When Science, Politics, Business, and Public Health Collide

We have been living with the threat of SARS CoV-2 for over a year and a half.  Republican leaders have always espoused a strong affinity for business interests over all else.  With that in mind, this pandemic is bad for the economy, and they have a strong desire to rush back to business as usual.  With most things rushed, things didn’t go as planned.  Ignoring preliminary threat levels back in early 2020, Republican leaders made some poor choices.  Their president thought that, if he pretended really, really hard, it would just go away and not threaten his chances for reelection.  He was wrong.

From here in the cheap seats, it is easy to see the mounting damage in this demolition derby we are calling the Covid-19 pandemic.  The virus not only didn’t “go away with the heat of summer” in 2020, but it also came back with a vengeance and brought with it some of its mutant friends.  

President Trump managed to get one thing right as they say about the blind squirrel eventually finding an acorn.  He streamlined the vaccine approval process and promised developers of a successful vaccine a cash bonanza in the end.  Where he seriously dropped the ball was in vaccine distribution.  Managing complex problems was not his strong suit.  With him, you just hit everything with a sledgehammer and ignore the collateral damage.

Blind squirrel finds an acorn

The scientific community, who had been working on a new approach to vaccine development for many years, had an mRNA vaccine ready for trials within a matter of weeks.  Fast-track testing and a pandemic full of test subjects enabled two successful vaccines to be approved on an emergency basis in early 2021.  Luckily, Trump didn’t stay in office and Joe Biden was able to fix the vaccine distribution mess.

By March and April of 2021, the vaccine distribution wrinkles were worked out and people were waiting in lines to get vaccinated.  All went well and everybody who wanted a vaccine got immunized.  Then a combination of Republican politics, misinformation, fear of government, fear of needles, and a plethora of unfounded rumors brought the vaccine program to a halt.  We were far short of our goal of herd immunity.

We had Republican leaders fighting the medical community, which provided fodder for the fringe antivaccine anti-masking crowd.  This included that strange group of folks who seem to show up in Walmart at 3 a.m. and at Burning Man festivals, who now had a new cause to make them feel special.  With a rush to return things to normal so businesses could get back up and running, Republican governors challenged the ever-changing advice of the scientific community and championed the cause of false freedoms within the Don’t Tread on Me crowd.

Examples of the American Fringe
The New Republican Party Support Group

With a world not yet vaccinated, and an under-vaccinated America, a vaccine mutant would come in and become the new enemy.  This Delta variant would be born in India and would find its way to our too-soon-opened and rushed back-to-normal homeland.  Infections would rise, more would die, and younger people would now feel the effects.  Republican governors like Ron DeSantis would do a victory lap because fewer people were dying.  This would have nothing to do with his actions and everything to do with science learning how to better treat the disease.

Fewer people were dying but more were getting sick, including many younger people ending up in hospitals.  They say that hindsight is 20/20 but it’s probably more like 20/30 because, while we can look back at what happened, we don’t know what would have happened if we had acted differently.

Our current hurdle is the 22% of Americans who actively identify with the anti-vaxxers.  A recent paper found that 8% were true hardcore within this group and 14% were less committed.  Within the anti-vaxxer group, almost half were Republican men, 34% Republican women, 14% Democratic women, and 6% Democratic men.  Of this entire group, 38% were white evangelicals.  Much of this pre-pandemic anti-vax movement was based on a 1998 paper published in the British medical journal, The Lancet linking autism with the measles vaccine.  Since that time, 10 of the 12 original authors retracted their support for the thesis, and the main author, Andrew Wakefield, lost his medical license for ethics violations.  It seems he had an undisclosed financial interest in the debunked claim and stood to earn up to $43 million per year selling specialized test kits.  The damage was done.  The anti-vax ball was already rolling and claiming victims.

So, where are we now?  We have a Republican party claiming to support personal freedoms, even when they violate the freedoms of others.  This same party claims to support business and all things that will help that economic engine run smoothly.  My mother’s expression that covers their response so far is, “penny-wise and pound-foolish.”  In my childhood, I didn’t understand the saying except in the context where she used it.  It would be later in life that I would learn the saying had its foundation with our British origins and the pound was currency and not weight.  The explanation is that someone is closely watching the minutia but missing the big picture.

In this case, Republicans are looking for a quick reset from restrictions that put a damper on the economy.  They want to ignore the big picture of an under-vaccinated nation facing a new mutated virus foe, in deference to opening the economy with the removal of mask mandates.  They are promoting no vaccine requirements, no masking restrictions, and even issuing executive orders preventing private businesses, school districts, and local municipalities from making such adjustments as needed.  This political polarization of the pandemic has exacerbated the economic harm it has already caused.

Florida, Georgia, and Louisiana have seen nearly 40% of all U.S. hospitalizations, and nationwide hospitalizations have tripled over the past month.  We are back to levels not seen since last February.  The seven states of Florida, Texas, Missouri, Arkansas, Louisiana, Alabama, and Mississippi, have some of the lowest vaccination rates in the nation and account for half the new cases and hospitalizations.  Florida set an all-time pandemic record on August 7, 2021, with 24,000 new cases.  Louisiana has the highest number of new cases per capita with 693 per 100,000, followed closely by Florida with 627 and Arkansas with 502.  If Louisiana were a country, it would be #2 in the world in cases per capita, right behind Fiji.

The green line is Louisiana and the Orange line is Florida

Economic impact?  Louisiana just canceled their Heritage Jazzfest for the fourth time since the start of the pandemic.  This festival is a major revenue engine for the entire economy of Louisiana.  I had my airline reservations for the festival but now must cancel.

It has only been recently that a few Republicans and even some conservative news figures have changed their minds.  Faced almost daily with news videos of gasping hospital patients who had gone unvaccinated pleading with others to take this pandemic seriously, the tide may be turning.  It’s too bad they couldn’t have seen the light before now.  It is now apparent that you can’t see when you are wearing political blinders.  The facts and information are readily available for those willing to open their eyes.  It is time to take a long-term approach to business and realize that short-term investments (vaccination and mask-wearing requirements) can pay long-term dividends.  To paraphrase President Joe Biden, be part of the solution, don’t become the problem.  In short, lead, or get out of the way.  Hopefully, Republicans like Ron DeSantis will listen, if not to the suffering, at least to the threat to their political careers.

They'll Never Learn

We can learn a great deal from our recent horrifying experience with a global pandemic, but we won’t.  If history is any judge, when the major SARS-CoV-2 infection rate and crisis wanes, so will our interest in preventing another pandemic from getting out of control.  We should have learned valuable lessons from the 1919 influenza pandemic, but that information faded with time.  Likewise, our responses to Smallpox, Yellow fever, Cholera, Scarlet fever, Diptheria, Polio, H2N2, Measles, Crypto, 2009 H1N1(swine flu), Whooping cough, HIV, and Ebola, should have prepared us better for Covid-19.

Spanish Flu Pandemic of 1918 Hospital Ward

Like even our major financial crises, we tend to marginalize our experiences once things improve.  The Great Depression, the energy crisis of the 2000s, the subprime mortgage crisis of 2007, the housing bubble of 2003, and the Covid-19 recession are, even now, minor annoyances.

From the pandemic experience throughout 2020 and 2021, we have been provided with a great deal of information.  Science worked miracles and had vaccine candidates in trials within weeks of being provided with the genetic sequence of the virus.  Vaccine testing and approval were put on the fast track.  All good things.  Now, seven months since we have had working vaccines, we are seeing a surge in infections due to a viral variant and vaccine hesitancy.  The vaccines work against the new variant, but people aren’t getting vaccinated, at least in sufficient numbers.

Why is this happening?  What could we have done better?  What can we learn in the future?  Answering the first question is easy, people don’t trust the government, so they don’t trust the vaccine.  What could we have done better?  Also, easy to answer but difficult to implement.  Many people in the rural south and other rural areas have a poorly functioning or non-existent medical system.  Our medical business model is just that, a business where profit is paramount.  There is little money to be made in rural communities, so these people rely on clinics and substandard healthcare.  Many just turn to their religious leaders and prayer.

What if we had provided a healthcare system that serviced all our citizens, regardless of profit?  Perhaps these people would have a place of trust to turn to and wouldn’t have to rely on rumors, misinformation, social media, and word of mouth.  Build up a level of trust by treating everyday medical problems.  That way, when a pandemic strikes in the future, people in these underserved communities would have someone they could turn to for good medical advice.  More people would get vaccinated, and we would all benefit from earlier herd immunity.

Will this happen?  Doubtful.  We are a nation of the here and now.  We look for financial rewards that provide gratification today, not at some point in the future.  We will have other “fish to fry” once this pandemic is on the mend.  We spent billions, perhaps trillions of dollars solving this problem and have paid dearly for the lessons that should have been learned.

As Scotty Beckett said in For Pete’s Sake, Little Rascals 1934, “They’ll never learn.” 

It's All About the Deaths

While Florida leads the nation in new Covid infections and hospitalizations, the governor is not concerned.  He is only concerned with the death rate, not infections.  People who get sick, hospitalized, intubated, suffer long-term debilitating effects from the infection are of no consequence.  These sick patients are occupying hospital beds, overworking hospital personnel, and perhaps preventing others from getting proper treatment for some other ailment.  DeSantis doesn’t care.  He only cares for his poll numbers and making things easy for his Republican followers who may be of a similar mindset.  Hospitals and doctors have gotten better at not allowing people to die from the virus so DeSantis considers that he can take a victory lap.  As long as the death rate is down, all is well.

There are now (August 4, 2021) 11,863 Covid patients hospitalized in Florida, according to data the U.S. Department of Health & Human Services released on Tuesday, a jump of more than a thousand patients from the old record of 10,389 reported on Monday.

Florida added an all-time daily record of 21,683 cases on Saturday, the most recent day cases were reported.

DeSantis is now trying to blame the Florida infection rate surge on immigrants crossing our southern border.  It is Biden's problem, not his.  Someone buy the man a map, Florida doesn't share a border with Mexico.

What's With This Delta Variant?

In a posted study from China, the Delta variant was detectable after only 4 days while the original Alpha strain took 6 days.  This indicates the Delta variant replicates faster within the body.

The term "viral load" is used as a measure of the density of viral particles in the body.  The Delta variant had viral loads up to 1,260 times higher than those measured in Alpha infected patients.

While the Delta variant was first detected in India, it now represents over 80% of new cases in the U.S.

With unvaccinated individuals in a maskless environment, one individual with the original Alpha strain would be expected to infect 2.5 people.  In that same environment, Delta would infect 3.5 to 4 people.

The Pfizer and Moderna vaccines are very effective at preventing serious infection or death.  Breakthrough cases of vaccinated individuals with the Delta variant represent well below 1% of the total infections and virtually 0% of the deaths.

Summary:  Mask up, get vaccinated. 

What Could Go Wrong?

DeSantis's dreams of becoming the next president of the U.S. are fading.  I believe that by late September or early October this should be clear even to him.

Florida Governor Ron DeSantis and Aspiring Presidential Candidate

On June 29, the seven-day average of new cases for Florida kids under 12 was 205. By July 29, that number had increased more than sevenfold to 1,544.  The increase in infections for the under-12 group is now higher than among 60-64-year-olds.

The number of patients presenting at Memorial Health and Joe DiMaggio Children’s emergency rooms with COVID also has exploded, from 23 in June to 240 in July, a nearly 1,000% increase.

The Delta variant is up to 1,000 times more virulent.  Symptoms will appear in under a week in most cases.  Florida's juvenile Covid infection rate is second only to Texas.

Schools open in a couple of weeks.  Children will be crowding into classrooms, busses, and cafeterias.  Florida's governor Ron DeSantis has ruled by executive order 21-175 that funding may be withheld from public schools if they mandate masks.  The handwriting is on the chalkboard.  Infections will rise among our children, teachers, and school staff, most will survive, some will suffer long-term effects, and some will die.  Mandatory mask-wearing and required vaccinations would have prevented up to 90% of the spread of the disease but our governor says, no.

What could possibly go wrong?

The Light at the End of the Tunnel

 In January of this year, I saw the light at the end of the tunnel.  Vaccines were being approved that could end the nightmare of Covid.  At first, we struggled with short supplies and cryptic announcements of vaccine availability.  Age brackets and occupations were prioritized.  Everyone was clamoring to get vaccinated.  By April, weeks after receiving my second vaccine, we ventured out, cautiously.  We made a driving trip north to spend time at a resort in Vero Beach, Florida.  We felt safe.  Life was slowly looking more normal.

By July, that light at the end of the tunnel turned out to be the headlamp of the Delta Variant Train with hundreds of thousands of unvaccinated on board.  It was the re-release of Alice Cooper’s first solo album, Welcome to My Nightmare.  We were facing a multi-pronged attack of unvaccinated zombies living in the parallel reality of fear and conspiracy theories, being supported by Republican politicians who saw this as an opportunity to score political points.

Now, without some change in the status quo by way of vaccine mandates or highly incentivized vaccine coercion, we will face cycles of viral infection, illness, death, hospital crowding, and mask-wearing.  This will be our future.  It is truly sad that our national medical problem will require a political solution, if not through sound leadership, through the ballot box.