A10 EZ RE THE WASHINGTON POST.WEDNESDAY, DECEMBER 2 , 2020
the coronavirus pandemic
BY WILLIAM WAN
AND BRITTANY SHAMMASAmericans heard the pleas to
stay home. They were told what
would happen if they didn’t. Still,
millions traveled and gathered
during last week’s Thanksgiving
holiday, either doubting the
warnings or deciding they would
take their chances.
Now, like any partygoer wak-
ing from a raucous weekend —
feeling a bit hung over and per-
haps a tinge of regret — the
nation is about to face the conse-
quences of its behavior and will
need to quickly apply the lessons
before heading into the double-
header of Christmas and New
Year’s.
Health experts point to several
key takeaways: Many states were
overwhelmed by unexpected
surges in testing — with many
families hoping a negative result
might make their planned gath-
erings a little safer. Some airports
were not prepared for the huge
crowds that had not been seen
since the beginning of the pan-
demic, making it difficult for trav-
elers to maintain social distanc-
ing.
But perhaps the most obvious
lesson: Public health messaging
needs to be retooled, as whole
swaths of the country are simply
tuning out the warnings from
officials and experts.
“We have to rethink how we’re
communicating. Blaming people,
yelling at them, stigmatizing
them — clearly it’s not working,”
said Angela Rasmussen, a virolo-
gist at Georgetown Center for
Global Health Science and Secu-
rity. “We have to show compas-
sion and empathy. Understand
where people are coming from
and persuade them to do other-
wise.”
As bad as the country’s infec-
tions and hospitalizations are
now, they will probably worsen in
coming weeks because of the mil-
lions of interactions that oc-
curred during Thanksgiving, ex-
perts say.
In recent days America’s infec-
tion curve has already become a
sheer mountain-climber’s cliff
with record-breaking case num-
bers and hospitalizations. If peo-
ple travel and gather for Christ-
mas as they did this past week,
they project, the country’s al-
ready catastrophic situation
could reach levels where hospi-
tals are forced to choose which
patients to save and which to let
die, and where lockdowns be-
come unavoidable realities of ev-
eryday life.
“What concerns me is that
Thanksgiving is an American hol-
iday,” said Melissa Nolan, an epi-
demiologist at the University of
South Carolina. “Christmas is an
international holiday — it’s cel-
ebrated around the world. So if
Thanksgiving is an indicator of
how much travel we can expect at
Christmas, I think that is very
concerning.”
Prepare for crowds
The past few days around
Thanksgiving ended up among
the busiest for air travel since the
start of the pandemic, according
to figures from the Transporta-
tion Security Administration.
The agency screened nearly 4.
million passengers between Nov.
25 and Nov. 29 this year. That’s
down almost 61 percent com-
pared with the same time frame
last year, when the number was
11.7 million.
Still, the days around Thanks-
giving made for some of the busi-
est travel times since mid-March,
and many airports saw large
crowds. At Chicago O’Hare and
Phoenix Sky Harbor Internation-
al airports, people crammed into
security lines and around check-
in kiosks, with little space sepa-
rating them, local TV outlets re-
ported.
Experts say airports should be
prepared for holiday surges and
more stringently enforce mask-
wearing, speed up check points
and space out boarding gates so
travelers can stay several feet
apart.
Meanwhile, top officials are
trying to mitigate the damage
already done for this holiday.
Those who traveled during the
holiday should get tested and
avoid crowds, said Assistant Sec-
retary for Health Adm. Brett Gi-
roir.
“Make really sure you adhere
100 percent to mask-wearing, to
avoid crowds because you could
inadvertently have gotten covid
and spread it,” Giroir said on
CNN.‘Time for gloves off’
During this small window be-
tween Thanksgiving and Christ-
mas, the thing most in need of
course correction is the country’s
messaging, many experts say.
“If we see a post-Thanksgiving
surge of cases and deaths, is that
going to change people’s minds
for Christmas?” Rasmussen, the
Georgetown virologist, asked. “I
kind of doubt it, because cases
and deaths were going up already
before Thanksgiving.”
Many people seem to be con-
tinuing to indulge in a kind of
magical thinking and denialism,
as they have all year long. “It’s like
‘I know this is a bad idea, but I
want to do it, so I’ll find a reason
and way,’ ” Rasmussen said.
To counter that, some health
departments put out messages
ahead of Thanksgiving designed
to shock and scare residents into
paying attention. Among the
bluntest messages were images
posted by the Salt Lake County
Health Department on Twitter.
One showed a family smiling for a
photo around a Thanksgiving ta-
ble.
“Everybody say, ‘I was just ex-posed to COVID!’ ” a text bubble
says. The caption offers a stark
warning: “Thanksgiving leftovers
won’t taste as good if you’re on a
ventilator.”
The campaign was intended to
shock people out of pandemic
fatigue, said health department
spokesman Nicholas Rupp.
“It’s kind of time for gloves off,
to be really direct and to say, ‘You
need to understand what’s at
stake here,’” he said.
In Mississippi, health officials’
message was even starker.
“We don’t really want to see
Mamaw at Thanksgiving and
bury her by Christmas,” Missis-
sippi State Medical Association
President Mark Horne said at a
Nov. 12 meeting. “You’re either
going to be visiting her by Face-
Time in the ICU, or planning a
small funeral by Christmas.”
But the problem with such
intensely fear-based messages is
they risk conditioning people to
tune out even more, said Matthew
Seeger, a risk communication ex-
pert at Wayne State University in
Detroit. Those who saw a shock-
ing ad at Thanksgiving may be
even more prone to ignore it by
the time Christmas rolls around.
“It’s like when a hurricane
comes and you issue an evacua-tion order but nothing happens,”
Seeger said. “The second or third
time you hear that evacuation
order, you’re even less likely to
leave.”
Instead of relying solely on
fear-based messages, health offi-
cials need to craft messages that
sound less like schoolmarm lec-
turing and instead make the issue
deeply personal for people. “You
can’t just focus on numbers and
statistics,” he said. “People need
to be able to see the physical
manifestation of this virus in
their lives for their behavior to
change.”
The most effective tobacco ads,
for example, show smokers
speaking with an electronic voice
box after having their larynxes
cut out, and children describing
the feeling of losing their parents.
In Salt Lake County, health
officials have created another
campaign to do exactly that. The
videos feature local residents de-
scribing their personal experi-
ences with covid-19, the disease
caused by the coronavirus. The
thinking, Rupp said, is, “Let’s take
us out of that equation complete-
ly and put it in the hands of
someone they might recognize.”Stick with a unified messageThe other major communica-
tions problem heading into
Christmas is how badly the wa-
ters have been muddied by incon-
sistent and often deliberately
confusing messaging by the
Trump administration and its al-
lies.
Seeger was among a group of
experts who literally wrote the
Centers for Disease Control and
Prevention’s 450-page manual for
how U.S. leaders should commu-
nicate during a health crisis. In
the past year, U.S. officials have
broken nearly every rule in the
book.
Leading up to the holiday, sev-
eral Trump allies mocked health
officials’ Thanksgiving warnings.
Former White House coronavirus
adviser Scott Atlas said people
shouldn’t avoid seeing the elderly
just because health officials say
so: “For many people, this is their
final Thanksgiving believe it or
not.”
Sen. Ted Cruz (R-Tex.) tweeted
an image of a turkey above the
words “COME AND TAKE IT.” He
added: “Twitter Leftists are losing
their minds that we’re not willing
to give up Thanksgiving. Wait till
they find out we won’t give up
Christmas either.”
Those advocating that peoplestay home didn’t always send
clear messages, either. Denver
Mayor Michael Hancock (D) post-
ed social media messages advis-
ing against travel while on his
way to Mississippi to celebrate
Thanksgiving with his family, the
Denver Post reported. He later
apologized.
In these polarized times, it’s
unlikely those conflicting mes-
sages will disappear by Christ-
mas. Going forward, the incom-
ing Biden administration will
need to establish more unified,
but also more nuanced messages.
For example, health experts deal-
ing with a community where wa-
ter has been contaminated, often
give residents multiple strate-
gies: Drink bottled water. If you
can’t, then boil the water.
“Not everyone’s willing to do
the same thing,” Seeger said. “Just
repeating one thing over and over
at some point starts becoming
counter effective.”Make it easier to get tested
The sudden demand in testing
that led up to Thanksgiving
caused hours-long lines from
New York to Wisconsin to Or-
egon, as many sought to establish
they were virus-free before gath-
ering with friends and families. In
Denver, officials shut down one
testing site within an hour of
opening because it reached ca-
pacity. In Olympia, Wash., offi-
cials turned away 200 waiting
cars.
Ahead of Christmas, health de-
partments need to better spell out
for families the limits of testing
ahead of such gatherings. States
and federal authorities also need
to better coordinate public, com-
mercial and university labs, so
that those at capacity can share
their burden.
“Testing itself isn’t a bad thing,
but people started using it to
justify doing whatever they want-
ed,” said Saskia Popescu, an epi-
demiologist with George Mason
University. “And people who real-
ly needed tests couldn’t get them
because sites were overwhelmed.”
Scott Becker, chief executive of
the Association of Public Health
Laboratories, warned that a nega-
tive result doesn’t necessarily
mean you have a clean bill of
health since a person can test
negative in the morning and be
positive by evening, if he or she
was recently infected and is just
beginning to incubate the virus.
“There’s nothing about getting a
one-time negative result that is
foolproof,” he said.
“The best advice is really to
stay home,” he said. “The second
best thing after that is to take a
variety of steps to reduce risk. You
can’t just rely on any one thing.”Heed your own misgivings
For at least one couple, the
warnings and pleas from public
health officials didn’t fall on deaf
ears.
Susan Askew and her husband
made the thousand-mile drive
from Miami Beach to spend
Thanksgiving with her elderly
parents in Delaware. Askew wor-
ried a holiday alone would crush
her parents’ spirits after being
isolated for months.
But along the road — around
the time they reached the D.C.
area — Askew started having sec-
ond thoughts as she thought
about all the warnings from au-
thorities. After learning her
mother was also questioning the
gathering, they agreed to cancel
at the last minute.
“I would not forgive myself if
something happened because I
slipped up,” Askew said.
As for Christmas, the family is
leaning against gathering but will
play it by ear.
[email protected]
[email protected]Why health o∞cials are terrified of a p andemic Christmas
After Thanksgiving travel
surge, o fficials say a
new approach is neededDAVID RYDER/GETTY IMAGES
Thanksgiving travelers wait for security screening at Seattle-Tacoma International Airport. Some airports were not prepared for the huge
crowds that had not been seen since the beginning of the pandemic, making it difficult for travelers to maintain social distancing.SCOTT OLSON/GETTY IMAGES
A coronavirus test site in Chicago. As bad as the country’s infections and hospitalizations are now, they
will probably worsen in coming weeks because of the millions of interactions during Thanksgiving.BY NICK MIROFFInvestigators at the Depart-
ment of Homeland Security are
bracing for a new wave of fraud
attempts by criminal groups that
officials expect will try to take
advantage of the extraordinary
demand for doses of the corona-
virus vaccine.
Pfizer and Moderna, the two
drug companies that applied for
emergency vaccine approval this
week, have said they will produce
enough doses for about 20 mil-
lion people this month. Health-
care employees, law enforcement
personnel and other front-line
workers are expected to be first
in line.
Production will ramp up after
that, but it will probably take
several months for companies to
make enough doses for the na-
tion’s entire population of
330 million. Fraudsters looking
to exploit that unmet demand
are a concern for Homeland
Security Investigations (HSI), a
division of U.S. Immigration and
Customs Enforcement (ICE) that
announced a new operation this
week to stop them.
“We’re especially concerned
about financial fraud schemes, as
people who are thinking they’re
going onto legitimate websites
are asked to provide financial or
personal data,” said Steve Fran-
cis, the assistant director for
global trade investigations at ICE
and the head of the agency’sIntellectual Property Rights Co-
ordination Center. “We’re trying
to stay ahead of these criminal
organizations, who are very cre-
ative in finding ways to try to
exploit people.”
During the first phase of the
ICE operation this spring, the
agency targeted criminals who
were trying to ship counterfeit
personal protective equipment,
such as fake N95 masks, as well
as phony tablets of drugs like
hydroxychloroquine, an unprov-
en treatment that President
Trump has repeatedly promoted.
ICE has opened more than 700
pandemic-related criminal in-
vestigations since April, seizing
$27 million in illicit profits and
shutting down 70,000 website
domains, Francis said.
The agency is more worried
about data theft and financial
fraud than criminal groups ship-ping fake vials of the vaccine,
Francis said: “We’re concerned
that people will go online search-
ing for ways to become vaccinat-
ed, and they will be asked to
register to receive treatments by
providing personal identifying
information.”
Approximately 85 to 90 per-
cent of the work of the Intellectu-
al Property Rights Coordination
Center in recent years has fo-
cused on counterfeit goods pro-
duced in China and Hong Kong,
but the pandemic brought a
rapid diversification. Investiga-
tive teams have disrupted fraud
schemes and seized goods from
at least 40 countries this year,
Francis said.
“This is a global pandemic,
and with PPE in high demand,
criminal organizations all over
the world pivoted to that,” he
said.While ICE is best known for its
Enforcement and Removal Oper-
ations division — responsible for
arresting and detaining immi-
gration violators — its investiga-
tive branch is one of the federal
government’s main tools for root-
ing out fraud and interdicting
counterfeit goods.
“We will continue to use our
broad legal authorities and long-
standing relationships with do-
mestic and international law en-
forcement agencies and private
sector partners to address this
emerging public health threat,
and will sustain our efforts to
disrupt and dismantle criminal
networks seeking to profit from
the covid-19 pandemic,” Derek
Benner, HSI’s top official, said in
a statement. “ICE HSI has been
at the forefront of the govern-
ment’s investigative response to
covid-19-related crime since theonset of the pandemic and will
remain a leader in the fight to
prevent vaccine fraud and to
protect the health and safety of
Americans.”
Homeland Security officials
are working with drugmakers to
ensure that vaccines and other
products are clearly labeled,
Francis said. The companies will
set up hotlines to gather tips
about potential fraud.
Francis said the first ship-
ments of vaccines distributed in
the United States will be pro-
duced domestically, but as pro-
duction also increases globally,
customs officials and other in-
spectors will continue to work
with companies to keep fake
products out of the market.
Both the Pfizer and Moderna
vaccines will require two doses,
spaced several weeks apart.
[email protected]With vaccines coming, federal investigators are on the lookout for fraud
Financial schemes,
data theft are main
concerns, officials say