The slippery slope of the COVID public health response has gotten even more slippery with the predominance of the highly contagious delta variant.
The game has changed, and now, it is becoming more apparent that beyond six months the powerful MRNA vaccines are slipping, and boosters are needed, especially among the elderly, the immuno-compromised, those with chronic illnesses, and workers on the front lines who are frequently exposed to COVID.
Soon we will all need boosters. But the need for boosters should not undermine confidence in the vaccine, but simply underline its limitations in the face of real world contact with a highly infectious variant.
The virus itself, which can cause complications and long-term damage to every organ system of the body, provides more than enough motivation to take not only the initial two shots, but also the booster.
Too often, health decisions are made based on emotions, rather than reason, and a government official talking down to your concerns doesn’t help, nor does a news media pounding the same drum even after the playing field has changed.
USA TODAY's opinion newsletter: Get the best insights and analysis delivered to your inbox.
This reasoning applies to vaccine passports at a time when the efficacy of the vaccine is waning against delta as well as to all public health measures from vaccines to masks to testing.
Adjust as playing field changes
Consistency isn’t possible as the playing field changes, but dogma never inspires public confidence.
Yet, as an Italian study recently demonstrated, governments use linear public health pronouncements to justify an overreach and control, using the politics of fear.
The study, published in PLOS One, concluded wisely that “media narratives exclude neither scientific issues nor scientific experts; rather, they configure them as a subsidiary body of knowledge and expertise to be mobilized as an ancillary, impersonal institution useful for legitimizing the expansion of political jurisdiction over the governance of the emergency.”
Political assertions are far from the same thing as saying that these measures always work. Certainly, school closures and lockdowns are to be avoided at all costs, because the physical (delayed screenings and treatments), psychological (anxiety, depression, substance abuse, isolation), and economic devastation have been shown throughout the pandemic to way outweigh the limited benefit in terms of viral control.
When it comes to masks, and even more so to vaccines, the benefits are real and the risks or downsides are small.
In these cases, government mandates may seem purely political, but so are autonomic refusals falsely described as personal choice.
After all, taking the vaccine not only means you are less likely to get very ill or go to the hospital, it also definitely decreases your risk of spreading the virus to others, which makes it a public health concern.
Businesses and schools have every right to request a vaccination or proof of immunity (including natural immunity from having overcome COVID), or to institute regular rapid testing.
Better to identify and screen contacts as opposed to having to close businesses or quarantine entire classrooms. Of course, we must keep in mind that now with delta, vaccination is by no means an assurance that a person is free from carrying COVID.
It is clear from many studies that the way to keep schools open is with widespread vaccination, testing, masking, distancing (three feet) and proper ventilation. Closing schools because of your child’s right to refuse to wear a mask makes as little sense as forcing masks on little kids who can’t tolerate them.
Resisting a government mandate is just as politically dogmatic as blindly following it.
The public health reality here is simple, even if the politics are complex.
You can do everything right and still get sick
I was reminded of it this week when I heard from a dear friend of mine in south Texas. He's a great internist who provides service at nursing homes, hospitals and in the office. He is overweight and over 60, and he had the Moderna shot more than six months ago.
Two weeks ago, he contracted COVID. He told me he has been encountering many unvaccinated people without masks from both sides of the border and they are spreading it.
My friend got very sick, despite the vaccine, suffering a high fever, extreme fatigue and a decreased oxygen saturation. He said that if it weren’t for the vaccine, he would have ended up on a ventilator. He managed to stay out of the hospital, barely, and wished he had had a booster.
You can do everything right and still get sick, which is all the more reason not to do everything wrong. Not because the government tells you, but because it is the right thing to do.
The playing field is changing, the goal posts are moving, and we must move along with them.
Dr. Marc Siegel, a member of USA TODAY's Board of Contributors and a FOX News medical correspondent, is a professor of medicine and medical director of Doctor Radio at NYU Langone Health. His latest book, "COVID: the Politics of Fear and the Power of Science," was published last fall. Follow him on Twitter: @DrMarcSiegel
You can read diverse opinions from our Board of Contributors and other writers on the Opinion front page, on Twitter @usatodayopinion and in our daily Opinion newsletter. To respond to a column, submit a comment to email@example.com.
This article originally appeared on USA TODAY: COVID vaccines: Why you must adapt as delta variant runs rampant