by Mike Critelli

Vaccinations and boosters are necessary to our pandemic containment strategy. But they have been inadequately marketed. If telling people what's good for them were enough, no one would smoke, overeat, or do drugs. All health-related messaging in the pandemic needs the same sophisticated marketing we are used to getting from Amazon, Apple, and Netflix.

Though necessary, vaccines and boosters just aren't enough. We also need 

• more rigorous and universal testing 

• a better understanding of natural and hybrid immunity and how healthy lifestyles strengthen our immune system

• more antiviral treatments to reduce hospitalizations and deaths

• better data and analytics and insights

As feared, mental health, substance abuse, and chronic disease management have suffered and been subsumed by Covid. We've done poorly in these arenas. This didn't need to happen.

However, amidst the grim news, we ought to also celebrate successes:

• The rapid development and deployment of vaccines is an unprecedented success. 

• Although antiviral treatments weren't encouraged, the recent FDA emergency use authorization of Pfizer's antiviral treatment gives us hope that we can prevent many hospitalizations.

• We have learned a great deal about how to treat Covid-19 patients in hospitals. And are achieving better outcomes for covid hospitalized populations.

• Although we still underuse telehealth, its acceptance is far broader than it was in pre-pandemic 2020.  It isn't an inferior substitute for an in-person visit. It can be a more effective way of meeting patients where they are.

• The crisis has awakened us to the need to update and overhaul our long-term elder care strategy. Too many people died in overcrowded, poorly managed nursing homes, even in wealthier communities.

Keys to 2022

Data

The data we collect on virus prevalence and risk is deeply flawed, inadequately designed, and statistically manipulated by both the extreme right & left. When our current reporting systems cite an average .5% death rate from those who get infected, that doesn't inform any subgroup of the population as its real risk level. Real hospitalization and death risks vary widely by segments but we don't know why or how widely.

The absence of good data is causing different influential organizations to take apparently incompatible approaches to the virus. The NFL and NBA have taken different approaches to quarantining fully vaccinated players. 

The absence of prevalence and risk data at a population segment level makes divergent responses like these more likely. Many members of the public are confused by this divergence and inconsistency. Hence, their distrust of results grows.

Vaccine Mandates

The Biden Administration, as well as many state governments and private employers, put all their eggs into the vaccination mandate basket. One reason for the resistance to this strategy is a failure to address conflicting data on the value of natural immunity. Many countries, including the Israeli and Italian governments, have recognized the value of natural immunity, combined with recent rapid negative tests, as a substitute for vaccinations in issuing passes for public venue access. With the Supreme Court defeat of the OSHA mandate for private businesses and other non-healthcare employers, these issues and hybrid immunity must be carefully considered.

This rigid adherence to the vaccine mandate has negative consequences, regrettably among essential healthcare workers forced out of work. Whatever benefit we gain in reducing infectious disease spread by mandates may be offset by exacerbating an already existing shortage of healthcare workers: among them, delayed cancer screenings or the inability to have healthcare workers help patients manage life-threatening chronic diseases through frequent diagnostic testing. Healthcare disparities producing poorer outcomes for people of color will only worsen. 

The Supreme Court has ruled that the vaccine mandate for healthcare institutions receiving Medicare or Medicaid funding is within the Biden’s Administration’s authority. It recognizes that none of us want to acquire an infection from a healthcare worker at a hospital that we did not have when we were admitted. But we hope that this mandate can be incorporated into a more effective long-term infection prevention strategy.

Strengthening Immune Systems Through Healthy Living

A physician for an obese 60-year-old friend of mine with hypertension and Type 2 diabetes told him in early 2020:

I have told you for years that failing to control your weight is taking 10-15 years off your life. I am now telling you that if you don't lose weight fast, you have a 25-50% chance of dying within two weeks if you get the virus.

My friend lost all his excess weight last year. He brought his blood pressure, glucose, and cholesterol levels under control. And he is a far happier person. His doctor made the risk real and compelling by elevating its statistical probability. By reflecting my friend’s specific health status in his risk assessment, the doctor succeeded in getting the right behavioral response.

In 2022, we will focus the MakeUsWell Network more heavily on the importance of good nutrition and improved mental health. Both can provide foundational value in reducing the negative impacts of Covid-19 virus and other pathogens while treating other debilitating diseases and illnesses.