COVID-19 Redux

Woulda. Coulda. Shoulda.

Photo by author

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The SARS-CoV-2 variant was a “novel” virus i.e. humans had never encountered it and had no acquired immunity (some had innate immunity). It was a highly transmissible airborne pathogen (~765 million confirmed global cases; actual number much higher) and moderately lethal (infection fatality rate estimates in the range of 0.1% to 0.5 %). Approximately 1.2 million people died from it in the USA and ~7.1 million worldwide (statistical estimates from US-CDC and WHO).*

It was a big feckin’ deal.

State and federal public health and medical professionals and scientists jumped into action to protect human health and life. They instituted a set of well-tested measures to contain the spread and impact of the virus such as closing public spaces (schools, businesses), masking and social distancing to reduce airborne transmission, and development/delivery of effective vaccines to prevent serious illness (morbidity) and death (mortality). The very rapid rollout of mRNA-based vaccines is estimated to have prevented ~18 million hospitalizations and ~3.2 million deaths in the USA.* The American public was universally and deeply grateful to these talented hard-working scientists, public and medical health professionals for protecting the nation so well. (Just kidding with that last sentence!)

*[Note: population statistics, especially captured during a public health crisis, have a moderately high margin of error trending toward undercounts. They can and should be critiqued but not ignored until a better more accurate data set is presented in their place.]

Testing. Testing. 1, 2, 3.

When I get ready to talk to people, I spend two thirds of the time thinking about what they want to hear and one third thinking about what I want to say. — Abraham Lincoln

Some of the best feedback I ever received was when I was told that I had very good ideas but the WAY I expressed them made it harder for the audience to hear/appreciate them. Hmmm. Audience? Now that was a novel concept! Like many people, I was so focused on what I was doing and saying that I forgot the audience who would ultimately determine the success of most of my endeavors. User/customer perspective. Point taken.

(Here’s a little story about the benefits of my becoming more focused on audience satisfaction)

The programmatic response to the Covid-19 pandemic was based on the best available science and public health and medical practices. But it’s impossible to ignore the degree of social/economic disruption and fear and rage those interventions provoked. I believe we are still dealing with some of the political and cultural aftershocks of both the pandemic itself and the governmental response to it.

Context matters. In countries and cultures with a long history of top-down governance (e.g. China, Japan etc.), a strict program of viral containment and mandated vaccination creates few negative ripples. In a country like the USA with a strong libertarian culture (Declaration of INDEPENDENCE; Give me LIBERTY or give me death; Don’t tread on me!), imposition of governmental controls and intrusion into the “private” sector will tend to trigger a strong response of anger and mistrust and conspiratorial thinking. This dynamic response will often outlast the crisis period itself and influence future events.

20/20 hindsight is a mug’s game

The world is full of Monday morning quarterbacks who claim that if THEY had been in charge, everything would have been handled better. Yeah, sure. But there is a place for looking back and learning from experience and preparing to do better the next time. Examples of these look-backs include medical post-mortems and M&M (mortality and morbidity) conferences, military after-action reviews, and post-game video analysis in sports.

Virologists and public health experts tell us that the question about the next epidemic is not IF but WHEN. So by way of strategizing for an optimal national and local response to the next US public health crisis, I would propose the following approach of maximum information sharing and minimum imposition of external controls. ⬇️

⬇️ FOR IMMEDIATE PUBLIC RELEASE ⬇️

The X virus currently circulating in the US is airborne and transmitted through the nose/mouth. Humans appear to have no natural immunity to it. It is causing illness and death in certain parts of the country and is expected to spread quickly and widely.

An N95 mask will prevent inhalation of about 95% of viruses the size of X. Wearing a mask will prevent some but not all infection. These can be purchased at LINK.

There is considerable scientific evidence that vaccines provide strong protection against severe disease and death (go to LINK for summaries of best peer-reviewed research). A vaccine is being developed for the X virus and will be available soon to every person who wants to receive one.

Young children, people over age 60 and those with compromised immune systems are always at higher risk for serious illness/death from a viral infection, and may want to take added precautions (e.g. avoid densely crowded spaces) to reduce exposure. People living in congregate care facilities should inquire about the infection control procedures being implemented there.

EVERY ADULT SHOULD DECIDE HOW TO BEST USE THIS INFORMATION FOR THE SAFETY AND HEALTH OF THEMSELVES, THEIR CHILDREN AND THEIR WORK/BUSINESS.

That is all.

I believe that the above arms-length approach will result in higher rates of illness, hospitalization and death than the more maximalist program used during the COVID-19 period of 2020-2023. This reality should be shared and prepared for, but better to work with the audience/culture rather than against it when developing any government strategy/program. This will increase receptiveness and minimize public unrest and mistrust in expert advice.

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