Although I materially agree with the observations in Matt Bai’s most recent Washington Post column, I don’t think he fully apprehends their implications. He states his thesis pretty clearly in his opening sentences:
Democrats, who nominally control Washington, are about to face a reckoning on covid-19.
At some point soon, they’re going to have to start treating the coronavirus not as the uncontrollable public health crisis it used to be, but as the public policy crisis it has now become.
After the obligatory sideswipe at Donald Trump he continues by dividing the American public into three groups:
The largest group is the fully vaccinated. For most of us, the new variant is a serious nuisance, like an especially virile flu, but not much more than that. It’s unpleasant (I know, because I have it), but if this were the version of covid that hit everyone who got infected in 2020, no school or business would have closed.
The second group is the immune-compromised, even if they are vaccinated — including people with underlying conditions and the elderly. The risk to them remains high, and the extra care they have to take can be isolating. But that’s the case with every contagion, including the flu. We don’t reorder the society around it.
The third group is, of course, the unvaccinated. (I’m not including children under 5, who are still not eligible for a coronavirus vaccine.) They’ve now had a year to absorb all the warnings and weigh all the arguments. They’ve seen high-profile vaccine deniers — talk show hosts, Trumpian candidates — needlessly dying from a virus they chose to exploit.
At this point, the unvaccinated are like unrepentant smokers. We’ve spent decades telling them they might get lung cancer. We’ve plastered warnings everywhere.
But you know what? All of us get to make our own idiotic choices — that’s the American way.
which brings to mind Robert Benchley’s observation about people who divide other people into groups. And it’s where I think Mr. Bai hasn’t thought things through. The definition of the first group is, shall we say, emergent. Yesterday it was people who’d received two doses of the Pfizer or Moderna vaccine; today it’s people who’ve also received a booster. Tomorrow? Who knows?
The second group is equally fluid. How does one distinguish between the first and second groups? Presumably, if you’ve been fully inoculated and you still contract COVID-19, are you in that second group? Is there a real empirical distinction between the two? I don’t think so.
His remarks about the unvaccinated are equally problematic. People who smoke don’t provide as great a risk to those who don’t as people who are not inoculated against COVID-19 pose. Consider President Biden’s recent remarks:
All these people who have not been vaccinated, you have an obligation to yourselves, to your family, and, quite frankly — I know I’ll get criticized for this — to your country.
Get vaccinated now. It’s free. It’s convenient. I promise you, it saves lives. And I, honest to God, believe it’s your patriotic duty.
Does that sound like an acknowledgement that people have a right to make their “own idiotic choices” to you? Me, neither. Is that position reconcilable with mandates? How?
The reality is that those who are unwilling to accept a heightened level of risk, regardless of cost-benefit, will not be persuaded. That’s playing out right now in the work stoppage being carried on by Chicago’s teachers.
Mr. Bai goes on to make a valuable observation:
Sure, you can argue that the virus still overwhelms hospitals and is costing us a ton of money. But that’s a capacity problem, not an existential crisis. You don’t solve technical shortages by shuttering schools and keeping nurses at home with draconian quarantine policies.
There are a couple of things we need to come to terms with. Failing to expand capacity permanently is predicated on the assumption of “Zero COVID” and that assumption is decreasingly supportable. Reasonable people may have different views of that but I think it reflects a basic problem with our whole healthcare system.
After that lengthy exposition he finally gets to the point:
If Biden is going to beat the pandemic rather than be undone by it, he is going to have to acknowledge the new reality, which is that our public policy is way too weighted toward a bunch of people who made the wrong choice.
Biden said as much in remarks at the White House Tuesday, addressing his comments to the unvaccinated. That’s fine.
But it’s his own Democratic constituencies — teachers unions, local governments, ultra-leftist Trump haters who refuse to let go of the culture war over the virus — who would continue to hold the country hostage to what now is a manageable public health risk. In Montgomery County, a group of parents and teachers who want to close the schools issued a call this week for children to stay home in protest.
Biden needs to take these people on and steer his party toward a more sensible course.
There is an old phrase used to characterize such advice: whistling past a graveyard. President Biden can’t “take these people on”. Not only has he failed to do so throughout his lengthy political career, he depends on them.
There’s another reality that we’ll need to come to terms with soon. As the number of “fully vaccinated” people (whatever that means at the time) rises as it undoubtedly will the percentage of “fully vaccinated” people hospitalized for COVID-19 and who die of it will rise. That’s just mathematics. Look at any study, any infographic on those hospitalized with COVID-19 and those who died of it. The percentage of “fully vaccinated” in their number is non-zero. That mathematical fact alone will provide all of the ammunition those Democratic constituencies Mr. Bai calls out need to continue the “culture war” over the pandemic into the indefinite future.
We’ll fight it out, it’s the American way.
Interesting to me at least that China is still trying total lockdowns of large cities as if to eradicate it.
I don’t know if that’s just their basic instincts for control showing or if they know things we do not. This is an expensive effort to totally eliminate a coronavirus, proven to be slippery as soap, unless they know the bug better than our experts do, their effort will be a one hundred year march.
Almost two years in we still lack the testing capacity to track the disease and even regular people still do not have access to timely testing. The fact that Omicron spreads easily among the “fully†vaccinated combined with mild symptoms and asymptomatic spread and it’s game over.
There will probably be other variants. It seems clear that vaccination and getting covid do not protect you from getting a new variant – they only reduce symptoms and effects. What is the plan for the next variant?
Part of the current “crisis” is not about the virus itself, but the public health measures put in place that were never going to be sustainable when the virus spread becomes endemic. At my wife’s hospital, there are tons of stories of the cascade effect of the precautions put in place, such as nurse’s husband tests positive, and she has to stay home for ten days, and then one of her kids tests positive few days later, and the ten day period starts over, and then finally she tests positive, has flu-like symptoms and now she may be out for I don’t know how long. I’ve heard similar local stories that pharmacy chains are going to reduced hours because of isolation policies coupled with PCR tests. (Illinois is not following CDC guidance shortening isolation/ quarantine AFAIK)
We need more antigen tests since last Spring. We have PCR tests that can read positive for months after infection even though the person is not contagious or symptomatic. Most vaccinated people are probably not infectious by the time they test positive, but an antigen test would be what’s needed to be sure.
Bali’s piece is both aggravating and snobbish. He sounds like a know-it-all in describing the characteristics and intentions of the 3 groupings of people constructed around the virus. The first two – vaccinated and immune-compromised are the “innocents.†The 3rd category are the bohemians – stupid risk-takers, inconsiderate of others, or perhaps even mentally compromised.
No where in Bali’s rambling dissertation does he wonder off the vaccine reservation, assaying those in that 3rd set of people, as having legitimate concerns about the risks of taking the vaccine. I’m not taking the vaccines, for instance, because I don’t think the government entities pushing them (CDC, FDA, Fauci) have proven to be trustworthy in their data collections, length of clinical trials, conflicts of interest, nor their transparency as to what is in these vaccines.
I also don’t believe the CDC’s number of 97% of those hospitalized with COVID are unvaccinated. An El Camino hospital in N CA exemplifies a contrasting figure, citing that 57% of it’s COVID patients were vaccinated – only one being on a ventilator. One hears and reads scores of different stories and statistics from around the country indicating more the waning effects of vaccinations than assurances of their continued efficacy. However, through all the vaccine ambivalence, the government, nonetheless, continues to ramp up vaccination demands, changing definitions of being “fully vaccinated†to include 3.4 plus jabs to meet their criterion, as they turn a deaf ear and chastise those who question how toxic these vaccines really are.
I just read PD’s comment, in which he brought up a valid point -the unsustainable public health measures being administered. I would add that said response is more knee-jerk than responsible.
Just the mandates themselves, where people are fired or have to resign, if they refuse vaccination, are jeopardizing the operations of all first responders – the staffing in hospitals, fire/police departments. Hospitals have had to close down entire wards because of the lack of personnel. Now, Biden belatedly wants to mail out home test kits to people. However, the post office is having a tough time keeping it’s operation going, as carriers are leaving due to non-compliance with the vaccine mandates. How will their delivery be on those test kits?
Stupid moves and policies only beget more problems.
Had Fauci and his NIH cohorts not sabotaged the initial usage of a few common antivirals, there would have been little chance these vaccines would have received EUA approval.
https://www.theepochtimes.com/more-good-news-on-ivermectin_4196934.html
Meh, I think his 3 groups are a pretty reasonable way to look at it. People with just 2 shots still have OK protection. At this point the vaccinated, banning a new variant, are protected about as well as they are going to be. The second group is probably larger than most think but there isn’t much we can do for them.
The last group has already decided to take the risk. I just wish they would stay home and take more ivermectin rather than come to the hospital. The volume is affecting the care of other patients. More seriously, there is no quick way to address capacity especially since capacity is not just bed space but also people. Longer term we can address capacity but it will cost a lot more. Who is going to pay for that? Maybe have an insurance surcharge for people who dont get vaccinated?
“rises as it undoubtedly will the percentage of “fully vaccinated†people hospitalized for COVID-19 and who die of it will rise.”
Sure, but we would have so many fewer hospitalizations it would be a trivial problem as it would be a high percentage of a small number. (The unvaccinated are generally not good at math so this will be difficult for them to understand.)
“At my wife’s hospital, there are tons of stories of the cascade effect of the precautions put in place”
I track that for our department and yes it has happened but it has not been very often for us and our group is very fertile with lots of young kids. When it does happen it gets talked about a lot. The good news is that they come back. The ones really killing us are the ones who are leaving and not coming back. The ones who wont work ICU anymore, the ones who retire early and even the ones who leave the profession entirely. The ED nurse who walks out in the middle of a shift saying she couldn’t take it anymore.
Steve
That’s my point. We are attempting to provide mass care with artisanal medicine. If we’re going to continue the present way that care is provided, why aren’t we training enough physicians, nurses, technicians to do the job?
This problem didn’t start with the pandemic—as with so much else the pandemic just exposed the risks. It also didn’t start with Medicare. It did start with the Flexner report more than a century ago.
I’m sure that various people’s experiences are all over the map. But this…:
“I’m not taking the vaccines, for instance, because I don’t think the government entities pushing them (CDC, FDA, Fauci) have proven to be trustworthy in their data collections, length of clinical trials, conflicts of interest, nor their transparency as to what is in these vaccines.”
…I think illustrates one of the biggest public policy failures. Jan is correct. The vaccines are leaky and transient. At bare minimum leaky wrt Omicron. Long term effects are unknown. They have been oversold.
Data integrity is poor; it is disputed or revised, politicized and there are attempts to either avoid disclosure or discredit alternative points of view. Yet the data is always portrayed in conjunction with a policy prescription with absolute surety. Not a way to engender trust.
Speaking of public confidence. How about masks? If we were serious we would have made an all out effort at making N95’s. More to the point. The large number of pictures of politicians not wearing a mask – and being conveniently excused for it – while other population groups’ activities are restricted or they are ostracized – is no way to lead or generate compliance.
And Biden? He’s just a one trick pony. At the end of the day, despite all the public policy attempts, and all the attendant costs, we now have Omicron racing like wildfire through populations. We have only managed to attenuate mortality. That’s valuable, but who would care to measure tradeoffs?
I think it likely that the emerging herd immunity and diminishment of covid will be the time for someone to whisper into Biden’s ear that, politically, its time to declare victory and deemphasize the current costly policies. Of course he has painted himself into a corner, but I’m sure media can help him out of that problem.
Unless there is a dramatically longer-lasting, more effective vaccine against it I doubt there will ever be “herd immunity” against SARS-CoV-2. It mutates too quickly.
The smallpox vaccine was 95% effective; its protection lasted 3 to 5 years. It didn’t appear to mutate as rapidly as SARS-CoV-2 does.
We should count our blessings. Has there ever been a successful human vaccine against any coronavirus before?
https://vector-news.github.io/editorials/CausalAnalysisReport_html.html
â€The statistically significant and overwhelmingly positive causal impact after vaccine deployment on the dependent variables total deaths and total cases per million should be highly worrisome for policy makers. They indicate a marked increase in both COVID-19 related cases and death due directly to a vaccine deployment that was originally sold to the public as the “key to gain back our freedoms.†The effect of vaccines on total cases per million and its low positive association with total vaccinations per hundred signifies a limited impact of vaccines on lowering COVID-19 associated cases. These results should encourage local policy makers to make policy decisions based on data, not narrative, and based on local conditions, not global or national mandates. These results should also encourage policy makers to begin looking for other avenues out of the pandemic aside from mass vaccination campaigns.â€
You probably won’t see this study in any government-supported main stream media publication. Establishment doctors might glance at it, but be more interested in how they can scoff at it’s credibility. Just like the incredible frequency of collapse or deaths by athletes these days (over 60 fold over pre COVID), such cause and effect links to this vaccine are usually dismissed, unless it’s your own family member or friend who is injured or dies from it.
steve,
Totally agree that increasing capacity is a long-term thing. But we are almost two years into this and I don’t see anything being done on that front or even discussed. Everyone still seems to be banking on a return to the 2019 status quo.
Andy- Nursing school is 3 or 4 years and then it takes additional training to become an ICU nurse, lets say 6 months to work independently and about a year to become good. Post med school the fastest route to ICU care is 5 years I believe. Takes a long time. People arent really thrilled with doing ICU care if they have to wear PPE all of the time and half of your pts die.
I think people did count on vaccinations too much. As we have seen people who are vaccinated are hospitalized and end up in the ICU much less often. I dont think anyone really thought we would see so much and such prolonged resistance. That said, I know our nursing school and others in the area are increasing class size. We will get more nurses but dont know if they will want to do ICU or floor care with covid pts. On the doc side we saw fewer than expected go into critical care training in some specialty routes. (ICU is where there have been the most staffing issues, plus I have about 20 critical care docs so I deal with these issues.)
Then, once we have all of these new specialists what do we do with them when we dont have a pandemic surge? Who pays them?
” Long term effects are unknown. ”
What long term effects have we seen with other vaccines? What are you expecting?
jan- Looking at whether the vaccines work without comparing those who received the vaccine vs those who did not makes little sense. If the total number of cases/hospitalizations increase you would want to know how much that is due to each group. Did you actually read this?
Steve
https://khn.org/news/article/hospital-emergency-rooms-swamped-seriously-ill-non-covid-patients/
More and more the state of our hospitals are becoming destabilized by the downsizing of staff due to vaccine mandates, and the influx of seriously ill patients, not suffering from COVID, straining what staff is left. It is such an unnecessary medical dilemma that has been constructed around the hyper focus and downright lies feeding this mismanaged virus.
“CDC Director Rochelle Walensky — “The overwhelming number of deaths, over 75%, occurred in people who had at least four co-morbidities. So really these are people who were unwell to begin with.â€
Ya don’t say.
Dave –
By “herd immunity” what I was trying to convey is that the virus has become so prevalent that natural immunity will become more important than vaccines. Second, this mutation has now dumbed down the virus so much that it is on par with everyday colds and flues. And as the task at hand (cited earlier in this comment) has changed to revising covid mortality statistics down the cost benefit of all the public policy initiatives is going still deeper into doubt.
Politicians saw a crisis they couldn’t let go to waste. But now its hung around their necks.
jan- The article you cite says nothing about losing people due to mandates. It says they are quitting because they are burned out. Since you like stories here is one from a doc in rural Ohio. This also helps to address Andy’s question that I may not have addressed very well. In ordinary circumstances you offer more money if you have worker shortages. We are now offering staff $100-$200 EXTRA per hour to cover ICU. Still dont have enough people. Its the work and the burnout from dealing with the nasty people.
https://khn.org/news/article/hospital-emergency-rooms-swamped-seriously-ill-non-covid-patients/
Also, Beckers does the best job I can find tracking workers who left due to the vaccine requirements. At most places it is 1% or less. The highest I have seen was one place in LA at 5%.
“on par with everyday colds and flues. ”
It is less virulent than earlier covid but it is not the flu. Feel free to cite evidence about the number of deaths and hospitalization from prior flu or colds.
Steve