What the Next 18 Months Can Look Like, if Leaders Buy Us Time
Telling everyone to wear masks indoors has a sociological effect. Grocery stores and workplaces cannot enforce mask wearing by vaccination status. We do not have vaccine passports in the U.S., and I do not see how we could. Places can either say “wear a mask regardless” or just accept that people who don’t want to wear one will not.In the early days of the pandemic it made sense for everyone to wear a mask, not just the sick — as the C.D.C. and the World Health Organization were recommending — if only to relieve the stigma of illness. Now, as we head toward the endgame, we need to apply the same logic but in reverse: If the unvaccinated still need to wear masks indoors, everyone else needs to do so as well, until prevalence of the virus is more greatly reduced.Even if the only people not protected by the vaccines were those hesitant to use them or who had false beliefs about them, public health principles would not allow us to say that any threat to their health is their problem, at least not while the virus is still spreading at substantive levels. Infectious diseases create risks for others.There are those who are not yet vaccinated because they haven’t managed to navigate the process, or have started late, or are concerned because of bad experiences with the medical establishment. The immunocompromised remain vulnerable. Even if the unvaccinated were all conspiracy theorists and dead-end anti-vaxxers, we would need to take virus levels into account before discounting the risks even to them.Plus, Covid-19 can still terribly burden our health resources, especially in those areas that still have many unvaccinated adults.The C.D.C. guidelines are essentially implying that the risk that the vaccinated will transmit the virus to others, including their unvaccinated children, is so vanishingly low that it is not worth worrying about. But if that’s their position, they should state it clearly and explain it, not just say that “fully vaccinated people have a reduced risk of transmitting” the virus.And is the expectation that the unvaccinated will all simply go with the guidance and stay masked? That does not fit with what we’ve observed in this country over the past year, especially with the ongoing polarization over these questions.
AbstractSweden was well equipped to prevent the pandemic of COVID-19 from becoming serious. Over 280 years of collaboration between political bodies, authorities, and the scientific community had yielded many successes in preventive medicine. Sweden’s population is literate and has a high level of trust in authorities and those in power. During 2020, however, Sweden had ten times higher COVID-19 death rates compared with neighbouring Norway. In this report, we try to understand why, using a narrative approach to evaluate the Swedish COVID-19 policy and the role of scientific evidence and integrity. We argue that that scientific methodology was not followed by the major figures in the acting authorities—or the responsible politicians—with alternative narratives being considered as valid, resulting in arbitrary policy decisions. In 2014, the Public Health Agency merged with the Institute for Infectious Disease Control; the first decision by its new head (Johan Carlson) was to dismiss and move the authority’s six professors to Karolinska Institute. With this setup, the authority lacked expertise and could disregard scientific facts. The Swedish pandemic strategy seemed targeted towards “natural” herd-immunity and avoiding a societal shutdown. The Public Health Agency labelled advice from national scientists and international authorities as extreme positions, resulting in media and political bodies to accept their own policy instead. The Swedish people were kept in ignorance of basic facts such as the airborne SARS-CoV-2 transmission, that asymptomatic individuals can be contagious and that face masks protect both the carrier and others. Mandatory legislation was seldom used; recommendations relying upon personal responsibility and without any sanctions were the norm. Many elderly people were administered morphine instead of oxygen despite available supplies, effectively ending their lives. If Sweden wants to do better in future pandemics, the scientific method must be re-established, not least within the Public Health Agency. It would likely make a large difference if a separate, independent Institute for Infectious Disease Control is recreated. We recommend Sweden begins a self-critical process about its political culture and the lack of accountability of decision-makers to avoid future failures, as occurred with the COVID-19 pandemic.
