Meghan Fitzgerald, RN, MPH, DrPH, is an adjunct associate professor with the Columbia University Mailman School of Public Health and a private equity investor. She has decades of experience working in the healthcare field, ranging from frontline patient care to advising prominent healthcare firms. Here, she shares her take on the implications of mixed Delta messaging for those who are still unvaccinated.
Data last week from the Centers for Disease Control and Prevention (CDC) show that 0.004% of the 163 million Americans who have been fully vaccinated against COVID-19 have experienced serious “breakthrough” infections. To put this figure in context, you’d have a higher chance of dying from a shark attack than from COVID-19 as a vaccinated swimmer. Yet, judging by the media coverage and rushed guideline changes surrounding the surging Delta variant, you’d never know it.
Despite rising case counts—especially in the south—there is some good news. The seven-day average for daily U.S. deaths attributed to COVID-19 is running around 300 or so, less than 10% of the previous peak. If 300 people died of COVID-19 every day for a year, we’d lose over 100,000 more lives. This is tragic. However, once again, context matters. According to the CDC, the current rate of COVID-19 deaths is now rivaled by annual deaths from heart disease (655K), cancer (600K), accidents/unintentional injury (173K), and stroke (150K)—all serious conditions receiving minimal media coverage.
Breathless media reports about rising cases are technically correct, but tend to distort and mislead without context. When you look closely at Delta-driven outbreaks, such as the one Provincetown, MA, the major part of the story—missed by many news outlets—is how well the vaccines worked.
Out of the thousands who descended on the P-town party over the July 4th weekend, only four vaccinated folks ended up in the hospital and no one died. If no one was vaccinated, this story would have ended as badly as it was covered.
I’ll be blunt: The pandemic has created a cottage industry of paid consultants, politicians and made-for-TV public health experts competing for ratings, products, and votes with snappy tweets or edgy interviews. Left in the void of the never-ending COVID echo chamber are the millions who remain unvaccinated and unpersuaded (or worse, open to discredited conspiracy theories).
According to a May Gallup survey, however, one out of five vaccine-reluctant adults are open to reconsidering. Twenty-one percent say they are likely to change their mind and get vaccinated. This translates to about 5% of all U.S. adults. But national strategies and public health messaging are failing this group, who are less likely to be college-educated and more likely to be influenced by the positive vaccine experience of a friend than a message from their governor. As a result, the United States has been unable to clear the 50% mark when it comes to fully vaccinating the population.
What will it take to convert those on the fence? Three things:
- New risks: The Delta variant and its repercussions among the unvaccinated is a motivator for getting a shot. Florida, which set a new daily record for COVID hospitalizations on Sunday, is now experiencing an uptick in vaccinations.
- Local confidants: The vaccine-reluctant will likely be more impacted by conversations with family, friends, local physicians, or other healthcare providers who can really help explain the details of the vaccine experience and answer any immediate personal safety questions. A national message cannot do this.
- Requirements: If people are required to get vaccinated for school, work, or to do the kinds of activities they want (like take a cruise), they may finally agree to get a shot.
In the meantime, misguided mandates and bad coverage will do nothing more than create further mistrust on the part of the unvaccinated while infuriating the vaccinated. Coronavirus is airborne and highly contagious, so a policy to have the unvaccinated use a mask in between bites of food is not going to protect them from catching something as contagious as the chicken pox.
Still, remedial measures in COVID hotspots may be necessary, like asking those in high-risk, high-contact spots to show proof of vaccination. These tactics will be up to local leaders and employers.
Most infectious disease experts believe COVID-19 will become endemic. This means we will continue to live with it, like the seasonal flu. The goal should be to render COVID-19 a public health nuisance for most people (like the common cold) using vaccines, not to continuously implement strategies that guarantee failure and public mistrust.
The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.