The Lancaster County Health Advisory Council is looking to review the local response to the Covid pandemic at the suggestion of one of its members, who contends the Amish community’s laissez-faire approach to preventive measures was better than the active measures endorsed by mainstream authorities.
“If you think about it, they actually got a lot right that we that we didn’t,” Dr. Brian Cicuto told his fellow council members Friday at the council’s bimonthly meeting.
Specifically, he said, the Amish didn’t mask, didn’t socially distance, didn’t shut down schools or businesses and did not try to mandate vaccines when they became available.
Regarding social distancing, “we know that that 6-foot rule was made up out of nowhere,” Cicuto said. Lockdowns, he said, contributed to the social and mental health concerns being seen in schools.
As for masking, “we know that masking doesn’t control nor prevent the spread of the virus,” he said. “… I think the Cochrane review last year that came out finally put that to rest, even though most of us knew ahead of time that they really didn’t do anything.”
His views are supported by science, Cicuto said, but were ignored at the time and have been since. Meanwhile, health systems are doubling down on “irresponsible decision making,” he said.
“Going forward, this fall flu season, we don’t want to make those same mistakes again,” he said.
‘There needs to be a balance’
The other council members welcomed the idea of reviewing the pandemic response. Several, however, said there is more to the Covid story than Cicuto was asserting.
For one thing, there is data out there that supports masking, said Deborah Willwerth, president of UPMC Lititz.
“There needs to be a balance,” she said. “It can’t be, you know, completely one way or another.”
Union Community Care provides medical care to Amish and Old Order Mennonite patients through its Plain & Healthy program. The community has many public health strengths, the health center’s President Alisa Jones said, including active lifestyles, healthy eating and strong social bonds, and they deserve to be acknowledged.
Regarding Covid, it’s essential to understand what saved lives and what put populations at risk, she said. Families, including hers, lost loved ones to the virus, and that has to be front and center in any conversation.
“I don’t think we can discard things that absolutely protected people, and the data is there,” she said.
Cicuto said he would welcome a respectful, data-driven discussion.
The county commissioners created the Health Advisory Council in 2021 and reauthorized it in 2023 As Cicuto noted Friday, it has no power to set policy or implement health measures itself. Rather, it provides data and recommendations to the commissioners, who then decide on any action.
Accordingly, much of its work involves hearing from subject-matter experts on various topics. Much of Friday’s meeting consisted of a presentation on human trafficking and the fight against it, led by Executive Director Melinda Clark of the North Star Institute and Andrea Smith, assistant director of YMCA Lancaster’s Sexual Assault Prevention & Counseling Center.
The conversation initiated by Cicuto was listed on the agenda as a “discussion on the importance of planning for underrepresented communities.” Those include faith-based communities, he said, and they should be brought to the table and heard, so that going forward, they’ll have “faith and trust in us that we’re going to do the right things.”
The Amish approach to Covid
It’s broadly agreed that the Amish didn’t follow pandemic mitigation guidance.
After the initial lockdown, they “completely ignored the rules,” Allen Hoover told One United Lancaster. Hoover is the director of the Parochial Medical Center, a clinic based in New Holland that caters to Plain Sect populations.
They masked in mainstream public settings to some extent, he said; but within the community it was business as usual. That included church services, communion from a common cup and the custom of lip-to-lip “Holy Kisses.”
The result? A wave of illness and death, Hoover said. Covid “went through the Plain community like wildfire.”
And then it was over, he said. When the second wave came through, its impact was “much, much less than the first.”
As for vaccination, it isn’t widespread among Plain Sect communities, but most elderly and immunocompromised individuals have been vaccinated, Hoover said. There isn’t a “blanket aversion” to the vaccine per se, but there was to the political push that surrounded it, he said.
So, was the Amish approach successful? Evaluating it would necessitate, at minimum determining how many community members fell ill and died of Covid. One would also want to adjust for factors such as age and health status.
However, reliable numbers simply don’t exist, Hoover said. They could have done better than mainstream society, or they could have done worse.
The Parochial Medical Center itself has some of the best documentation of Plain Sect Covid cases, perhaps even the best, but it’s nowhere near to being complete or definitive, he said.
“That’s absolutely correct,” he said when asked to confirm the absence of sufficient data.
The Lancaster Health Advisory Council meets every two months at the county Public Safety Training Center. Its next scheduled meeting is Friday, Nov. 1.
Covid public health measures: The current consensus
In the years since the pandemic, officials have acknowledged mistakes, even serious ones, in public health guidance and policies that were promulgated, especially in the early days when data on the novel coronavirus was limited and uncertain.
Experts warn, however, that those reevaluations have frequently been exaggerated in the media and online. Here’s a brief overview:
Masking
In January 2023 the Cochrane Library released a review of studies examining masks’ effectiveness in reducing viral illness. The authors wrote that wearing surgical masks in public “probably makes little or no difference” and that the effectiveness of N95 masks is “very uncertain.”
Many reports summarized the findings as “masks don’t work.” However, in a follow-up statement, Cochrane called that “an inaccurate and misleading interpretation.”
Third-party commenters noted that the study’s material was limited to random controlled trials, mostly considered viruses other than Covid and covered tests that involved advising people to wear masks, not the results if they actually did. There is abundant evidence from lab and epidemiological studies confirming that masks indeed work if adopted and used correctly, they said.
6-foot distancing and lockdowns
In January, Dr. Anthony Fauci told a Congressional panel that the CDC’s 6-foot-rule was “an empiric decision that wasn’t based on data.” The rule, stricter than that applied in many other countries, was burdensome: Former Food and Drug Administration commissioner Scott Gottlieb called the rule “probably the single most costly intervention of the pandemic.”
Among other things, the difficulty of applying it in congregate settings was part of the rationale for widespread school lockdowns. Officials now agree that was counterproductive.
School closures “did not significantly stop the spread of Covid, while the academic harms for children have been large and long-lasting,” the New York Times reported in March.
Lockdowns contributed to a huge spike in unemployment and a sharp recession, hammering the U.S. economy. Government relief spending contributed to a fast recovery, but also, along with supply chain snarls, to inflation, which rose above 9% in 2022 before subsiding.
Researchers say the 6-foot rule appears to have stemmed from earlier guidelines, coupled with a conjecture, subsequently disproved, that the covid virus was transmitted on droplets breathed out by infected people, which would fall to the ground within a few feet.
That said, it is still the case that infection risk declines with distance, even if there isn’t a sharp cutoff. Researchers during the pandemic did find correlations between social distancing and lower infection rates.
Economic and social impact aside, the net health effect of masking, social distancing and lockdowns was positive, according to the Brookings Institute. Its analysis suggested that they slowed transmission significantly until vaccines became available, saving a net of about 800,000 lives.
Vaccines
Lastly, while vaccine mandates present thorny ethical and political challenges, the safety and effectiveness of Covid vaccines is well documented. Through the end of November 2021, Covid vaccines prevented more than 1 million U.S. deaths and 10.3 million hospitalizations, according to the Commonwealth Fund. Those who remained unvaccinated died at significantly higher rates than those who received the shots.
