Sorry for the hiatus, gang, but I’ve been out saving the world by stabbing people—most times twice!
I’ve finally stepped off that crazy merry-go-round—objectively victorious! Now, I’m getting my bearings, checking the weather, reading the room… and I’m super confused.
America is giving off some serious “George Bush with the Mission Accomplished banner” vibes right now.
I’m sure you’re reacting to life now just like I did then: “WTF is wrong with these people? What reality do they live in?”
This isn’t over! Positivity rates are SPIKING. Immunized people are testing positive, getting sick, or even getting hospitalized! (But not dying, and that’s pretty darn awesome.)
Emotionally, we’re still a mess. We’re spinning plates. How do we balance our desire for public health, our sense of community and responsibility, and our personal needs for normalcy—especially the one that says you NEED to go to Fiji right now before everything locks down again?
This juggling act, in and of itself, is difficult, but we’ve got jackasses swatting at our plates and sabotaging our hard work. Still.
It’s the same old troublemakers: the anti-maskers and the anti-vaxxers.
Today, I group them together for what they really are—anti-faxxers.
Did I make up another word? I think probably…
We’re gonna get nice and ranty, and then I’ll try to answer some of the frequently asked questions rattling around the zeitgeist these days, finishing with a strategy for our new, new, new normal.
Catching COVID and Catching Up With the Anti-Faxxers
What are the anti-mask and anti-vaxx crowd up to these days?
On the mask front, Facebook Karens are using their kid as a political prop in their anti-mask crusade.
Yes, in case you were literally in a cave or are a time traveler from the future, Americans’ stance on masks during a global pandemic is most likely dictated by who you voted for in the last election.
These two things shouldn’t even be loosely correlated.
Back to what’s happening… Long story short: mom belongs to some anti-mask group, decides to have her kid “make a stand” and then post it online for imaginary internet points.
“UNMASK OUR CHILDREN” is what protest signs and social media posts exasperatedly say. These people are engaged in the fight of their life, concerned that the rights of them and their families are being trampled before their very eyes.
The same eyes that don’t blink during the active shooter drills, for the lack of teacher AND student support, and for the resultant broadening mental health crisis. Eyes are wide shut, though, for all of the opportunities to engage positively with their children’s education…
The anti-mask sentiment through this entire ordeal has been nauseating at best and infuriating on the regular.
The mask thing brings out the ugly in me. It costs nothing. The controversy itself is foolish. At the end of the day, it’s a representation of something that some folks’ defense mechanisms just won’t allow them to accept.
Nothing brings out the ugly more than the anti-vaxx crowd.
Please note there is a difference between vaccine-hesitant folks and fact-deniers.
It is my professional mission to help people sort through ALL the BS, interpret the facts correctly, and make the best decisions for themselves while calling out all the charlatans. In other words, if you are vaccine-hesitant I consider it my professional mission to help you. I’ll gladly give you as much time as you need.
On the other hand, don’t dress yourself up as a hesitant person if you are actually anti-vaxx.
Secondly, we must address the notion of the false dichotomy saturating our culture right now. Any participant would believe the two sides are not believing in vaccines vs believing in vaccines.
The only TRUE dichotomy is those trusting of vaccine science vs those believing in pseudoscience and falsehoods.
Anti-vaxx should be a fringe position, not an accepted part of society.
In the early months of the vaccination effort, I had this awesome piece roughed up, discussing how the anti-vaxx movement has reached a new height of sophistication in its stupidity.
Their BS is getting WAY smarter. These toxic liars have been upgraded from the National Enquirer to the celebrity gossip rags. I mean, we all know Hillary Clinton isn’t a wolf-boy in disguise, but MAYBE Jennifer Aniston is dating 50 Cent (or the equivalent in 2020 pop culture references–I haven’t been outside in a while).
In other words, modern vaccine misinformation has a spin that’s much more thinly veiled, a bias that is better disguised, and “facts” that are more “sound” and more subtly distorted.
The purpose was simple: provide a good sarcastic tear-down of the new tricks, while also advocating and rooting for the most resistant.
I was solely motivated just to blast the dopes on my social media feeds barking back at the celebration of providing those first doses to the most vulnerable. Or maybe it was the people who were telling me–THE immunizer with all the smart people connections–to “do your research.”
I wrote it, then scrapped it. I just don’t think it matters.
Listen, if the following is true…
- This is the most scrutinized, tested, and implemented medical intervention in modern history
- BILLIONS of doses have been administered with ASTOUNDING success and efficacy
- Any reported (but not necessarily related) adverse events are a drop in the bucket compared to the success and benefit
…then any anti-vaxx claim has literally no leg to stand on. Why refute them?
On top of this, these anti-vaxx folks are often worried about being ‘manipulated by the media’, prioritize ‘research’, ‘freedom’, and ‘liberties’ conveniently ignore two (of MANY) very important points showing how they, themselves are, in fact, are being manipulated by “shadow” activities:
- The anti-vaxx conspiracy theories and talking points are being supplied by 12 not-very-credible people with questionable motivation
- Anti-vaxx arguments are being fed and amplified via coordinated cyberterrorism acts by adversarial foreign governments
If all of the above is true, which it is, what the hell can we do? Up is down, blue is right. Reality itself is in question. Why bother?
We bother because we must. Here’s my call to action: we all MUST engage with the anti-faxxers in public forums.
“It’s fruitless, dude, and my shrink said stop picking fights with people online. We’re not changing anyone’s minds!” Yes, voice in my head, yes.
We must. We engage for the same reason I present this to you in this rant, even though it’s the same old same with new, shiny spin: to prevent misinformation from infecting the truly hesitant or, worse, vaccine advocates.
We must push back because sometimes the lack of disagreement is perceived by our monkey brains as support or strength in a position.
Modern life is one where people are–from waking until bed–saturated with editorial misinformation that is destroying society.
We can’t let it lie.
Much of our discourse takes place in a public space, where misinformation spreads like wildfire. There are many folks watching. Most of us agree with reality and not the lies, but save our energy because it is usually directly fruitless.
If folks like you identify the misinformation and call it out directly, and more experts like me join in the conversations, there will be a groundswell of fact-checking that will help turn the tides here. At the very least, it will give those who tend not to engage but have their doubts some comfort and confidence.
Here’s an anti-mask response I made during the Saugerties school masking debacle:
Why engage? This is the high school group project meme that still haunts us. Our classmates NEED to know that members of our group are sabotaging our progress, whining and complaining all the time.
We can’t normalize this nonsense.
Get used to saying these things:
- I don’t believe this is factual
- Do you have a reputable source for that claim?
- Do you have expertise in this subject matter through education or vocation?
- Dr. Neal thinks your an a$$hole
Leave the last one off. Unless you need big guns. I got your back.
The Delta Variant – Almost like the Movies!
The reason for my saltiness about the anti-faxxer crowd is pretty justified… The unvaccinated and indignant WILL be variant factories. Strike that: they ARE variant factories.
Did you watch Contagion during quarantine as I did? It’s scary how accurate it was! Sh*t gets real, real quick and society devolves because this virus spreads easily and kills nearly everybody infected to punish Gwenyth Paltrow for having an affair.
In real life, Gwenyth only has a coochie candle, and our punishment for that is a disease that isn’t that dangerous.
Yes, you read that right, and no, I’m not losing it.
Let’s talk turkey: The “freedom fighters” are partially right; COVID-19 has a “low” fatality rate and primarily affects more traditionally vulnerable populations. If you’re young and healthy, you’re not LIKELY to die from it.
Who’s vulnerable? Patients over 65, patients with immune-compromised situations, those with cardiovascular or respiratory risks.
Morose statistics aside, all functioning adults and most children know COVID-19 is extremely dangerous not because of the death rate alone. It is also very insidious. It spreads in the asymptomatic or presymptomatic, then takes WEEKS to develop into serious disease. It then requires WEEKS of intense treatment at a hospital. Death is normally 4-6 weeks after exposure or symptoms start in those with high risk. It attacks organs in the cardiovascular system causing near-permanent damage if you survive it.
If COVID-19 didn’t tie up all the resources and have the potential to crush our healthcare systems globally, it’s easy to say that it “only” killed 1.3% like the misinformed always point to. It’s not ebola and you won’t bleed from your ears.
In comes the delta variant. A COVID-19 mutation that spreads farther and MUCH faster than previous strains, with reports of transient spread (ie WAY less than the normal 15 minutes of exposure time). Sounds a bit more like my Contagion movie, right?
And it is spreading! Here’s an epidemiologist I follow:
As of today, 83% of all US cases are delta strain.
Even with this intel, I personally am not stressed about Delta. Delta is the least of your worries.
If you are vaccinated and NOT vulnerable, you really shouldn’t fear delta. The data shows that while delta is spreading quite rapidly and having a bit of fun with the unvaccinated, it isn’t much more dangerous compared to the previous circulating strain. Yet.
If you are vaccinated and ARE vulnerable, time to get real selfish. Delta won’t take you out (most likely), but it may make you quite miserable, which includes a hospital stay. You should:
- Wear a mask in public at all times
- Practice social distancing
- Hand wash frequently
- Avoid high-risk people and high-risk environments, as we covered in our blog here
Delta is the least of our worries because most people will be fine if vaccinated AND the next version of COVID is what you should be worried about.
The New Mutants & Advice for this Phase
The missing ingredient to make COVID19 a movie star is a higher fatality rate. One more box to check, we’re almost there!
Imagine the perfect storm of a virus that requires the system-crippling treatment of COVID-19, that spreads too fast and too furious, and that also has even a slightly higher fatality or even hospitalization rate.
I’d like to posit that if the delta strain mutates to become more dangerous, it will be worse than the scenario presented in Contagion. And Lawrence Fishburne can’t help us then.
This is the future we’ve been trying to avoid. This very possible dystopian future is all thanks to the anti-faxxers.
“GET ME MORE VACCINE!” Shouts the aging hippie. Not quite yet, my friend.
Boost Me Up, Buttercup?
Here’s me in March, frantically immunizing 1700 people in our first mass clinic (and royally screwing it up). I’m sweating head to toe, running around the place on 3 hours of anxiety-riddled “sleep,” having eaten a handful of Dunkin Munchkins and 3 thimbles of regular Pepsi over the past 11 hours.
Someone I immunized in January stops me and says, “Hey, any word on the boosters?”
Ask any of the COVID Busting Volunteer Army and they’ll tell you my #1 pet peeve was being asked about boosters while we’re trying to get first doses into the arms of the masses. We all had a number of good laughs about it.
Booster chatter has plagued me since day 3. My advice then is the same advice I’ll give you now: don’t think about it.
Even with all this delta stuff, we have no definitive answers or recommendations yet.
To keep it real, as I do, we must know that there are little nuggets of information that are being spun up into media narratives. It’s leaning towards annual boosters of SOME sort, but, as I’ve said, it’s currently ALL SPECULATION.
Your vaccine doesn’t expire. In case you’re wondering what I’m referencing, NY launched an online vaccination
nightmare record called Excelsior Pass. It had an “expiration date” which was more from a document “freshness” standpoint vs a vaccine efficacy thing that was not communicated at all, and a number of people believe their vaccine expires! It doesn’t, and it’s no indication of the timing of a booster.
Here’s what we kinda do know, which is different than what we knew just a couple of weeks ago:
- Boosters, conceptually, are necessary to improve immune response that wanes over time. Shingles vaccines provide this function, for example.
- There are signs that our immune response (especially in the vulnerable population) does seem to drop, but we don’t know the nitty-gritty yet
- Boosters could also be used as a computer patch to a new exploit or stronger virus. We can modify (or add to) the current Lady Moderna or PHIZAAAAS (as we called them) to give protection to new mutations as well as to reinforce our current response.
- As it currently stands, we have ample protection over at least a year (that’s how long we’ve been using them) and our current mRNA vaccines have strong protection against the current variants. In other words, we don’t really need a booster right now.
- If that changes, guess who will tell ya? Literally every f*cking person on the planet, but also ME. Better follow me on the IG and Facebook, and then subscribe to my newsletter.
Booster Mix and Match?
There are no formal recommendations on boosters, yet all these questions are popping up about them.
The most common question about boosters is the mix and match mentality: will I be stuck with ‘Dern Burn for the rest of my life, or can I be vaccine-fluid?
Logistically I think it would be difficult to accomplish consistency. What if we’re out of Moderna, or they stop making doses? I think studies will be intentionally constructed (as they have been in Europe) to test mix-and-match vs consistency.
My assumption is that it will not matter one lick, and if it did, it would not be significant enough to warrant a “stick with what you’ve gotten” recommendation.
What about the JJ folks?
“You specifically mention mRNA a number of times. Do you not like JJ?”
JJ is the street name for Johnson and Johnson, in case you’re not as cool as us.
Let’s have another ranty, tough talk here folks…
From a public health standpoint, JJ was great. It offered lots of protection during a time where we needed to stop this spread, and it opened the door to needle-phobic folks who want one-and-done. Don’t think for a moment I don’t appreciate the hundreds of folks I met who got JJ because of an overwhelming, real fear of needles and vaccines, but did it to protect themselves and others because it was the right, smart thing to do.
That being said…
From an individual protection standpoint in an environment where mRNA vaccines exist and are plentiful, my recommendation as a practitioner and trusted expert has been to skip the JJs and go for mRNA. Pfizer is great because of the 3 weeks, small needle, and small dose (0.3ml vs 0.5ml)
Reading between the lines, I’m not a JJ fan and I’d be real happy if everyone moved to mRNA, as we’ve now conducted the largest clinical trial in history on this “new” tech and have overwhelmingly positive results.
Questions swirl among those with JJ buyer’s remorse, especially after today’s NYT article. “Should I get an mRNA dose for better protection???”
- There’s no evidence to support the need for it, yet.
- Seeing how these are under emergency authorization, there currently is no guidance on that scenario that says anything beyond “You’re protected enough, don’t sweat it.”
- Therefore, legally you CAN’T get a dose of mRNA, unless a prescriber is breaking protocol.
I believe JJ folks will start a new 2 dose series in light of information confirming the importance of the second mRNA dose for lasting protection.
Juggling Training: Advice for the New, New Normal
Time for that management strategy I promised. How do we move ahead?
Dealing with Anti-Faxxers
Grace and patience are important. Staying positive and upbeat instead of giving in to our base instincts is crucial.
BUT, anti-faxxers are definitely standing in the way of progress. Call a spade a spade. Don’t let them normalize their anti-science.
They need to hear that they are wrong and until they’re ready to join the conversation in good faith they need to not engage themselves. Make the hits, push back, but don’t get ugly.
Don’t let anti-faxxer bullies go unchecked. Speak up. Tag an expert.
Public Health & Rapidly Changing Policies
Understand that public health policies are crafted in our collective best interest but three things are true:
- These policies are about acceptable risk for the general public. At some point, people will die from COVID, and we will just have to get used to it. As long as our systems are intact, folks are clearly going to die.
- Public health policies don’t need to be present for you or others to do the right thing
- Changing policies, like the removal of the mask mandate, cut both ways. Those who are anti-faxx will suffer the real consequences of this and WILL become statistics.
Always try to over-serve your community as so many have done for generations before. If that can’t be done, at least try for a win-win. Hold the door open for those who need it.
There are far more people who will appreciate your efforts than there are anti-faxxers.
Our Personal Needs For Normalcy
Here’s my advice to everyone: ‘Enjoy your summer.’
Read that again, this time make it sound more ominous and sinister. Yeah, that’s what I mean.
Take this opportunity now to socialize, travel, vacation, and be normal. Do so now, because I believe trouble is brewing.
If you are not vaccinated, please get Pfizer or Moderna ASAP.
If you are vaccinated and NOT vulnerable, don’t sweat the delta variant. Be safe, but I believe you will be OK even in high-risk situations.
If you have unvaccinated kids in your house (like me!!!), I would keep them out of high-risk situations as best as possible, and they should wear masks, distance, and handwash like it’s 2020.
That being said, I took our kids to Great Adventure, Cape Cod, and we leave for Aruba in a few weeks. They mask when in public, if we go to a restaurant we request outdoor seating, and we carry hand sanitizer by the tubful.
Generally, kids will be fine—even with delta. Don’t take that for granted and play roulette with their health. Minimize the risks and be safe.
If you are vaccinated and vulnerable, it’s 2020 all over again, with a bit looser restrictions. Low-risk people, low-risk environments, and all the mitigation strategies you know and love.
Sit tight and wait for formal recommendations about boosters.
We’ve all come so far, don’t let the euphoria of the new, new, new normal trip you up.
Is it Really Over?
I’m writing my Victory Lap article. Yesterday we had a lil’ awards ceremony held by elected officials in our honor. Super awesome, but bittersweet.
We’re all celebrating a return to normal, but COVID-19 isn’t over and won’t be for a LONG while, if ever.
My advice will now seem much more tempered compared to this time last year. We know the enemy (the virus and misinformation). We know the options. We know what works and what that looks like.
There IS a lot to celebrate. The reality is we NOW can see a light at the end of the tunnel. I’m leaning towards that light being another train.
If you read nothing else in this article, read my current advice to every patient I care for: enjoy your summer.
Seriously… Let your guard down. Travel. See family. Get a break.
Because it won’t last. And it could get worse.