The Residential Library

The sometimes demented, frequently irreverent, and occasionally stupid musings of Ron Hargrove

Get Vaccinated. Get Masked. It’s the Only Way Out of This.

By The New York Times Editorial Board [August 5, 2021]

The United States is firmly entrenched in another coronavirus surge, and it seems that many leaders around the country still have not learned the most important lesson of the past 18 months: It takes quick, decisive action and clear communication to get ahead of this virus. Temporary restrictions now are the only way to avoid more stringent ones down the line. We know that masks work. That vaccines work. That mandates work. To keep schools, restaurants and other businesses and institutions open — and to bring the Delta variant to heel — communities will need to use all of those tools together.

To be clear, the Delta surge is poised to be less severe than previous surges in the United States. Thanks to a largely successful vaccination campaign, roughly half the population, including 80 percent of seniors, is fully inoculated against the virus this time around. That means in most places, even accounting for a very small portion of breakthrough infections among vaccinated people, hospitalization rates and death tolls are not likely to be anywhere near as high.

But when it comes to the coronavirus, any surge is bad: The longer the virus spreads, the greater its chances of evolving in ways that make it more transmissible, or more deadly, or that render existing vaccines impotent. The surest way to avoid that dreaded outcome is to get as many people vaccinated as quickly as humanly possible. And the fastest way to do that now — after months of concerted effort to persuade the wary and reach the disenfranchised — is with vaccine mandates.

Some 93 million people who are eligible for the shots have yet to receive any. Surveys suggest, and experts believe, that a good portion of those holdouts would get vaccinated if they were made to, by their employers or schools, or if it were required for certain activities, like traveling, attending cultural events or dining out.

The power of federal officials to issue a national vaccine mandate is questionable at best. (It has never been tested, but most legal scholars say it would not withstand court challenges.) But a 1905 Supreme Court decision made clear that individual states can indeed require people to get vaccinated. State and local officials have made regular use of that power in the century since — among other things, requiring children to get vaccinated against a roster of other diseases to attend public school.

They should use that power now to combat the coronavirus pandemic. Officials in every state should make coronavirus vaccination a requirement for participation in a whole roster of social activities, from indoor dining to theatergoing and gym use. They should also require all public employees — including police officers, firefighters and teachers — to be vaccinated against the coronavirus as a condition of employment. Hospitals and long-term care facilities should require all of their employees to be vaccinated as well. (Nursing homes have not yet been required to report vaccination rates for their employees, but by some estimates, those rates hover below 50 percent. The elderly continue to be among those most vulnerable to the virus’s worst effects.)

Some entities already have taken steps in this direction. Many universities require proof of vaccination for students to enroll. In California and New York City, hundreds of thousands of government workers must now show proof of vaccination or submit to weekly testing. At least some private companies are also starting to issue employee mandates.

But so far, many of the unions that support these workers have resisted mandates, making the work of state officials that much more difficult. In fact, as Joseph G. Allen, the director of the Healthy Buildings program at Harvard University’s T.H. Chan School of Public Health, recently noted in The Washington Post, vaccination rates for many unionized workers are abysmal. In New York City, as recently as late June, they hovered around 40 to 50 percent for police officers, firefighters and corrections officers.

That’s not nearly good enough. Average people don’t often have a choice about interacting with these professionals. It’s fair and right for unions to protect their members from unjust policies; workers should be given paid time off to get vaccinated, and should not be penalized if they have cause for a legitimate medical exemption from vaccination. But the virus is not going to wait for those issues to be resolved. Employers and workers need to come to agreements now.

Unions are not the only institutions whose support is needed. The Food and Drug Administration can help clear the way for mandates by granting the mRNA vaccines produced by Pfizer and Moderna full approval as quickly as possible. (It is welcome news that the agency is reportedly aiming to accelerate its timetable.) Public health experts agree that the shots are both safe and highly effective, but state leaders and private businesses have been reluctant to mandate them without cover from federal regulators. (It would also help if the F.D.A. had a permanent commissioner; it’s bewildering that President Biden has yet to appoint one, in the middle of a pandemic and more than six months after he took office.)

Until vaccination rates increase, masks — and thus, mask mandates — will continue to be necessary. Resistance to this idea is understandable. The mask culture war has been exhausting, the people most likely to abide by mandates are the same ones who need those mandates the least because they are already vaccinated, and in the long run it will be far more important to get people vaccinated than to pester them about face coverings. But public policies should reflect what science has made clear: Masks work. They are cheap and easy to use, and it still makes sense to require them in public indoor spaces, in places where the virus is spreading rapidly.

The Centers for Disease Control and Prevention needs to do a much better job of explaining this to the public. Officials there erred not by dropping mask recommendations earlier this year but by implying that the move was permanent. The agency is now scrambling to correct course. Last week the C.D.C. advised vaccinated people to wear masks in public indoor spaces in regions where the virus is surging. But officials were slow to share or explain the data behind this latest change in guidance.

There is no good excuse for such communication blunders at this stage. Reversing public health edicts is frustrating — and politically fraught — but it’s also part of good public health practice. Leaders at every level should frame it that way. They should also make clear that no success against this virus will ever be secure until the vast majority of people are fully vaccinated against it.

In the pandemic’s early days, the most prescient doctors and scientists described a future in which mask mandates and other restrictions were repeatedly imposed and lifted as the virus waxed and waned. We are living in that future now, and we are likely to be stuck here for a while longer, even if the Delta surge suddenly fades, as it did in Britain. The best way to protect ourselves, and to prevent more surges, is to get vaccinated. But until many more people do just that, we’ll need to keep our masks handy.

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