Until 2020, few Americans needed to think about how the virus spreads and how the human immune system works. The pandemic offered painful crash courses. Sometimes it seemed that science was rapidly evolving the virus itself.
So, the New York Times asked experts to revisit the nightmare. Of the most important public health measures introduced during Covid, did it be scientifically maintained and turned out to be wrong?
This issue is especially important now. Because a pandemic that could overturn America's life is inevitable. One candidate has already surfaced: bird flu.
Perhaps the biggest lesson learned is that, according to some experts, recommendations during the pandemic are necessarily based on new and incomplete information. However, during Covid, federal agencies projected more confidence into valuations than they often were guaranteed.
Next time, scientists said officials should be more open about uncertainty and prepare their public for guidance that could change as threats become a clearer focus.
Rather than promoting precautions as an absolute solution, we should acknowledge that a single intervention is not perfect, but many incomplete measures can build breakwaters.
Lindsay Mar, an aerial virus expert at Virginia Tech, said:
“You need an umbrella, you need boots, you need waterproof pants and a jacket. And you're probably going to try and avoid the puddles,” she said.
vaccine
It's a victory, but the authorities initially sold too much profit.
In a sense, the mRNA vaccine was a victim of an unexpected success in the 2020 clinical trial. These results were spectacular. Shott has driven out the symptomatic disease caused by the original version of the coronavirus at a miraculous rate.
However, government officials had to return to their enthusiasm as the groundbreaking outbreak of infections surged in the summer of 2021 as a surge in delta variants. Americans were told to get a booster. After that, many times.
Federal health officials should have admitted from the start that their long-term effectiveness was unknown, said Natalie Dean, a biostatistician at Emory University.
Distrust in the safety and efficacy of Covid vaccines has hit other vaccinations, including those targeting pediatric diseases such as measles.
“I think that early insisting that this prevents all infections will ultimately undermine public confidence,” said Saskia Popescu, an infection prevention expert at the University of Maryland.
Still, the vaccine saved an estimated 14 million lives in the first year since its introduction.
Spreading through the air
The surface wasn't a problem. That was the indoor air.
Disagreements among scientists about how the coronavirus travelled had a profound effect on the way Americans were told to protect themselves.
Early on, health officials alleged that the virus was spreading to large droplets where infected people cough and sneeze on other people and objects. The “fomite” theory led to a protocol that made little sense in retrospect.
Remember the Plexiglass barrier during the president's discussion? Face shield? The school was closed mid-week for cleaning. People were scraping off groceries and mail.
“The whole hygiene theatre was terrible and unfortunate,” said Michael Osterholm, an infectious disease expert at the University of Minnesota. It wasted millions of dollars and gave people a false sense of security.
It took several months for the health agency to admit that the virus was carried high by small droplets called aerosols. Sadly, the insight initially led to another overreaction.
Some states have closed beaches and parks and banned outdoor interactions despite “there are good scientific evidence that outdoor events are low risk,” Dr. Dean said.
Ultimately, realizing that the virus is floating primarily indoors, the Biden administration has gained funds to improve ventilation in schools.
masking
It worked if the correct mask was used correctly.
As the pandemic spread across the United States, masking has transformed from a public health intervention to a cultural flashpoint.
Assuming they are worried that the coronavirus will move like the flu and that hospitals may not have enough resources, federal Heath officials have told the public they don't need masks at first.
When scientists learn that the coronavirus is in the air, their advice suddenly reverses. Still, authorities initially recommended fabrics that were less effective in avoiding airborne viruses, and did not support more protective N95 ventilators until January 2022.
Dozens of studies have shown that when used correctly and consistently, N95 masks or their equivalents cannot prevent infected people from spreading the virus and signing up for the wearer.
Unfortunately, some flawed research and the politics of personal freedom have created a culture war surrounding the use of masks, particularly by children, said Bill Hanagh, an epidemiologist at the Harvard Chan School of Public Health.
If another respiratory outbreak occurs, he said, “I am very worried that the entire constituency has already dumped the masks.”
Asian children wear masks on a daily basis, especially during seasons of respiratory viruses and allergies, some experts noted.
“We would like to inject more infection prevention, especially in primary schools during respiratory virus season,” Dr. Popescu said. “It seemed like a really great way to get kids back to school.”
Herd immunity
Chimera. We didn't get there.
For almost two years after the pandemic began, experts spoke about reaching herd immunity after a sufficient population gains protection by getting sick or vaccinated.
That was a mistake, experts said. Immunization of herds is possible only if the immunity is sterilized. This means that it will prevent reinfection and last a lifetime. There is neither immune to most viruses.
Seasonal coronaviruses, Columbia University epidemiologist Jeffrey Sherman, who argued that the new coronavirus could also cause re-infection, said Jeffrey Sherman changes rapidly enough to receive repeated infections throughout his life.
Once the vaccine arrived, authorities first presented the shots not as a way to reduce the severity of the infection, but as a way to stay safe from the virus forever.
“There was a lot of confusion and misconception about herd immunity, that the toothpaste somehow had returned to the tube,” Dr. Dean said.
School closure
It's necessary at first. Over time it becomes suspicious.
Some aspects of the pandemic cause as many rancor as school closures. In many parts of the country, test scores never recovered, and absenteeism became an cumbersome issue.
However, experts said closing schools in the spring of 2020 was the right decision. Ideally, schools resumed their decline, but there were measurements for ventilation, testing and mask improvements – to reduce the risk.
“And of course we didn't actually have those things,” Dr. Hanazi said.
By early fall 2020 it was clear that school children had not been significantly driving community communication. Still, many schools remained closed for months than necessary, disrupting children with distance learning, causing some to fall irreparably behind.
“It's really tough for a quarterback on Monday morning,” Dr. Sherman said.
“We don't have a counterfactual alternative scenario to see how it actually unfolds.”
It would be stupid to base school policies on how the coronavirus behaved when the avian flu turns into a pandemic, he and others warned. Other respiratory viruses, such as the flu, tend to be fatal among young children and elderly people.
“There are all reasons why we think that the future flu pandemic is far more dangerous to young people than Covid,” Dr. Hanage said. “I think we should talk about what we can do to alleviate communication in schools.”
Lockdown
They slowed the virus, but the prices were high.
The pandemic has destroyed local businesses, raised unemployment rates and increased household debt. Many people feel that lockdowns are blaming much of the damage and that their harm outweighs some kind of benefit.
Many scientists see it differently. “The economy has been shut down by the pure power of the pandemic,” Dr. Osterholm said.
The policies of the US states did not approach the strictness of the people of China, India, Italy and Jordan – people were not allowed to leave their homes at all – and much of the workforce and social activity continued as they were deemed essential, he pointed out.
By the end of May 2020, indoor dining and religious services had resumed in most parts of the country, despite many cities continuing to enact temporary bans as virus levels rose and fell.
The shutdown may have been unpopular in some cases as it was introduced without a clear explanation or ended in front of the eyes.
Instead, Dr. Osterholm said health officials were able to enact the concept of “snow day.” People stayed at home when the hospital was overwhelmed. Just as it did when the road snowed, behavior returned to normal when the situation eased.
The closure eased the burden on hospitals, slowed the transmission of the virus, and took longer to develop a vaccine. Studies from several other countries have shown that staying at home and restrictions on mass gatherings are the most effective means of suppressing virus transmission within communities.
“No matter what people do in 2020 before they get vaccinated, they'll save millions of lives,” Dr. Hanazi said. “If we hadn't done anything, then if we hadn't really done anything, things would have been much, even worse.”
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