In recent days, this type of talk is very common coming on the heels of President Biden’s speech and updates to CDC isolation and quarantine guidance that very much concretize the endemicity of COVID-19. By articulating a sustainable and practicable scientifically informed path forward, these plans are part-and-parcel of a very successful public health policy known as harm reduction.
Rooted in the world of HIV, hepatitis C, sexually transmitted infection prevention, as well an injection drug use, harm reduction identifies the fact that individuals will take risks and providing them with guidance to modify risks has great value. Counseling abstinence fails and serves to drive risky behavior underground devoid of any attenuation.
Unlike the other infectious diseases, the approach to COVID-19 this past year (and stretching back to the early days of the pandemic) has been one consistent with an “abstinence-only” approach that eschewed any risk-taking. By promoting such an approach — that was not practicable by many — not only was behavior driven underground but the ability of the public to risk calculate was stunted.
Chastising joggers without masks, lamenting high passenger volumes on airplanes and scowling at Disneyland attendees, the advocates of abstinence jettisoned everything we learned about public health communication from decades of research and practice from the realm of harm reduction.