I was originally going to write an article this week about a certain Atlantic article that encouraged people to travel with their unvaccinated children, because they’re “just like vaccinated grandparents”…but! We all know what’s wrong with that, and so I’ll instead talk about something with a lot more room for nuance – COVID’s endgame, and at what point we can accurately say that this is all over.
The history of disease eradication is worth mentioning for a minute. I hear the phrases “get rid of COVID” and “eradicate COVID” tossed around a lot, but we need to move away from that rhetoric, and grasp the fact that eradication just doesn’t happen. Out of tens of thousands of diseases, we’ve only completely obliterated one – smallpox. We’re close with polio, but the rise of anti-vaccination sentiment and les impasses politiques have stalled the WHO’s home stretch in the last remaining parts of the world, including Pakistan, Afghanistan, and Nigeria. However! We’ve removed 99% of polio from the world. You, me, and our children and neighbors can live our lives without real risk of being paralyzed by this incurable disease, and that’s not insignificant. Stamping out disease and incinerating it down to the last remaining spike protein is so far beyond what’s possible for us today, heavily due to the anti-vaxx movement. If it still has not been possible to eradicate polio, an effort beginning in 1955, stalled by an anti-vaxx movement that exploded in 1998, why do we assume that we can eliminate COVID in 2021 following the presidency of a deranged man who spewed misinformation every time he opened his mouth or the bird app?
So with that, it follows that it’s a little naive to shape our rhetoric around “getting rid of” COVID and getting to zero cases, or 10, or even 100. We should instead aim towards adding COVID to the roster of illnesses that we just have to think about from time to time. The best comparison that comes to mind is influenza – from the “Spanish” (read: Arkansas) flu of 1918 to the spread of H1N1, many forms and mutations of influenza have been around for centuries. But each new “variant” of the flu doesn’t induce mass hysteria – we have a flu season every year, so we take the flu shot, are a little more sanitary than normal, and a little extra careful of people with sniffles. And if you do catch the flu? Chances are you won’t be hospitalized, but we’re equipped to treat you either way. That’s the endgame.
The way I see it, COVID and flu seasons will probably end up coinciding, and we may just see a lot of people wearing surgical masks in public spaces during these times – I know I will be. We may just be taking booster vaccinations for years down the line, and that’s okay. Eventually, the novelty of COVID will wear off and we’ll be habituated with this disease on our roster.. and that’s okay.
Vaccinations are undoubtedly the biggest catalyst that the US has right now to “end” the pandemic, and thanks to the Biden administration throwing all their weight behind the effort, we’ve been able to keep a neck-and-neck speed with the variants. I have as much distaste for Biden-Harris as the next leftist, but this explosive pace would not exist if another party were in power. (If you want another read on vaccinations and the end of the pandemic, check out Saagar’s article. Just ignore the part where I’m slandered as anti-J&J). But even with the exponential growth of vaccinations, positivities are still around, and even rising. Why?
The number of positivities says absolutely nothing about how many people are actually sick. The PCR technique makes it so that a small segment of a piece of DNA can be magnified over and over and over to detect positivity. Think of it like zooming in on your DNA, detecting the smallest amount of COVID, and blowing it up to display on a billboard. This is why PCR is so much more sensitive and accurate than a rapid test.
A year ago, 3000 cases per day meant a large number of those 3000 people going to the hospital, a lot of them being symptomatically ill, and none of them vaccinated. Today, 3000 cases per day can more likely mean many of them are asymptomatic, residually positive from a prior infection, vaccinated and protected, mildly symptomatic, with a much smaller proportion of people who are seriously ill. This is the biggest flaw in analyzing a pandemic from a statistical/numerical perspective – you miss the nuances of the big picture. Hospitalizations and deaths are not at all where they were. From personal observation, COVID cases in the ER are more an anomaly now than the norm. A positive COVID test today isn’t the death sentence that it would’ve felt like a year ago – and that’s a step towards the endgame we want.
Morally, should our end goal be to eradicate disease? Is that our obligation, given that we have the technology? Probably. But how many decades and billions of dollars are we going to funnel into every single disease on this earth? To what end? How much of measles are we okay with, and in what country are we okay with it existing? The moral solution would be to eradicate disease, yes, but that solution exists in a fantasy. In the real world, our goal has to look more like flu season: bringing cases down to a point where we can go about our daily activities without having to analytically think about whose germs we’re breathing in. If that comes at the cost of wearing a mask and being a little less social for a couple of months per year, so be it. The most basic pillar of life is that we’re hardwired to adapt to a changing environment, and mold our survival and livelihoods around all the curveballs that are tossed into the mix. So it goes.
Feel free to reach out to talk about any of this – this piece is really heavily my personal speculation, and I’d love to get into it further!
Appreciate the plug!!!