There is no clear way to reach a postpandemic world in the U.S. Over the past two years, we have developed a number of scientific tools for the prevention and treatment of carbon dioxide. We stumbled in implementing them. Our public health messages were not clear about how to use the tools, which included vaccines, masks, tests, and temporary activity restrictions. The result is confusion among the public that has left us vulnerable to the disease and unable to respond to new and more transmissible variant such as BA.2 and its sub lineages, which are infecting a rising number of people across the nation. One million people have died in America during the Pandemic. We are woefully unprepared for future changes that could be more deadly and contagious.
A change in direction for our national health messages is needed to recover from these mistakes. As cases rise, it is an opportune time for the Biden administration to launch a new communications campaign through the Centers for Disease Control and Prevention. Drawing a line in the sand is what the campaign needs to start. 100,000 deaths can be accepted as part of our new normal. It would be morally reprehensible to lose tens of thousands more Americans to the disease. The deaths orphan hundreds of thousands of children and the serious illnesses destroy an entire generation of older Americans and wreak havoc on the economy.
The Omicron variant made us vulnerable at the beginning of the year. American society was disrupted by a surge of cases caused by this highly transmissible version of the virus. Hospitals, already struggling with staff shortages, were once again overwhelmed. The mild variant was deadlier than the dangerous Delta variant because of failures in containment. The country averaged more than 15,000 deaths per week in February. We have suffered more deaths than any other nation.
Why haven't we protected ourselves? Federal agencies focused on a vaccine only strategy when it was available. Their attempts to pursue other safety measures have been slow and infrequent. Governments have rushed to abandon almost all mitigation strategies. There is confusion about how dangerous the virus is and what precautions still need to be taken because of the different manners in which measures have been introduced.
There is a whiplash change in messaging that confuses more people than it helps. At the end of February, the CDC switched from a tool that focused on new infections to one that relied on hospital admissions andOccupancy. Many counties that used to be high-risk have now become low-risk. Recommendations for behavior were added to the ratings. It doesn't recommend masking indoors for medium-risk counties anymore. The change seems hard to justify because there is a lag between spikes in reported cases and the increase in hospitalizations. The new system will be less useful for everyday decision-making due to the fact that new cases are poorly tracked and trends are not emphasized.
Many of the CDC recommendations leave decisions up to individual judgement. If you go to any gym in the country, you will find members taking care of their equipment, even if they don't have a mask. CDC messaging is reflected in these poorly protective behaviors. Agency messages place vaccination and masking at the top of their preventive measure lists, but do little to differentiate the importance of these measures from the less important ones. Despite robust evidence for the superior effectiveness of N95s, the CDC does not recommend the use of them. The agency emphasizes comfort and states that people should wear the most protective mask they can that fits well. N95-type masks are more protective than others according to the agency. It had warned Americans not to wear these masks because of supply shortages for medical workers.
Shifts in our scientific understanding of the disease caused some CDC positions to change. The changes seem to be driven by public pressure or arbitrary. If there are staffing shortages, the agency reduced recommended isolation periods for health care workers from 10 days down to seven. They shortened the recommended isolation and quark period for the general population to just five days, regardless of whether a person was still infectious or not. The agency says that people can spread the virus another eight days after their symptoms start.
Rochelle Walensky acknowledged that the goal was to allow people to keep going. While the move was necessary to prevent economic strain in certain sectors, a five day isolation period and no test requirement were not enough to minimize risk.
Walensky gave a mixed message on mask wearing. She said in an interview on February 21 that wearing a mask was easy and painless, but that it was the scarlet letter of the Pandemic. She said that they were making it hard to live normally. It's a real failure in public health communications to make conflicting statements about a vital tool.
A new and successful communications campaign needs to begin by defining how much death and disease the country can accept from this virus. The targets need to be set by public health experts. Congress has recently refused to spend money on prevention and treatment.
It's important for the federal government to let the public know when and how they should use masks. Everyone needs to understand that these tools are very effective but difficult to continue for a long period of time. When key metrics begin to rise, those short term measures should be easy for the public to adopt. The public is ready to respond if multiple fallback plans are also widely publicized.
Changes to how we distribute public health information will need to be made for a long time. We need celebrity involvement, online media, educational materials and broadcasts, and in-person outreach in these efforts. We need ambassadors from different communities and materials in multiple languages.
Local governments and courts have made this kind of coordination difficult. Their opposition was aided by the lack of a clear top-down vision, vacillation on key pieces of guidance, and the failure to establish links between guidance and underlying science. Public messaging can be used to counter misinformation.
Two years ago, we didn't know much about how to treat COVID. We have failed to translate this knowledge into clear messaging that would prompt action. A nationwide public health communication strategy that is consistent and free from political influence is necessary to close the space between knowledge and action.
The views expressed by the author or authors are not necessarily those ofScientific American.