PASTCF President’s Column November 2021

At this time we have lived with a pandemic for more than a year and a half. I took a look at the column I wrote for the May 2020 issue of SciTech†. I was right, sadly, that we would be fighting the pandemic for a long time and that period would leave a dark legacy. But even sadder is that my hopes for how we would emerge from this dark chapter as a kinder and more compassionate society, clearly have been dashed.

Confrontations and adversary positions have hardened and we have become a cruder and ruder society. The selfishness of the richest countries (yes, that is us and our buddies) in hoarding the largest share of vaccines, thereby depriving the rest of the world a chance to get out of the Covid hole, is absolutely shameful. We have also squan­dered the great opportunity an abundance of wonderful vaccines gave us. We could have been in a much better position, thanks to all the vaccine doses we grabbed and kept for ourselves. But we didn’t even take full advantage of that. More shame on us!

Someone commented a few weeks ago, correctly, that getting a handle on the pandemic isn’t so much about “following the science” as it is about “following the data.” Yes, the science has produced the vaccines, but public health policy needs to be based on analysis of the data and it’s data science that ought to guide us at this point. The important data items involve infection rate, serious illness and mortality rates, and contagiousness, as a function of age, gender, medical condition, economic condition, location, and vaccination status.

With our stockpile of vaccines, approximately 95% of adults in the US could have been vaccinated by the summer. Pfizer, Mod­erna, and Janssen/J&J are extremely effective vaccines. We know that the chance a fully vaccinated person contracts the virus is very small, roughly an order of magnitude smaller than the chance for an unvaccinated person. In addition, the chance of getting seriously ill after infection is also an order of magnitude smaller, and the same is probably true for the mortality rate. And, of course, the chance of transmitting the virus is smaller for vaccinated people.

Suppose 95% of adults were fully vaccinated by June of this year. It would have meant we had achieved close to herd immunity. We would have protected our children, effecting a safe environment before the school year started. And the Delta variant would not have stood much of a chance. To put it bluntly, according to a study backed by the Peterson Center on Healthcare and the Kaiser Family Foun­dation, it is estimated that during the four months of June-Septem­ber 2021, 90,000 lives were needlessly lost. Can we put it any more plainly?

Based on the data, I think the time has arrived for the federal government to impose a nationwide vaccination mandate. All the wishy-washy reservations about the vaccines have been firmly debunked by now. They don’t implant chips in your body. They don’t change you DNA. They don’t cause infertility. They don’t permanently put strange com­pounds in your body. The contents of the shot disappear from the body after it has performed its task, telling the body’s defense mech­anism to be on the lookout for the Covid-19 virus. This is exactly how vaccines work. Vaccine-related side effects are minimal and pose a minuscule risk compared to remaining unvaccinated. They work, and they work very well. Yes, there are breakthrough cases, which is true for any vaccine, but in most of those cases there were underlying conditions. For that matter, if more people had been vaccinated early on, most breakthrough cases would not have occurred in the first place. Almost anybody who wants to be vaccinated can be. There are underserved communities, urban as well as rural, but there is no reason local health services cannot take care of that. They just need to work harder at it.

Since early summer the age range for those eligible for vaccina­tion has been brought down from 18 to 12, and now expanded to age 5. Younger children will take a little longer.

There are two hot legal potatoes: the idea of a national mandate and the associated exemptions. They have been treated as third rails. But there is no legal reason why. I found that the 10 October column by Jessica Levinson, Opinion Columnist at MSNBC, is an excellent source of information to debunk popular misapprehensions on these potatoes.

Clearly, the government has the obligation to craft regulations that protect people and make society safe. Some obvious examples: we are not allowed to kill each other; we should drive on the right side of the road and wear seatbelts; children and adolescents are not allowed to use alcohol or tobacco products. Further, of course, a fair number of states require children entering school to be vaccinated against diphtheria, measles, and other diseases, to protect themselves and their fellow students. We know this works! Similarly, employers have a duty to provide a safe workplace for their employees, which can (or should) include vaccination mandates, as long as those mandates are applied without discrimination.

It is obvious that medical exemptions need to be allowed. However, there is no excuse (and indeed no constitutional or other legal impediment) for religious exemptions. Freedom of religion guarantees all people the freedom to believe what they want, but not necessarily to act as they want or to act as they believe their religion prescribes. This is particularly so if they violate neutral laws that are in place to protect all of society. I cannot claim the right to drive on the left-hand side of the road because I feel that is what my religion requires of me. This matter was already settled by the Supreme Court in 1879. It makes perfect sense to allow the government to put restric­tions on religiously required actions. Without appropriate restrictions anyone could be allowed to opt out of any law by claiming a religious exemption. To define this further, the Supreme Court ruled in 1949 that “Conduct remains subject to regulation for the protection of society.” And in 1990 the Court reaffirmed once again that conduct can be regulated by the government without exemptions for any individual’s beliefs.

This would be a good time for a law mandating vaccination with only medical exemptions. There are no major religious entities that tell their believers not to be vaccinated. We may conclude from the large number of religious exemption requests that these are largely being used to run around vaccine mandates, giving license to individ­uals to endanger themselves and all of society while prolonging the pandemic’s grip. It would be good for the church to say unambigu­ously that there is no basis for religious exemptions.

Vaccination has clearly been politicized. Data collected by the New York Times clearly shows, as expected, a direct relation between the number of Covid deaths per 100,000 and the percentage of unvaccinated adults, at the county, as well as the state level. But significantly, there is also a direct relation with the voting record in the 2020 election; in red counties there were in October 2021 more than three times as many Covid deaths per 100,000 as in blue counties. And the turmoil surrounding vaccination mandates makes the conclusion inescapable that what are presented as religious beliefs are really political beliefs. A year and a half on, we find ourselves in a situation brought about by ineffective and misguided leadership at the top level, especially in the first half year of the pandemic. Good science has given the gift of vaccines that work wondrously. Add mask mandates and social distancing and there is a path to a better day. But too many still refuse the science and the mandates, vilifying and actively hindering those who follow the path. More unnecessary deaths and economic pain will follow what we have endured already.

The whole of society may share the blame for allowing us to get into a situation where this could happen. But the whole society, no exceptions, now has the responsibility to get us out of it, one hopes rather sooner than later.