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Perspective: Don’t approach omicron like a hammer looking for a nail

We need public health officials to look at the full picture, not just COVID-19

White House press secretary Jen Psaki walks to the podium as Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, departs after speaking about the COVID-19 variant named omicron during the daily briefing at the White House in Washington, Wednesday, Dec. 1, 2021.
Susan Walsh, Associated Press

There’s a popular phenomenon among medical students where they self-diagnose with every ailment they’re currently studying. Closer to home, when my stepfather was helping teenagers with drug addiction, he became convinced that all my friends and I must be doing drugs.

This idea has a name: Maslow’s hammer, or the “law of the instrument,” based on Abraham Maslow’s famous quote: “If the only tool you have is a hammer, you tend to see every problem as a nail.”

For many epidemiologists and public health officials, every new COVID-19 variant is another nail.

We’re watching this phenomenon take place in real time among public health officials. You likely never realized it, but you’ve been ignoring some Centers for Disease Control and Prevention recommendations your entire life. If you have toddlers, are they in rear-facing car seats? If you’re making brownies, does your family lick the bowl? Do you have elderly relatives that are still driving at night? If you’re of childbearing age, do you use condoms with every sexual encounter with your spouse if you’ve been in an area with Zika present during the past six months (look at a globe — that’s most of it)? If you do any of these things and more, you’re wantonly risking your life and those of your children, according to the CDC.

But with COVID-19, everything changed. Suddenly we became hooked on every word out of the mouths of a handful of suddenly very influential epidemiologists, and their pronouncements have real effects on the lives of families across the country. Their risk tolerance was always zero, but now, their risk tolerance has become our own.

COVID-19 moderates like myself have long decried a lack of off-ramps, and this is why they don’t exist for the public health establishment: There is no tolerable amount of risk allowable.

The problem, then, is when every concern is a nail or, in this analogy, when the only risk is COVID-19, you lose the forest for the trees, ignoring every other possible threat.

Others are noticing. In a newly released article for ScienceDirect, three public health researchers take issue with the CDC’s guidance that masks be worn by all unvaccinated individuals, noting in particular the effects on young children over the age of 2.

“We feel that the CDC and Dr. (Anthony) Fauci have, by focusing exclusively on SARS-CoV-2 transmission, got this wrong,” they write, “and that this guidance is not good public health when the limited potential benefits of this policy are considered alongside the potential harms” (emphasis mine).

But the prevailing attitude looks more like this tweet from a prominent epidemiologist:

She tweets frequently about her struggles with anxiety — an understandable side effect of this level of constant vigilance and fear. But that is the the problem with viewing the pandemic solely through the lens of avoidance of a virus. We’ve been facing any number of public health emergencies in the past two years, and they’re not limited to COVID-19. We have an epidemic of drug overdoses, mental health crises and loneliness. All of these issues have serious and documented impacts on physical health.

In the face of a new variant, we still haven’t learned the lessons of Maslow’s hammer tunnel vision on COVID-19 and COVID-19 alone. Appearing on Sunday political shows, Fauci discussed the threat from the omicron variant, repeatedly warning we have to “prepare for the worst.” On ABC’s “This Week” he said, “You want to be prepared to do everything and anything.”

Is doing anything and everything in the face of a variant about which we know little — but what we do know indicates it’s not exactly a five-alarm fire — an appropriate public health response? Dr. Angelique Coetzee, a board member of the South African Medical Association and the professional who first identified the variant, told The Telegraph, “Their symptoms were so different and so mild from those I had treated before. … It presents mild disease with symptoms being sore muscles and tiredness for a day or two (and) not feeling well. So far, we have detected that those infected do not suffer the loss of taste or smell. They might have a slight cough. There are no prominent symptoms.”

Does this seem like an appropriate moment for the world to halt international travel, to discuss further lockdowns, to encourage hospitals to suspend elective surgeries and to reintroduce mandates? If you are singularly focused on COVID-19 and COVID-19 alone, you might think so, and as such, might be a hammer in search of a nail. It’s time to expand our roster of experts past those with expertise in virology and epidemiology and listen to those with a better grasp of the full public health picture.

Bethany Mandel is a contributing writer for the Deseret News and an editor at Ricochet.com.