This is a real-life story problem. See if you agree with my solution.
A few weeks ago, some of my immediate family made an hour's drive to visit my elderly parents. From a pandemic perspective, it's fair to say that my parents are not in our "pod" or "bubble". We've seen them in person two or three times in the past year.
On the drive over there, we discussed whether or not to wear masks while in their house. We decided it wasn't necessary. Our logic was as follows:
- My father has been vaccinated
- My mother had not been vaccinated yet but was, at that time, a recently-recovered COVID-19 patient who got through the illness well and, according to her doctor, had some natural immunity from the illness
- My two children on this trip, both young adults, both have been vaccinated (both are considered essential workers)
- The only two at this get-together who were unvaccinated (at that time) and didn't have robust levels of disease-induced antibodies (to the best of our knowledge) were my wife and me. We reasoned that (a) everyone else at the get-together had some level of immunity and so were unlikely to infect us; (b) even if she or I was infected, everyone else had some level of immunity, so it seemed unlikely we would infect them; and (c) the risk of her or me infecting one another was independent of this get-together.
So what do you think? Don't worry about my feelings, I'm a big boy - talk plainly.
I think you were pretty safe. We may not ever be at a "zero risk" place. We do the best we can. I'll bet your parents were tickled to see you all.
ReplyDeleteDirty little secret, the son and daughter-in-law who have the three kids came to see us last August. They were just there for a couple of hours. Our son said he would make the kids wear their masks if we wanted, but they were hot, and we said they didn't have to. We got away with it. Now all of the adults in that group are vaccinated or awaiting the second shot. After that happens we will probably get together with them and not wear masks. Might be outside if the weather is nice. That was the only time we have seen them for a year, and they only live 90 miles away. Children change a lot in a year.
I think you gave due consideration to all the variables. There was some risk but not a flagrant disregard of safety. I hope this terrible period is coming to an end. I want to do everything to finish it. Whatever the epidemiologists recommend.
ReplyDeleteWhat does it mean to be vaccinated?
ReplyDeleteWell if the vaccine has a ninety percent efficacy, it means that 90 percent of vaccinated people who are exposed to the virus will not become symptomatic. However many of those 90 percent MAY have a period of time when the virus will be active until the body shuts it down. The BIG question is can these people spread the virus to other people during this period, i.e. be asymptomatic spreaders during this time.
There is some evidence that they don’t, i.e. that the vaccination protects not only the person vaccinated but also those with whom they come into contact. But the evidence is not overwhelming and conclusive yet. Also it may change as the variants become more prominent since they appear to be more likely to infect people, cause more severe cases, and be resistant to the vaccine.
The vaccines, even those with a 65 percent efficacy, seem to protect completely against getting a case that will result in hospitalization or death. Some people say that this is all that people really want. However, we have abundant evidence of a wide variety of long term virus effects in moderate cases. I don’t think anyone should take the attitude that is OK to risk a mild or moderate case of infection by this virus, either for themselves or others. This will become especially a big problem if variants grow in their ability to transmit, cause more severe cases, and be resistant to vaccines.
The meaning of 90 percent efficacy also depends on how many people out there are infected and capable of infecting others. Don’t think of the 90 percent efficacy as being a personality trait and hope you are one of the 90 percent who has immunity. Think of it a situational variable in which you will be able to avoid the virus in 90 percent of the people who transmit the virus to you. However if you are exposed to a sufficient number of inflected persons, eventually you will be one of the 10 percent who gets a mild to moderate case, and can pass that case on to others.
As far as interacting with vaccinated people (unless they are socially isolating) I would still observe masking, distancing and handwashing until the incidence in the surrounding community gets very low. I have some concern that incident will never get low and that a mutating virus will become like the seasonal flu rather than eradicated like smallpox, and that we will be always racing to take vaccines to keep ahead of the virus.
Here in the states we have not employed two very effective means of controlling the virus that have been used extensively in Asia, first isolating infected people from family, and extensive contact tracing and self isolation. The Chinese built camps for their infected people which helped shut down household transmission. Here we have accepted household transmission which means that if any person in a household gets infected, other members are highly likely to become infected. We have falsely high beliefs about our safety at home, and with non- resident family members. For months at every news conference Governor DeWine would have a tragic story of infections, hospitalizations and deaths caused by relaxed attitudes toward family gatherings.
So far all the emphasis appears to be on getting vaccinated in order to relieve the mask, social distancing, and occupancy requirements. I don’t see any emphasis on getting the virus incidence at such a low level that contract tracing and isolation could become effective tools in eradicating it. I think we are looking for a truce with the virus rather than conquering it.
If the transmission rate R0 can be reduced to less than one, the incidence of infection will drop exponentially. If any of the variants have an R0 greater than one, they will rise exponentially. I would recommend that we fight back on all fronts and crash this thing. During this pandemic, I don't think I've heard the term "civic duty" used once. Do these words no longer have purchase with the American mind? I consider my immunization to be as much for my fellow citizens' benefit as for my own.
DeleteJack, many thanks - great comments. Would you mind if I share these views with some of my friends?
DeleteJim,
DeleteYou are always welcome to share my comments. When I was in the mental health system I got used to the idea that my comments would be shared widely. So I tended to make them so that can be done.