COVID: What’s Next

Healing our country and effectively combating the pandemic requires that we communicate with each other. At this moment this seems impossible. Many Republicans honestly believe in a false narrative that has been constructed over decades. Their beliefs politicize what should be a common concern for all Americans. This isolates them from the rest of their American family and prohibits them from taking the actions needed to protect our public health and revive our devastated economy. How can we bridge the chasm and promote a healthy conversation with our insular fellow citizens?

I recently heard a conservative analyst say that to effectively communicate with Republicans and possibly begin a healing discussion, it was necessary to focus on feelings and emotions rather than rely on facts and figures. He also said that berating these folks only makes them firmer in their resolve and less likely to hear any differing points of view. The idea, he said, was to point out fundamental inconsistencies in the news and their ideas in a non-threatening way, and then let them work it out for themselves. For some, this will open the door to expanded conversations. For others, it will have no effect.

How do we unite and return to “normal”? There are two things that need to happen. The first is to increase public health measures to overcome the pandemic. This is happening now. The second is to unite by taking the politics out of the crisis.

With over 440,000 dead Americans and 2,000,000 dead worldwide, we have a public health crisis. There is no need for it to be a political one. Unfortunately, many of our fellow Americans believe that wearing masks, following public health guidelines, and getting vaccinated means surrendering their personal freedom. At the same time, these same people rightly believe that each of us should take responsibility for our actions. Here lies the problem.

In a democracy, our freedoms come with responsibilities. One such obligation is to carefully consider how exercising my freedom impacts on yours and then behaving accordingly. That means, each of us is responsible for both our freedom and that of others. I may have the right to risk my own life, but I do not have the right to risk yours. One way of thinking about public health guidelines and regulations is that they are formalized definitions of our duties towards each other.

Ending this catastrophe requires coordinated local, federal, and international efforts. We need to realize that it will take years to “normalize” our situation. On the local and federal levels, it is necessary to vaccinate at least 85% of all 330,000,000 Americans to create what some call herd immunity. This is a massive undertaking that requires wartime like logistics to manufacture the vaccine, distribute it to every corner of the nation, and administer it. That is the easiest part. The harder task is convincing at least 85% of Americans to get vaccinated and then voluntarily follow public heath procedures for a year or more into the future.

Vaccines are not a silver bullet. While providing a higher degree of immunity to those vaccinated, vaccines will not immediately stop the pandemic. What they will do is slow the spread of the virus, lessen the severity of its infection and reduce the death toll. During and after the vaccination campaign Americans will need to continue to protect themselves by wearing masks, social distancing, and washing their hands. Why? Because there will continue to be sources of infection both domestic and international.

Herd immunity, many people mistakenly believe, will put an end to this tragedy and allow us to get back to our open, freely socializing ways. Herd immunity does not end the disease. It only makes it harder to spread and unprotected people are still vulnerable.

As we have recently seen, measles, once well under control, has again become a public health concern due to the anti-vaccine movement. Anti-vaxxers think that the measles is relatively harmless. As part of their movement, they form networks of like-minded people who themselves are unprotected. When the measles appears, it spreads rapidly. As a result, the threat to the public quickly increases and places people who have not been vaccinated due to medical conditions at a growing risk.

There are four groups at risk of serious complications: children younger than 5, adults over 20, pregnant women, and people with compromised immune systems. The CDC points out that 1 in 5 people with measles requires hospitalization. This is often due to pneumonia, which is the how most children die. Another threat is encephalitis which can leave a child deaf or with brain damage. Also measles can cause complications during pregnancy leading to premature births and low birth weights. There is also the long-term risk of a fatal central nervous system disease that can appear 7-10 years after infection. Measles compromises the immune system and opens the door for COVID.

Viruses mutate. The strains from the UK, South Africa, and Brazil, are examples of how quickly the coronavirus can mutate and spread. Viruses can share genetic material and traits with other viruses, such as drug resistance or the ability to spread more quickly. The new strain can be more virulent and may make current vaccines less effective or useless. It is easy to see that unprotected people are the equivalent of petri dishes where viruses are free to mix and mingle, posing the potential threat for new deadlier diseases.

Public health does not stop at the US border. The last year has shown how disease has no boundaries. That means that our actions cannot stop at the border. The same steps we need to take in the US to ensure the availability of vaccine and the other materials, such as needles and syringes, must be taken around the world. This requires an international effort in which the US plays an important role.

What will it take to vaccinate people world-wide? Currently, vaccine supplies are limited by the manufacturing capacities of the pharmaceutical companies who developed them. Around the world there are many qualified pharmaceutical manufacturers who have unused capacity. They could be licensed to produce more vaccine, thus increasing supply, and speeding up distribution. Likewise, there are not enough trained people to vaccinate everyone. Here too, a massive training effort is required and, again, can be implemented through international efforts.

This will cost a lot. Poorer nations do not have the resources to purchase vaccines nor the infrastructure to administer them. Yet, we cannot ignore their plight since that places us at a greater risk. Hence, the US and other developed nations will have to provide the funds and the personnel to assist in building the necessary infrastructure and provide training.

If we do not do this then we are faced with a continuous cycling of COVID strains, like the flu, but far more deadly. Imagine the yearly scramble trying to anticipate which strains of COVID will likely strike and preparing vaccines for them. As with the flu, the more strains circulating, the greater risk of an unanticipated strain spreading without a corresponding vaccine and creating another pandemic.  

The bottom line is COVID is not going away soon. How completely we unite and respond, both at home and abroad, will determine how many loved ones die or are disabled, and when we might eventually return to the “normal” we all desperately want. It is up to all of us. This rises far above politics.