Q&A: Dr. Lucy McBride ’95 on COVID-19, Risk, and Mental Health

Dr. Lucy McBride ’95, a practicing internal-medicine physician in Washington, D.C., began a newsletter last year addressing COVID-19 and mental health. With facts, science, and humor, she puts pandemic headlines into perspective and helps her readers fight coronavirus anxiety. 

As the pandemic begins to lift, McBride spoke with PAW about how to recalibrate our thinking about COVID risk.

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Courtesy of Dr. Lucy McBride ’95

We know the vaccines are safe because of robust clinical trial data and the real-world data on safety.

There’s a lot of misinformation and confusion. One of the things people are confused about is they think the mRNA (in the Pfizer and Moderna vaccines) is going to affect your DNA and that it’s part of the virus. It’s not. It is a protein that gives your body the instructions to make antibodies against the spike protein of SARS-CoV-2 (the virus that causes COVID-19). It then gets degraded in your body and goes away. It’s like giving someone a paper recipe to bake a cake, and then the recipe gets thrown away.

The other misconception people often have about the vaccines is that they were rushed. The name Operation Warp Speed was an unfortunate name because it somehow suggests the process was rushed when no corners were cut. It was just an all-hands-on-deck effort to get the technology figured out. The trials were done in very sophisticated, careful, thorough ways.

In the news, we’ve heard a lot about variants and the need for booster shots. Should we worry?

The reason you would need booster shots is if the virus mutates in a way that escapes the immune protection conferred by the vaccines. That has not happened yet. Nor do we expect that to happen, given how quickly we are crushing the curve and how robust we know the immune response to be from these vaccines. It’s just not anything that anybody should be worried about. 

Let’s worry about what we have to deal with now. Let’s worry about Americans who are hesitant to get the vaccine, not whether you need a booster. Could the sky fall? Sure. But it’s probably not.

Read PAW’s Tiger of the Week about Dr. Lucy McBride ’95

When I read the news, rarely do I hear anyone put it the way you do — look how amazing this vaccine is. Look at how robust it is.

David Leonhardt at The New York Times is one of the lone journalists writing about, why all the negative news about variants when it’s just not important? What’s important is these vaccines are the clear ticket to normalcy: Your risk of getting COVID-19 is dropped to 0.0005 percent. If you’re in that tiny category of people that does get COVID after vaccination, you’re going to get a cold or a mild illness, most likely. 

Are there exceptions? Yes. But the vaccines are stunningly effective against the virus. They take death and severe disease off the table. They prevent transmission and they cover all the variants. 

People have this irrational fear, out of proportion to reality, because they aren’t hearing from sane, rational voices who are doctors and scientists being like, dude, if you’re vaccinated, go live your life. 

What’s “coronaphobia,” and how we should be thinking about risk when it’s low, but not zero?

I wrote an article for The Huffington Post about what I call “coronaphobia,” and I also wrote a piece for The Washington Post about what I call “fear of normal,” or FONO. What I’m seeing is an epidemic of unbridled fear that is basically the reverberations of the anxiety that we all experienced when the pandemic was happening in full force. As the pandemic comes under much better control, we need to shift our thinking and then our behaviors to reflect reality. 

The way we combat those feelings of vulnerability and fear is by framing risk and putting data in context, and not getting swept up in headlines. Understand the nuances of your particular situation, your particular risk profile — which, if you’re vaccinated, is as close to zero as it can get without being zero.

One of my favorite lines that I’ve been saying is, we’ve never been promised a risk-free existence. We can’t tack the risk down to zero, and nor should we, because tacking down to zero has enormous costs to society. If we’re going to wait for zero COVID to reopen schools, allow people to reconvene with loved ones, and go back to work, we are just exacerbating further diseases of despair and depriving people of reaching their broader human needs. 

We need to realize how extraordinarily effective the vaccines are, how extraordinarily liberating they should be to the way you think, feel, and behave.

Should young children go to schools and summer camp when they can’t get vaccinated yet?

The risk of COVID-19 is really, really small in kids. It’s a smaller risk than the seasonal flu. We don’t close schools and mask kids in flu season. We have somehow as a society, quote-unquote, “tolerated” the fact that hundreds of kids die from the flu every year. This virus has generally spared children, particularly young children. So in my view, and in the view of many people I know and respect in academia and immunology and virology and public health, schools should be open, camps should be open, the little ones don’t need to be wearing masks outside even now. And then of course if they get infected, the risk is of transmitting it to an unvaccinated adult, but most adults are going to be vaccinated by July. 

If you’re under 11, the risk of getting COVID is teeny, and the benefits of them going to camp, going to school, playing on the playground, and hanging out with their buddies is huge. If I had a 5-year-old, they would be outside unmasked, going to camp, and licking the playground equipment — as long as I’m vaccinated and my parents are vaccinated. This is where nuance matters and people need to speak to their pediatrician and understand what the risks are.

At the beginning of the pandemic, we were told, “Hide in your home from this virus.” It’s so hard to think now that it’s OK to be exposed.

That’s where we’ve failed in the public-health narrative. We haven’t practiced harm reduction; we’ve been practicing scare people to reduce risk to zero. 

The most interesting thing to me about the pandemic is how it’s laid bare the critical importance of addressing our mental health. Mental health is health. If I have one takeaway for people, it’s to think about your mental health like you do any other organ system. We need to recognize that whether or not you had COVID-19, during the pandemic you experienced some sort of loss and grief, and that is part of your health. And so addressing it like you do any medical issue is healthy. 

Interview conducted and condensed by Elisabeth H. Daugherty