Friday, September 24, 2021

Problems of the Pandemic, Beyond the Statistics

It’s bad enough that the United States has had, per the New York Times, 42.6 million coronavirus cases and 680,000 deaths.  How we have handled Covid-19 has precipitated real concerns, which have contributed to those totals and, if unresolved, will also damage how we do in the future.

In “The Extremely Weird Politics of Covid, in the September 21st New York Times, columnist Ross Douthat documented how, just before the pandemic caused restrictions, The London Review of Books, a “highbrow left-of-center publication,” said good things about civil disobedience during the 1600s Florence plague, agreeing with people defying “quarantines, lockdowns, and what we now call social distancing,” whereas such resistance is now almost exclusively advocated by conservatives.  Also, last year, “the right briefly favored restrictions when they seemed likely to fall mainly on foreigners and the left briefly suspended its zeal for restrictions when the transgressors were left-wing protestors.”  All of this shows that neither side has been consistently principled, meaning that neither has always made American health their top priority.

On the issue of strangely missing information, two related articles also appeared in the Times.  The first, Zeynep Tufekci’s August 29th “Show Me the Data!” posed the following: “Who should get vaccine booster shots and when?  Can vaccinated people with a breakthrough infection transmit the virus as easily as unvaccinated people?  How many people with breakthrough infections die or get seriously ill, broken down by age and underlying health conditions?,” along with “the Food and Drug Administration has asked that vaccine trials for children aged 5 to 11 be expanded, but why weren’t they bigger to begin with?”.  F.D.A. and Center for Disease Control, where are you?  Why is there no information, still, on the last three of these issues?

The second piece, “The Hard Covid-19 Questions We’re Not Asking” on August 30th by Joseph G. Allen and Helen Jenkins, had more, specifically “Does everyone need to wear a mask?  Are unvaccinated children safe in schools?... What happens if vaccines for children younger than 12 are approved at the end of the year but only 35 percent of this age group get vaccinated” as is now the case for 12 to 15-year-olds, “who have had access to vaccines for months”?  If we reach March with similar children’s inoculation rates, “does that mean masks should come off then anyway?”  These authors also asked a higher-level question, phrased as “What is the purpose of Covid-19 precautions now?”  That is important, now that goals, for example, of “Kids need to be in school, period,” “getting to zero infections and staying at that level before dropping restrictions,” and to “make this virus like a seasonal flu,” now conflict with each other.

On the explanatory side, another article, again in the New York Times, clarified “Why Covid Vaccines for Kids Are Taking So Long” (Daniel Carpenter, September 20th).  The author, who also wrote a book about this agency, blamed the F.D.A., which is now asking for “up to six months of child vaccine trial safety days, rather than two, and larger sample sizes.”  He saw a difference, not acted on well enough by the F.D.A., between the coronavirus and diseases for which “there are generally adequate existing treatments or more time than Covid-19 allows,” justifying a slower approval pace and more conservatism.  He did relate that Pfizer, for children aged 5 to 11, “will apply for emergency authorization by the end of the month.” 

Taking all this, we have “Six Rules That Will Define Our Second Pandemic Winter,” by Katherine J. Wu, Ed Yong, and Sarah Zhang, an updated version released in The Atlantic on September 21st.  These precepts are “the role of vaccines has changed (again)” from preventing all infections to stopping only the most severe ones, “the proportion of vaccinated people matters, but who they are and how they cluster also matters” as Americans without the shots are more likely to do the latter than those in other countries and older victims tend to require more ICU beds, “the people at greatest risk from the virus will keep changing” with the faster-spreading Delta variant putting more children in danger, “as vaccination increases, a higher proportion of cases will appear in vaccinated people – and that’s what should happen” which makes sense since as absolute numbers of a population decrease their percentages will also, “rare events are common at scale” reminding us that for example 40,000 breakthrough infections among 40 million inoculated people is still only one per thousand, and “there is no single “worst” version of the coronavirus” as different variants may prove to be most effective against the unvaccinated and vaccinated.

Even after all of the insights above, the best single thing we can do has not changed.  Get the shots. 

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