Learning from the pandemic vs. repeating it

“Wouldn’t you agree that the vaccines are a disappointment?”

“Well, you can’t dispute that we went overboard on masking.”

“Hmmm, there is one thing that you must admit – those public health rules were just too much.”

Casual personal conversations in the midst of upright drink-in-hand holiday crowds provide a snapshot of the prevalent sentiments of the day. I received such leading questions in conversations at gatherings in December. The content reveals broad misunderstandings, a distrust of science, and a rapid movement away from the lessons learned during the pandemic.

COVID-19 vaccines. Because of 20 years’ research on spike proteins, new vaccines were quickly produced and tested in scientific clinical trials. The vaccines were highly effective and safe. There was hope that true herd immunity would be achieved if 90% of the population was immunized.

But alas, immunization rates were far less than 90%, the virus mutated frequently, and the hope of true herd immunity faded. Over time, however, a kind of hybrid immunity developed, which dramatically reduced severe illness, hospitalization and death due to COVID infection.

Earlier column:Dr. Jerry Kruse: The toolbox of harmony

How effective are COVID immunizations? On December 13, 2022, the Commonwealth Fund published a U.S. study that provided a stunning answer. For the 24 months from December 2020 to November 2022, it was found that the vaccines prevented 120 million COVID infections, prevented 18.5 million additional hospitalizations, and prevented 3.2 million deaths. Over those two years, the vaccination program saved the U.S. an estimated $1.15 trillion in medical costs. Yes, $1.15 trillion. A disappointment? Quite the contrary.

Masks and public health guidance. SARS-CoV-2 arose as a novel virus, a highly infectious and virulent agent for which no person had immunity. This virus had more potential for widespread infection and death than did the virus responsible for the Great Influenza Pandemic of 1918.

Throughout the current pandemic, all decisions were influenced by balancing safety measures with the normal activities of life. Early on, when uncertainty prevailed, the needle tilted appropriately toward safety, and the major tools for safety were masking and isolation. As immunity rose and a better understanding of the science of the virus was gained, the needle shifted in progressive increments toward return to normal activities of life.

In the first 15 months of the pandemic, there were three occasions when hospital systems were near collapse due to the heavy burden of severe illness caused by the infection – in selected cities during the initial surge of the virus, and later across the nation for surges caused by the alpha and delta variants. These surges occurred before a large segment of the population was effectively immunized, and masks and isolation were the tools that prevented a public health catastrophe.  Masks and solid public health guidance preserved the integrity of our health care system – and prevented much suffering and loss of life. Overboard on masking and public health guidance? I think not.

Those who doubt the effectiveness of vaccines, masking and public health regulations trivialize this pandemic. Too quickly, lessons learned have been cast aside, lessons from the great scientific advances that allowed the development of such effective vaccines and lessons from the excellent public health recommendations that were made in a time of ever-changing variables.

The high degree of immunity and the relatively low virulence of the omicron strains have allowed us to return to more usual activity. Unfortunately, the pandemic has not yet run its course. The emergence of more infectious variants of omicron, like the current XBB.1.5 strain, threaten an upsurge in cases. And the possibility of the emergence of a new, more virulent COVID strain that could produce another surge in hospitalizations and death is possible.  Maintaining a proper diligence for these possibilities will be a difficult task. A recent publication provides an illustration.

An article in the Dec. 2, 2022 issue of the American Journal of Medicine describes a population-based study in Canada that found a highly significant correlation between COVID-19 vaccine hesitancy and risk of serious traffic accidents. In an analysis of more than 11 million individuals, people who were unvaccinated were 48% more likely to have been involved in serious traffic crashes than people who had received at least one dose of the vaccine.

The author of a lay commentary wrote: “Of course, skipping a COVID vaccine does not mean that someone will get into a car crash. Instead, the authors theorize that people who resist public health recommendations might also ‘neglect basic road safety guidelines.’”

Jerry Kruse, MD, MSPH, is dean and provost, SIU School of Medicine and CEO, SIU Medicine.

This article originally appeared on State Journal-Register: Learning from the pandemic vs. repeating it