Better in their words…

Before there was a COVID-19 vaccine, it was reasonable to try to delay the time until you met the virus. All things being equal, for most adults, you will do much better meeting COVID-19 after vaccination then before.

This logic applies foremost to the elderly. But it is unclear if it applies to children. That’s another reason why schools should never have closed, as some of us forcefully argued. The vast majority of children in the United States eventually got covid prior to vaccination anyway. They might as well have learned something along the way.

Once you have offered a vaccine, and one year, 2 years pass, trying to delay meeting the virus is silly. This isn’t a sexually transmitted disease, nor Ebola, it’s a highly transmissible respiratory virus. You will not be able to avoid it forever. Getting it in November 2023 rather than December 2022 is a pointless distinction. You’re just a little older.

And yet, many people are chasing this delusion. They’re using tests, masks, and otherwise being a general buzz kill, to delay the time until they get COVID-19.

Right off the bat: their goal is illogical. Nothing will be substantively different when they get it a few months from now anyway. They won’t be able to delay much more than that, even with the most draconian interventions.

The second thing that’s illogical is that some of what they’re doing will actually delay the time to covid: like sitting in your house all day like a recluse. But some of what they’re doing will not delay the time. Mask wearing is one of those things. Testing is another.

The reason the pre-pandemic consensus was not to advise the community to mask was because it was not shown to reduce the acquisition of respiratory viruses in 14 randomized control trials. The data were remarkably negative. This might be due to the quality of the mask, but it also might be due to the compliance of the individual. But one thing is clear, current compliance is atrocious. Nearly no one is wearing it correctly. The chance it works is even less than the trials.

Even the most ardent and passionate mask people have gaps at the bridge of their nose. But their greater failure is that they’re not able to wear it all the time. No one can.

Recently representitive Katie Porter fired a staff member for giving her COVID. This is a shameful stain on her legacy. Punishing a human being for spreading a highly transmissible respiratory virus reflects a poor sense of ethics, and a poor understanding of science.

What about immunocompromised people?

The first thing to be said is many people self-identify immunocompromised, but they do not have conditions that actually increase the risk of bad COVID outcomes. They are living in a semi-delusion, with a false understanding of their risk.

Second thing to be said is some people have a transient, immunocompromised condition. Such as people in the throws of a bone marrow transplant. These people should take severe precautions, but understand that these are time limited. Something will change. Their immune system will come in, and then they can relax precautions.

Third thing that has to be said is that some people have a sustained immunocompromised condition. These people have to make peace. Have to decide how they want to live the rest of their lives. The truth is most of these people have already returned to normal.

The group of people who are most resistant to returning to normal are politically left of center, healthy young people, who may be suffering from an inaccurate understanding of the virus, in some cases complicated by untreated depression or anxiety.

They foolishly use moral language to justify their position, rather than articulate a sensible rationale for it. That’s unfortunate.

Thankfully, their influence on other people has waned. But not fully. Their delusion has still resulted in masking children in philadelphia. It also makes working in a hospital miserable. Hospitals continue to have a useless mass policy.

Just consider one fact: for 3 years there have been zero randomized trials testing what we’re doing inside of hospitals. It’s easy to set policy, it’s hard to actually understand if what you’re doing is benefiting anybody.

At the current moment it is likely that the policy is harming people who are hard of hearing, who want to interact with their provider, and harming the culture of medicine. Education, and in-person events is in decline. Practicing medicine is less joyous than it was before. Being told to wear a useless mask after everyone has already had COVID is part of the problem.

Some argue that masks should continue for RSV or flu. They have forgotten that we have run studies on these topics, and they were negative.

Long pandemic, living in the shadow of something that’s over, is an ongoing threat to rationality and evidence everywhere. Some point to sustained COVID-19 deaths, but this is incorrect. No one is hospitalized with ARDS anymore, deaths are largely incidental. The pandemic is over. Some people are still fighting the last war. For the losing side.