If you’re vaccinated, you can relax. If you’re not, you should be worried.
“Now, Ken,” I’m sure you’re thinking, “You’re a doctor, how can you say, ‘Relax.’ Aren’t there still risks?”
Of course, there are. And this gets to one of the problems with how doctors communicate. We spend so much time explaining all of the caveats and exceptions and statistical analyses of any topic that the primary message — in this case, that COVID vaccines work REALLY WELL — can quickly get lost, and people quite understandably continue to freak out.
So when I say, “Relax,” I’m saying in the same sense that I would say, “Hey, come on over. We’ll sit out on the deck and have a margarita.” Now, if I were talking like a doctor, I might instead say, “Hey, come on over. Of course, please realize that there are risks to you getting in your car and driving over here. The chance of a fatal accident for a person driving the 4 miles from your house to mine is approximately X out of 1000 passenger-miles. So when you get in your car, make sure you put on your seat belt, make sure that the tires are inflated, make sure to check your rearview mirrors, and make sure your flashers are working. I hope you do everything you can to minimize the small but real chance that you could be in a fatal accident on the way over. But come on over anyway. We’ll have margaritas.”
All of that stuff is true, but should that be the point of the message? Climbing the stairs to your house with the bag of groceries is a risk. Taking a shower is a risk. Mowing the lawn is a risk. Life is full of risks, and we take these risks because the values of those actions far outweigh the small possibility of harm.
As more data have been collected and analyzed, we know that the great thing about the COVID vaccines is it is that they have reduced your chance up getting really sick and dying of COVID to the level of these everyday risks that we accept as part of life.
Here again I want to digress to the facepalm phrases that are often used in communications from doctors. (For the past year I have railed against the term “Social Distancing.” I put it in quotes because I despise it so much as I feel that it is a hurtful, psychologically and even spiritually destructive term. Physical Distancing is just as understandable and is more accurate about what we want to achieve whereas “Social Distancing” implies that we need to avoid each other on every single level. And people quite appropriately have been put off by it and even rebelled against it.) The current What-were-they-thinking? term being bandied about in medical media circles is “Breakthrough Infection.” The problem with this term is that when someone who is vaccinated against COVID then gets infected, this is not a breakthrough. This is an expectation. If you live in a place where there are a lot of unvaccinated people and COVID is literally in the air, this virus will land on the membranes of your nose and cause you to have transient colonization with this virus. It may even cause a mild, flu-like illness. However, the term Breakthrough Infection has created an impression that these sorts of infections are unexpected and, therefore, that vaccines don’t work.
Well, they DO work, especially when the virus lands on your nasal mucus membranes. If COVID lands in your nose and starts multiplying, the COVID vaccine has primed your immune system to expect it and to expel it as quickly as possible, usually within a matter of hours or a couple of days. It’s like people showing up at a club where there is a really burly bouncer, and COVID is just not on The List. There may be a little bit of an argument or even a scuffle at the door, but COVID will be booted expeditiously. On the other hand, if you’re not vaccinated, the bouncers are on break, and all hell can break loose. And once COVID gets into that club, it can cause a lot of damage, and it takes a lot more effort to get rid of it.
So that’s the thing. If you are unvaccinated, you’ve got a problem. The delta variant, as we know, is much more contagious than previous variants, and the viral load it produces is much greater. This is how evolution works. Viruses are constantly producing new variants, experimenting with their genome, and the variants that can infect people more effectively and more robustly are obviously the ones that are going to win in an evolutionary race.
And evolution moves lightning fast with viruses. Evolution is a generational thing with a human generation taking about 20 years. Viruses, though, can replicate in a matter of a day or even a few hours. So even if we give this virus a very generous and probably too slow generational time of 24 hours, that still means they can evolve about 7300 times as fast as humans.
Luckily, the COVID vaccines that have been developed are very effective at targeting parts of the virus that don’t change, the spike proteins that are necessary for the virus to infect human cells. That means that they are likely going to be continue to be effective at preventing serious disease going forward.
If you are unvaccinated, though, you’ve got a problem. Your chance of getting infected with COVID is much higher, and your chances of getting very sick and dying of COVID are immensely higher than for those who are vaccinated. I have known quite a few people over the past year before vaccines who died of this disease. However, I do not know one person who had a serious side effect from the vaccine. So, for your own good, if you’re not vaccinated, just do it.
I’ve heard people say they won’t get vaccinated because they trust their immune system. Look, your immune system may be awesome, but your immune system needs a heads up to set up that bouncer to boot this killer out of your body before it can cause a problem.
I’ve heard people that God is going to protect me from COVID. Well, God already has. God has created really smart people who developed amazingly effective vaccines that will protect you and your family.
One caveat to my driving-the-car analogy is that if you have kids under 12, your car doesn’t have seatbelts or car seats for them yet when it comes to COVID vaccines. The delta variant does seem to be making kids sicker although most of them will do well. Still, I can completely understand that, if you are a parent with a child 11 years old or younger, this must be a very stressful time for you.
That’s why it is still so important, when we go into public indoor spaces, that we wear masks. Even if like me, you are vaccinated, and even if COVID only takes up residence in my nose for a few hours or a day without me knowing it, I don’t want to pass it on to a kid who can’t get vaccinated or someone whose immune system is not as effective as mine. It’s a small thing to do. It’s easy to do. It helps me sleep easier at night knowing that I’ve done something that might save someone’s life, even if I will never know it.
So while we’re not out of the woods yet, if you are vaccinated, your chance of living through this and living well afterwards is really great. And for the time being, please have mindful conversations with people in your life who are not yet vaccinated urging them to do so and continue to wear your masks for those who can’t yet get vaccinated.
And of you’re not yet vaccinated, I’m begging you: Just do it. Please. Just get vaccinated.
Oh, and by the way, if you do come over for a margarita, we’re going to wait two hours after we finish our drinks before you drive home, OK?