How to complicate a public health message

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If you take public transportation in Sweden, you have to wear a mask to keep from spreading Covid. Unless if it’s between 9 a.m. and 4 p.m. or between 6 p.m. and 7.a.m. Or unless you have a reserved seat. Or unless you were born after 2004.  

I believe that wins Sweden the prize for the most complicated Covid regulation on this planet. Or any other. 

There is a certain logic to this. Germs don’t move from person to person outside of rush hour. They’re also very fond of reserved seats, so if you have one they’ll stay with you and you don’t need a mask. Besides, you spent extra money for that seat, and germs travel in inverse proportion to how much money people have. 

If you were born after 2004, your math isn’t up to figuring this out. Automatic exemption. 

I’ve heard a rumor that the Covid virus doesn’t like pink. I’m not a big fan myself, so I can understand this. So if you wear pink–well, that’s not enshrined in law yet. I’m just saying: You might not need a mask then either. 

Relevant but slightly odd photo: This is Fast Eddie (he sneaks into the text later) in motion.

Yes, Sweden’s made an admirable mess of its public health advice. Its public health agency started out by telling people that masks weren’t effective against Covid. In fact, it said, they could be dangerous. In April, the chief epidemiologist wrote the European Centre for Disease Control (which is based in Stockholm), warning it not to recommend masks. It would imply that “the spread is airborne,” which would “seriously harm further communication and trust.”

To hell with science, we’ve got to protect communication and trust.

And when those annoying scientists established that the spread is primarily airborne? It stuck by its wrong advice with admirable pigheadedness. While other countries began emphasizing masks, Sweden’s chief epidemiologist was still swearing blind not only that the case for them was weak but that they could actually increase the spread.

In December, the country finally required masks on public transportation. Except when–

Yeah. See above. You can’t expect me to retype all that. 

About half of the country’s commuters still hop on their bus or train barefaced–including the head of the public health agency, who forgot that it was rush hour. 

In one municipality after another, some bureaucrat will still pop up and forbid employees to wear masks–in schools, in libraries, in places of that sort.  Because if masks were dangerous once, they’re dangerous now. Eventually the bureaucrat has to back down and the whole Punch and Judy show starts somewhere else. I don’t know that anyone’s calculated how many people are exposed to the virus while everyone waits for the bureaucrat to back down.

So basically, when the government’s advice was wrong, the format was right: It was straightforward and simple and it gave people something they could do, which is how public health advice should work. When their advice was right, though, the format became incomprehensible.

My thanks to Bear at Scribblans for giving me a shove in the direction of this fast-moving train. 

 

Covid clarity, British style

On Monday night, the government announced that if you’re over 70 and haven’t been contacted about vaccination, you can sign up in one of three ways, the third one being by calling your GP. 

The next night, GPs in the southwest said (by way of the nightly news), Please don’t call us. We’re already coming unglued. 

It’s a small thing (unless you’re trying to hold a GP’s office together), but it’s a reminder that in spite of the vaccinations going well, we’re still governed by incompetents. 

 

Clarity, South Korean style

South Korea has started testing symptomatic pets for Covid after finding its first pet-case, in a kitten. Animals that test positive will have to be kept at home for fourteen days, or if the owner is in quarantine (the country has quarantine facilities for anyone who tests positive), they’ll be kept in a quarantine kennel or cattery. 

The resident cat here at Notes, Fast Eddie, has written a very forthright letter to his Member of Parliament to protest, and also Larry the Cat, who works inside and outside 10 Downing Street. I tried to explain that South Korea’s a whole different country from Britain but he doesn’t see what difference it should make. 

You never win an argument with a cat.  

 

Hopeful things that aren’ vaccines

In response to a recent post, Mabel Kwong commented on the need to not just vaccinate against Covid but also treat it, so I’m including one potential treatment and other ways of responding to it. 

An experimental antiviral drug developed in Canada could cut recovery time in Covid patients who aren’t hospitalized. It’s called peginterferon-lambda, and may it be as effective as it is hard to pronounce. 

In a small test, patients who got a single injection were four times more likely to recover within a week than people in the control group. They were also less likely to need hospital treatment. The effect was clearest in people with the highest viral loads–the people who are considered most likely to pass on the disease.

A large trial is planned.  

And doctors at Imperial College London and the headteacher at a secondary school argue that government guidance to schools should emphasize air quality, not just masks and hand washing. They point out that the airline industry has taken the issue seriously and the risk of catching Covid on a flight is now lower than in an office building or a classroom. And I’ll go ahead and admit that this is news to me.

Airlines are circulating a mix of fresh and recycled air through High-Efficiency Particulate Air filters, and since I’m admitting ignorance, I might as well say that this is the first time I’ve known what HEPA stands for. 

Where permanent HEPA filters aren’t possible, portable ones can be used. 

There’s a lot of pressure on the government–understandably–to reopen the schools. If there’s any discussion about HEPA filters, or even opening the windows, it hasn’t leaked out yet.

*

In the US, a study hints that banning evictions and utility shutdowns reduces the spread of Covid by 4% and deaths by 11%. 

The study can’t prove it, though. This isn’t the kind of thing where you can do a randomized study, assigning people to groups that either do or don’t get evicted and creating a placebo group that gets evicted but thinks it doesn’t. All the study could do was compare counties that banned evictions and utility shut-offs with ones that didn’t, so other factors might well have affected the numbers. 

Still, when you look at people going from living in apartments to sleeping in homeless shelters or moving in with family, both in overcrowded conditions–

Someone who wasn’t involved in the study but who got herself quoted anyway said, “Housing is healthcare.”

66 thoughts on “How to complicate a public health message”

  2. Pingback: How to complicate a public health message – Willing Yourself To Win

  5. There has been conflict over here because , while officials are saying it is safe to reopen schools, teachers (backed by their Unions) are refusing to go back until they are vaccinated. Having taught in the public schools for many years, I can only back the teachers. How many schools can invest in the proper air filtering equipment,? There were years I taught when there was no soap in the rest rooms. All of a sudden there is $$ for complete new air filtering systems, PPEs and custodial staff to clean and sanitize ? (Some nights our trash cans didn’t get emptied). Some of the older buildings were never cleared completely of asbestos. Now the air is pure and everything is sanitized ? Yeh, maybe if the teachers do it themselves (as some must , where classes are changed.) Sorry, I cannot fault the insistence on getting the vaccine.

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  6. Random thoughts:
    If you’re born after 2004, you can’t count. Most have not starter learning that skill yet. There is talk of pushing to College. Although some argue that Bachelors would suffer too much in the learning process. MA’s have refused flatly. MS unions are negotiating. PhD’s are researching the issue.
    Political science 101. If you screw the first time, do it again the same way over and over again, until the environment changes to fit your solutions. (Or the entire body of voters has died)
    Most GP’s are not solvent anymore. That’s why they’re glued… (Can I apply for the worst joke of the year award?) 🥇

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  7. People’s inability to adopt the practice of wearing a mask, in Sweden and in many other parts of the world, astounds me. Apparently, we have not evolved as far beyond the ant species as we think. Must bring food to nest. But food=toxic crystal. Must bring toxic crystal to nest. But many dead ants surrounding toxic crystal. Must crawl over dead ants to reach toxic crystal to bring to back to nest….

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  8. It wasn’t easy getting through to a GP’s surgery before. At the moment I have to call once a week and if I only have to try five times before it’s not engaged I’m doing well. I’m already not looking forward to this week’s call.

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  9. At last, the UK Government can honestly hold up a single example of a worse ‘complete failure to get a grip on the pandemic’ than theirs, but are STILL topping the deaths per million of population tables themselves, due to their comfortably more abject performance over a much wider set of cock-ups.

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  10. It’s all very well for GP surgeries to tell people not to ring them – and I quite understand why – but not all older people are able to cope with technology. My friend’s 89-year-old mother-in-law was supposed to book an appointment online. She didn’t know where to start. So people do need the option of booking by phone. Although trying to get through to our surgery is a nightmare at the best of times!

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  11. Its nice to know that there’s somewhere with worse covid communications than the UK! Especially after all the right-wing paper went on and on about how well Sweden was doing and they hadn’t bothered with a lockdown! It does seem that that places that missed the first wave get clombered in the second or third wave (except Taiwan, of course).

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  14. Regarding Covid Clarity British style: What a mess having both GP networks and mass vaccination centres operating independently. At risk patients, usually older adults, may be invited several times to attend different vaccination centres. They get confused and don’t attend, wasting booked vaccination appointments. If they get a call from a mass vacc centre, they assume that their GP is no longer providing the vaccination. They may be concerned about where they will be getting their second dose and if it will be the same as their first (if for example they use a mass vacc centre for the first and their GP for the second).
    I have many friends who are pharmacists, but there is plenty of capacity for GPs to vaccinate their patients without adding the option for vaccinations at a pharmacy. A vial of Astra Zeneca Oxford vaccine nominally contains 8 or 10 doses (although I can squeeze out 12 full doses from the 10ml vial). Pharmacists might not be able to use the whole vial within its 6 hours shelf life, whereas GPs can almost always call up a few vulnerable patients to use up the entire vial.
    GP vaccination sites have been stymied by restricted stocks of vaccine – they are all set up to roll out the programme but can’t plan ahead (staff, rooms, telephoning patients etc) when they have no vaccine and don’t know when they are getting any more.
    At least GPs will get an extra £10 for taking the vaccine to a housebound patient.
    Surely we could have had a plan to sort this out without duplication and confusion?
    Apologies for the rant…

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    • Just after the mass vaccination centers opened, one or more of the papers ran a story about a woman who got two first doses of who knows which vaccines a day or so apart. She was elderly and getting a little loose at the edges and, well, if the doctors said she should get vaccinated, surely they knew what they were doing. So yes, rant appreciated. Leave it to this government to mess with a system that’s working well. Or as well as it can given the problems with writing the vaccines out of idiots.

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