Perhaps even more significantly, he has become opposed to any attempt to prevent spread. At least, he opposes masks and disinfecting surfaces. He does see it as appropriate for me to have an air filter in my office since I deal with elderly clients, but opposes any further use of air purifiers. And his is generally opposed on principle to any attempt to stop the spread. Everyone will end up getting it, he says, so why bother. Instead, he wants a cure. And the good news is that we may be months away from having an effective treatment. So (I said) isn't it better to delay people getting it until treatment is available.
And, in fact, there seems to be a general opposition to any sort of prevention or mitigation on the right, in favor of cure. Most recent is the case of Allen West, unvaccinated, infected, and hospitalized, who has promoted the superiority of treatment by monoclonal antibodies over vaccines because vaccine "enrich[es] the pockets of Big Pharma," as opposed to monoclonal antibodies which, also come from big pharma. And certainly plenty of right wingers are angry at the prospect of having to get regular booster shots and see it as an affront.
I really do not understand this insistence that we must forego all prevention and mitigation and focus entirely on cure. I can understand it over lockdowns, which carry high economic and social costs and are only sustainable in the very short run (a few months at most). I can sort of understand it over masks, which, though mostly sustainable over the long run, are uncomfortable and not sustainable for restaurants, bars, and gyms. But why the resistance to vaccines? And even if vaccines require regular boosters, why the outrage over that?
I think it might be because right wingers hope that if everyone gets COVID everyone will have long-term immunity. And there might be something to the approach if COVID was like, say, measles, and getting it once did give lifetime immunity. But it belongs to the same category of virus as cold and flu, which give only a short-lived immunity. Cases of re-infection have occurred. While information on the subject remains sketchy, some evidence points to the possibility of immunity lasting as little as three months to as long as five years, with a median of 16 months.
So far as I can tell, right wingers want to go back to their pre-pandemic lifestyles with no change whatever and no disruption, not even small changes like getting regular shots. How many people get sick or die as a result is simply unimportant. But what they ignore is that people getting sick and dying is itself disruptive. Take it from me, being sick for a week, convalescent for a week, still not full steam for a week, and then having to catch up is a whole lot more disruptive than getting a shot. Getting a shot every six months is less disruptive than being out of action for two weeks every two years or so. And having places you want to do business closed because everyone is sick is also disruptive.
Another part (and have have gotten this very strongly at work) is the sense that those of use who accept any sort of inconvenience in the interest of mitigation have been brainwashed by a sinister elite that is offering suggestions with no scientific merit, not to stop the disease, but simply to control our lives. This view ranges from completely nuts (our anti-vaxxer arguing that the vaccine contains a microchip that will tell "them" about everything we do) to semi-rational (my boss saying that I an succumbing to propaganda, and that the people making these suggestions know less than they think).
Which leads to the subject of testing. We need more of it, lots more. Again, going back to personal experience, I knew that home testing existed. I looked at the shelves of the pharmacy and didn't find any. My boss had a test kit and explained that you have to go up to the counter and ask for one. Well, the first time I asked the store was sold out, but I got one on a second try. But tests are expensive ($24 for two). And even more significantly, they are extremely hard to replace. So when my boss first felt symptoms, he didn't want to "burn" a test, but asked for an appointment. It took several days to get in and several more to get results and by then the whole office was infected. I went ahead and burned a home test when it became impossible to deny that I had symptoms and actually found out before he did that I had it. But by then I had met with five or six clients, called in a witness to a will signing, gone dancing, gone shopping, etc. If home tests had been cheap and plentiful, everyone could have tested as soon as they felt symptoms or suspected exposure, and we could have stopped this a lot faster. I also burned a test at the end of my quarantine to see if I was still positive (I was). So now I am out of tests everywhere I look they are sold out.
Home tests have their drawbacks. They are less sensitive slower lab tests and catch the infection only about 87% of time. Tests are therefore sold in pairs with the recommendation that if the test is negative, take a second test two days later. Two negative tests should be good enough. Furthermore, the rapid tests are tests for antigens (proteins on the shell of the virus), a good marker for contagion. And getting fast result allows people to quarantine and warn others sooner rather than later, a vital tool in stopping the spread.
Furthermore effective, simple treatment is probably coming down the pike in the form of a pill that can be taken at home and can be much more widely affordable than monoclonal antibody infusions.* Thus far the COVID pill has been 50% effective at preventing hospitalization and death in high-risk patients. If taken early, could it prevent or at least mitigate illness altogether? There is even hope that it may prevent household members from being infected. Treatment is more effective the sooner it starts. Thus rapid, widespread testing is critical to important treatment.
So how do we make home test kits cheap and plentiful and how do we get people to use them?
Making home test kits cheap and plentiful is certainly doable. Many other countries have done it. The holdup in the US appears to be FDA insistence on a medical level of accuracy. That creates an obstacle to production. Joe Biden has promised to invoke to Defense Production Act to produce 280 million tests, but that is less than one test per American -- far too few to allow the frequency of testing that we need. So the best way to increase production appears to be for Biden to change classification from medical device to public health tool to remove the FDA regulatory barrier. And that is my number one issue these days. Let's all write to the White House to urge him to make the change. Here is the link. Write or Call the White House | The White House.
Some people have objected that making home test kits universal will lead people to stop reporting their diagnoses, making it harder to track the disease. There are two responses to this. One is that keeping track of the disease is merely an end to stopping it, and if the best way to stop it reduces reporting, so be it. The second is that if COVID pills become widely available, people will have a strong incentive to report a positive test -- to get treatment.
But that still leaves the issue of getting people to actually use the tests. Why should that be a problem? After all, the fact that tests are sold out proves that they are in high demand. Some 79% of Americans have expressed eagerness for home tests and an interest in regular self-testing. Unlike all prevention measures, testing has not become a culture war issue. It is often presented as an alternative to vaccines.
But given the overall trajectory of this country, can anyone doubt that if rapid testing becomes widely available it will become a culture war issue. Swabbing the inside of your nose is uncomfortable. Asking people to do it regularly is burdensome. Already some people in the more paranoid precincts are spreading wild stories about something harmful on the swabs. Saliva tests avoid the swab, but have to be mailed to a lab. Some paranoid people fear the lab as well. And who can doubt that once widespread testing becomes available, doing it regularly will once again make you part of the "sheeple" who have been brainwashed into fear, and will become an intolerable threat to freedom.
Weekly testing the workforce is offered as an alternative to vaccines. How long before it starts to feel like harassment? It is being proposed as a way to control spread in the schools. Do you think ant-mask parents will accept the alternative? No doubt there are Asian or Nordic countries where if people were asked to self-test before going restaurants or bars or large public gatherings, they would do so. In the US they would not. And imagine the outrage if any restaurant or bar or public gathering started requiring rapid tests as a condition of admission.** Imagine the lines of people waiting!
In short, how do we avoid making COVID testing a culture war issue? My advice would be to avoid fanfare. Just have it show up on the shelves -- well advertised, but without a big governmental announcement. Do focus group tests on how to sell it to the vaccine skeptics, but my guess is that the most effective pitch will be two-fold. The closely track the reasons not to be concerned that self-testing will reduce reporting. One is the emphasize the privacy and secrecy of the test. Nobody else has to know about it. And the other is to sell it as something to do out of self interest. Find out soon so you can have effective treatment!
*Presumably antibodies would continue to be used for high-risk patients.
**Actually, I am told that the Albuquerque Folk Festival did require rapid testing for everyone who did not present a vaccine card, but (1) that was presumably a distinct minority of people attending, and (2) it did not attract anti-vaxxer types.
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