I am going to bring this series of blog posts on identifying disinformation to a conclusion. In this part V, I will summarize the key messages from the first four blog posts and add a few other pointers.

During this pandemic, those of us dedicating significant amounts of time to educate the public found that we still couldn’t keep up with all the false information. In this case, I am referring to addressing “disinformation,” the spread of incorrect information with the intent to harm, confuse, mislead, or otherwise affect people’s hearts and minds to accept lies and/or support the position of those who are spreading the false information. This is opposed to “misinformation” that is incorrect information, but the person spreading it did not realize that the information was incorrect or incorrect at the time. Whether it be misinformation or disinformation, the other thing we found is that combating it was like playing the game whack a mole, in that every time we successfully countered incorrect information, new misinformation or disinformation popped up to replace it. Because of this, we cannot successfully win this battle for truth on our own; we must educate the public how to recognize suspicious information. Fortunately, we had so many examples of people spreading disinformation that patterns that can alert us to disinformation emerged.

Disinformation comes from many sources, including foreign countries. The motives of those who spread disinformation can be diverse. For a foreign country, it often is the intent to sow distrust in the U.S. government and discontent among the populace. For home-grown purveyors of disinformation, perhaps they stand to financially benefit, sometimes there are political aspirations or motivations, and sometimes these sowers of disinformation like the public attention and adoration they receive from those who want to believe the lies. There may be other reasons as well. But, a common thread was narcissism and lack of empathy. These persons do not care if they harm others so long as they gain whatever benefit it is they are seeking for themselves.

What are the patterns that can alert the public to be suspicious of the information being conveyed?

1. Credentials.

We often saw that physicians and other health professionals who were promoting misinformation and disinformation were not in specialties that generally treat patients with COVID-19 or have expertise in treating acute infections, respiratory disorders and hospitalized patients. Examples were pathologists, neuroradiologists, ophthalmologists and chiropractors. Certainly, that does not mean that the physician may not have very specialized knowledge about COVID-19, but this should be a red flag when that advice is contrary to physicians who are specialists in those areas of practice in much the same way that a dermatologist offering advice about prenatal care that is inconsistent with information put out by the American College of Obstetricians and Gynecologists should be suspect.

2. The use of grandiose, overly dramatic or inflammatory language.

Reputable physicians and scientists generally try to maintain objectivity and professionalism. It would be greatly out of character for these experts to use inflammatory or offensive language in explaining science or public health recommendations to the public. On the other hand, one physician who was spreading disinformation repeatedly referred to the COVID-19 vaccines as “needle rape.” To compare vaccination to one of the most psychologically and physically traumatizing events that can happen to a person is beyond the pale and offensive in its trivialization of the dehumanizing trauma that these victims of sexual assault have suffered. The language is obviously intended to inflame the hearts and passions of those they are spreading disinformation to rather than to stimulate the mind. We also heard many of those spreading disinformation about the vaccines using language to conjure up images of Nazi Germany, making reference to the Nuremburg Code, and often using variations of the phrase “crimes against humanity,” all of which were intended to create a false equivalency between vaccinations and various historical atrocities. When you hear or read this kind of language, a red flag should be raised to suggest that an attempt is being made to emotionally manipulate you and that the information is likely unreliable.

3. The use of emphatic and absolute statements.

There are very few things that we can say are absolutes in medicine – always happen or never happen. That is because diseases can manifest themselves and behave differently between children and adults, between young adults and the elderly, between men and women, between the immunocompromised and the healthy, and even in individuals of the same age and gender. So, another warning sign is when sources make statements that are absolutes. Physicians and scientists will often qualify their statements and advice – “based upon what we know today” (understanding that new data may come along in the future that could change our understanding of the disease or its treatment), or “based on a recent study” (leaving open that more studies or larger studies might change our understanding), or “based on the limited data we have available” (acknowledging that we have some data, but it may not apply to people that are different than those who were study participants, or to people with additional medical conditions than those studied). An example of an absolute statement that should raise a red flag that we heard during this pandemic was “masks do nothing.” Now, we can debate the effectiveness of different kinds of masks, their effectiveness under different conditions, or the effectiveness with different variants, but if someone tells you masks provide absolutely no protection or if someone tells you that masks provide complete protection, this should be reason enough to look for another source.

Another very helpful indicator as to whether you can trust a source is that reputable physicians and scientists will often answer questions when there is a new development with some variation of “we don’t know” or “we need more information before we can answer that,” whereas those spreading disinformation rarely answer questions by admitting that the science is evolving or that it is too early to answer the question with any certainty.

4. The use of anecdotes as evidence.

We often heard those promoting misinformation making comments such as “I treated [fill in the number] patients with ivermectin and they all did great.” That is an anecdote; that is not science. Were all of those patients young, healthy and low risk and would be expected to have good outcomes even without treatment? Did all of them have confirmed infection? How do you know none of them deteriorated and didn’t go straight to the hospital without notifying you, especially since a number of physicians making this claim did not treat patients in hospitals?

5. Internal inconsistencies in their arguments.

Think about a person in an interrogation room at a police station. A skilled detective can tell when the person is being truthful, because truth has internal consistency to it. The various pieces fit together and make sense that they would occur in the manner and the order the witness describes. On the other hand, when you can get a person to talk for an extended period of time and that person starts out with a lie, it is incredibly difficult to maintain the lie because things eventually don’t make sense and cannot be connected in a logical way. So, too, if you give someone spreading disinformation enough time to talk, you will generally see them get tripped up. Let’s look at an example. A very common internal inconsistency arose when some doctors made the argument that people should not take the COVID-19 vaccine because it was only authorized for emergency use, but not yet fully approved by the FDA. That could certainly be a reasonable concern for some people and worthy of discussion. However, what they suggested as the alternative, and what patients seemed more than willing to do, was to take various medications that were neither authorized or approved by the FDA for prevention or treatment of COVID-19. In fact, the FDA even warned the public not to take one of the recommended medications. The inconsistency was using FDA approval as the criteria for prevention of COVID-19 and using it to arguing against one measure, but then disregarding it in recommending another.

6. Misuse of data.

One common tactic used to create fear of getting vaccinated was for purveyors of disinformation to point to the thousands of deaths reported to VAERS (the Vaccine Adverse Event Reporting System) as being due to the vaccines. This would make sense to the majority of Americans who are not familiar with VAERS, but can tell from the name that this is a system that reports vaccine adverse events. But, this was intentional deception by the physicians who were suggesting causality, when in fact, the site is for reporting by the public so that the CDC and FDA can be alerted if the frequency of an adverse reaction exceeds the background rate of those symptoms or conditions. Prior to the pandemic, more than 8,000 persons in the U.S. die each day on average. To keep the math simple, if you consider that about half of the U.S. was vaccinated this year, you would expect roughly 4,000 deaths each day unrelated to COVID-19 among the vaccinated, in fact, even higher than 4,000 because those being targeted for vaccination were the elderly and those with underlying medical conditions. Those perpetuating fears of vaccination attributed all of the deaths in VAERS that would be expected under pre-COVID conditions and unrelated to COVID-19 and the vaccines to the COVID-19 vaccines. Even just resorting to common sense, if the FDA temporarily stopped vaccinations with the J&J COVID-19 vaccine when only three cases of Thrombosis with Thrombocytopenia Syndrome were identified through the VAERS reporting, it should cause everyone to question that the CDC and FDA could then believe that there were thousands of deaths caused by the vaccine, yet take no action or even issue a warning.

7. Failure to cite studies and identify any limitations to those studies.

It is not uncommon for purveyors of disinformation to indicate that studies show support for their position, but then not produce those studies when asked. Further, we have never heard these disseminators of falsehoods ever describe any limitations to the studies they are referring to. Reputable physicians and scientists are always willing to provide the evidence for their statements or opinions. They also are quick to point out limitations of these studies, such as patient selection or study design, and usually will provide caveats that we cannot be certain that the findings will apply to patients that are different than those who made up the study participants or who are treated under different conditions than those used in the study.

Health professionals can certainly have differing opinions about the best treatment for a particular patient. These differences can arise because clinical trials have not yet provided us with evidence of the best treatment or because the particular circumstances of the patient are different than those who have been enrolled in clinical trials. These professional differences of opinion are appropriate.

My objection is to health professionals who offer the public and their patients advice that is clearly and demonstrably erroneous, contrary to the guidance of the CDC, FDA, professional associations and their own peers, and has great potential to harm patients. At the heart of this, physicians always have a duty to act in the best interests of our patients and we have an obligation to inform our patients and tell them the truth, as best we understand it. Lying to and deceiving patients should be abhorrent to physicians.

We are starting to see physicians held accountable for purposeful and repeated dissemination of disinformation. I believe appropriate actions can include discipline by state medical boards, loss of hospital privileges and revocation of board certification.

However, the disciplinary process is a lengthy one because of the need for investigations and hearings. In the meantime, it is essential for the public to be aware of the red flags of disinformation that we have listed above in order to protect themselves until the system can, because in an internet and social media age, disinformation spreads faster than the virus.

This blog series is intended to help readers in identifying when you should be suspicious that information you are being provided is intentionally false and/or misleading. I am not trying to strong-arm anyone into making a decision that they don’t think is right for them; I am merely trying to avoid people making decisions that they may regret because they believed disinformation and based their decisions on incorrect information. I believe that if we equip people with the true facts, they generally will make the right decision.

In the prior post, I warned people to be on the look-out for sources that use overly dramatic or inflammatory language and I provided you with a number of examples. Reputable doctors and scientists try to remain objective and professional, and therefore would not be expected to use that kind of language.

Now, we will look at another warning sign: The use of unqualified absolute statements.

Science evolves. Therefore, beware of sources who when speaking about a novel disease that we are still learning about, make dogmatic statements without qualifications to those statements such as “based on this recent study, based on limited data, based upon what we know at this time, etc.” Reputable doctors and scientists know that when we are learning about a new disease or condition, we often find that things change as we see the disease or condition play out in more people of different ages, socioeconomic groups; different genders, races, or ethnicities; and with different underlying medical conditions. So, if the source doesn’t admit that they have been wrong about anything in their evolving understanding of the disease or doesn’t qualify their statements as above, acknowledging that our understanding may change as we get more and new research in, then you should be very suspicious of the reliability of that source.

Diseases often affect children differently than adults, young adults differently than the elderly, and immunocompetent persons different than those who are immunocompromised. Reputable doctors and scientists realize this. Therefore, when a source makes dogmatic statements that he or she applies to everyone, that too should cause you to scrutinize what they are saying before you accept it.

Similarly, I can’t think of any medication that is completely safe and completely effective. So, when someone promotes a treatment as being so, that would be a good time to look to a more trusted source for information.

Let’s turn to Dr. Cole again for some examples.

1. “We have never tried an mRNA vaccine in humans before.” This is one of his easiest false statements to debunk. Notice the warning signs. “We have never…” An absolute statement with no qualifications, other than at the end of the sentence where he states, “in humans,” leaving open the door that perhaps they have been used in animals. Also notice that the statement is also used to promote fear. But, is it true? No. In the past decade, mRNA vaccines have been developed for avian influenza, cytomegalovirus, Zika, Chikungunya, Ebola and Rabies and all of these have been administered to humans in clinical trials.

• Dr. Cole also expresses concerns about the large numbers of people being vaccinated, “with no ability for recompense if injured or in case of death.” Again, notice the absolute and unqualified statement – “no ability” for those who have been injured to be compensated. That sound doubly scary – you could be injured or die and you or your family would receive no compensation. Can that be true? No. People can be compensated for injury or death from the COVID-19 vaccines through the Countermeasures Injury Compensation Program (CICP). There are caps on the damages in the amounts of $50,000 per year for loss of employment income and about $370,300 for death, but clearly Dr. Cole’s statement that there is “no ability for recompense if injured or in case of death,” is completely false.
• In one of Dr. Cole’s videos, he expresses how nice it is to see the audience without “faces covered with unnecessary cloth that does nothing.” This is another example of an absolute statement – “does nothing.” We can certainly debate how effective masks are, and Dr. Cole could certainly raise valid points depending on the type of mask worn, whether the mask is worn correctly, what the environmental conditions are, etc., but instead he goes too far with an absolute statement without any qualifications in stating that they do “nothing.”

Undermining his statement is a photo from his website that appears to have been recently taken down. Obviously, masks must do something.

• Here is another example from one of Dr. Cole’s videos: “Never in the humanity, in the middle of a pandemic, have we said ‘oh let’s vaccinate during the pandemic.’” Hopefully, now you can spot the absolute part of the statement – “Never” in all of humanity (notice the dramatic flair, as well?). We don’t have to go back very far in history to see that this is simply not true. We used vaccines in the past three influenza pandemics (1957-58, 1968 and 2009).

In the next part of this blog series we will look at more warning signs and some examples.

In this part of the series on identifying disinformation, we will look at clues from what purveyors of disinformation say that should raise red flags.

If you are new to the blog or you did not read parts I and II, I just want to reiterate some important points. My intention in writing this blog series on disinformation is not to strong arm anyone into getting vaccinated if they are not yet vaccinated and don’t want to be. What I hope to accomplish is that if you don’t want to be vaccinated, at least do not make that decision based on lies and untruths. To make good choices, one has to understand the options and the pros and cons of those options. What I object to is those who spread disinformation tricking people into not getting vaccinated by deceiving them. If you have the correct information and decide that the vaccine is not right for you under your particular circumstances, then I can respect that.

This series provides the reader with clues to help discern when they may be getting disinformation. While there are quite a number of foreign nations, organizations and individuals spreading disinformation, I am using a local Idaho doctor as my example because he uses almost every one of these techniques and is very skilled at it. So, let’s look at some examples. All of these are references to or quotes from Dr. Ryan Cole from interviews or videos of his talks. Also, I am going to try to point out how common sense can indicate that what he is saying is not likely true rather than trying to argue his points by referencing clinical studies that many of my readers may not be able to easily evaluate for themselves.

1. The use of overly dramatic or inflammatory language

Most true experts and scientists will try to remain objective when they explain science to the public. Contrast this with some of the overly dramatic and inflammatory language used by Dr. Cole:

Dr. Cole commonly calls the COVID vaccines the “fake” vaccine, “needle rape”, or the “clot shot.” I have called Dr. Cole out on this, but he defends himself by saying that this is what others have called the vaccines. Okay, maybe if you say this once, you might be able to attribute this to others; but when you say this in multiple settings on multiple occasions, you now have to own it. No legitimate public health expert or scientist to would result to what is essentially the equivalent of name-calling. Notice that these names are intended inflame your emotions, rather than inform your mind. Legitimate scientists don’t do this.

So, let’s think about this first example of the COVID vaccines being “fake” vaccines for a minute just from a common-sense point of view. Below, I will point out that another warning sign is that the arguments of disinformation promoters lack internal consistency. Let’s consider Dr. Cole’s statement that these are “fake” vaccines. There are only two possible meanings I can conclude from Dr. Cole calling the COVID vaccines “fake” vaccines – (1) that they are not really vaccines and/or (2) they don’t work. If he means the first, then he has an internal consistency problem. In one of his videos, he rails against organizations who have implemented vaccine mandates. The answer is for the legislature to prohibit such mandates. However, if the COVID vaccines are not vaccines, then obviously a prohibition against vaccine mandates would not prohibit employers from requiring COVID vaccinations.

But, let’s suppose that since the first possible explanation really doesn’t make any sense, that it is not what Dr. Cole meant. Let’s consider the alternative, that he is implying that the vaccines simply don’t work. I could certainly provide you with ample scientific evidence that they do, but consistent with my commitment above to only apply common sense given that not everyone will be able to read and understand all these clinical studies, let’s think about this for a minute. So, if the vaccines don’t work, then your chances of getting infected, getting severely ill and being hospitalized should be the same whether vaccinated or not. So, let’s consider Idaho. Of Idahoans over the age of 18, 69.6% have been fully vaccinated. Let’s call it 70% just to make things simpler. Okay. If the vaccine does not work, then in a large population of people such as Idahoans over the age of 18, we should expect to see as many infections, hospitalizations, patients in critical care and deaths from COVID among those vaccinated (i.e., 70%) as those unvaccinated (30%) if the vaccines really are “fake” and don’t do anything to protect you.

Now, let’s look at the numbers made public by the Idaho Department of Health & Welfare for the period of time from May 15 – October 9, 2021. What about infections? Remember, if the vaccines are “fake” then the numbers should be roughly 70% vaccinated and 30% unvaccinated. The real numbers for infections – 12% vaccinated and 88% unvaccinated. Well, what about hospitalizations? 10% vaccinated and 90% unvaccinated. What about the most seriously ill requiring critical care? 8% vaccinated and 92% unvaccinated. And, lastly, what about deaths? 13% vaccinated and 87% unvaccinated. I think everyone can see that Dr. Cole’s characterization of the vaccines as “fake” at minimum doesn’t make any sense, but at worst it is just an outright lie and intention to deceive. Again, if you chose not to get vaccinated, that is your business, but I just don’t want you to make that decision based on Dr. Cole convincing you that the vaccines are “fake.”

What about “needle rape?” To me, this is one of the most outrageous, offensive and unprofessional statements Dr. Cole has made. This language must be intended to inflame the passions of the audiences he talks to, but this again is not the language a reputable physician or scientist will use. First of all, it is beyond the pale to compare vaccination to one of the most psychologically traumatizing and dehumanizing assaults and acts of violence that a person can endure. To equate the two is to minimize and trivialize the physical and emotional trauma suffered by victims of sexual assault, which is utterly despicable. To hear this false equivalence made by a doctor is all the more shocking and reprehensible. When you hear language like this from a source, you should be loath to give credibility to his other statements or at least carefully scrutinize his other claims.

What about the reference to “clot shot?” This appears to be a reference to Thrombosis with Thrombocytopenia Syndrome (TTS). It is quick and easy to check out the CDC website to see how often “clots” are with the various COVID vaccines. The first thing you will note is that this adverse effect is rare. This reveals Dr. Cole’s bias against the vaccines that he refers to them as “clot shots,” when looking at the numbers, just as we did above, quickly demonstrates that this is not a fair characterization. For the J&J vaccine, there are 47 confirmed reports out of 15.3 million doses administered. For the Moderna vaccine, there have been two reported cases out of 394 million doses. So, are blood clots a risk that a reasonable person might consider in deciding whether to get vaccinated with the J&J vaccine? Certainly. However, what Dr. Cole does not tell you is that the risk for blood clots is orders of magnitude higher with COVID infection.

• In one of his videos, Dr. Cole refers to the COVID vaccines as “a poisonous attack on our population and it needs to stop – now.” Again, we see his use of pejorative language that is meant to conjure up fear rather than taking the scientific approach of explaining the pros and cons to help people make an educated decision.

• You will also hear Dr. Cole make outrageous veiled references to Nazi Germany when he alleges that hospitals that require COVID vaccination are violating the Nuremberg Code. The Nuremberg Code is a set of research ethics principles developed in response to human experimentation that was dangerous and conducted by German physicians on human subjects without their consent and often related to efforts at “racial hygiene.” Again, like his comparison of being vaccinated to being raped, this comparison to the Nazi treatment of Jews is outrageous, inflammatory and despicable. Further, he demonstrates a complete lack of understanding in seeming to suggest the Nuremberg Code is a law that applies to private institutions in the United States, which it does not.
• In a similar vein, you will hear Dr. Cole make many references to crimes against humanity related to the COVID vaccines. Again, these statements are exaggerations intended to inflame the heart rather than inform the mind. Crimes against humanity include such things as genocide, war crimes, massacres, ethnic cleansing, and terrorism. Again, a reputable physician or scientist will stick to facts and be objective, rather than resorting to inflammatory, exaggerated and offensive references. We should be able to sit down and have a rational discussion about the pros and cons of a vaccine mandate. I don’t have a public position on these and I would be willing to listen to arguments for or against, but I will not engage in a dialogue with someone who uses this kind of shocking, inflammatory and inflammatory language.

We should be able to have rational discussions of the pros and cons of any treatment, medication or vaccine. Be warned that when doctors or others try to veer away from rational discussions and a balanced presentation of the risks and benefits, they are generally trying to influence you by emotions rather than facts.

We have only just scratched the surface and covered one of the tactics that should serve as a red flag that those promoting disinformation may use. In part IV of this blog series, we will cover additional red flags.

In Part I of this blog series, I discussed what disinformation is, why it occurs, and why it is dangerous. I want to reiterate; I am not trying to combat disinformation because I want to force anyone into doing anything that they choose not to do. As I stated, my intent is to make sure that everyone simply has the best information as we know it so that they can make an informed decision of what is best for them. I see too many people who have been tricked into making decisions that they would not have made if they had only had good information. Unfortunately, sometimes those decisions made due to lies have cost people their health or even their lives.

So, with Part II, we will begin the rest of this series with how to identify disinformation, or at least how to recognize that that the information you are hearing or reading may not be reliable. Today, we are going to begin with how to recognize a purveyor of disinformation, or at least that the source of the information may be questionable.

As I was thinking of examples to provide readers so that you can see how to recognize real-life examples of disinformation, I realized that a doctor here in Idaho, Dr. Ryan Cole, provides an abundance of examples in almost every category that I am going to discuss. To be clear, Dr. Cole is not the only physician who is providing disinformation. Further, I am not suggesting that everything that Dr. Cole says is disinformation. Indeed, it is that fact that makes Dr. Cole one of the most dangerous sources of disinformation (more on that later). I also believe that Dr. Cole provides very instructive examples because I believe that he is one of the most effective physicians that I have seen at presenting disinformation in a very persuasive manner.

[A note – I know Dr. Cole. I actually like Dr. Cole, but I hate what he is doing. I believe that Dr. Cole is very smart. I have met with Dr. Cole for a couple of hours to express some of my concerns and he has provided me with some of his defenses, few of which I find compelling. There are some things upon which we agree. However, we disagree on more than we agree. This was the second time we met during the course of the pandemic and Dr. Cole’s and my exchanges have always been respectful.]

So, let’s take Dr. Cole as our example and see what clues we can see that tell us we should be skeptical of him as a source for reliable information.

1. Specialty

The first thing that should make us “consider the source” is that Dr. Cole is a pathologist, specializing in disorders of the skin (dermatopathology). As you can see from his website, he owns and operates a laboratory that conducts testing of pathological samples. That is great. Pathologists are very important, but they rarely treat patients. Most often they provide laboratory results to physicians who do treat patients. That certainly does not exclude him from having expertise in the prevention and treatment of COVID, but it he is not in a specialty that is generally involved in direct patient care, and it should just be a warning sign that he may not be the best source of information on this particular issue. Just as you would generally not look to a neurosurgeon to evaluate and treat a prostate condition, generally you would not visit a pathologist or dermatopathologist to evaluate and treat COVID.

2. “The lady doth protest too much, methinks.”

I am reminded of this quote from William Shakespeare. It is a reference to one of his characters, Gertrude, who goes to such lengths in her attempt to convince the audience, that she actually loses her credibility. It is very interesting to listen to the beginning of some of Dr. Cole’s interviews and videos. He seems to go to great lengths in an attempt to persuade the audience of his credibility. I have given hundreds of interviews about COVID. Similarly, I have listened to countless experts on COVID as they are introduced. Generally, the introduction consists of this is Dr. such-and-such with this title who serves in a particular role. That’s it. Think about the reputable experts that you have listened to or gone to see for medical evaluation or treatment. Do you know what medical school they went to or where they did their training?

Dr. Cole on the other hand provides us with an over-abundance of information – he is a doctor, he is “Mayo Clinic trained”, he is board certified in anatomic and diagnostic pathology, he specializes in dermatopathology, and he has done “PhD research” in immunology.

But let’s look closer. Obviously, Mayo is an outstanding institution, so he wants us to know he should have our confidence in him because of this outstanding training. That is impressive… until we find out that Mayo was anxious to avoid association with Dr. Cole. The famed Minnesota medical center on September 21, 2021, distanced itself from Cole’s anti-COVID-vaccine claims in an email to a reporter. Mayo spokesman Bob Nellis wrote: “Mayo Clinic is aware of claims made by Dr. Ryan Cole regarding vaccines. Dr. Cole was trained at Mayo Clinic but is not a Mayo Clinic employee. His views do not represent Mayo Clinic.” It is important to note that Dr. Cole must believe that Mayo Clinic is reputable in that he wants you to know he trained there, but Mayo Clinic has its sights on Dr. Cole and wants to make sure that no one is associating his views with those of the Mayo Clinic.

The next thing is that Dr. Cole wants you to know that he did “PhD research.” Hmm. Well, I think that the phrase “PhD research” would imply that you are doing research as part of your candidacy for a PhD, but note that Dr. Cole did not receive a PhD. Doing research is great and an admirable pursuit, but it seems a bit misleading to make this point at the beginning of his talks and interviews as if he is perhaps trying to gain extra credibility by creating the idea in people’s minds that he may be extra qualified as both a physician and PhD.

I find another subliminal message that Dr. Cole uses fascinating. Of course, throughout the pandemic, we have seen doctors interviewed at hospitals while caring for patients. It is not uncommon for physicians to wear their scrubs and/or lab coats while caring for patients, and it is understandable that this might be their attire if you are interrupting their patient care activities at the hospital for an interview. But, note that Dr. Cole has given at least two talks at the state Capitol building. For his videos, he is always in scrubs and/or his lab coat. For the state Capitol, he wore his lab coat both times. I have given many talks and interviews over the years I was practicing medicine. I don’t recall once that when not at the hospital or in my office that I wore scrubs and/or a lab coat. Think about the doctors that you have seen interviewed who were not at the hospital. Do you recall ever seeing one in a lab coat? My guess is that Dr. Cole is trying to send the message – see, I am a very busy doctor having just rushed in to the Capitol to give you a talk in between treating patients.

There is nothing wrong with any of these things. It is just that in aggregate, you begin to see that it seems that Dr. Cole sees the need to go to greater lengths than normal to try to gain our confidence in him as a credible source to speak on COVID.

3. Fact Check

Finally, whenever you want to check out about anyone who is in the public and seems to be stating controversial things or things that seem to be contrary to what the experts are saying, try searching for that person’s name and fact check. In Dr. Cole’s case, you will find numerous fact-check articles that go through point-by-point to demonstrate things he has publicly stated that are not true or are misleading. In addition, there is a scientist who actually does have a PhD in immunology on social media who goes segment-by-segment of some of Dr. Cole’s videos to point out where what he says is correct and where it is false.

In the next part of this blog series, we will go through quotes from Dr. Cole’s videos that will help you learn how to spot disinformation.

This is part one of a series of blog posts that I will write on this topic.

For purposes of the blog post, I am addressing “disinformation,” the spread of incorrect information with the intent to harm, confuse, mislead, or otherwise affect people’s hearts and minds to accept lies and/or support the position of those who are spreading the false information. This is opposed to misinformation that is incorrect information, but the person spreading it did not realize that the information was incorrect or incorrect at the time.

Why is recognizing disinformation important? As a physician, I have had some patients choose not to follow my medical advice. That is fine, and I certainly understand that patients have to consider many factors when making their decision about a treatment that are particular to them, their circumstances and even their personal beliefs or religion. My job is merely to make sure that the patient makes an informed decision – i.e., they understand what their diagnosis is or what diagnoses I am considering if I don’t know their diagnosis yet, what the various treatment options are, what the potential side effects and risks are with each treatment, what the potential benefits are, and what the risks are of not undergoing any of the treatment options. When people understand the risks and benefits, I always support my patients in the decision they have made. What was disheartening was treating patients who did not understand their condition or the risks of the treatment they chose, only to end up seeking my help once things went badly and most often, there was little I could do to help them at that point.

So, the dangerous thing about disinformation is that it can result in people making decisions that are different than those they might have made if they had the correct information. A friend of mine made an investment decision based on some very bad information and lost 2/3rds of his investment. Fortunately, it wasn’t his life savings, and he will recover financially and of course, that failed investment did not threaten his life. But, as doctors, we do see patients who chose to follow disinformation, only to end up seriously ill in the hospital before they realize they were deceived.

Disinformation is not new, although I do believe it is much more prevalent and sophisticated today. Social media and the internet make disinformation much more appealing and pervasive, and in many cases, targeted. We know that foreign countries, such as Russia, China and Iran use social media to promote disinformation in the U.S. Russia used social media in an attempt to thwart Hillary Clinton’s run for president. Iran used social media in an attempt to undermine President Trump’s reelection. Thwarting disinformation should be of bipartisan interest. Unfortunately, many of these foreign interests have also found it advantageous for them to sow distrust of public health and the vaccines.

Disinformation comes from many sources and not just foreign countries. The motives of those who spread disinformation can be diverse – perhaps they stand to financially benefit, sometimes there are political aspirations or motivations, and sometimes these sowers of disinformation like the public attention and adoration they receive from those who want to believe the lies. There may be other reasons as well. But, a common thread is narcissism and lack of empathy. These persons do not care if they harm others so long as they gain whatever benefit it is they are seeking for themselves.

Personally, I have always wanted to know the truth, even when I didn’t like it. As a long-time CEO, I always made it clear to my team that I wanted the truth, even when I wouldn’t be happy about it, because only when you know the truth can you make informed actions as to how to deal with the bad news or issues. I have never found burying my head in the sand and just hoping a problem would go away to be a successful strategy. Often, the problem only becomes worse.

As far as the COVID pandemic, I am not promoting or advocating for vaccine mandates. I have not expressed a public opinion as to whether there should be mandates, and if so, under what conditions. That is not my focus. My focus is on trying to make sure that people had the best available and correct information on which to base their own decision about whether to get vaccinated. In my experience, people armed with the right information often make the right decision. With that said, my bias is that I certainly do want everyone to make the choice to get vaccinated. But, I am not willing to lie to people or trick people into getting vaccinated. If someone decides that vaccination is not right for them, I just want to make sure that they have made an informed decision not be get vaccinated- not a decision based on disinformation.

We are all vulnerable to disinformation, though certainly some are more vulnerable than others. Sometimes we believe things merely because someone we know and trust provides that information to us, e.g., a family member, a friend, or a coworker. Sometimes, we are afraid or anxious and we want to believe disinformation because it will bring our anxiety levels down. We saw this in action when at the beginning of the pandemic, when we had more fear than knowledge about this virus, some people wanted to accept the disinformation campaign that COVID was a hoax. If it is a hoax, then obviously there is no reason for concern. Unfortunately, that disinformation cost some people their lives because they took no measures to protect themselves.

It is also human nature to accept the first explanation for something that is shocking because we are programmed to want to have an explanation for why the unexpected happens. That first explanation can become reinforced, even when wrong, if we simply hear or read it repeated by others, and especially by others we trust or “people like us.” These explanations can also be reinforced if repeated by the President, other elected officials, or people in positions of authority such as physicians or those who declare themselves to be experts in that area. Once we are accepting of those initial explanations, it can be hard to reject those explanations, even when later presented with facts and evidence, especially when the explanation we first accepted continues to be reinforced by those in our social networks or those in whom we have placed our trust.

In the next series of blog posts, we are going to look at how to spot disinformation, how to determine whether it is disinformation, and how we might address some of the disinformation.

Again, it is important to be clear – I am not trying to force anyone to do anything they do not want to do. I am not trying to change anyone’s belief system or political affiliation. My only intention is to help those who want to make their own decisions, but want to do everything possible to ensure that their decisions are based upon correct information. As a former CEO, I often disagreed with people over the best way to respond to a certain set of facts. That is perfectly fine. What is not good for a CEO, a business, or any individual is when we don’t agree on what the facts are.

Key Takeaways:

Until we have more data –

(1) If you have not had COVID-19 and are unvaccinated, you and your family, friends and loved ones are at risk. Please get vaccinated as soon as possible.

(2) if you previously had COVID-19, we cannot tell you how much or little protection you may have against reinfection, and whether reinfection might cause more severe disease, so please get at least one dose of vaccine.  

(3) The vaccine is safe and effective. As Governor Little said, “Since the COVID-19 vaccine was made widely available to everyone in May, nearly all new COVID-19 cases, hospitalizations, and deaths are among the unvaccinated.”

The science around COVID continues to evolve and our understanding regarding natural immunity vs. vaccine-induced immunity is limited by what science is available at this time to evaluate effectiveness. There is no question that there remains much that we do not yet know.

1. There are conflicting data from studies looking at the strength and durability of natural immunity. These studies often involve only one vaccine, and any conclusions from these studies cannot be assumed to be the same for other COVID vaccines. These studies also have taken place in different countries at different times, where the virus variants may differ. It is not yet clear whether the strength and duration of immunity may vary depending upon which variant someone was infected with.
2. The fact that some people who have recovered from COVID appear to have robust immunity that lasts for many months is a very good thing, although I do not want anyone to get infected in the first place and risk the fate of nearly 700,000 Americans who have died from COVID or the fate of many others who are suffering the long-term consequences of COVID. But I certainly am happy that it appears few will be reinfected, at least with the variants that we have encountered thus far.
3. Getting COVID and developing natural immunity (immunity from infection) is far more dangerous than getting vaccinated and developing vaccine-induced immunity.
4. COVID has caused many hospitalizations, deaths and in many cases long-term complications, such as so-called “long-COVID.”
5. While some studies look back at populations of people who have had COVID and have seen evidence of strong immunity, it should be noted that natural immunity is variable – some people develop more protection for a longer period of time than others. The problem is that we have no practical way as of today to identify those persons who have recovered from COVID that are likely to have strong immunity. The fact that someone may have a positive antibody test, does not necessarily mean that the person is protected from reinfection, nor that any protection the person does have will protect against future variants.
6. Antibody tests are qualitative (positive or negative) and do not indicate immunity. Even those that are quantitative and provide an antibody titer are not standardized and we do not yet know the titer that would indicate protection from infection.
7. Studies have looked at the natural immunity of persons who, in most cases, had symptomatic COVID.  We do not have sufficient data to determine whether those who previously had asymptomatic infection or those who had severe disease have robust and durable immunity. There are reasons based upon our knowledge of immunology to believe that it could be different for these persons.
8. There is some waning of immunity with natural infection. It is likely that this period of time may differ among individuals, though one interesting model published in the Lancet suggests that those with natural immunity are likely to be reinfected in a median of 16 months from the time of their peak antibody response.
9. Some reinfections can result in more severe disease with the reinfection than were experienced with the initial infection.
10. Even those who previously had COVID appear to benefit from at least a single dose of vaccine.
11. For those with prior COVID, we do not know how long the protection will last and how effective it will be against future variants.

• Do you have an immunodeficiency or condition that causes you to be moderately to severely immunocompromised and you previously received the J&J/Jannsen vaccine? YES –> Unfortunately, the CDC does not have enough data on this situation to recommend a booster at this time. Talk to your doctor, but go no further in this decision guide. If NO –> Go to next step.

• Do you have an immunodeficiency or condition that causes you to be moderately to severely immunocompromised and you previously received the Pfizer or Moderna vaccine? YES –> You are eligible for a booster if it has been at least 28 days since your second Pfizer or Moderna vaccine shot. If NO –> Go to next step.

• Did you get the Pfizer vaccine? YES –> Go to next step.  NO –> You have to wait, but not for long. Only Pfizer’s data has been reviewed and considered by the FDA and CDC so far. They will be reviewing Moderna and J&J/Jannsen soon, so just stay tuned for more info on those vaccines. Go no further in this decision guide.

• Are you a resident in a long-term care facility (e.g., a nursing home)? YES –> You SHOULD receive a booster shot if it has been 6 months or more since your second shot of the Pfizer vaccine. NO –> Go to next step.

• Are you 65 years or older? YES –> You SHOULD receive a booster shot if it has been 6 months or more since your second shot of the Pfizer vaccine. No –> Go to next step.

• Are you between the ages of 50 and 64 and you have cancer, chronic kidney disease, chronic lung disease, dementia or another serious neurological condition, diabetes, Down syndrome, a serious heart condition, HIV infection, liver disease, sickle cell anemia, or a prior stroke? YES –> Talk to your doctor because your underlying medical condition may qualify you for a booster does 6 months after your second dose of the Pfizer vaccine, and if so, you SHOULD get the booster. NO –> Go to next step.

• Are you between the ages of 18 and 49 and you have cancer, chronic kidney disease, chronic lung disease, dementia or another serious neurological condition, diabetes, Down syndrome, a serious heart condition, HIV infection, liver disease, sickle cell anemia, or a prior stroke? YES –> Talk to your doctor because your underlying medical condition may qualify you for a booster does 6 months after your second dose of the Pfizer vaccine, and if so, you MAY get the booster. NO –> Go to next step.

• Are you at high risk for exposure to COVID-19 due to your work or other circumstances? YES –> Discuss with your employer or physician because you may be eligible for a booster 6 months or more following your second dose of the Pfizer vaccine. NO –> you are not eligible for a booster dose of vaccine at this time, but stay tuned as we come out with more and new recommendations.

I know. You have been cooped up far too long. You are so ready to be over this coronavirus, so what better way than to take a trip?

Well, if you plan to travel, consider these things:

Consider the state(s) or countries you are travelling to.

1. Get an update as to any travel restrictions for the states you will be visiting and for any airlines that you may be traveling on. Hawaii currently has the most significant restrictions on travelers for domestic travel, but some countries have banned Americans from traveling to their country. Also keep in mind that a state or country may adjust their restrictions on relatively short notice. For example, the state of Maine has indicated that if a traveler is coming from a state with a surge in COVID cases, Maine’s public health authority may require testing and quarantining. A number of countries are known for being able to shut down their countries on very short notice. If there were to be a significant outbreak, that government may suspend your plans to leave the country. I heard from a friend of a friend that on their international travel, the country of their destination became concerned about rising cases. The passengers on their flight were escorted by the military to a hotel for quarantining for almost two weeks and the travelers were expected to pay the hotel costs of their quarantine.
2. Check to see if the state or country you are travelling to has a mask mandate. In the U.S., at least seven states, plus Washington D.C. and Puerto Rico have mandates in place as of the time of this writing. Also, check the city you will be in since some cities have mandates in states that don’t.
3. Check to see if the hospitals are overwhelmed in the region you plan to visit. Remember, many people need medical attention for things other than COVID. It is scary enough to need urgent or emergent care when you are away from home, but it will be especially dangerous if the regional health care system is overwhelmed.
4. If you have specific plans to dine at a restaurant or attend an entertainment venue, make sure you check ahead to make sure you meet any restrictions that the venue may have in place, particularly around vaccination.
5. If you will be on a cruise, stay flexible. Many ports of call have made sudden decisions not to allow visitors and you may find that your cruise line has to make changes to its itinerary. Also, keep in mind that if you will be on a cruise that does not require passengers to be vaccinated that an outbreak could mean that the ship will have difficulties finding a port that will allow entry, especially if those local hospitals are already overwhelmed. Therefore, be prepared that you may have a greatly extended stay on the cruise ship.
6. Return from international travel to the U.S. currently requires a negative COVID test within 3 days of your planned travel. Make sure that you identify where you can get tested in the country you will be visiting that will be able to give you test results within that window of time.

Special precautions no matter where you are traveling:

1. Be sure to travel with your COVID vaccination card. It is also a good idea to have a photo of your card on your phone or stored in an app approved for providing vaccination documentation, such as CLEAR or CommonPass. Keep in mind that it is a crime to use a fake vaccination card in some states and countries.
2. Keep in mind that if cases were to surge, you may be forced into quarantine, so take at least an extra week or two of medications with you. Also keep this in mind if there is a specific date that you need to be back home and take this into consideration in planning your itinerary.
3. Also, ensure that there are arrangements for someone to care for your home, pets and other obligations in the event of an unexpected requirement for quarantine. Also, ensure that you have the financial means to pay for the hotel room or other quarantine costs, as many governments do not pay for this.
4. Even if you are vaccinated, but are traveling with children who are not, from time-to-time, various airlines, countries and states have required a negative COVID test to travel. Therefore, make sure that you are prepared to spend the time that may be necessary for quarantine if one of your children was to test positive.
5. Have a plan for where you would seek health care at your destination in the event you or someone you are traveling with were to become ill from COVID or ill or injured from anything else.
6. If you are traveling outside of the U.S., make sure that your insurance plan will cover your medical care in the countries you are visiting. Most often, insurance plans will have some coverage for emergencies, but few plans cover medical evacuation. Therefore, you may need to consider travel insurance.

Takeaways:

1. Relying on faith as your strategy for protecting yourself and others from COVID is unbiblical.
2. Relying on faith as your approach to protecting yourself and others is inconsistent with your own belief system.
3. Reliance on faith as your approach to protecting yourself and your family from COVID doesn’t make sense.
4. Reliance on faith to protect you and others from COVID is a perversion of what scripture teaches us.
5. Reliance on faith to protect us from COVID damages our effectiveness as witnesses to others.

In the roughly ten years that I have been blogging, I rarely express my religious views. My blog has been primarily focused on health care administration, health care reform, health care innovation, health care law and, over the past year and a half, COVID.

Some time ago, a wise mentor told me that everything is spiritual. I rejected that premise at first, but I have come to realize more and more that it is true. Thus, I find that I cannot separate my recommendations for protecting Americans from COVID from the religious concerns that many are expressing to me lately.

In the past couple of months, I have probably had discussions with at least 50 vaccine hesitant folks, convincing at least 37 of them to get vaccinated. Initially, concerns mostly focused on medical and scientific issues. However, in the past month, by far, the most common reasons I hear from people are religious concerns. Weeks ago, the major concern was that the vaccines are the mark of the beast. Therefore, I wrote a blog piece as to why this view is completely contrary to scripture. In the past couple of weeks, by far and away, the most common rejoinder that I get to my encouragement to get vaccinated is that the person will rely on their faith. Worse, some religious leaders are providing reliance on faith as the justification for failing to implement measures to protect children and their families in religious schools. Thus, once again, I feel compelled to write another blog piece to expose the fact that this position is unbiblical in order that my fellow brothers and sisters are not mislead by what seems like, on its face, a noncontroversial position like we should rely on our faith to protect us.

Let me once again, make some disclosures, so that folks will understand my theology:

1. I am a man of faith and a very devoted Christian.
2. The denomination with which I affiliate is Southern Baptist.
3. I believe that the Bible is the inspired word of God.
4. I believe in the inerrancy of scripture.
5. I believe that to discern truth, we are to test all things against what scripture says. 1 Thes. 5:20.

Should we rely on faith for our protection from COVID?

Reliance on faith for protection against COVID is unbiblical.

I have faith that there is a loving God, who sent His Son to die for my sins, and that because of my confession of sin and acceptance of Jesus as my savior I am promised eternal life. This is not blind faith – each element of this is supported by promises made in scripture.

On the other hand, no amount of faith will protect me from aging, disease, and death, unless the Rapture intercedes. The Bible tells us that we are not promised tomorrow. Prov. 27:1. Revered men of God, such as Billy Graham, understood that no where in scripture do God’s words justify reliance on faith to protect us from disease or to avoid physical death. The apostles were all men of faith. They are all dead. We all know people of great faith who have all aged, all deteriorated to some degree with age and all died. The Bible does not teach us that if we have faith, we won’t get diseases or get into accidents or die from those diseases or accidents. Similarly, God does not promise us and the Bible does not teach that persons of faith are immune to or will avoid all infectious diseases. Our hospitals are full of sinners, but not every patient is devoid of faith.

In fact, the Bible makes many references to the fact that Christians will be subject to trials and tribulations. (e.g., Count it all joy, my brothers, when you meet trials of various kinds, for you know that the testing of your faith produces steadfastness. James 1:2-3. Blessed be the God and Father of our Lord Jesus Christ, the Father of mercies and God of all comfort, who comforts us in all our affliction, so that we may be able to comfort those who are in any affliction, with the comfort with which we ourselves are comforted by God. 2 Cor 1:3-4.) The book of Job describes great afflictions of disease and suffering on the part of Job, whose faith in God was affirmed by this testing. Many of us would have to ask ourselves on self-examination whether our own faith would hold up as strongly as Job’s did.

The devil tested and tempted Jesus by taunting Him to jump off the top of the temple and to rely on God and His angels to swoop Jesus up before He would strike the ground. Jesus rebuked the devil, telling him, “The Scriptures also say, ‘You must not test the Lord your God.’” (NLT).

Clearly, scripture teaches us that we are not to purposefully put ourselves or others in harm’s way counting on God to save us or them. Don’t misunderstand me, I have seen miracles and I know God works miracles and is capable of performing miracles. But, scripture teaches us that we are not to put ourselves or others in danger and just assume that God will intervene supernaturally to protect us or them. When we avoid the protective measures recommended by public health authorities, that is exactly what we are doing.

As I said, my faith is grounded in the promises of the Bible – that because I have repented of my sins and accepted Jesus as my savior that I have the promise of eternal life. However, any faith that I have that because I am a child of God, God will ensure that I am not exposed to COVID, infected with COVID or end up seriously ill or dying from COVID is not only unjustified by scripture, it is unbiblical.

Reliance on faith for protection from COVID is inconsistent with your own belief system.

Now, it is true that I likely don’t know you, can’t know your heart and can’t possibly know how you put your faith into action, but I am making an educated guess here, because I am guessing you are not a Saint (my apologies to those of you who are).

But, let’s just think about this for a minute. I applaud you for your faith. But, while you may feel that your faith will protect you from COVID, I am wondering whether you extend this protection conferred by your faith to other parts of your life. Do you leave your house unlocked trusting God to protect you from would-be criminals? Do you allow your children to play in traffic, trusting God to protect them from harm? If you were having worrisome symptoms, would you refrain from going to the doctor for evaluation and treatment, trusting that God will fix whatever ails you? If you go on a camping trip, do you not take a tent or camper or protective clothing, assuming that God will protect you from the elements because of your faith?

If you answer all of these questions that you do indeed trust your faith to protect you and others in all of these instances and all other aspects of your life, then I apologize to you, am in awe of you, God bless you and this blog post is not intended for you. But, I doubt there are many of you that fit into this category. Even the Pope has bullet-proof glass in the Popemobile, counting on that to stop a bullet rather than his faith.

If you are only asserting protection based on your faith relative to COVID, but not the other areas of your life I have mentioned above and others, then an honest examination into why you adopt this inconsistency will be illuminating. I suspect that critical self-examination will reveal that your dependence on faith against COVID as opposed to all other areas of your life has less to do with your faith and devotion to God and more to do with your politics, ideology, or other nonbiblical influences on your life and decision-making and are more likely to come from Facebook than The Holy Bible.

Reliance on faith for protection from COVID doesn’t make sense.

If our faith is sufficient to protect us from COVID, then we must conclude that those who have been afflicted, hospitalized and died were not people of faith or had insufficient faith. Let’s just take the smallest number – the number who have died. Does it really make sense to you that the 4,315,821 persons across the world, or even just the 618,710 Americans who have died from COVID were all atheists? Or, if you attribute it to simply insufficient faith, as opposed to no faith, do you believe that you have greater faith than all of these people?

Reliance on faith for protection from COVID is a perversion of what the Bible teaches us.

In my medical practice, I have taken care of atheists and people of almost every religion. I also distinctly remember caring for three people I knew very well, knew their deeply-held religious beliefs and knew their commitment to living Christian values in their own lives. Two of them developed cancers and the third a non-malignant, terminal disease. This third person was in his thirties, had weeks to months to live, was estranged from his family and had no one to care for him and could not afford hospice care. So, my wife and I took him into our home and cared for him.

What I remember was the most painful thing for him was misguided Christians who felt compelled to share their unbiblical views that he was afflicted with disease and was dying because he did not have sufficient faith. I hope I have adequately made the point above that this is a decidedly unchristian and unbiblical view.

The Bible is also replete with passages that teach us to care for and protect children and the vulnerable. The Bible also teaches us that our religious leaders have great responsibility and accountability to God for acting in accordance with his teachings. I am praying that our religious leaders will see the errors of their ways when they advocate that schools should not take all possible steps to protect children, most of whom will be vulnerable, when they make a decision that is contrary to the advice of every public health organization. Unfortunately, these leaders must give an account to God for their actions and decisions. Romans 14:12. I feel confident that explaining that the decision was based on a survey of parents or emails received from these parents will not seem like a strong defense as they stand before the throne of God.

Reliance on faith for protection from COVID damages our witness to a lost world.

I was not saved until I was in my thirties. I remember that I was trying to figure out why my Christian friends seemed to have so much joy in their lives and I did not. I saw in them something I wanted and it drove me to Christ.

On the other hand, I fear that people will look at the ineffective leadership of many who hold themselves out to be Christians, the disdain that these leaders seem to have for those who do not share their beliefs or ideologies, their rejection of science and medicine, their embrace of lies and misinformation, and their promotion of self-interests and personal freedoms at the expense of others’ well-being and conclude that if that is Christianity, they want nothing to do with it. Further, the decisions by religious leaders that show no regard for the welfare of children is very likely to turn many away from the Church. Finally, one merely needs to watch a pastor yelling and ranting on social media that people wearing masks are not welcome in his church (as if it is his church) to realize how repulsive this will be to those who are lost, and see how supposedly being a God-fearing, Christian is role modeled.

It is not too late. If you do have faith and are using that as your strategy against COVID, then read the scriptural references above and pray to God that He will provide you with wisdom and insight. Then adopt these public health measures and encourage others to do so. Examine the witness that you are providing and determine whether it is one you will be proud of when you stand before the throne on judgment day. And take care of others as God commanded us all to do.

Barbra sent in the following comment to my blog: “I am new to your blog but loved the honesty and caring it portrays. I know this may make you laugh, but I have a sibling who will not get vaccinated. Why?… Because it’s the sign of the beast in the book of Revelations! I mean Holy Cow! I can’t seem to change his mind. Any suggestions?”

I replied to Barbra that I didn’t laugh because this was not the first time people had expressed this concern to me, and those people were very sincere in their concern. I also was told of a woman who came to the hospital severely ill with COVID and subsequently died, but explained prior to her death that she did not take the vaccine because she did not want a chip implanted in her.

As a Christian, I am getting tired of politicians waving their Bibles for photo ops, while not demonstrating the behaviors that the Bible commands of us. Frankly, I wish politicians would spend more time reading their Bibles than waiving them around. So, when people actually want their behaviors to comport with the word of God, I am thrilled and always happy to try to answer their questions. So, I respect that these people expressing their concern about the vaccine are God-fearing and want to do the right thing by God.

With that said, to answer this question, we must turn to the scripture itself. The short answer is that we can conclusively and definitively state that getting the COVID vaccine is not taking the mark of the Beast. What follows is my analysis of scripture that provides us with this answer.

As Barbra points out in her question, the reference to the mark of the Beast occurs in the Book of Revelation. My favorite translation is the New Living Translation, so I will quote scripture from that unless I indicate that I am using a different translation.

The reference to the mark of the Beast occurs in Revelation 13:16-17:

He required everyone – great and small, rich and poor, slave and free – to be given a mark on the right hand or on the forehead. And no one could buy or sell anything without that mark, which was either the name of the beast or the number representing his name.

So, to interpret what is meant by this passage, we must put it in context. Who is he? What is this mark? Why would whoever he is require people to take this mark? Who is the beast?

Revelation is the last book of the New Testament of the Bible. It was written by the apostle John. It is a difficult book for most Christians to understand because it uses apocalyptic language, rich with imagery and symbolism that would have been more familiar to early Church Christians than to us today. While many Christians view Revelation with fear, it is actually a book of hope and great comfort for Christians. Those who should view the book with fear are those who probably won’t read it – those who do not know and have not accepted Christ as their savior.

In fact, God tells us in Revelation 1:3:

God blesses the one who reads this prophecy to the church, and he blesses all who listen to it and obey what it says.

One of the reasons that this prophecy is a blessing is it describes the ultimate triumph of good over evil, God over Satan. We live in a world full of sin. We live in a world where truth has become the enemy and people pervert the word of the Bible and proclaim to be Christians while at the same time expressing hate of others. The good news is that God will only let Satan rule this world for a limited period of time before God and His armies come back, take control of the world, and rule over this world after banishing Satan forever.

So, the majority of the book of Revelation is prophecy (i.e., it provides us divine revelation about future events) and describes what happens in “end times.”

The beginning of the “End Times” is signaled by the rebirth of Israel as a nation, which occurred in 1948. This is the fulfillment of the dry bones prophecy in Ezekiel 37, which is interpreted in Ezekiel 37:21: “I will take the Israelites out of the nations where they have gone. I will gather them from all around and bring them back into their own land.” This sets the stage for the Tribulation period[1]. Thus, we are living in the end times.

It is clear that the rebirth of Israel as a nation is necessary for the fulfilment of future biblical prophecies to be possible. For example, the peace covenant between the antichrist and the leaders of Israel that signals the start of Tribulation would not be possible if there was no nation of Israel.

The Tribulation referred to in the book of Revelation is the Great Tribulation – a seven-year period where the Holy Spirit, the “great restrainer” is removed, allowing Satan to have free reign. It will be a period of false peace, world-wide disasters and tremendous loss of life. In a mockery of the triune God – the Father, the Son and the Holy Spirit, Satan will have his own trinity – Satan (also referred to as the Dragon – a counterfeit God), the Antichrist (also referred to as the Beast – a counterfeit Christ), and the False Prophet (a counterfeit Holy Spirit). Paul warned of a “man of lawlessness” in 2 Thessalonians 2:3,8-9 in a reference to the antichrist. It is John who refers to the antichrist as “the beast” in Revelation 13:1-10.

Now, while God through John does not give us a strict chronology of events and complete clarity as to what all those events are, He does provide some important facts and timelines. As mentioned above, the Bible provides us with an event that signals the beginning of “end times.” Because of that, we know that we are living in those end times. But, the Tribulation comes later (we are in end times, but we have not yet gone through Tribulation) and we know that the antichrist (the beast) is not revealed and does not rise to prominence until the Tribulation period. Thus, no one can be taking the mark of the beast until they are in the Tribulation period and the beast has been revealed. This is how we can be confident that the COVID vaccine does not involve taking the mark of the beast.

Now we can answer the questions about Revelation 13:16-17. Who is “he”? We can tell from the context of the earlier portion of Revelation 13 that the “he” is a reference to the False Prophet. What is the mark? We don’t know. The Bible does not tell us, other than it will be necessary to buy and sell things during this period of the Tribulation. We also know that those who refuse to take the mark will be persecuted by Satan and we know that when God comes back to reclaim His rightful place as King, those who have taken the mark will be punished for taking the mark. We don’t even know whether the mark is something physical – some believe it will be of the nature of a tattoo, others believe it will be a computer chip of some kind – but it may not be a physical mark as it appears to once again be a perversion of the actions of God to preserve His people by Satan to destroy his followers. Revelation 7:3-4:

Wait! Don’t hurt the land or the sea or the trees until we have placed the seal of God on the foreheads of his servants[2]. And I heard how many were marked with the seal of God.

Who is the beast? This is the name John gives to the antichrist.

There are other clues that we are progressing towards the Tribulation period.

The Bible tells us that there will be growing apostasy. Apostasy means a falling away from the truth; willful departure or defection from the faith; or abandonment of the faith.

1 Timothy 4:1-2 King James Version (KJV):

Now the Spirit speaketh expressly, that in the latter times some shall depart from the faith, giving heed to seducing spirits, and doctrines of devils; Speaking lies in hypocrisy; having their conscience seared with a hot iron.

The reference to “latter times” means the “End Times.” We are certainly seeing this prophecy being fulfilled today, and it will greatly increase during the Tribulation. People are promoting lies and conspiracy theories in some cases for power, in others for money, and yet others to curry favor. They are willing to promote lies that will harm others, all the while professing to be Christians. These are the people God refers to in Matthew 7:22-23, where He says that on judgment day, many will call out His name, but He will reply, I never knew you.  Get away from me, you who break God’s laws.

This is why I am very careful about the sources I read, listen to and study. 1 Thessalonians 5:21 tells us that we are to “test everything.” That means that we must constantly evaluate news, doctrine, philosophies, theories and everything else we are told or read against scripture. If it is consistent with scripture, it may or may not be true; but if it is inconsistent with scripture, it is false. We have to be careful about our sources and realize that in the End Times (which we are in now), the Bible teaches us that many, including leaders, will promote false teachings, false religions, false doctrines and the promotion of cults. We see evidence of this every day. We have seen false teachers and many cults since 1948. We see how easily people can be misled, how easily people will adopt beliefs that are verifiably false and how leaders will promote those lies or misinformation in order to further their own goals.

2 Timothy 4:3-4 (NASB):

³ For the time will come when they will not tolerate sound doctrine; but wanting to have their ears tickled, they will accumulate for themselves teachers in accordance with their own desires, ⁴ and they will turn their ears away from the truth and will turn aside to myths.

2 Timothy 3:1-8 (NASB):

But realize this, that in the last days difficult times will come. ² For people will be lovers of self, lovers of money, boastful, arrogant, slanderers, disobedient to parents, ungrateful, unholy, ³ unloving, irreconcilable, malicious gossips, without self-control, brutal, haters of good, ⁴ treacherous, reckless, conceited, lovers of pleasure rather than lovers of God, ⁵ holding to a form of godliness although they have denied its power; avoid such people as these. ⁶ For among them are those who slip into households and captivate weak women weighed down with sins, led on by various impulses, ⁷ always learning and never able to come to the knowledge of the truth. ⁸ Just as Jannes and Jambres opposed Moses, so these men also oppose the truth, men of depraved mind, worthless in regard to the faith.

We are warned in 2 Thessalonians 2:3 not to be deceived. Especially dangerous will be those lies that have some element of truth or those promoted by charismatic leaders who promote falsehoods as supposed Christians, but saying other things or demonstrating behaviors that are clearly unbiblical.

When both the creation of the nation state of Israel and the growing apostasy have occurred (and they have), all the pre-conditions for the Tribulation to take place are met. For pre-tribulationists (the view I support), the only remaining event prior to the start of Tribulation is the Rapture.

Rapture

At the time of the rapture, the dead in Christ will be resurrected and those Christians living at the time will be instantly translated into their resurrection bodies and both groups of people will be “caught up” to meet Christ in midair and taken directly to heaven.

John 14:1-3 (NASB):

Do not let your heart be troubled; believe in God, believe also in Me. ² In My Father’s house are many rooms; if that were not so, I would have told you, because I am going there to prepare a place for you. ³ And if I go and prepare a place for you, I am coming again and will take you to Myself, so that where I am, there you also will be.

1 Corinthians 15:51-54 (NASB):  

Behold, I am telling you a ^[a]mystery; we will not all sleep, but we will all be changed, ⁵² in a moment, in the twinkling of an eye, at the last trumpet; for the trumpet will sound, and the dead will be raised imperishable, and we will be changed. ⁵³ For this perishable must put on the imperishable, and this mortal must put on immortality. ⁵⁴ But when this perishable puts on the imperishable, and this mortal puts on immortality, then will come about the saying that is written: “Death has been swallowed up in victory.

1 Thessalonians 4:13-17 (NASB):

But we do not want you to be uninformed, brothers and sisters, about those who are asleep, so that you will not grieve as indeed the rest of mankind do, who have no hope. ¹⁴ For if we believe that Jesus died and rose from the dead, so also God will bring with Him those who have fallen asleep through Jesus. ¹⁵ For we say this to you by the word of the Lord, that we who are alive and remain until the coming of the Lord will not precede those who have fallen asleep. ¹⁶ For the Lord Himself will descend from heaven with a shout, with the voice of the archangel and with the trumpet of God, and the dead in Christ will rise first. ¹⁷ Then we who are alive, who remain, will be caught up together with them in the clouds to meet the Lord in the air, and so we will always be with the Lord.

[There are many views of when the Rapture occurs: pre-tribulationism (which I subscribe to), mid-tribulationism, post-tribulationism, partial rapture, pre-wrath view and others.]

Pre-tribulationism

The Church[3] will not go through the judgments prophesied in Revelation 4-18. Support for this view comes from:

1. A literal interpretation of the Bible. The Bible is a compilation of many different forms of literature. A literal approach means that when the language is clear and unambiguous, we should accept it literally. On the other hand, we understand that some portions of the Bible are not meant to be read literally, such as parables and apocalyptic literature. This is also true in our everyday life in interpreting what others say. We take others literally, but we know when not to. If I say, it is raining outside, others would be right to conclude that wherever I am located, there is precipitation and rainfall. On the other hand, if I say, it is raining cats and dogs, one would be justified to believe it is raining wherever I am, but one is not intended to believe that cats and dogs are actually falling from the skies.
   1. Revelation 3:10 (NASB): Because you have kept My word of perseverance, I also will keep you from the hour of the testing, that hour which is about to come upon the whole world, to test those who live on the earth. This is a critical promise. God is not promising to spare Christians from all trials in their lives, but rather from “the hour of the testing, that hour which is about to come” or as some other translations state it, “the hour of trial that is coming” – a clear reference to the Great Tribulation.
   1. The Greek word John used is translated “from” carries the meaning of separation, in other words, that believers will be completely separated from these trials/events.
   1. Throughout Tribulation, saints are killed. The word “saint” is not a reference to our colloquial use and meaning of the term, but rather the term for all who are saved in Christ. How can this be if the Rapture occurs before the Tribulation? It is because the Church saints are raptured, but Tribulation saints are not. We currently are living in the Church age, which started at the Pentecost. Church saints are those that were saved prior to the beginning of Tribulation. They will be raptured prior to the start of the Tribulation. There are others who are not saved prior to the Rapture, but become saved during the Tribulation. They are referred to as Tribulation saints and many of them will be martyred during the Tribulation.
   1. There are many references to the Tribulation in the Old Testament and New Testament, yet none of them mention the Church, supporting the notion that the Church is raptured prior to the Tribulation and therefore not present during this 7-year time period.
   1. The great increase in apostasy and the events during the Tribulation occur because of the removal of “the restrainer”- the Holy Spirit. The Holy Spirit indwells in believers, thus, when believers are raptured just prior to the Tribulation, it makes sense that the restrainer is removed allowing Satan and the antichrist to put their plans into effect, though the plans will ultimately fail because God remains all-powerful and in control.

Second Thessalonians 2:3-7 (NASB): No one is to deceive you in any way! For it will not come unless the apostasy comes first, and the man of lawlessness is revealed, the son of destruction[4], ⁴ who opposes and exalts himself above every so-called god or object of worship, so that he takes his seat in the temple of God, displaying himself as being God[5]. ⁵ Do you not remember that while I was still with you, I was telling you these things? ⁶ And you know what restrains him now, so that he will be revealed in his time. ⁷ For the mystery of lawlessness is already at work; only He who now restrains[6] will do so until He is removed. 

• The Church is not appointed to wrath. Romans 5:9 (NASB): Much more then, having now been justified by His blood, we shall be saved from the wrath of God through Him. 1 Thessalonians 5:9 (NASB): For God has not destined us for wrath, but for obtaining salvation through our Lord Jesus Christ. Jesus delivers us from the wrath to come.
  • The Rapture is not the Second Coming. Christ does not come to earth in the rapture; he meets us in the air. In the Rapture, Christ comes for His saints. In the Second Coming, Christ comes with His saints.
  • The Rapture occurs in the “twinkling of an eye.” 1 Cor. 15:51-52. In other words, the Rapture occurs suddenly and quickly. The Greek word for “caught up” in 1 Thessalonians 4:13-17 implies a sudden, jerking, violent rendering or taking, much like you might pull a child’s arm who is in the path of a car.
  • References in the Bible to the “blessed hope” refer to the Rapture. Titus 2:13 (NASB): looking for the blessed hope and the appearing of the glory of our great God and Savior, Christ Jesus. The blessing is not only that we will be spared from the Tribulation and its judgments, but that once raptured, we will no longer have to face sickness, sadness, pain or death.

Other views:

Mid-tribulationism

This view holds that the Rapture will occur midway through the 7-year Tribulation, and that the taking up of the two witnesses of Revelation 11 following their resurrection represents the rapture of the Church. Mid-tribulationists believe this to be consistent with the verses that indicate the Church will be delivered from the wrath, and the wrath in Tribulation begins at the midpoint of Tribulation.

Why I do not support this view:

1. It is not consistent with the literal interpretation of the other scripture I have provided above.
2. There is no indication in the Bible that the two witnesses represent the Church. It is not entirely clear who the two witnesses are, but there are arguments to be made that they are Moses and Elijah or Enoch and Elijah. But whoever they are, much of Revelation 11 doesn’t make sense unless the witnesses are literally two individuals, not the entire Church.
3. While the greatest wrath is during the last half of the Tribulation with the most severe judgments, the entire Tribulation period is a “time of trouble” and a period of time characterized by wrath given the acts of ungodly men- growing apostasy and rampant sin with the withdrawal of the restrainer.

Post-tribulationism

This view holds that God will rapture the Church after the Tribulation at the Second Coming. Post-tribulationists argue that Revelation 20:4-6 refers to all believers being resurrected at the end of Tribulation. They also believe that the reference to saints during the Tribulation means the Church has not previously been raptured. Post-tribulationists also believe that Matthew 24:37-40 is describing the Rapture at the Second Coming.

Why I do not support this view:

1. Rev. 20:4-6 is referring to the resurrection of the Tribulation saints, not the Church saints.
2. The reference to saints during the Tribulation refers to those persons who were saved after the Rapture, not the Church saints.
3. Matthew 24:37-40 describes those who are not saved who are taken away to judgment, not raptured to heaven.

So, I hope that this analysis leaves you convinced that the COVID vaccine cannot be the mark of the beast. First, while we are living in end times, the Tribulation has not yet begun. The antichrist is not revealed until the Tribulation period and one cannot take the mark of the beast until one knows how the beast is. Second, as I hope I have made the case, if you are a true Christian who has acknowledged Christ as your savior and repented of your sins, you will not be here for any part of the Tribulation period, so you will not have to make the choice whether to accept the mark of the beast. That will be the choice to be made by those who go through the Tribulation, including those who only come to know and accept Christ after the Rapture and after the Tribulation period is well underway.  

One way that we follow God’s commandments to love others and protect the children is to get vaccinated so that we help bring an end to this pandemic.

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[1] There are many references to trials and tribulation throughout the Bible and certainly, we all experience trials and tribulation throughout our lives. However, when I refer to Tribulation in the context of the End Times, I am referring to the “Great Tribulation,” which is a reference to a specific 7-year period of time rather than the general tribulation that we experience throughout our lives.

[2] Those that will be sealed by God are those who come to know Christ and accept Him as savior once the Tribulation begins, after the Rapture has already taken place. God does not need a physical mark to know His children. He knows us by what is in our hearts, our words and our actions that follow.

[3] In the Bible, Church means all those who are saved in Christ during the Church age (which we are living in right now). It has nothing to do with earthly churches. It includes all those, Jews and gentiles, who have been saved through repentance of sin, confession of belief in Christ and asked Jesus into their hearts and lives.

[4] These are references to the antichrist.

[5] This refers to the abomination of desolation.

[6] This refers to the Holy Spirit.