Thread by @EvanDonovan

😷DAY 2: FLORIDA MASK TRIAL😷

Day two of the trial begins in a few moments.

Several Florida families are suing @GovRonDeSantis and the Dept. of Education over the ban on mask mandates.

Plaintiffs (families) are still presenting their case.

WATCH LIVE:

I live tweeted Day 1 of the trial yesterday, you can see that whole thread here:

https://twitter.com/EvanDonovan/status/1429793487524929537?s=20

As I mentioned yesterday, it sounds like the families' attorneys will be calling Dr. Mona Mangat of St. Petersburg as a witness today.

I've spoken with her before about her #COVID19 concerns:

wfla.com/community/heal…

Here we go.

Judge Cooper is going through the exhibits to make sure he has all the right ones.

Again, here is the link to all the trial documents so far.

I do not have exhibits loaded there yet, but I will do so now.

nexstartv-my.sharepoint.com/personal/edono…

Let's do this in links — here's the link to all the plaintiffs' exhibits

filemail.com/d/legehhwefzyg…

Here's the link to the defense exhibits

dropbox.com/sh/ynr8tatvx89…

Here's the link to the defense's affidavit for Dr. Jay Bhattacharya, Professor of Medicine at Stanford and Senior Fellow for Economic and Policy Research, whom defense will be calling as a witness later today

dropbox.com/sh/usi81zi3vyt…

Judge Cooper mentions that he marked plaintiff's exhibits with the pi symbol π

And marked the defense exhibits with delta Δ
(nothing to do with the Covid variant)

Gallagher mentions that the defense not submitting exhibits earlier creates prejudice.

Says defense had a cavalier attitude yesterday when plaintiffs questioned where the exhibits were that defense was referencing — "we just submitted them 15 minutes ago."

Judge and Gallagher are discussing the exhibits.

Gallagher says he does not object to Exhibit 47 - a composite list of articles including one from Frontiers in Psychology entitled "Masking Emotions: Face Masks Impair How We Read Emotions"

dropbox.com/sh/ynr8tatvx89…

After initial discussion, Gallagher also notes he does not object to Exhibit 48.

This is the CDC report that Defense kept referring to yesterday — Mask Use and Ventilation Improvements to Reduce #COVID19 Incidence in Elementary Schools in Georgia

dropbox.com/sh/ynr8tatvx89…

Those references from Defense attorneys led to Judge Cooper pointing out other parts of the report that undercut the defense

https://twitter.com/EvanDonovan/status/1429944451930148869?s=20

Gallagher objects to Defense Exhibit 46, a Declaration from Hillsborough County teacher Angelo Leopardi.

Gallagher withdraws objection.

Judge describes it as declaration of her experiences as a teacher, points out she says she's a lifelong Democrat.

dropbox.com/sh/ynr8tatvx89…

Judge says the attorneys are working well together, notes they seem in good shape, but this is a very tight timeline (trial only scheduled to last through tomorrow)

Judge seems ready to begin, asks for next witness

Plaintiffs attorney Josh Sheridan asks to invoke rule (Rule of Sequestration - wants Judge to put witnesses in waiting room so they can't hear other testimony)

Notes that it doesn't apply to parties to the lawsuit, so @lesleyabravanel can stay in the Zoom

Plaintiffs call and judge swears in Dr. Mona Mangat

B.S./M.D. from Northeastern College of Medicine, internal medicine and pediatrics residency and University of Tennessee-Memphis, board certified in immunology, etc.

bayallergy.com/meet-the-physi…

Mangat: See adults and kids in practice, describes how the immune system is like a see-saw, when well-balanced it fights things that are not supposed to be in the body

Also does immunology where immune system can't fight off pathogens leading to recurrent infections

Been in private practice since 2007.

Treat #COVID patients? Yes

Ages? "Cradle to grave"

Difference in volume of patients over past year?

No specific data, but usually see decrease in volume leading up to summer months

But this year it's been constant, no lag

Delta variant?

Describes it, origins, etc. infects kids and people faster, produces much more virus in people, much more contagious, evidenced by R-naught

Viral load is over 1,000x greater than original Wuhan virus. Became primary variant in ~July of this year

Do you rely on CDC? Yes so do people around the world

Foremost authority on these issues? Yes

Reviews current CDC recommendations about visitors to school, students, spacing in class, masks, ventilation, screening, testing, handwashing, etc.

She's being questioned by plaintiffs' attorney Josh Sheridan

Sheridan: yesterday Defense attorney Bean referenced a Georgia study by CDC, timeline bother you?

Yes, because it was before Delta

CDC allowed to evolve on recommendations?

Not just allowed to, they should

Sheridan asks about AAP, American Academy of Pediatrics.

Mangat reviews their profile and history, and their recommendations

Sheridan: Any credible data or study showing masking can harm children?

Mangat: not aware of any long-term

Sheridan: Short-term impacts?

Mangat: Exhibit 14, study showing toddlers ages 1-3 have a little more difficult identifying emotions and understanding facial cues in that age group

Sheridan: your opinion on that?

Mangat: very impt for kids to understand those cues

Mangat: most important in those ages, toddlers. As kids get older, they get that info from other cues, not as important for them

Sheridan: so it matters which ages we're talking about?

Mangat:Yes, we should be much more concerned about masking kids under the age of 3 than older

Sheridan: understanding of how things are going in Florida schools right now?

Mangat: 50 kids a day being hospitalized, etc.

Sheridan: understanding of ventilation in schools?

Mangat: no great effort has been made, would require lots of upgrades, HEPA filters, not feasible

Mangat: open air classrooms better, or windows open, but not feasible in Florida. That leaves us vaccinations and masking, social distancing etc.

Believe there is an underreporting of cases. Appears there's been a move to not share data in a timely fashion.

Mangat: Data dumps that skew data, no daily covid reports from state, also only 1/3 of school districts sharing good data

Sheridan: contact tracing?

Mangat: not being done at level it should be to stop spread of #COVID

Sheridan: you see CDC report, defense exhibit 18? Opinion?

Mangat: lots of concerns, not clear what was happening there, what were other layers of mitigation, how well were people masking, what was community transmission rate at that time, all those factor in

Sheirdan: long-term effects of #COVID on kids under 12?

Mangat: Not cared for kids with MISC, i've cared for adolescents who are #longhaulers, shortness of breath on exertion, fatigue, chronic cough.

Also cared for many patients who suffered b/c they can't be in person schoool

Mangat: creates anxiety, depression, etc. other issues from remote learning

Sheridan: any agencies that don't recommend masking?

Mangat: none i know of

Sheirdan: opinion of Dr. Jay Bhattacharya's summary?

Mangat: careful with how he's presenting. he's hypothesizing a lot

Mangat: Bhattacharya is well-regarded in aging and health economics, but not virologist, pathologist, practicing doctor, etc. So I would view his words with caution

Plaintiff done

Cross-examination by Daniel Bean

Bean: nanometer vs. micrometer - difference?

Mangat: 1000x

Bean: you mentioned Florida is second to Mississippi in ? where is that from?

Mangat: I believe in CDC data

Bean: Aware that #DeltaVariant hospital admissions in UK have decreased?

Mangat: Not aware of specific UK data

Bean: you said lesser importance of facial cues as kids age, but still important?

Mangat: yes

Bean: where did you read summary of Bhattacharya?

Mangat: online, would have to get that for you

Bean: you said he hypothesizes things that may not be true, what specifically?

Mangat: he thinks herd immunity through natural immunity, which doesn't take into account the human toll, or the variants

Bean: Familiar with Dr. Unnasch's comments on herd immunity?

Mangat: no

Bean: done any studies on masks in classroom?

Mangat: no

Bean asks judge for a moment

Bean: you said you're seeing more patients, are they from schools with or without mask mandate

Mangat: not aware of where they're coming from

Bean: Unnasch said we'd be done with coronavirus by October, can you confirm?

Mangat: no i can't

Sheridan objects, overruled, she answered

Bean: effectiveness of cloth masks?

Mangat: Exhibit 15, study in Mayo Clinic this summer, lab study. With no regard to social distancing or type of mask, showed 99% reduction of particle distance

filemail.com/d/legehhwefzyg…

Bean: size of particle is smaller than nanometer?

Mangat: 50-100 nanometers, N95 mask keeps 95% out that are up to 300 nanometers

Also probably doing good job on small particles as well

Bean: size comparison?

Mangat: aerosol smaller than dust mite, particles you see spit out of someone's mouth are bigger

Cross finished, no redirect

Judge: if there's a #COVID positive person in class, is that most important person in room to wear mask?

Mangat: no, equally important that others wear masks, especially those that are vulnerable

Judge: that's what's behind CDC recommendations?

Mangat: yes because vaxxed or unvaxxed can still spread

Judge releases witness

Judge asks if anyone needs break

Defense attorney Bean asks for 10 minutes

We're on break until 10:45

Here's video of Dr. Mangat talking about the @MayoClinic lab study trying to identify effectiveness of masks

Plaintiffs call @lesleyabravanel from Florida's east coast

She is a plaintiff in this case and a mom

Questioned by attorney Erin Barnett

E-learning last year? Yes

Experience this year? It's been a disaster, both kids have already had to miss school from getting sick and quarantine. Sounds like no #COVID but had to quarantine and missed 4 days of school

Notify school that pending #COVID19 test?

Yes

Did school system force your kid to quarantine?

Nope, they never said a word. I did it because I wanted to care for other kids, but school system didn't make me

Barnett: your son was negative?

Abravanel: yes

Barnett: have you been in the school this year yet?

Abravanel: no, just went to open house to meet teachers. Got email from school saying all visitors and students must wear masks to Open House, and all staff. So it was great, everyone had masks on — that day only

Abravanel: Horrified at setup of desks. Clusters of 4 desks at one table pushed together

Barnett: social distanced?

Abravanel: no of course not, on top of each other

Barnett: barriers or plexiglass?

Abravanel: no, i wish, there was nothing

Barnett: different from last year?

Abravanel: tbh i don't know because they were home

Barnett: why'd you bring this lawsuit?

Abravanel: because we're throwing our children into a petri dish right now. How will we protect kids and staff from #DeltaVariant without masks?

Abravanel: makes no sense to have peanut-free rooms because a kid has peanut allergies and not have this. i'm fine complying with that, even though my kids love peanut butter

Barnett: kids vaxxed?

Abravanel: no but will get it as soon as they're eligible

Barnett: any effort by school to stop spread?

Abravanel: no, just hand sanitizer. I saw nothing.

Barnett: did you feel safe on campus?

Abravanel: yes because i was wearing a mask

Barnett: what interaction besides meet the teacher on campus?

Abravanel: none, just pickup and dropoff

Barnett: you mean "the car line"

Abravanel: yes

Barnett: masks during that?

Abravanel: staff, some. kids, most of them, but it's outside so not always.

Abravanel: i have data showing only 96 out of 1100 students opted out of masks in my kid's school, age range of school is 5-11 so none eligible for vax

Barnett: parents decision or public health?

Abravanel: public health. they have to get 6 vaccinations for school

Barnett: do your kids wear masks outside of school

Abravanel: yes, except during summer camp, but that was in a bubble with no one in or out for 2 months

Barnett: did your kids get health issues from masks?

Abravanel: no! fewer colds, flus, etc

Abravanel: my kid has been seeing a therapist because he's terrified of getting sick

Barnett: seek guidance from pediatrician?

Abravanel: yes, they require masks in office, pediatrician said to wear masks

Barnett: familiar with CDC recommendations?

Abravanel: of course

Barnett: what particularized harm will you suffer if your kid's school doesn't have right to enact masking under current EO?

Abravanel: i'll be a nervous wreck, fear that our kids will get sick, instead of worrying about them doing well in school or a god forbid a mass shooting

Abravanel: it's not the harm i'll suffer, it's the harm my kids will suffer. This is so horrendous and preventable

Barnett: online learning an option?

Abravanel: not for us, our kids need to be in brick-and-mortar

Barnett: why school board?

Abravanel: because we elect them, they are local, if not them then who? they should be running school

Exam done, cross begins

Bean: your school board just enacted mandate, correc?

Abravanel: yes

Bean: you made decision to give your kid #COVID test when he was sick

Abravanel: yeah sure

Bean: you'd let someone else?

Abravanel: yeah of course, if school said get #COVID19 test, i'd be fine with it

Bean: if you didn't agree, would you let it?

Abravanel: probably

Bean: anyone know your kid better than you?

Abravanel: maybe my husband

Bean: does governor's EO preclude barriers in school?

Abravanel: yes, a mask is a barrier

Bean: i mean plexiglass barriers, EO doesn't prohibit them?

Abravanel: not sure

Bean: does @GovRonDeSantis EO say no social distancing?

Abravanel: no but school did, doing their best I guess

Cross-exam done, no redirect

Judge releases Abravanel as witness

Next plaintiffs' witness: Dr. Grace Hunte

Gallagher will question Dr. Hunte

Background of training?

Hunte: Emory school of medicine, U of Colorado pediatric residency, now works in general pediatrics in hospital setting at Johns Hopkins All Children's at Sarasota Memorial Hospital program

hopkinsallchildrens.org/Find-A-Doctor/…

Gallagher: volume of kid patients?

Hunte: increase, 1-2 #COVID patients a week in hospital, last year more like 1-2 a month

School-aged children?

Yes. Youngest this past week, saw mother give birth to child with #COVID19. Saw baby 7 days old have fever with #COVID

Hunte: several 3-month old babies, 9-month old babies, and older

Gallagher: for newborns, any other co-morbidities or health issues

Hunte: no, otherwise healthy when born

Gallagher: any other issues with #COVID19 complications?

Hunte: yes, some unexpected. 17yo had acute pancreatitis with it, younger children who developed leukemia with #COVID, teenagers who've had cardiac arrhythmias or heart murmurs

Gallagher: kids under 12 more at risk?

Hunte: Yes, no vax for them

Reviews @CDCgov recommendations and @AmerAcadPeds, she agrees with them

Gallagher: aware of any literature that doesn't endorse masking in school?

Hunte: not aware of any reputable or peer-reviewed journals not recommending that

Gallagher: parental decision or public health?

Hunte: public health

Exam done, no cross-exam

Judge releases witness

Discussion of whether to go forward to take break

Next plaintiffs' witness: Dr. Tony Kriseman

Attorney Joshua Sheridan will question him

Sheridan: area of practice?

Kriseman: Pediatric pulmonology, board-certified in both

Bio?

Kriseman: undergrad in South Africa, training at Tulane, residency at USF, professor of pediatrics at USF

hopkinsallchildrens.org/Find-A-Doctor/…

Sheridan: process of becoming infected with #COVID?

Kriseman: explains process

Sheridan: size of particle relevant?

Kriseman: two issues, source and recipient. Source are large, encased in mucuous or saliva, can be checked by any sort of approved mask

Kriseman: unmasked person will cough droplets, they become aerosolized, even a gaiter can slow down droplets, effect is that the data supports both people wearing masks

Sheridan: CDC recommendations include layers?

Kriseman: masks are just one, ventilation, vax, etc.

Sheridan: opinion on masking the most uniform protocol given difficulty with ventilation and social distancing

Kriseman: one of the most important yes

Sheridan: familiar with any credible data that masking harms children?

Kriseman: no

Kriseman: change in prevalence of #DeltaVariant changed how many kids were being hospitalized. 20 in June, then multiply by factor of 15 in July, exceeding that in August. Delta became most prevalent strain in ~July

Sheridan: any studies before delta have same gravity?

Kriseman: exacerbated due to delta, much more contagious, as much as chicken pox

deaths exaggerated?

Kriseman: factor of 5 higher than the flu. 400k a year vs. 80k a year in a normal flu year

Sheridan: masks result in better, same, or worse results?

Kriseman: lots of data showing it would be better, there's some saying it would have no impact, hard to see any result that could make it worse

Parents are scared by #COVID, even if kid isn't ill, having to quarantine keeps at least one parent at home, economic impact is big

Sheridan: parent or public health decision?

Kriseman: none of us is island, so public health decision. Medical decision in that it works. Got rid of so many diseases from vaccinations, difficulty teaching students about them. Don't see why we can't do the same with #COVID

Exam done, Bean on cross

Bean: recommendations evolve?

Kriseman: of course

Bean: you done any studies on masks in class?

Kriseman: no

Bean: in your declaration for this case, you cite a NY Times opinion article involving NC school study.

Bean: did that study have control group with no masks?

Kriseman: no, limitation of study.

Bean: do we know about ages or ventilation, etc.

Kriseman: just grades they attended

Cross-exam done

Redirect from Sheridan: another sentence from that study?

Kriseman: yes, they quote data from other studies, and they point to other data in Israel, all saying good idea to mask

MMWR report from Georgia is from Nov-Dec last year which states multi-layer approach to school mitigation is important, which includes masks

Sheridan finishes, Bean comes back on re-cross

Points out study concluded no statistical signficance

Kriseman: also says masks are important

Bean: in Florida decision is up to parents, correct?

Kriseman: that's a philosophical as well as legal. it's not only on that child

Kriseman: if it was tetanus, that's one thing. But the parents' decision affects everyone.

Bean: it's how much individual freedom you're willing to give up

Kriseman: we could debate that for a long time

Bean: yes, we could

Re-cross done

Judge adjourns for lunch until 12:45

Defense will present when we come back from lunch, plaintiffs are through

/fin for now

Ok we're back

Defense has witnesses

First, a motion for voluntary dismissal

Attorney Jared Burns presents on behalf of defense

Request court voluntarily dismiss for 7 different reasons

Standing - McCarthys, Scott, Anderson, Douly [sp] failed to present evidence for standing

They failed to present evidence for standing

As for those who have presented evidence - two are in Hillsborough County, which just implemented a mask mandate

Judge - which your client is trying to get them to drop

Burns: i don't understand relevance

Judge: your client is trying to get them to drop thta

Burns: No evidence presented yet to that effect

So parents who are in counties already mandating masks don't have standing, and burden is on plaintiffs to prove standing

All plaintiffs who have testified in this case are in mask mandate counties

if court rules, it's an advisory opinion

2) this falls under political question doctrine. Policy is now being presented as testimony. Evidence is the same as those arguments.

Burns: Surely, court cannot find failure to follow CDC recommendations violates the state constitution. Then you could fire all state health authorities because CDC would rule. Federalism would become irrelevant.

This is a difference of policy, not a constitutional violation

Burns: Chief Justice Roberts just said public health questions shouldn't go against policymakers. Medical literature is in flux.

Delta variant is brand new, Dr. Unnasch testified that research and data is still in flux.

Any decision of what is safe and secure for people in this pandemic is for the other branches, not judiciary

Same is true for separation of powers (I think this is argument 3 of 7). Here, plaintiffs want judiciary to overstep Dept of Health, governor, etc.

4) governor has constitutional authority to direct state agencies to promulgate rules about this.

5) plaintiffs have failed to present evidence against every other rational basis. No set of facts that can show conceivable basis for upholding the law.

Florida parents have fundamental right to make health care and education decisions for their children. Numerous other mitigation measures don't implicate covering faces. EO provides detailed reasoning for decision.

EO's Whereas clauses explain no statistically significant difference between Fla. counties in 2020-21 school year with masks and without.

Plaintiffs have presented some evidence, but this supports rational basis that there's evolving science and legitimate debate

It's neither arbitrary or capricious.

6) Failure to exhaust administrative remedies. Challenging admin rule requires petition before admin judge or in district court of appeal, so count 5 should be dismissed

anything regarding disabilities much also go through other steps

7) this was about an indispensable party but I missed part of it. Dept of Health is not a part of lawsuit so court should not make any declaration about its rule

Plaintiffs made lots of argument, but people of Florida delegate authority to executive and legislative branches. They can be held accountable.

Ultimately, decision of who decides what should cover a child's face is left to parents. Other 2 branches made that clear.

Under Rule 1.420(b) *need to check that number* we request you dismiss the case

Whisenhunt for plaintiffs will respond

Judge: start with evidence of plaintiffs standing

Whisenhunt: Part of standing argument is they are citizens, and gov has exceeded authority

Whisenhunt: *citizens of the state of Florida

Judge: Do we need to hear testimony that they live in the state? Are there any

Judge: I'm concerned about issue of plaintiffs who didn't testify, because I didn't see any proof. I need some evidence they live in Florida

Judge: but for plaintiffs who did testify, the fact they live in counties that have now issued mask mandates doesn't negate their standing.

Defense is arguing governor has authority and can prohibit these counties. But even if they didn't, plaintiffs who testified have standing

Judge: The only other argument that gives me pause is to indispensable party (Dept of Health is not a defendant)

You've asked me to rule on Dept. of Health's rule, but you didn't sue the Dept. of Health. What's up with that?

Whisenhunt: DOH rule wholly consumed EO

Judge: I can't order anything to DOH because they're not a party

Whisenhunt: If court rules on EO, it can't be excised out of DOH rule

Judge: I think what I can do is rule or not rule on current defendants in case. I don't know that that goes to determination on DOH on anything

Judge: TBH before defendant filed indispensable party defense, I was wondering why you didn't sue DOH

Whisenhunt: fair question. there was discussion of that on strategy

Judge: well that's fine, but I can't direct DOH to do anything, that's clear.

Judge: I'll reserve on count 5 with regard to DOH, but doesn't mean I can't rule on defendants. Any other responses?

Whisenhunt: I'd rely on earlier arguments, and those used in motion to dismiss. Also, Burns just used very selective quote from Unnasch. Context matters.

Unnasch's testimony - if you look at that one statement - looks like it supports defense. But in the whole, it's overwhelmingly opposed to their position.

A lot of defense argument has relied on selective facts. We're not asking judge to issue mask mandate. Nor Gov. DeSantis

We're saying the people of Florida elect leaders to make decisions. And they elect school boards to do exactly that. Now deprived of that ability

Don't know how anyone could argue that in a pandemic it could be rational to tell ppl to avoid advice of worldwide experts

Judge: anything else on plaintiffs who haven't testified? Because otherwise I think I have to grant the motion with regard to those plaintiffs

McCarthy and Dooley were dropped as plaintiffs because they joined the federal lawsuit out of South Florida (all kids w/ disabilities)

Burns: we dispute a party can dismiss itself. That safeguards defendants.

Judge: no one has brought that up until now. No motion on it.

Those who testified have standing. Those who didn't, put on no evidence of standing.

Let's frame it like mortgage foreclosure. Mortgages change hands lots of times. Normally, I deny motion to dismiss, but that doesn't obviate requirement through affidavit or verified complaint or at trial, standing.

Judge: that's my ruling, people who testified and their spouses and children proved standing. I deny other points of motion but i reserve on count 5. Mr. Burns, I recognize your argument there to see how case progresses to end to figure out what to do.

Judge: Perhaps evidence and further arguments will help. I understand your arguments.

Housekeeping from Gallagher: Attorney Silver whose motion to join was denied yesterday, wants a more "complete" order

Judge: 15 minute break now before Bhattacharya

Here we go.

First defense witness for @GovRonDeSantis is Dr. Jay Bhattacharya of Stanford.

DeSantis has used Bhattacharya on several roundtables over the past year and a half.

He'll be questioned by Daniel Bean.

wfla.com/news/florida/d…

Bean: Describe role at Stanford

Bhattacharya: professor of medicine, also teach health economics course, statistics course

Bean: What is epidemiology of infectious disease?

Bhattacharya: study of how it spreads, consequences, mitigation, etc.

Bhattacharya: i do research full time, I don't practice medicine, research includes infectious diseases and its policy, epidemiology, management of patients in health care systems

Bean: any other employment?

Bhattacharya: consultant with company called Acumen

Bhattacharya: which works with FDA and others to track vaccine effectiveness, etc. Also a research associate at National Bureau of Economics just to publish research through them, not working for them.

Degrees?

MD and PhD in Economics from Stanford

Judge: MD specialty?

No

Judge: did you specialize in something for your MD?

Bhattacharya: No

Judge: have you ever practiced medicine?

Bhattacharya: No

Bean: have you ever been published?

Bhattacharya: yes, 150+ times in peer-reviewed journal, more than that in non-peer reviewed

Bean: difference?

Bhattacharya: send paper or study, journal sends to peers, lots of back and forth with suggestions and comments before journal finally agrees to publish

Bean: compensation for this testimony?

Bhattacharya: none

Bhattacharya: Been researching #COVID19 since February 2020, major co-author of seroprevalence study (spread through population) published in several journals including JAMA

Also done on efficacy of lockdown policies that was published in Europe,

Bhattacharya: published on unequal effects of lockdowns on racial minorities, series of other studies

haven't worked harder since medical school

Bean: any payment for anything on #COVID19?

Bhattacharya: no. wanted to do productive work, felt ethically not right to take $

Bhattacharya: as a matter of protecting myself against false allegations, I decided not to accept any $ on COVID research

Bean: topics you've published on?

Bhattacharya: earliest was on HIV policy in US and developing countries, specifically distribution of drugs, also obesity

Bhattacharya: published extensively on Medicare and elderly populations. Fair amount on population aging, consequence of aging, all this is pre-COVID

Bean: published on #COVID19?

Bhattacharya: 2 seroprevalence studies I mentioned, also on asymptomatic spread,.....

Bhattacharya: also attitudes of racial minorities toward mitigation strategies, and just recently on location of testing centers, all those were result of studies

Especially the two seroprevalence studies. Effectiveness of lockdown measures like mandatory stay-at-home on spread

Bhattacharya: infectious disease epidemiology is a subset of epidemiology. Has its own methods sometimes not use outside of ID epidemiology

Bean: what is serological?

Bhattacharya: serology in context of #COVID19 is prevalence of antibodies in body.

Bhattacharya: most people exposed to virus produce antibodies, last for some time after infection. Serology is the measurement of those antibodies in people. Population serology is about how many people have those.

Bean: books?

Bhattacharya: yes two, textbook on health economnics in 2013, used around the world, includes chapter on epidemiology including compartment models i mentioned.

Also book on Japanese health policy

What's SIR model?

Bhattacharya: Susceptible Infected Recovered

Bhattacharya: standard models used to forecast disease spread. Start with population, some become infected go from S to I and get some immunity, then move from I to R.

Series of equations that track people across those compartments used to forecast.

Bean: how many times published on COVID?

Bhattacharya: 5, not yet published 6th. Throughout epidemic I've been writing in popular settings, op-eds in @thehill, @WSJ, @USAToday, @Telegraph, couple places inIndia

Been trying to talk about policy at large to people more with COVID

Bhattacharya: article published in @WSJ after participating in @GovRonDeSantis roundtable after my comments about masking children

(Author's note: link below)
wsj.com/articles/masks…

Bhattacharya: we found 40x as many infections in LA County than cases had been identified to date.

That means disease had spread much more than we realized at that point in the pandemic.

Bean: other study?

Bhattacharya:that paper found similar result -- 2.8% of Santa Clara..,

...had evidence of infection. That changes survival rate.

Almost 40-50x more infections found by us than recognized by public health data.

Partly due to testing resources not deployed effectively, etc.

But also lots of those infections had no symptoms

Bean: So lots of those folks who got #COVID19 weren't identified?

Bhattacharya: Yes, for every case, probably 2-3-4 that are missed. Public health measures do not identify the majority of infections. That's why lockdowns have been ineffective in stopping spread.

Bean: any racial disparities you identified?

Bhattacharya: yes, big ones. In knowledge and implementation of mitigation measures. This is the 6th paper I've been mentioning on testing centers

Location of testing centers were in affluent, "lower-fraction minority communities"

Bhattacharya: tended to put testing centers in whiter communities. Lockdowns have much more disparate effect.

In LA County - Hispanics and Blacks have had much larger fraction of infections.

In Florida, infection rates among those communities have not been higher relatively

In lockdown places, you see more affluent communities affected, while poorer communities are more afflicted with #COVID19

I published paper in European Journal of Clinical Investigation, major journal, compared Sweden and South Korea, neither of which mandated lockdowns

Bhattacharya: using methodologies published in @ScienceMagazine, how did Sweden and South Korea do.

Finding was lockdowns had no distinguishable effect on spread of the disease. Same spread in those countries as ones that issued stay at home orders and business closures

Bean: Have you testified on #COVID in other places?

Bhattacharya: yes, US House and Senate, several state legislatures

I also serve as informal advisor to @GovRonDeSantis

Bean: When did you start with DeSantis?

Bhattacharya: early in 2020, spoke for a few hours on effectiveness of lockdowns, we discussed a series of papers, we've spoken a dozen times or so since then. Every time focused on discussion of papers and scientific evidence

Bhattacharya: @GovRonDeSantis and I have discussed vaccine strategy, masking kids, all kinds of issues surrounding #COVID strategy

Done roundtables I think 4 of them with DeSantis

Bean: Moves to enter Exhibit 24 into evidence, it's a link to latest roundtable

Gallagher objects—link never provided

Judge: You agreed to it, don't understand argument

Gallagher: Video was never provided to us. Also this link was removed by @YouTube

Judge: You agreed to put this in evidence

Gallagher: it was piece of paper

Judge: that's disingenuous

Judge overrules Gallagher objection obviously

Discussion about admitting this into evidence

The video is long (more than 20 minutes), Judge concerned about how court reporter will get it into evidence

Bean: who was present?

Bhattacharya: me, @GovRonDeSantis, Dr. Cody Meissner

Bhattacharya: also teacher, student, etc.

They're now playing the video of @GovRonDeSantis latest roundtable

This is the one that

Gallagher: Objection - scope

Judge: none of this was raised before you agreed to admit this into evidence

Gallagher: we thought we could object to the veracity, that it was subject to challenge

Judge: I'm required to watch it now, I can decide what weight to give it

Whisenhunt: evidence can be admissable for one purpose, but not for another.

Here's the link to the video that they're reviewing right now on @rumblevideo.

rumble.com/vkd74v-07.26-c…

Bhattacharya in video: "I don't think #DeltaVariant changes calculus or the evidence in any fundamental way. Look at Sweden, kept schools open, unmasked, no social distancing. Teachers were at lower risk of #COVID than rest of population. Kids had no deaths."

Bhattacharya: Kids are not spreaders of the disease in any signficant way. Masks have marginal impact, and do cause some harm to children developmentally. On net, not a good idea to mask children.

Bhattacharya: Key thing is hospitalizations and deaths. Focus on cases serves no public health purpose. Protect the vulnerable. But tracking cases for its own sake is now counterproductive.

.@GovRonDeSantis: ample time to study masking children, any study that shows it provides benefit?

Bhattacharya: only 1 randomized study, in Denmark, no statistical benefit to mask wearer.

DeSantis: Pro-maskers, can they point to anything?

Bhattacharya: some yes, but ...

Bhattacharya: ....it's poorly correlated evidence. Saw study in Florida that teachers had higher rates, and kids were pretty protected. Correlational evidence is mixed, no randomized evidence supporting it.

Dr. Meissner (in video): difficult to get out opinions that don't toe the party line. I agree with Dr. Bhattacharya. First of all, we're seeing disease in 2 populations - adults who have not vaxxed. Everyone agrees that adults should be fully vaxxed.

Meissner: vaxxed are 99% protected. Small percent will be COVID positive with minor symptoms, but that's not intention of vaccinations. We do that to keep them alive and out of hospital.

Additional concern with way CDC defines 'case'.

Meissner (cont): They're saying anyone with positive test assay is a case, but we don't do that with other diseases, like chicken pox. But 80% have no symptoms.

@GovRonDeSantis I looked at Pfizer and Moderna data, they counted case as positive test WITH symptoms

.@GovRonDeSantis that's different than how CDC is counting it.

Meissner: yes we're concerned about disease, not positive test. Only small # of those who are hospitalized are there because of COVID, uses example of kid there with broken leg. CDC not differentiating.

Meissner (in video): I'm a member of @AmerAcadPeds, I have not had much success at presenting an alternative perspective to their view that kids should be masked.

I believe they are virtue signaling.

Meissner (in video): CDC has been clear that masks are to prevent spread from asymptomatic people to others.

(video lagging...hard to transcribe)

Meissner: Likelihood of kids becoming sick even if infected is pretty small. Strongly disagree that all kids 2+ need to wear masks

Meissner: We've done generational harm done to children - physical, emotional, psychological - we've shut down schools to protect adults

That's the most devastating consequence of SARS-COV2 epidemic. Emotional impairment of health to kids.

Meissner: Masking is not a very effective way to prevent infection. We may develop a strain that is more dangerous than #DeltaVariant. But right now, @CDCgov recommendation for masking indoors in close environments, even choirs, schools, etc. is not effective

McDonald in video: My position is simple: masking children is child abuse. There's no evidence masking helps vs. COVID. Substantial evidence that it harms children. I've said this since 2020. I reinforce this position. Not a single child has benefited from masks, all been hurt

McDonald in video: kid has mask anxiety. Autistic person is worse, they can't attend their normal things. Appalled we're even having this discussion. Every rational adult knows children don't need to have their faces covered.

More children die from flu, and they never wear masks

McDonald: Study from Germany showing kids are a 'sink' from passing on to adults. Depression and anxiety have gone up 300-400% in last year. Teen and child suicide increased from 2019 to 2020. Lockdowns are a catastrophe. Masks are destroying our country.

McDonald: California now is a medical apartheid state. Children not wearing them are viewed as immoral or dangerous or non-compliant. Even kids who don't want to wear masks but are forced are ostracized. Kids can't co-exist in my city with mask mandate if they don't wear them

McDonald: Kids see masks right away. They judge other kids without masks.

Judge intervenes -- asks to take a break. Notes we're 30 minutes into video, about 20 minutes left.

Judge takes break until 3:15.

/fin for now

We're back - video resumes

@GovRonDeSantis is asking questions of an administrator in Jacksonville at a private school I believe

They had an optional mask policy, all 450 students were in person eventually last year, and they had a fairly 'normal school year'

Author's note: I have to start putting together evening newscasts, so I'm not gonna transcribe all this. Also, relevance from administrator, parent, and student is not as important as the doctors.

I will have an eye on this and will come back when they return to trial

Bhattacharya: I want to talk about harms of masking. Psychological and developmental harms are real. We often talk about them as if they're a harmless solution. I'd ask fellow epidemiologists to think about. Just bc you think there are no costs, you have to listen to people.

Meissner (in video): Education is one of a kid's most fundamental rights. Helps with equal opportunity. Closing schools exacerbated social divide.

Video over, back to Bhattacharya testimony

Bean: COVID data based on age?

Bhattacharya: Shows 99.8% survivability overall. Seroprevalence studies show people over 70 have 95% survival rate

99.95% for people under 70

for children 99.99% survival rate

Bean: what about children transmitting?

Bhattacharya: remarkable finding, children are not big transmitters of disease unlike lots of other diseases, including flu. They are inefficient spreaders.

Bhattacharya: A study in @NEJM had striking finding, author said no single instance of child passing to adult within the study, whereas adults passed to children.

Study from Sweden in NEJM - kept schools open throughout pandemic for kids <15, no social distancing, no masks

....and they had no student deaths, and lower rates of #COVID19 among teachers, i.e. they were at lower risk than other adults outside school

Literature show kids need to see faces in order to develop socially, language.

Masks cause harms to their social and emotional dev

WHO explicitly says do not mask if you're 2-5, opposite of CDC which says everyone above 2+

Also a study showing other harms for masking — people say they have difficulty breathing, headaches — we should take those self-reported issues seriously

Bhattacharya: Study of blood donors masked vs. unmasked. When they analyzed the blood, they showed slightly higher levels of hypoxia, which is lower oxygen levels in the blood.

Bean: Do you consider WHO good medical organization?

Bhattacharya: Certainly a recognized one. Pays to look carefully at evidence that these associations cite, then make up your mind about the quality of evidence, and use that when you look at local conditions

Bhattacharya: Director of CDC Robert Redfield said masks were better than vaccines, I think he regrets that, it's not true. No randomized evaluations on efficacy of masks that I'm aware of

Bean: How effective if not worn correctly

Bhattacharya: pretty ineffective

Bhattacharya: most effective are N95, must have tight seal, if not worn properly, they leak air around sides and above and below

That's why folks who wear glasses they fog up, because air leaks. If not worn properly, they have very low efficacy

Only high quality study I've seen on masks and #COVID19 is from Denmark, randomized 3,000 with masks and without.

What they found during time of high community spread is probability was not statistically significantly different between masks and without.

Bean: Does FDA consider mask medical device?

Bhattacharya: Yes, formerly class 2.

Bean: what that mean?

Bhattacharya: class 1 band-aid, class 2 mask, class 3 pacemaker

Bean: does #DeltaVariant change opinion on efficacy of masks?

Bhattacharya: best evidence probably from Public Health England. They say Delta is *less lethal* for both under 50 and above 50. Is more transmissable. Does not escape vaccine or prior infection immunity though

Bean: can you talk about particle size? Nano vs. micrometer and typical cloth masks?

Bhattacharya: a little complicated, but virus itself is about 100 nanometers in size. Size of droplet or aersol that holds virus?

Aerosol 5 micrometers

Masks do poorly with aerosols

That's why it fogs your glasses

Masks much more effective with droplets, bigger particles, more than 5 micrometers.

Different masks have diff properties, cloth are by far the worse with droplets and aerosols, surgical masks not much better with aerosol

Bhattacharya: N95 quite good at stopping both. My observation is most people wearing masks in common use outside health care settings do not wear them very tightly. If you touch face, replace mask frequently. If they get moist, they get less effective.

Bhattacharya: aerosols like cloud, they sit in room with you, once we realized it has aerosol, physical distancing was changed.

Bean: CDC global view or local view?

Bhattacharya: nation at large. Recommendations on whole host of topic are extremely conservative

Bhattacharya: consistently when you think about CDC recommendations, you should take local conditions into account.

Bean: Does Delta change any opinions from your declaration or here today?

Bhattacharya: no. less deadly, more transmissable. No evidence masks stop spread

Bhattacharya: coming into pandemic, we had evidence that masks were not that effective in stopping spread.

This is RNA virus, they mutate continuously, possibility it mutates is always there, to date none of those mutations have put it in a form where masks would benefit

Bhattacharya: providing parents option to opt-out will have no predictable effect on mutations

Bean: best decision made by parent?

Bhattacharya: yes. they see the kid, talk about experiences, weigh that against evidence on infection control

Bean: Your declaration is 19 pages with 50+ footnotes, that correct?

Discussion of a typo

Move to make him an expert in accordance with Rule 90.02 of Florida Statute.

Judge: other judges recommend not qualifying someone as expert, rather let them be questioned by other side

Bean: has any court ever said you're not an expert?

Bhattacharya: no

Exam is done, Gallagher doing cross

Gallagher: if we can have one agreement, please wait for me to conclude question before answering

Gallagher: you don't treat #COVID patients?

Bhattacharya: No

Ever treated any?

No

None in practice?

No, I don't have a practice, I do research full-time

You mentioned working for Acumen, what do they do?

Provides advice to FDA and helps conduct safety of vaccines, etc.

Gallagher: you said earlier you're doing this out of goodness of heart or pro-bono, any other sources of income?

Bhattacharya: just Stanford and Acumen

Gallagher: you write about lots of topics?

Bhattacharya: i write about infectious disease epidemiology since start of career

Gallagher: any studies of #COVID in Florida?

Bhattacharya: written extensively, mostly national, also in non-peer reviewed journals

Gallagher: currently on sabbatical?

Bhattacharya: Yes

Gallagher: when start?

Bhattacharya: a year ago, I go back next week

Gallagher: You have not published any peer-reviewed study on masking in schools?

Bhattacharya: No

Gallagher: and nothing on transmissability of #COVID among school-aged children?

Bhattacharya: the piece I did in Europe included children

Gallagher: with exception of two serological studies, those are the only pieces you did with your own research, the rest is aggregated from others?

Bhattacharya: all peer-reviewed pieces are original work to me.

Gallagher: you have not authored any peer-reviewed study on efficacy of masking in children?

Bhattacharya: no

Gallagher: never practiced medicine

Bhattacharya: correct

Gallagher: so you don't render care

Bhattacharya: not since medical school

Gallagher: you mentioned @GovRonDeSantis, said he is smart and could 'be an epidemiologist'

Bhattacharya: example, he was familiar not just with abstracts of scientific methods I brought up, he knew not just abstracts but methods, and had cogent opinions with good context

Many epidemiologist don't do that as well as the governor.

Gallagher: how many convos to get that conclusion?

Bhattacharya: every time since we talked. even when i bring up papers that are obscure, often he knows those papers

Gallagher: last time you spoke?

Bhattacharya: we spoke about Regeneron therapy, monoclonal antibodies for patients that do get COVID.

Gallagher: how often speak?

Bhattacharya: maybe dozen times since September last year including public settings (roundtables, maybe 4-5)

Bhattacharya: different participants each time, not involved in guests

Gallagher: media there?

Bhattacharya: they were at the first one, media asked lots of questions, another one in March media was there.

Gallagher: but not the one played in court today?

Bhattacharya: no

Bhattacharya: no high quality evidence shows masks work. For extraordinary claim, you need extraordinary evidence. I don't think it exists. Claims are that it's key to stopping spread. That scientific evidence doesn't exist. What evidence does exist (from flu) doesn't support it.

Bhattacharya: (Reviews @ProfEmilyOster Brown study.)

Gallagher: you say lockdowns are not effective in defeating #COVID?

Bhattacharya: yes, very little high quality evidence showing they've had an appreciable effective. Even lockdown places have seen significant disease spread

Bhattacharya: risk of severe outcomes for child are very low

Gallagher: in terms of vaccine eligible, would vaxxed and non-vaxxed have same risk pattern?

Bhattacharya: vaccine reduces risk, but amount of reduction depends on original risk itself. So reduces more for older ppl

Gallagher: do you track Florida data?

Bhattacharya: state-level yes. Seems like we've peaked. I don't like positivity rate, but the case rate has declined for first time in about 45 days.

Gallagher: based on?

Bhattacharya: CDC data

Gallagher: last time you reviewed data?

Bhattacharya: Sunday or Monday, whatever CDC reported thta day. I noticed because case rate declined for first time in weeks.

Positivity rate is flawed statistic. Depends on who is tested. For ex when kids are tested, pos rate declines

Bhattacharya: positivity rate not useful for tracking #COVID

Gallagher: ever useful?

Bhattacharya: no, case rates within certain age groups is most important. how are vulnerable populations faring as #COVID19 spreads

Gallagher: What was most recent case count you saw in Fla.?

Bhattacharya: 100 per 100,000, something around that order of magnitude. Peak was around that.

Gallagher: gross number?

Bhattacharya: gross number is not that interesting.

Gallagher: higher or less than 150,000?

Bhattacharya: I don't track it, I track the rate.

Gallagher: as new science evolves, should you change opinions?

Bhattacharya: Yes

Gallagher: Do you know of any studies that have been modified with new info?

Bhattacharya: yes, for example CDC withdrew a study last year showing correlation between masks and spread

Gallagher: (asks about email Bhattacharya wife sent during a study)

Bhattacharya: you're asking about private email sent by my wife w/o my knowledge or that of study?

Gallagher: that affected the study, right?

Bhattacharya: not sure it did, we worked hard to get participants

Bhattacharya: Test kit we used was approved by FDA later

Gallagher: you concede the email affected the study?

Bhattacharya: i did not concede that

Gallagher: didn't it?

Bhattacharya: that was peer-reviewed, found to be worth publishing

Gallagher: originally published pre-print?

Bhattacharya: yes, to get scientific comments and feedback. Studies that are correlational in general are not as good as randomized.

14 randomized studies show community mask-wearing doesn't protect against flu

Bhattacharya: Brown study is important because it looks at Florida data and whether there's correlation. Answer is no, it doesn't find any correlation between masking of students and slowing of disease spread in Florida last year

Gallagher: That's in pre-print as well, right?

Gallagher: That's in pre-print as well, right?

Bhattacharya: Yes

Gallagher: but not peer-reviewed?

Bhattacharya: I just peer reviewed it for you right now

Gallagher: asks about email/study again

Bhattacharya: tabloid article you're referencing, shows ad hominem insinuation.

Gallagher: was there an internal Stanford investigation?

Bhattacharya: it was a fact-finding mission

Gallagher: Stanford enforces masks?

Bhattacharya: I believe indoors yes

Gallagher: Back in March, you participated in roundtable with Dr. Scott Atlas, others. No compensation for that? Bear your own travel costs?

Bhattacharya: I did

Gallagher: in that roundtable you said masks don't help stop spread

Bhattacharya: I was citing WHO...

Bean: Objection - needs to let witness finish answer

Bhattacharya: Comment from WHO was citing their discussion on masks

Gallagher: YouTube removed that video fo the roundtable?

Bhattacharya: I don't know why they removed it

Judge: is this the one you wrote to @WSJ about, doctor?

Bhattacharya: yes

Gallagher: YOu signed Great Barrington Declaration, correct?

Bhattacharya: I was co-author with Harvard professor and Oxford professor. The writing of the declaration came about as we were discussing our positions.

gbdeclaration.org

Gallagher: if you use other people's results, is that considered your research?

Bhattacharya: yes absolutely, for instance data I'm citing on masks and flu based on my metaanalyzing data from 14 studies

Gallagher: what's difference between your own study and others' research?

Bhattacharya: all research relies on others' work. Danish mask study is randomized, etc. Every piece of research done relies on work of others.

Gallagher: But your serological study, you collected the data yourself?

Bhattacharya: yes. I'm not sure of the distinction you're trying to get at

Gallagher: it's 5, should we recess?

Judge: let's recess until tomorrow

Bean: can we do East Coast witnesses first, then bring Dr. Bhattacharya back later?

Gallagher: no objection here

Judge thanks everyone.

Trial resumes for Day 3 - expected to be final day - tomorrow Wednesday at 9:30am

/fin for now

Worth noting:

https://twitter.com/malar0ne/status/1430245162756706305?s=20

Full story here:

https://twitter.com/WFLA/status/1430312871787892740?s=20

https://twitter.com/EvanDonovan/status/1430526588131622912?s=20