Commentary: COVID Reality Check

By Tia Will

I strongly disagree with almost everything David Greenwald wrote on Monday about our current & future approach to COVID.

1. “Our biggest concern is that we are going to continue to see preventable cases, hospitalizations and, sadly, deaths among the unvaccinated,” Walensky said. It shouldn’t be. Our biggest concern should be the possibility of more variants. How do you think the Delta variant arose? It came from our unwillingness to implement and maintain the preventive measures to control the novel virus in the first place. If you look at our county’s website graphics you will see that every time we masked, distanced , chose outside activities and avoided crowds, the virus came under control, every time we didn’t, it surged. Around a year ago I wrote here that my nightmare scenario was the emergence of a variant that was highly transmissible, had high lethality, attacked the young, and was vaccine resistant. Delta was just the virus’ first stab at that. Do we honestly think if we just let the virus spread, even amongst just the unvaccinated,  the nightmare scenario cannot occur?

2.”The good news is that if you are fully vaccinated, you are protected against severe Covid, ” Let’s look at this a little closer. The current vaccines confer a 95 percent chance that an individual who contracts the virus will not have severe COVID or die or a 5% chance you will. Viral Roulette anyone?  This focus on severe disease and death only was useful in the beginning when the biggest concern was to keep people out of the hospital in order to “flatten the curve”. This was a worthy goal when hospitals are overwhelmed but which allowed the “only the vulnerable” will be affected attitude to arise. This neglected other undesirable consequences both economic and medical – shutdowns, deaths of those under 50 ( often our first responders and medical personnel), careers and lives not taken, but ruined by long COVID, and, once again, the rise of variants.

3. “Otherwise, I am kind of done with this”. This is exactly the attitude that has brought us to this place. Some people were “done with it” the moment Trump started downplaying it. This should never be about our personal degree of boredom, or impatience, or frustration with the acts of others. I realize you were being “glib” but glibness, IMO, has no place in the time of a pandemic with many lives, disabilities, careers still at stake.

4. “But at this point, I don’t know what else to say.”  I do.

a. Stop minimizing on the one hand or on the other, throwing up our hands, shrugging our shoulders in despair, and do what we should have done from day 1. a) choose outdoor activities, avoid crowds, mask, & distance; b) avoid areas where we know the virus to be surging; and c) vaccinate all who will accept it but accept that the vaccine is one only one protective measure, not the panacea so many feel it is. IMO this is largely the fault of the CDC whose guidance implied to many that the vaccine was the great liberator and once vaccinated you could resume your normal life. Did they seriously not consider the unvaccinated would do the same?

5. “At some point people, who make their bed, have to lie in it.” The problem with this attitude is that we are all in the same bed. We will all be subject to any variant that may arise while they are cavorting “under the covers” and we are pretending we are safe.

My last and possibly most important point. We need to stop dividing the country into subsets. First it was, it only affects the old or those with pre-existing conditions (as though they did not matter). Then it was let’s not address it since it seems to be affecting mostly the blue states. Let’s divide into those who are “afraid of the virus” and those who “refuse to live their lives in fear”. Now I hear on social media, let’s divide into those who are vaccinated (responsible) and those who are not and let the latter live with the consequences. As tempting as this approach might be, we are all going to live with the consequences. If that consequence is a new variant with the properties of extreme ease of transmission, an asymptomatic phase, high lethality, or increased long term effects which attacks the young (who are not immunized), and is vaccine resistant, we will all pay the price.

We as humans need to stop dividing ourselves in clans and fight this virus as one people. We had a leader who made that nearly impossible for the first year. That does not have to be our path forward. We could do what we should have done in the very beginning and treat the virus, not each other, as the enemy no matter where we fall on the political spectrum.

About The Author

Tia is a graduate of UCDMC and long time resident of Davis who raised her two now adult children here. She is a local obstetrician gynecologist with special interests in preventive medicine and public health and safety. All articles and posts written by Tia are reflective only of her own opinions and are in no way a reflection of the opinions of her partners or her employer.

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  1. Matt Williams

    The points that Tia makes are reinforced by the following statement of Yolo County’s Heath Officer Dr. Aimee Sisson,

    Yolo County reports 82 vaccine breakthrough cases

    Out of more than 115,000 Yolo County residents who are fully vaccinated against COVID-19, 82 — or about 0.07 percent — have had breakthrough cases of the virus through last Tuesday, according to the county’s health officer.

    Two of those 82 individuals were hospitalized and one died, said Dr. Aimee Sisson, who expects the proportion of breakthrough cases to increase as more of the county becomes vaccinated.

    “Here in Yolo County, with about half of the population fully vaccinated and a vaccine that is 80 percent effective against the Delta variant, I would expect 17 percent of cases to occur in fully vaccinated people,” Sisson said. “So I’m not alarmed that on a recent day, five out of the 17 new cases in Yolo County were in vaccinated people.”

    In those vaccine breakthrough cases, however, she has seen viral loads indicating a greater likelihood of being able to transmit the virus to others, including the unvaccinated, which is one of the reasons Sisson last week recommended that everybody wear masks in indoor public places, regardless of vaccination status.

    Those over 65 or immunocompromised are strongly recommended to do so as they are at greater risk from breakthrough cases.

    But getting the unvaccinated vaccinated remains the top priority.

    “These vaccines are great, they’re highly protective,” said Sisson.

    Heading into last week, the case rate in California among unvaccinated individuals was 4.9 per 100,000 residents. Among the vaccinated, it was 0.6 percent.

    The unvaccinated are eight times more likely to become infected than the vaccinated, Sisson said, and nationwide, the unvaccinated are 79 times more likely to die of COVID than the fully vaccinated.

  2. Keith Y Echols

    I dunno…..the way I (think I) understand the situation is that the goal is to reach heard immunity.  Why?  So the virus doesn’t have anymore easy targets which allows it more time to figure out ways around our natural defenses and the vaccine.  Among the vaccinated, the virus mostly either doesn’t infect them or briefly/mildly infects them.  That much lesser amount of time active leaves the virus far less of a chance to to be able to mutate into a more virulent and dangerous strain. Eventually the virus has nowhere to go and dies out among the vaccinated (also those with natural anti-bodies…though current evidence suggests that those anti-bodies only stick around for 3-6 months).  But if you have unvaccinated people around then the virus can keep jumping around and propagating and has more time and opportunity to mutate.

    So, I believe that the unvaccinated should be segregated.  If they don’t want to be vaccinated, I suppose that’s their right.  But for the common good they need to be segregated.  Frankly, I’m surprised that medical insurance companies aren’t pushing back against the unvaccinated. But in terms of policy,….I think first, that the unvaccinated should lose any right to ICU beds in hospitals.  If the ICU starts to fill up and a bed is needed, the unvaccinated should have to give up their beds to others that need them.  Secondly, I believe the unvaccinated should not be allowed to visit hospitals, nursing homes…etc…  They shouldn’t be allowed into public schools (when vaccines are available for kids under 12).   Obviously no rules are 100% applicable to everyone….there are legitimate medical reasons why some can’t get vaccines….but for the most part I think my reasoning applies to the majority of the unvaccinated under the assumption that it’s their choice that they are unvaccinated.

    As far as outgoing messages to everyone.  I do think a more positive message needs to happen.  I think the best and most effective message (outside of get vaccinated) is to get healthier.   There needs to be a nation wide push to seriously encourage (not shame, accuse or nag) people to get healthier.  I say this as someone who has a couple co-morbidities he’s working on.  A strong message in relation to the virus to lose weight (exercise/eat healthier), lower your blood pressure, stop smoking, etc…. needs to be out there…..sure Doctors have been telling us to do this all along.  But there really hasn’t been a strong message about it in relation to the virus.  The information is there….most know that if you’re unhealthy you’re probably more likely to experience worse effects from infection (actually this goes beyond Covid).  But so far much of the outgoing message seems to be a nagging one of wearing masks and getting vaccinated (both important things to encourage).  I dunno maybe the CDC needs to hire Richard Simmons and Jane Fonda….or maybe Vince Vaughn as the owner of Average Joe’s Gym to spread the get healthier message.

    1. Bill Marshall

      Your last paragraph is profoundly true, and should be seriously promulgated simultaneously with the vaccines, masks, distancing… all good tools in the toolbox to combat the pandemic…

    2. Alan Miller

      If it were that simple as putting out a message, those with unhealthy lifestyle would already be healthy.  Does anyone really believe it’s a matter of ‘education’ ?  (hint:  Like Chevron, “people do”)

      1. Bill Marshall

        Maybe we should use financial incentives to thwart obesity, lethargy, etc., like a few have proposed for meth users… just shedding some frustrated irony…

        Alan M, I sorta of agree with you, as far as what ‘education should do’… but habits/behaviors have their own “inertia”… so it is not that simple…

      2. Keith Y Echols

        You missed the point.  It’s not about educating the unwashed masses.  It’s about manipulating their feelings.   It’s about HOW the message is conveyed.  I said in my initial post that people already know the facts…it’s just a question of if they believe them or want to follow through on them.  If you keep telling people to fall in line and do what you’re told and you’re a bad person for not following all the other lemmings…then all your doing is getting the immature and rebellious factions of the population to push back.  That’s always been liberals problem; messaging.  They always take the cerebral approach of “educating the population” which often comes off like (and often times is) admonishing elitism.  Conservatives messaging often play on emotions.  The one major exception I think was Obama’s first campaign; “Change that we can believe in”…”Yes we can”…all feel good things are going to change (when in reality….relative to the progressives…Obama was far more central than anyone was led to believe.

        So as far as Covid messaging goes; it has to bring a feeling of strength and comradery (though that part is harder given people are being told to keep 6 feet apart, out of crowds and to wear masks).  But getting communities to rally around fitness and health….challenge the rebellious if they can be healthier than everyone else.  The government could team up with healthcare insurance providers to give incentives to local communities for fitness achievements.  I dunno….live music in the park at the end of run/walk/bicycling events.

    3. Tia Will

      I completely agree with a widespread health promotional message. But considering the response Michelle Obama got when she tried to encourage health foods, gardening and increased physical activity, I doubt the efficacy of such an approach given the number of people who have adopted a “don’t tell me what to do…my rights attitude”. Even when the advice is obviously sound and abridges zero rights.


      1. Keith Y Echols

        But considering the response Michelle Obama got when she tried to encourage health foods, gardening and increased physical activity, I doubt the efficacy of such an approach given the number of people who have adopted a “don’t tell me what to do…my rights attitude”. 

        It’s all about the WAY the message is delivered.  For much of the population educating them and being nice, positive and encouraging is not what they want to hear.  They want to hear how powerful they are.  How special they are…etc…   Tell them that the Chinese are in better shape (and live longer) and eat healthier than us but with some good old fashion hard work like their grandfathers did in WWII they can be better.  You know what the red states love?  Local competition.  One town beating the other; Springfield vs. Shelbyville.  So start sponsoring more 5K-10K races and challenge the regional towns to see which one has more runners that can finish in certain times.  Local body building/fitness competitions.  Sponsor those American Ninja Warrior kind of obstacle course competitions among regional communities.   I don’t know, I’m spit balling ideas.  But it’s all about the attitude behind the message to properly engage a significant portion of the population.

        1. Bill Marshall

          “Mayor Quimby” to reference The Simpsons, rather than South Park.

          Thanks for the grin!

          Quimby exactions/fees have been used since ~ 1970 acquire “Parkland” and improve the frontages, including major “South” Davis parks… I realize, ‘not your intent’, but you made a great ‘funny’… needed a grin today… thanks!

        2. Tia Will

          For a different perspective about what is needed beyond messaging, I highly recommend Sara Bernal’s piece on improving the availability and affordability of healthy foods to those whose incomes do not allow for healthy choices as a way of life. Her article is posted 7/21 on the Vanguard.

  3. David Greenwald

    “5. “At some point people, who make their bed, have to lie in it.” The problem with this attitude is that we are all in the same bed. We will all be subject to any variant that may arise while they are cavorting “under the covers” and we are pretending we are safe.”

    I think the point I was making here is that unless we are going to mandate vaccination there is not much we can do.  Moreover, wearing masks and self distancing won’t work if there is a population who refuse vaccinations and refuse masks. Variants will breed from this population.

    1. Bill Marshall

      I and others have opined that restricting medical resources (particularly ICU), other medical attention, medical insurance coverage/reimbursements, from those who are eligible, but refuse vaccinations, are logical, ‘just’, and might be a good “stick” as far as Covid illness… Some might consider that “heartless”, but how many times must you try to throw a potentially a drowning person lifelines, that they reject, (masking, distancing, vaccinations), before those not taking all those lifelines are excluded of given much lower priority from medical care, hospital space?

      I think the medical term, modified as to “what they are doing to help themselves”, is called ‘triage’… and unlike normal uses of the term, “by their own misguided (others have said, ‘selfish’) choice”…

      1. Tia Will


        There are instances of clerks having been shot and killed for insisting that a customer wear a mask. Can you imagine the backlash, threats, and outright violence health care workers would face if they started refusing care or removing oxygen or vents from the non vaccinated. I agree with the basic principle of triage, but having been threatened myself more than once for following my medical knowledge and experience over a family’s misconceptions in far less volatile circumstances, I would not dream of putting this responsibility on individual health care workers.


  4. Alan Miller

    it only affects the old or those with pre-existing conditions (as though they did not matter)

    Yeah, I’ve not heard anyone address this in the media.  Why in America do we place such low regard for the old and sick, as if they are not human?  Maybe can’t answer the question, but it’s important to note that is the culture of our ‘great’ country.  So clear, we just accepted the attitude.

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