I’ve been reading some articles lately and thinking, oh my god yes, finally someone is saying what I’ve been thinking.
The thing is, they are saying things that I think a lot of us have been thinking, but we’ve been too afraid to mention them, lest we be cast down by the social media powers that be for being stupid or callous or uncaring or selfish or… well you know can probably guess where this is going.
I’ve been wondering if, when and how we’d ever revisit mask mandates at school. Then I read The Case Against Masking Kids in School in The Atlantic:
Many public-health experts maintain that masks worn correctly are essential to reducing the spread of COVID-19. However, there’s reason to doubt that kids can pull off mask-wearing “correctly.” We reviewed a variety of studies—some conducted by the CDC itself, some cited by the CDC as evidence of masking effectiveness in a school setting, and others touted by media to the same end—to try to find evidence that would justify the CDC’s no-end-in-sight mask guidance for the very-low-risk pediatric population, particularly post-vaccination. We came up empty-handed.
…
Therefore, the overall takeaway from these studies—that schools with mask mandates have lower COVID-19 transmission rates than schools without mask mandates—is not justified by the data that have been gathered. In two of these studies, this conclusion is undercut by the fact that background vaccination rates, both of staff and of the surrounding community, were not controlled for or taken into consideration. At the time these studies were conducted, when breakthrough infections were much less common, this was a hugely important confounding variable undermining the CDC’s conclusions that masks in schools provide a concrete benefit in controlling COVID-19 spread: Communities with higher vaccination rates had less COVID-19 transmission everywhere, including in schools, and those same communities were more likely to have mask mandates.
I have to admit, while I knew that masks were not required in school in Britain (for students under 12), I did not realize they were also not required in many other European countries. I also did not know that there was so little conclusive evidence that masking in schools significantly reduces rates of community spread.
I have been very thankful that I live in a state where mandated masking in public spaces, as well as in schools, has been part of the public health response from day one. I felt much safer (finally!) returning to in person learning in the fall knowing that my students and colleagues, as well as my kids and their peers, would be masked. But I have to admit I don’t have faith in our ability to follow the science and put an end to masking in schools at an appropriate time.
When I run in a huge open park near my house most of the people that pass me are masked, even though no person or group is anyone near anyone in this huge open space for more than the few seconds it takes to pass someone on the (very wide) ample path. We are clearly wearing masks in San Francisco for reasons other than protecting the health and safety of ourselves and others. The fact that we’ve spent the last year deriding the governors of Republican states like Florida and Texas for banning mask mandates in school (which to be clear, I view as dangerous public health policy), leads me to believe it will be very hard for us to separate mask wearing in classrooms with our political identities as public health-minded progressives. I just don’t think we’re going to be able to make a rational decision about this for a long time.
Which brings me to this episode of NYT’s The Daily from last week, that aimed to be “a statistically sound effort to take the temperature of the American public on exactly how it’s thinking about Covid at this moment that might or might not be a pivot in the pandemic.” The overall argument of the episode was that “when you look at all this, what you end up seeing is that people’s attitudes toward risk doesn’t seem to be driven by rational thought or scientific evidence, so much as it seems to be driven by political belief.”
An exchange from the episode:
Michael Barbaro: Right. What’s interesting about what you’re saying, David, is that it’s not only showing that partisanship is dictating whether people get vaccinated, which I think we did know. It’s also showing that even those who do get vaccinated, who do believe the science that shows vaccines are protective, are still having a pretty high level of fear that suggests they actually don’t really feel protected. And that’s counterintuitive.
David Leonhardt: That’s right. So if you believe the science, you should go get the vaccine, because all the science says the vaccines are very safe and very effective at preventing serious Covid illness. But let’s focus on that second beat just for a second. The science says vaccines are very effective at preventing serious Covid illness. So if you believe the science, it doesn’t argue only for getting vaccinated. It also argues for living your life in a way that reflects that you’ve been vaccinated.
I understand that we’re only just starting to come out of the omicron wave (in some parts of the country), which has put huge strains on hospitals health care professionals. Obviously the most important thing that people need to be doing right now is getting vaccinated and boosted. I do think there were moments in the episode when they put the ideas of “Republicans aren’t getting vaccinated” and “Democrats aren’t acting like they are vaccinated” next to each other like each side was complicit in the same degree of “not following the science.” That is a false equivalency that wasn’t stated but implied, and I think it should have been clarified. The US has a far higher death toll than any other large, wealthy nation precisely because we have so many un- or under-vaccinated people, especially older people who are at high-risk for getting seriously ill or dying from Covid. The unvaccinated are straining our health care system and endangering the lives of others who need medical care for unrelated reasons. They are prolonging the pandemic by keeping hospitalization and death rates high.
But ultimately the vaccinated might prolong the pandemic in their own ways, by pushing for policies that aim to reduce the risk of transmission without taking into account the negative affects to our health and well-being those policies present.
And I think this is very important to emphasize. The steps we have taken to minimize the spread of Covid had big benefits. They saved a huge number of lives. But they also have had enormous costs. And by almost any measure, American society just isn’t functioning very well right now. Violent crime has soared and it started soaring shortly after the pandemic began.
There was just this interesting study out that showed Americans’ blood pressure had gone up. Many people have just been working from their homes. Mental health problems have gone up. Drug overdoses have soared. And so the idea that we’ve all isolated ourselves and we’ve sublimated these normal human interactions, that has had huge costs. And so I think the thing we need to grapple with is at what point do the costs of pandemic precautions outweigh the benefits?
And then, of course, there are school closures and the untold ways they have harmed children. I absolutely believe that we kept kids at home for WAY too long in California, and especially in the Bay Area. We were not following the science, but instead were following our fear, and our children paid dearly for it. I don’t think we’re truly willing to be honest with ourselves about what a huge policy failure it was for students to be in remote learning for 15 months. And if we aren’t willing to admit to our mistakes, we certainly can’t learn from them.
And we need to learn from them, because things aren’t going to get better for a long time. At least, the decisions aren’t going to get easier. Another article from The Atlantic, helped me to understand how messy and unsatisfying the definition of endemicity is. That ultimately it means nothing, and “achieving it” will never be something experts agree has happened, nor will it matter much even if they do, because “reaching endemicity” doesn’t actually help us understand what our future with the novel coronavirus might hold.
Endemicity, then, just identifies a pathogen that’s fixed itself in our population so stubbornly that we cease to be seriously perturbed by it. We tolerate it. Even catastrophically prevalent and deadly diseases can be endemic, as long as the crisis they cause feels constant and acceptable to whoever’s thinking to ask. In a rosy scenario, reasonably high levels of population immunity could bring the virus to heel, and keep it there; its toll would be roughly on par with the flu’s. As coronavirus cases drop from their Omicron highs in the United States and other countries, there’s at least some reason to hope things are bending in that direction. But at its worst, endemicity could lock us into a state of disease transmission that is perhaps as high as some stretches of the pandemic have been—and stays that way.
If the end game of this pandemic is us figuring out how to live with Covid – how to live with the risks of Covid that will always be somewhat unknown – then we have a lot of work to do in figuring out how we’re going to assess risk and live with this. If omicron presents as much, or less, risk to me (as a double vaxxed and booster adult with no underlying conditions) than the flu or an auto accident, does it really makes sense for me to continue avoiding all the things I’ve been avoiding not to catch it? Yes, I understand that we can’t all get sick at the same time; society will come to a screeching halt if there aren’t enough “essential” workers showing up at their jobs. But once the case numbers come down and we don’t have to be so worried about too many people calling in sick for society to function, does it make sense to maintain all these safety measures? And if so, for how long? If endemicity doesn’t guarantee anything, at what point do we start living with the risk? Because it seems like we could be stuck in this limbo for many more years to come.
I’m sure this post will be unpopular. I remember being called “Trumpian” back when I balked at the closure of open park spaces early in the pandemic, so I can only imagine how poorly this post will be received. And I’m sure I did a piss poor job of saying most of this, and that the parts of the articles I picked are lacking in some way. I want to say more but it’s late and I know if I don’t just publish this it will never go up. And I want it to go up because I think we need to start talking about this stuff. So many of us are so unhappy. We talk about burnout and chronic stress and depression and the terrible weight of “no end in sight,” but we aren’t willing to talk about how our current pandemic response is contributing to, or causing, how horrible we feel. We tell ourselves it’s okay to feel hopeless because it has to be, but maybe it doesn’t have to be anymore. Or at least maybe it doesn’t have to be, soon.
I just think we need to start talking, and thinking, about an off ramp. It’s going to be a long time before public health policies change (at least where I live). Maybe if we start the conversation now, we’ll be ready to accept those changes, even embrace them, when they happen. Maybe we’ll even be thankful that they’ve finally been made. Maybe if we start changing lanes now, slowly and with caution, we’ll be ready to approach the off ramp when it’s finally revealed.
