Pandemics and other biases
A pandemic is the worldwide spread of a disease affecting many people across multiple continents. It is usually caused by a new virus to which most people lack immunity. Ebola and the hantavirus are now in the headlines. In such outbreaks, a rapid response is set to contain the spread and reassure the public. Some outbreaks do not cause the same alarm but are no less deadly.
On February 7, 2020, a paper by Wang et al. described the clinical characteristics of 138 hospitalized patients with pneumonia caused by a novel coronavirus infection in Wuhan, China. Like others, I had heard of coronavirus and had watched early reports. In December 2019, my index of concern was low. As an ICU physician, I knew if the coronavirus continued to spread, my work would be directly impacted.
The paper from Wuhan, China, covered the period from January 1, 2020, to January 28, 2020. On January 1, 2020, there were 6,061 known cases of novel coronavirus. The first confirmed case of the novel coronavirus in the US was announced by the CDC on January 20, 2020. By February 3, that number had increased to 20,626.
The information in this paper claimed an ICU admission rate of 26% and a mortality of 4.3%. It was at that moment that I became alarmed. I wrote about my concern for MedPage Today in February 2020. My piece was submitted on February 7. On February 11, 2020, the WHO announced the new name for this virus would be COVID-19.
By the time I wrote my piece, there were 37,606 recorded cases. My warning was that ICU services would rapidly become overwhelmed, and a failure to act would be potentially catastrophic. As of early 2026, over 1.2 million Americans had died from COVID-19. The COVID-19 pandemic is considered the deadliest disaster in US history.
It was very difficult for many to accept the deadly consequences of COVID-19. False information about the origins and treatments of COVID spread widely. Sometimes, the spread of information acts to confirm a bias, even when the underpinnings of that bias are evidence-free.
Novel viruses carry in us few preconceived notions, and our relationship to them is likely agnostic, at least at the beginning. Immunity derived from vaccines and exposure protects us from future risks. Negative beliefs can also spread like a virus, and for many, repeated exposure fails to immunize against them. Unlike biological immunity, confirmation bias and recurrent exposure tend to strengthen our worst inclinations.
Antisemitism is a toxic social pathology, a disease, and it is now a pandemic. It was always lurking, perhaps akin to the latest measles outbreak. In 2000, Measles was declared eliminated in the United States. This is defined as the absence of continuous transmission for at least 12 months. This public health triumph can be traced to years of vaccination efforts and the two-shot measles, mumps, and rubella schedule. In a recent letter published in The Lancet, the US is now at high risk of losing its measles elimination status.
The lessons of measles apply to other outbreaks. We hope to permanently eliminate what threatens us, but the worst threats and the most dangerous ideas might just lie in wait for our slightest lapse in vigilance. Often described as the oldest hatred, antisemitism lies dormant and waits for a chance to break out.
Antisemitism is a shape-shifting conspiracy theory that has been around for thousands of years and can take root in political and social environments. It is not based on rational facts but rather a fever dream that grafts onto modern anxieties. The late Lord Jonathan Sacks, former chief rabbi of the UK, described antisemitism as a mutating virus.
This opinion piece is my warning. Truthfully, it might be too late for the current outbreak. I saw this many months ago, and although I reacted, I failed to describe it as a pandemic. For the first time in the US since 2019, antisemitic attacks resulted in 3 fatalities. Violent assaults involving deadly weapons increased by 39% between 2024 and 2025.
On December 14, two individuals opened fire on more than 1000 people celebrating the Jewish holiday of Hanukkah on Bondi Beach in Australia. That attack killed 15 people. A recent report by the Executive Council of Australian Jewry (ECAJ) documented 1,654 anti‑Jewish incidents across Australia between Oct. 1, 2024, and Sept. 30, 2025, in addition to 2,062 incidents nationwide the year before.
Although Jews have been in the UK for the last one thousand years (originally arriving, probably serving in the Roman Army), they were formally expelled by the King’s edict in 1290 following a case of blood libel. They were readmitted in 1656 under Oliver Cromwell. No doubt a few hidden Jews remained during the expulsion, but the current UK Jewish community traces its integration into the UK back to Cromwell’s time.
The Jewish community in the UK accounts for 0.5% of the population. As of 2022, 17% of all hate crimes were against Jews. On April 29, 2026, two Jewish men were stabbed in Golders Green. A group possibly associated with the Iranian regime claimed responsibility. Britain is currently experiencing an unprecedented surge in antisemitism, which, since early 2026, has been described by government leaders as a crisis. In 2025, 3700 individual incidents of antisemitism were noted.
In the last year, antisemitism in Canada has reached record high levels. A 9.4% increase in incidents as compared to 2025, totaling 6800 documented acts, which include violence, vandalism, and harassment. The city of Toronto has seen a surge of synagogue shootings and a 71% increase in police reported hate crimes against Jews. A recent piece in the Atlantic cited what it described as Canada’s polite pogrom – a national tolerance for zealotry is purging Canadian Jews from public life.
It is impossible to consider antisemitism now without unpacking the newest version, anti-Zionism. Consider the danger from slowness and the lack of recognition of the connection between SARS and COVID-19, or between H1N1 and the flu. Some will haggle about whether anti-Zionism is a strain of antisemitism.
Many claim the privilege of distinction by asserting that anti-Zionism is simply political criticism of policies advanced by the Israeli government. Some would further denounce antisemitism while defending anti-Zionism. This argument goes even further by claiming that the State of Israel should expect no fundamental connection to world Jewry. By this argument, even some Jews assert anti-Zionism while claiming support from the Jewish community.
Zionism describes the Jewish desire for self-determination to live in the Jewish historical homeland. Like all land claims, the problem is complex, but the violence and vitriol against the Jewish claim for Israel stand apart. Rather than anti-Zionism as separate from the hatred against Jews, it is better thought of as a Trojan horse, filled with antisemites now granted access to the inner sanctums of civil society.
For physicians, a particular tragedy has been the sharp resurgence of antisemitism in the medical community. In years past, Jewish students were specifically excluded from many medical schools simply because they were Jews. Over time, opinions changed, and Jews were granted access, and Jewish physicians became leaders, teachers, and scientists for the betterment of all.
Post October 7th, 2023, studies have shown that nearly 40-88% of Jewish healthcare professionals are the target of anti-Jewish bias, harassment, and discrimination in medical schools and the workplace. Calls abound for the boycott of “Zionist” physicians.
Antisemitism is now rife not only in medical schools, hospitals, and clinics, but also in the medical literature. Earlier in this piece, I quote The Lancet, but that journal and others have published many papers, commentaries, and letters with an anti-Zionism bias. For the Lancet, this struggle goes back at least a decade. Enthusiasm for the publication of anti-Israel submissions has only been matched by an equal enthusiasm against the publication of the counterargument.
Underpinning all of this is the new embracing of the physician as the mouthpiece for “social justice.” As espoused by bioethicists Beauchamp and Childress, social justice is about inequities in health resource allocation. One is hard-pressed to see how anti-Zionism and antisemitism advance equity.
Outbreaks of viral illnesses, both novel and familiar, need constant vigilance to prevent the deadly spread. This latest resurgence of the oldest hatred against the Jews proved that it never went away and may never do so. All we can do is seek to practice the best physical and moral hygiene. By doing so, we serve the public as best we can. Like the earliest signs of the coronavirus, we owe a fiduciary duty to remain vigilant and warn. That time is now.
