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  • Writer's pictureDr. Bow Tie


December 16, 2021 marks the one-year anniversary of my first COVID-19 vaccine. I had such hope that day that we would soon see the end of the pandemic. Instead, I am here a year later urging and begging folks to #GetVaccinated. Things have not changed as much as they should.

We have had some victories. Vaccines are rolling out with plenty of access in the United States, and we have antiviral treatments showing real promise as a backup (but not preventative).

A recent modeling study showed that without vaccines, we would have seen 1.1 million more deaths this year, with over 10 million more hospitalizations. We just hit 800,000 deaths since the pandemic began, it's impossible to imagine more.

The Supreme Court has decided not to block New York State's healthcare worker mandate. This is GOOD. I have written before why mandates are necessary, especially in healthcare settings. Three judges dissented, but contrary to Gorsuch, Alito, and Thomas wringing their hands, no established religion is against vaccination and they don't have real moral ground on which to stand against protecting our patients.

Cleveland Clinic, on the other hand, saw the injunction on the federal mandate and let their coward flag fly, reversing their institutional healthcare worker vaccine mandate and putting their patients in danger. It's not that we don't need the doctors, nurses, respiratory therapists and those who have left because they are misinformed about vaccines or what they call "medical freedom." It's not that those HCWs should not be frustrated when "the patients aren't getting vaccinated, why do I need to be 'forced'?" (even though that's a very good reason to get vaccinated). Hell, it's not that those doctors and nurses aren't sometimes being threatened and abused by the very patients they try to treat. But public health is paramount in a pandemic, especially when we have safe and still effective (possibly slightly less so with this variant, but still significantly) vaccines.

HCWs still have to fight disinformation that sows distrust in science, much of it from or heavily endorsed by some in our own ranks. People who forgot their training in the pursuit of money or clout or fame, and who can wield catchy phrases or memes for grift and essentially thievery, when the truth is always more nuanced and often less exciting. They go on TV and podcasts and spread false information and then in the next breath sell you their snake oil.

This is fueled further as one extreme pretends America is being made great by ignoring science and demonizing those that speak for it. Then the other side (less extreme, more reactionary) has to dig themselves in, and you get a screaming match, with the rest of us caught somewhere in the middle. Some find a way to profit from it, and others, like me, try to cut through the disinformation to find a way through the pandemic with as few deaths as possible.

We also face politicians so hell-bent on returning to the status quo that they don't want to learn any lessons from all this.

Southern and Midwest state governors are touting “freedom of choice” and then outlawing businesses from instituting public health measures. Some of them are basically pro-COVID at this point, in service of their future political bids. I refuse to believe it is "inevitable" that "everyone will get COVID." I know I have to accept that it's a possibility, but that translates to a lot of people (most of whom will be less privileged than me) dying because they won't get the same resources I could if I got infected.

Meanwhile, President Biden and our supposed Democratic majority have failed to put enough money into public health tools like testing, tracing, and protection. There is no reason every home shouldn’t be getting free rapid tests and N95 masks delivered regularly (instead they’re trying to implement insurance reimbursements, because we al know how easy it is to get insurance companies to pay for anything). The administration also ignores the fact that working from home has proved to be a much more viable option than we ever thought, especially when people are sick or recovering (even without COVID).

And, of course, we are not working hard enough to reduce vaccine inequity in the rest of the world, which I have already discussed.

By nature we are a selfish people. From the beginning a prevailing sentiment has been “I want to live my life the way it was pre-pandemic. I’ll do whatever it takes.” For some it’s been to shirk all science even as it evolves to be more accurate (“you said not to wear masks! Now you want us to wear masks! No way!”); for others it’s been to actively do everything asked and recommended, but with the thought of “If I do these things, I can go back to not masking and be like it was before.” Then when that doesn’t happen as quickly (because the virus persists, not because of any political move) they’re frustrated and they start to distrust the measures (there's a reason my blog is called "Managing Expectations").

For example, despite a plethora of evidence, people (both vaccinated and not) still think masks don’t work, or object to mask mandates on other grounds, because we haven’t acknowledged the need for a layered approach as we crest a fifth wave.

Masking+rapid testing when not vaccinated is still a layer of protection, but it is not a complete layer, nor is it the most effective on its own. Cases do slip by and people get exposed. It must be a strategy used as an adjunct to vaccination.

America should not go back to what it was before, but it is hard to shake that in a public health crisis. This was a tipping point for us. An objective viewer sees the knife’s edge our previous existence walked. This should change our country, and instead of trying to ignore a pandemic away, we should redirect funding to where it is needed: to education and to public health tools/resources. We need to create a proactive pandemic response for what will come, rather than starting from behind as we have every step of the way over the last two years - this will include some individual-level changes (maybe seasonal masking like in East Asian countries, or other similar measures). Going blindly back to pre-pandemic America would mean we failed to learn the lessons of the last two years.

Be safe this holiday season, which may mean canceling holiday plans if there is an exposure or positive test or even just symptoms (it's not "just a cold" until proven so with multiple tests). Please continue to ask questions, wear a mask and avoid large crowds where you don't know the vaccination status, and please get vaccinated. Vaccination (plus our other layered measures) remains the ONLY way out of this pandemic without continued devastating loss.

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