Two pandemics -- real and fable

Last update: 7/25/22 

The editor offers the following personal anecdote as a specific example of an important pandemic management issue that will be discussed in subsequent sections of this blog note. A few days ago he was having brunch with his daughter and his 8 year old granddaughter at an upscale restaurant. Outside or inside? It suddenly looked like it was about to rain, so he grumbled his OK to eat inside. He knew from pre-pandemic experience that this relatively new restaurant had excellent ventilation and high ceilings, so ... OK ... OK. But after two or three steps inside, everything was not OK.

A "New Normal" brunch

Most of the staff were not wearing masks, the waiters, the busboys, the cashiers ... and the few that were wearing masks were wearing rinky dink cloth crap. He immediately determined to keep his own well-fitted N95 securely in place until a few moments after his food was placed on the table in front of him. 

After a while, a waitress came to take the orders, young, very young, wearing no mask. Quick check: his N95 was still locked and loaded ... then she leaned in closer than 3 feet with a big smile while he held his breath ... oh no, please don't open your mouth to laugh ... too late. Showers of invisible aerosols spewing everywhere. He was certain that he could could feel them bouncing ever so gently off the backs of his hands like teensy weensy poison raindrops. 

When he looked around, he could see that everyone in the room was younger than he was, much younger, and none of them was wearing a mask. Welcome to the New Normal wherein old folk like his 80 year old self wore masks and younger folk were barefaced.  Except ... except for the party at the table on his far left and another group at a table to his right. Looking more carefully, he could see that every person at each table was as old as he was, possibly older. So why weren't they wearing masks?

Why did we mitigate? 

Back in 2020 we mitigated in order to slow the spread of the virus in order to reduce the number of severely ill patients that would have otherwise overloaded our hospitals and other health care facilities. In the first half of 2021, as vaccine distribution became widespread, we started to abandon masks, social distancing, and other mitigation mandates ... until Delta demolished our hopes of achieving herd immunity.

Thereafter our rationale for mitigation became muddled, confused, confusing, as did the guidance we received from the CDC and other pandemic managers. Most Americans were fed up with masks, social distancing, and other pandemic restrictions. They wanted to return to normal living no matter what. The surge of the far more transmissible Omicron and its sub-variants in 2021 did not diminish this craving. At mid-year there is limited, but convincing evidence that we are in the midst of yet another surge; nevertheless our pandemic managers are voicing muted concerns. Their voices are muted because the experts are acutely aware that strong guidance is likely to be ignored by most people in most states ... California being a notable exception.

• "Covid Rises Across U.S. Amid Muted Warnings and Murky Data", Julie Bosman, Thomas Fuller and Edgar Sandoval, NY Times, 7/18/22 

Spoiler alert: The previous sections of this this note presented straight-forward summaries of pandemic facts. What follows are the blog editor's personal interpretations of the facts.

Two pandemics: real and fable

At first, there was one pandemic that started in China and reached the U.S. in late 2019 or early 2020. It was perceived to be a "one size fits all" phenomenon that posed equal menace to everyone in all fifty states. Accordingly, President Trump's Task Force and his CDC issued the same guidance to everyone everywhere ... "We're all in this together" ... We don't wear masks to protect ourselves, but to protect each other"

However, by the end of May 2020, evidence emerged that supported an alternative perspective. All of us were not equally menaced by the coronavirus. Indeed, more than 80 percent of its fatal victims were 65+ and/or were made vulnerable by diabetes, compromised immune systems, or other health conditions. 

By contrast, the vast majority of the younger, less vulnerable population who became infected would either have no symptoms, mild symptoms, or incur treatable illness from which most of them would recover. For this majority, COVID has been not much worse than a bad flu. So when the polls declare that most Americans are fed up with the pandemic, the polls are correct. Most Americans are fed up because most are caught up in a fable, and they want the fable to end now.

The only people who really needed guidance as to how modify their behavior were those who were vulnerable and the families and friends who loved them. Families and friends, especially those who lived with the vulnerable, would go out of their way to avoid infection because they did not want to pass the infection on to the vulnerable people they loved. This minority were involved in a real pandemic.

The minority who are most vulnerable plus our friends and family who love us do not indulge in wishful thinking; we know that this pandemic is still an ongoing menace. The CDC and other public health experts should not speak to us in muted voices. They should speak directly to us, not the majority, and tell us loudly and clearly what we should do to avoid infection because we will listen.

• "Covid’s risks are concentrated among Americans of Biden’s age.", Benjamin Mueller, NY Times, 7/21/22

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Links to related notes on this blog:  

• "Has President Biden been infected by Omicron yet?", Last update: 7/13/22
• "Our pandemic of the elderly -- unvaccinated, vaccinated, and boosted", Last update: 7/18/22