Guidelines, like some promises, were made to be broken.
In the midst of the record number of Covid-19 cases that are reported, there is also a lot of confusion with regards quarantine and isolation. It used to be a strict two-week isolation protocol that was instituted in the early days of the pandemic for those exposed. Today, some guidelines even state that health workers who have been given vaccination boosters do not need to isolate themselves if they are asymptomatic.
So why is it so difficult to sustain health recommendations? To get a better understanding of this dilemma, let us analyze the different factors involved in the process that leads to the dissemination of health guidelines.
We have come to expect that scientific facts and evidence run the medical industry. This has developed in us a sense of trust in what our health experts advise. Thus, it is surprising to realize how these recommendations can be influenced by politics, the media, and by consumer groups.
Political groups want to get the best mileage in times of health crisis. They want to prove that they are on every aspect of care, no matter how trivial. They will try to exert influence on medical decisions. At times, this is good; at other times, this over-involvement increases health care costs.
The media is ready to pounce at every news story. An outbreak is a great story. So is a new drug, and its possible adverse reactions. Whenever there is a potential for public interest, expect the media to be there. It is a great ally for information dissemination. It is also a clear enemy of disinformation. It can shape the opinions of the masses, and mass opinion is not always right.
Public behavior in the age of social media is a powerful influencer. Man has always followed the actuations of the majority. We have seen this rear its ugly head during the pandemic, where a supposedly new concoction endorsed by a celebrity gains ground even without studies. The public, desperate for cures, tries it out and loses.
Experience teaches us that we shouldn’t jump on every new piece of advice we’re given, even if it comes from experts. This may only be a trend or a passing whim. Even in the era of evidence-based medicine, this is a reality. Yes, even experts may not have all the answers, though they may be our best bet even if they are not always correct.
Take smoking, for instance. Fifty years ago, physicians considered them to be harmless and hip. Tobacco companies invested a lot of money in promoting it, even funding sports events with the cigarette product as the main sponsor to prove their safety. Sugar, coffee, and even sun exposure all had different recommendations and concerns in the recent past. So why all the changes?
As technology and methods prosper, there is an evolution of the different research methods that are followed in order to come up with medical answers. Past experiments are revised, researches are collated, and this collation may reveal different truths. A research method called a meta-analysis collects and analyzes the results of different studies, and this collection of data may change existing recommendations if the summarized evidence proves something different. The vast changes made over the years in health recommendations represents advancements in science. As new strategies come up, past methods are revised. New findings are generated, leading to a change in general theories, expert opinions, and eventually medical guidelines.
The public health implications can sometimes be remarkable. Twenty or so years ago, the recommended cut-off for the diagnosis of Diabetes Mellitus was at 140 mg/dL. When it was lowered to 126 mg/dL as a result of various studies, and due to the increasing number of Diabetes complications, you can imagine the turmoil this caused not only to the medical community but to the general public as well. This also happened when hypertension guidelines were changed to represent a more aggressive stance towards lowering blood pressure. Patients became less confident in their physicians, and in turn, physicians have to deal with accepting the new recommendations.
Scientists themselves make mistakes. Premature generalizations and information biases reveal that even the smartest among us can be prone to error. Whether they admit it or not, they can also be affected by politics or the media. This is not to mention that the promise of a huge payback may also blind their judgement.
And so we go to the problem of changing recommendations for Covid-19. Expect more changes in the future as more data come out. How long can the virus survive in our bodies? What do vaccines do, and how long can they sustain immunity? What about the new drugs – how effective can they be? Will these new methods result in a decreased need for isolation and quarantine?
Note that the reason why Covid-19 was such a concern when it came out was because of its potential to cause death. Then, it was found that there were certain comorbid conditions such as immunodeficiency, chronic illness, and advanced age that makes one susceptible to complications. Now, most infections are mild. Even the infectious agent itself has evolved into different strains with different clinical presentations.
Changes in health recommendations are entirely out of our control. However, for as much as we should trust in new and more advanced technology and the consequential findings, being critical and not accepting everything as gospel truth is important. Every case has a different situation that must be discerned specifically. That is why it is always a good idea to keep in touch and seek expert advice, not just your own judgment. Common sense may not be so common, but in the hands of the common man, it may make things worse.
Learn from the changes. They are here to stay.