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Public is 'shell-shocked' by the latest turn of the pandemic

WASHINGTON — The death of the coronavirus has been greatly exaggerated. In vaccinated and unvaccinated regions of the United States alike, the pandemic plods on. Five months after President Biden declared on the Fourth of July that the nation was nearing “independence” from COVID-19, the virus is still here.

With the arrival of the new Omicron variant, as well as the resurgent Delta strain, a new problem appears to have arisen: public confusion, made worse by pervasive exhaustion.

Some of that may have to do with confused messaging, but also with the fact that public health authorities appear to be as confused as the public itself. Questions about Omicron — for example, how infectious it is, how virulent, how well it escapes immunity — have not been resolved. The inability to make definitive assertions and the need to say something have led to conflicting guidance.

“Many members of the public are suffering from pandemic-related information overload,” Gary L. Kreps of George Mason University, a health communications scholar, told Yahoo News in an email. “They are dazed, confused and feeling a bit shell-shocked.”

Those sentiments are playing out in a number of ways. In the Buffalo, N.Y., area, for example, football fans in this football-crazed region recently endured contradictory messages about whether they needed to be vaccinated to enter a stadium to watch two undefeated teams play.

There followed a controversy about vaccination checks and masks, as questions persisted about a local school district that was giving students “mask breaks” in the middle of the school day, which undermined the point of masking in the first place.

“It just would make sense if everybody would get on the same page," a local educator lamented.

Getting on the same page appears to be increasingly difficult, for elected leaders, public health officials and ordinary people alike. As much as public health officials have learned in the last two years about how to control the virus, the pandemic keeps presenting new questions, new scenarios and new uncertainties. Full vaccination still means two shots of an mRNA vaccine for Pfizer and Moderna recipients (Johnson & Johnson is the one-shot outlier), but should that change to three shots in order to reflect the Omicron variant’s greater potential for immunity escape? Israel, meanwhile, had been contemplating a fourth shot (a government health committee ruled against that measure earlier this week).

Vaccines are hardly the only point of contention. Should masks be mandated? Should businesses and schools brace for closures again?

A billboard at a pharmacy in Grand Central Terminal in New York City on Dec. 9 advertises COVID-19 vaccinations.
A pharmacy in New York City's Grand Central Terminal on Dec. 9 advertises COVID-19 vaccinations. (Spencer Platt/Getty Images)

“There are about 10 swirling cross-currents, many of which are changing rapidly with emerging science that is being produced by the hour,” Dr. Bob Wachter, chair of the department of medicine at the University of California, San Francisco, told Yahoo News in an email. “And on top of that is two years' worth of Covid exhaustion. This was a novel coronavirus two years ago, but the novelty is long gone.”

As we enter the third year of the pandemic, vaccines, masks and other measures continue to be subject to the same political, cultural and scientific crosscurrents at work in the first stages of the pandemic. Some people have thrown caution to the wind, less out of incaution than from exasperation. “People around the world have been through so many alarms — both real and false — that many people have been conditioned to stop fearing COVID-19 in the same way,” the psychologist Adam Grant recently wrote in the New York Times.

Omicron refocused attention on the pandemic, which gave officials the opportunity to remind the public about a variant that had seemingly been forgotten: Delta. “Cognitively, it’s easy to focus on Omicron — the new 'new thing' — but Delta remains a clear and present danger, with 1,000 deaths a day in the U.S., a number that should produce outrage but which seems to elicit a ho-hum reaction,” says Wachter of UCSF.

Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, and Dr. Anthony Fauci, the president's top medical adviser, have routinely said that protecting against Delta by getting vaccinated and boosted is the best way to protect against Omicron too, especially since a booster shot appears to provide strong protection against the variant. And while the number of people receiving a booster dose has risen, first-dose uptake has been anemic for months.

Health care workers tend to a COVID-19 patient at Providence St. Mary Medical Center in Apple Valley, Calif., in January this year.
Health care workers tend to a COVID-19 patient at Providence St. Mary Medical Center in Apple Valley, Calif., in January. (Ariana Drehsler/AFP via Getty Images)

If boosters are the best protection in the months to come, only about 17 percent of the American population is fully protected for the winter. Most of the world's other countries (95 percent of the global population) haven’t even started offering a third shot, which means that the coronavirus will continue to proliferate, ending lives and disrupting them, while potentially giving rise to new variants.

In the midst of all this, people are trying to make endless risk calculations, about whether it is safe enough to travel, whether they need to plan for a return to the office about whether schools will stay open.

American public health officials have been at pains to say that new lockdowns won’t be coming. The president has said that schools should stay open too, in a signal to the teachers' unions, which could push to close them as they did in 2020. Still, Biden’s popularity is dropping, a trend that appears to reflect the fact that there's no end in sight to the pandemic. The president had promised to restore responsible, science-based guidance, but the Oval Office cannot keep a microscopic pathogen from going where it wants.

Given the uncertainties and challenges of the present moment, there is only so much that even the most knowledgeable authorities can say. “In general, the message of the White House and reputable public health officials since Biden took office has been pretty consistent,” Michael X. Delli Carpini, a professor of communications at the University of Pennsylvania, told Yahoo News in an email. Those messages, about vaccines, masks and appropriate risk, have hardly changed for months.

Carmen Penaloza receives her first dose of the Pfizer COVID-19 vaccine at a pop-up clinic offering vaccines and booster shots in Rosemead, Calif., on Nov. 29.
Carmen Penaloza receives a dose of the Pfizer COVID-19 vaccine at a pop-up clinic in Rosemead, Calif., on Nov. 29. (Frederic J. Brown//AFP via Getty Images)

The problem, Delli Carpini says, is that “this message is being sent in an environment in which multiple other voices (including the past administration, many Republican governors, some media pundits, etc.), are sending very different and misleading messages, leading to confusion, mistrust and partisan divides on what people know and how they behave.”

Democrats have blamed Republican opposition to vaccines and masks for prolonging the pandemic, and those same Republicans have in turn blamed Biden. The White House recently lambasted Republican House leader Kevin McCarthy, an ally of former President Donald Trump, for “actively undermining the fight against COVID.”

McCarthy isn’t alone. Last week, another Trump ally, Sen. Ron Johnson, R-Wis., promoted mouthwash as a COVID-19 treatment. The usual round of debunks and fact-checks followed, but once Johnson’s false claim hit the internet, there was no effacing its presence.

Defeating the virus altogether — that is, actually eradicating the pathogen — no longer seems like a possibility, with most epidemiologists agreeing that the most realistic goal is turning the pandemic into an epidemic, marked not by constant emergencies but quiescent periods punctuated by spikes. Even that, though, seems ever more distant, with more than 100,000 new cases per day in the United States, according to the CDC. Deaths have risen too.

Sen. Ron Johnson, R-Wis., addresses a Senate Foreign Relations Committee hearing at the U.S. Capitol on Dec. 7.
Sen. Ron Johnson, R-Wis., at a Senate Foreign Relations Committee hearing on Dec. 7. (Alex Brandon-Pool/Getty Images)

Nor have authorities made clear what long-term living with the coronavirus will look like, whether masking will become a regular practice, whether booster shots will become the norm or whether schools will stay open (they are closing again). Also unclear is whether restaurants, movie theaters and other entertainment venues can survive the unpredictable cycle of reopenings and restrictions, mask orders and vaccine mandates.

America Has Lost the Plot on COVID,” ran a recent headline in the Atlantic. And that was before the Omicron variant came along like a sleeper wave, complicating the fight against the formidable Delta variant, which is itself a more transmissible SARS-CoV-2 strain. The twin assaults complicate the messaging of public health officials, which in turn complicates the calculations of ordinary Americans who had been hoping to resume ordinary life by now.

In a recent email newsletter, Brown University economist Emily Oster described talking to a friend who was finding that recent developments — the rise of Omicron, a resurgent Delta — were upending what she had hoped would be a new sense of normalcy.

“Most of the questions I hear are not really about the medical details of Omicron,” Oster wrote. “The angst is broader. The variant renewed feelings of fear, of anxiety. Will we ever just be able to have a f***ing playdate or plan a vacation?”

A man receives a nasal swab to test for COVID-19 at Los Angeles International Airport in December last year.
A man receives a nasal swab to test for COVID-19 at Los Angeles International Airport in December 2020. (Mario Tama/Getty Images)

Confusion has been building for months, arguably before even the arrival of the Delta variant. It began in late spring, says Dr. Leana Wen, a former Baltimore health commissioner and contributor to the Washington Post. With cases falling across the country, the CDC revised its masking guidance on May 13, telling vaccinated people they no longer had to wear masks.

“They never recovered from their disastrous communication in May that opened the floodgates to Delta,” Wen told Yahoo News. About six weeks after the mask mandate was lifted, a coronavirus cluster in Provincetown, Mass., alerted public health authorities to the presence of Delta in the United States and, more importantly, its heightened ability to spread (though, crucially, not to evade vaccines).

By the end of July, masks were back, and the anxiety that seemed to have receded in the first half of the summer had returned. Meanwhile, Republican governors who had been spoiling for a fight with Biden decided to challenge school-based mask mandates. Later, many of those same governors would challenge Biden’s vaccine mandate for private employers too.

At the same time, regulators at the Food and Drug Administration fought each other and other agencies about whether booster shots were necessary. Some argued that vaccine doses should instead be shipped off to other nations, while others countered by pointing to data showing that protection against Delta was significantly heightened by a third shot.

Safeway pharmacist Ashley McGee fills a syringe with the Pfizer COVID-19 booster vaccination at a vaccination clinic in October in San Rafael, Calif.
Pharmacist Ashley McGee fills a syringe with a COVID-19 vaccine dose at a clinic in October in San Rafael, Calif. (Justin Sullivan/Getty Images)

Omicron in effect endorsed both arguments. Boosters do work against the variant, but variants will continue to arise in low-vaccination regions like sub-Saharan Africa. The Biden administration insists that vaccine delivery, not vaccine supply, is the primary challenge there.

Where does all this leave the ordinary person?

“I study this for a living, and my head hurts as I try to multiply all the probabilities to make a rational choice about whether to go out to dinner in a restaurant or fly to visit my mom in Florida,” says Wachter of UCSF. “I can only imagine how it feels for people with other day jobs, or who don’t think about medical decision making or Bayesian reasoning for a living.”

Wachter offers simple advice to the perplexed: “The best you can do, I think, is find a few experts you trust and see what they’re thinking and doing.”