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  • Writer's pictureDr. Bow Tie

The Politicization of Healthcare, Part 1

The pandemic is not over. Let's get that out of the way - the Omicron surge is on its way out, but it will not be the last, especially with the premature drop of mask mandates without any plan for future surges. We'll get to that in a few minutes. From the beginning of this pandemic, politicization has ruined any attempt at a national response. There should have been a bipartisan effort to embrace efforts to control the pandemic. We initially stated that masks should be preserved for healthcare workers (which was quickly spun into "no one should wear masks") but that should have spurred a surge in creating masks enough for everyone. Once we got past that hurdle with homemade masks, we should have embraced masks - instead we got a politically driven anti-mask campaign in which I saw people fake disabilities and throw tantrums to avoid the most minor of inconveniences.

That was only the beginning. People in and out of government have insisted on inserting political motives into a pandemic that should never have been political at all. We should have come together and redirected funds appropriately and created the appropriate resources to protect ourselves and each other from a deadly virus that does not stop at political lines. Instead we have half-assed our pandemic response for two years and nearly a million deaths. That's not even an exaggeration. A million fucking deaths, many of which could have been preventable.

Now, a majority of my ire has been directed at one side of the political spectrum, but not all of it. Biden took a whole year to get better-quality masks and COVID tests out to the public (and even then there are persistent shortages and you still have to go through insurance reimbursement - if it is necessary to fight a pandemic, it should be free and easily accessible...cowards). Now that we're approaching the midterms, they've finally convinced the CDC to adjust parameters to give them cover instead of stepping up to the challenge.

The CDC released updated guidelines this week. Now, their main focus seems to be avoiding strain on the healthcare system, but their focus is too narrow. Their update is based on the reasoning that we have high rates of vaccination and resource availability, which as I have already discussed, is not the case. They also highlight infection-mediated immunity as a reason to relax measures, except we already know that that infection-mediated immunity is not reliable or consistent/long-lasting compared to vaccine-mediated immunity. More data on that just came out this week! See below. Further, "letting it rip" is not a valid way to achieve any kind of herd immunity when people will die by the thousands in doing so.

They do point out that hospitals and other healthcare settings should not relax measures yet and should adhere to previous guidelines, but anywhere outside of those settings, masks are "a scarlet letter" (I'd laugh at the CDC Director's comparison of a life-saving measure to a 17th-century prude's mark of shame if it wasn't so idiotic).

The CDC also claims that we have wide access to tests and treatments, except that testing has been frustratingly scarce at times, and drugs like Paxlovid and molnupiravir (which are supposed to be given within days of symptom onset) are seldom in stock in pharmacies. So, as AIDS activist and research Gregg Gonsalves points out, this is a lot of overstatement.

They have also adjusted "community levels" to be less based on cases and more about hospital admissions and % of staffed beds occupied by COVID patients (I am extremely glad they acknowledge staffing). I have already pointed out in previous posts how we have been consistently behind the ball in responding to surges. We know that cases and deaths are no longer as tied together thanks to vaccines and mitigation (when they're in place), but hospitalizations lag a couple of weeks behind case count rises. Instead of investing in better surveillance (such as wastewater monitoring, which has been shown to be surprisingly effective in tracking surges), we are simply loosening parameters and thresholds, which is a higher level of spread and exposure (which can lead to more hospitalizations). There are also issues with how these levels, based on county hospitalizations, are calculated that will likely underestimate transmission and risk in some areas but overestimate it in others, leading to unbalanced mitigation. If you create guidelines based on hospitalizations, you will be IN a surge before you take any steps to prevent or mitigate it.

At least, that would be if there were plans for mitigation. The CDC has elected instead to go the "personal responsibility" route because they have apparently forgotten the name of their fucking organization. No thresholds for when mask mandates should go back in place, when measures need to be scaled up, no goals for % vaccination rates. Just "you may choose to mask at any time" and "consider efforts", which leaves disabled folks, immunocompromised folks, and kids (under five still cannot yet be vaccinated, and 5-11 are still vulnerable to infection even though the vaccines protect against hospitalizations, long COVID, MIS-C, and death) high and dry.

It's the midterms this year and it is obvious that the Biden administration wants to score points with those who are done dealing with the pandemic. Changing parameters to make things look rosier is a frustrating move by the CDC at a time when science communicators like me have tried for two years to repair the distrust in science created by those who profit from anti-science. Don't get me wrong, I still believe in the CDC when they actually fulfill their mission, but as I have repeatedly stated, ignoring the pandemic does not make it go away.

Why am I writing about this, then? Am I just complaining because I want to mask forever? No, of course not. I make these points so that, when COVID surges again and these thresholds are met, if we are behind the curve again and need to adjust mitigation measures and maybe even put mandates back in place, that people around me don’t assume it’s a political ploy. It’s a response to a pandemic that continues to kill us and our children.

In the meantime, if you really don't want to keep wearing masks but also want proof that we can feel more relaxed about it, get vaccinated and get everyone around you vaccinated. Protect kids in schools with masks until they can all get vaccinated. Care about other people, and as always, ask questions. I welcome them.

Infection-Mediated vs. Vaccine-Mediated Immunity:

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