NY Times: The Morning: Do Covid precautions work? (with Omicron) FYI, I couldn't cut and paste the charts in the article. -- (edited)
Posted by
Inigo (aka Inigo)
Mar 9 '22, 05:24
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Daily life in red and blue America has continued to be quite different over the past few months. It’s a reflection of the partisan divide over Covid-19. Consider:
In the country’s most liberal cities, many people are still avoiding restaurants. The number of seated diners last month was at least 40 percent below prepandemic levels in New York, Philadelphia, Minneapolis, San Francisco, Portland, Ore., and Cambridge, Mass., according to OpenTable. By contrast, the number of diners has fully recovered in Las Vegas, Miami, Nashville, Phoenix, Charlotte, N.C., and Austin, Texas, as well as in Oklahoma, Nebraska and New Hampshire.
Residents of liberal cities like New York, Washington and San Jose, Calif., are still spending significantly more time at home and less at the office than before the pandemic began, according to Opportunity Insights, a Harvard-based research group. In more conservative places, the rhythms of daily life have returned nearly to normal.
During the Omicron wave, schools in heavily Democratic areas were more likely to close some classrooms or require that students stay home for extended periods.
Mask wearing remains far more common in liberal communities than conservative ones.
These stark differences have created a kind of natural experiment: Did Omicron spread less in the parts of the U.S. where social distancing and masking were more common?
The answer is surprisingly unclear.
Nationwide, the number of official Covid cases has recently been somewhat higher in heavily Democratic areas than Republican areas, according to The Times’s data. That comparison doesn’t fully answer the question, though, because Democratic areas were also conducting more tests, and the percentage of positive tests tended to be somewhat higher in Republican areas.
No single statistic offers a definitive answer. When I look at all the evidence, I emerge thinking that liberal areas probably had slightly lower Omicron infection rates than conservative areas. But it is difficult to be sure, as these state-level charts — by my colleague Ashley Wu — suggest:
The lack of a clear pattern is itself striking. Remember, not only have Democratic voters been avoiding restaurants and wearing masks; they are also much more likely to be vaccinated and boosted (and vaccines substantially reduce the chances of infection). Combined, these factors seem as if they should have caused large differences in case rates.
They have not. And that they haven’t offers some clarity about the relative effectiveness of different Covid interventions.
Vaccines, above all
The first lesson is that Covid vaccines are remarkably effective at preventing severe illness. Here are the same four states from the above charts, this time with death rates instead of case rates:
The messiness of the previous charts has given way to an obvious pattern: Covid death has been far more common in red America. Over the past three months, the death rate in counties that Donald Trump won in a landslide has been more than twice as high as the rate in counties that Joe Biden won in a landslide, according to Charles Gaba, a health care analyst.
The second lesson is that interventions other than vaccination — like masking and distancing — are less powerful than we might wish. How could this be, given that scientific evidence suggests that mask wearing and social distancing can reduce the spread of a virus?
Early in the Omicron wave, at least one expert accurately predicted this seeming paradox. Dr. Christopher Murray, the founder of the Institute for Health Metrics and Evaluation at the University of Washington, wrote an article for The Lancet, a medical journal, arguing that interventions like masks would have “limited impact on the course of the Omicron wave.”
I followed up with him by email, and he offered a helpful explanation. Although masks reduce the chances of transmission in any individual encounter, Omicron is so contagious that it can overwhelm the individual effect, he said.
I’ve come to think of the point this way: Imagine that you carry around a six-sided die that determines whether you contract Covid, and you must roll it every time you enter an indoor space with other people. Without a mask, you will get Covid if you roll a one or a two. With a mask, you will get Covid only if you roll a one.
You can probably see the problem: Either way, you’ll almost certainly get Covid.
This analogy exaggerates your chances of getting infected, but it still highlights the basic reason that masks and distancing have had a limited effect. “It really is a function of the extreme intensity of Omicron transmission,” Murray told me.
A 95 percent drop
Together, these two lessons can point the way to a sensible approach to Covid in the coming months.
One, nothing matters nearly as much as vaccination. A continued push to persuade skeptics to get shots — and to make sure that people are receiving booster shots — will save lives.
Two, there is a strong argument for continuing to remove other restrictions, and returning to normal life, now that Omicron caseloads have fallen 95 percent from their peak. If those restrictions were costless, then their small benefits might still be worth it. But of course they do have costs.
Masks hamper people’s ability to communicate, verbally and otherwise. Social distancing leads to the isolation and disruption that have fed so many problems over the past two years — mental health troubles, elevated blood pressure, drug overdoses, violent crime, vehicle crashes and more.
If a new variant emerges, and hospitals are again at risk of being overwhelmed, then reinstating Covid restrictions may make sense again, despite their modest effects. But that’s not where the country is today.
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