In “Open Everything” published in The Atlantic on February 9th, 2022, Yascha Mounk discusses his arguments for lifting any remaining COVID-19 restrictions to “shake off the pandemic malaise.” He asserts that we are “in danger of prolonging the status quo more than is justifiable” and that “the time to end pandemic restrictions is now.” The broad strokes that Mounk makes are diametrically opposed to substantiated public health policy that currently exists as well as the minutiae of circumstances relative to COVID-19 when viewed from an equitable lens. I find his claims to be inattentive to the differences in American public health infrastructure that exist at local, city, and state levels, and come from a place of privilege tied to educational status and economic freedom that not all Americans are necessarily privy to. Mounk states that “the strongest reason to keep up pandemic restrictions is that some people remain vulnerable” including unvaccinated people as the primordial example. He follows up with the rhetorical question, “What do we owe to them?” This argument is flawed for several reasons. First and foremost, by focusing on the unvaccinated, Mounk neglects two populations that are also highly susceptible to contraction of COVID-19 regardless of vaccination status: the elderly and the immunocompromised. While individuals of these two groups may be vaccinated, their weakened immune systems render them much more vulnerable than a younger vaccinated individual with a fully intact immune system. Also consider the case of children under the age of 5 years old, who are ineligible to receive the vaccine. Thus, vaccines are not the “end all, be all” seems to implicitly affirm. And neither is Paxlovid, the antiviral drug created by Pfizer with promising clinical results, as it is not yet standard of care and by no means fully accessible throughout the country. Mindsets such as Mounk’s appear to normalize the idea of getting infected, as preventive measures and treatment strategies exist that will avert serious illness or complications caused by COVID-19. With varied pharmacogenetics from person to person and the possibility of developing long COVID, the course of one’s coronavirus infection is not standardized simply on the basis of vaccination status or demographics. Furthermore, viruses like COVID-19 do not simply exist in a vacuum, as they constantly mutate and correspondingly change in infectiousness and virulency as seen with the Delta and Omicron variants. The data about individuals who are fully vaccinated and boosted that contract COVID-19 should inform the American public that we should continue to keep our distance and mask up, even if many who test positive are asymptomatic as they are still viral carriers and transmitters of the disease (possibly even increasingly so, given the lack of telltale symptomatology). The declaration to adopt a laissez-faire attitude to the spread of COVID-19 is misguided, ableist, and based upon a sense of false confidence about our collective safety from the virus. Returning back to Mounk’s claim that we do not owe anything to at-risk populations, Mounk’s example of unvaccinated people does not detail the level of nuance that truly exists among unvaccinated populations. The stereotype about unvaccinated people as uneducated and uneducable does not account for educational and health literacy disparities that directly coincide with lower socioeconomic status. This assumption places undue culpability on the individual without recognition of the accessibility barriers that at-risk populations are predisposed to. While many of us may be fortunate enough to possess an adequate understanding of the underlying science that wards off misconceptions or conspiracy theories surrounding vaccines, there are legitimate risks and side effects to the vaccine, even if the rate of complications is low. This consideration is further marked by tangible symptoms one might experience as their body develops antibodies in response to vaccination and extensive historical trauma perpetuated against vulnerable populations (e.g., the Tuskegee Syphilis Study). Moreover, at-risk populations experience the highest incidence and mortality rates due to COVID-19, which magnifies the decisions and effects of the societally powerful against those with much less. Mounk asserts that “Wearing a mask in highly vaccinated New York does little to save an unmasked person in barely vaccinated Mississippi.” If you were to take this concept and apply it unilaterally to the topic of voting in a highly populated state, many would argue that you still have a civic responsibility to vote regardless of what the polls, predicted outcomes, or what anyone or anything else might say. Similarly, our social contract extends this far as well; just because one’s potential risk may be purportedly lowered in certain areas, our obligation as health-conscious citizens does not cease to exist. Mounk’s proposal that “we should be willing to tolerate some risk of infectious disease” strikes me as incongruent with the goals of health care and public health altogether. If we strived to simply reduce the number of hospitalizations or injuries to a certain annual threshold, we would be missing the point entirely. While benchmarks are certainly an important motivating and tangible measure of success, why would anyone stop short of a goal when it relates to public health and safety? While coronavirus is considerably different from any sort of infectious disease that has had a large-scale effect in recent history, imagine if the researchers who developed the smallpox vaccine decided to stop their efforts once 50 percent or 60 percent of the global population was no longer susceptible to the disease. Mounk’s article is sorely lacking from the point of view of public health experts and officials, and rightfully so — Mounk’s perspective is largely contentious to anyone with a science or health care background, and the lack of data and verifiable policy recommendations that support his standpoint reflects this. If the CDC is not recommending an end to mask mandates and pandemic restrictions, who is anyone to disagree otherwise, especially without the appropriate medical/public health education or industry-specific experience to inform their claims? In reality, I can only contend that Mounk’s piece is largely performative and is simply a lamentable commentary regarding the current state of public health in the United States, and the privilege to dismiss COVID-19 as a matter of inconvenience. Otherwise, “Open Everything” is simply an appeasement to the educated elite without regard to current public health policy or existing inequity across health literacy, socioeconomic status, and educational attainment. And in the grand scheme of things, pandemic “restrictions” like wearing masks and attending events occurring with proper precautions in place is not the end of the world that Mounk makes it out to be. Source
