Tuesday, December 06, 2022

The Doctor Giving DeSantis’s Pandemic Policies a Seal of Approval

MIAMI — Dr. Joseph A. Ladapo has come out strongly against mask mandates and lockdowns, only supports vaccination campaigns if the shots are voluntary and will not say whether he himself has been vaccinated.

But in pushing for State Senate confirmation of Dr. Ladapo as Florida’s next surgeon general, Gov. Ron DeSantis has found a partner in fighting what Dr. Ladapo calls the policies of “fear.”

For a Republican governor whose brash opposition to conventional public health wisdom has helped fuel obvious presidential ambitions, the appointment of Dr. Ladapo signals Mr. DeSantis’s determination to continue powering through a pandemic that has already cost 68,000 lives in Florida — this time, with what the governor can claim is a medical seal of approval.

The Florida Senate confirmed Dr. Ladapo’s appointment on Wednesday by a 24-15 vote, with all Republicans voting in favor over strong objections from Democrats.

The DeSantis doctrine has asserted that older people should be protected from the virus but that younger people who are less at risk should do as they wish. Otherwise, the psychological and economic effects might be too damaging, both for individuals and for Florida’s cachet as a mecca for tourism and international business.

“Telling the truth, I think, is important, and I think that’s what Dr. Ladapo understands,” Mr. DeSantis said in selecting the former researcher at the University of California, Los Angeles, to run the Florida Department of Health. “You’ve got to tell people the truth, and you’ve got to let them make decisions.”

But when it comes to the warped politics of the pandemic, few agree on the truth.

Mr. DeSantis has built his political brand as a fighter, especially against Dr. Anthony S. Fauci, President Biden’s top medical adviser on the pandemic. Dr. Ladapo has helped Mr. DeSantis bolster his stance as a governor unafraid of living with the virus.

Florida ranks among the 20 worst states for its pandemic death rate and among the 12 worst for its case rate, but Mr. DeSantis has argued that the state also suffers when its economy and schools are restricted.

Some of Dr. Ladapo’s positions, like his opposition to lockdowns and mask-wearing in schools, have been conservative stances for some time and are beginning to be accepted by liberal leaders now that more people are vaccinated and cases are plummeting. But these views were relatively rare among physicians in charge of public health policy at the time he was espousing them.

To like-minded scientists who felt that their dissenting views had been silenced, Dr. Ladapo’s move from researcher to policymaker gave hope for those who hold views outside the mainstream.

To scientists appalled by Florida’s hands-off approach to the virus, Dr. Ladapo’s ascent cemented their belief that public health had become entrenched in the nation’s polarized politics.

Dr. Ladapo’s predecessor, Dr. Scott Rivkees, a surgeon general with more conventional views, had all but vanished from public view since warning early on in the pandemic that masking and social distancing would need to last for at least a year. Since his appointment, Dr. Ladapo has been a fixture at Mr. DeSantis’s side as Florida has abandoned those virus mitigation measures and banned their enforcement by local authorities.

“Florida will completely reject fear as a way of making policies,” Dr. Ladapo said.

He did away with school quarantines and masks. When public health officials across the country were urging vaccines as a way to end the pandemic, Dr. Ladapo was raising warning flags about possible side effects and cautioning that even vaccinated people could spread the virus. He has refused to disclose his own vaccination status, which he maintains is a private matter.

Thought Dr. Ladapo has acknowledged that vaccines are highly effective at preventing hospitalization and death, he said October that “adverse reactions” to vaccines should receive more attention and urged people to “stick with their intuition and their sensibilities.”

Equally troubling for his critics was Dr. Ladapo’s failure to reject more fringe views on virus treatments, including the drugs hydroxychloroquine and ivermectin. He joined Mr. DeSantis in clamoring for the federal government to supply some monoclonal antibody treatments even after they had been deemed ineffective against the Omicron variant, which dominated caseloads.

“To say he’s out of the mainstream would be an understatement,” said Dr. Ashish K. Jha, dean of the Brown University School of Public Health. “His views are not only very unorthodox — they don’t make any sense.”

The Florida Department of Health did not respond to The New York Times’s requests to interview Dr. Ladapo.

Before the pandemic, Dr. Ladapo, 43, who immigrated from Nigeria when he was 5, was an accomplished clinical researcher at UCLA, with degrees from Harvard in medicine and health policy. He focused on topics like smoking cessation and cardiovascular risk for HIV patients.

In early 2020, he contacted Dr. Jeffrey Klausner, a professor of medicine at the University of Southern California, to discuss lockdowns, which Dr. Klausner saw as having limited utility.

Dr. Ladapo did not want to take policies at face value, Dr. Klausner said: “He was the kind of guy who’s going to be reading an article in the medical or scientific literature and then going to the references, digging up those references, and then going to the references of those references.”

In April 2020, Dr. Ladapo published an opinion essay in The Wall Street Journal, titled “Lockdowns Won’t Stop the Spread.” He argued that it was too late to stop the virus altogether, so policymakers should consider the heavy toll of shutdowns and not just “the singular goal of reducing Covid-19 deaths.”

His national profile grew. More opinion pieces followed.

A few months later, Dr. Ladapo appeared clad in a white medical coat on the steps of the United States Capitol with a group of people who called themselves “America’s Frontline Doctors.” Some physicians in the group gave misleading claims about the virus, including that the drug hydroxychloroquine was an effective treatment. The Food and Drug Administration advises otherwise, warning that it could cause irregular heart rhythms.

A video of their appearance, shared by President Donald J. Trump, went viral online before social media platforms could remove it for spreading misinformation. One of the group’s founders, Dr. Simone Gold, was later charged with violent entry and disorderly conduct in the Jan. 6, 2021, Capitol siege.

Asked about the group during confirmation hearings, Dr. Ladapo said he supported its push for “individual autonomy.” He said doctors should not be limited in their use of hydroxychloroquine. He called the science on another drug, ivermectin, “unsettled,” though the FDA has warned that it can be dangerous in large doses.

Emails released by a congressional committee reviewing the Trump administration’s coronavirus response found that, in August 2020, Dr. Deborah L. Birx, the response coordinator, pulled out of a White House round table with Dr. Ladapo and other proponents of pursuing herd immunity by easing Covid-19 restrictions, which most experts said could not be achieved except at the cost of more deaths. She called them “a fringe group without grounding in epidemics, public health or on-the-ground, common-sense experience.”

Dr. Ladapo’s pandemic policy views unnerved some at UCLA, according to a former supervisor who was interviewed by the Florida Department of Law Enforcement for a background check.

The anonymous supervisor held the opinion that Dr. Ladapo’s views violated his Hippocratic oath to do no harm, and “created stress and acrimony among his co-workers and supervisors during the last year and a half of his employment,” as first reported by the USA Today Network.

Dr. Ladapo told Politico he was disappointed that disagreeing with someone had “become a ticket or a passport to activate personal attacks.”

His hiring stirred discontent at the University of Florida, where he is now a tenured professor. Of his annual $437,000 income, nearly $200,000 is defrayed by the university.

The chairman of the board of trustees, Morteza Hosseini, who is a top DeSantis political donor, pushed for Dr. Ladapo to be hired. Dr. Ladapo was granted tenure in only two weeks.

Faculty members later objected to the hasten process, though a university said it had been “standard.”

“I am very concerned that the state is not getting the best science and the best public health information,” said Dr. J. Glenn Morris Jr., the director of the university’s Emerging Pathogens Institute. “There’s not the sense of the development of a public health strategy that goes beyond politics.”

Academics who described him as a talented data scientist said he had attempted to balance protecting people’s health with the costs of prolonged restrictions.

“We’ve been sold a lot of fear over this whole thing, and people don’t make calm, considered judgments when there’s this underlying message of being afraid,” said Dr. Harvey A. Risch, an epidemiologist at Yale. “He of all people has managed to keep that in check and comes off as very collected.”

Dr. Ladapo’s unwillingness to strongly recommend the vaccines echoes how Mr. DeSantis has evolved on the shots. Though the governor pushed to get older residents vaccinated, he lost enthusiasm as anti-vaccination sentiment grew among Republicans.

Mr. DeSantis once stood next to a man making the false claim that a coronavirus vaccine “changes your RNA” without challenging his claim. The governor has also suggested without evidence that the vaccines could hurt female fertility.

About 66 percent of Floridians are fully vaccinated, compared with 64 percent of all Americans, but the state ranks lower than average when it comes to booster shots. Mr. DeSantis will not say if he has gotten boosted, even after Mr. Trump seemed to swipe at him, calling politicians who would not reveal their full vaccination history “gutless.”

Physicians have been disheartened at the lack of support to improve vaccination rates among vulnerable communities.

Other actions by Dr. Ladapo has also baffled public health experts.

He rewrote guidelines during the surge of the Omicron variant to discourage asymptomatic people who were not at high risk from getting tested — though infected people can spread the virus even without symptoms. He argued that testing was most valuable for people who might need treatment.

And he refused to wear a mask when he visited State Senator Tina Polsky, a Democrat, though she had asked him to, citing a serious health condition that she later revealed to be breast cancer. He said he meant no disrespect but did not apologize.

As cases plunge in Florida, Mr. DeSantis and Dr. Ladapo have committed more deeply to their policies.

Mr. DeSantis has backed withholding $200 million from administrators in 12 school districts that mandated masks. Some Republican lawmakers are trying to ban medical boards from revoking a doctor’s license for spreading Covid misinformation.

One such complaint had been lodged against Dr. Ladapo. It was dismissed.

Kitty Bennett and Sheelagh McNeill contributed research.

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