Like many doctors, Washington, D.C.-based internist Lucy McBride, MD, found herself fielding question after question from worried patients when the COVID-19 pandemic struck in March 2020.
She decided that the best way to reach everyone would be to send out mass email blasts to all her patients, addressing the most commonly voiced concerns. Two years later, what began as daily emails written only with her own patients in mind evolved into a newsletter that reaches over 18,000 inboxes each week.
But McBride has since become a controversial figure in the conversation around COVID-19 precautions, primarily due to her outspoken opposition to in-school mask mandates and school closures. She is a founding member of a group of doctors and scientists known as "Urgency of Normal," which that schools remain open and in-person regardless of COVID case counts and vaccination rates.
McBride, who earned her degree from Harvard ľֱ School in 2000 and completed her residency at Johns Hopkins, is not an immunologist or infectious disease expert by training. Still, she was recently invited to before the House Committee on Energy and Commerce, articulating how social isolation, the fear of contracting and spreading COVID-19, and the overall confusion around how best to move through the pandemic has had serious health effects on a number of her patients.
In her , McBride noted that school closures and mask mandates have disproportionately hindered children with learning disabilities and autism, as well as English language learners, in addition to preventing kids from being able to "appropriately connect with peers, teachers, coaches, and mentors."
McBride, however, doesn't see herself as a "COVID minimizer," a gibe she said has been thrown her way as a result of her public opinions.
"I have taken this virus so seriously," she told ľֱ. "I've had patients die from COVID, I've had patients in ICU from COVID. I have patients with long COVID. I have patients with COVID today, right now."
For McBride, the problem is the lack of nuance when it comes to addressing policy, evaluating available data, and figuring out the best way to protect adults and children, while also keeping in mind other mental and physical health conditions.
"This is a concept that Twitter kills. This idea of being able to have two ideas at one time, like, we can be glad our kids are being able to unmask and we can be worried about the future," she said.
McBride explained that the only way she'd support in-school mask mandates would be if "we had better data that showed that the benefits of school mandates outweighed the harms." Many of her critics are quick to point out that this prioritization of nuance seems to take a backseat in the school mask mandate debate, with opponents of the policy often data or dismissing existing studies to favor their viewpoints.
When asked how much more data would need to be published in order for McBride to support in-school mask mandates -- given that a of recent have, in fact, shown the benefits of such a policy -- she said that it's an impossible question to answer. The emotional and developmental harms, she argued, still override any benefits.
While the Urgency of Normal's recommendations received some support, McBride acknowledged that many detractors were upset by the group's insinuation that everyone -- particularly the most marginalized communities who have been the hardest hit by the pandemic -- can, or wants to, return to a previous state of normalcy that didn't work for so much of the population.
"The urgency of normal to our group was not mutually exclusive with the urgency of equity. It's an attempt to try to bridge the divides, not exacerbate them," McBride noted.
She made a point to recognize her privilege as a physician with a private practice, and how she has been trying to use that privilege to offer services. In addition to the newsletter, McBride said that her practice hired another doctor to take on half of her patients so that she could dedicate the other half of her time to pro-bono work. She said she also makes herself available to anyone who takes issue with her opinions.
"I wish we could get back to a place where we can have hard conversations. Like that's the job of doctors, to have hard conversations," McBride said. "It's not to sugarcoat reality or to catastrophize. That's my job, my duty is to help people cut through a lot of noise in the public space and noise internally that makes them anxious."