Personal Decisions and the Common Good

In its?recent announcement, August 11, 2022, the CDC offered its “streamlined” recommendations on how to proceed as COVID-19 has become endemic. It’s here to stay, the announcement makes clear, and we must learn to live with it.

The question is, how?

The CDC offers some very specific recommendations about operating in the day-to-day of Covid: what to do if you are diagnosed, when to wear a mask and when not, get tested and not. The announcement also illustrates how far we are from the early months of the pandemic and, simultaneously and surprisingly, how close.?

By way of explanation, here is an anecdote.

Fifteen months ago, fully vaccinated and ready to resume some form of normal life, I called my dentist’s office to schedule a cleaning. My appointment was to be routine, but it was May 2021 and nothing about a trip to the dentist, or anything else, seemed routine. Recall that people were isolating their mail, obsessively washing their hands, hunting down scarce Lysol, and scouting grocery pickup times.?

I was prepared to wait in my car until called, walk into the building through a special entrance, report on travel, recent Covid tests, symptoms, exposure, and have my temperature taken. These so-called intrusions into my private life seemed perfectly reasonable to me.?

I was also prepared, and eager, to share the news that I was fully vaccinated. I assumed that the medical professional who would clean my teeth would most likely be vaccinated as well.?

Would that indeed be the case, I asked? The response took me by surprise.??Vaccination, I was told, was “a personal decision” and medical staff were not required either to vaccinate or to reveal their vaccination status.?

But if an unvaccinated and potentially infected hygienist (who, after all, was seeing many more open-mouthed persons per day than I was seeing in a year) spent 45 minutes leaning into my open mouth, why would her decision not, in effect, become mine, her Covid my Covid???

To my mind, personal decisions are those that affect only the people making them. Whether or not I chose to get vaccinated in 2021, however, could have a dramatic impact on others. It could affect my ability to pass the virus to them and the virus’s ability to generate variants that would eventually evade vaccination (at least in part).?Deciding whether or not to get vaccinated could not possibly be “a personal decision.”

But as we head into late summer and fall, 2022, “it’s a personal decision” has become the norm.??It reveals itself in the CDC guidelines and in the recommendations that other agencies and experts describe and emphasize.?What was once, at least in my mind, the problem, is now presented as the solution.

Here is epidemiologist Greta M. Massetti in the CDC’s latest assessment: “persons can use information about the current level of COVID-19 impact on their community to decide which prevention behaviors to use and when (at all times or at specific times), based on?their own risk?for severe illness?and that of members of their household, their risk tolerance, and setting-specific factors [emphasis added].”??

The language is clinical, but the implications are not.??Think about yourself or, if there is any extension of the self at all, the boundary extends only as far as your front door.??Make personal decisions based on your risk tolerance and that of others in your home. Don’t make decisions about those outside your small, tight circle who might be affected by your behavior.??

What’s clear here is that the CDC is meeting the majority where the majority is; its guidance reflects our national reality.??As a country, too many of us refused at the outset to embrace the common good, the idea that “we are all in this together.” We have therefore arrived at the collective conclusion that I am in it for me and mine, and you for you and yours.?

Indeed, “it’s a personal decision” has become our national mantra. At its worst, it is a reflection of our failure to come together during a national emergency; at its best, a hope that having thus failed, we will respect rather than belittle or deride each other’s decisions, whether we agree with them or not. That we have been reduced to this, to the hope that we will at least be civil to each other – that this even needs to be said (though it clearly does need to be said) – strikes me as sad indeed.

Have we come a long way? In some respects, of course; we know more about Covid than we did in 2019; we have vaccines that keep most people alive; we have home tests and therapeutics; we know which masks work best. In other respects, we have not come far enough. As a?country, we have recorded by far the most Covid cases, the most hospitalizations, the most deaths, and (as I write this) the most “active cases.” And we still don’t know the full extent of long covid’s human cost.?

And then in other respects, we have not come?any way at all. Making decisions only for oneself is what got us into the complex, disruptive, and dangerous place in which we find ourselves today.??A more hopeful and decidedly more communal vision of who we are to each other will need to get us out.

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PS: for a simple story of what the world looks like when people actually care about each other’s lives – and to feel that we still have within us the capacity to do unto others as we would have them do unto us –?read this?in last Saturday’s Washington Post.