David Wallace-Wells is at the helm of Ezra Klein's podcast today and talks about "pandemic revisionism" with Katelyn Jetelin. It took them quite a while to get around to the topic of what worked and what didn't—thank God for transcripts!—and when we finally got there we were still left with no answers:
We know vaccination saved more than 3 million people in the United States. That’s a pretty easy analysis....But beyond that, we still do not know what works best to slow the spread of Covid-19 in terms of non-pharmaceutical interventions. For example, test and trace, or isolation, or quarantine, or indoor mask mandates, or closing venues. And this is very surprising to me because that means we still can’t answer important questions like you’re asking, like, their effectiveness or even more importantly, the trade offs.
We can see in the scientific literature that prolonged shelter in places are linked to, for example, harmful alcohol use. But how does that compare to uncontrolled viral transmission? We don’t know.
....How much masks reduced transmission in a population is not an answer we have. There’s been very few studies that have looked at this. And among the few studies, there’s a huge range, around 9 to 45 percent reduction in transmission with community masking. And this range means that these studies were done in different settings and different cultures. So many unanswered questions remain.
My own best guess is that test-and-trace is effective, but only if it can be done well. In the US it can't be. Indoor masking is moderately effective but probably a nonstarter in the US thanks to the mask truthers. Social distancing is effective. School closures aren't effective because of the health tradeoffs to keeping kids at home. Cleaning surfaces is not effective. Shelter-in-place is questionable. Border restrictions are pointless between countries with similar levels of infection. Banning large gatherings—theaters, churches, sports events—probably works well to minimize superspreader events. Plexiglass shields are ineffective and possibly even counterproductive. Improved ventilation is effective, but it's not clear how effective it is.
This doesn't leave much: just social distancing, cutting back on large gatherings, and indoor masking in places where health officials won't be lynched for suggesting it. What's worse, this is only a guess about what worked with COVID-19. A future virus with different characteristics might respond entirely differently.
This leaves me with my single biggest question: How much risk should we take with vaccines? They are by far the most effective response, so what should we do if we get to the point of mass production of a future vaccine before testing is complete? Go ahead and administer it if early results look good? Or bite the bullet and wait?
What we need - in addition to whatever else works - is a system that makes self-reporting and isolation **at least as desirable*** as ignoring symptoms and continuing to interact with other people.
What would that look like? For those who work, it would mean that a positive test would result in the government paying 100% of regular take-home pay until the worker tested negative. For everyone who tests positive, working or not, it would mean the government would pay 100% of the (additional) cost of having everything delivered to their home. For those who tested positive, and took care of children, it would mean free child care and/or in-home care provided by the government. For everyone, it would mean free transportation (in a well ventilated car, with masking) to go to an outdoor setting so that "isolation" didn't mean "restricted to your home".
In short, if we provided wrap-around full, free service to anyone testing positive, that would largely remove the incentives to (a) go to work when ill, (b) continue to take care of minors in a home, when ill; and (c) interacting with others, when ill (for example, grocery shopping).
OT: I really think Kevin’s Florida apologia 3 weeks ago - the whole “slaves benefitted from slavery was just a footnote and thus nothing to worry about” post - is going to need to disappeared down the memory hole pretty soon. More details of DeSantis and his education board trying to restore the confederacy in the schools keeps emerging every week.
https://amp.miamiherald.com/news/local/education/article278582149.html
Kevin post criticized Florida's curriculum saying: (a) It spends too much time telling kids that American slavery was unexceptional because everyone did it; (b) It spends too little time describing the actual conditions of North American slavery; and (c) It significantly overplays the virtue of white abolitionism.
I read through the article. Informative, but nothing in it contradicts what Kevin said. I'm sure if you just call Kevin racist a few more times then racism will end.
Kevin,
On your larger point, which (I fear) is that most of these non-pharmaceutical interventions are pretty weak tea, I agree with you. But OTOH, I thought that a big part of *why* they were weak, is attributes of the American population. I thought there was reasonable evidence from, y'know, actual functioning polities not run my madmen, like Taiwan and South Korea, that test-and-trace and lockdowns actually worked? That early and aggressive border closures worked (e.g. New Zealand) ?
I mean, yes, to paraphrase Rorschach from _The Watchmen_, *we're* locked in here with *them*, so we can't have nice things. But that's not the problem of the *interventions*, but the population on which they're being .... imposed. Other, less irrational populations will have better results, no?
So far, 1 in 260 Americans have died of COVID-19. What intervention is 'worthwhile' or 'practical' depends very strongly on how deadly a pandemic is and how it is transmitted. A pandemic with a death rate of 1 in 2,000 (4X as bad as an average flu season) is very different from a death rate of 1 in 50 (6.6 million deaths). If a pandemic was deadly for the young or middle aged (like the 1918 pandemic) rather than old (COVID-19), it would also seem much worse.
Today Republican media (and mainstream media to a lesser extent) is telling viewers that the public health measures against COVID-19 were ineffective or actively harmful, and also lying about what measures were taken--only a few years later. Both could take a different line the next time a pandemic hits, they are irrational and unpredictable.
Pandemics are rare and unpredictable. What is clear is that the Republican line on COVID-19 will disrupt and diminish public health efforts across the board for the foreseeable future.
This is exactly right -- an effective response to a pandemic that kills 1/260, and leaves children practically alone, is going to be completely different than a response to SARS, with a fatality rate of 10% and which, IIRC, killed young and old alike.
Similarly, the care you take with widely deploying a vaccine depends upon fatality rate, as well as the efficacy of the vaccine.
My guess is also that with fatality rates 10X of Covid's, that people will see for themselves the risk of skipping the vaccines, and you'll see less denial.
Finally, almost every lesson KD is guessing at is Covid-19 specific. There are diseases that spread through surfaces.
It's really cute when academics, wonks, and geeks try to figure out methods for problems when the problems are the humans. Seat belts weren't a great method until the humans it was aimed at decided to use them.
I know, I know, how can you modify behavior on such a large scale....
It's still cute though.
"We have met the enemy and he is us."
Walt Kelly
Pogo
1970
Tout à fait.
We do know how to minimize deaths from covid. There was a huge difference between the US and European countries on the one hand and Asian countries such as Japan which adopted isolation, tracing and masking on the other. This includes Australia and New Zealand, although they had geographic isolation.
This kind of action did not prevent infection, it postponed it. But when those countries did open up and infection rates were very high most people had been vaccinated and the death rate was much lower. China may have been one of these countries, but we have little real information and what reports we do get are distorted by nationalism in the media.
Kevin has persisted in ignoring the Asian countries and concentrating on the relatively small differences between the others. Testing the efficacy of masking in a place like the US is difficult because so many people don't mask or don't do it properly. And when everybody does it as in Japan, then differential tests are also difficult. But the overall results between countries with overall maximum precautions and those with so-so precautions are unambiguous.
Yes! I recall reading that, following the limited SARS outbreak, the government of Taiwan developed a pandemic playbook with sixty-odd actions*. When Covid-19 was identified, they followed that protocol, with outstanding results. I believe that Japan, South Korea, Australia, New Zealand acted similarly, having also been on the ‘front line’ of SARS — they also did well, as you note.
*unfortunately I have had difficulty trying to locate the source of this report
There's huge cultural differences between the US (and some European countries) and China and Japan. Seems like the Japanese are naturally subservient to their government and leaders. The Chinese, of course, don't have a choice. There's no way Americans are going to submit to the kind of lockdowns that were imposed on those countries.
What about Australia, which had a mortality rate that was less than 25% of ours ?
Wasn't a lot of that because they restricted incoming travel? (Which is easier to do when you're an island nation.)
What, no disparaging stereotype of Australians, Atticus?
Did I make disparaging comments about other countries?
The phrase "a lot of that " is doing a lot of work here. How much ? Sure restricting incoming travel almost certainly played a role but how much is not clear. Trusting science and that the government is acting in good faith also played a big role but who was undermining that faith here ? Donald J. Trump did his best to undermine our response. And 40 years of Republican preaching has made a lot of people overly suspicious of everything of everything but the simpleminded lowest common denominator blather from Fox News et al.
And we may not be an island nation but the U.S. has oceans on either side of the country which makes us quite different from Belgium or the Czech Republic for example.
This is a good discussion:
https://www.nytimes.com/2022/05/15/world/australia/covid-deaths.html
How do you explain this?
https://www.statista.com/statistics/1109011/coronavirus-covid19-death-rates-us-by-state/
Obviously Americans resist unified action for mainly political reasons, but that's no reason to deny that such action is effective.
Also, people have terrible intuition about what is 'effective'. One key goal of public health measures against infective disease is to reduce transmission (R0) below 1. COVID-19 had a very high R0, but many diseases have R0 close to 1 (but are deadlier than COVID), so combining a couple of measures that each reduce transmission by 10%-30% would do the job. And each public health measure slows down the spread of a pandemic.
Remember, vaccines that cover 80-90% of a population and are have effectiveness of 60-80% are enough to stop most childhood diseases.
Raise your sleeve. Here comes the bullet!
Cleaning surfaces is not effective
Not for Covid. It's possible it may be for other viruses.
School closures aren't effective because of the health tradeoffs to keeping kids at home
I'm aware of the education tradeoffs. What are the heatlh tradedoffs?
My own best guess is that test-and-trace is effective, but only if it can be done well. In the US it can't be.
The US had better damn well hope the next virus isn't a lot more deadly. There's no reason save politics contact tracing "can't be done" in the US. By all accounts Google and Apple had phone-based apps for this purpose ready to go in March, 2020, but were never released. For reasons.
Shelter-in-place is questionable.
Maybe, but isn't this a central component of social distancing, which Kevin (rightly, I believe) indicates is effective? If you want people to socially distance, aren't you essentially asking them to stay home most of the time (provided, of course, there are any stupid and counterproductive rules against outdoor activities)?
I agree with most of your comments and overall I think we need to seperate things that worked or didn't work for Covid vs. things that may work for all or most pandemics. We can't fight the last war by overlearning what worked for Covid.
Yes. The policies that didn't stop Covid did an excellent job of stopping the flu and other (seasonal) viral outbreaks. Not having the flu on top of Covid was very helpful--though it did cause some problems when restrictions were lifted.
Just because steps were not as useful against Covid as we'd like does not mean those steps were not useful.
There was a pretty good app California was using, I even got alerts, and a friend got infected and reported. I don't understand why it was abandoned.
I spent the critical, initial stage of the outbreak (February-June, 2020) in the Bay Area and never heard a thing about the app you mention, and I was pretty obsessively following Covid-related news. When was it released? This is frankly the first I'm hearing about it...
The app wasn't released until after that point. Because it had to be written.
The vast majority of the deaths were also after June, notably? And the vaccine wouldn't come for another year later?
"The US had better damn well hope the next virus isn't a lot more deadly. There's no reason save politics contact tracing "can't be done" in the US. By all accounts Google and Apple had phone-based apps for this purpose ready to go in March, 2020, but were never released. For reasons."
You think people are willingly going to let the government track their every move through some type of app on their phone? Of course some will. But there will be enough that would never do that to probably render the tracing at least somewhat ineffective.
The tracking app didn’t involve the government, it was strictly crowd-sourced. It did depend on self-reporting of positive tests.
There were limitations inherent in the technology; it measured proximity but couldn’t take barriers into account. So you could be ‘exposed’ to a positive-tested neighbor even if neither of you ever left your apartment. It was that and other false-alarm issues that held the app back.
Got it. Thought it was something sponsored/owned by the government. I was just envisioning the blowback from people who thought the government wanted to put a tracking device on them. Although, I'm not sure what you described would be much more palatable. I'm not some anti-government nut but I also don't want my every movement tracked.
IIRC, tracking data was anonymized and not shared with other users. The only information output to users was an alert to a potential exposure, without specifics of person, time or place.
You think people are willingly going to let the government track their every move through some type of app on their phone?
No, I don't. Which is why you make use of certain public amenities (cinemas, malls, supermarket, Walmarts, buses, airports, schools, etc) contingent upon willingness to check in with your phone. If you want to get all your groceries delivered, no problem. But if you want to enter public places during the critical stages of a deadly epidemic, then yes, you've gotta scan. Which yes, would be a heavy lift in an anti-science country like the US. Which is why you'd need firm political leadership to implement something like this. But it could be done.
I'll add: the US skated by with "only" 1.2 million deaths from Covid. A terrible toll—and surely among the worst on the planet (probably THE worst adjusted for wealth and health infrastructure). But it wasn't such a cataclysm so as to threaten the viability of a functioning society or polity. But what if the next virus is far deadlier? What if we're dealing with something more like ebola, or MERS?
The country's manifestly weak state capacity is no joke, but a very serious problem.
Funny.
Most people I know feel the lesson of COVID was not to overreact. All men must die. Limiting our freedoms, crippling the education of a generation of children (want to bet whether the negative impact of school closures will still show up in studies on economic performance of pandemic kids in fifty years?), ace taking a huge economic hit isn't worth it for a disease that kills a fraction of 1% of the population, mostly people with significant comorbidities who would have died within a year or two anyway.
The biggest divide here is safetyism.
Look at Braveheart here, willing to sacrifice anyone just so they don't have to wear a mask or not cough on their neighbor. Freedom!
One other measure we could have taken is to use scrubbers to clean the air in enclosed spaces. This is similar to the idea of better ventilation but more rigorous.
Engineers who design semiconductor fabs understand airflow and cleaning extremely well. It is not difficult or expensive to scrub the air of nearly all virus particles. Also, we want to be careful that the virus is not spread more by moving air around. Airflow should be from ceiling to ground, not cross-wise.
With a couple of iterations these could be made cheaply enough to clean the air in restaurants, classrooms and offices.
In addition, testing should be required for access to many public spaces.
School closures actually worked pretty well. Mehdi Hasan makes that very clear here:
https://www.youtube.com/watch?v=-h5xyGdVfvo
As well, the evidence is that masking with a real mask, meaning N95 or better, works pretty well.
School closures worked when everything else was closed, too. Else you're just displacing the contagiousness to the broader public. There needs to be event limits and masking of the kids will just go to them and spread the disease there.
Unless it is influenza or another coronavirus, the next pandemic will almost certainly have a different set of properties, but we cannot know in advance specifically what they will be. One of the nasty surprises in COVID was that infected people were transmitting the virus before they (or anyone) knew they were infected.
We will have to figure out the properties each time a new pandemic happens. It is usually possible to determine two important things fairly early: 1) the degree of infectiousness, from tracking the local rate of increase at infected areas, and 2) given an infection, the risk of death or other serious effects. Those two statistics determine how aggressive the vaccination program should be (this calculation has been known since the 1920s).
I believe that in some ways we were actually pretty lucky with COVID. We cannot presume that this will be true for the next time. And there is every reason to believe that next time will come sooner rather than later.
At least as important as the degree of infectiousness is the route of transmission. Covid is airborn; you catch it by inhaling virus laden droplets usually produced by someone coughing or sneezing, or sometimes just by shouting or singing. In general, airborn diseases are the hardest to control, although the world-wide lack of success in controlling malaria says that insect vectors can be difficult to deal with too. Diseases that require physical contact, STDs for instance, are relatively easy to contain.
I agree, but sometimes the route of transmission is apparent and sometimes it isn't. In the case of COVID, the importance of airborne transmission was debated for quite a while. Transmission via surfaces was at first assumed to be important (remember cleaning our shopping cart handles?), but turned out to be minor. Cleaning surfaces was still a good thing to do until we knew we didn't have to.
Yes. Determining the route of transmission is the critical first step in figuring out how to contain the disease. In the early part of the covid pandemic, much effort was wasted on sanitizing surfaces, effort that could have been more productively employed if it had been known that transmission was almost entirely airborn.
The truly alarming possibility is a pandemic in which we cannot determine the rate of severe disease in time, i.e. a disease with the transmission characteristics of covid and a disease course like that of rabies or AIDS.
The fact that we still prefer not to talk about how the risks were not evenly distributed across the population bodes ill for the next time.
I'm not sure how to. Those who are against helping others literally took advantage of those statistics.
The fact that we still prefer not to talk about how the risks were not evenly distributed across the population bodes ill for the next time.
I'm not sure what you're basing this on. I think it's universally acknowledged that, say, food service workers and supermarket cashiers were at greater risk than tech analysts who could work from home. Economic class is always an issue in America. I mean, one other facet is this: PMC and affluent folks with good insurance all their lives were less likely to suffer from comorbidity factors in the winter of 2020 than working class Americans.
Is any of this really a secret that we've been avoiding a discussion on?
>I'm not sure what you're basing this on.
First of all, I’m basing this on age. Here in Belgium, by far the greatest risk factor is age. If you are below retirement age, the risk of dying is very low. Deaths for 85+ account for half the total. Unless I’m mistaken, this was not mentioned above.
Obesity was also a factor. Again, not mentioned. Why not?
Obesity was also a factor. Again, not mentioned. Why not?
Obesity was very frequently talked about as a risk factor in the US.
Look, I’m not saying that no one ever spoke about these things. But in an article that talks about how to deal with the next pandemic, I’d expect some mention of how pathogens can leave wildly different footprints through a population. And lack of such recognition, in my opinion, bodes ill for the next time.
Cleaning surfaces would depend upon the vector, of course. It's what keeps many older pandemics from re-occurring. It also makes it easier to tell when some place is safer or not.
Masking and air cleaning works, but mask truthers are definitely a problem. I've avoided getting it again despite going to events, vacations, buttoned hotels... because when spread is higher, I follow the rules and mask and run air filtration.
And after getting vaccinated, I've managed to avoid getting it at all. And I haven't masked since my first vaccination, except during the outbound leg of a flight for an expensive vacation, just in case.
The only anti-Covid thing I really do is get regular boosters.
Your anecdotes may vary.
But have you gone to places it has spread? Conventions with thousands of people? Concerts, Burning Man, etc? Tight spaces where singing, dancing, aerobic activities?
I have.
My wife is an ER doctor. She points out there is a HUGE difference between the medical use of masks (fitted, N95 standard, deposed of regularly, wore by a trained user) and the masking that was common in say the supermarket (reused home made masks, bandanas etc).
The effectiveness of masking could be much better....
Engineering psychology is the applied behavioral science that works to design products that humans can and will use safely and effectively. I’m retired but I hope someone is working toward a mask/system regime that works much better than the present designs. Perhaps an embedded chip that signals when the mask is properly fitted (differential pressure?), perhaps machines in drugstores that scan your face and produce 3D-printed custom masks; chip could indicate when the mask is no longer effective?
I read a number of studies of masks; all struck me as having shortcomings. Lab studies of materials didn’t look at how masks were actually worn by lay persons; population studies didn’t either, generally relying on self-reports.
Yeah, but maybe it doesn't need to be perfect to be protective (unless you're in a hospital where exposure is higher and with greater frequency).
Exposure, but not enough to cause infection, trains the immune system. In the same vein (excuse the pun) as viral loads, so too is the rate of exposure.
Nothing’s perfect, that’s why they are N95s, not N100s. : )
My understanding is that a well-fitted N95 mask is most effective at protecting the wearer, particularly in settings where no one else is masked, but that if everyone is wearing something, even if they're not high-quality respirators, that's also pretty good at reducing spread.
👍
In any future emergency health situation there is no response of any kind at all that won't be hysterically opposed by conservatives.
Conservatives want either silent fire alarms because they don't like noise or fire alarms that can't be turned off.
Power without accountability is brutality and that's why conservatives are so attracted to it.
They have to be stopped before they can do that.
Jetelin made clear you cannot assume the best in the next pandemic.
From a public health standpoint, you need a risk-averse starting point. You cannot just assume that lessons learned in this pandemic will apply to the next. You absolutely would lock down in an exceptionally virulent hemorrhagic fever virus, right? (Or maybe you'd wait until after a spreader event?)
But broadly speaking, you don't know what you don't know about a new viral outbreak.
Recently I read a summary, which I can't find now, which asserted that school closures and masking by students were actually pretty effective, because kids are very efficient spreaders, responsible for a large fraction of family infections.
Without a link this is just so much hand-waving, I know.
Even a vaccine regimen requires substantial populace participation but because of the truthers who knows how effective it would be; the bottom line is that next time you do what you can (masks, social distance, etc.) until a vaccine comes along (which because RNA tech could be less than a year) and then that’s it.
Stating outright surface cleaning is ineffective generaly is an overgeneralisation from the specific case of Covid. There can certainly be vectors where it certainly could be. Overdrawing conclusions from one pandemic where a factor can be more or less effective based on the biological profile of the virus is itself a source of risk.
I think you missed the elephant in the room.
First, credibility is the most important thing you need to fight an epidemic. US elites squandered their credibility with ham-handed censorship, obviously stupid rules (remember the paddle boarder getting arrested?), biased rules (casinos stayed open, churches closed; movie shoots were able to server catered meals to workers but restaurants had to close), biased enforcement (BLM protests was OK, Sturgis was not; Gavin Newsome at the French Laundry; masked workers at the Met Gala serving unmasked stars), and shutting down schools with little or no consideration of the impact on children whose parents did not have PCs, Internet, and the time and capability to support their learning.
Second, vaccines are obviously critical. We should have had challenge trials for COVID vaccines. We did not because many of the people developing the vaccines did not want a working vaccine released in the run up to the 2020 election since that would have enabled Trump to campaign as a hero and probably win re-election.
People like MF are the pandemic problem that we dont know how to solve. When someone doesnt care about results (about any topic), but is instead approaching every issue looking for endless grievances and partisan whining, you cant solve that with better information or more research or more funding or anything to do with health.
True.
The main lesson from the way that the US dealt with Covid19 is that you shouldn't elect for president a POS like Trump when a pandemic is coming (or any other time).
Trump was part of the problem. He should never have agreed to shutdowns longer than the original "two weeks to flatten the peak" and he should have forced challenge trials to speed up vaccine approval.
Like hell he should have. He has no expertise in communicable diseases, virology, immunology or public health. Challenge trials were rejected for ethical concerns, and Trump knows nothing at all about ethics.
Ahah, so you think that plans should never adapt to actual facts on the ground.
Also, he never agreed to any shutdowns, so you're doubly wrong.
+1
What, in his first paragraph, do you disagree with? Are you saying those things did not exist? Or that they did not lead to credibility issues?
I disagree with the second paragraph. I don't think anyone was postponing deployment of the vaccines for political purposes. But there's a lot of truth in his first paragraph. All those things he listed caused a lot of resentment. Maybe not with you and your circle of friends but that doesn't mean it didn't with many others.
Regarding the 1st paragraph, none of that really matters.
I mean, it obviously does if your priority is resentment and grievances. But if your goal was surviving a pandemic in good order, none of that really matters.
Whine on if you must!
I think it does matter if you want people to comply. We are not China. We're not going to lock people in their houses at gun point. So when there a things like he listed that erode credibility it reduces the likelihood of people willingly going along with the restrictions.
Of course not. But how should we deal with people who knowingly kill a neighbor?
Does he disagree with the first paragraph, "I think you missed the elephant in the room.", that paragraph?
'Just asking questions.'
Lol. My bad....the second paragrapgh.
In other words you want to only allow the "right" public gatherings in the next pandemic, those you politically favor to continue their business while we lose our livelihoods, those with the "right" opinions to post and get audiences on social media, the bright and beautiful to be unmasked while we mask, your politicians to violated distancing and cluster rules while we miss weddings and funerals.
Why should I or any other person who disagrees with your politics and who thinks that the Met Gala is an absurd waste of money to flatter a bunch of self absorbed idiots but weddings and funerals are important agree to give government this power next time when we saw how it was abused the last time?
A rational person, who I would assume prefers not to die an avoidable death from a communicable disease, would use her/his voice and vote to push government, including public health authorities, to learn from past mistakes and prepare for and take better measures in the future. Public health measures such as sanitation regulations, vaccination mandates, water supply protection and treatment have saved (tens of? hundreds of?) millions of human lives. Enormous progress has been made since Dr. Snow removed that pump handle; why should we think that no more gains can be made?
Yes, one would limit it to necessary public gatherings. Like getting food and necessities; protesting being murdered, you know, important things.
I will stipulate that some leaders shut down events while not shutting down others, based on personal desires instead of public safety.
Replace "shut down events" with "convicted people" or "funded projects" or any other government function, and it is just as valid.
Leaders are fallible humans.
If you demand that we remove their power to shut down events to save lives because some abused it, you must also demand that we remove all power from government, because it can and has been abused.
We did not because many of the people developing the vaccines did not want a working vaccine released in the run up to the 2020 election since that would have enabled Trump to campaign as a hero...
Your whole screed reeks of ludicrous right wing resentment, so I'll confine myself to only the above inanity: the US began injecting citizens with the Covid vaccine exactly three days after the United Kingdom started doing so, in December of 2020. Are you suggesting the British, too, nefariously delayed their vaccine rollout with an eye toward US presidential politics?
The obvious answer is that your wild-eyed paranoia is utterly baseless, and that in fact what transpired is that vaccine development and rollout in the US happened at an appropriate (and indeed miraculously rapid) pace, based on the available science and trial results. Indeed there was significant political interference—from the Trump White House!—which sought to pressure researchers to rush the release of vaccines for the very reason you allude to (to enable Trump to campaign as a vaccine hero).
Imagine the public health disaster that would have unfolded in the US had the vaccine rollout been botched because of a premature, politically-pressured release.
I will just note a few of the falsehoods and misleading statements in MF’s comment.
- There was no ‘biased enforcement’ at the Sturgis rally because no mitigation measures were enforced at all — no requirement for masks, distancing or testing.
- Many school systems took measures to make learning materials available to all students: https://nces.ed.gov/whatsnew/press_releases/2_22_2022.asp
- It would have been unethical to conduct challenge trials of Covid vaccines with those at greatest risk (the elderly and immune-compromised), and little or nothing would have been learned from trials on carefully screened, healthy, low-risk individuals.
If you compare a protest of someone being murdered as being the same as a tourist party, I think you don't need to be listened to.
They say half or more of the population has had at least one infection. Based on that I’d say it’s darn near impossible to prevent infection without isolating. I’ve not ever had it. Or perhaps I was exposed but was asymptomatic.
Even worst case, with only a 9% reduction in transmission, masks saved lives. Period.
This is not something we let go just because it is difficult.
If we have a similar situation in the future where masks save lives, then requiring masks is a fight worth having.
Kevin would be better advised to reform his question as what works in the face of massive 'Conservative' intransigence. As it is, we've got people who are actually _proud_ of their 'patriotic' noncompliance with what are after all basic prophylactic measures. And are saying so right here.
Conservative organizations creating an actual plan to dismantle civil society and the rule of law,
https://apnews.com/article/election-2024-conservatives-trump-heritage-857eb794e505f1c6710eb03fd5b58981
These projects are just smoke-screen. What Trump will do will be much much worse than what they plan.
This may have already been brought up in the comments by now, but the only way that keeping schools open during a pandemic would really work is if we invested in high-end air filtration/HVAC systems for all schools.
I believe there was an article very recently in the New York Times that the cruddy air quality in at least 50% of school classrooms across the United States is what makes it so controversial to tightly pack-in students while a pandemic is raging outside the classroom. If the air quality was much better a classroom is less likely to be a super germ incubation unit.
Imagine a classroom where students could sit next to each other without a mask while folks are literally dying outside their doors.
There are multiple benefits to being able to send your little Brantley to school, you remove him from being under your feet while you are working remote during the day, he gets an education so he has a chance of getting into that Ivy league university you plan to donate a new building too so your special child gets admitted to the university (the building donation ensures that his application is not sent to the circular filing cabinet), and you can be pretty flipping confident that he will not get sick if the classroom he is in is not already filled with air saturated with germs from kids with colds, or Covid.
They say money can't buy you love, but it can buy us classrooms that folks would be comfortable sending their kids too in case of an emergency.
My sister can note that she has first-hand experience dealing with what were oftentimes upper middle class / wealthy parents that complained the most about not being able to foist their kid off on teachers for most of the day during the pandemic.
I get that school closures are a bugaboo of yours Kevin considering all the posts you put up with studies that say school closures did not help prevent the spread of Covid, but there is plenty of evidence out there that areas in the U.S. and other countries that had regions where they kept schools open, ended up with plenty of kids who became ill, the countries (mostly in Asia) where the kids in school were seated farther apart than usual from each other and wore masks during the school hours, they seem to get through the pandemic just fine.
If the U.S. Schools emulated some of the actions that schools in Japan, Taiwan, etc., took to keep kids in school, that would be great, but good luck with that.
Many parents (and not just in schools in the Deep South) did not care if their students were sent to a classroom where the kids spent most of their time coughing Covid germs directly into each others mouths', they just wanted their kids out from under their feet while they went about their day.
So many teachers who made it through the pandemic have made it their mission to make sure they do not encourage their kids to become educators, not everyone, but society as a whole treated educators (at all levels, including at the University level) like crap during the pandemic. We may have lost a whole generation of students who would have strongly considered becoming a teacher because of how angry we were at teachers during the pandemic who were not willing to suck it up and get to the classroom and take care of, I mean teach their students while the adults did the hard work of trying to bring home the bacon during the pandemic.
People in the US have this intense, silly focus on America as if we were the only country with any agency. In the case of COVID the problem is that we never managed to do any measure correctly. This is the reason we largely failed in the fight against COVID. We didn't quaranteen properly (in government run facilities with strict discipline but also with amenities that make the experience survivable) , we didn't contact trace properly (i.e, with a stringent protocol and sufficient personnel), we didn't mask properly (because we didn't have any masks at the beginning among other things), we didn't vaccinate in sufficient numbers. Any measure we tried was executed halfway at best. No wonder none of them worked very well. Hence the entire discussion here has no real traction.
South Korea for example did much better than we did because they took COVID seriously from the beginning. And were able to get the population to cooperate.
Another point: some things that have turned out unnecessary, like surface sterilization, were unnecessary for COVID. They may well be necessary for other viruses with different properties. I'd definitely recommend sticking with them for next time until we know enough to abandon them.
Another thing: The CDC did not have a plan in the drawer, complete with a stockpile of assets (PPS, ventilators, swabs etc.) that they could have pulled out, modified for the parameters of the current situation and executed. Instead they were improvising from the get go. They had probably more publications than any other similar agency in the world which is why we naively believed they were the best. Not that the Europeans fared much better....
The failure of the CDC was mainly because the Trump administration, via the "White House Coronavirus Task Force" basically stopped them from doing anything useful, to try to hide how serious the issue is.
The CDC could have put 100 times more resources into developing test kits and investigating routes of transmission, but it didn't because it was blocked from above.
Didn't Trump implement operation Warp Speed?
No.
They were developing the vaccines long before the government got involved, and were pushing the government to give them more money, and the governemnt in genereal (not only trump) were ready to do it. But it was not his initiative, and apart from not blocking it, he contributed nothing.
In general, people give the president (any president, not just Trump) much more credit than the president actually deserves for things that happen during his time.
What absolute hogwash.
Yes, it can. We might chose not to. That's different.
Then the mask truthers should be broken in the same way other criminals are. If I went into a restaurant and started licking all the exposed surfaces, they'd ask me to leave, and if didn't police would MAKE me leave. Mask truthers can be treated the same way.
We knew how to deal with lynchers in this country once upon a time.
The number one (#1 !!!) way to stop a pandemic is to fund and run a continuous infectious disease surveillance program that can identify and characterize new (and existing) diseases early on.
1) Active community and hospital infectious disease monitoring of existing and detection of new disease.
2) Laws and plans for public health officials to take action early. With the power to shut down or quarantine areas--schools, hospitals, big planned events, clubs, border crossings, ports, airports, counties, etc. The steps needed are smaller the earlier they are taken. If a disease is confined to a building or ship, it is a small problem. If it is confined to a school or set of clubs, still small. If canceling the Daytona 500 stops a pandemic, do it. Wait until the disease spreads through LA, and a massive effort is required.
Require the public health official to get a meeting with the mayor and convince him to shut down his town's big festival and you have designed for failure. Which is where the US is at today. Jaws isn't a movie about a big fish, it is a movie about a public health failure.
China knows how to stop a epidemic but not a pandemic while the rest of the world spreads the disease.