Previously published at GBH News.
Like most of us, I’m confused and concerned about the latest news regarding COVID-19 and the Delta variant.
Everyone in my immediate circle, including me, is fully vaccinated, healthy and, if no longer young, then not elderly yet, either. So I’m confident that if any of us got sick, we’d experience nothing more than mild symptoms.
But what about others? We all encounter people on a daily basis who can’t be vaccinated because they’re too young or have compromised immune systems. If we don’t mask up once again, are we all going to turn into carriers who fuel yet another surge of a disease that has killed 613,000 of our fellow Americans?
In addition, there’s the resentment we can’t help but feel toward those who resisted masking and are now resisting vaccines. Josh Marshall, writing at Talking Points Memo, put it this way: “Masking is coming back largely because of the actions of the unvaccinated and also largely for the benefit of the unvaccinated [Marshall’s emphasis]. The burden of non-vaccination is being placed on those who are vaccinated. That basic disconnect is our problem.
“That disconnect places no effective pressure on the voluntarily unvaccinated while sowing demoralization and frustration and contempt with public authorities among those who’ve gotten the vaccine,” he continued. “No good comes of that combination.”
So where does that leave us? More than anything, I think the media need to do a better job of communicating risk. Even with Delta, which is far more contagious than the original iteration of COVID-19, the vaccines are highly effective. No one died in the now-infamous Provincetown outbreak, and life there is already returning to normal. As President Joe Biden said recently, what we’re dealing with now is a “pandemic of the unvaccinated.”
There are all kinds of data that show Delta isn’t a problem for people who are vaccinated. For instance, Zeynep Tufekci of the University of North Carolina tweeted on Sunday that just 6,587 have been hospitalized among the 163 million people who’ve been vaccinated. That’s an almost unmeasurable 0.004%.
There’s good news on the vaccination front, too, as the number of people getting the shots has been rising since mid-July. Presumably there are several reasons for that, such as fear of Delta as well as a sudden burst of semi-responsible behavior by leading Republican officials and right-wing media figures. More good news: Walmart and Disney announced over the weekend that they’re going to require their employees to be vaccinated.
The Centers for Disease Control and Prevention hasn’t covered itself with glory, arguably sending the country into a panic over the Provincetown outbreak before all the data were in. But as scientists who are responsible for public health, they’re going to try to provide guidance in real time, and sometimes they’re going to get it wrong. Which means that the media need to do better by not obsessing over infinitesimal numbers.
“Scary, sensational headlines about P-town have sparked confusion this week, but the problem is much bigger than a single outbreak in a single town,” said Brian Stelter, the host of CNN’s “Reliable Sources,” in his Sunday commentary. “The problem starts with the CDC and its absolute failure to communicate clearly and effectively. Sloppy news coverage then makes a bad situation worse.”
As Stelter noted, COVID hospitalizations are up nationally because of the Delta variant. But they’re up far more in states with low vaccination rates like Louisiana than in states with high rates like Vermont. If you and your family have been fully vaccinated, the pandemic is largely over.
My attitude about COVID since the beginning of the pandemic has been to take it seriously and follow the guidelines and mandates, but not to exceed them. I taught two of my classes in person and took public transportation throughout — masked, of course. I was thrilled when the mask mandate was dropped, and I’m not eager to go back to it.
But I will if those are the rules. I’ve gone grocery shopping a couple of times during the past week, and I’ve pulled out my mask and put it on. I didn’t think it was necessary, but most of the other shoppers were wearing them, so I didn’t want to seem cavalier.
This week we’re going on vacation, and on our way home we’re going to visit my 92-year-old father-in-law in upstate New York. He’s fully vaxxed, but that presents a dilemma, doesn’t it? The vaccines simply don’t work as well among the elderly. Maybe we’ll mask up. Maybe it will be nice enough that we can sit outside.
The past 17 months have been a nightmare for the country and the world. Just a few weeks ago, it seemed like it might be over. It wasn’t.
But that doesn’t change the fundamental facts. We are in a far better place than we were during the height of the pandemic. Vaccines work. With some adjustments, life can return to normal. And the media need to report this ongoing story with context and nuance rather than sending everyone into a panic with each twist and turn.
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Without masks, if you are vaxxed your odds of getting covid from an unmasked infected person next to you are now about 1/12 with delta. Just a few months ago the odds were 1/25 or less.
Less than two months ago the odds that person would be infected were about 1/300 in Massachusetts (reflecting a test positivity rate of about 0.3%). Today they are around 1/100.
So two months ago your odds were 1/25 x 1/300 or 1 in 7500.
Today they are 1/12 x 1/100 or 1/1200… and even less favorable in many communities.
There are indeed many uncertainties. Your personal protection from being vaxxed could be greater. Ventilation counts. The test positivity rate in my community, Revere, was 1.6% last week, so 1/100, about the state average then, was about 1/70.
Vax makes another huge difference. With it, your case will be so mild most people won’t notice it. Of every 150 to 200 hospitalized, only 1 will have been vaxxed.
If no one wore a mask, today every 1 or 2 rush hour subway train trips would generate a new covid case and that infected person would infect 9 more on average.
So well argued and written.
My biggest concern is stopping transmission. Yes, those of us who are vaccinated and have healthy immune systems will get through a COVID-19 infection, even of the Delta variant, in much better shape than those who haven’t been vaccinated. But wide transmission itself leads to mutations, some of which may make COVID even less resistant to vaccines. We’re already hearing reports about the Delta Plus variant, although it’s not clear yet if it’s even more transmissible than Delta.
I’m very annoyed with my fellow Americans who have refused the shots heretofore, but unfortunately, the variants that we’re seeing arose in places where the shots weren’t/aren’t widely available, and social distancing was going to be difficult under the best of circumstances. I’m not excusing Narendra Modi or Jair Bolsonaro — they took a bad set of circumstances and made the worst possible decisions — but there was probably a limit to what even competent leaders could have done.
Since vaccines seem to be in limited supply, how about we give all of the vaccines that Americans are refusing to the densely populated countries who would like to have them and maybe avoid the evolution of the Epsilon, Zeta, Eta, Theta et al variants while we can?
What I don’t see, and want to see, is quantification of what the risks of severe breakthrough disease in the elderly and those with comorbidities is, particularly with delta in the mix.
I’m healthy and under sixty-five. My three close contacts are my parents, in their nineties, and my partner, over 65 and with a number of health issues that make him vulnerable. I don’t want to silently spread delta to *any* of them.
So the articles that reassuringly mention that the few vaccinated people who got severe disease in the Provincetown outbreak also had comorbidities — aren’t reassuring.
I share your concerns. I think Dan here pointed out — which was important — that the media overemphasized a fear, not based on solid data, that vaccinated people might be JUST as likely as unvaccinated people to spread the virus. We had believed before last week that it’s not even close, by a mile. The media, based on CDC’s understandable concern about a small data set, gave us the impression that there might not be any difference in who spreads it. As Dan points out, it turns out that that’s not the case. (If I understand it correctly!)
When CDC asked me to get involved with covid (in Jan 2020 to help “scale” Chinese mortality data in older patients to USA populations with different health norms), I snidely complained to my daughter (who is a celebrated epidemiologist) about how fuzzy the data was. “Welcome to my world,” she replied. Epidemiologists combine good statistical skills with deep knowledge of how previous epidemics progressed.
I’m a pretty good statistician, but I have become particularly adept at Bayesian methods (hence the odds statements in my first comment). Few in medical fields work with Bayesians because sample sizes are small and because FDA generally does not allow Bayesian analysis for regulatory work. CDC found me because I’m evidently the last living person among the folks that developed indoor air pollution tests with regard to cigarette smoke 40 years ago.
So… CDC does and has done amazing work on covid. Back last fall, it predicted that vaccines might not provide full protection against spreading the disease because respiratory disease viruses can usually be found in nose and throat, where antibodies cannot easily attack them. Hence masks!
Researchers certainly found a bit of spread that way, but until delta (which upped the nose load by a factor of as much as 1000!) it was not too bad.
Well, how does CDC know now? In Provincetown, 60,000 showed up for July 4 weekend. A covid cluster was quickly noticed, because we live in a state that notices these things. When CDC saw the first data (the original cases and early spread numbered about 400), they took special interest. The original cases have now produced more… have spread to about 1000 and growing. How do we know? We live in a state that tries to trace cases. It notices these things. Hats off to Massachusetts and to all of New England. It’s as good as it gets. But if you want perfection, only God, if she or they exists, can provide it.
“the media need to cover it with context and nuance”
I totally agree. Unfortunately, half the public will not understand the context and nuance.