SO, OTHER THAN EVERYTHING, WHAT WERE THE TRUMPISTS WRONG ABOUT?:

Although the protection that vaccination offers against infection wanes after a few months and protection against severe disease decreases somewhat after four to six months, vaccines have been strikingly effective at reducing the risk of death, especially the mRNA vaccines produced by Pfizer and Moderna. In the U.S. in the last quarter of 2022, people who had been vaccinated and boosted were about one tenth as likely as unvaccinated people to be killed by Covid and half to one third as likely as people who were vaccinated but not boosted.

Until vaccination and effective treatment became available, the primary means of preventing death from Covid was reducing the risk of infection. Disruptive as they were, strategic closures of indoor activities reduced infections and deaths substantially. When people don't congregate indoors, the spread of Covid decreases exponentially. Masks, particularly when worn by people who are infectious as well as people who are exposed, further reduce spread, as does the isolation of infectious patients.

The first year of vaccination alone is credited with averting an estimated 14 million Covid deaths.

Studies from New York City, the U.S. as a whole and 11 European countries all come to a similar conclusion: Indoor closures prevented at least 50% of infections and deaths in 2020, with masking further decreasing spread. New York City's closure of indoor businesses and gatherings in mid-March 2020, for example, reversed the exponential increase in cases and resulted in a rapid decline in deaths, which lag infections by three or four weeks. Deaths in New York City decreased from more than 700 a day in mid-April that year to 300 a day two weeks later and 15 a day by July 1. Closures prevented or delayed many infections until hospitals became less overwhelmed and better treatments and vaccination became available.

In the U.S. and many other countries, however, schools were closed when they could have remained open, with devastating educational, social and economic harms. Mandates to close and open businesses were not tightly tied to real-time data, and the decision-making process of balancing costs and benefits was not transparent, creating avoidable antagonism and distrust. The simple truth that controlling any pandemic is essential for economic progress was often lost, along with many lives that did not have to be.

Masks proved to be surprisingly effective, although public discussion of them has been muddled. Masks have two different benefits: to reduce the amount of virus released into the air from people with Covid (source control) and to protect someone from inhaling the virus from the air (personal protection). Mask-wearing is crucial for source control because approximately half of the risk of spreading Covid occurs when infected people feel fine, either before they become ill or because they never develop symptoms.

Laboratory studies demonstrate that masks reduce the spread of the virus. N95 masks are more effective than surgical masks, which are more effective than cloth masks. When both those who are infected and those who are exposed wear masks, even if only cloth or surgical masks, the decrease in risk of infection is substantial. No mask is perfect, and breakthrough infections can occur, for example, because an N95 mask isn't worn properly or doesn't fit well. Successive variants of SARS-CoV-2 have become strikingly more infectious, making it even more important to wear effective masks when the virus is spreading.

High levels of community masking, including both source patients and exposed people, have been associated with reductions in infections ranging from 10% to 80%, with more protection when there is consistent mask-wearing in high-risk areas such as households.

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