COVID-19 treatment and vaccine update thread

[Anonymous Bosch]

The take-away for me isn't so much the middling efficacy of the vaccine in terms of preventing COVID-19, it is that the vaccine apparently was 100% successful in preventing hospitalization and death in the trial participants that did contract COVID-19. While there is obviously still concern about long-term effects from less severe COVID-19, keeping people alive and out of the hospital seems like a win to me.

…which is likely to be crucial if what Scott Gottlieb stated about the more contagious variant of the coronavirus on Face the Nation comes to pass:

Adding to the urgency with getting shots into the arms of the American people is the emergence of a new, more contagious variant of the coronavirus, which was first detected in the United Kingdom but has now been identified in California, Colorado and Florida.

Public health experts argue that following the same mitigation techniques such as mask-wearing and social distancing will help slow the spread of the new strain, but acknowledge that vaccination will be the key.

Gottlieb, however, warned the U.S. is "not vaccinating quickly enough to create backstop against the spread" of the new variant, which represents 1% of new infections. He said by March, the new strain will be the majority of infections.

Detection of the new variant comes as the nation is experiencing another spike in coronavirus infections, with more than 20.4 million confirmed cases in the U.S. and more than 350,000 deaths. Gottlieb has predicted cases will peak in January, but said the new strain "creates more risk that this epidemic peak could get extended."

"We still have a ways to go with this current surge of this epidemic until we start to see cases decline, hospitalizations start to decline and hopefully deaths start to decline," he said. "A new variant does create a lot of risk, however, that we start to see accelerated spread."

[Daehawk]

I remember them predicting 180,00 deaths . Not that long ago.

[Smoove_B]

We're still not going to vaccinate our way out of this in the short term. There needs to be a focus on the NPIs and doing everything we can to get unified mask policies and indoor dining/drinking prohibitions nationwide. Regardless of the new strains in their increased ability to spread, they can't jump from person to person if we don't encourage the activities and behaviors that allows them to do so.

[Lorini]

We're still not going to vaccinate our way out of this in the short term. There needs to be a focus on the NPIs and doing everything we can to get unified mask policies and indoor dining/drinking prohibitions nationwide. Regardless of the new strains in their increased ability to spread, they can't jump from person to person if we don't encourage the activities and behaviors that allows them to do so.

LA didn't encourage anything, in fact actively discouraged it, and still ended up with the worst Covid situation in the country. I think we're going to see the best we'll ever see regarding mask wearing and social distancing. Too many people simply refuse to do it. They've cut off party house's gas and electricity because these houses would not abide by the rules. They've shut down restaurants, they've been in lockdown at least three times, doesn't matter, the hospitals still had no ICU available and some still don't have enough oxygen.

So vaccination is about all that's left that we can rely on.

[Smoove_B]

So vaccination is about all that's left that we can rely on.

I wish I could comment specifically on what LA County has been doing, but in full disclosure I haven't been following closely; I can barely keep up with my own state's insanity.

That being said, if we're down to 100% reliance on a vaccine then we're doomed. At some point communities either have to start accepting the idea of a social contract or we need to all just go Mad Max. Vaccination is part of the toolbox; it cannot be (and was never designed to be) the only solution during a pandemic caused by a novel virus.

[dbt1949]

I fail to understand how African countries can have smaller (percentage) of cases and deaths than the US. They don't have near the resources nor hospital services we do.
Only thing I can think of is they are under reporting the cases.
Of course they are naturally more isolated than the US and probably don't travel as much. Or maybe they're smarter than the average US citizen.

[ImLawBoy]

They may also have much lower testing capabilities to find out if people actually have it.

[Defiant]

I fail to understand how African countries can have smaller (percentage) of cases and deaths than the US. They don't have near the resources nor hospital services we do.
Only thing I can think of is they are under reporting the cases.
Of course they are naturally more isolated than the US and probably don't travel as much. Or maybe they're smarter than the average US citizen.

It could be a number of factors (or combination of factors). Their median age being a lot lower could be why they're not not seeing as many deaths.

[Anonymous Bosch]

We're still not going to vaccinate our way out of this in the short term. There needs to be a focus on the NPIs and doing everything we can to get unified mask policies and indoor dining/drinking prohibitions nationwide.

Heh, right, because more restrictive prohibitions are a surefire recipe for success.

The following fully peer-reviewed study from Stanford researchers puts it plainly:

Assessing Mandatory Stay‐at‐Home and Business Closure Effects on the Spread of COVID‐19

Abstract
Background and Aims
The most restrictive non‐pharmaceutical interventions (NPIs) for controlling the spread of COVID‐19 are mandatory stay‐at‐home and business closures. Given the consequences of these policies, it is important to assess their effects. We evaluate the effects on epidemic case growth of more restrictive NPIs (mrNPIs), above and beyond those of less restrictive NPIs (lrNPIs).

Methods
We first estimate COVID‐19 case growth in relation to any NPI implementation in subnational regions of 10 countries: England, France, Germany, Iran, Italy, Netherlands, Spain, South Korea, Sweden, and the US. Using first‐difference models with fixed effects, we isolate the effects of mrNPIs by subtracting the combined effects of lrNPIs and epidemic dynamics from all NPIs. We use case growth in Sweden and South Korea, two countries that did not implement mandatory stay‐at‐home and business closures, as comparison countries for the other 8 countries (16 total comparisons).

Results
Implementing any NPIs was associated with significant reductions in case growth in 9 out of 10 study countries, including South Korea and Sweden that implemented only lrNPIs (Spain had a non‐significant effect). After subtracting the epidemic and lrNPI effects, we find no clear, significant beneficial effect of mrNPIs on case growth in any country. In France, e.g., the effect of mrNPIs was +7% (95CI ‐5%‐19%) when compared with Sweden, and +13% (‐12%‐38%) when compared with South Korea (positive means pro‐contagion). The 95% confidence intervals excluded 30% declines in all 16 comparisons and 15% declines in 11/16 comparisons.

Conclusions
While small benefits cannot be excluded, we do not find significant benefits on case growth of more restrictive NPIs. Similar reductions in case growth may be achievable with less restrictive interventions.

And to quote the conclusion from the PDF:

In summary, we fail to find strong evidence supporting a role for more restrictive NPIs in the control of COVID in early 2020. We do not question the role of all public health interventions, or of coordinated communications about the epidemic, but we fail to find an additional benefit of stay-at-home orders and business closures. The data cannot fully exclude the possibility of some benefits. However, even if they exist, these benefits may not match the numerous harms of these aggressive measures. More targeted public health interventions that more effectively reduce transmissions may be important for future epidemic control without the harms of highly restrictive measures.

[Daehawk]

109 year old Haley Forstner got her covid vaccine shot today. She rode a horse and buggy to Chattanooga to get her Spanish Flu vaccine back a century ago. She just entered into an assisted living facility 2 weeks ago. She turns 110 in March. Amazing.

This was her last year.


And then.

[ImLawBoy]

Wow! Does the vaccine make everyone look that much younger?

[El Guapo]

Wow! Does the vaccine make everyone look that much younger?

There is a significant downside in that anyone who is less than 100 becomes an embryo.

[Smoove_B]

Heh, right, because more restrictive prohibitions are a surefire recipe for success.

The following fully peer-reviewed study from Stanford researchers puts it plainly:

You do realize that was a retrospective observational study focused on the response in the early stages of the pandemic, right? In short, it was done to examine decisions and outcomes early in the pandemic. This in no way should be used to justify decisions made now. When SARS-CoV-3 or 5 comes around, we can remember the lessons they've enumerated here and make better decisions in the early days of the next pandemic.

So yeah. January of 2021isn't March or April of 2020 and there's universal agreement that many of the restrictive prohibitions enacted nationwide earlier last year were (1) patchwork (2) disorganized and in some cases (3) absolutely uncalled for. In NY and NJ they were too late.

We are in a raging inferno right now; vaccination isn't going to save us. Elimination of indoor dining? That will help. Trying to get people to somehow care about their behavioral choices, particularly as it relates to wearing masks and not socializing with individuals outside of their own household? Also helpful; also NPIs.

EDIT: And to clarify, I don't endorse endless lockdowns. I fully support the idea of paying people and business owners to stay home and stay closed long enough to break the chain. But if we can't do that because of a lack of political will and/or the average American doesn't give a rat's ass about anyone other than themselves, then we should just open the floodgates and be done with it. I'm getting closer to the end of my rope and I've had just about enough, for reference. But I’m tryin’, Ringo. I’m tryin’ real hard to be the shepherd.

[$iljanus]

I fail to understand how African countries can have smaller (percentage) of cases and deaths than the US. They don't have near the resources nor hospital services we do.
Only thing I can think of is they are under reporting the cases.
Of course they are naturally more isolated than the US and probably don't travel as much. Or maybe they're smarter than the average US citizen.

From what I read, many of the countries have a younger population so you don't have as many critical cases. But also many of the countries have experience with outbreaks and they may not have all the fancy ICU facilities we have but they know how to contact trace and isolate along with quarantining. In a way, many African countries deserve the vaccine more than other countries who pissed away the opportunity to get ahead of the virus.

[Lorini]

So vaccination is about all that's left that we can rely on.

I wish I could comment specifically on what LA County has been doing, but in full disclosure I haven't been following closely; I can barely keep up with my own state's insanity.

That being said, if we're down to 100% reliance on a vaccine then we're doomed. At some point communities either have to start accepting the idea of a social contract or we need to all just go Mad Max. Vaccination is part of the toolbox; it cannot be (and was never designed to be) the only solution during a pandemic caused by a novel virus.

I guess LA County is doomed, noting that the health people and the governor and Dr. Fauci all say that if we reach 70%-80% of the population vaccinated, then we can get back to 'normal' so I'm not quite understanding you. In the short term, we are definitely doomed, but there really isn't any more than can be done here.

[Smoove_B]

I will eat my socks if we get 70%+ of American vaccinated. Not because we don't have the vaccine stock or the ability, but because I am rapidly losing faith that Americans will vaccinate in the numbers necessary to help address this.

Also don't read into "getting back to normal". Even if we somehow magically reach 70%+ vaccination levels things are not going to light-switch back to the way life was in January of 2020. There's still going to be reduced indoor capacities and a call to wear masks. Addressing the pandemic in America is helpful, but unless things dramatically change the latest projections I've seen have numerous hot-spots around the globe continuing to rage through 2023. As long as that continues, there's always going to be chances of additional variants and cluster outbreaks in the U.S. - particularly in communities that have low levels of vaccination and aren't following guidelines to limit spread.

I wish I could be more upbeat about all this, but today I'm low. I'm happy vaccines are available and I look forward to getting mine as soon as it's available.

[Zaxxon]

I will eat my socks if we get 70%+ of American vaccinated. Not because we don't have the vaccine stock or the ability, but because I am rapidly losing faith that Americans will vaccinate in the numbers necessary to help address this.

Also don't read into "getting back to normal". Even if we somehow magically reach 70%+ vaccination levels things are not going to light-switch back to the way life was in January of 2020. There's still going to be reduced indoor capacities and a call to wear masks. Addressing the pandemic in America is helpful, but unless things dramatically change the latest projections I've seen have numerous hot-spots around the globe continuing to rage through 2023. As long as that continues, there's always going to be chances of additional variants and cluster outbreaks in the U.S. - particularly in communities that have low levels of vaccination and aren't following guidelines to limit spread.

Oh, I'm with you. (Assuming this was in response to my update.) [Edit - I'm confusing my COVID threads--you weren't responding to me!] I'm under no illusion that 80% is magical, nor that it's achievable (can't even vaccinate kids yet, so at present 80% can't happen). I track the days-till-80% as it gives me something to focus on other than how fucked we are.

Although at the present rate of vaccination, even if we could keep it up all the way to 80% it's simply demonstrating how fucked we are. (Current rate = we're less than 50% from the first lockdowns to reaching 80%.)

[Daehawk]

After a year of vaccine though wouldn't the ones at risks just be those who refuse the vaccine and wont wear a mask? Wouldn't that kinda sort itself out?

Well not counting the medical problems for some and the very young who cant wear that stuff or be vaccinated. BTW how young can you be vaccinated anyways?..infants? Doubtful.

[Smoove_B]

Just to clarify, the goals of 70-80% vaccination are for eligible adults. It's recognizing that kids (anyone under 16) and whatever % of the population can't be medically vaccinated would be protected by the 80%+ of us that are.

[Kraken]

I wish I could be more upbeat about all this, but today I'm low. I'm happy vaccines are available and I look forward to getting mine as soon as it's available.

My sister got hers today. She's only 60 but a recovering cancer patient with compromised immune system. When she fibbed a little and said that she babysits her grandkids a few days a week, they basically frog-marched her into the clinic. (She does plan to start babysitting again when my nephew starts his new job next week, so not a big fib.)

I don't expect they'll get around to me until April or May. I'm still in the "everybody else" category, and it's not going smoothly in MA.

[Daehawk]

Under 16?..thats older than I thought. Figured a cutoff would be around 8...or 5. I got my shots at around 4 or 5 as I recall. Maybe I was a little older for all I remember at that age.

[Zaxxon]

Just to clarify, the goals of 70-80% vaccination are for eligible adults. It's recognizing that kids (anyone under 16) and whatever % of the population can't be medically vaccinated would be protected by the 80%+ of us that are.

So you're suggesting that once we get the vaccines approved for 12+ as seems to be expected in the next few months, the target will actually be more like 60%-70% of the country?

[Daehawk]

I need to look up why some shots like the Polio one last forever and ones like this and Flu are a year if that.

[Smoove_B]

Under 16?..thats older than I thought. Figured a cutoff would be around 8...or 5. I got my shots at around 4 or 5 as I recall. Maybe I was a little older for all I remember at that age.

The closer someone is to 18, the more likely their immune system functions like an adult (18+). From what I understand, the next round of vaccines will likely be approved for 12-16 year olds, though I'm not sure exactly which one that will be (only Pfizer? both?)

I seem to recall reading that the approval and use of the vaccines for group after that should be faster (6-11?) but I can't remember why. I am also having a hard time believing parents are going to get their kids vaccinated simply because (1) it's new and (2) kids are at lower risk for complications. This, of course, will keep the virus circulating as well because kids are dirty little disease spreaders.

So you're suggesting that once we get the vaccines approved for 12+ as seems to be expected in the next few months, the target will actually be more like 60%-70% of the country?

I'm not sure how the messaging will change. They might (and I hope they do) say they want to have 80%+ of the eligible adults vaccinated by 7/1 and 50% of the eligible 12-17 year olds vaccinated by 9/1 (or whatever).

[Smoove_B]

I need to look up why some shots like the Polio one last forever and ones like this and Flu are a year if that.

It's because for influenza there's what's known as a "vast reservoir of novel variants". In short the influenza virus jumps species and as it's moving through different animals (primarily aquatic water fowl, pigs and humans), it's genetic information is being modified. Those modifications are then potentially changing how the virus presents itself to your immune system. Each year it's a guessing game what variants will emerge as the dominant strain so they create a best guess vaccination and hope they get it right. For polio, it's only humans - there's no novel variants being created. Once we stopped rampant transmission in the human population, circularizing virus levels made it less likely you'd be exposed. For influenza, it's not possible.

Maybe this is too much, but if you want to read more about antigenic drift and shift (what's happening with influenza each year), this is a good link from the CDC.

[Lorini]

I will eat my socks if we get 70%+ of American vaccinated. Not because we don't have the vaccine stock or the ability, but because I am rapidly losing faith that Americans will vaccinate in the numbers necessary to help address this.

Also don't read into "getting back to normal". Even if we somehow magically reach 70%+ vaccination levels things are not going to light-switch back to the way life was in January of 2020. There's still going to be reduced indoor capacities and a call to wear masks. Addressing the pandemic in America is helpful, but unless things dramatically change the latest projections I've seen have numerous hot-spots around the globe continuing to rage through 2023. As long as that continues, there's always going to be chances of additional variants and cluster outbreaks in the U.S. - particularly in communities that have low levels of vaccination and aren't following guidelines to limit spread.

I wish I could be more upbeat about all this, but today I'm low. I'm happy vaccines are available and I look forward to getting mine as soon as it's available.

The reason I think it might happen is that private enterprise especially entertainment is going to crack down on people who aren't vaccinated once it's widely available. Here in CA (maybe in all the states, don't know) you can download an app that shows if you are vaccinated. Want to go to the movies? Need to be vaccinated. How about Disneyland? Where's that vaccination proof? And of course the cruiselines.
I'd also like to point you to an article I think is truly excellent in discussing the way the vaccinations are being framed and asking for a different framing (from the Atlantic) https://www.theatlantic.com/ideas/archi ... s/617829/
As long as there's an insistence that people behave vaccinated just as if they weren't vaccinated, there's little point to getting vaccinated. This article espouses and I agree, that yes, there's more risk with allowing people to gather who are vaccinated, but that risk is acceptable given the effectiveness of the current vaccines. By telling everyone that there's little real impact to their lives in getting vaccinated, they are going to have a lot of resistance once the vaccines become more widely available. Why not take some risk to get more people vaccinated and let them go around without a mask as long as they are with vaccinated people (I won't be, but I think people should be able to). We already know that they won't get great vaccination rates for 'the good of the community' so let's try something different.

[Smoove_B]

It's a great article (and the author is a well-respected professional and a voice I trust) - there was mention of it on the other side of the fence. However, I think people are focusing on the wrong parts. Towards the end:

The pandemic is a bedeviling problem that vaccines alone cannot immediately solve. As long as the supply of doses remains limited and the coronavirus continues spreading at high rates across the country, public-health officials need to communicate that the greatest risk reduction comes from a combination of measures that includes good masks, distancing, and ventilation.

That's where we are right now and where we're likely going to be parked until summer, unless something changes.

And officials need to enable the public to take those measures

I'm stuck on '"enable the public to take those measures" when we've been repeatedly told (sometimes with actual threats) to take a hike.

Vaccinations (existing, new) are likely the single greatest invention in our collective lifetimes. They're medically unique in that they provide a benefit to not only the person that receives them, but to the community in which that person lives. The SARS-CoV-2 vaccination is absolutely going to be instrumental in changing our individual interactions, but I'm having a hard time imagining going to see a movie, attending a convention or eating indoors at a restaurant any time soon - even after getting vaccinated. The reason is other people and how they've collectively acted over the last year. I keep coming back to a quote from 2017:

—while recognizing that staying infection-free is not the only thing that matters to people

That's been made abundantly clear unfortunately and it's something I've been struggling to process since last March. For me, I keep coming back to a quote from 2017:

"I don't know how to explain to you why you should care about other people."

Will vaccines change how I'm able to interact with my parents? How they'll be able to interact with their granddaughter? Yes.

Am I going to a concert or a board game convention any time soon, even after I get vaccinated? Absolutely not. I'm still learning that I have extended family members that I'd been seeing regularly are anti-maskers and now anti-vaccine. I can't even process socializing with them ever again at this point.

[Blackhawk]

I'm of the opinion that, short of national restrictions, we're currently doing the most we ever will. More businesses will open, more people will eat out, more parties will be held, more people will forgo masks. People are tired, and people are lazy. Our measures are only going to go down from here.

The line for me was my kids' school going back to 100% full time in-person with no masks in the classrooms in a county that's at the second highest risk status in a state that is 100% open. Smoove says not to expect to go back to January 2020 'normal.' Around here, we're already there unless an individual makes a conscious, personal choice not to be. And it's utterly selfish, but my greatest hope right now is that me and my family will get vaccinated before any of us gets sick enough to die or be crippled for life. After that, I hope the suffering of others is minimal, but I'll be shamefully content to let them make their own choices knowing that their stupidity can't directly affect me anymore. There's just nothing else I can do anymore, and I'm exhausted from trying.

[Zaxxon]

I was out picking up some materials for next week from the doorstep of my kid's teacher, which is the first time I've left the house this week other than to run outside. After my daughter--masked despite no one else being there while she ran from the car to the doorstep--got back to the car, set down the stuff in an empty seat, and sanitized her hands, we hit the main road back to the house.

And saw the local Mexican restaurant, parking lot packed to the gills.

The struggle to keep a positive attitude toward others while they fail to make decisions that honor the social contract is... real.

[Lorini]

One thing I found out after wearing a mask is that I spit. Quite a bit in fact. My tongue was reconstructed so it doesn't behave like a regular tongue. People say it's not noticeable, but the mask sure showed it. So I will be wearing a mask from here on out. My second vaccination is on the 11th. On the 20th, I'll have a couple of friends over (masked, with hand sanitizer on the table, social distancing when eating) to play board games. The first week in March we are taking our first trip in over a year to San Diego Zoo. Staying at a hotel. Of course masked and social distanced. I'm not going to go anywhere where I can't socially distance unless it's with people I know really well (like my board games friends).

Yes we all know that the next few months aren't going to be good but hopefully we'll make it through. I just don't see any other way, short of a police state.

[Daehawk]

One thing about not being able to get a vaccine soon is that there are new ones coming out all the time and by the time you get one you can probably choose which you get depending on your choice of company and effectiveness vs side effects.

[Smoove_B]

I'm of the opinion that, short of national restrictions, we're currently doing the most we ever will. More businesses will open, more people will eat out, more parties will be held, more people will forgo masks. People are tired, and people are lazy. Our measures are only going to go down from here.

Sadly, this is also where I am and it's depressing the hell out of me - personally and professionally. I've been at this for (checks calendar)...25 years now and to have a realization about your profession and a significant swath of the general public at this level is rather disturbing (if I do say so myself).

I can understand (and have dealt with) the general public saying, "I don't understand why [X] is important" on any number of topics. I don't know how to process the general public saying "I've heard what you've said, and I don't care." And that ranges from general education all the way up to communities all over the United States actively passing laws and regulations to limit/remove public health powers in the middle of a pandemic.

My tank is empty.

[Isgrimnur]

I say this with no sarcasm or humor.

I am so sorry that the general public is not only unworthy of your efforts but also actively rejecting the help that your work and that of others attempt to provide.

[Daehawk]

Lack of raising as a child is catching up with humans.

[Zarathud]

It comes down to leadership. There was a critically small window when you could persuade people to act responsibly.

We’re impatient and short-sighted as a people — unless given a dream that can be achieved and there are steps along the way. But there was no call to self-sacrifice and community. Irresponsible and selfish behavior will no longer get you shamed, but upvotes on social media.

[Blackhawk]

It comes down to leadership. There was a critically small window when you could persuade people to act responsibly.

It wasn't just that the leadership missed that window. It's that the leadership used that window to actively sabotage both current and future efforts. We're paying the price for that now.

[Anonymous Bosch]

I'm of the opinion that, short of national restrictions, we're currently doing the most we ever will. More businesses will open, more people will eat out, more parties will be held, more people will forgo masks. People are tired, and people are lazy. Our measures are only going to go down from here.

Sadly, this is also where I am and it's depressing the hell out of me - personally and professionally. I've been at this for (checks calendar)...25 years now and to have a realization about your profession and a significant swath of the general public at this level is rather disturbing (if I do say so myself).

I can understand (and have dealt with) the general public saying, "I don't understand why [X] is important" on any number of topics. I don't know how to process the general public saying "I've heard what you've said, and I don't care." And that ranges from general education all the way up to communities all over the United States actively passing laws and regulations to limit/remove public health powers in the middle of a pandemic.

My tank is empty.

Keep in mind, your earlier statement cuts both ways:

"I don't know how to explain to you why you should care about other people."

In other words, if your proposed public health solution = more restrictive NPIs as a means to control COVID and forced business closures, you're undeniably proposing inflicting tremendous harm upon others. Such lockdowns aren't necessarily all that inconvenient for those working upper-middle class and higher jobs, who can afford to stay living in comfortable housing and continue working remotely from home. But small businesses and the lower-income earners that work there suffer the most from mandated isolation, both mentally, physically, and especially financially. So if you're insisting upon depriving others of their ability to feed their families and keep a roof over their heads in the name of public health, they'd be justified in making the exact same statement to you.

[Isgrimnur]

It's almost as if we should do more as a people and government for those negatively impacted than trying to keep things as "normal" as possible so they can bear the burden of the disease rather than the burden of the attempts to control it.

[Smoove_B]

In other words, if your proposed public health solution = more restrictive NPIs as a means to control COVID and forced business closures, you're undeniably proposing inflicting tremendous harm upon others. Such lockdowns aren't necessarily all that inconvenient for those working upper-middle class and higher jobs, who can afford to stay living in comfortable housing and continue working remotely from home. But small businesses and the lower-income earners that work there suffer the most from mandated isolation, both mentally, physically, and especially financially. So if you're insisting upon depriving others of their ability to feed their families and keep a roof over their heads in the name of public health, they'd be justified in making the exact same statement to you.

I think I've been pretty clear from day one. I fully support/endorse making sure everyone has what they need to survive this in the short and long term. If that means paying business owners to stay home? Terrific. If that means paying restaurant owners to make food for people struggling with food insecurity? Awesome. If that means connecting people to the mental heath services they need right now? Perfect. Figure out how to pay mortgages and rent? We can do that. Address utility bills? Also possible. I am in no way suggesting we shut it all down and then it's everyone for themselves; I don't think anyone in my profession has said anything close to that at any point. What we keep saying is that these half-measures and mental gymnastics we're engaging in to justify dining indoors (for example) undercut the effort of trying to get kids back in school. Politically we're sending mixed messages because we have collectively decided the economy is more important than anything. We collectively possess the ability to address the issues associated with short-term restrictions enacted to drive down community spread. We lack political will and a collective will to abide by a social contract in order to do so.

[dbt1949]

I think Americans have the most freedom of any country in the world and therefore resent confinements and limits more than anyone else in the world. And are therefore more willing to ignore those confinements.
Anyways it's a theory.