What we are doing to college kids is total madness
College campuses are escalating restrictions on those who least need them
This is a post about the absolutely insane, crushing restrictions being imposed on young, healthy vaccinated (often booster and often naturally immune) people by institutions of knowledge. In order to prove my thesis that these policies are misguided, let me start with some basics.
When it comes to COVID19, there are only 3 things any of us can do:
We can lower the risk of bad outcomes when we encounter the virus.
We can delay the time to meet the virus
We can engage in theater which does not delay the time to meet the virus
What goes in these buckets?
Category 1 (risk reduction) is easy. You can’t modify your age, a huge risk favor, but you can modify your vaccination status, and you can modify your weight and general health.
Category 2 (delay time to virus) is harder. We don’t have many well done studies, but theoretically if you sealed yourself in a bunker and ate canned food, you would do this. Wearing a snug n95 might also delay the time to meeting the virus. The challenge with these interventions is they are not sustainable by most people, and may lead to fatigue or backsliding, and thus the effect is transient.
Delaying serves 2 purposes:
For the individual, it makes sense if, by delaying, you can do something for category 1 that you cannot do today. If you are waiting for your vaccine, for instance, by all means delay.
For the community it makes sense, if, by some delaying, the pandemic trajectory is bent and hospitals are less likely to be overwhelmed.
Delaying also has a downside. It may hurt your mental health, particularly when you do it effectively. If you need evidence of this damage: please see twitter.
Category 3 (useless, virtue signaling theater) is the most common. Wearing your mask when you enter a restaurant and walk to your table, but not when you sit there for 2 hours laughing and drinking is one example. The fact this policy exists reflects serious impairment in thinking & total failure of policy makers.
Making a 2-4 year old wear a cloth mask in day care (which the American Academy of Pediatrics recommends against the advice of the World Health Organization), but, of course, kids take the cloth mask off to nap next to each other for 4 hours in the same room! Theater.
Closing beaches and other outdoor activities. Wearing a mask outside. The list goes on and on, and most things we did fit in this category. On a side note: Here we review all data on masking.
Enter young, healthy college kids.
The vast majority are either double vaxxed or have natural immunity or both, and some are also boosted. They are young (lucky them!), and the majority are healthy. What more can such students do for Category 1? Nothing.
What about category 2? It appears that many universities are making college kids wear masks, restricting their movement, banning gatherings etc. Here is just one example of how extreme they are:
These severe restrictions might actually delay the time till college kids meet the virus! But it does so with a huge disruption to their lives. All the wonderful things of being young require being very close to other people. Many simply cannot occur with a mask on.
Will these restrictions benefit the college kids? Absolutely not. When they eventually meet the virus— and they will— on vacation or next semester— they will just be a little older, but have similar great chances of doing well.
Will the restrictions benefit society? Doubtful. After all, everyone not on a college campus is not following any of these ridiculous rules, and the pandemic trajectory will be dictated by those (aka 99.9% ) of places.
It will likely not even to protect the faculty and staff on campus, who will largely face risks when they leave work and go home and on vacation, and again, if these folks have already optimized Category 1, delay makes little sense.
Will it harm the college kids? Absolutely, it will. Their mental health will surely suffer from this isolation. It has already. I will say again: all of the joys of youth require being close to other people.
What is the net balance? The net balance is these policies are catastrophically detrimental to them. Moreover, there is no countervailing benefit to staff or society to justify the huge imposition. It is morally and scientifically bankrupt.
Truly, I can’t even understand how anyone thinks these policies are justified. I am also surprised college students have accepted them with scant protest. I can only surmise that many have been mislead into thinking this sacrifice serves a broader interest (i.e. believe they are being altruistic), or that the incentives on their lives and career for conformity are so great they are afraid to speak up.
I suspect the strong link between restrictions and political party may also affect them. After all, the youth most strongly leans left (full disclosure: as do it!), and thus adheres to the identify badges of the left (but in my case, sadly, I spent too many years studying & publishing on scientific evidence to turn my brain off).
In short, draconian restrictions on vaccinated young people or those with natural immunity living in tiny pockets of college campus makes no sense, and is a policy that contributes to a harm in societal well-being. The policy is unethical and illogical.
To young people: I am personally sorry that those of us who recognized the futility and harm of these policies could not have done more to shield you from the anxieties and risk aversion of the irrational.
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PS, I have written on this before
https://www.medpagetoday.com/opinion/vinay-prasad/94785
Love your link to masking studies. Though I suppose our leaders are not familiar with "The Science."
Your piece today and that of another substacker, ianmsc@substack.com are worthy of the Christmas Eve hall of fame. The scariest thing of all to me is not this passport/ mandate/ mask/ media insanity, as you have so thoughtfully written, but the fact that so many of us blindly comply. We don’t have to be told to lockdown. We’re doing our politicians’ bidding for them. De facto lockdowns.
Excellent commentary Dr. Prasad! I wish we heard MORE MDs, scientists in each state of your same breadth of knowledge posting and sharing the same thoughts/concerns. Sure there are some...but many just behind closed doors. Last year when I took my 2 daughters to see their Ped. for a well child check they complained to her about "having" to wear their mask on recess and how hot it was...the Ped. promptly rolled her eyes and said "I know...it doesn't make sense.." NO it sure doesn't...but do you think she would have said that outside the exam room or to her boss?! Nope..doubt it...and why again?? I really think you should do a write up about the "why"...why do you think this is happening? Collect a bunch of your colleagues in the SanFran area and beyond from different disciplines of medicine...Peds. for sure...and ask why? Do they believe 2-4yr olds at daycare should be masked...if so why? Do they believe this theater going on in college is helpful..if so why? If not why not....and why is this continuing from the top down. I think if you say the word "conspiracy" you are automatically tarred and feathered as you say....but what is the motivation? Who does it benefit to mask 2-4yr olds? Who makes $ off of that? Its insane. I live in the MOST restricted county in all of WI with ONGOING mask mandates...Dane co (Madison/UW, etc)...72 counties in all of WI and we have the only mask mandate...yet cases HERE are higher than in other counties...it makes little sense. Many of us are at the point where we travel for the day outside of our county to do errands, eat at restaurants, etc where we can choose to mask or not and we don't get odd looks or stares! And no...if we feel a little sick we stay home! Common sense rules! We moved our youngest to a preschool outside of our area so he could be unmasked all day...vs. a 4yr old with a speech delay being masked all day and not having the option of seeing the lips of the teacher he's learning from and she see his. They would never make any accommodation for him....so now we have to drive a distance to have freedom of choice and basic common sense for a young child with a speech delay and how is he best served in school for success. Its insane. Many things are not adding up and thank you for continuing to speak about these things. No matter what you or I or anyone personally thinks about Trump or what we agreed or disagreed with regarding his presidency...hopefully we can all agree that while counties in a variety of states may mandate masks, etc....there would be 0% nation wide vaccine mandates and attempts to block schools/counties from taking away citizen's personal choices.