Saturday, December 19, 2020

Take Your Medicine!

I should have posted this several days ago, but I don't think it's outdated yet.

As everyone probably knows, Pfizer's vaccine for COVID-19 has been approved for emergency use by the FDA, and the inoculations have begun.  (The Moderna vaccine seems poised for approval within a day or two.)  Not without some glitches, of course, especially as our rulers and betters have tried (often successfully) to jump in line ahead of unimportant, disposable people such as frontline healthcare workers.  And there have been some mixups in shipping sufficient numbers of doses, at both the Federal and state levels.  But it's okay, everything will work out eventually, we have to trust the experts and other authorities, especially now that Joe Biden has been elected and Science will save the day.

Once again, NPR's Morning Edition gave me food for thought, with indigestion, three stories in one day.  This one, for example, though it began by giving me a laugh when the host, Rachel Martin, said that most of the patients served by her interviewee are "first and second-generation Latinos."  Yes, I know what she meant, and it isn't entirely her fault since American discourse on ethnicity stinks to high heaven, but still.  She's using "Latino" as a racial category opposed to "whites," which is problematic for many reasons.  Imagine if she'd said "first or second-generation whites."  Really, Rachel, "first or second-generation Americans" would have done the job admirably, and it's what you meant anyhow.

Anyway, the physician Martin interviewed, Eva Galvez, gave this example of inadequate information among her patients.

It was a family who came in to get care for their children. And so the visit really was not a visit for Mom and Dad. But Mom asked me if the vaccine was safe, and she had heard some information on a social media platform that the vaccine had long-term side effects and that the vaccine was actually risky. And then she asked me, how can you ensure that this vaccine is safe? And then what I told her was that we had done very many studies, and it had gone through a rigorous process and that, based on my reading, that it was safe. And what I conveyed to her was that all vaccines have side effects, but that the risks of the side effects generally are less than the benefits of getting the vaccine. And that was how we ended up leaving the conversation. So she didn't tell me that she was going to get the vaccine, but she certainly seemed open to the vaccine. And so it's really fighting two battles here. One is trying to convince people that the vaccine is safe and that it is important, but at the same time is also trying to rectify all of those messages that they have been getting from other sources. So these conversations really do take time.
This is good, because instead of telling the woman she was stupid and anti-science, she took her questions seriously and tried to answer them.  But look at the bit about hearing on a social media platform that the vaccine had long-term deleterious effects.  That's not unreasonable or alarmist, though it's unavoidable given the rush to produce and certify the vaccine.  It should be remembered and stressed that the approval is for an emergency situation.  (It occurs to me also that flu vaccines, which must be revised each year, also don't get long-term studies before they're approved.)  The discussion I've found always focuses on immediate effects, such as pain at the injection site for a day of two afterward.  That, if I recall correctly, is also a possible effect of the flu shot and other vaccinations I've gotten in the past several years, though I've never experienced it.

So I appreciate Dr. Galvez' candor with her patients.  I'm not so happy with the next doctor Martin interviewed, Anthony Fauci.  Martin began with a typically dumb reporter's question, if the first inoculations "feel like the beginning of the end to you?"  Fauci responded with some vacuous platitudes.  Martin then asked wouldn't it be terrible if people refused to get the vaccine, and what should we do?

It isn't only African Americans. It's Latinx and many white people feel the same way. We've got to get the message across and explain to them what their hesitancy is and what their reluctance is and try and reason as to why they're understandable, but they're really not based on facts. If you look at what goes on historically with vaccines, overwhelmingly they are the safest and most effective interventions in medicine when it comes to infectious diseases. We've got to keep trying to get that message out because it's to the benefit of the individual, but to the benefit of the entire society.

I haven't been impressed by Fauci as a spokesman for Science.  There's no reason why he should be any good at it, I guess, but communication is part of a physician's job, and on top of that he has been anointed by the media as the Anti-Trump of the pandemic.  So it's not good that he says here that "we" should "explain to people what their hesitancy is and what their reluctance is and try and reason as to why they're understandable."  This is authoritarianism, understandable in a physician of Fauci's generation but unacceptable.  First you have to listen, to let them tell you what their hesitancy is.  Even if their hesitancy is irrational, as it often is; sometimes it isn't, though.  

After all, Fauci has been saying that Santa Claus "is exempt from this because Santa, of all the good qualities, has a lot of good innate immunity," a line that sounds as if it were composed by Pete Buttigieg's platitude AI.  USA Today explained, "But with millions of Americans already sick with COVID-19, children have been worried about Santa, especially this Christmas Eve when he visits millions of homes. And there's no denying that Santa, because he is older and overweight, would at first glance appear to be at higher risk of developing severe disease from COVID-19."  Speaking of "not based on facts," this is the trouble with impressing children with the reality of a mythical being: when something goes wrong, you have to come up with crap like Fauci's reassurance. But grandfatherly Dr. Fauci knows what's best for you.  

And today he told the nation that he'd given Santa the vaccine; even that he "measured [Santa's] immunity," which is how you say, not a thing.  I know he's a grandfather in private life, but Fauci comes across as the kind of patronizing adult who neither understands or likes children very much.

The fictional Santa is safe from COVID, it's true, but unfortunately he's not the only Santa.  On that same morning, Rachel Hubbard reported on Morning Edition that her parents play Santa and Mrs. Claus every year.

My dad is not a mall Santa. He and my mom live in Cordell, a small town about 100 miles west of Oklahoma City. Working in rural Oklahoma, my parents spend their time visiting with people at community events, in nursing homes and at schools. Most years on Christmas Eve, dad is visiting people in their homes. People just expect to see him around town.

"They've always seen Santa, and he's always been around when they need him, and he can just come by their house," my dad said. "It's just not the same this year." 

NPR is not usually kind to religious people and others who don't want to give up their traditions because of the pandemic, but apparently Santa cosplayers have special status.  However, as Hubbard acknowledged, Fauci's claim that Santa is immune isn't true.  I wonder if it even occurred to him that there are real people out there who have to cope with children's beliefs about them.  But Doctor knows best.

Stephen Arnold is president and CEO of the International Brotherhood of Real Bearded Santas (IBRBS). He says at least three of the organization's 2,200 members have already died from the coronavirus. (One in Florida and two in Texas.)

"That has created consternation amongst ourselves. Whether we cancel the season altogether, whether we ignore the warnings or whether we find a compromise," Arnold said.
Many of these men rely on the Christmas season to supplement their income, so it isn't just a matter of self-regarding ego. 

According to an informal survey IBRBS did of its membership, about one quarter has decided to proceed with Christmas appearances without masks or social distance. Another quarter has canceled their seasons altogether, and the rest have landed somewhere in the middle.

Hubbard and her siblings are properly concerned about her parents' health.  Santas around the country have been creative in coming up with creative alternatives, and even Hubbard's parents have had to bend to reality.  If they are valuable to their community, and they clearly are, they need to be around next year too.

In a recent digital event, children were able to ask Santa questions. While there were questions about what kind of cookies Santa likes (sugar cookies with lots of sprinkles) and whether Rudolph always leads the sleigh (yes, his nose lights the way), kids also expressed anxiety about what was happening.

My dad told them this: "I know some of you are having to do school at home, and your parents might not be working right now. I just want to let you know that Christmas is going to be OK. Everyone is going to make it; we're going to make it through this."

I don't say this because I don't care about kids, but because I do.  It is a pity that Fred Rogers isn't with us anymore: he could have helped find ways to explain the pandemic to children without condescending or lying to them.  He's dead, though, so the rest of us must grow up and be helpers ourselves. Where children are concerned, Fauci isn't helping.

Resistance, even antagonism, to authority has its upside and its downside.  I think we've made a lot of progress in the past half-century when it comes to holding authorities accountable, requiring them to explain and justify themselves.  They still don't like it, and NPR is on their side, along with most corporate media.  We have to be responsible about it, not just yelling "No" like two-year-olds; we have to exercise critical thinking, as difficult and unpopular as that is with authoritarians.  There's no easy way to do it.  

I myself intend to be vaccinated when it becomes available to me, which will probably be in a few months.  But I'm glad for the interval, so I can wait and see how it goes in the meantime.