How bad, and how big a problem, has public health messaging been through the coronavirus pandemic? Pretty bad, and pretty big. (1/x) nymag.com/intelligencer/…
“In January, as the earliest scary research into the outbreak in Wuhan began arriving from China, public-health officials downplayed the threat and systematically advised coronavirus panic be channeled into vigilance about the flu, which they considered a bigger problem.”
“In February, as initial data arrived from China showing a dramatic age skew in mortality, with the older at far greater risk, and the very old at greater risk still, political leaders and public-health officials did practically nothing to protect the most vulnerable.”
“Indeed, in New York, where now 6,000 have died in nursing homes, totaling roughly 6 percent of the nursing-home population, Governor Cuomo granted legal immunity to the executives who run those facilities.”
In New Jersey, it was four times more dangerous to be in a nursing home at the start of the pandemic than to have been a British soldier sent off to fight in World War I.
“In March, as evidence about the imperfect-but-still-significant efficacy of masks began rolling in, the WHO continued to advise against them. As recently as March 8, Anthony Fauci was advising the same thing on 60 Minutes.”
“Even Obama health-care adviser Ezekiel Emanuel, who recently touted a study showing several hundred thousand American cases were averted by mask-wearing, spent the winter insisting that masks could not help.” Not just that they wouldn’t save us—that they offered no protection.
“In April, as it became clearer that outdoor transmission was significantly harder than indoor transmission, public officials across the country nevertheless continued closing parks and beaches.”
“Rather than emphasizing that outdoor activity was basically safe, so long as you kept your distance, we were told that for all but the most essential activities we should stay indoors—where we then entertained ourselves in part by shaming those selfish enough to go out.”
Among other things (increased stress and economic burden) this meant that when the protests over the killing of George Floyd began, they looked to conservatives and covid skeptics like a perfect test of liberal hypocrisy—perfect in that no matter what, hypocrisy would be proven.
“If the disease spread rapidly through the assembled protesters, conservatives felt, it would show that those who’d spent the spring scolding Americans for resisting lockdowns didn’t care as much about public health as they did about advancing their own set of political values.”
“(Liberals, of course, would put it differently: that the cause was worth the risk.)”
“And if there were relatively few new cases, the thinking went, it would demonstrate that the lockdowns themselves had been unnecessary.”
“Three weeks later, we have the first results from the natural experiment: Across the country, from Minneapolis to California and New York City to Albany, the protests produced, at most, very few additional cases of COVID-19.”
“(The same, more or less, was observed in the aftermath of the much-derided Lake of the Ozarks Memorial Day party, where one sick partygoer may have infected as many as … one other.)”
“Does this mean we’re out of the COVID-19 woods, all clear for mass gatherings and the end of social distancing, and that the intrusive and intensely burdensome lockdowns of the spring were excessive? Well, no.”
“The same week, a major study of the effect of lockdowns across the world found that, in the U.S., social distancing and shelter-in-place guidelines prevented as many as 60 million additional cases.”
“And if those measures had been implemented sooner and more effectively, one review suggests, between 70% and 99% of American deaths could have been avoided. Instead of 120,000 deaths, we might have had fewer than 2,000.”
“These two findings would seem to contradict each other, but only if you are proceeding from the reductive assumption that either lockdowns were absolutely necessary or that no precautions at all were.” Unfortunately, that is precisely the false binary health messaging suggested.
“But scientists have known for months that ‘all or nothing’ was a misleading way to approach the question of how to combat the spread of the disease — which could be substantially mitigated by warm weather, mask-wearing, and better hygienic practices.”
“(Indeed, one recent analysis of more than 1,000 “super-spreader” events around the world, for instance, found that more than 97 percent of them took place indoors.)”
“But all the way up through the beginning of the protests, and even after, America’s jury-rigged, Rube Goldberg health-messaging apparatus failed to communicate most of these nuances.”
That apparatus — epidemiologists, local public-health officials, civic-minded journalists, improvising and coordinating guidance in the total absence of any federal leadership— was improvised because of that failure of leadership, which has been of course much larger problem.
“All of this guidance was also issued in something of the fog of war, of course, and each piece, taken on its own, might seem sensible—the science being new, and imperfect, and often contradictory, it’s reasonable to try and guide the public toward more caution rather than less.”
“But taken together they suggest a perhaps concerning pattern, one familiar to me now from years of writing about climate change and its long-understated risks.”
“Instead of simply presenting the facts—what they knew, how certain they were, and what they didn’t know—experts massaged their messaging in the hope of producing a particular response from the public (with faith they could expertly enough massage it to produce that outcome).”
“Throughout, public-health messaging was hobbled by two complementary and distorting convictions.”
“The first was a strong preference for universal messaging rather than more targeted guidance, which brought us to effectively national shelter-in-place orders before most of the country had even tried social-distancing, mask-wearing, and a focus on the most vulnerable.”
“The result was a whiplash from ‘just the flu’ to ‘stay at home, perhaps for months.’ We didn’t even try some of the moderate measures, like mask-wearing and the end of medium-size gatherings, that have allowed Japan to basically defeat the disease without much pain at all.”
“The second problem was a lack of confidence in the public’s ability to process nuances and act responsibly.” This is especially tragic because the result of massaged messaging has been more distrust of health guidance, which makes the public less likely to honor advisories.
“As @chrislhayes has suggested, the only real hope for states like Arizona, where ICUs are quickly approaching capacity, is universal mask wearing — but it’s almost impossible to imagine the state actually honoring a policy like that, at this point, were it even implemented.”
“And for all the love showered on Anthony Fauci through the spring, the failure to push mask-wearing when it might have really mattered may ultimately prove the most catastrophic misstep of the whole American response.”
“This has been a global pattern, or at least was in the early days of the epidemic. But almost everywhere but America, the experts learned their lesson quickly.” Here, I’m not sure we have. (X/x)
