3979 + 1: When that Someone is Someone You Know

We got the call on a Wednesday morning that my husband’s ex-wife had checked herself into the hospital the night before with a bout of pneumonia and COVID. She had tested positive one week earlier.

On the day they intubated, the doctor helped her call the son that lived nearby to designate her medical power of attorney. A nurse stood witness. When her kidneys failed the doctor had suggested strategies to consider. The children would decide on the path forward and speak with the doctor again within the hour, except within the hour their mother had gone into total organ failure and was put on life support. It was Friday morning.

These two sons and their wives had to make the most difficult of all decisions. They said their last goodbye, one by one, through a phone held to her ear. It happened so fast, and it was all so preventable.

On that Friday, 3,979 other families also mourned the loss of their loved one. Wives, husbands, friends, families, sons, daughters and grandchildren woke up in the middle of the night and couldn’t believe their someone was gone. 3,979 families were cheated of their last goodbye, the chance to hold the hand of their loved one as they left this world, or to kiss their cheek. There were 3,980 COVID deaths on that Friday. 3,979 plus ours.

Only five people had been infected with the novel coronavirus in the United States as of January 5th, 2020.

On January 31, 2021: 26,147,162 people have had the virus and 440,843 have died. Four hundred and forty thousand, eight hundred and forty-three people have died. Both numbers will be higher by the time you’ve read that sentence. More than 95,000 people have died of COVID in this first month of 2021. That’s about 20,000 more deaths than last month and more deaths than any other month of the pandemic so far.

You begin to wonder what, if anything, will sway public opinion to use every tool we have available to stop the spread and help eradicate this virus? There is something we could try.

My thoughts went to the national media campaigns that have been launched for various causes in my lifetime. These campaigns must have faced a similar challenge in their effort to change behavior. There were, of course, lots of important campaigns to consider, but the seat belt campaign is eerily similar.

Seat belts were added to vehicles in 1968, but not adapted by law until the early ‘80s. When the first seatbelt law went into effect the public was outraged. “This is a violation of personal freedom!” The Michigan state representative that enacted the law received hate mail comparing him to Hitler. One of his colleagues in the Michigan House called the seat belt bill “a pretty good lesson in mass hysteria created by a corporate-controlled media” and warned that the government would outlaw smoking next.

A 1976 review of the seat belt campaign got to the punchline in the first paragraph, “Carefully controlled studies of advertising campaigns find no effect on belt use.”

At the time, U.S. injuries in motor vehicles were the leading cause of death in people 1-35 years old. More than half of traumatic spinal cord lesions that resulted in paralysis occurred in vehicle crashes. Almost 1 in every 50 people would be injured in vehicle accidents.

Forty-one years later, 47 percent of the 37,133 people killed in motor vehicle crashes were still not wearing seat belts. National seat belt use finally increased to 90.7 percent in 2019, but we can’t wait that many years to change public opinion on COVID.

In Washington, Mo., a small city an hour west of St. Louis, the City Council considered a bill last August requiring residents to wear masks to prevent the spread of the coronavirus. Protesters marched, 356 people signed a letter to the local paper vowing their opposition to being “forced to cover our mouths in public.” By Thanksgiving, with local cases surging and the hospitals overflowing, the City Council brought a mask order back for another vote. This time, Councilman Nick Obermark, an electrician, was the sole member of the nonpartisan council that changed his vote, allowing the mandate to pass.

One of the reasons he changed his vote was because he has a child the same age as a local 13-year old Middle School student who on Halloween had become the youngest person in Missouri to die of COVID-19 complications. That small community discovered the key to changing hearts and minds lies in how close and real the danger seems. Councilman Obermark later remarked of his change of heart, “We tried nothing and it isn’t working,” he said, “so we have to try something.”

The seat belt report noted that current technology may mean behavioral change strategies are the only ones available for some pubic health problems. However, sometimes our focus on behavioral change can delay the adoption of other alternative strategies. In the case of reducing motor vehicle deaths, several passive approaches, such as air bags (a technology-based approach), weren’t pursued for many years.

Does it make sense to attempt to change every person’s behavior (wear seat belts or, in this case, masks) or provide automatic protection where the technology is available to do so?

The report questioned, “If faced with the choices today, would we purify water at the source or would we launch an ad campaign to attempt to persuade everyone to boil his or her drinking water? Would we require pasteurization of milk before it is sold or would we pass a law that each family had to boil their milk before it is consumed?”

Today’s advanced technologies have produced COVID vaccines in an unprecedentedly short time. To be successful, a vaccination program needs to achieve a 60% target within two years. If we do not do that, COVID becomes endemic on the continent. Our own Anthony Fauci has set a target of 70–85% in the U.S. by this summer. No one should underestimate the challenge ahead or how difficult the persuasion will be.

The USA TODAY/Suffolk Poll, taken Aug. 28-31, 2020, found that about two-thirds of the 1,000 voters surveyed – 67 percent – would either not take the vaccine until others have tried it (44%) or not take it at all (23%). The reasons cited boil down to one thing: mistrust. The government pushed the development of this vaccine too fast, the government sent mixed messages, the testing is all trial and error, “I’m not going to be anyone’s guinea pig!”

Forty-one percent of those surveyed would not get the coronavirus vaccine even if the federal government required it, and a sizable slice of the country generally opposes immunizations of any kind.

An international poll released by Reuters last Friday found less than half of Americans polled said they would definitely be willing to take a COVID-19 vaccine when offered – a much lower percentage than most other countries. In Britain, for example, 73% of people said they would get vaccinated, while in Denmark the number was 70%.

The purpose of vaccines is to train our immune system to remember an infectious agent – without our having to contract it. And, in the science of vaccines, we’ve had lots of experience.

A virus replicates by making copies of itself once inside a host, but sometimes it makes mistakes. It’s been compared to hitting the wrong key when you type. These mistakes can cause the virus to weaken, but it can also cause the virus to become stronger, different, more contagious.

Every new infection/host gives the virus this chance to mutate and, over time, small mutations converge in ways that change its behavior. COVID mutations are happening all over the World. When people travel they may bring a new mutation or variant back home where it mingles with homegrown variants and continually morphs in its effort to survive. If these variants develop rapidly enough, and skillfully enough, they may outsmart the vaccines we have already developed.

Herd immunity occurs when a large portion of a community (the herd) becomes immune to a disease, making the spread of disease from person to person unlikely. However, the more contagious a disease is, the greater the proportion of the population that needs to be immune to the disease to stop its spread. For example, the measles is a highly contagious illness and as much as 94% of the population must be immune to interrupt the chain of transmission.

Vaccines can create herd immunity, if the requisite number of the community gets the vaccine. If the proportion of vaccinated people in a community falls below the herd immunity threshold, exposure to a contagious disease could result in the disease quickly spreading again. A good example is Measles, which has recently resurged in several parts of the world where people are not getting vaccinated, including the United States.

It’s happening this week in Israel where serious COVID cases have surged again among those who have not yet been vaccinated, despite having delivered more vaccines per 100 people than any other country in the World.

Herd immunity can also be reached when a sufficient number of people in the population have recovered from a disease and have developed antibodies against future infection. But there are challenges with this method. We don’t yet understand how long immunity lasts for COVID, and, in the U.S., over 70% of the population, 200 million people, would have to recover from the virus before we would reach immunity. With the current COVID infection fatality rate, an extraordinarily high number of people would die in the process.

There is this sort of implicit belief that when you need a message to reach the largest range of people or perhaps the whole of a population, mass media campaigns are the way to go – and there’s lots of approaches for those campaigns.

Mostly, I think we believe that if people knew better, they would do better. This is because most people are rational and make careful, deliberated choices. right? Maybe we assume that if someone knew something was dangerous, they would not take unnecessary risks. If you have had a teenager, you know this is unfortunately not true (although plenty of adults fall into this category as well). Based on the number of car crash commercials I remember growing up, there is apparently a firm belief in the ability to scare people straight.

As far-fetched as it may seem here at the end, I’ve written and deleted vast swaths of information as I hobbled through my own approach to getting out the message, eventually settling on a little of everything. But one comment in the seat belt study stood out: that local, personally directed campaigns were particularly effective.

Just like Councilman Nick Obermark was moved by the 13-year old that could have been his someone that died, I think we’re all more sensitive to friends talking frankly as friends, family talking to family, parents talking to kids, or sometimes kids talking to parents.

For myself, my husband and his sister, the death of someone we knew hit us hard. We had only seen her periodically for the past 25 years, but she was still part of the family – the mother of my husband’s children and grandmother to three marvelous young men that are just beginning their adult life. It is beyond heartbreaking to see children lose their mother.

Announcing the Launch of Millions of Personally Directed COVID Campaigns

IT’S ON US. If you agree all of us should do everything we can to eradicate this virus, share your story. Talk to your friends and family. Share this story if you will.

There’s links at the end if, like me, you’re the more-data-is-better kind of person. There’s even a link for how to talk to people that don’t want the vaccine. Let’s launch millions of personally directed campaigns and stop COVID. #COVIDzero

• Get the vaccine as soon as you are eligible and encourage your family, friends and neighbors to do the same.
• Wear a mask, even two if you want. Be sure they fit properly, and keep them over your nose.
• Be vigilant and increase your dedication to stop the spread by masking and social distancing.
• Continue to wear a mask after you’ve been vaccinated, for now. Read why here.
• Stay home for all but essential activities, avoid gatherings outside your household. Avoid enclosed spaces.
• LET’S STOP COVID

We can do this for just a few months more until enough people are vaccinated. We can do this. For ourselves, and for each other, until no one knows someone that has died of COVID.

References:

The COVID Tracking Project at the Atlantic
https://covidtracking.com/data

A Vaccine Against COVID-19 Would Be the Latest Success in a Long Scientific History
https://time.com/5835668/vaccine-history/

An 8-Point Guide To Talking To The Vaccine Sceptic In Your Family
https://www.vogue.co.uk/news/article/how-to-talk-to-anti-vaxxers

How did we develop a COVID-19 vaccine so quickly?
https://www.medicalnewstoday.com/articles/how-did-we-develop-a-covid-19-vaccine-so-quickly#Safety-monitoring-after-vaccination

Covid-19 vaccines are great — here’s why you also still need to wear a mask for now
https://www.msn.com/en-us/health/medical/covid-19-vaccines-are-great-but-you-still-need-to-wear-a-mask-for-now/ar-BB1deFtg

What Changes Minds About Masks? In This Small Town, It Was A Child’s Death
https://www.npr.org/sections/health-shots/2020/12/08/943990136/what-changes-minds-about-masks-in-this-small-town-it-was-a-childs-death

Exclusive: Two-thirds of Americans say they won’t get COVID-19 vaccine when it’s first available, USA TODAY/Suffolk Poll shows
https://www.usatoday.com/story/news/politics/2020/09/04/covid-19-two-thirds-us-wont-take-vaccine-right-away-poll-shows/5696982002/

Israel’s Early Vaccine Data Offers Hope https://www.nytimes.com/2021/01/25/world/middleeast/israels-vaccine-data.html

Why some coronavirus variants are more contagious—and how we can stop them
www.nationalgeographic.com/science/2021

The History of Vaccines
https://www.historyofvaccines.org/timeline/all

When New Seat Belt Laws Drew Fire as a Violation of Personal Freedom by David Roos, history.com
https://www.history.com/news/seat-belt-laws-resistance

The United States Department of Transportation
https://www.nhtsa.gov/risky-driving/seat-belts

Consumer Response to Seat Belt Use Campaigns and Inducements: Implications for Public Health Strategies
https://www.acrwebsite.org/volumes/9279/volumes/v03/NA-03