State Leaders’ Messages on Pandemic Stand in Contrast to Messages from Medical Frontlines

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“Recently, doctors in both Chicago and Nashville described seeing pediatric intensive care beds filled by adult COVID-19 patients . . .”

By Barbara D. Alexander, MD, MHS, FIDSA

This week, President Biden and members of his administration urged states to maintain or reinstate mask wearing mandates to prevent the spread of COVID-19. They were countering the dangerous precedent set by states that lifted their mandates prematurely, declaring a return to normal and implying that we can let down our guard against COVID-19.

As acknowledged by Dr. Rochelle Walensky, Director of the  Centers for Disease Control and Prevention,  it is an appealing message.  “People want to be done with this. I, too, want to be done with this.”

As the president of the Infectious Diseases Society of America, I want to be done with this as well. But I also know that, as President Biden, Dr. Walensky and other pandemic response leaders have told us,  we can’t let up now. I see this in my daily practice, and I hear it from the more than 12,000 IDSA members that include physicians and other health care providers on the front lines of hospitals and community public health settings. They tell me:

  • The challenges their communities and health systems face remain overwhelming and far from normal;
  • We are running a race now against the spread of more transmissible variants of the virus that causes COVID-19;
  • We need to keep protecting ourselves and each other, by doing what we know works, including wearing masks, avoiding crowds and getting vaccinated;
  • We have gained ground from the lessons we have learned and applied during the last year;
  • We have reason for optimism, but not to let down our guard.

We should take pride in the progress we’ve made together against this pandemic. The cost has been high. Too many Americans have lost their lives, their jobs and their homes. We’ve all lost precious time with friends and loved ones, and we’ve missed the rites of passage and celebration that bring us together. We can’t let those sacrifices go to waste by becoming complacent now.

“We need help,” a member in Texas told me in a recent meeting, even as the leadership of his state indicated the crisis is under control. While hospitalizations there remain stubbornly high, data indicate that more transmissible and potentially harmful variants of the virus are circulating in Houston, the state’s most populous city. At the same time, vaccination rates remain in the single digits across the state – far from what would be needed for herd immunity. “Lifting the mask mandate will put lives in danger,” he said.

In Utah, a member working in a clinical laboratory reported that while testing with contact tracing remains a crucial tool for stopping the spread of COVID-19, the amount of testing for the virus has dropped from a high of 10,000 tests daily to around 1,000. At the same time the rate of positive tests remains high – about 10 out of every 100 – she said, suggesting “significant community transmission.” And, as her lab races to identify the spread and scope of COVID-19 variants, equipment used to quickly identify variants remains in short supply, limiting the amount of high-volume work that can be done. The impacts of the pandemic continue to hinder other health responses, as well, she said, with shortages of testing supplies for HIV, hepatitis B and other infectious pathogens.

The impacts on the ground continue to confront our physician members with conditions they never thought they would see in an American hospital. Recently, doctors in both Chicago and Nashville described seeing pediatric intensive care beds filled by adult COVID-19 patients.

In Florida, where no statewide mandate has ever been in place, illnesses continue to increase even as vaccine rollout accelerates. In two recent weeks, more than two thousand people statewide died as a result of the virus.

Our Congressional leaders have responded appropriately with passage of the COVID-19 rescue legislation that is bringing desperately needed resources to public health departments, health facilities, communities and hard hit families across the nation.

We need political leaders, policy makers, and people from all across the nation – regardless of the mandates in place where you live — to get behind one message: If we do not control the virus now, we give the variants an opportunity to lead to a resurgence. The risk that our hard fought progress will stall is very real. While the scientific discoveries that have led to the development of safe and effective vaccines have been remarkable, ongoing viral infections lead to new mutations and variants that threaten the success of these vaccines, with the risk of putting the finish line out of sight again.

We don’t want another year like the last one. Mask up America. We all have a part to play to reach the end. Every time you put a mask on, you make a difference.

Dr. Alexander is president of the Infectious Diseases Society of America (which produces this blog) and a professor of medicine and pathology at Duke University School of Medicine where she also serves as director of Transplant Infectious Diseases Service; head of Clinical Mycology Laboratory and director of the Transplant Infectious Diseases Fellowship Program. She is principal investigator of the Duke University NIHT32-funded Transplant Infectious Diseases Interdisciplinary Research Training Program.

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