Looking back with perfect 20/20 hindsight, what did the US and other countries do right and wrong with regards to COVID?
Just to kick it off, it seems to me that we should have restricted international travel earlier. Also, the restrictions on outdoor exercise may have been counterproductive as the virus is more likely to spread inside than out.
On the other hand, bans on large events like sports and political rallies probably saved many lives.
Thoughts?
I’d say that oddly enough, the fact that influenza rates during the pandemic plummeted means that measures like social distancing and masking definitely work for preventing the spread of respiratory viruses. In other words, the anti-COVID measures worked like gangbusters against influenza because it’s not quite so virulent as COVID.
Of course, that wasn’t quite so apparent when looking at COVID rates, because of the differences in incubation times, transmissibility, etc…
I wish they’d figured out that it was essentially not transmissible outdoors earlier, and that you had to spend some minimum time in proximity with an infected person to get enough of a viral load to become infected. That would have alleviated a lot of paranoia- “are we going to get it through the drive-through at KFC?” type nonsense. And it would have allowed people to safely do things like go to church outside, attend sports events, and so on, without so much uncertainty and fear.
I sort of feel like the first phase of the pandemic was the FUD phase, the second phase was the “living with it” phase (meaning you masked up, and otherwise did your thing), and the third phase was the “Is it over? Do I still need to wear a mask?” phase.
…looking back at the New Zealand pandemic response: I wouldn’t have changed a thing. It was the right combination of exceptional leadership from both Prime Minister Ardern and our Director General of Health Sir Ashley Bloomfield, clear public health messaging, and the elimination strategy that remained in place until the vaccine rollout was over.
I’m under zero illusion that this exact same plan could have been implemented anywhere else. And if we were hit by another pandemic, the way that our society has been broken by the relentless waves of disinformation that I don’t think we could do it again.
But there isn’t anything I’d really change in what we did. Happy to elaborate if you have any specific questions, and if I’ve got the time.
Yeah, you had unusual circumstances, but you handled them nearly perfectly. the US never had a chance to keep covid out, even for a time. I think we (the US) should have:
Had clearer, more nuanced, and more humble official communications. (“we don’t know” is sometimes the correct answer.)
Pushed harder for people to mask, rather than encouraging “distancing”. For that matter, we should never have pushed the false narrative that 3 feet, or 6 feet, or some other magic distance would protect us. That’s not how air (and things carried by air) works.
Pushed harder for better ventilation in public spaces. This is something we are still not doing.
Opened the schools much sooner, with masks and ventilation in place.
I think this is related to my biggest suggestion: We should have been more aggressive in teaching people why measures were being used early on, that didn’t need to be used later on. Make it clear from the beginning that mitigation efforts are aiming at a moving target, and we expect things to change as we learn more.
When this first started, we had no idea how it actually spread, and so we were much more restrictive in what we were doing. Masks, avoiding public places, social distancing, hand sanitizing, frequent cleaning of all surfaces that people touch, transparent barriers for cashiers, all that. This was covering all the ways a disease could, potentially, be transmitted.
But we eventually figured out that certain types of transmission were not occurring, so things like cleaning every surface, hand sanitizing, and avoiding outdoor gatherings were not strictly necessary.
We didn’t communicate this very well, so lots of people kept doing things they didn’t need to do for far longer than they should have, while others gave up on all measures because “The rules are always changing!”
There’s not much we could have done about the politically motivated anti-science attitudes that were so common, but we could have maybe alleviated at least some of the honest confusion.
I’ll be completely honest and say that even knowing it was a moving target, it was still very frustrating. Part of the problem wasn’t so much that the guidance was unclear, it was that it wasn’t backed up with anything that would allow you to actually make informed decisions.
For example, in the late summer, early Fall of 2020 it seemed like we had guidance about masks, etc… but they were always “IF you are doing X, Y, and Z”, then wear a mask, stay six feet apart, etc… But no actual guidance about whether it was even wise to do X, Y or Z in the first place, even with the precautions. Not even anything local case-rate related.
I mean, there were a LOT of paranoid people right up until spring of last year, who probably had no real reason to be so paranoid because they were vaccinated and boosted. But they were still wearing masks, avoiding restaurants, and so forth, because there was no guidance about how risky it actually was, just what the prevention measures were.
I think that’s because a lot of people in our society are just so math-phobic that if you started talking percentages, the reception would have been even worse.
“They said I was only 50% likely to get COVID at the pub! So why am I sick now?!?” “How did I get my mom sick? There was only an 80% chance I was infectious!”
That, and lots of people were just opposed to making any sacrifices. Okay, sure, go the pub, but accept that this means you shouldn’t visit you mom afterwards.
People wanted certainty in an inherently uncertain situation.
Heh. I’m still wearing masks and avoiding restaurants. The risk is certainly less now than it was, but my friends my age who’ve had covid have been pretty damn sick.
I think a lot of it has to do with whether or not someone is looking to “get back to normal”. The virus is with us to stay, and AFAIK, it’s not going to get any better than it already is.
So it comes down at this point to what your baseline COVID fear level is; are you willing to engage in these preventative measures indefinitely? When are the cutoffs?
I’m guessing that COVID is going to be very similar to the flu in the way it’s reported- some science wonk websites will have all the data, the public authorities will have some less than helpful public information published, and occasionally if the community rates are particularly high, it’ll end up in the media as a sort of PSA/curiosity. I was thinking about this the other day; now that the effectiveness of at least the N95 masks is well demonstrated, what would be the point to start wearing them to avoid catching the flu? I realized that it’s not at all clear or well communicated from the public health authorities how the flu season is going, and at which point masking makes sense, vs. being an unnecessary annoyance.
Same goes for COVID- now that the pandemic is effectively over in the US, what are the guidelines going forward? At what case count should we mask up/take off our masks? And so forth… it’s almost like everyone’s pretending it’s something that happened in a discrete sense, instead of being something that’s now endemic.
In particular here in the United States we were getting some mixed messages. You weren’t supposed to go to a picnic or to the beach but it was perfectly safe to go to a protest. While I realize the protests were important, combined with some prominent politicians like Gavin Newsom throwing an outdoor party for his friends it sent the message that the decision discourage outdoor activities was arbitrary.
This post is a good example of why it was difficult to provide guidance at any level.
Nobody ever said it was “perfectly safe” to go to a protest. For some protests, large spikes in cases were expected - which did not materialize. Risk mitigation advice was given (try to distance, mask up, etc) but case spikes were still expected.
Based on what actually happened (some extra cases but not a large spike), the body of knowledge was extended and we developed a better idea of how it spread. It helped that many of the protests involved people more apt to follow that guidance. That’s opposed to outdoor events like Sturgis, where the attendees largely eschewed such measures, and large spikes did materialize.
So even here we have an example where what people hear/remember and what guidance was actually provided are totally at odds. And that’s even with the benefit of hindsight.
See, that’s a good example of what I meant about the math-phobia.
None of these options were “perfectly safe”. But they weren’t guaranteed dangerous, either. So it becomes a question of, “Is the risk worth it?”
Problem is, very few people want to make that calculation. They’d rather be given a checklist, or just be told to do whatever they want.
You’re right, nobody said it was perfectly safe and I suppose this is my fault. I didn’t hear a lot of pushback from authorities about going to a protest but at the same time they were warning us to not go to the beach. The important thing is that we were getting mixed messages, but sure, let’s focus on me saying “perfectly safe.”
There weren’t mixed messages is the thing.
“Not hearing a lot of pushback” is not the same as authorities not providing it. It’s not exactly their fault if people hear what they want to hear. That’s selective hearing, not a mixed message.
What some (and not even all) health officials said was there was a balance to the harm due to the pandemic vs the harm due to systemic racism (for the George Floyd protests) and that systemic racism plays into COVID risks (which they did - the racial disparity early on was large). The harm from not going to the beach doesn’t even compare.
That’s not a huge amount of nuance to process, yet many people very clearly can’t handle even that much.
Should have been an iron-fisted approach. Near-total lockdown of borders and incoming travelers. Forceful quarantines of positively-tested individuals. The stimulus checks should have been several times larger.
The vaccine should have been raced even faster, maybe getting done and ready within 8 months instead of 14.
While an earlier vaccine would certainly have been even better, I think it’s important to remember that effective, safe vaccines were developed in less than a year (COVID emerged as a major health crisis in February/March of 2020, and vaccinations of high-risk people began by December of that same year), and that was an incredible and unprecedented achievement.
There wasn’t really a way to push it faster.
IIRC, the first mRNA candidate vaccine was ready for trials in Jan '20 - before many countries, including the US, even had confirmed cases - and the rest of the year was spent on clinical trials ensuring they were safe and effective.
Given the immense pushback to vaccines we still have and some of the legitimate early safety concerns that persist to this day, pushing to even faster approval, only really achievable by relaxing measures to ensure both efficacy and human safety, would still be a bad idea in hindsight.
Honestly, that you remember this as inconsistent advice pisses me off. There was never anything inconsistent about public messaging regarding beaches or protests. Everyone who went to those protests KNEW that they were taking risks doing so, and decided it was worth it anyway. That there was “inconsistent messaging” was just a right-wing talking point, trying to make it look like “the other side” was acting hypocritically. Obviously, they succeeded.
The US had cases before Covid was recognized to be a problem. Locking down borders wouldn’t have bought us much, as we already had more domestic sources than we could (or were willing to) monitor and control.
I guess if we’d also implemented widespread testing (we didn’t have enough test capacity to do so) and heavy contract tracing (we could have done this) and tight quarantining of everyone identified as a contact (without enough masks for medical professionals, this would have been tough, too) it might have helped to implement those policies if we’d ALSO closed the borders. But just closing the borders without those in place would have made very little difference.
Ditto; though I do know some people my age who had mild cases.
I’ve got four different risk factors, and nobody to take care of my work, or long-term to take care of me either. At some points being out for even a few days can screw up my work, and long covid would be a disaster. It isn’t only dying that’s the potential issue.
Probably not a bad idea for me, or for others in similar positions.
– We should have had a much larger stockpile of PPE for medical and other critical personnel; and it should have been routinely inspected with items replaced and/or updated as needed. Plus which, there should have been a clear plan for producing lots more of them, in multiple locations, on short notice. And this isn’t really 20-20 hindsight; there had been warnings about the possibility of serious epidemics for years.
If we’d had those supplies, the whole thing about ‘don’t wear masks (we need them for the medical workers)’ wouldn’t have happened. That would have both at least somewhat reduced distrust in the CDC, and saved some lives (no way to tell how many); as well as somewhat reduced stress on people who wound up having to be in close proximity to infectious patients while having only improvised or multiply-reused PPE available to protect themselves.