Until 2020, few Americans had to think about how viruses spread or how the human immune system works. The pandemic offered an intensive painful course. Sometimes it seemed that science was evolving as quickly as the virus itself.
The New York Times therefore asked experts to revisit the nightmare. Among the most important public health measures introduced during COVID, which resisted scientifically, and which turned out to be bad?
The question is particularly important now, because pandemics that could upset American life are inevitable. A candidate has already surfaced: the bird flu.
The largest lesson learned, said several experts, is that the recommendations of any pandemic are necessarily based on emerging and incomplete information. But during the covid, federal agencies often projected more confidence in their assessments than justified.
Next time, scientists have said that officials should be more frank on uncertainties and prepare the public for advice that can change as the threat is clearer.
Rather than promoting preventive measures such as infallible solutions, they must also recognize that no single intervention is perfect – although many imperfect measures can build a rampart.
If you venture into a “huge rainst storm, your umbrella alone will not prevent you from getting wet,” said Linsey Marr, an expert in virginia tech virus virus.
“You need your umbrella; You need your boots; You need your pants and your waterproof jacket; And you would probably try to avoid puddles, “she said.
Vaccines
A victory, but the civil servants suffered advantages at the start.
Arnm vaccines were, in a sense, victims of their own unexpected success in clinical trials in 2020. These results were spectacular: the shots elected a symptomatic disease caused by the original version of the coronavirus at miraculous rates.
But government representatives had to return to their enthusiasm while revolutionary infections with the Delta variant jumped in the summer of 2021. The Americans were invited to obtain boosters. Then again, and again.
Federal health officials should have recognized at the beginning that long -term efficiency was unknown, said Natalie Dean, a biostatisticist at Emory University.
The distrust of the safety and efficiency of coastal vaccines now weighs on other vaccinations, including these targeting infantile diseases such as measles.
“Make allegations from the start that it was going to prevent all infections was, I think, a little overpromises” which ultimately undermined public confidence, said Saskia Popescu, an expert in prevention of infections at the University of Maryland.
However, vaccines have saved a estimated 14 million lives Just the first year after their introduction.
Airborne propagation
Surfaces were not the problem. The indoor air was.
Disagreements among scientists on how Coronavirus traveled experienced deep ramifications on how Americans were invited to protect themselves.
At first, health officials insisted that the virus spread through large droplets that have been touched or sneezed by an infected person to other people or objects. The theory “Fomite” led to protocols which had no sense retrospectively.
Remember Plexiglas barriers During presidential debates? The face protects? Schools have closed for cleaning the days halfway through the week. People were rubbing grocery store and mail.
“The entire hygiene theater was terribly unhappy,” said Michael Osterholm, expert in infectious diseases at the University of Minnesota. He wasted millions of dollars and gave people a false feeling of security.
Health agencies have taken month to admit that the virus was transported at altitude by tiny droplets, called aerosols, which could be expired, covering long distances inside. Unfortunately, this idea initially led to another excessive reaction.
Some states have closed the beaches and parks and have prohibited outside interactions, even if “there are good scientific proofs that outdoor events are lower risks,” said Dr. Dean.
Finally, the understanding that the virus was mainly floating inside prompted Biden administration to affect funds to improve Ventilation in schools.
Masking
It worked if you used the right masks correctly.
While the pandemic spread to the United States, masking has gone from public health intervention to a cultural flash point.
Assuming that the coronavirus has traveled as the flu and feared that hospitals would not have enough resources, federal health officials first declared to the public that masks were not necessary.
This advice was suddenly reversed once scientists have learned that the coronavirus was in the air. Despite this, managers initially recommended fabric masks – which are not very effective in preventing airborne viruses – and did not approve More N95 and protective respirators until January 2022, well after a large part of the public ceased to use fabric masks.
Dozens of studies to have noted that when used correctly and consistently, N95 masks or their equivalents can prevent infected people from spreading the virus and protect carriers to contract it.
Unfortunately, several erroneous studies and the policy of personal freedom have created a cultural war surrounding the use of masks, in particular by children, said Bill Harage, epidemiologist at the Harvard Th Chan School of Public Health.
In the event of another respiratory epidemic, “I am very anxious that a whole constituency has already thrown masks,” he said.
Asia children regularly wear masks, especially during the respiratory virus seasons and allergies, have noted certain experts.
“I want us to infuse more prevention of infections in elementary schools, especially during the respiratory virus season,” said Dr. Popescu. “It seemed to be a great way to bring children back to schools.”
Herd immunity
A chimera. We never got there.
For almost two years after the start of the pandemic, the experts spoke of reaching the immunity of the herd once the population had acquired protection by being sick or being vaccinated.
It was a mistake, experts said. The immunity of the herd is only possible if immunity sterilizes – which means that it prevents reinfections – and throughout life. Immunity to most viruses is neither.
Seasonal coronaviruses change fairly quickly so that people undergo repeated infections throughout their lives, said Jeffrey Shaman, an epidemiologist at Columbia University who insisted very early on that the new coronavirus could also cause reinfections.
Once the vaccines have arrived, those responsible first presented the blows as a way to remain safe from the virus forever, rather than a means of reducing the severity of infections.
“There was a lot of confusion and false ideas on the immunity of the herd – that the toothpaste returned to the tube in one way or another,” said Dr. Dean.
School closures
Necessary at the start. Doubtful over time.
Few aspects of the pandemic cause as much resentment as school closures. In many regions of the country, test results have never recovered and absenteeism has become an insoluble problem.
But the experts said it was the right decision to close schools in the spring of 2020, when a poorly understood pathogen swept the country. Ideally, schools would have reopened this fall, but with measurements – improved ventilation, tests, masks – to mitigate risks.
“And of course, we really had none of these things,” said Dr. Harage.
At the beginning of autumn 2020, it was clear that schoolchildren were Do not conduct community transmission Significantly. However, many schools have remained closed for months more than they should, forcing children to mingle with distance learning and to make some people fall.
“It’s really difficult for the quarter of Monday morning,” said Dr. Shaman.
“We don’t have the counterfeit, this alternative scenario to see how it would really have played.”
If the bird flu is transformed into a pandemic, it would be stupid to base school policies on how the coronavirus behaved, warned and others. Other respiratory viruses, such as flu, tend to be more fatal in young children and older adults.
“We have every reason to think that a future influenza pandemic would be much more dangerous for young people than Covid,” said Dr. Harage. “I think we should talk about what we could do to alleviate transmission in schools.”
Lockdown
They slowed down the virus, but the price was high.
The pandemic destroyed local businesses, has been shot unemployment rates and increased household debt. Many people now believe that locks were to blame for a large part of the damage – and that their damage won over all the advantages.
Many scientists see it differently. “The economy was closed by the pure force of the pandemic,” said Dr. Osterholm.
No policy of the American state has approached the rigor of those who China,, India,, Italy Or Jordan -Where people were not at all allowed to leave the house-and a large part of the workforce and societal activities continued because they were considered essential, he noted.
At the end of May 2020, catering services and indoor religious services had taken over a large part of the country, if they had been interrupted, although many cities continued to prohibit temporary prohibitions as virus levels increased and decreased.
The closures may have been unpopular in part because they were introduced without a clear explanation or end in sight.
Instead, said Dr. Osterholm, health officials could have established a concept of “snow day”. People stayed at home when hospitals were exceeded, as they do when the roads are snowy, but their behavior returned to normal when the situation was unleashed.
The closures released the burden of hospitals and slowed down the transmission virus, buying time to develop a vaccine. Studies of multiple Other countries also have noted that the orders and restrictions on the household on mass gatherings were the the most effective measures for Transmit virus within communities.
“Everything people have done in 2020, before people were vaccinated, save millions of lives,” said Dr. Harage. “If we hadn’t done anything, really did nothing at all, things would have been much worse.”