When Narrative Takes Flight

If you would believe it, I have submitted three notes with this exact dumb mistake. I’ve only been fortunate that my editor caught it both other times. Thank you for spotting it for me (once again).

However, your comment must remain up as a badge of my dishonor and shame!

No issue with your central points about MSM framing around vaccine issues. And you correctly noted the MSM had ignored relevant issues such as bailouts and employee workloads/exhaustion. But I would point out two other SWA narrative issues, based on my career in aviation

1. Every article I saw uncritically quoted SWA managemnt claims that the problems were explained by weather and ATC. But even the articles that noted that no other airlines had been badly hurt by weather and ATC (usually buried in a later paragraph) failed to highlight the contradiction, or to openly tell readers that management’s claims were dubious, or even bothered to ask SWA why people should accept their claims when no one else was affected?
2. No article included anything that would cause readers to doubt the longstanding narrative that SWA is an incredibly dependable well run airline with wonderful employee relations, despite the evidence from last week’s debacle. In fact their operational and IT systems have been second rate for decades, and the days of management and employees marching together arm-in-arm ended a long time ago. Not to say SWA is a bad airline, but reporters are working strictly within a manufactured PR image that no longer reflects reality. Similarly, reporting still assumes that SWA fares are always lower than the Legacy airlines when that also hasn’t been true for a long time. Antagonisms between management and staff (especially pilots) at SWA have been high for years, partially explained by boneheaded managers living off the goodwill Kelleher created 25 years ago, and partially explained by pilot militancy.

Perhaps the problem wasn’t totally driven by media desire to shoehorn SWA’s meltdown into an unjustifiable vaccine framing, although I’m sure that’s what happened with outlets focused on their owners’ political objectives. But in many MSM outlets, it seems the problem was that reporters couldn’t deal with a story that contradicted the official SWA-is-pretty-wonderful narrative and were struggling to come up with anything (including unverified twitter/facebook posts) that might possibly provide an alternate explanation

Hubert, I think both of your points are 100% correct, and I’m grateful to hear your expertise.

I think that I at least tap-danced or alluded to the first point you made in some ways, but your second point, the more specific existing Southwest narrative, is spot on, too. Everything that everybody knows about SWA probably affected the willingness to challenge certain implications of the inconsistency. In fairness, I think that will probably happen to some degree in the latter part of this news cycle that unfolds over the next week or so, but it has not yet.

Even speaking personally, it’s hard for me to overcome the good brand equity SWA has in my mind/heart.

I don’t disagree with the idea that a private entity should be able to mandate certain things such as a vaccine, but there needs to be discussion around whether these companies are truly private anymore. After being bailed out by the government, it’s easy to see how many of the organizations will do whatever is directed to them so that they can remain eligible for that sweet sweet bailout in the future.

One of the first thoughts I had hearing about Southwest, which airline will NOT require vaccine and advertise it? Highly doubtful, but it is 2021.

A guy I graduated with, is a pilot for Southwest. he generally post very positive messages saying that he loves the company, but did post a negative meme yesterday about not getting the vaccine. If I had to guess, I’d say vaccine mandate fade for Southwest.

Completely off topic, but the other thought I had when watching Blue Origin yesterday, we remotely pilot capsules to space but are still relying on pilots for air travel. I know, I know, a lot more hurdles to get to pilotless flying, but I preprogram every mission on Google maps with my drone and have for a few years now.

I think we were pretty clear in saying we both see vaccination as a civic duty and in not identifying pre-existing infection as identical but as being comparable in meaningful ways. Hybrid immunity, as I’m sure you know even better than we, also demonstrates powerful synergies, and so we would not only agree with but reinforce your very fair points.

But from a policy perspective, we think that the treatment of natural immunity as a non-entity closer to the absence of immunity is a major narrative error, hence our position on this. That is, we see letting the perfect be the enemy of the good as a fatal flaw in the present political environment.

First, that’s great info. And it makes me want to ask more questions. But that’s so insignificant to the one key point you make. You’ve identified the biggest problem as Rusty’s note addresses. I’m just thankful to hear a true medical expert actually acknowledge it, because my guess is that you are the only way out, except for mass social unrest or war. But I know that you are one way out that will work.

Now what to do about it? I personally think the fastest fix would be for very public humble pie by heads of both organizations, followed by resignations. Even if Fauci simply said,
"yes, when we told you at first masks weren’t helpful, and to wash your hands because it isn’t airborne, we were trying to avoid panic and profiteering so that our front line workers could get masks. We should have admitted this sooner. We should have earlier than today admitted our failure to require hospitals stock PPE during prior scares of Sars1, MERS, Ebola, bird flue, H1N1, etc. especially before adding water features to lobbies or another layer of administrators.

Looking forward from this once in a lifetime health crisis, I believe my successor has learned that being completely forthright with what we know, and admitting where prior guidance ended up being shown as likely wrong with new information, is important even concerning information.

That failing to treat the public as adults, but instead trying to manage to desired behaviors opens the door to wild conspiracies and destroys the authority and credibility of this organization in enough minds to more than jeopardize any expected benefits.

Here’s my successor, who was thoroughly investigated by Fox News and CNN and Shawn Hannity and the NYT, etc. and found to have no possible involvement or connection with anything related to the NIH grant to WIV or Trump or Biden or whatever other objection du jour to tell you what we know at this moment about natural immunity and vaccination for various strains and over time."

Now

1. They’re not going to do that on their own until it gets a lot worse, which terrifies me,

2. It won’t convince everyone, but it will convince some and others will be more likely to move beyond the denial / anger / bargaining stages towards acceptance.

3. It’s not going to happen unless experts demand it, first privately, then publicly. Right now the “experts” are MDs from low end med schools with unrelated specializations, wearing lab coats in front of cameras with the time and energy to organize, create websites, jump on social media, and travel around speaking. Or even my kids’ seemingly dementia suffering biology teacher (Biology BS), on local news calling herself an immunologist before making claims about masks and test accuracy.

4. I know that you actual experts, you are tired- more tired than you have ever been. And you are emotionally spent, numb even. You have nothing left in the tank. You are not hiding in your home in fear. You are still fighting, or just getting a few hours of sleep, or trying to catch up on EMRs. You have been spending endless hours in labs running tests, tracking strains, or in the ED fighting to save lives, now for those fearful of a small risk vax suffering a bigger one given their comorbidities. You have missed a few years of your life and family. But for those of you 45+, that’s why your residency was unbearable. You were being prepared exactly for this. You know how to do this. You know you can. WE NEED YOU TO.

5. If nothing changes, I also fear the medical profession takes a credibility hit that could take decades to recover. Fauci and Rand Paul may currently be the faces of your profession to the public.

If you don’t / can’t, if you retire or switch careers after this, I won’t blame you. This has been and still is your generational professional war. Nobody blames a soldier with PTSD for retiring. They are still honored for their contribution.

You know better what needs to be done. It probably seems too daunting. One step at a time. Elephant bites and all. Here’s my thoughts that I don’t think you need:

1. Call out the top-heavy healthcare bloat. 3 layers of high comp management was an unacceptable drag in crisis, whose policies forced decisions into bureaucratic hell hole. Whose building monuments with their names on cornerstones instead of stocking a large room with PPE, or adding ED beds, actually killed people, even their own employees. Yet they worked from home for safety while collecting 6 or 7 figure comp (and now 2 or 3 layers of hierarchy). Demand change. Back to MD at the top with business manager as assistant. Board of community and physicians. Simple. Nimble. Efficient. No more studies by someone earning $500k on how to save $100k by making RN work even harder.

2. Organize locally. Have community outreach. Both in person and streaming online. Answer questions. And please, please, debate answers. Show the public that not everything is known or absolute, but what can be taken from that, especially for certain risk categories. Encouraged people to pursue general health. Speak the unspeakable. If you wouldn’t have your family living in an NYC high rise with shared air handling and little outside exposure, then say it. Use the same group to talk to local and state officials and school boards, and not just in back channels. Let the public know they are getting expert advice. You don’t have to say someone is an idiot. Show your credentials, state the facts as you know them to be, not as you were told by an org only half the people will trust. The other person will have violated the “better to be thought a fool, than open your mouth and remove all doubt”.

Lastly, thank you again for all you have done and continue to do to help us get through this. And I am sorry for the so many times you have been discouraged because it seems like nobody is listening. I think it’s often because the wrong people, with plenty of time, debatable motives, are taking advantage of the confusing and silent fog to talk the loudest. Lots of people are ready to shut off the 24 hour news and go on with their lives once you tell us how.

I think it’s undoubtedly true that acting as though natural immunity were non-immunity would increase vaccination rates, and I think increasing vaccination rates is an unequivocal social good. I think relying on that method also carries social costs, and it sounds as though I may apply somewhat more weight to those costs.

I’m an ER doc. There is currently an oversupply of ER docs since the big ER staffing companies have come to own many of the residency programs.

I would love to call out all the bloat and regain a little control over my own work environment.

But I work for a big ER staffing company. The bloated managers at that corporation pay me a little bit, and if I call them out, they will fire me. But they own the means of production (or rather my contracted hospital does, but same thing effectively in our big-fish-eat-the-little healthcare economy). Then I’ll have to spend more time at my lower-paid second job to feed my kids and I’ll have even less time to call them out.

So, mostly I just whine about all this to my ER nurses. They, in turn, whine to me about how vaccine mandates are evil and vaccines are not our civic duty. I humor them because the alternative gets ugly.

(Oversimplifying for brevity.)