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How to Sort Through Mixed COVID Messaging, According to a Public Health Expert

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Meghan Fitzgerald, RN, MPH, DrPH, is an adjunct associate professor with the Columbia University Mailman School of Public Health and a private equity investor. She has decades of experience working in the healthcare field, ranging from frontline patient care to advising prominent healthcare firms. Here, she shares her take on why the American public receives so much mixed messaging regarding COVID-19 safety policies.

Why can some people remain unvaccinated in a place of work but not on a cruise in the same state? How does removing your mask on a crowded flight only to put it back on after landing make sense? You are not crazy; it makes little sense, yet here we are. 

I still hear from some seniors who are washing their groceries out of fear of COVID-contamination, which isn't necessary. Meanwhile, millions are sitting on the vaccination sidelines because of confusing statements about masking and social distancing from roundtable “experts” and misplaced fears around post vaccine side effects. My colleague summed it up in one question: Why can’t the public health community speak with one voice?

The short answer: It's impossible.

Last week while giving a live interview, I had to answer why the World Health Organization (WHO) reissued mask-wearing guidance while the U.S. Centers for Disease Control (CDC) did not. Within the span of my five-minute interview, news was breaking on booster shots (under review), breakthrough infections in the vaccinated (expected), and the Delta variant being highly transmissible (true). At the same time, a bipartisan bill was circulating to relieve airline passengers from wearing masks inflight. It is all enough to make your head spin. 

There is a diverse mix of global and local issues that makes a one-size-fits-all set of communications and protocols from public health officials unrealistic. To make it even more confusing, there are partisan politicians on both extremes masquerading as public health pugilists. They are using the COVID-19 crisis to advance an agenda. This feeds conspiracy theories and causes many people to tune out true experts.

However, there is a roadmap for making sense of the moving parts. When I read a public health story, I will double, or triple click to see the sourced data, as good reporting will have a hyperlink to navigate the claims. If you do the same, give yourself credit that you can read the salient points of a clinical paper and its findings. If the results are confusing, speak to someone you trust, like your own medical provider, who has your interest (not votes, money, or Twitter likes) in mind. 

Ultimately, public health leaders who live in a world of scientific evidence agree on three important things:

  1. Vaccines work
  2. Variants are manageable
  3. The U.S. only wins if the whole world beats the virus

Vaccines Work

Evidence to date shows existing vaccines to be highly effective at preventing hospitalizations and death against the variants (including Delta), but only for those fully vaccinated. With 48% of the U.S. population fully vaccinated, the virus is finally starting to run into some roadblocks. America has gone from zero shots in arms to vaccinating hundreds of millions around the world in less than a year. As a result, the guidance will evolve on interventions, vaccines, and treatments regarding efficacy and safety.

Variants are Manageable

COVID-19 vaccines are not 100% effective, so some people have and will become reinfected. No one in public health should issue an absolute on anything in this pandemic.

If we look at the unfolding evidence around the Delta variant, we see that it is highly transmissible, but researchers are still studying exactly how lethal it is. In Israel, where this variant is rampant but vaccination rates are high, reported deaths and severe cases remain low. In the U.K. where Delta is now the dominant variant, new COVID cases are decoupled from both hospitalizations and deaths. This is all we can really ask from good vaccines: that COVID is rendered a nuisance instead of a debilitating illness or death sentence. 

A Global Approach Matters

The world is at different stages of COVID-19 control, and it is America's problem too. We have a long way to go. Only about 38% of people globally have received even just one dose of a COVID-19 vaccine.

In India, less than 5% of the population is fully vaccinated. The country faces a dire shortage of oxygen, which is the lifeblood for treating those who cannot breathe. With these sobering facts, you can understand why the WHO is giving mask-wearing guidance and the CDC is not. 

The one area for improvement and debate will be around policies that account for the health of a population while also considering the livelihood of individuals decimated by this catastrophic event. Those who have missed medical appointments, lost jobs, or lost their way due to addiction and a lack of support for mental health also matter. It is important to be able to individualize general health guidance.

Most people in the public health went into the field to protect and serve. My motto is simple: Be intellectually curious, engage in healthy debate, and evaluate your own risk. Discuss what you read with your own healthcare provider and be patient. Most people in public health are also grappling to separate signal from noise and learning as the pandemic unfolds.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.

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