Dear Editor,

Let’s be clear at the outset, I’m all about the science. In the past year we continually witnessed efforts to supplant data-driven health guidance with politically motivated drivel. We have the mis-informer in chief to thank for much of that. Nonetheless, it is now clear that public health officials also made a series of mistakes that increased the pain and suffering wrought by the pandemic. We need to acknowledge the messaging failures in our response to Covid-19. It’s important because the latest round of perfectionist scolding could snatch defeat from the jaws of victory.

Let’s start with the breathtaking, cynical about-face in guidance surrounding masks. In early 2020 the messaging went from ‘most people don’t need them’ to ‘masks are the best weapon against viral spread, and should be required in public’. In hindsight we now understand that CDC was trying to stave off a run on N95 masks when hospitals were critically short of PPE. But shooting straight about that shortage and encouraging grass roots cloth mask production would have been a superior message. 

That reversal exemplifies a recurring pattern, public health experts keep exhibiting blatant paternalism toward the public. The experts fear that people will respond to anything that increases their safety - masks, rapid tests, or vaccines - by behaving recklessly. The theory that a false sense of security leads to reckless behavior is attractive to public health officials. Similar fears queered the messaging for almost every new public safety measure, including seat belts, helmets, and condoms.

Also, the CDC and WHO have continually focused on setting rules for people to follow instead of explaining the mechanisms of Covid-19 transmission. Explaining the mechanics, and updating that understanding over time, would have empowered people to make informed calculations about risk in different settings. Instead, the experts repeatedly chose to offer fixed guidelines that invoked a false sense of precision and encouraged public shaming by self-appointed safety monitors.

The side effects of this approach are now apparent. State after state (and countless individual mask shamers) put enormous energy into policing outdoor gatherings and behaviors. But super-spreading isn’t equally distributed. Poorly ventilated indoor spaces facilitate the spread of the virus over longer distances, and in shorter periods of time, than almost all forms of outdoor activity. There is a scientific reason that there are few documented cases of transmission outdoors, even after a year of epidemiological work: open air dilutes the virus quickly, and the ultraviolet light helps deactivate it. Yet public health messaging still does not emphasize this distinction, and pictures of ‘scandalous’ outdoor gatherings still clog the Internet because they reliably generate outrage.

Amidst all the scolding and rule mongering, the need to prioritize health risks holistically has largely been ignored. Harm reduction is the recognition that some crucial physical and social needs cannot simply be put on hold. Pretending we can replace the complexities and trade-offs of real life with absolutist health rules is counterproductive. Consider abstinence-only education: not letting teenagers know about ways to have safer sex results in more of them having sex with no protections.

Which brings us to the current moment, and the paternal advice regarding life after vaccination. Over 26% of the population has now received at least one shot, and roughly 2.5 million more get jabbed each day. Medical experts and the chattering class are already complaining about the significant number of Americans who are ‘vaccine hesitant’. And indeed Vladimir Putin and his trolls are splashing anti-vax memes all over social media to stoke vaccine fear. In other words, at this stage in the game, the most important harm reduction factor is clearly the effort to maximize the vaccine adoption. But as soon as inoculations began, health authorities took pains to message a list of things that vaccinated people still are not allowed to do.

The science is incomplete, but a consensus is growing based on initial studies. The vaccines do not completely prevent transmission potential (known as ‘sterilizing immunity’), but they do massively reduce the viral load of vaccinated individuals if they are re-exposed. Being vaccinated won’t eliminate the possibility of asymptomatic transmission, it just drastically lowers that risk.

Instead of pitching post-vaccine freedom to encourage maximum uptake, public health paternalism is emphasizing the negatives - don’t fly, don’t visit your grandkids, don’t have family gatherings. Those recommendations aren’t wrong, but they are incomplete. Ignore Putin’s trolls. Get vaccinated people. Then make your own informed decisions about safe socializing as you help our society rebuild.

Derek Ridgley
Nederland

(Originally published in the April 8, 2021, edition of The Mountain-Ear.)