An Illusion of Consensus

An Urgency of Normal doctor looks back

Dr. Nikki M. Johnson

We are thrilled to introduce you to our newest contributor, Dr. Nikki M. Johnson, a founding member of the Urgency of Normal team. Nikki has been an original and brave voice calling out hypocrisy in our nation’s Covid response and advocating for children via social media and her writing. Here, she talks about the personal costs of speaking out against an illusion of consensus in medicine and asks some probing questions about why so few doctors defended evidence-based medicine.

-Natalya and Dana

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On a cold winter’s day last January, I left my parked car and pulled a paper mask from my pocket to don for the morning ritual of walking into the hospital. It had become hospital policy to wear an “isolation mask” throughout the hospital to protect myself and others from COVID-19 transmission. But that day, when I looked at the mask in my hand, I felt an overwhelming urgency to return to normal. Not just everyday living but a reality- and evidence-based existence.

Not just for myself but also for my patients and my children.

You see, in medical school, I learned that paper surgical masks were to be worn in sterile environments to protect the wearer from getting debris in the mouth and nose. I also learned that high-filtration particulate respirators protect the wearer from airborne diseases in close contact with infected patients.

Throughout my twenty-plus years of learning, training, practicing, and teaching medicine, I had never worn a mask outside of an operating room, another sterile environment, or the room of a patient sick with an infection spread by droplets or airborne particulates.  For decades, my colleagues and I had trusted and followed the CDC's isolation guidelines because we knew they stood up to scientific rigor and offered standards we could rely on.

However, the CDC, NIH, medical organizations, and physician and scientific colleagues I respected, ignored their standards and decades of evidence to create policies during the COVID-19 pandemic. Public masking recommendations, especially for children, were something I’d never heard about and never imagined would happen in Western society.

They had somehow reached a scientific consensus without using the available scientific evidence. 

Unfortunately, the public bought it. I recall writing an op-ed in the summer of 2020 to encourage government officials to reopen schools. The editor wanted me to add masking to reopening protocols, but I disagreed. However, at the time, I couldn’t advocate against masking if I wanted to get children back into classrooms.

I thought it was a trade-off we had to make.

And while I can see why government agencies would want to formulate a public narrative, I will always question why so many of my colleagues followed it. For a while, I questioned my own sanity, being one of only a few voices speaking against a false consensus. Previously published studies supported my views, but everyone had either forgotten or ignored them. 

But on that January day, I’d reached the peak of my tolerance for the policies that formed the imaginary scientific consensus on COVID management. I could already see evidence of the predictable harm to children, including my own two daughters, who struggled socially and psychologically.

Holding that crumpled paper with elastic ear loops and bent wire was a visual reminder of the joke my profession had become.

I wondered how we arrived at this place of disregard for humanity and whole human health. On that day, I decided to speak out about it and tweeted the following:

My tweet was reported to my employer. I was issued a "final warning" on disciplinary action.

I was furious.

Every word I tweeted was based on past evidence. The conclusions of the recently published Cochrane Library Review on physical interventions to prevent viral transmission confirm previous research. Dr. Tom Jefferson and colleagues combed through randomized control trials, the gold standard of scientific study, and concluded public masking offers little prevention of human transmission of influenza-like and Sars COV2 illness. 

This evidence should steer a return to the previous practice of creating a genuine scientific consensus. Not an imagined one or one driven by political ideology.

It should signal the end of required masking in schools, hospitals, and other public places.

Sadly though, since publication on January 30th, no public health agency or medical organization has released a statement of apology or reversed their recommendations on general masking.

So I call on the CDC, NIH, American Academy of Pediatrics, and public health authorities to advise the public of the findings of this review and issue factual statements about masking to de-escalate public fears. I believe this is a necessary step toward recovering trust and restoring the process of forming scientific consensus.