Making sense of COVID data and recommendations

Anyone trying to keep up with the current state of medical knowledge and recommendations regarding the COVID pandemic is bound to be confused. 

The data are conflicting, garbled, and inconclusive.  The recommendations are constantly changing, haphazard, arbitrary, and inconsistent.

Making sense of COVID information requires more than simply studying data or following recommendations.  It is useful to consider what the recommendations say about the data. 

For example, the recommendation that people who have been vaccinated against COVID should receive booster shots suggests that health officials believe that the protection provided by the vaccines is not long-lasting.  It is not necessary to quote the precise clinical data upon which this recommendation is based; the fact that the recommendation is made at all gives a pretty good idea of what the data show.  Likewise, the recommendation that people who have been vaccinated should wear masks indicates that health officials believe that vaccination does not reliably prevent the spread of disease.  In fact, it suggests that health officials are not confident that either masking or vaccination prevents the spread of the disease.

The fact that COVID mitigation recommendations consist largely of various permutations of vaccination, mask-wearing, hand-washing, six-foot distances, and little else suggests that the notion that the pandemic can be "stopped" by policy interventions is likely wishful thinking, and that the medical community does not know nearly as much about the virus as it would like, or perhaps should.  The "experts" may know more than the average person about the virus, but this does not guarantee that anyone knows enough to give definitive recommendations.  There is a lack of information necessary to enlist popular support for COVID health interventions, and this lack of information is not remedied by assurances of public health officials who seem to have a different story every week.

Official guidance regarding COVID is marked by uncertainty, lack of consistency, and policy volatility, and the result is lack of confidence in the official response to COVID.  This lack of confidence is exacerbated by people's own observations: many people know someone who became infected with COVID despite faithful mask observance or who was vaccinated.  Others know people who were unvaccinated and had mild cases of the disease.  These personal experiences, even though they do not support denial regarding the existence or seriousness of COVID, provoke skepticism when officials and celebrities claim that the situation is so dire that personal liberties must yield to the same public health capriciousness that has so little to show for itself.  The result is even less confidence in the public health community.  The official recommendations and mandates regarding the COVID pandemic become the world's longest-running game of Simon Says, and eventually, popular opinion treats them as such.

Many of the people who are reluctant to be vaccinated or submit to inconsistent masking requirements are not anti-science or anti-vaccination or even anti-social.  They merely want some assurance that when they are asked to give up any degree of personal freedom, or subject themselves to novel interventions, that there is a compelling reason to do so.  Mere assertions that "it is clear that masks stop the spread" or "vaccinations are highly effective" are not compelling when a person of average intelligence notices that the changing recommendations regarding masks and vaccines are not consistent with these assertions.

To make sense of our current state of knowledge and experience, it may be helpful to think of different types of immunity — specifically, immunity that prevents a person from dying of COVID, immunity that prevents a person from spreading COVID, and immunity that eventually leads to herd immunity and consequently resolution of the pandemic.  Current recommendations and the data reported in the media suggest that the vaccines that are currently available can prevent death from COVID.  They do not effectively or reliably prevent the spread of COVID, and since their effectiveness appears to wane over a period of months, they make only a minor contribution to herd immunity.  It is unclear how mandates or vaccine passports would change these circumstances.

Some people may have valid concerns regarding the side-effects of the available vaccines.  The novelty of mRNA vaccines in human subjects, the reported exacerbations of autoimmune diseases such as lupus and rheumatoid arthritis, and the apparent lack of efficacy of the Chinese and Russian vaccines are legitimate factors to be weighed by people deciding whether or not to get vaccinated. 

The conclusion of all of this is that, fairly or not, public health officials do not have the credibility necessary to convince a sizable portion of the population to go along with vaccination and masking recommendations.  There is lack of a compelling argument that relinquishing liberties to improve compliance with recommendations having marginal or time-limited efficacy will produce significant benefits.

The COVID pandemic will recede.  It may disappear completely, decline to a very low level with sporadic flares, or become endemic.  Our society will survive it, although its impacts on individual lives will vary greatly.  When the history of COVID is written, however, "policy" will likely have had a much greater effect on social institutions than on the course of the pandemic. 

Image: Pixabay, Pixabay License.

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