The Terrible Cost of Ignorance

Chris Crouch was anti-vaccine. Now his pregnant wife had covid, and he faced a terrible choice.

‘You are not going to die,’ he said, making a vow he wasn’t sure he could keep.

Ariana Eunjung ChaFebruary 14, 2022 at 8:48 a.m. EST

Now, four years later, he was in a hospital intensive care room remembering their courtship as his wife lay unconscious, hooked up to a tangle of machines keeping her alive. Diana was 20 weeks pregnant, and he had a decision to make.

If doctors delivered the baby now, they told him, she would have the best shot at surviving. But the baby was so premature that it would almost certainly die. If Chris waited, he could lose them both.

As the pandemic enters its third year, untold numbers of Americans have agonized over such treatment questions that could mean life or death for their loved ones. Confronting the possible loss of a spouse or life partner is invariably painful, but with covid-19, the severity and suddenness of the illness and the isolation from friends and family have compounded the torment.

The choice in front of Chris was a deeply personal one that only he could make.Diana Crouch was 18 weeks pregnant when she tested positive for the coronavirus, ultimately spending 139 days in the ICU fighting for her and her baby’s lives. (Drea Cornejo/The Washington Post)

Diana was on a ventilator, but her condition was spiraling downward. The coronavirus had thrown her body wildly off balance, and doctors told Chris they needed to move her to a treatment of last resort, in which they would pump her blood through a machine outside her body to take pressure off her heart and lungs. The odds were scary to begin with — an estimated 40 to 50 percent of people going on that machine die — and the baby was putting an additional load on her body that she might not be able to handle.

Chris and Diana were married in the summer of 2019 in a small garden ceremony, and life had been pretty close to perfect since then.

They were opposites, but in ways that complemented each other. Born in Monterrey, Mexico, and raised in North Carolina, Diana was quiet and tended to choose her words carefully. He was a gregarious Texan with a quirky way of recalling dates, numbers and interesting facts about everything from football to legal statutes, a habit that sparked lively conversations with strangers wherever they went. They agreed on conservative values — he was raised Baptist and she was Catholic. And they shared a sharp sense of humor, enjoying shows like “The Office” together.

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They had a boy, Cain, and Chris was promoted to sergeant at the Harris County Sheriff’s Office, a job that provided a steady enough income that Diana could stay home and take care of their blended family. He had two boys from his previous marriage; she had a girl from hers.

The family was young, healthy and happy, and when the pandemic hit, they were worried like everyone else. Before long, though, they started feeling that the dangers of the virus had been exaggerated and that they wanted to get back to their lives.

When the vaccines came along, Chris became outspoken against them, espousing views that were common in his workplace and much of Texas but that put him at odds with his mother, sister and the close friends he had grown up with in the Heights, a liberal bastion in Houston. Despite his family’s pleading, Chris and Diana were adamant they did not need to be vaccinated. They did wear masks, but only when required.

Chris felt that vaccine mandates infringed on personal liberties, a perspective promoted by Texas Gov. Greg Abbott and other prominent Republicans. And Chris and Diana also worried that the shots had been developed too quickly. As he liked to say, “God gave us our immune system and we can fight the viruses with our own immune system.” Diana, meanwhile, was leery of anything that might hurt the developing baby she carried. She knew that early stories linking the vaccines to miscarriage and infertility were false, but thought avoiding them was the prudent thing to do, like skipping wine, raw fish and unpasteurized cheese — especially given some of the medical community’s early hesitation. The World Health Organization and the U.S. Centers for Disease Control and Prevention now recommend that all pregnant people get vaccinated.

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In the summer of 2021, soon after President Biden declared the pandemic almost over, their two-year anniversary was approaching and the couple decided to go to Las Vegas to celebrate. They stayed at the Trump hotel, walked along the Strip and caught a showing of Cirque du Soleil. Diana had a headache, but it didn’t keep them from going out and having fun.

As soon as they returned, however, she developed a low-grade fever and exhaustion unlike anything she had experienced. Late on Aug. 6, she cried out that she was having trouble breathing. Chris called 911, reminding himself that in his line of work, he’d seen a lot of people go to the hospital for covid — with most recovering after a little oxygen.

Diana’s case would turn out to be far less simple.

The emergency doctors at the hospital immediately transferred her to Texas Children’s Hospital in Houston, which had created a special unit for pregnant people with covid. Chris remembers Diana screaming when doctors told them she needed a ventilator: “I have kids. I can’t die.” He held her and made a promise he wasn’t sure he could keep: “You are not going to die,” he vowed.

From the start, Diana’s case weighed on Cameron Dezfulian, a critical-care specialist supervising or consulting on dozens of pregnancies. “She was unusual,” he recalled.

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Most of his other patients had preexisting conditions such as obesity and were close to full term at 36 to 40 weeks. Diana had been healthy, about 110 pounds and at 18 weeks when she arrived at the hospital, still in the second trimester of her pregnancy. She had at least a month before the fetus would be considered viable — a situation that complicated treatment options.

Pregnancy does extraordinary things to the body, and the interaction of those changes with covid is something scientists are only beginning to understand. From the beginning of the pandemic until this month, 27,854 pregnant women with covid have been hospitalized out of 167,000 cases reported to the CDC. Many, like Diana, were young and unvaccinated. More than 267 of them have died, making covid-19 a top cause of maternal mortality.

A study of nearly 2,700 pregnant women funded by the National Institutes of Health and published Feb. 7 in the Journal of the American Medical Association found that pregnant women with covid-19 are at greater risk of pregnancy complications — in addition to risks from the virus itself.

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Doctors are still baffled about why they get so sick. It could be that pregnancy causes a person’s immune system to be in a heightened state of alert to protect the baby and that when the system is exposed to a virus, it overreacts. Another theory suggests the opposite — that pregnant people are immunosuppressed so that their bodies don’t reject the developing fetus. Fetuses also pull oxygen and blood to the placenta. When combined with a virus like covid that can cause lung damage and blood clotting, the body’s balance may be upset.

Whatever the cause, Dezfulian said, “there is no doubt pregnancy and the coronavirus are a setup for more illness.”

For Chris, the next 10 days blurred together. He wasn’t allowed to leave the hospital room because he was also assumed to have the coronavirus. He’d joke to the doctors and nurses every morning, “I bet you’re tired of seeing me …”

Chris had never lost anyone close to him. And as he stared at his wife and saw her suffering, he couldn’t shake the question that kept popping into his head: “Was this my fault?”

During those long hours alone, he struggled with how strongly he had held to beliefs about the vaccines without really examining them. Increasingly, he felt a responsibility to warn others about his mistakes, so he began writing to friends, family and even strangers on Facebook, urging them to get the shots. Somewhere along the way, he got vaccinated himself.

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“When you sit there and you see your wife on life support because of covid, you throw out politics,” he said later. “None of that matters anymore.”

Dezfulian’s team had hoped that the oxygen they were pumping into Diana’s lungs through a ventilator would enable her to fight off the virus. Instead, things were going in the opposite direction. “Every day we were losing a little bit of ground,” the doctor said.

Fourteen days after she arrived at the hospital, the group concluded it was time to move Diana to another machine called ECMO, or extracorporeal membrane oxygenation, in which the blood is pumped outside the body to give the lungs and heart a chance to rest. The decision to put a patient on ECMO is not taken lightly. The therapy, developed in the 1970s, is lifesaving in the right circumstances. But it can also lead to bleeding, stroke, seizure, blood clots and infection. Moreover, the equipment is scarce, the staffing intensive, and the treatment can run up hospital bills in the millions.

At the beginning of the pandemic, many people were worried about rationing ventilators, but instead it’s been ECMO that has been in limited supply nationwide. “That is the tough part nobody wants to talk about,” Dezfulian said. “There are a limited number of pumps, and you make some decisions on the likelihood they will have a long life and a good life.”

On the day his team recommended ECMO for Diana, a somber trio of staff members appeared in her room to visit Chris. He doesn’t remember the exact words they used, but they seemed to speak in euphemisms. “They would ask how you were” and then throw in a question, like what would he want done if his wife’s heart stopped. “They were giving you hints,” he said.

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Chris didn’t fully understand it then, but the staff members were part of the medical center’s palliative care team trained to support very ill patients and their families, especially with end-of-life decisions and care. He said he came to dread seeing them in the hallways: “When you see those people, you pray they avoid your room.”

Chris was worried about putting Diana on the new machine. When he googled ECMO, he said, he found that “it’s a bad, bad deal.”

Using ECMO during pregnancy is extremely rare. One study from the University of North Carolina detailed what happened in nine cases from 2008 to 2017: Only three of the women lived and only five of the babies, for a survival rate of 33 percent and 55 percent, respectively.

Chris remembers asking a ton of “what if” questions that no one could answer. He kept coming back to something Diana had told him as they shared their childhood dreams. “All I ever wanted to do was be a mom. As a kid, that’s all I ever wanted,” she had said.

So he decided he had to try to save them both. “I didn’t know if one or the other was going to live, or both were going to die,” he said. “I didn’t know if I was going to go back home without anybody.”

Doctors had expected Diana to be on the machine for up to about 21 days. When that marker came and went, Chris told himself to be patient as he stared at the tubes of blood swirling around his wife’s body.

On day 30, it seemed as if their ordeal might be over. Diana woke up and was even able to get on her phone and text her family hello. Chris remembers the whole staff smiling and making plans for next steps.

The happy moment was all too brief. It wasn’t long before Diana started seeming confused. Soon, she could no longer see, even though she was still talking to Chris. An hour later, she slipped into a coma, and the somber group of three walked into the room again.

Diana was suffering from “an embolic shower,” in which blood clots burst and scatter, the doctors explained. Three had gone to her brain, causing strokes, and another had lodged in a wall of her heart, resulting in a heart attack. It was a known complication of ECMO, but they had not been able to put her on blood thinners because she had had bleeding in her gastrointestinal tract and in her throat, where doctors had cut a hole for the ventilator.

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Now, the doctors told Chris that even if Diana woke up, she might “not be the same,” she might not remember him or the children. Chris crumpled into the chair next to her and wept. Dezfulian came by and prayed with him.

“That’s when I prayed the most,” Chris said, “because at that point, even the doctors were like, ‘We don’t really know what to do next.’ ”

Diana went back on ECMO, and as the days slowly passed, Chris could see her belly growing. Through everything, the baby’s heart rate held steady and he was growing nicely. On Nov. 10, when Diana had been in the hospital for more than three months and the baby was 31 weeks along, doctors delivered a baby boy by Caesarean section. He was 4 pounds and 12 ounces.

The infant was healthy. But Diana’s body seemed exhausted from the ordeal: She developed an infection, as well as an air leak in her lungs, and one eventually collapsed. Doctors began preparing for a lung transplant.

It was in this dark moment that things began to shift. Without the added stress of carrying the baby, Diana’s body began to repair itself, and by the end of November, doctors were able to wake her up. She was tremendously weak and, at first, didn’t know Chris. His heart felt like it was disintegrating. But then, when a nurse told Diana he was her husband, she pointed to a picture of them on the beach that Chris had posted on the wall and said, “No, that’s my husband.”

Slowly, against all odds, Diana’s memories came back and she began asking about her other children and wondering how it could be that she was no longer pregnant. She asked Chris, “Why didn’t anybody tell me I was going to have a C-section?”

Just before Christmas, on Dec. 23, Diana was able to return home. Chris rattled off the numbers to her: 139 days at the hospital, 101 on a ventilator, 51 of those also on ECMO. She was still attached to an oxygen tank and had three tubes in her lungs to keep them inflated that were pretty painful. But she couldn’t wait to be home.

As soon as they arrived, Chris scooped her up and put her in a bed Diana’s father had set up on the main floor, and Cain, 1, and daughter Miranda, 7, piled onto the blankets. Chris cradled their newborn baby, Cameron, plump and healthy, whom they had named after Dezfulian, Diana’s doctor. Cameron had been discharged several weeks before Diana.

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One day after they were safely home, Chris finally told her about the choice he had had to make.

She replied that even if things had not worked out the way they did, “I wouldn’t change anything.” He felt relief, but also sadness for all the others who had been in the same spot as he had — or would be in the future.

Doctors are optimistic that, physically, Diana will make a full recovery, but it will take time, and she’s still weak on her left side because of the strokes. Emotionally, she’s struggling. She has anxiety about seeing people and leaving her home for fear that she and loved ones will be infected with the virus.

“Things I used to do before, I can’t do anymore. … And so it’s hard for the kids and it’s hard for me, because you want to do so much more. And they want you to do so much more,” she said.

Most of their extended family who had resisted vaccines have now gotten them after learning of Diana’s ordeal, but a few remained reluctant. In January, they got word that Gilbert, one of Diana’s favorite relatives on Chris’s side who was also unvaccinated, had covid. He was one of the first people Chris had told about his feelings for Diana, and he was always joking to Chris that he had done well for himself in finding her.

Shortly before Gilbert was put on a ventilator, he sent a video to relatives describing his condition. Diana texted encouraging messages. “God is going to hug you very tight,” she typed into her phone, and sent a video of Miranda saying they were praying for him.

He died in late January, and Diana cried all night.

Drea Cornejo contributed to this report.

Athletes and Death by Vaccine: A Lie Spread with the help of a U.S. Senator

How the falsehood of athletes dying from coronavirus vaccines spread

Glenn Kessler

“Of course, we’ve heard story after story. I mean, all these athletes dropping dead on the field, but we’re supposed to ignore that.”

— Sen. Ron Johnson (R-Wis.), in an interview on “The Charlie Kirk Show,”Jan. 27

Johnson made this comment after he asserted that there have been “over 22,000 deaths reported in association with the [coronavirus] vaccines” — and then quickly adding “that doesn’t prove causation.”

We have explored before how Johnson routinely raises concerns about vaccines by citing data from the Vaccine Adverse Event Reporting System (VAERS), a database co-managed by the Centers for Disease Control and Prevention and the Food and Drug Administration. Anyone can submit a report to VAERS, and the reports are not verified. The numbers are basically meaningless.

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In this instance, we are more interested in his comment about “athletes dropping dead on the field.” His staff says, as with his references to VAERS, that Johnson is just asking questions, not making factual claims.

“Senator Johnson stated he has heard stories of athletes dying on the field and those should be investigated,” spokeswoman Alexa Henning said. “The Senator’s point in raising these issues has always been that our federal health agencies should be concerned about reports on adverse reactions related to covid-19 vaccines and they should fully investigate and make their findings available to the American people.”

She provided a link to a website called Good Sciencing, maintained by anonymous people, that has a blog post with the headline, as of Jan. 31: “577 Athlete Cardiac Arrests, Serious Issues, 352 Dead, After COVID Shot.”

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Here’s the rub: This claim has been debunked repeatedly. The story of athletes dropping dead from coronavirus vaccines has its roots in mysterious Austrian websites with ties to that country’s far-right populist party, the Freedom Party. Those stories were then recycled by right-wing media in the United States and then eventually came out of the mouth of a U.S. senator.

As is often the case, a kernel of truth — some people have reported an inflammation of the heart muscle known as myocarditis after taking mRNA-based vaccines — has been exploited by purveyors of falsehoods. Medical research shows the risk of getting myocarditis from the coronavirus itself is about 100 times higher than getting it from a vaccine.

Let’s follow the misinformation trail.

A Danish soccer player collapses

On June 12, during the Euro 2020 match between Denmark and Finland, 29-year-old Christian Eriksen suffered cardiac arrest shortly before halftime. Almost immediately, there was speculation online that the midfielder, who had seemed healthy, had a reaction to a coronavirus vaccine — even though his club football team, Inter Milan, said he had not been vaccinated.

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Lubos Motl, a blogger and physicist with a history of making false claims about coronavirus vaccines, tweeted that Eriksen had received the Pfizer-BioNTech vaccine 12 days earlier. He claimed his source was a radio interview with Inter Milan’s chief medic and cardiologist, an interview that never happened and was quickly denied by Inter Milan and Radio Sportiva.

Motl deleted his tweet, but it was amplified by other vaccine skeptics who did not delete their tweets, such as Alex Berenson, a former New York Timesreporter, and Brazilian journalist Allan dos Santos. (Their Twitter accounts were later suspended, as was Motl’s.) The false claim quickly spread to Facebook, in many languages.

One entity that jumped on the story was Report24, a German-language website based in Austria. A commentary by a staff member identified as “Willi Huber” cited another Berenson tweet to claim that Inter Milan actually had started vaccinating players in March. (In reality, the Italian team did not schedule vaccinations until July, according to Italian news reports, before the start of the new season.) “If Eriksen was vaccinated with the Pfizer/Biotech vaccine, a possible side effect would be myocarditis,” Huber wrote.

Austrian websites fan the flames

On Sept. 14, another Austrian website, Wochenblick, posted a story with a provocative headline: “Dead doctors, dead mothers: Why have so many people suddenly dropped dead?” The article included a list of unexplained deaths, claiming that many appeared to be vaccinated and asserting that heart damage was one possible side effect. “Is this just coincidence, or could there be something that connects all of these deaths?” the article asked. If it’s related to the coronavirus vaccines, “there could very well be many more of these ‘unexplained’ deaths very soon.”

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It was a self-fulfilling prophecy. A few weeks later, on Oct. 4, Wochenblick zeroed in on athletes: “Young people die after vaccination — athletes suddenly collapse!” Deaths were becoming a “Twitter trend,” the article said, promoting a Twitter hashtag to collect reports of sudden, unexpected deaths. “The number of cases of this heart disease is apparently literally shooting through the roof at the moment,” the article said.

Correctiv, a German fact-checking organization, in September exposed how Wochenblick and Report24 appear to operate in tandem to spread false information, including attempting to influence elections in Germany. Report24 was created in March apparently by a group of Wochenblick employees after an editorial dispute.

But Correctiv concluded that virtually all Report24 authors “seem to use pseudonyms or do not exist at all,” and the listed addresses for both organizations do not lead to an editorial office. The address is also associated with another online site, Info-Direkt, that also publishes false reports. Correctiv found numerous links between identified people working for these websites and the Freedom Party of Austria, a link that is “little disguised” given the editorial tone and subjects covered by the three websites.Myocarditis can be a side effect of coronavirus vaccines. But experts agree that the benefits of vaccination far outweigh the rare and often mild risks. (John Farrell/The Washington Post)

After Wochenblick focused on dead athletes, Report24 picked up the ball. On Oct. 28, under Huber’s byline, the website published what it claimed was “a long list of ‘suddenly’ deceased or seriously ill athletes,” more than 75 in the previous five months. Buried in the story was this caveat: “We do not claim that all of these people became ill and died because of the vaccination, nor that there is a proven connection in the case of vaccination.”

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The long list of Report24 articles on the coronavirus appears to demonstrate a bias against coronavirus vaccination. But in an email exchange with The Fact Checker, a person who responded to emails addressed to Huber said, “Our editorial policy is not anti-vax, it is pro-truth.”

“If there are studies available, which prove government claims regarding vaccinations are wrong, we will report,” the emailer wrote. “If there is trustworthy, independent proof, that vaccinations work, we will report. If we can prove that people died close after their vaccination, we will report.”

After an exchange of questions about the Correctiv report — which indicated Huber was a pseudonym — the emailer wrote: “Analyzing your style of questions and topics, you are part of politically biased fake news media, so our communication ends here. Sadly, you are not interested in truth but in leftist prejudices.”

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Norbert Geroldinger, managing director of Wochenblick, did not respond to a request for comment.

The ‘news’ travels to the United States

Report24’s post caught the attention of vaccine skeptics in the United States.

On Nov. 4, the HighWire tweeted a translation of the Austrian article to its more than 100,000 followers. The HighWire is associated with the anti-vaccination group Informed Consent Action Network, which is headed by Del Bigtree, a major voice in the anti-vaccination movement.

Two days later, Granite Grok — run by what it calls “fire-breathing, right-wing, hard-charging, gun-toting, opinionated, outspoken, rabble-rousing, letter-writing, radio microphone stomping, Conservatives and Rational Libertarians” — also posted about the Report24 article.

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The report then spread across Facebook and on social media. On Nov. 10, it was fact-checked and labeled as false by PolitiFact as part of its partnership with Facebook. “The athletes listed in the German news story did not all die, nor did they all have heart attacks,” the fact check said, noting the caveat buried in the story.

But that same day, Wochenblick upped the ante: “At least 69 athletes collapsed in one month, many dead.” The article asserted that the mainstream media was ignoring the obvious connection to coronavirus vaccines.

By Nov. 16, the HighWire had produced a video titled “Why Are Healthy Athletes Collapsing?” that restated the debunked Report24 list. That led to another fact check by PolitiFact on Dec. 1 that flagged the video as false, limiting its circulation on the Facebook platform. A few weeks later, the HighWire reedited the video to remove names of players who had not been vaccinated.

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The headline was not changed, but a disclaimer was added: “To be clear, a causal link has not been established between the covid vaccine and the conditions of the athletes in this video. This video represents an ongoing investigation into the question ‘When have we ever seen this many athletes collapse on the field of play?’ ”

That same month, the website Good Sciencing jumped on the bandwagon, posting a list of nearly 200 athletes and almost 100 deaths — which quickly grew. On Dec. 6, the popular right-wing website Gateway Pundit reported on an updated Good Sciencing list that now claimed nearly 300 athletes had collapsed or suffered cardiac arrests after getting a coronavirus vaccine in 2021, with many dying. That list, apparently assembled in part with help from a closed “sudden injuries and deaths” Telegram messenger group, was fact-checked by and found riddled with errors.

Nevertheless, the list circulated “like wildfire” among players in Europe’s top soccer league, according to the New York Times, hampering vaccination efforts among players. Reports also spread that 108 FIFA soccer players had died in a six-month period in 2021. That was fact-checked as false by Reuters.

For fact checkers, it’s like a game of whack-a-mole. By late January, Good Sciencing claimed its list had grown to 577 players, with 352 dead. (Any close scrutiny finds links of deaths to a vaccine to be highly tenuous.) On Jan. 21, the HighWire posted a new video, titled “Healthy athletes are still inexplicably collapsing.”

Johnson’s staff suggested we speak with Ken Ruettgers, a former Green Bay Packers offensive tackle who started a website that collects information on bad reactions to coronavirus vaccinations after his wife suffered what he called “a severe neurological reaction” after her first Moderna shot.

“People are observing what they believe to be an increase,” Ruettgers said in a phone interview after emailing links to his sources: the Good Sciencing list, the Granite Grok post and a report on Wochenblick’s estimate of 69 collapsed athletes in a month. “Based on what we have been seeing and what the CDC has said, it is a legitimate question,” he said, referring to a CDC advisory of rare reports of mild myocarditis after vaccination, especially adolescent males and men under the age of 30. “I think it is a good hypothesis. Maybe something is there or it’s just our bias.” As he put it in a later email, “Bias (confirmation bias, cognitive dissonance, etc.) plays a role in human and public perceptions and opinions,” so “further research would be a good action.”

But respected medical experts say there is no question: Contracting the coronavirus is much more dangerous to an athlete than getting vaccinated.

“Those lists are total misinformation. Most of the cases are from other established causes of sudden cardiac arrest in athletes, and some cases even occurred before the pandemic began,” said Jonathan A. Drezner, editor in chief of the British Journal of Sports Medicine who conducts research with the National Center for Catastrophic Sport Injury Research, which monitors all cases of sudden cardiac arrest (SCA) and death in athletes across the United States.

“The risk of myocarditis from mRNA vaccines is about 1 in 20,000,” he said. “The risk of cardiac involvement in young athletes from [covid] infection is about 1 in 200.” The risk estimates come from peer-reviewed studies published in the Journal of the American Heart Association.

Drezner, director of the University of Washington Center for Sports Cardiology and a team physician for professional sports teams, added: “Importantly, myocarditis represented 4 to 9 percent of SCA in athletes before the pandemic began, so these numbers are well within what has been routinely captured for viral-related SCA.”

Dermot Phelan, director of sports cardiology at Atrium Health in Charlotte, says he constantly gets questions about these lists from players, coaches, teams and leagues.

“Sports Cardiology remains a small subspecialty, and I personally know most, if not all, of the main practitioners in this country. We discuss this regularly as we do not want to miss any issue that will put our athletes at risk,” he said. “None of us have seen a true confirmed on-field death related to vaccination. While there is clearly a very, very small risk of mild myocarditis with vaccinations, the benefits far outweigh the risks.”

This depressing saga shows how “just asking questions” is used as a get-out-of-jail card for those peddling falsehoods about the coronavirus vaccines. Any vaccine carries some risk, but these lists of athletes, often assembled by anonymous individuals with no apparent medical credentials, are sketchy and anecdotal; there is no baseline comparison that would put these figures in context. Caveats that would detract from the scare headlines are buried.

Meanwhile, these reports have had their intended effect: spreading fear among athletes about covid vaccinations. A responsible politician would determine the facts, not “ask questions” premised on unverified claims made by bottom feeders of the Internet.

Anyone who spreads this misinformation, in whatever form, earns Four Pinocchios.

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