The Morning Jolt

Health Care

The CDC’s Unforced Error

People wear masks around Times Square as cases of the coronavirus Delta variant continue to rise in New York, N.Y., July 23, 2021. (Eduardo Munoz/Reuters)

On the menu today: The U.S. Centers for Disease Control and Prevention and the Biden administration make a critical error by recommending vaccinated Americans put on the masks again; sorting through who’s still not vaccinated and why; figuring out Simone Biles’s early withdrawal from the Tokyo Olympics; and the spectacularly inane argument that Saudi Arabia is more “progressive” than the United States.

The CDC Chooses to Play Motivational Psychologist

The Johns Hopkins School of Medicine: “Although vaccines afford very high protection, infection with the delta and other variants remain [sic] possible. Fortunately, vaccination, even among those who acquire infections, appears to prevent serious illness, hospitalization and death from COVID-19.”

If you’re vaccinated, the Delta variant could conceivably make you sick. But you’re extremely unlikely to have complications serious enough to require hospitalization or be life-threatening. For the vaccinated, the Delta variant is a potential inconvenience; for the unvaccinated, it has the potential to be a menace.

In America, there are three groups of unvaccinated people.

The first are kids ages twelve and under who are not eligible to get vaccinated yet. Pfizer has said it intended to request emergency-use authorization for its vaccine for children ages five through eleven in September or October — and in the past, it has taken the FDA about a month to approve the EUA. But earlier this month, an unidentified FDA official said that approval of the kid-friendly version could take longer — and that authorization could come “early to mid-winter.”

Thankfully, COVID-19 poses a low risk to children. As noted a little while ago, a child’s odds of surviving an infection are 99.995 percent, and those who did succumb suffered from preexisting serious brain- or nerve-related disabilities. As of June 28, roughly 4,000 of the 4.1 million children infected with COVID-19 have developed “multisystem inflammatory syndrome” (MIS-C); 37 have died. A study in England of 46 children who contracted MIS-C found that “six months after they were discharged from the hospital, only one child still had systemic inflammation, just two children had heart abnormalities and six children had gastrointestinal symptoms. All but one child were able to resume school, either virtually or in person.”

The second group of unvaccinated Americans are those who know themselves to be seriously allergic to one of the ingredients. It’s hard to get a precise number of how many Americans have these sorts of allergies, but the American College of Allergy, Asthma and Immunology stated earlier this year that, “Reactions to vaccines, in general, are rare with the occurrence of anaphylaxis estimated at 1.31 in 1 million doses given. Subsequent to the FDA emergency use authorization of the mRNA-based Pfizer-BioNTech COVID-19 vaccine on Dec. 11, 2020, and the Moderna vaccine on Dec. 18, 2020, anaphylaxis rates as of Jan. 29, 2021 are reported by the CDC to be five per million with Pfizer-BioNTech and 2.5 per million with Moderna.” Any way you slice it, Americans who are severely allergic to the vaccines are pretty rare; if the rate really is five out of every million Americans, we’re talking about 1,640 people nationwide.

The third group of Americans, who get by far the most attention, are those who choose to not get a vaccine that is free, proven to be effective, recommended by almost every doctor in America, and that is available at just about every drugstore. The first vaccinations started in mid December; all American adults became eligible for a COVID-19 vaccine on April 19, and teenagers became eligible May 10.

Whether or not the U.S. Centers for Disease Control and Prevention and the Biden administration want to admit it, by recommending all Americans, including vaccinated ones, go back to wearing masks in public places, they are asking the vaccinated to make another sacrifice to protect the unvaccinated — and many in that group are those who have chosen not to get vaccinated. If you see getting vaccinated as the responsible choice, the responsible are being asked to alter their behavior to protect the irresponsible.

And let’s keep in mind, a Venn Diagram of those who currently refuse to get vaccinated and those who refused to wear masks in the past and those who will continue to refuse masks would not quite be a complete circle, but there would be considerable overlap.

A lot of vaccinated Americans are going to ignore this new edict, and it is hard to blame them. Back in May, the CDC declared, “If you are fully vaccinated against COVID-19, you can resume activities without wearing a mask or staying 6 feet apart.” The Delta variant that has emerged since then is more contagious, but not more virulent or more likely to kill you. If you’re vaccinated, your risk of a serious reaction to infection is the same as it was two months ago. If you’re unvaccinated, your risk of a serious reaction to infection is the same as it was two months ago.

Yet the CDC is telling Americans that the circumstances have changed dramatically — that it’s time for vaccinated people to mask up in public places if they’re in more than half of the country, and calling for universal indoor masking for all teachers, staff, students, and visitors to schools, regardless of vaccination status.

This is leading to absurd decisions, such as the White House requiring all staffers to wear masks indoors, even if they are vaccinated. (If there are any White House staffers who are unvaccinated, they are few and far between; anyone who has contact with the president was prioritized for vaccination in the first few months.) Right now, Washington, D.C., has 21 COVID-19 patients in hospitals, and six in the ICU — out of 345 ICU beds total in the city.

Very quickly and subtly, the goal of our COVID-19 response has shifted from preventing hospitalizations and deaths to preventing infections — even though COVID-19 infections are likely to continue for many years, even if vaccinations grow more and more widespread. Breakthrough infections are not that scary; I know people who have experienced them, and they’ve felt lousy for a day or two, and then they got better. The same thing happens every flu season. We don’t go to the public-health equivalent of Defcon One over flu season.

These new CDC edicts feel like virologists and epidemiologists pretending to be psychologists, trying to figure out what statements will be most likely to get unvaccinated Americans to go out and get their shots. They are likely to backfire, spectacularly. The CDC may not want this to be interpreted as a declaration that the vaccines don’t work, but those who were already wary, skeptical, or vehemently opposed to vaccination will see the return of mask mandates as evidence that the vaccines don’t change anything, and thus getting vaccinated just isn’t worth it.

No More Biles at the Tokyo Games

Last night, USA Gymnastics announced that Simone Biles had withdrawn from the final individual all-around final at the Tokyo Olympics “in order to focus on her mental health” — after doing the same for the team gymnastics final.

Picture a pro athlete who, right before a huge competition, learns that a close family member has been killed in a car accident. Physically, they’re fine. Their muscles, tendons, and ligaments are just as strong and flexible as they were the day earlier. But emotionally and psychologically, that athlete is in no condition to compete, and no one would begrudge that athlete for declining to compete.

That sounds like the phenomenon at work in Biles’s recent decisions: Physically she was fine, but emotionally and psychologically, she just wasn’t where she needed to be. And a gymnast who can’t concentrate properly is a gymnast at a much higher level of serious injury. If she didn’t think she would be at her best, or even close to her best, then withdrawing was the right decision. And this year’s Olympic games are just different — all of the athletes have lived through an extra year of training, waiting, and hype, all of the virus protocols and social distancing, no fans in the stands. I think Dominic Pino made some strong points about the value of coaching in keeping a top-tier athlete mentally prepared and emotionally durable. And for at least 14 years, the team doctor for USA Gymnastics was basically Hannibal Lecter. As the Wall Street Journal reported, “An examination of USA Gymnastics’ response to the allegations shows the federation ignored the possibility that its brightest star had been sexually abused while in its care, walled her off from investigations, and she didn’t know it for years.”

With that said, it’s really hard to overstate what a shock it is, and how legitimately disappointing it is, to watch the athlete who’s been the centerpiece of the coverage of the Games suddenly decline to compete at the last second. She is this Olympic’s Michael Phelps, Carl Lewis, Jackie Joyner-Kersee, Mary Lou Retton, smiling out at us from the Wheaties Box. She was capable of handling the pressure four years ago in Rio. And now, her Tokyo Olympics legacy is a dramatic underperformance in the all-around qualifiers and a shocking early withdrawal. It does raise the question whether NBC, and other institutions that heavily cover the U.S. Olympic team, established an ever-accelerating cycle of hype that wasn’t good for Biles and wasn’t good for all of the lesser-known U.S. athletes, either.

The higher the expectations, the higher the pressure. Some sports psychologist or statistician may eventually determine that being the most famous and heavily covered American athlete in a particular Olympic year makes you less likely to win a gold medal — I’m thinking of “Dan and Dave,” Michelle Kwan, some of the post-“Dream Team” U.S. basketball teams. Then again, swimmer Michael Phelps did so well, year after year, that I feared he would test positive for gills.

ADDENDUM: The commentary pages and social media have incentivized the hottest, most controversial, and most provocative takes, regardless of whether they make any sense. Max Boot argues that Saudi Arabia is more “progressive” than the United States because the kingdom requires subjects “need to show proof of vaccination to enter schools, shops, malls, restaurants, concerts, public transport.”

I say “subjects,” because if your society’s laws come down from a king and you have no say in them, you’re a subject, not a citizen.

If you want to cheer for a society where the government can require you to show your government-issued documents anywhere you go, fine. This is still the same government that bars freedom of expression, holds show trials, bars Jews, bans gays, restricts women’s rights, and beheads prisoners in “Chop Chop Square.” If you want to cheer that regime, fine, but don’t call it more “progressive” than the United States because we’re not willing to install a World War II movie-style “papers, please” regime in our train stations.

Calling Saudi Arabia more progressive than the United States is stupid, and Max Boot is stupid for making it. But he’s gotten the world to pay attention to him again, and I suppose that’s the ultimate goal.


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