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History Repeating

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    Much like COVID-19, the 1918 influenza pandemic “hit hard and fast,” growing from a few cases to a nationwide outbreak in just a few weeks, and similarly, local governments responded by issuing closure orders in an attempt to contain the spread. In keeping with the similarities, folks grew tired of the burden of compliance and yearned for a return to normalcy and as such, rushed back to return to pre-pandemic life. Unsurprisingly, the results of these decisions were mostly catastrophic. If we can take away anything from this event that occurred over a century ago, “it is that a premature return to pre-pandemic life risks more cases and more deaths,” and yet, current trends across the United States seem to indicate that we are doomed to repeat history1.

    People are understandably tired of the strain and stress created by the COVID-19 pandemic and all of the related restrictions. They are eager to remerge into the world and are emboldened by the ever-increasing number of people vaccinated. Individuals are far from alone in this expressed desire. State governments, claiming financial hardship and emotional burden, are reversing mandates and “opening up” their states.

    As a prime example of such an “opening,” on March 2, 2021, Governor Greg Abbott of Texas issued Executive Order GA-34 to provide that, “in all counties not in an area with high hospitalizations: (i) there are no COVID-19-related operating limits for any business or other establishment; and (ii) individuals are strongly encouraged to wear face coverings over the nose and mouth wherever it is not feasible to maintain six feet of social distancing from another person not in the same household, but no person may be required by any jurisdiction to wear or to mandate the wearing of a face covering2.”

    Many preeminent specialists in the scientific and medical communities are offering warnings against such behavior and decisions; explaining that we are not yet out of the woods where COVID-19 is concerned. Dr. Anthony Fauci, one of the country’s top and arguably one of the most visible infectious disease experts, recently cautioned against this behavior, advising of the risk of a new wave of infections caused by a premature departure from social distancing and mask-wearing and exacerbated by new strains of the virus, such as the more contagious variant thought to have originated in the United Kingdom3.

    When expressing his concerns, Dr. Fauci pointed to stalled progress in the declines in the number of cases and deaths. He advised that “[w]e do want to come back carefully and slowly about pulling back on mitigation methods. But don’t turn its switch on and off because it really would be risky to have yet again another surge.”  However, in a direct counter to Dr. Fauci’s warning, Mississippi Governor Tate Reeves defended the decision to “open” the state by advising that numbers were down, and vaccines were on the rise.

    These announcements made and justifications offered by government representatives from Texas, Mississippi, and even Alabama, who followed the example of Mississippi and Texas, lifting its mask mandate as of April 9, 2021, come on the heels of news of the growth of variants. Notably, “a person with the [UK] variant can infect 43% to 90% more people than the older versions of the virus, new research from scientists at the Centre for Mathematical Modelling of Infectious Diseases at the London School of Hygiene and Tropical Medicine shows.” Although vaccination distribution is on the rise, this statistic lends credence to the thought that the virus will indeed spread faster than the states’ ability to vaccinate its citizens. It is also critical to remember that there is not yet a firm understanding of the three primary vaccines’ effectiveness against some of these variants, in particular the UK strain4.

    That said, there is no question that coronavirus restrictions have had a significant emotional and mental impact on individuals, and “taken a heavy economic toll on businesses like bars and restaurants, raising pressure on governors to ease limits.” However, Josh Michaud, associate director for global health policy at the Kaiser Family Foundation, said indoor bars and restaurants are “exactly the types of environments where the virus spreads most easily,” reinforcing the view that while there is some benefit behind reopening, the consequences could be disastrous and irreversible5.

    Cindy Prins, an epidemiologist at the University of Florida, recently spoke out against the rampant lifting of mask mandates, explaining rather simply that “…we still have COVID circulating and don’t have the majority of people vaccinated.” She went on to suggest that before restrictions are holistically lifted, states should be able to claim a noticeably low transmission rate, as well as a substantial number of fully vaccinated people, in order to “reach a balance where we feel like we’re not going to have widespread transmission6.”

    There is no intention to vilify the Governors who are making decisions to reopen their states, nor should the goal be to have the country on lockdown forever. Rather, the medical and scientific communities are imploring these leaders and their constituents to consider a time when it is reasonably safe in accordance with available statistical data, and then open in a measured and thoughtful manner.

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