Given the recent increase in hospitalizations and deaths from COVID-19 in the U.S. and globally, it is inconceivable that people in positions of authority, like he Florida Surgeon General, Dr. Joseph Ladapo, would continue to make irresponsible comments with respect to the mRNA vaccines that have been successfully used to combat this pandemic.
While misinformation is described by the CDC as “false information shared by people who do not intend to mislead others”, disinformation is when “false information is deliberately created and disseminated with malicious intent”. We as preventive medicine physicians need to be on alert for both types of falsehoods and actively combat them.
You can do this by starting with the ACPM’s Vaccine Confident campaign, which “…is designed to create a dialog with preventive medicine experts about why you are confident in the science behind vaccines and their effectiveness, ultimately to instill consumer assurance in making the decision to get vaccinated”. There are a variety of resources and graphics available to help you spread the word! Vaccine Confident Toolkit | ACPM
With over 1.2 million cumulative deaths from COVID-19 in the U.S. and around 65,000 COVID-19 related deaths in 2023, this continues to be a disease that can be deadly. In particular, patients who are at higher risk, such as the elderly, those who are immunocompromised, or who have certain underlying conditions such as obesity, severe heart disease, or COPD, need to ensure they are properly vaccinated (primary prevention), against COVID-19 to start, and then do what they can to mitigate their increased risk for COVID-19, due to their underlying medical condition(s) (tertiary prevention).
Other steps that can help to protect us and our patients include using masks when we go out, particularly if we have an increased risk for the disease, or if we work in or spend a long time in areas of increased risk, such as in health care settings. Then there is the discussion to be had about testing. Without going into the details of the epidemiology of testing, with which you are all very familiar (secondary prevention), there is likely some utility to testing patients at home or in the clinic, so they can isolate from family members and/or stay at home, to decrease their risk of transmitting the disease to co-workers and the general population.
And yes, while these tests, the antigen tests more so than the PCR tests, are plagued by a poor positive predictive value and many false positives and negatives, they can serve as a guide to high-risk patients to not only stay at home when they get COVID-19, but also to quickly seek out anti-viral therapy or get treated with monoclonal antibody therapies.
We all know COVID-19 is going to be with us for the foreseeable future. Thus, we need to take the mantle of leadership as preventive medicine physicians, especially colleagues in the clinical setting, and make sure we provide appropriate information on testing and vaccines, along with available therapeutic options, while rapidly and directly counteracting misinformation and the more malicious disinformation.
Mirza I. Rahman
MD, MPH, FAAFP, FACPM