"When [Public Health] Works, It's Largely Invisible"
January 5, 2022 4:49 PM   Subscribe

Your Local Epidemiologist: "I received thousands of emails, messages, and comments after my last post, all asking, essentially, the same thing: Is there any hope? So, I interrupt my regular broadcast with a big, loud answer: YES."

"Vaccines are working. And not just working okay, they are working incredibly well. [...] In addition to vaccines, we actually got very lucky with Omicron on many fronts. [...] And although we have a issues right now with distribution and supply, help is on its way."
posted by MollyRealized (34 comments total) 57 users marked this as a favorite
 
This is a really well-crafted message - detailed, and also relatable:
It’s because Americans got their vaccine in 9 months, which shattered all time records for development of previous vaccines. But speed didn’t mean it was rushed. It meant leveraging a whole lot of smart people, money, and decades of previous work to get us a vaccine in 9 months. (I talked about all of these things in a previous post here.) It also meant that more than 500,000 people volunteered to test the vaccine. ... People from 6 months old to the elderly participated. From all different backgrounds. And those neighbors of ours are a key reason we are saving so many lives right now. This couldn’t have been done without each and every one of them.
It can be really easy to focus on the negative, in practically every aspect of our lives. (I know I personally have a tendency to forget all the things I've accomplished in a day and only see all the things NOT yet done, just as a minor example.)

There's so much that could have gone better, that could have been done better - but as Dr. Jetelina points out, there is SO much that went right - including the work of a whole lot of smart people, and the willing contributions of so many vaccine trial volunteers - and it's really good to recognize that. Repeatedly, and loudly, to counteract the all-too-common tendency to only see the bad.

Thank you so much for posting this, WCityMike2!
posted by kristi at 4:59 PM on January 5, 2022 [34 favorites]


Thanks for this post. For me, it is reassuring to hear from experts directly, rather that through a reporter's lens (no aspersions intended against reporters). For those who like this kind of content, Dr. Paul Klotman, the President of Baylor College of Medicine, records a very folksy and yet very scientific COVID update every week, usually on Fridays. For those interested, here's the most recent message, a Q and A.
posted by ferdydurke at 5:07 PM on January 5, 2022 [5 favorites]


Her newsletter is a wonderful resource to subscribe to, whether it's via mail or RSS.
posted by MollyRealized at 5:07 PM on January 5, 2022 [6 favorites]


This is nice and all, but I feel like a lot of the hopeful messages should be amended with ".. in America" or ".. for America".

Plenty of countries are still struggling to secure the first doses for their populations.

Booster doses in wealthy countries have eclipsed vaccinations given out to poorer nations.

I'm glad to see a positive message and good news for so many, but reading articles praising the U.S. for getting the vaccine within 9 months feels bittersweet when so many are still struggling to even get started.
posted by fight or flight at 5:17 PM on January 5, 2022 [26 favorites]


(archive.is version for that second link.)
posted by fight or flight at 5:26 PM on January 5, 2022


It's stretching the limits of believability to think that rich countries wouldn't put themselves first - especially democratic ones.

But if the United States and the other world powers aren't being actively crushed by the pandemic, there's a hope they can turn some of their attention to helping out other countries.
posted by meowzilla at 5:45 PM on January 5, 2022 [7 favorites]


I'm glad to see a positive message and good news for so many, but reading articles praising the U.S. for getting the vaccine within 9 months feels bittersweet when so many are still struggling to even get started.

I so agree. We in the U! S! A! could and should be doing a whole lot more to vaccinate the third world lest we get an extra-lethal Omicron on steroids. As I mentioned before, my mom got the flu in 1918 but it was the first flu that went overseas in the first World War and came back a mutated killer monster. What could come for us next terrifies me.
posted by y2karl at 5:48 PM on January 5, 2022 [8 favorites]


I have friends with these anti-vax anti-mask little Trump supporters -- usually but not always sons -- living at home. They got their shots and boosters but not their kids or their kids' friends and it scares them that they could have an asymptopic infection and infect their own children.
posted by y2karl at 6:02 PM on January 5, 2022 [2 favorites]


The pharmaceutical companies who developed these vaccines will have made many billions of dollars by now, so it's time to release the patents, so other countries with the capacity to do so can start local production. OECD nations should also start distributing the vaccines more broadly, to get more of the world's population vaccinated, or we will have still more variants.
posted by lipservant at 6:06 PM on January 5, 2022 [8 favorites]


But if the United States and the other world powers aren't being actively crushed by the pandemic, there's a hope they can turn some of their attention to helping out other countries.

as I understand it, there will be no end to Covid (and its variations) until we fully attend to every country. The analogy I heard from a biochemist was that of a forest fire. We may think we've put it out, but as long as there is an ember anywhere, it's inevitable that it will flare up, there will be another fire.

The good news is the experts know this. As is so often the case in this timeline, the issue isn't a problem with the science, or just knowledge in general -- it's communicating it to the people who are making the decisions, which in a democracy, is all of us really. Which makes pieces like this so important. As ferdydurke put it ...

it is reassuring to hear from experts directly,
posted by philip-random at 6:13 PM on January 5, 2022 [6 favorites]


I'm glad to see a positive message and good news for so many, but reading articles praising the U.S. for getting the vaccine within 9 months feels bittersweet when so many are still struggling to even get started.

It is unambiguously good that instead of waiting four years (which was the previous record, per YLE) for a vaccine to be developed, the COVID vaccine was instead developed in nine months. No need for a "but..."

Could we just appreciate this good news and the absolute benefits this accelerated timeline provides to poorer countries?

I know Pfizer didn't solve the historical distortions of global wealth inequity developed over hundreds of years of colonialism concurrently with the development of the vaccine, but c'mon, they would have needed AT LEAST twelve months to solve both problems.
posted by dngrangl at 6:36 PM on January 5, 2022 [40 favorites]


The way you can tell I'm smarter than you is in how I can find the misery in any situation.
posted by aramaic at 6:47 PM on January 5, 2022 [45 favorites]


Ontario has done okay with vaccine roll-out, but our entire health-care system is crashing now because our moronic Premier hates nurses. He's now stashing federal Covid relief funding so that he can spend it on his next election.
posted by ovvl at 6:56 PM on January 5, 2022 [8 favorites]


The pharmaceutical companies who developed these vaccines will have made many billions of dollars by now, so it's time to release the patents, so other countries with the capacity to do so can start local production. OECD nations should also start distributing the vaccines more broadly, to get more of the world's population vaccinated, or we will have still more variants.

Anyone in the world can produce the AZ vaccine if they want to. My understanding is that you have to pay "some" costs for certification - the tests required to prove that the product you're making adheres to the purity and effectiveness of the original in order to gain the right to label your product as the AZ vaccine and piggyback on its FDA / other certifications. Otherwise, you'd be fraudulently labeling your vaccines as something it's not. But otherwise, it's effectively patent free, with one interesting exemption - you can't sell it for profit, so you have to prove that you're only recovering costs, and if you're in violation of that, then AZ can pull your license.

What happened is that due to this restriction on profits, no firm has an incentive to produce the vaccine. CSL in Australia for example, took production of the AZ vaccines offline to produce snake antivenin instead, because doing that was more profitable, and they've since ended production completely.

Without a profit incentive, the vaccine simply doesn't get produced. I think if CSL, or other firms, could sell the AZ vaccines at a small profit (20% or so?) overall production would be a lot higher - they'd be producing as much as people are willing to buy. Right now, AZ costs about $3 per jab, while Pfizer costs $35 per jab. Even adding a 20% profit margin to each AZ jab would only increase its cost to $3.60.
posted by xdvesper at 7:00 PM on January 5, 2022 [10 favorites]


I work in PH. YES, agree on hope/good news. Now we just need -everyone- to get the jab, and boostered, including those in hard to reach locations (cold chain is hard)!
posted by esoteric things at 8:09 PM on January 5, 2022 [5 favorites]


Great visual showing the "immune walls" of the United States, England, and Austria: Link. It's apparent why the proportion of Omicron's reduced virulence attributable to pre-existing immunity as opposed to intrinsic properties of the virus is an important question for some countries. Also, clearly resistance to taking vaccines isn't limited to the United States.
posted by eagles123 at 8:21 PM on January 5, 2022


But if the United States and the other world powers aren't being actively crushed by the pandemic, there's a hope they can turn some of their attention to helping out other countries.

That's a dichotomy that is not only false but upside down - sort of like saying if I weren't being actively crushed by the cold then I would put a sweater on. There's a good chance that if the African continent had been given a more generous supply of vaccines that omicron may never even have arisen.

It is utterly foolish to apply zero-sum thinking to a global pandemic, but people seem to keep doing so despite being shown time and time again that you can't America-First your way through this.
posted by splitpeasoup at 8:25 PM on January 5, 2022 [9 favorites]


... it scares them that they could have an asymptopic infection and infect their own children.

Er, asymptomatic. Man, my typos are going straight up
posted by y2karl at 8:27 PM on January 5, 2022 [10 favorites]


I would think the United States would want to promote vaccination in other countries more, given that the last two variant waves came from countries with low vaccination rates.

Give the damn virus less space to evolve, please
posted by eustatic at 8:36 PM on January 5, 2022 [2 favorites]


I want to believe.
posted by Capt. Renault at 8:46 PM on January 5, 2022 [1 favorite]


The way you can tell I'm smarter than you is in how I can find the misery in any situation.

Not smarter, but certainly not so tediously self-absorbed to think that a thread about a global pandemic that has killed millions is a place for enforced positivity and jingoism. Maybe the mods should add a [US-centric] or [positive pro-America vibes only] tag to future posts so "miserable" non-US Mefites know that we're not allowed to engage?

Could we just appreciate this good news and the absolute benefits this accelerated timeline provides to poorer countries?

We can definitely appreciate the good news while acknowledging that vaccine inequality is what's going to make this pandemic last longer and be more deadly in the parts of the world that the wealthy West likes to conveniently ignore. If you want to avoid another variant fucking with the rest of your future, talking to people, raising awareness and lobbying your representatives about vaccine inequality will help.

And it's not even just about rich nations/poor nations, but also areas of inequality drawn within those nations along social lines.

When "we" truly means all of us and not just privileged Americans, then yes, I will joyfully stop to "just appreciate this good news".
posted by fight or flight at 2:59 AM on January 6, 2022 [7 favorites]


"Your Local Epidemiologist" really sounds like she wants public health to be invisible not because it is working, but because it isn't. The story from the public health world--the part that deals with patients, not statistics--paints a much more grim picture, that of health systems across the world under immense pressure. Here's the actual situation on the ground in the US:
Consider, for example, that we continue to have a critical shortage of blood. Early on, this was because people were afraid to venture out. But what’s causing the shortage now? Are we using more blood because we have so many sick patients? Or are donations down? What has happened to the donors? Have they died? Are they sick? Are they exhausted and overwhelmed? Or no longer impelled to help?

I fear we are losing our capacity to persevere, and that is something harder to replace than masks. Even before the pandemic, physicians had twice the risk of burnout of the general population and had an estimated 40 percent rate of depression and suicidality. Now, 60 percent to 75 percent of clinicians experience symptoms related to depression, sleep disorders and post-traumatic stress disorder. The numbers are likely higher in nurses.

Some sources estimate that 30 percent of health-care workers have either quit or been laid off since February 2020. Thousands of us have died. The health-care employment sector has decreased by 450,000 workers since February 2020. While medical school applications are at an all-time high, a first-year intern cannot replace a physician with 30 years of experience.

The only solution left is for those of us who remain behind to work longer and harder. Indeed, the Centers for Disease Control and Prevention recently issued guidance to mitigate worker shortages, allowing us to work even if we are infected and symptomatic. There is such a thing as being too essential.
It's not just the US and their baling-wire-and-bubblegum health care system, either, here's a reporter from the UK on how their health system is getting slammed (edited from Twitter format):
Overall the picture is clear: While ICU is under less pressure from Covid this year, the rest of the hospital is facing more. One critical care consultant told us they may end up having to redeploy staff from ICUs to other wards. Not so much less pressure as different pressure.

Here’s the same story from the US. Less load on ICUs, but immense pressure elsewhere. What we’re seeing is the real-world manifestation of what many have said for weeks: reduced severity is great news, but pressure is a function of both severity & volume.

I hope people can now appreciate why the current situation is so hard to condense into a simple takeaway. Yes, a much lower share of cases are developing severe disease. Yes, deaths for this wave will remain well below past peaks. But no, this does not mean everything is fine.
posted by Glegrinof the Pig-Man at 4:50 AM on January 6, 2022 [5 favorites]


Not smarter, but certainly not so tediously self-absorbed to think that a thread about a global pandemic that has killed millions is a place for enforced positivity and jingoism.

You do realize that there are dozens and dozens of COVID threads dominated (justifiably) by negativity, skepticism, and a dark view of the future? You do not need to prove your disinterestedness, superior insight, and cosmopolitanism in every COVID thread that comes along.
posted by praemunire at 7:16 AM on January 6, 2022 [12 favorites]


Some sources estimate that 30 percent of health-care workers have either quit or been laid off since February 2020. Thousands of us have died. The health-care employment sector has decreased by 450,000 workers since February 2020.

"Quit or laid off" so the writer of this opinion article is (perhaps inadvertently?) expressing the opinion that vaccine mandates among health care workers are making things worse. Even if refusers are a tiny percent of overall worker populations, in times where there is little slack it makes a big difference, and the total number is at least in the thousands across the US. IDK, maybe there was a better way to deal with vaccine deniers who are otherwise competent at their jobs, at least temporarily.

Or he's expressing constrained personnel management strategies among hospital administrators, ie: being able to move workers from a currently under-used area of medicine to another, instead of laying them off.
posted by The_Vegetables at 7:24 AM on January 6, 2022


You do realize that there are dozens and dozens of COVID threads dominated (justifiably) by negativity, skepticism, and a dark view of the future?

Pointing out that there is vaccine inequality across the globe that is disadvantaging poor nations and may lead to more variants in the future is not "negativity, skepticism, and a dark view of the future", it is reality. It's a necessary call to action.

Anyway, since this post is apparently required to be positive, here are some positive ways you can get involved thanks to the WHO's vaccine equity campaign site:

- Donate to the COVID-19 solidarity response fund
- Materials to help spread the word about vaccine equity

Here is Amnesty International's campaign against vaccine inequality, where you can write a message to be sent to the vaccine companies (or use their messaging to write to your own representatives).

Here is UNICEF's call to action and campaign that you can share on social media.
posted by fight or flight at 7:54 AM on January 6, 2022 [7 favorites]


It's a necessary call to action.

Not a word of that is accurate.

It's not "necessary" because (a) the issue of global vaccine equity is and no doubt will continue to be discussed in various COVID threads here, as it has been all along; and (b) whether or not a moderately popular left-leaning website canvases the subject has essentially no bearing on what will happen in the future.

It's not a "call to action" because it's not actually calling to any action. (Also it tends to be super unpersuasive to call people "tediously self-absorbed" and jingoistic just for paying any attention to some possible positive aspects of the situation. That's not language you use with target audiences you've hoping to convert to some action, that's language you use against your enemies.)

Keyboard activism has its limits, and it's easy to turn it into a sad parody of itself.
posted by praemunire at 8:14 AM on January 6, 2022 [10 favorites]


IDK, maybe there was a better way to deal with vaccine deniers who are otherwise competent at their jobs, at least temporarily.

If someone working in public health is a vaccine denier, then by definition, they are not competent at their job.

I can hold a kind of backhanded respect for people who, for whatever kookoo-bananas reason, think that vaccine puts microchips in your brain or that it's secret biowarfare or some such nonsense. They're deluded, but at least they're operating rationally inside their delusion.

But if someone doesn't believe that stuff, and is resisting getting vaccinated for... what? some job related reason? They want a stipend? They want extra days off in their contract? Because they just "have a deeply held personal feeling" and that selfishly gets to override basic social responsibility? Nah, buddy.

Whether they're deluded or selfish, everyone working in public health should be vaccinated. Can't manage it? Then you are not competent at your job.
posted by The Pluto Gangsta at 8:29 AM on January 6, 2022 [7 favorites]


Mod note: Hi friends. I know it's a stressful time and there is a lot of bad-news stuff about covid and many other big topics, and that this brings a lot of feelings that different people handle differently. Mefites in general are pretty well aware/saturated with all the ways things are going badly. It's possible to both acknowledge problems/things going wrong and at the same time allow that some are going better. No need to fight over which single topic must be the only focus; we can be aware of/discuss multiple aspects. Please be kind to each other, nearly everyone is having a hard time these days.
posted by LobsterMitten (staff) at 8:49 AM on January 6, 2022 [4 favorites]


So, I walk past a drive through free vaccine/covid testing center a few times a week, and there's always a line for both sides, and you know that makes me feel a little bit of hope every time. I mean, it doesn't make it any less real that when I go shopping there aren't still people dick-nosing it, but the dick-noses don't make the people doing the right thing any less real either. And, right here and now, I'm just too tired not to savor the moments where I do get those little bits of hope.

So hey, I'm gonna keep being careful, I'm gonna keep telling everyone I know to be careful, but I'm also going to take the time to share this with friends who are just feeling overwhelmed and are struggling to find a reasons to not just give up.
posted by Gygesringtone at 10:31 AM on January 6, 2022 [6 favorites]


When "we" truly means all of us and not just privileged Americans, then yes, I will joyfully stop to "just appreciate this good news".

Oh, man, you said it. Although I do understand the pang of longing for good news towards which we climb over each other like well diggers in a cave in, these are the hardest time in my memory at least.
posted by y2karl at 12:38 PM on January 6, 2022 [1 favorite]


The good news is the experts know this. As is so often the case in this timeline, the issue isn't a problem with the science, or just knowledge in general -- it's communicating it to the people who are making the decisions,

#DontLookUp

it doesn't make it any less real that when I go shopping there aren't still people dick-nosing it


Got my booster a couple days ago, and about 10% of those waiting in the queue and the 15 minute post-jab observation pool were proudly nostrils-out. Of those, two in three were middle aged white men and the rest were middle aged white women. This is why we can't have nice things.
posted by flabdablet at 7:11 PM on January 6, 2022


Got my booster a couple days ago, and about 10% of those waiting in the queue and the 15 minute post-jab observation pool were proudly nostrils-out. Of those, two in three were middle aged white men and the rest were middle aged white women. This is why we can't have nice things.


So like, I've been trying to figure out how to respond to this, because hey, I'm pretty explicitly acknowledging that things aren't perfect. In fact, that's the point of my story, that the things that are bad don't somehow magic the good things into not being true. But I'm also trying to point out that sometimes we can be hopeful despite the good things, and your response of just saying "nu-uh" is frustrating. Like I mentally composed several replies that would get rightfully deleted. I mean there's hopeful elements in your story, but I'm not about to tell you not to feel how you feel. I just wish you'd give me the same courtesy.

As near as I can tell you're not saying my story's a lie, right? Like we can agree that the thing I'm describing is true. So what on earth does it cost you to let me feel happy about it? Especially after I'm very explicate about needing to feel a little hope right now.

And zooming out, do you disagree with things in the article? Like that chart of all the people saved because of vaccines is AMAZING. I REALLY wish it was more people saved, but that doesn't mean that every god damn one of those million of lives saved isn't worth celebrating. Like, those are my friends, my family, maybe me. I'm not asking you to change your response, because it's just as important for people to grieve those lost as it is to celebrate those saved. I'm just asking that you recognize that those of us celebrating are having a reaction that is just as healthy, appropriate and based in reality as yours, and if you don't want to join in, fine, but that doesn't mean you've got to piss in the punch bowl? We're not denying the severity of the disease, or the truth of how much work still needs to be done, or anything like that. We just need to feel some other human emotions right now, and that's allowed. You're allowed to be angry about nose dickers, and I'm allowed to be happy at boosters. Maybe someday I'll need to vent about nose dickers and you'll need to take a moment and say "hey, vaccines saved a lot of people".

I'm just sick of the implication that I'm doing the pandemic wrong because I occasionally look at the majority of people who are working together to beat the damn thing and feel proud to be part of a group that's making sacrifices rather than spending 100% of the time focusing on the bad behavior.
posted by Gygesringtone at 8:32 AM on January 8, 2022 [7 favorites]


But I'm also trying to point out that sometimes we can be hopeful despite the good things

That should read "despite the bad things".
posted by Gygesringtone at 8:43 AM on January 8, 2022


Mod note: One deleted. Seriously read this again. Further attacking other members, insisting on only bad news or similar will get a ban or time-out.
posted by taz (staff) at 1:05 AM on January 9, 2022 [1 favorite]


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