Strange but true: A consensus is congealing among the medical mainstays of cable news that we should start rolling back COVID rules quickly. The expert class is typically cautious to a fault, but in the last 36 hours I’ve seen three separate nationally known MDs push public officials to dispense with the mandates they instituted to try to control Omicron.
Even stranger is that they’re making that push while headlines like this are circulating on the wires:
We haven’t had many “EXPERTS SAY ‘LET IT RIP’ AS DEATHS SURGE” news cycles during the pandemic.
What gives? Dr. Leana Wen, a CNN contributor, explained in an op-ed today for WaPo. In an era of extreme pandemic fatigue, knowing that there are new waves (and variants?) yet to come, we have to pick our spots when urging people to take precautions. Leave mask mandates and social distancing rules in place when cases are low and the public will learn to ignore them, convinced that officials are stuck in a perpetual state of emergency irrespective of the threat level. But relax the rules quickly when cases abate and maybe Americans will pay attention the next time they’re tightened again.
The elite “forever pandemic” mentality is destined to breed “done with COVID” complacency in the average joe, in other words, to the extent it hasn’t already. Wen wants to meet in the middle, nudging rulemakers to switch to a “done with COVID (for now)” posture as case counts warrant.
The most important step is to have a quick off-ramp for masking. While many people do not see masking as a major inconvenience, plenty see it as a symbol of the pandemic. Mandatory masking, especially in schools, has engendered major opposition, and a reasoned conversation about when to lift mask requirements is overdue…
Along with mandatory masking, other precautions should also go, including venue capacity limits and pre-departure testing for international travel. The one pandemic restriction I wouldn’t change is the vaccine requirement. In fact, I’d encourage municipalities, businesses and the federal government to embrace it even more…
To be sure, I am not advising that we throw all caution out the window. There will be many who cannot let their guard down, including the immunocompromised and parents of young children. They will still choose to be careful and voluntarily limit their activities. The Biden administration needs to speed up anti-viral treatments and expedite authorization of pediatric vaccines. They should closely monitor when additional boosters are needed and provide free testing and high-quality masks to those who want them.
But it’s time to allow — even encourage — most Americans to enjoy their “hot vax spring.” An effective public-health response depends on knowing when to end a state of emergency. Vaccinated people should enjoy the months ahead and appreciate this period of relative calm while we can, before another variant threatens to upend our lives again.
She says she’s even coming around to the position that masks should remain optional regardless of how much transmission is happening locally. If your community is being overrun by a highly contagious but not terribly lethal variant like Omicron, masking requirements should depend on hospital capacity, not cases. So long as hospitals aren’t strained, the masks can remain a matter of choice.
And meanwhile we should vaccinate as many people as possible, as that’s the best defense against the sort of severe illness that sends people to the ER. “The vaccinated, who have done everything right, should not have any restrictions placed on them; it’s not fair to them and it disincentivizes vaccination,” Wen concludes.
Dr. Ashish Jha isn’t as keen as Wen to drop all restrictions immediately but he agrees with her that they should go soon, and for the same reason:
Why be judicious with mandates?
Because over time, effectiveness of mandates wane
People tire of them
Key is to communicate:
During periods of low infections, restrictions come off
During potential future surges, public health measures may need to temporarily return
— Ashish K. Jha, MD, MPH (@ashishkjha) February 1, 2022
Dr. Scott Gottlieb is simpatico as well:
"Society isn't going to tolerate these things in perpetuity. The mitigation we've adopted has to be used to deal with epidemic peaks, not be a constant way of life," says @ScottGottliebMD. "We are going to have to be willing to withdraw these mitigations." pic.twitter.com/Ddyn16dRK6
— Squawk Box (@SquawkCNBC) January 31, 2022
Why are so many doctors thinking about this? Because, even though daily deaths are averaging north of 2,500 a day, deaths are a lagging indicator vis-a-vis cases. And cases have dropped steeply in America’s hot spots, in keeping with the rapid decline South Africa saw with its own Omicron wave. New York City:
Cases nationally are following the same trajectory. Today the average is at its lowest point in nearly a month. A fine time to ease off restrictions!
Just one question. Is there any reason to believe Wen, Jha, and Gottlieb are right in thinking that the public is still responding to cues from officials in the form of COVID guidance? Why should we assume that dropping mask mandates now will make people any more willing to comply later if a new variant comes along that threatens another surge? I think it’s a well-meaning fantasy on their part. It’s rational as far as it goes, the same way it was rational for the feds to eventually abandon the color-coded terrorism alert system they instituted during the early days of the post-9/11 period. Because the alert level was almost always set to “orange” (the second-highest level), Americans began treating that as normal; that desensitized them to the threat and may have led them to tune out during periods when special vigilance really was required. Lazily leaving mask mandates in place indefinitely causes the same problem. If you want people to be extra vigilant at certain times, you need to encourage them to be less vigilant at other times.
The difference between the terror alert system and COVID restrictions, though, is that we’re experiencing a 9/11 every day lately. Even during a “good” stretch of the pandemic, when deaths have dropped, we’re enduring a 9/11 each week. In an environment like that, people will arrive at the conclusion that there’s no way to stop the “terrorists” no matter how vigilant you are and so you might as well go about your business and hope you’re not a casualty.
Here’s Wen nudging CNN viewers yesterday to enjoy the coming period of COVID quiescence while it lasts.
We could be in for a much better spring and summer ahead. This is the time to prepare for what could come next (including threat of new variants)—while lifting restrictions and helping vaccinated/boosted Americans gauge their risks & encouraging return to pre-pandemic normal. pic.twitter.com/kboGsgtUMZ
— Leana Wen, M.D. (@DrLeanaWen) January 31, 2022