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Senator Paul’s Skepticism of Experts Sets a Very Dangerous Precedent

Why should experts guide our national response to COVID-19? Maybe you missed that lecture in medical school, Dr. Paul. It’s because experts know more about it than you do.

Edward C. Halperin, M.D., M.A.

‘Decentralized Power’ in Public Health

Photo Credit: Nicholas Kamm/AFP

During US Senate hearings in March and June, Senator Rand Paul of Kentucky, a Republican and an ophthalmologist, voiced multiple criticisms of Dr. Anthony Fauci. For the last 34 years, Fauci has served as the Director of the National Institutes of Allergy and Infectious Disease. For many Americans, he has become the face of medical expertise regarding the COVID-19 pandemic. Pointedly critical of his recommendations on slowing the COVID-19 spread, Senator Paul ridiculed Fauci’s expertise, hurling combative comments such as: “We shouldn’t presume that a group of experts somehow knows what’s best for everyone.” “I don’t think you’re the end-all. I don’t think you’re the one person who gets to make a decision.” “Only decentralized power and decision-making, based on millions of individualized situations, can arrive at what risks and behaviors each individual should choose. That’s what America was founded on — not a herd with a couple of people in Washington all telling us what to do, and we like sheep blindly follow.” Paul decries reliance on experts. It’s a dangerous precedent for a US Senator to take. If one follows Paul’s logic, why should we only allow “certified experts” to pilot passenger aircraft? If the plane is about to take off and the voice overhead says, “Ladies and gentlemen, I’ve never flown one of these, but read an article about how this works… so buckle up,” would Paul settle in for his flight? Maybe he’d like the plane flown by a “decentralized” vote of the passengers?

Paul is also wrong about “decentralized power” in the realm of public health. Public health authority in the US is already highly decentralized to states and county health authorities. In countries that actually exert central leadership in the face of a pandemic, like Germany, ventilators, ICU beds, and testing are handled far more efficiently and with less loss-of-life than under the gang-who-can’t-shoot-straight pandemic management style of Donald Trump’s administration. Paul’s skepticism of “experts” is particularly curious insofar as he is a physician himself. Medical specialists demonstrate their expertise by achieving board certification by recognized national organizations. For example, I am board certified as a radiation oncology physician by the American Board of Radiology. Cardiologists are board-certified by the American Board of Cardiovascular Medicine and ophthalmologists by the American Board of Ophthalmology. How about Rand Paul? As has been widely reported in the press, he never achieved certification by the American Board of Ophthalmology. Instead, he invented his own board, called it the National Board of Ophthalmology, helped write the questions on the “board examination,” took it himself as an open book take-home examination, certified himself, and installed his wife and father-in-law as officers of his self-created “board.” His certification house-of-cards long ago collapsed. For someone with both so little respect for the concept of documentation of medical expertise, and so little demonstration that he possesses any understanding, to publicly criticize the COVID-19 expertise of Dr. Fauci, one of the world’s leading experts on infectious disease, would be funny if Paul didn’t take himself so seriously. Fortunately, most public health experts, physicians, and the American public do recognize both the value of expertise and Dr. Fauci’s service to his country.

Perhaps he thinks we should ignore nuclear engineers and allow the operation of a nuclear reactor to be placed in the hands of anyone who has some free time on their hands?

Dr. Paul graduated from Duke University’s School of Medicine during a period when I was on the Duke faculty. I have no recollection of him as a student. He must have been bright enough to get admitted. He also illustrates a pronouncement of my father, who expressed an opinion within his area of expertise: “There are bright people in this world who don’t have any common sense.”

Would he prefer to drive his family on a bridge over a canyon designed by anyone who owns a pencil and a piece of paper or, instead, rely on a civil engineer with years of experience in bridge design?

As appeared in The Globe Post on July 13, 2020.