LENOX — America’s Doctor Unleashed. It’s a sight to behold as Dr. Anthony Fauci, assured of a key role in President-elect Joe Biden’s administration, as chief medical adviser, appears daily in multiple media interviews and at other public events, offering his sage wisdom and advice.
He’s unburdened by the need to play footsie with the Trump administration’s science skeptics, led by the lame-duck chief executive, who’s rounding the corner toward the exit ramp.
It’s tempting to break out in song, specifically the “Hallelujah” chorus from Handel’s “Messiah,” not only to summon some elusive Christmas cheer this season, but also to celebrate the imminent arrival of safe and effective vaccines. But, only if we are patient, vigilant and realistic about the hurdles still ahead.
Appearing at a virtual conference for New England higher education leaders this week, Fauci acknowledged that, until now, the lack of a national virus-fighting strategy has left states and cities to fend for themselves with minimal funding.
Still treading cautiously to avoid offending the current administration in its waning weeks, he explained that the approach of “delegating a lot peripherally to the states and the cities to be on their own leads to disparateness in terms of the level of responsiveness from one state to another.”
That means that states like Massachusetts and New York, among others, have been more effective in combating COVID than numerous Midwest and Southern states, where the virus is on an especially vicious rampage. Our Northeast region is hard hit, to be sure, but by carefully calibrating close-downs, restrictions on gatherings and near-universal mask-wearing, we are striving to manage the emergency and protecting our residents from the apocalyptic conditions seen elsewhere.
In his appearance, Fauci unleashed his strongest pushback against deep-seated and widespread public distrust in science and facts. Adopting or rejecting public health guidelines, such as wearing face coverings and avoiding indoor gatherings, is a political statement rather than common sense based on settled medical principles, he said.
“It is astounding how, in the face of obvious facts, people are still denialists,” he lamented. “We are in the middle of a historic, devastating pandemic, the likes of which we have not seen in over 100 years. And yet in certain states, cities and regions of the country — even when the hospitals are overflowing with people who are desperately ill and dying, it’s real data — there are still people who are saying it’s fake news or it’s a hoax.”
Fauci is on a mission to convince skeptics of that, by stressing that if you’re vaccinated, “you create an umbrella of protection over society that protects the vulnerable.”
But, the rollout of the vaccine over the next six months and beyond requires the greatest peacetime mobilization in the nation’s history, and there’s little room for error. The logistics of fair, equitable and effective distribution of the Food and Drug Administration-approved vaccines are daunting.
With a Massachusetts population of nearly 7 million, it will take several months for even half of them to receive a vaccine, which is limited to adults, at present. Even if hundreds of thousands or a million Massachusetts residents are vaccinated by next spring, the pandemic will remain a formidable threat, Gov. Charlie Baker noted earlier this week.
But, epidemiologists hope the initial vaccine rollout will lower death and hospitalization rates by providing immunity to the state’s most vulnerable populations. But, that doesn’t mean the number of cases will fall at a meaningful rate, particularly if the general public becomes cavalier once vaccines become more available.
“There’s no question that as we start to pump this vaccine into the population, we’re going to blunt this virus,” said Dr. Philip Landrigan, director of the Program for Global Public Health and the Common Good at Boston College. “It’s a more complicated question of what it’s going to do to the spread of the disease in the population. If people in large numbers let down their guard and say, ‘Wonderful, the vaccine is here. We can go party,’ then we’re going to have a problem.”
Another concern cited by experts: People vaccinated may still be able to transmit the virus, even if they don’t become ill themselves.
“We don’t know that [available vaccines] help prevent transmission, necessarily. If it really works to prevent all infection, including asymptomatic infection, that should help bring things back to normal quickly,” according to Dr. David Hamer, a Boston University infectious disease expert and physician at Boston Medical Center. “But, if, say, it helps protect against disease, but not infection — so people can become infected, shed virus, and then not become symptomatic because they’ve had the vaccine, but still can spread it on to other people — that would be a concern.”
So, the optimism and even exultation many may be feeling has to be tempered by a harsh reality: “Let’s not allow the news of vaccines to blind us from continuing to press on the importance of continuing to improve currently available public health measures,” wrote Dr. Michael Mina, an epidemiologist at Harvard, in a tweet.
Bottom line: Mask-wearing and social distancing will be needed well into the future, even after many people get the necessary double-dose vaccine. How many? That’s another conundrum, as polls indicate 40 to 50 percent of Americans are leery about getting the shots.
Whether they can be convinced, or some form of requirements or mandates will be needed, will determine if we’ll be able to rest easier by next summer and beyond.
Information from The Boston Globe was included in this commentary.