By Kevin Roche
I have typically taken the risk at the end of each year of making a few predictions about what I thought some significant developments in health care might be. My accuracy was pretty typical of most so-called prognosticators–not that great. So I will make a few observations on what I think 2021 might have in store for us in regard to the epidemic, but without much expectation of correctness.
2020 has been a brutal year and we have endured a huge amount of self-inflicted damage. I would love to believe that 2021 will magically be better, but why should it? The same factors that made 2020 a disaster are still in place. The most significant of those factors is the general lack of knowledge or understanding among the public of critical information. This is not due to stupidity or even ignorance in most cases. It is a combination of social factors and widespread personality traits that limit people’s willingness to even seek all the appropriate information or conduct their own thoughtful analysis.
Social media has exacerbated a trend toward people thinking slogans or memes are information. And it intensifies tendencies toward undue tolerance of and belief in so-called experts and political and other authorities. I am astounded that people see something on social media, or even the traditional media, a sentence or two, a 30 second video clip, and accept that this could be a meaningful description or explanation of anything. It has gotten to the point where I am not sure that many people really understand what data, facts, truth really are. It isn’t something any one person says. And anything that purports to be information needs to be tested and questioned. How was that information was gathered? What errors might have occurred in the process of gathering it? What other information might be relevant to have a complete picture? It isn’t simple, and it certainly isn’t communicated in a brief message. But in a supposedly ever more sophisticated world with ever more educated citizens, people seem increasingly to accept, even seek, the simplest, most superficial approaches.
And somehow among our young people in particular there is a tendency to just blindly follow whatever they read or see on social media or elsewhere, with no critical appraisal applied. The political lens applied to everything has magnified this defective approach to the world. Our educational system, especially the public version of it, apparently is teaching no critical reasoning skills, but then why would it, the last thing administrators and teachers want is someone who grows up to challenge the nonsense they are often taught. This attitude facilitates the authoritarian approach adopted by many of our politicians.
In the first part of 2021 unfortunately these tendencies will collide with the realities of vaccines and respiratory viruses. People have been led to believe that somehow widespread vaccination will make CV-19 disappear. That isn’t going to happen. The vaccines, coupled with widespread infection levels, will substantially slow case levels, but there will be residual levels. And our excessive efforts to suppress CV-19, along with any virus’ tendency toward ongoing mutation, could lead to strains against which the vaccines are less effective. And adaptive immunity, as I keep saying, isn’t some absolute barrier against exposure, but does make infection and infectiousness much less likely. Given the media’s love of hysteria and panic, failure of the vaccination program to meet unrealistic objectives, will likely set off new rounds of fear and despondency among the public.
And any lingering of cases will only be a further excuse for the continuing dictatorial approach of most of our governors, an approach apparently shared by the incoming administration. These people have fallen in love with being dictators and their behavior is excused and abetted by the media. I keep waiting for more of the public to revolt and recognize the harms caused by excessive focus on suppressing CV-19. But it looks like a long wait.
2021 will only be better if people start thinking for themselves and start challenging authority and demanding a more rational, balanced response to the epidemic.