COVID response lags, again and again by Marjorie Arons-Barron

The entry below is being cross posted from Marjorie Arons Barron’s own blog.

Remember Dr. Li Wenliang, the Wuhan whistleblowing eye doctor whose warnings to medical colleagues about the not-yet-identified Covid virus were dismissed by Chinese authorities as “false comments” and rumors?  In January 2020 my info-holic husband told me about Dr. Li and predicted this could be the start of a dangerous pandemic.  I remember our discussions at the time. About how difficult it would be to get a quick understanding of the pathogen, how evolving scientific information could be manipulated by politicians, especially given the deep partisan divisions in our country, making a post-911-like unified national response unlikely.

We had recently been in Vietnam and Japan, where people regularly wear face masks in public to protect themselves, and we pondered the wisdom of doing so here. But our leaders initially discounted their use, possibly because there were not enough masks to protect public health and they had no plans for mass production.  So, mask-less we traveled to Florida in late January to places later identified as hotbeds of Covid.

During the past two years, we’ve been blessed by the rapid development of effective vaccines and the sacrifices of frontline workers, damned by those in power who lie about public health matters for private gain, and confused by what we should next do to survive and deal effectively with a likely endemic disease.  Unfortunately, even since the departure of the blatantly dangerous Trump Administration, we have been ill-served by many in positions of authority, at all levels,  who have not often exercised necessary foresight and then bungled eventual implementation.

Remember how getting access to vaccinations in February 2021 was a blood sport? Finding a place that had vaccines and getting an appointment took 24/7 vigilance, internet agility and unusual patience. The failed internet process was highly reminiscent of the tortured roll-out of the Affordable Care Act under President Obama, but with wider impact. In both cases, the bumps eventually got ironed out. Now Massachusetts has one of the highest immunization rates, with 75.3 percent fully vaccinated, and 92.2 percent having had one shot. Perhaps we’re safer, but it doesn’t always feel that way.

We’ve not yet gotten testing protocols right. Long lines for PCR tests have become the norm, and finding at-home rapid antigen tests has become a scavenger hunt. There were not enough tests in the state, and finding pharmacies and other sites that had them was often fruitless. Websites announced new deliveries, but supplies were gone by the time you could get in your car and arrive at the store.

There’s no excuse for the slowness of the Biden administration to contract for the production of adequate testing kits. This week they announced they’ve ordered 500 million tests, bring their total purchase to a billion, which will go online free of charge, starting next Wednesday. With delivery time, that could mean a two-week delay. This past week Governor Baker announced a contract for 26 million rapid antigen tests over the next three months, a time frame he couldn’t guarantee with further supply chain disruption. Another case of too little, too slowly.

Despite the positive announcements, the foot-dragging has been frustrating, and the procedures for getting the tests and insurance reimbursement remain unclear.

As with vaccines and tests, government guidelines for mask wearing have been endlessly muddled. The city of Newton had a mask mandate for indoor public spaces; neighboring Needham has no such rule. Somewhere along the border, Needham Street in Newton becomes Highland Avenue in Needham. It’s never clear what protocol kicks in precisely where. Why should small business owners in one place have an enforcement burden with which competitors just yards away do not have to contend? These conflicts run across the state.

No one says vaccination mandates are easy to enforce. I’ve heard complaints of laxity in verifying vaccine credentials at a major cultural venue, with people waving their cards and moving inside with less scrutiny than willfully blind bars checking ID’s of college kids in pursuit of beer.

Thursday the Supreme Court upheld vaccination mandates for certain health care workers but ruled the federal government couldn’t require large businesses to mandate vaccines for employees. The Court’s reasoning was painful, leaving us hoping companies would sustain the vaccine requirement on their own to ensure the continuity of their labor force. Some large employers, like GE, have already backed off. The private sector has joined the government in letting us down.

Covid is causing a hospital crisis. Facilities are strained. Health care workers are sick or burned out. The President is directing military health care personnel to a handful of the most stressed cities. The Governor just announced an executive order to redeploy a variety of professionals among our hospital system, better utilizing physician assistants, loosening credential standards for internationally trained physicians, and altering other staffing requirements. Why wasn’t this plan put in place before the system went into total melt-down?

And there’s more. The state just launched, a government website to ensure the state has our vaccination records so that eventually we won’t have to carry our vaccination cards with us. I was not alone in discovering the state couldn’t confirm any of the information I put in. At least, when I called for help, a friendly state employee could walk me through filing a request for forms to circumvent the problem. And within a day or two, my state records had been updated. A small success against the backdrop of one after another bungle.

Despite the confusion, the failure to plan, implement, communicate, – or perhaps because of it – the rate of infection with the Omicron variant in this peak period (even among people who are fully vaccinated) means that our best hope to avoid or reduce the impact of infection is a multi-pronged approach. That means full vaccination, plus quality masks, plus avoiding large groups in venues with inadequate ventilation or in which you can’t guarantee the other participants have been as careful as you have.

Wouldn’t it be wonderful if all levels of government could agree on an approach based on scientific best practices (even if requiring updates) and uniformly applied? Wouldn’t it be reassuring if we had community consensus on what is best for the public good? It seems little enough to ask, but, ah, on what planet would that be a possibility?