People Have Gotten ‘Institutionalized’ by COVID

I n the film The Shawshank Redemption, an elderly character named Brooks gets released after 50 years in prison. Instead of celebrating his release, however, he is tentative — and shortly after experiencing the freedom of the outside world, he hangs himself.

“These walls are funny,” Morgan Freeman’s character Red explains to his fellow prisoners as they process the news. “First you hate them, then you get used to them. Enough time passes, you get so you depend on them. That’s ‘institutionalized.’”

As the vaccine has brought the promise of liberation from a year of masks, lockdowns, canceled travel plans, and forgone family visits, there is a contingent of Americans who are simply not prepared to move on. They have somehow gotten used to the restrictions and are wary of returning to their pre-COVID-19 lives. In short, they’ve become “institutionalized.”

Last week, somebody wrote into the New York Times advice column “Tripped Up,” mulling when they could travel again:

My husband and I are both fully vaccinated, and the Centers for Disease Control and Prevention says that we’re good to travel — with some modifications, of course.

But I am faced with a dilemma. Alaska, where we live, has been on the forefront of vaccinations. But until everyone we might encounter on a trip has been vaccinated, I am struggling with the idea of getting on a plane unless it’s absolutely necessary . . .

The writer goes on to ask whether she should travel if “there’s some chance, however small, that it could endanger others.”

In reality, a growing body of evidence suggests that vaccines are highly effective at preventing transmission, meaning that it is unlikely that a vaccinated traveler is going to pass on COVID-19 to somebody else — and the most vulnerable Americans have had the opportunity to get vaccinated for months. About eight in ten U.S. COVID-19 deaths occurred in those 65 and older, and 70 percent of that population is now fully vaccinated, with 83 percent having received at least one dose. Furthermore, given the large percentage of vaccine-hesitant Americans, deferring plans until everybody one may encounter on a trip is fully vaccinated would effectively mean never traveling again.

In another story, the Wall Street Journal quoted a woman from the Washington, D.C., suburbs who was concerned about letting her vaccinated parents make an overdue visit to see their grandchildren, because she was concerned about her children getting infected. After considering various measures, such as testing and quarantine, eventually the grandmother said she’d likely wait until the children are fully vaccinated.

Again, the likelihood of somebody who is vaccinated transmitting COVID-19 is low. But on top of that, children who have gotten the virus are at extremely low risk of developing severe symptoms. Waiting until children are fully vaccinated would mean delaying any sort of visits until at least this fall, or potentially until 2022.

It would be one thing if these attitudes were confined to a few random risk-averse people. But their approach is a reflection of the message being sent by leaders and public-health officials. The vaccinated President Biden is often seen wearing a mask outside, and he said recently that it was a “patriotic responsibility” for Americans to wear masks indefinitely, regardless of their vaccination status. Anthony Fauci, who has been fully vaccinated for months, has said he won’t go to restaurants or movie theaters. “I don’t think I would — even if I’m vaccinated — go into an indoor, crowded place where people are not wearing masks,” he said. He also said, “I don’t really see myself going on any fun trips for a while.”

There are those who may argue that if some people are being extra cautious or government officials are making non-binding statements, it doesn’t directly affect those who want to ease up on the precautions. But the problem is that we are in the midst of a destructive feedback loop. Leaders make statements that overstate the current risk of COVID-19, which ends up guiding the decisions of local officials, and it also makes people more nervous about returning to normal. The people who are nervous remain less likely to pressure local officials to change irrational policies.

More than a year after schools shut down, they have not fully reopened in many places — and it still is an open question whether all schools will be back to normal in the fall. In Washington, D.C., Mayor Muriel Bowser is now allowing weddings to take place — as long as they don’t allow dancing. She would not commit to considering easing up the rule so that vaccinated people would be able to dance at their own weddings. In Brookline, Mass., and Montgomery County, Md., local officials decided to maintain outdoor mask requirements even after their states mostly ditched them. The CDC, despite revising mask guidance, has maintained recommendations that children’s summer camps require everybody to wear masks outside unless eating, drinking, or swimming. This, even though outdoor transmission is rare at best and again, children are incredibly low risk. Particularly in areas where it can get brutally hot and humid during the summer, forcing children to wear masks all day is simply inhumane. This particular recommendation is so absurd that Fauci himself couldn’t maintain a straight face when asked to defend it in a television interview.

The common thread in the “institutionalized” concept of COVID-19 is a disproportionate emphasis on low probability events and unknowns. People always take on some degree of risk in their lives. They could die in a car accident, but they still drive. They could drown, but they still swim. In 2019, there were 93,700 preventable injury deaths occurring in Americans’ own homes.

It is true that when it first arrived, COVID-19 presented an unacceptable risk, especially to many vulnerable populations. But with the exceedingly high vaccination rates among the most vulnerable, the situation is dramatically different today. Drastic measures that may have once been justified no longer make any sense, because the risk calculus has changed. Forgoing travel when you’re unvaccinated because you don’t want to transmit the virus to somebody vulnerable and unvaccinated is a lot different from traveling when vaccinated, and when most vulnerable people are vaccinated.

It’s true that vaccines are not 100 percent. It’s true that there is always a risk that a variant could develop that can get around the vaccine. And it’s true that we don’t know whether there are long-term health effects of COVID-19 to children who had mild cases. Yet while the risk of COVID-19 may never be zero, in normal times, we take many actions that entail at least some risk. Furthermore, it could take decades before we have an understanding of various unknowns, such as long-term health effects. We cannot put our lives on hold while we wait for answers.

Instead, people should celebrate the miracle of these vaccines, embrace their liberation from COVID-19 prison, and get on with their lives.