No, the pandemic goal posts are not being moved

There have been a lot of comments, discussions and posts on the changing messaging and complaints that public health officials are moving the goal posts.  This opinion explains really well why that is not happening.

www.washingtonpost.com/opinions/2022/01/09/pandemic-goalposts-vaccinations-guidance-jerome-adams-surgeon-general/

Jerome Adams was U.S. surgeon general from 2017 to 2021. He is a distinguished professor and director of health equity initiatives at Purdue University.
With recent calls for a return to mask mandates, third (and fourth) shots, and changes in isolation and quarantine guidance, people have been asking whether public health officials are “moving the goal posts” in the covid-19 pandemic. The short answer is: No, they’re not.

The end goal remains the same: a reopening of society that reasonably and equitably balances the risks of clinical vs. societal harm from the novel coronavirus. Much as the virus has changed form and presented new challenges, our fight against it has also needed to evolve.

If we are going to apply a football metaphor to the pandemic, a better one would be this: As in football, the battle against covid requires a team effort. Our best plays? Get vaccinated, get boosted and wear masks. Since the coronavirus broke out in 2020, however, our team has barely managed to move the ball past midfield. We fell far behind against initial variants of the virus — strains that were less deadly than delta, or less contagious than omicron, or both. Now we are battling reinforcements that are stronger and more agile than the opponent we originally planned for — and we’re losing.

For most of 2020, many of us thought that once fully vaccinated — which initially meant two doses of the Pfizer or Moderna vaccines, or one dose of Johnson & Johnson — our lives would return to pre-pandemic normal. Masks would come off, schools and workplaces would reopen, and we’d declare victory over covid. But then the delta variant arrived, and hospitals began once again filling with covid patients.

That’s why no one is “moving the goal posts” by calling for boosters and more (and better) masks. Most experts predicted early on that herd immunity could be reached at somewhere between 80 and 90 percent of the population vaccinated. Some suggested it could be as low as 70 percent. But we’ve suffered from both poor luck and poor effort.

A year after covid vaccinations become available in the United States, our vaccination rate sits at a dismal 62 percent — far from even the most optimistic estimates of herd immunity. And variants such as delta and omicron — both highly contagious and prone to cause breakthrough infections — push the threshold up further still, forcing scientists to amend the definition of “fully vaccinated.”

In football terms: We got lazy on defense.

Omicron has proved so contagious that our country has shattered its own record for daily cases. The one bit of good news is that, due largely to the protection afforded by vaccinations, plus many who now have some immunity from previous surges and infections, we’ve seen some decoupling of cases and hospitalizations. Scientists are now saying we should pay less attention to case counts, which again — unfortunately — brings complaints about officials changing “the rules” to suit their narrative.

Despite a decreasing fraction of cases being hospitalized, however the sheer number of new infections is still overwhelming health-care workers and hospital systems. Remember, a much bigger pool negates a smaller percentage. And to keep going with football metaphors: While some are focused on the end zone, those who’ve been caring for the infected since the pandemic started are barely able to hold our field position.

There is some good news in the midst of the latest surge: Vaccines and boosters have been approved for more of the population, allowing us to move closer toward herd immunity. More rapid tests are in the works, which will help limit the infected from spreading the virus. High-quality masks are increasingly available. And new oral antivirals, along with monoclonal antibodies, should help many who get sick to recover.

Unfortunately, covid isn’t done with us — not by a long shot. And, as in sports, our team isn’t likely to win if our players aren’t on the same page. If we hope to defeat not just omicron but also future variants, we must accept this reality, plan for the long haul and adapt to our evolving opponent. Our game plan must include vaccination, testing, treatment, masking, ventilation, improving overall health and, critically, a team effort to execute these practices.

In sports, the most successful teams have coaches who communicate clearly and effectively, and players committed to following the game plan and to putting the team ahead of their individual desires. The new year is a great time for some introspection and a renewed commitment by all of us to execute better — otherwise the goal posts may keep appearing further and further away.