Stories >> Healthcare

Marty Makary: Risk of COVID is now very low — it's time to stop living in fear



COVID cases are collapsing in front of our eyes. Daily cases are now one-tenth the number of daily flu cases in the middle of a mild flu season, with a now-identical case fatality rate. That's because the few Americans testing positive are often young, feel fine, and underwent testing as a screening requirement for playing sports or attending gatherings.

The US positive rate is now at a record low, below 3%. Projections for the coming weeks and months are even more favorable. That's because roughly 80% to 85% of adults are now immune — more than 6 in 10 adults are now vaccinated and more than half of unvaccinated adults have natural immunity from prior infection. In public health, when a virus has trouble jumping around because more than 8 in 10 adults in a community are blocking its transmission, we call that herd immunity.

Yet some people want the pandemic to stretch out longer, insisting on a futile goal of absolute risk eradication.

Posturing to be on the side of science, they ignore the science on the effectiveness of vaccinated and natural immunity and dangle variant fears. They wear masks after being fully vaccinated even though there has never been a documented cases of a fully vaccinated person who is asymptomatic transmitting the virus.

They've paralyzed the nation with fear.

Some point to the Yankees as an example of the risk of a breakthrough infection. Indeed, one player of the 50 vaccinated players tested had COVID symptoms, representing the rare instance of a breakthrough infection. But his immune system worked. It resulted in the infection being very mild. Vaccines are highly efficacious in preventing the infection, and nearly perfect in preventing COVID death.

Of the other seven players who likely tested positive, none had symptoms. Their immune systems worked to ward off the virus when it landed on the mucosal membrane of their noses. Just because a PCR test, which can detect as few as 10 molecules of virus particles, reveals evidence of a remnant virus does not mean there is any health concern.

Our battle is not against positive tests, it's in preventing serious illness and death.

San Francisco General Hospital now has zero COVID patients in the hospital and the city reported 2 new positive COVID tests Wednesday. Is San Francisco still in a state of emergency? If so, it may never end. Seasonal flu would trigger the same health emergency criteria in perpetuity. Mayor Bill de Blasio says New York City will "fully reopen" on July 1 — but why wait until summer is half over?

At some point we have to live our lives. That time is now.

The fear-mongering will likely ramp up in the months ahead with warnings of new variants, and medical pundits fixated on "what ifs" over good news. They've already started. The CDC director, Rochelle Walensky, recently reported on the good news of rapidly declining case counts in the US. Then she added that variants "are a wild card that could reverse this progress we have made."

Why would any doctors say that right now? It's unproven, theoretical, and unlikely. It would be like discharging a patient home from the hospital after a long successful battle with cancer and telling them to remember that there is a small chance that their cancer could come back.

Medical and political leaders should show strong leadership and give balanced, science-based projections of what to expect in the future. The public has made tremendous personal sacrifices. Right now, Americans need hope.

Blaring non-stop warnings by our public health officials about variants is irresponsible. Here are the medical facts. We have seen hundreds of variants and none have ever evaded the power of vaccines to prevent death or hospitalization. The idea that vaccinated immunity may be fragile is a far-reaching hypothesis with no clinical data whatsoever to support it.

Variant fears have also entered politics. As revealed by the New York Post, the American Federation of Teachers got the CDC to add language to the agency's draft school guidance saying plans to reopen are conditional on the risk of new variants.

Schools should be fully open now. We've done far too much damage to a generation of children over infinitesimally small risks. Unwarranted fear of variants cannot be used as an excuse to continue propagating this harm.

The truth is this summer will be spectacular. Americans will remember the fullness of life and reconnect with people and activities that they miss. There will be little to no COVID news this summer.

But with little to talk about, I anticipate that the mainstream media will continue to find whatever warnings they can. The buildup will create anxiety over a hypothetical scenario, and that fear could result in pre-emptive closures and restrictions.

Many people say they do not feel comfortable traveling for work-related reasons such as attending national conferences this fall. That's based entirely on perception and not on science. The overly restrictive CDC guidance on travel does not help.

Too often, Americans see the COVID threat as binary — acting as if the threat is equally dire for everyone, or that it's nonexistent. Unfortunately, this distorted risk perception is blocking parents from watching their kids play sports, preventing families from being with their loved ones in the hospital, and depriving Americans of the dignity of participating in milestone life events, such as weddings and funerals.

We need to get over the fear. We need leaders to lift restrictions, and scientists to talk realistically about risk. We need to get back to living.

For many wealthy Americans, the COVID state of emergency has been good to them. But for the half of Americans who live paycheck to paycheck, they have had a much different pandemic experience — one defined by financial risk and kids at home who are struggling. Given the low, manageable, and declining public health threat of COVID in many regions of the country, let's let Americans assess their own personal risk and stop depriving them of their livelihoods.

Marty Makary, MD, MPH is a professor at the Johns Hopkins School of Medicine, Bloomberg School of Public Health, and Carey Business School. He is chief medical adviser to Sesame Care and author of the upcoming paperback book "The Price We Pay."


Click to Link




Posted: May 21, 2021 Friday 01:53 PM