An unvaccinated individual is 10 times more likely to be hospitalized with COVID-19; 11 times more likely to die from it.

EDITOR’S NOTE: This article was first reported today on Talk Ten Tuesdays.

Let’s start with some facts:

  • Smallpox, a viral disease that was around for millennia and killed an estimated 300 million people in the 20th century alone, was eradicated in 1980 through mandatory mass vaccinations.
  • Polio, once the most feared virus in the United States, paralyzed or killed more than half a million people worldwide every year throughout the 1940s and early 1950s, until vaccines put an end to it.
  • To attend public schools, all 50 states have childhood vaccine requirements for viral diseases, including polio, chickenpox, measles, tetanus, and others.
  • The U.S. military mandates vaccinations against a dozen diseases for all service members.
  • The COVID-19 vaccines are safe and work remarkably well. Currently, an unvaccinated individual is 10 times more likely to be hospitalized with COVID-19 and 11 times more likely to die from it, compared with a fully vaccinated person.

So, why such a hullabaloo over any COVID-19 vaccine mandates?

Last Thursday I spent six and a half hours teaching medical students. In compliance with university policy, we were all fully vaccinated and were all wearing masks. None of us enjoyed the face masks. Some wonder why masks are necessary, in a room full of vaccinated people. The answer is twofold: personal health and public health. The combination of a mask plus a vaccine protects your personal health. The mask lowers the risk of getting a highly transmissible virus. The vaccine lowers your risk of dying in the event you get infected.

The more compelling reason to do both, however, is not personal. Unless they are eradicated, viruses will continue to mutate. The World Health Organization (WHO) has already classified the Lambda and Mu mutations as variants of interest. It’s a public health imperative to reduce the rate of mutations of the SARS-CoV-2 virus, the cause of COVID-19. The combination of masks plus vaccines does just that.

Variants are the danger. The Delta variant is much more transmissible than the original Alpha strain. Many parts of the country with low vaccination rates are currently struggling with the latest wave caused by Delta. Cases are spiking, with more than 1,000 COVID-19 deaths a day, ICU bed shortages, and even healthcare rationing in particularly hard-hit areas. A future variant that is able to evade our vaccines would completely overwhelm the entire U.S. healthcare system.

Though the sickest victims are the unvaccinated, the pandemic continues to affect us all. Thanks to Delta, even the vaccinated are at risk of catching and spreading the virus, especially if not wearing a mask. This spreading of the virus could allow it to mutate into a vaccine-resistant form. President Biden’s six-step plan to help end the pandemic, announced last Thursday, targets all Americans for just this reason. The plan aims to reduce transmission and the development of future virus variants with vaccination and face mask mandates, booster shots, guidelines to keep schools open, and increased COVID-19 testing.

There are many reasons some Americans have vaccine hesitancy. Recommendations from public health officials have, at times, been confusing and inconsistent. This pandemic has been going on for 18 months, but COVID-19 is still in its infancy. Scientists and physicians are still learning new things about the virus and the disease it causes. Currently, 54 percent of all Americans are fully vaccinated. That’s too low to control viral transmission; that’s too low to limit mutations.

My students often ask me what I think the future of this disease will look like. My answer is that COVID-19 will be like the flu. It will become endemic, meaning that it will never completely go away. The virus will likely become more transmissible, yet less deadly. I believe that COVID will be a disease that humans can learn to live with. There will be a need for vaccines, regular booster shots, and periodic recommendations to wear face masks. And, like with the flu, we will learn to live with the risk of a virus mutation that evades the vaccines, resulting in another pandemic. That risk gets smaller the more we all comply with public health guidelines.

COVID-19 fatigue is real, and has been part of our psyche since the first wave ended in June 2020. Mask and vaccine mandates and more COVID-19 testing may feel to some like an infringement on our freedom. They’re not. They are our ticket out of this pandemic. The freedom we should care most about is not the freedom from mask or vaccine mandates.

The freedom we most need to fight for is freedom from the lockdowns, isolation, deprivations, economic depression, severe illness, and death that a vaccine-resistant mutation of COVID would cause.

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