Opinion | Heads I Win, Tails You Lose: The Antivax Protests

Performing autopsies for the coroner often puts me in the public eye. It’s a frontline job, and, as with all frontline health care positions, this job requires me to show up every day and serve everyone and anyone who comes through our door.

If someone dies suddenly, violently, or unexpectedly and no one can figure out why, then the government takes possession of the body and orders a coronial or forensic autopsy. It is one of the rare situations where a government agency has the authority to take away your property (in this case, your mortal remains, belonging to your next of kin) and literally inflict damage on it in order to protect unknown others.

Forensic pathologists save lives, and I’m proud to have examples in my own career: I’ve identified tuberculosis in a crowded jail, carbon monoxide poisoning in an apartment building, death by electrocution in a public spa. While our job mostly focuses on giving closure to the families of the deceased and helping them come to an understanding of what happened to end their loved one’s life, probably the most under-appreciated and crucial part of a forensic pathologist’s role is in recognizing and alerting the public to health hazards like unsafe sleep environments, fatally dangerous children’s play equipment, or transmissible infectious diseases like COVID-19 — including rare deaths from vaccines and treatments.

Sometimes serving the general public means you end up upsetting specific members of it. If the autopsy findings lead the coroner to determine that a death was by suicide, the decedent’s family members may be denied insurance benefits. They may have a great need for those benefits, and my medical opinion could mean they won’t get them. They are sometimes, rightly, outraged — and take out their rage over the insurance policy’s limitations on me, the stranger who has already delivered the worst piece of news they’ve ever had.

I have colleagues who have been hounded and stalked by dangerous, mentally unstable family members of decedents. One told me that she got two Dobermans after the son of a decedent followed her home. Another had credible death threats made against his office and him personally while he was working on a high-profile legal case involving the death of a man in police custody. He decided to spend time away from his family and under guard in a motel.

Last month, a motorized mob laid siege to the national parliament buildings here in Wellington, New Zealand’s capital, following the tactics and mimicking the rhetoric of a similar mob in Ottawa, Canada. The mob ended up occupying two entire neighborhoods outside the besieged Parliament for more than 3 weeks, barricading city streets and sidewalks, assaulting and spitting on children making their way to school, threatening to murder politicians, and flinging their own feces at police.

They professed a number of grievances, among them public health measures like vaccine and mask mandates that have proven the cornerstone of New Zealand’s successful efforts to respond to the COVID-19 pandemic and prevent deaths from this disease that has taken millions of lives in other countries.

Academics and people who speak publicly about public health matters were then, and are still, being harassed and doxxed by the protest groups in a coordinated campaign to bully them into silence.

These groups that are acting against public health measures work in the same way that terrorists do. They follow a handful of charismatic leaders in a loose network of organizations that work to attract new members while steadily indoctrinating their cadres. They primarily work online, spreading propaganda and fundraising off of lies, disinformation, and conspiracy theories. On the ground, they organize trespass protests that are disruptive to local residents and businesses; wave signs demanding peace, freedom, and personal choice; and unironically harass passersby who choose to follow guidelines and wear masks.

The international press has made much of the white supremacist symbols they brandish, including Confederate battle flags, swastikas, and nooses, coupled with threats to lynch democratically elected officials. Meanwhile, they threaten public health leaders online and in the press, many of whom have spent their careers serving the underserved and being paid less than their professional peers while they do so. “I didn’t go into public health for this,” said a colleague of mine recently.

This is how antidemocratic fringe groups work: they practice tactics that amplify their own voices, grab the spotlight and then lay the clickbait, issue unreasonable demands, and repeat disinformation under strict message discipline on an endless loop until they’ve drowned out all debate.

But those of us who have committed to a career in public health, who have sworn an oath to protect the entire public including the voiceless and the vulnerable, do not have the option of giving in to the disinformation onslaught. Millions of people worldwide have perished from COVID-19, and millions more will suffer and die and be left with long-term chronic diseases as each new wave of this pandemic washes over us and public health measures are relaxed and reinstated with each new variant.

We need to find ways to fight back — and ought to remember that we have plenty going for us. Despite 2 years of unrelenting disinformation, we still have overwhelming numbers in public support, especially among the growing category of those who have lost their loved ones in the pandemic or are suffering from long COVID.

In New Zealand, we enjoy one of the best public health responses of any country, with an extremely high rate of vaccination against the virus and a COVID-19 death rate that is still among the lowest in the world. Some of our Parliament protesters ended up disillusioned after they came to recognize that they had donated their time and money to a confidence scheme. Others gave up and went home once they saw that there were people around them sick and dying of infection by the highly virulent novel pathogen that they were told was no worse than the common cold.

Before the professionalization of public health measures and the development of vaccines, pandemics like typhoid, plague, polio, and smallpox increased mortality around the globe. COVID-19 will too. But just as humanity worked to eradicate smallpox and contain polio and typhoid, so will we eventually recognize that COVID-19 is causing long-term economic harm to society and needs to be eradicated. It took nearly 2 centuries from the development of the vaccine to the eradication of smallpox, and polio is still around despite unflagging efforts over decades to eliminate it.

Remote infection by Epstein-Barr virus has recently been found to lead to multiple sclerosis — so what will be the long-term consequences of SARS-CoV-2 infection, either from long COVID or serial re-infection from sequential emerging variants? We simply do not know. Those of us who are vaccinated and using masks, and who are teaching our children to protect their health, will have much better odds of sticking around and finding out.

Omicron is not likely to be the final wave of COVID-19, and current evidence points to the emergence of a new variant in places with low vaccine use and relaxation of mask mandates. We may need to get used to a new normal: higher overall human mortality, seasonal SARS-CoV-2 vaccinations chasing the tail of the last variant, and repeated applications and relaxations of mandates in different places around the globe to address surges.

Those of us sticking it out in the field of public health are going to need to keep doing what we always do — use our professional experience and our training to keep as many people as possible alive. We need to maintain our own peace of mind, and we want to protect the future of those we love. It’s not like we have any other choice.

Judy Melinek, MD, is an American forensic pathologist and CEO of PathologyExpert, Inc. She is currently working as a contract pathologist in Wellington, New Zealand. She is the co-author with her husband, writer T.J. Mitchell, of the New York Times bestselling memoir Working Stiff: Two Years, 262 Bodies, and the Making of a Medical Examiner, and two novels, First Cut and Aftershock, in the Jessie Teska forensic detective series. You can follow her on Twitter and Facebook.

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