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Who Among the Fringe Is Dangerous?

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There are irrational beliefs on both extremes of the Covid-19 policy debate. On the zero covid side: many want to wear n95s with no clear stopping rule. They want to compel others and even very young children to mask (2 year olds in New York City). They cheerlead for booster authorizations and mandates without credible data. The 4th dose in a healthy 51 year old, or 3rd in a healthy 16 year old. 

As recently as Omicron, they called for more circuit breakers (aka lockdowns).

On the extreme of the other side, we hear rhetoric that vaccines have microchips in them to track you. This is often said by someone who carries their phone with them everywhere. Some are categorically opposed to vaccination. They think a healthy 65 year old is better off meeting the virus than the vaccine. Gulp!

I think both extremes are not correct, but there is a key difference between them….

The second group might disproportionately affect other people by serving as a reservoir to spread virus. However the moment we learned that breakthrough was inevitable for all people, this argument vanished. Everyone can spread.

Perhaps the second group disproportionately affects others by potentially using hospital resources. However, when it comes to reinfection, the many who have natural immunity are far less likely to use hospital resources than those who are merely vaccinated. This too must be factored in. If anything it is only a first pass disproportionate use.

The first group (zero-covid) has affected others in numerous ways. They have implemented an only toddler mask mandate in the world in NYC. They favor forcing kids to wear the mask, even when their parents don’t want them too. They pushed for illogical booster mandates by colleges and hospitals and other jobs. They are the ones that are calling for mandatory 5-18yo vaccination as a precondition to attend public school. 

These are terrible policies. They have repeatedly pushed on FDA to lower the regulatory bar to approve vaccines for kids <5. This will surely be followed by mandates in private preschools. 

In other words, the first group uses existing institutions to push their agenda, even when it is absurd. They push toddler masking or forcing a 20-year-old man who has already had 2 doses and Omicron to be boosted 30 days after having had Covid19 or be pushed out of college. The second group does not appear to do the equivalent: they don’t ban a 65 year old from getting a vaccine. They merely make poor choices themselves.

I think this difference is relevant. Bad ideas and poor thinking will always exist, and there are many, varied ways of being foolish and illogical. But it should trouble us all when illogical people force others to participate in their delusion.

Republished from the author’s Substack

Author

  • Vinay Prasad MD MPH is a hematologist-oncologist and Associate Professor in the Department of Epidemiology and Biostatistics at the University of California San Francisco. He runs the VKPrasad lab at UCSF, which studies cancer drugs, health policy, clinical trials and better decision making. He is author of over 300 academic articles, and the books Ending Medical Reversal (2015), and Malignant (2020).


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