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Inflated Expectations

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eye on the news

Inflated Expectations

Politicians and public-health officials are setting unrealistic goals for controlling Covid-19. August 9, 2021
Covid-19

Without doubt, the Covid-19 pandemic requires urgent action: to protect the vulnerable from severe disease and death; to prevent the overwhelming of the health-care system; and to keep businesses, schools, and ordinary life humming. But the sense of panic infusing traditional and social media outlets as they report on the pandemic is out of all proportion to the reality of the situation.

The panic stems from a failure to ask basic questions. Are our leaders setting realistic policy goals? Have they put too much emphasis on eliminating Covid-19? Is there any historical precedent for the rapid completion of a vaccination campaign?

These days, Americans tend to demand that societal problems be 100 percent fixed as soon as they’re discovered. When they’re not, media outlets explode with dire warnings and moral outrage. Not surprisingly, politicians and policymakers respond to this panic, failing to maintain a realistic perspective on what’s possible and what’s not.

America’s failed attempts to prevent measles outbreaks offer evidence for the difficulty of eliminating an infectious disease. We should have eliminated childhood measles since we have a highly effective vaccine. Yet measles remain with us because some parents refuse to vaccinate their children, some children are ineligible for vaccination, and other barriers exist to vaccination. Sporadic measles outbreaks among these relatively small pockets of susceptible children allow the measles virus to persist in the United States, requiring ongoing efforts to control its spread.

The situation is no different for Covid. There are pockets of people who for various reasons will never be vaccinated. As a result, outbreaks will continue to happen. The elimination of Covid is highly unlikely; the more likely outcome is that it will become an endemic condition—a problem we learn to live with, like influenza or motor-vehicle fatalities. In 2019, there were 49 influenza deaths and 11 motor vehicle deaths per 100,000. Currently the average daily rate of Covid deaths is 0.15 per 100,000— representing an annualized rate of almost 58 per 100,000.

To understand how long it could take to get a supermajority of the population fully vaccinated against Covid, we might look to the first few years of the polio vaccine campaign in the U.S., which began after the vaccine was approved for use in 1955. Yet before it could even get off the ground, significant safety concerns led to a temporary halt to the program. Once it resumed, the vaccination effort took several years to achieve its maximum benefit, as evidence by trends in cases. At the start of the campaign in 1955, the country reported 29,000 cases. The number of cases then fell by half each year until there were approximately 120 cases in 1964. Given that the Covid vaccination campaign is only eight months old, our current halting progress should come as no shock.

Consistent communications in favor of vaccination are certainly justified. But media and public-health officials also have a responsibility to temper their responses to new outbreaks and to the slow progress of the vaccination effort. Doing so might allow the public to settle into a new, less-stressful normal.

Photo by PATRICK T. FALLON/AFP via Getty Images

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