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An oncologist who is very vocal on social media, Vinay Prasad, MD, has come under attack for a recent essay that he wrote about the COVID-19 pandemic and potential futuristic scenarios. Entitled, “How Democracy Ends,” the essay was posted on Substack earlier this month.
The essay is antisemitic and racist, says Art Caplan, PhD, director of the Division of Medical Ethics at New York University, who wrote a hard-hitting editorial about it in The Cancer Letter.
Caplan has a regular Medscape column on ethics; Prasad was a regular columnist on Medscape until earlier this year.
Prasad is a practicing hematologist-oncologist and member of the Department of Epidemiology at the University of California, San Francisco. He has been a prolific commentator on oncology issues. Since the start of the COVID-19 pandemic, he has also been commenting on pandemic issues, including policies regarding mask wearing and school reopenings.
In the essay, Prasad posits the idea that in a hypothetical future, an unscrupulous US president could distort the risk for illness as a “justification for military force and suspension of democratic norms.”
Halfway through the piece, Prasad says, “When democratically elected systems transform into totalitarian regimes, the transition is subtle, stepwise, and involves a combination of pre-planned as well as serendipitous events.”
He then cites Nazi Germany as example. “Indeed, this was the case with Germany in the years 1929–1939, where Hitler was given a chance at governing, the president subsequently died, a key general resigned after a scandal and the pathway to the Fuhrer was inevitable.”
That analogy angered Caplan, who says Prasad was stating that public health efforts, such as those related to COVID that were recently enacted in the United States and Australia, could dovetail with a repressive political agenda on par with Nazism in America.
“The notion that public health will lead us to fascism due to efforts to control COVID is ludicrous, dangerous, and offensive,” Caplan writes in his editorial.
Caplan continues by saying that “to mix the two — the public health effort to fight a plague with political forces that we ought to be watching carefully [such as Trump-endorsed White nationalism] — is imbecilic.”
Caplan observes that the Nazis had racist public health notions, including a race hygiene theory and the view that genetic threats had to be eliminated to preserve the supposed purity of the German race. Prasad does not address that public health element of Nazism, says Caplan. That omission makes Prasad’s argument “fundamentally racist. It’s anti-Semitic, anti-gay, anti-Romani people,” says Caplan.
Medscape Medical News contacted Prasad for a response, but he declined to comment.
On Twitter, where Prasad has more than 100,000 followers, he wrote that the essay “is about a future scenario where pandemic precedents may subvert democracy. It’s not a Holocaust analogy.”
The reaction within the medical community has been mixed. There were some angry comments in agreement that the essay was antisemitic, but also some responses arguing that it wasn’t and that supported Prasad.
Mark Shapiro, MD, a hospitalist in California, tweeted: “Comparing America’s COVID-19 response to the rise of Hitler is both wildly off base & totally unacceptable.”
Others called the assessment from Caplan inaccurate.
Jeffrey Flier, MD, professor of physiology and medicine and former dean of Harvard Medical School, Boston, Massachusetts, tweeted that Prasad’s essay was not antisemetic: “Not only is his piece *not anti-Semetic*, it’s not even remotely so, and anyone who makes that claim or supports it is either profoundly dense or malevolent….”
Notably, both Prasad and Caplan share some common ground. They have each stated that they are concerned with the subversion of democracy by right-wing movements in the United States.
Nick Mulcahy is an award-winning senior journalist for Medscape. He previously freelanced for HealthDay and MedPageToday and had bylines in WashingtonPost.com, MSNBC, and Yahoo. Email: [email protected] and on Twitter: @MulcahyNick.
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