The wrong way to start this piece would be stories about the horrors of COVID-19. I will start with what everybody should do.
- Keep your social circle small
Stay away from as many people as possible. If you know someone is a social butterfly and always around a lot of different people it would be prudent to stay away from them. Stay away from large groups, especially indoors. The best way to not get or spread the virus is to decrease exposure. The only sure way to do that is increased isolation and distancing.
The data is convincing that the vaccines are reducing the risk of death or hospitalization. Some of that data has been exaggerated but analysis of recent hospitalizations and deaths show significant benefits for people who are vaccinated. The FDA should have approved boosters for everyone in my opinion. The reason they did not is it appears the vulnerable populations, the elderly and sick, were the most likely to get breakthrough infections. Remember you still can get infected and spread the virus if vaccinated and it should not be a reason to loosen up other behaviors.
Most convincingly, The New England Journal of Medicine published a randomized placebo-controlled trial (Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine | NEJM) on the Pfizer vaccine last week. It demonstrates the vaccine has an excellent safety profile. It clearly prevents infections, hospitalizations, and deaths. It confirms what has already been seen with collected retrospective data. It is reasonable to think data on the other vaccines will follow and be similar. This is how science works.
- Wear masks
Mask data is not great in terms of effectiveness. The best data for protection is with higher level masks in highly ventilated environments. In the new world of the delta variant cloth masks appear to have lost significant effectiveness if it ever existed at all. Some areas of the world have started using medical quality masks in public places. I would recommend getting medical masks if you can. Masks can help if used properly but should not be viewed as any kind of absolute protection. One of the best reasons to wear one is to not irritate some of the people around you. Wearing a mask while indoors for brief periods of time is not worth creating an unnecessary ruckus.
- Clean surfaces
Almost all respiratory viruses have some transmission by surface and it is a major transmission source for many of them. I disagree with the experts on whether COVID -19 can be spread by surfaces. In any case, clean surfaces will prevent other infections which is desirable when COVID-19 is ravaging the medical system.
None of the above is any guarantee. As many people have found out you can do all of it and still get infected. The good news is most people are not going to be hospitalized or die from the virus. The vaccinated are even more protected in that regard.
I am not frightened. I am not going to cry. I am not going to pretend I am some kind of oracle from on high. I will not be the mouthpiece for any political position here. I am a simple stomach doctor.
The country is being divided. Misinformation is flying in from all sides. The messages have constantly changed. It is comical to hear people say “science” when almost nothing in the media reflects true evaluation of the science. Physicians have been guilty of playing that game. Some have allowed themselves to become political tools. And worst of all, some have decided to determine who they will care for based on patient decisions about their health care.
I have a patient get irritated with me almost daily when I suggest they get the vaccine. You would think the hospitals are filled with people getting vaccine side effects if you believed the stories I hear. I make it clear to them it is ultimately their decision but that the risk/benefit ratio is in their favor getting vaccinated.
There are patients who give my office grief over masks. I try to explain that even if they do not believe masks work it is a reasonable thing to do. I hate wearing a mask and I essentially have one on all day. It is always at least a surgical mask and occasionally an N95. I get funny looks at Costco now when I am wearing one. It provides some protection. More importantly it makes patients and others feel safer and that matters. In the same respect, people should not lose their mind over someone not being masked.
I get accused of being anti-vaccine because I do not think mandating is helpful. I get accused of being non-scientific because I dare point out mask data is not strong.
And there is the heart of the problem. People are so caught up in their position and need to be right they have lost empathy for the other side. It is no different than anything else in politics right now. If you veer away from the absolutes you are the enemy.
It is no different than what has happened over the past years. Unlike 9-11 which united us, COVID-19 has divided us. It has fed into all the other political divides.
There is no politics in the exam room.
I have evaluated medical studies for 30 years. I know what is a good study and what is a bad study. I also know when you have to move the lines and accept less strong data. COVID-19 is one of those times. It is important to be honest when you do that and realize better data is around the corner.
The government should not have to mandate behaviors. People should do it because it is the right thing to do. This should be up to the private sector. People should work from distance if they can right now. Businesses should encourage vaccinations and masking.
I know it is a lot to ask for people to not make bad decisions. The life of a physician is mostly telling people to make better decisions. Hospitals would have far less patients if people made better decisions. After 30 years I have learned some people are just not going to listen.
Make no mistake, bad decisions cost us all. Seven of the ten costliest diseases in the United States are obesity related. Tobacco, alcohol, narcotics, and more recently marijuana, make their mark on costs as well. Those costs hurt all of us. Substance abusers create all kinds of societal ills as well. The consequences of all of that will still be a problem when COVID is in the rear-view mirror. Calling the unvaccinated menaces lacks empathy we usually have. It does not move the ball down the field. It will just harden the resolve of the opposition.
They say there are no atheists in a foxhole. I suspect that same kind of realization happens in a patient dying in an ICU from COVID.
Everybody should take a step back. Put down your political biases. Listen to the simple stomach doctor. You will not see me get paraded out by a Christopher Constant or Felix Rivera. You also will not see me endorse some of the unfortunate rhetoric coming out of the mayor’s office.
I avoid unnecessary contact. I have been vaccinated. I wear surgical masks or N95s in public indoor places. And I keep everything sanitized around me. This stomach doctor is not stupid. And you should not be either.
Dr. Sweeney has practiced gastroenterology in Anchorage for 21 years, with the first three at JBER. The views presented here are his own and are not made on behalf of any organization.