Take this for whatever you think it's worth. No harm, no foul if you don't believe.
Last night I had a chance to ask all of my outstanding questions to someone who's been close to COVID since January of 2020, and has had direct conversations with almost all the folks you see on TV (Fauci, Scott Gottlieb, Wolensky, etc).
Thought I'd summarize it here for anyone who might be interested.
Me: even though breakthrough cases are increasingly common as the vaccines wane, they're still providing great protection against hospitalization and death, right?
Them: right. And the vaccines are still providing like 66% protection against infection too -- which is basically the number we were hoping for when we started vax development. They're still good! But even though infections are increasing, bad outcomes are still almost all among the unvaxxed or people with serious existing health problems (immunocompromised, etc).
Me: I delayed my booster by about a month, am I taking any real risk by doing that?
Them: not at all. There's some thinking now that the boosters are SO effective that the regimen should have three shots from the beginning though. But your odds of a bad outcome if you get sick are very low. So low that there's still a debate about whether we should be taking them or sending them to places that need them for 1st or 2nd shots. But we don't seem to be able to get those shots where they need to be in any event, so...
Me: it's so politicized and so muddy now, and I haven't spent any time trying to untangle it for myself, that I'm not clear on what Fauci and the CDC messed up at the start of this and what's just political axe-grinding. What are the legit criticisms of Fauci and the CDC?
Them: the biggest mistake was at the very beginning thinking that COVID would be like SARS or MERS (people are very sick before they're able to infect others/spread the disease), and that it would be ~easy to contain. There was a result (paper?) in Germany from mid-January 2020 that suggested how easily it spread that should have set off red alerts for everyone -- that asymptomatic people were actually contagious, but they took the wrong lessons from the problems with the paper (many 'asymptomatics' actually had cold symptoms) and missed the main finding (that people could spread this before they were really sick!). They screwed up.
Me: what about the mask thing?
Them: Fauci, etc were trying to protect N95 masks for health workers and also not panic people. But in hindsight the messaging should have been much clearer. Even if you protected N95s it turns out that even cloth masks and etc are effective against respiratory infections. COVID less so than some others -- but there's good evidence now that masks do help and they should have been much clearer and stronger that people need to be wearing them.
There's a bigger problem with masks in general though, one that goes back decades, and that's that there's no money to be made from researching their effectiveness -- so almost no one was doing it. It would have been easy to pay students at one dorm to mask through flu/cold season and then track illness vs another dorm (for example) but almost no one has done that kind of work. It's an institutional failing that we didn't know masking (and social distancing, etc) would effectively ELIMINATE the flu for example.
Also the desire to keep people from panicking was misguided in general. It muted or muddied too many important messages.
Me: you mentioned the flu. It was basically wiped out in the US last winter, right?
Them: yep. And is still almost entirely missing.
Me: so if everyone in the world masked up for a year -- would flu be eradicated?
Them: basically -- at least in the short run. There would still be reservoirs that would let it reemerge, but it's clear that masking makes it impossible to spread. A lot of what we though we knew about how respiratory disease spreads before COVID is likely to be proved wrong. It seems like aerosols are much more important and fomites/touching your eyes and nose and mouth are much less important generally.
Me: right -- so related to that, my impression is that being outside is virtually safe. That you are extremely unlikely to get COVID outside unless you're in someone's face since aerosols are dispersed into infinite volume?
Them: yeah -- the stuff from early in the pandemic about riding behind another biker and all that was just junk. Even inside if there's a big circulation of air it helps a lot. What we're learning from COVID might end up bringing in a new standard -- where HEPP(?) filters and ultraviolet light and heavier circulation of air is a the norm.
Me: I saw the news about the Pfizer and Moderna pills last week -- do those seem legit?
Them: We don't know yet. I can't see anything they'd gain by lying, but until we see the reviewed results it's worth reserving judgement. If they do check out they look to be VERY effective though.
Me: so in ...? months we're on the other side of COVID? If the pills check out?
Them: Unless there's something wrong with the tests, we'll probably have a pill approved for treatment in about three months and within six months or so they'd be widely available.
Me: and we're past COVID?
Them: COVID's never going to go away now, but it'll be like the flu or a cold -- you get sick and then get better. So yeah, sometime in 2022 it's probably not as big concern in the US.
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The caveat riding through all of this was that there's still a ton we don't really understand, so surprises could still happen. Plus this is one person's take on things.
Also, to the degree that people continue to be unvaxxed and refuse any effective pill treatment, COVID will continue to be a problem in that population.
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