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Are we going to attempt to mitigate the increasing risks of COVID?

by Dr. Colleen Sholar, Clearwater Valley Health

Risk mitigation:

What do the following all have in common: seat belts, traffic lights, speed limits, speed bumps, water treatment plants, sewers, public dumps, vaccinations, masking?

They are all public safety measures. We, as a society, have to create rules whether you call them guidelines, mores, laws, commandments, or a social contract. These rules serve the greater good and must go further than the obvious "don't kill each other."

Since the beginning of humankind, we have been collecting new sets of rules to help us live together in larger communities and with increasing technology. I would like to suggest that we are not giving up freedom to follow social safety measures, be it that you stop at a stop light to not hit me who is also driving through the intersection, or getting vaccinated to reduce the risk developing severe COVID disease which would expend already scarce healthcare resources during a pandemic or masking to reduce the spread of infection during a pandemic to yourself and those who are vulnerable. It is through following the rules of public safety measures, be they tacit or formal, that we can help each other, protect each other, and protect our other cooperative benefits.


The first vaccine was given in 1796, it was for smallpox. The story of smallpox was not without its own turmoil, there is no reason to romanticize history. There was a smallpox epidemic in the US from 1898-1904 and during that time there was significant vaccine refusal resulting in state mandated vaccinations, "vaccination raids" of physically forced vaccinations, and people who were infected often had to be physically dragged into an isolation house. Smallpox was eventually declared eradicated in the US in 1949, then in the world in 1980 and this has generally been considered the biggest achievement in international public health, it was no small feat.

Much of the delay in eradicating smallpox, our ongoing pertussis outbreaks, our ongoing measles outbreaks, and our current hospitalization rates for COVID-19 are due to vaccine refusal. Admittedly, the technology and knowledge available at the time of smallpox was not the same as today so perhaps that hesitation was more understandable but we have such a greater knowledge of microbiology/virology/immune system and technology is much more advanced. Vaccines are overwhelmingly safe. I am not denying that there is some risk of adverse reactions but these risks to each individual are exceedingly small especially when compared to the societal risk of ongoing outbreaks or in the case of COVID, an ongoing pandemic.

Please get vaccinated. Comirnaty AKA the Pfizer-BioNTech vaccine is FDA approved for all people over the age of 12 and the approval for the Moderna and Johnson & Johnson vaccines are close to formal approval.


Are masks fun? Nah. Are they sexy? No. Are they a breath of fresh air? Certainly not though a mint might help. Do they prevent you from spitting on me and sharing your infections with me? Yes, yes they do, please wear a mask with three layers of tightly woven material, a surgical mask or KN95 but remember they have to have a seal around the mouth and nose. Please protect me, protect my kids at school, protect your friends, family, and community members.

Are mask mandates a new idea? No! In 1918-1919 during the Spanish Flu pandemic, there were mask mandates in many western states. WWI was ongoing and people generally complied because there was a societal need to preserve resources. Your healthcare providers need you to know that we still need to you mask to preserve resources, this pandemic is raging and while we have many more methods to treat those with respiratory complications than they did in 1918 (the iron lung was not invented until 1927) these treatments are often complicated, expensive, and time consuming which requires many healthcare personnel resources (nurses, respiratory therapists, medical technologists for labs and radiology studies, increased demand on environmental services, etc) as well as material resources -all of these are in short supply.

Consequences of risky behavior:

As of this writing, we have lost several members of our community to this pandemic and we have so many more who are struggling with long hauler symptoms unable to fully participate in their usual personal and societal roles. We need to band together. The pandemic is here, we can slow the spread of infection and slow the use of scarce healthcare resources by getting vaccinated if you are >12yrs old, wearing a mask, staying physically isolated if you are sick or have been exposed to someone who is sick.

With resources in such short supply we as a region, state and nation are seeing adverse outcomes and even deaths from non COVID conditions as well as COVID. During my times at work I am actually much more afraid that someone will walk in with a GI bleed or other condition that needs a procedure or specialist not available at CVH because finding somewhere with the ability to do that procedure is a challenge I had not expected outside of a military deployment but even in my military training we could call a MedEvac and here that is not an option because LifeFlight can only take you to a hospital if there is a bed available.

Please do your part, your participation in our societies pandemic response is required.

Photo: Dr. Colleen Sholar

Window on the Clearwater
P.O. Box 2444
Orofino, ID 83544
Phone: (208) 476-0733
Fax: (208) 476-4140