American to do the same: Demand answers from our agency leads and elected officials.
To guide such a commission, we, along with six other scientists and physician researchers (Jay Bhattacharya, Ram Duriseti, Tracy Hoeg, Martin Kulldorff, Marty Makary and Steve Templeton), wrote the Norfolk Report, released in early February. This report poses specific questions to politicians as well as to federal, state and local health leaders about a range of issues including the failure to protect older high-risk Americans, misleading communication about disease risk, early failure to develop tests and secure personal protective equipment, (PPE), ignoring collateral damage and exacerbating social inequities through lockdowns and school closures and more.
We are not alone in calling for a commission. Back in August 2020, a group of physicians at Georgetown University called for a commission, posing questions such as “What happened to diminish the United States’ once-vaunted reputation for responding effectively and efficiently in a crisis, owing to its resources, deep scientific expertise, and ability to organize?” Another group, headed by Philip Zelikow, the director of the 9/11 Commission, formed in 2021 and conducted hundreds of interviews and devised work plans should a commission form.
Sen. Gary Peters (D-Mich.) also released a report at the end of 2022, which noted widespread governmental failures in the early days of the pandemic, such as empty stockpiles and emergency funds, failures in messaging, overreliance on foreign medical supply chains and a general failure to react quickly. Sens. Bob Menendez (D-N.J.) and Susan Collins (R-Maine) introduced legislation to form a commission in February 2021 while Sens. Roger Marshall (R-Kan.), Dianne Feinstein (D-Calif.), Kirsten Gillibrand (D-N.Y.) and Joni Ernst (R-Iowa) tried again later that year. A recent proposal by ranking members of the Senate Health Committee, Patty Murray (D-Wash.) and Richard Burr (R-N.C.) has also stalled.
Bipartisanship is crucial but, to date, seems elusive. House Republicans have formed a committee, which includes four Democrats, but a committee does not have the tools or the credibility of a commission that would have buy-in from both parties, could subpoena witnesses and can act independently of Congress. Without the help of outside experts, hearings are led by legislators that are generally ill-equipped to debate the merits of the scientific literature and policy decisions.
This was all-too evident at the recent House Energy and Commerce Committee hearings, where questions lobbed at leaders from the CDC, National Institutes of Health (NIH) and Food and Drug Administration (FDA) were met with underwhelming answers and little pushback. For example, in response to a question regarding the CDC’s failure to run early mask trials, CDC Director Rochelle Walensky suggested that there was no need to run them because there was enough observational data to conclude masks worked (and that it was justified based on high COVID-19 rates). The meta-analysis shows this is not accurate.
Had a large high-quality trial of mask effectiveness been conducted in 2020, we would have known sooner that mandates would do little to curb spread and masks would not have become the infamous symbol of political polarization that they did. She went on further to say that guidance on masking would not change in light of the new Cochrane review. No one pushed back on these baffling statements, nor others about vaccine efficacy, guidance on school reopening, and the social media silencing of those with dissenting viewpoints.
The Financial Crisis Inquiry Commission, established after the crash in 2008, investigated banking practices, reviewed governmental regulatory policies and evaluated decisions made by financial agencies. Key regulations were passed in response to the committee’s findings, such as the Dodd-Frank Wall Street Reform, the Consumer Protection Act, and the Emergency Economic Stabilization Act (EESA) which created the Troubled Asset Relief Program (TARP). The 9/11 Commission also led to consequential reforms of U.S. national security systems.
A COVID-19 commission is needed to achieve something similar for our pandemic response systems. The results will surely be embarrassing for both parties — but there is plenty of blame to go around, and neither party should shy away from the task of gleaning as many valuable lessons as possible from this catastrophe before the next pandemic hits. As this health emergency ends, we need an honest and clear-eyed bipartisan pandemic post-mortem to begin.
Margery Smelkinson, Ph.D., is an infectious disease scientist whose research has focused on many pathogens, including influenza and SARS-CoV2.
Leslie Bienen, DVM, MFA, is a veterinarian whose research and policy work focuses on zoonotic disease transmission and downstream effects of disease mitigation strategies.