As the latest coronavirus surge worsens, public health efforts to quell the pandemic are targeting two groups that might be dubbed the can’t-s and won’t-s.
Federal regulators sought to assist the first group by approving coronavirus vaccination booster shots for a select group of patients — those whose compromised immune systems could not generate sufficient protection with standard shot regimens.
Experts say that individuals who have undergone organ transplants or who may be undergoing cancer treatments or otherwise have low immune systems may benefit from the booster shots.
For most people, the existing two shots for the Pfizer and Moderna vaccines and the one shot for the Johnson and Johnson product have shown to provide significant protection against serious illness or death caused by the coronavirus, officials say.
The existing vaccines also appear to be effective against coronavirus mutations, including the current, highly contagious Delta variant.
Health officials and the vaccine makers continue to study whether the existing vaccines offer sustained protection, particularly against rising variants, for periods exceeding six months. For now, federal regulators have approved and recommend boosters only for the immunocompromised.
A threat to public health by the resistant
The greater risk, however, to the public’s well-being and the battle to quash the pandemic rests with individuals and groups that will not get vaccinated or cover their faces, experts say. The relentless politicization of public health measures, particularly in the South and Midwest, has led to paltry vaccination rates and virulent opposition to face masking — as well as giant spikes in coronavirus infections and hospitalizations.
The governors of Florida and Texas have been most outspoken in their criticism of common-sense efforts to battle the coronavirus, assailing federal and local officials who have pushed for vaccine and mask mandates. At the same time, the White House reported on Aug. 12:
“In the past week, Florida has had more Covid cases than all 30 states with the lowest case rates combined. And Florida and Texas alone have accounted for nearly 40% of new hospitalizations across the country.”
To be clear, the pandemic now has surged anew across the country (see New York Times “hot spots” map, above), with not only Texas and Florida hard hit, but Louisiana, Mississippi, Arkansas, Alabama, South Carolina, and Tennessee struggling mightily.
Louisiana officials have warned the state’s health system is on the verge of failure, overwhelmed by coronavirus cases. Mississippi officials similarly say their health system is on the verge of collapse, and they have begged for federal assistance. Arkansas and Florida both have set records for hospitalizations of coronavirus patients. Despite its high vaccination rates, Oregon has seen a surprising surge of virus cases, worrisome enough that the governor has ordered indoor face mask rules and sent National Guard troops to assist in hospitals.
Texas, even as its governor fights against public health measures to battle the coronavirus, has appealed to health workers from outside the state to work in hospitals dealing with pandemic-related, dire staffing shortages in the Lone Star state. Indeed, as the pandemic grinds on, exhausted health staff willing to continue their courageous toil — especially when taunted by anti-science extremists — are growing scarcer in bigger parts of the country, as the Washington Post reported:
“According to hospital executives and nursing administrators in several states, the struggle to find enough workers to care for people sick with covid-19 has emerged as a critical problem as other daunting shortages, widespread early in the pandemic, have eased. Once-scarce supplies of protective gear, ventilators and coronavirus tests are now plentiful, hospital officials consistently say. Finding ways to hire and keep nurses is the main problem, officials say, although some hospitals also are short on respiratory therapists and workers for nutritional services and housekeeping. Some hospitals could enlarge their bed capacity if they had more nurses to tend to the coronavirus patients who would fill them. The shortages are starting to interfere with other types of care. The disruptions are not as pronounced as during the pandemic’s early months, when hospitals routinely canceled elective procedures and other patients stayed away from needed treatment for fear of contracting the virus. Still, certain hospitals in the hottest of hot spots, such as the medical centers run by Memorial, are slowing other types of care so they can redeploy staff.”
Experts long have warned that the unvaccinated and those opposing public health measures heighten the risk for all, not only in fostering the spread and contraction of the coronavirus and threatening to cause huge problems for health systems. As long as the pandemic rages, the risks increase sharply that the virus continues to mutate, including with variants, like Delta, that pose new challenges — and that may overrun the strong protections offered by existing vaccines.
Mandates and political push-back to extremists
To combat the latest coronavirus surge, requirements for coronavirus vaccinations, face masking, distancing and other public health measures have gone up with increasing frequency and intensity by state and local governments, colleges and universities, school districts (notably for teachers and staff in the second- and third-largest public systems in Los Angeles and Chicago), businesses, and arts and cultural institutions.
Vaccination rates are slowly increasing after a summer stall, with rising numbers of people in hard-hit states apparently now seeing the advantages in getting the shots. And, after declining for a period, the popularity and usage of crucial testing for the coronavirus has risen anew with the Delta variant surge.
The legal and political push-back also is rising against leaders who argue against public health measures to quell the pandemic. Justice Amy Coney Barrett declined on behalf of the U.S. Supreme Court an emergency appeal by Indiana University students of lower court rulings upholding the state university’s vaccine requirements. Courts in Florida have taken up and in Texas have rejected governors’ executive orders barring school districts and local governments from imposing public health measures like face mask mandates.
As then-Gen. Colin Powell observed of ill-fated U.S. military interventions overseas, if you break it you own it. Will the “Pottery Barn rule” have consequences for politicians, notably those of the GOP stripe, taking extreme positions on public health policies to deal with the coronavirus?
In my practice, I see not only the harms that patients suffer while seeking medical services, but also the damages that can be inflicted on them by an array of awful circumstances and things, including:
In these cases, a crowd of problem people and institutions — these can include doctors, hospitals, insurers, regulators, and politicians — may press victims to move on, settle up, and they fast forget the lonely agony of the suffering. It can, however, take a long time for patients to recover from terrible illness or injury. Harms can last a lifetime. Patients may need medical services, as well as financial and other support for months or years. They also need closure and justice for wrongs done, as well as the sense that they may be able to help others avoid the problems that afflicted them.
We are not done with the coronavirus and the huge trauma it has inflicted on us all. In the U.S. alone: at least 620,000 deaths and 37 million infections. The country got to savor this summer, even briefly, what the world might be like with this nightmare quelled more and greater normality restored. Please get vaccinated. Officials are trying to make it as easy and convenient, as possible — and it’s free. All medical interventions carry risk. But vaccines’ benefits long have been shown to far outweigh their harms.
