"Peter, I respectfully disagree."

 Yet another doctor tells me I am dead wrong about COVID.

This time it is David Gilmour, M.D., a former Jackson County Commissioner.

My logic is a mix of the medical and the political. We have the capacity to make COVID hospitalization and death very rare in this country, if everyone medically able to get vaccinated did so. But near-universal vaccination isn't happening. Too many people aren't bothering to get vaccinated or are firmly opposed to it. It is a problem of messaging and branding--the stuff this blog writes about. 

The vaccine brand. My proposition is that vaccines developed two separate brand ideas. One--the dominant one--is that this was an extraordinary gift from medical science, a pandemic-ending lifesaver that is surely safer than getting the disease. I agree. I have that brand idea in mind.

The other brand developed in opposition. It was that there is nanny-state over-reaction to COVID, and pressure to get vaccinated is another iteration of it. It is pressure to conform, to knuckle under to the worrywarts. It is pressure to see COVID as a bigger deal than it really is. Some people consider the pressure a simple nuisance, like unwelcome people at one's doorstep with Bible tracts certain they will save your soul if you just listen to them. Some people see the CDC and Biden and state governors as tyrants pushing something risky, maybe even dangerous. They want to mandate vaccinations because the free people of America won't do it voluntarily--proof positive that it is unwelcome. That second brand makes it a choice between submission versus freedom. Seen that way, of course people resist.

France is trying vaccine passports. It is creating backlash, with huge anti-compulsion demonstrations. In the USA, the backlash is less visible, but also present in the form of low vaccination rates.

My suggestion to Democrats is to back off talk of passports and requirements, except in medical facilities. Quit trying to persuade. More "selling" confirms the tyranny brand. It becomes a contest, and getting a vaccination means losing. 

Ending talk of mandates and vaccine passports does not mean Democrats are taking silent glee in the deaths of Trump-supporting vaccine refusers. I argue that it means Democrats recognize when a political message is having a reverse effect.

David Gilmour is a family practice physician here in Southern Oregon. He maintained his practice while serving as a Democratic Jackson County Commissioner. He was a popular Commissioner and physician, with a reputation for being very reasonable.

David Gilmour says I misunderstand the situation. This is a medical emergency that requires government to do more, not less. Vaccinations work, and innocent lives are at stake.

David Gilmour Guest Post

Peter, I respectfully disagree. During the past year, the life expectancy for the U.S. population as a whole fell for the first time since WWII. That was all because of COVID-19, with over 600,000 dying this past year. 

Just giving up and accepting hundreds of thousands of more deaths as “inevitable” should not be an option. The vaccines work well at preventing serious illness and death. It makes sense to maximize vaccinations in select groups. Vaccinating front line medical workers, teachers, and others who have frequent contact with vulnerable people could be the first step. Mandatory vaccination of health care workers has already been sanctioned by the courts. All front line hospital and clinic staff and first responders should have vaccination (or alternatively frequent COVID-19 testing) as a condition for employment. 

If politics were out of the picture, that would raise no more eyebrows than past requirements for chest X-rays and PPDs to monitor for tuberculosis, or hepatitis screens to rule out active hepatitis.

Schools present a difficult dilemma during the COVID-19 era. Kids definitely can get and transmit COVID-19. Yet vaccinations are so far not available for children under 12. Even before the Delta strain, it was known that teachers can  catch and transmit the virus, both to other staff and to the children under their care. Mandatory vaccination of teachers and mandatory masking of everyone inside a classroom may become a necessary evil to both save lives and to prevent future school shutdowns from outbreaks. Such a decision should be made by the local public health authority and not be delayed by making it an item of negotiations between school boards and labor unions. Adding Covid-19 vaccinations to other required pre-enrollment vaccinations (such as meningitis vaccine) for entering college students will also do much to prevent university outbreaks and keep universities open.

When I was in my 20s, I had to carry a yellow vaccination book to be able to travel to many countries. I suppose that the booklet today would be maligned as a “vaccination passport." I would not be surprised that proof of COVID-19 vaccination along with a recent negative COVID-19 test will be a future requirement for crossing borders, and maybe for air travel. 

Yes, mandatory vaccinations and testing may be viewed by some as an abridgment of “freedom.” But with freedom comes a responsibility to do no harm to those around us. We still have a long difficult road ahead of us. Let's not blow it by doing nothing in the midst of crisis.