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Red Jahncke (Photo courtesy of the author)

Confused About COVID? Who Isn’t?

A month ago, the nation had reached an 80% one-shot COVID vaccination rate for those over age 18, with 96% of vaccines administered being the 95%-effective Pfizer and Moderna shots. Forty percent of the very-vulnerable elderly, whose early vaccinations from last winter were weakening, had received boosters. Pfizer had announced its 89%-effective home-use COVID treatment pill. The nation seemed poised to emerge from the pandemic and move forward. We seemed very well situated to avoid the enormous infection wave swamping Europe.

Then, Omicron.

The Omicron variant’s higher transmissibility and its apparently milder severity have scrambled the common wisdom about the virus.

Omicron is reinfecting people with natural immunity from prior infection in South Africa where it broke out and is sweeping through the population.

Initial research has found that natural immunity provides protection roughly comparable to vaccination. So, if natural immunity is failing in Africa, why would vaccination provide any better protection? Suddenly, the previously 95%-effective vaccines provide less certain protection, which certainly undermines any case for vaccine mandates.

It’s confusing.

Yet, even a month ago, mandates had already lost their rationale with the announcement of Pfizer’s new 89%-effective COVID treatment pill. The rationale for mandates has always been to protect vaccinated people from unvaccinated people. This has always been a suspect notion: if vaccines are effective, then vaccinated people run negligible risk from unvaccinated people; if vaccines are not effective, why get vaccinated?

The pill rendered the pro/anti-vax debate largely moot: no matter how anyone might become infected, soon, there will be a very effective pill to prevent serious illness – the same protection that vaccines provide.

For the vaccinated, the pill will remove risk from rare breakthrough infections. For the unvaccinated to continue to go unvaccinated, now with reliance upon the pill, cannot be considered unreasonable. It is not unreasonable to be hesitant since the vaccines are new and there is no data on their long-term effects.

Except that the pill, which is 89% effective against Delta and previous variants, may not be as effective against Omicron.

It is confusing.

Are we once again defenseless against a dangerous virus? Serendipitously, no, since the early evidence out of Africa is that Omicron causes milder infection.

Less protection, but less danger.

That’s a relief, except that the current wave in the United States involves the Delta variant. While Omicron has already arrived stateside, our current moderate wave began beforehand and even the highly infectious Omicron will take some time before replacing Delta as the dominant strain of COVID (or will both variants persist?).

Right now, it would seem prudent to get vaccinated and boosted and hope that the Food and Drug Administration approves the Pfizer pill as soon as possible.

However, where does that leave forward looking public policy and personal choices for individuals?

Mandating vaccines, which may or may not be effective, is bad policy. It is more likely to entrench anti-vaxers than to bring them around.

That COVID vaccine mandates are bad policy can be seen best by comparing them to the gold standard for vaccine mandates: the vaccine against polio, which is an unchallenged requirement in every school district in America.

Polio is a very serious disease. It is infectious. It can have dreadful outcomes, involving life-long disfigurement and disability. And there is no cure or effective treatment once polio is contracted.

The polio vaccine provides complete protection. It has life-long effectiveness; it has no serious side effects. There hasn’t been a case of polio in the U.S. for half a century.

COVID vaccines are not comparable. They are less effective, their efficacy wanes within a year and they may not be fully effective against new variants.

And, again, there’s a highly effective COVID treatment pill in the offing, presuming it can be tweaked for evolving strains. Conceptually, there is just as much rationale for mandating the pill. Are we going to do that?

COVID vaccines are more akin to the vaccine for the seasonal flu. Yet, there is no mandate for the flu vaccine, even in public schools, despite that the flu kills about 60,000 Americans in a bad year.

Already, four federal courts have stayed the implementation of different Biden Administration COVID vaccine mandates. One would hope the courts will decide the law with an eye to logic and science and suspend the mandates permanently. Everyone wants to defeat COVID. Yet, Omicron has demonstrated two things. The virus is here to stay, in one form or another. We need to learn to live with it, while deploying various weapons against it. Second, COVID presents an ever-changing and nuanced challenge, against which blunt-force mandates are inappropriate. Which is not to say that vaccines are not wonderful. They are and so is the new Pfizer COVID treatment pill. Americans should be thankful for both.

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