Personal responsibility, respect for others and common sense driven by good science are the keys to managing the pandemic. These simple facts can be lost on Americans who like to take pills, blame others for their misfortunes and negligence (and sue them), and believe that they can be exempt from manifest health risks (smoking, driving drunk, not wearing seat belts, gorging on high fat and caloric foods, contracting COVID-19).
The public health implications of selfish, reckless and personally irresponsible behaviors have been linked to coronavirus outbreaks at fraternity and community parties in college communities. Asymptomatic COVID-19, representing at least 40 percent of cases, is a silent agent, afflicting a local hockey team in Florida, a choir in Washington State and family gatherings all over the country. Even the most regulated presidential settings have spawned COVID-19 infestations among the most prominent national officials.
The calculus about COVID-19 is: Time spent in proximity to population congestion. The more people in a group, the closer they are together, for a longer period of time, the greater the likelihood that somebody in that group will be COVID-19 positive, likely not knowing it. Rallies, particularly those currently hosted and encouraged, are places where hundreds jam together, screaming, shouting, singing, coughing, sneezing and often hugging — projecting, through their excited utterances both droplet nuclei and vaporized particles that can travel 12 feet and hang in the air for many minutes and hours, and remain viable on surfaces for days. So touching objects or other people, and then touching one’s eyes, nose, mouth — or somebody else’s, is a connection to COVID-19.
For somebody who has already ostensibly contracted COVID-19 (and is responsible for the spread to his family and closest associates), the relative risk may appear (for him) to be negligible, especially since he disputes much of the clinical truth about the disease. But for those who assemble at the rallies, and for those who organize and staff them, and for those who feel compelled to appear openly and notoriously exempt from its effects while posing on stage, and for those to whom the rally goers return home — the calculus and science are not ambiguous. Ignoring fundamental, common sense, public health practices — and encouraging others to do so, given the science and medicine we know – which is being reinforced daily, is the emperor without clothes taunting naïve, trusting others to strip naked as well to please the court.
Here’s a stark fact. More than 220,000 have died of COVID-19 already, and the number of infections is starting to spike again — not fall. This pandemic is far from over.
There are very substantive economic policy and public health policy issues that converge — but they also diverge. We cannot afford to close our communities down again, because too many people will permanently lose their jobs, their businesses, their marriages and their families. We cannot afford not to be transparent and truthful about the science, because people will get sick and many more will die from COVID-19. We do not have a vaccine (and when we do, it will take may months to vaccinate 50 to 70 percent of the population). We do not have a routine treatment — though we have gotten much better at mitigating severe outcomes and death. And we don’t know if having the disease or getting a vaccine will confer immunity, or for how long.
In the meantime, part of the rally cry consists of categorical phantasms about letting the disease just spread to 20 percent of the population to create herd immunity. That policy advice is egregiously, medically irresponsible. Listening to this blabber only produces “heard” immunity — not “herd” immunity. Politicizing science and medicine is irresponsible.
We now know that some percentage of all people who get the disease — including those who are asymptomatic — will get a new disease they never had for the rest of their lives — a new cardiovascular, renal, respiratory or brain disease that will be a huge residual of the acute pandemic. It is the post-acute chronic syndrome diseases, including “long-hauler” cases of people not being able to shake the symptoms of their COVID-19 episode.
Rallies, as they are being held, are breeding grounds for COVID-19 transmission.
The public health implications of the rallies and officials who participate are sad reflections of a society that has lost its sense of personal and community responsibility. But these are unfortunate reflections of a nation with health status indicators shocking below those of most other countries. We have become lazy, obese, and irresponsible, expecting others to fix things in our lives when they go wrong. We have rights — but they come with collateral responsibilities.
If we are our brother’s keeper, then we should stop behaving like Cain. It is time to leave the New Egypt, find our way out of DeNile, and bring transparent good science, good medicine and informed public policy into the war on COVID-19.
Jay Wolfson is Distinguished Service Professor in Public Health, Medicine and Pharmacy, Senior Associate Dean in the Morsani College of Medicine at the University of South Florida and Associate Vice President in Health Law, Policy and Safety.