Chronically Epidemic

Top Stories of the Year: #5

It is time for me to count down the top stories of this year, particularly as covered in The Tracinski Letter.

Story #5 is at #5 for a reason, though not for a very good reason: because we all just stopped talking about it. I haven’t even covered it much since the beginning of the year, partly because there was so much else going on, and partly because nobody wanted to hear about it.

But just because we’re not talking about it doesn’t mean it went away. I am referring, of course, to the covid pandemic. At the beginning of the year, the best estimate is that somewhere around 850,000 Americans had died from covid. By the end of this year, that number will be over 1.1 million—more than 250,000 additional deaths. That’s a lot of people. Once again, for the third year in row, covid will be the third leading cause of death, just under heart disease and cancer. Yet we’ve all pretty much stopped talking about it, at least in America.

So let’s talk a little about it as we reach the end of the year.

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Partly, this is just “covid fatigue,” the natural unwillingness to maintain an abnormal set of conditions over a long period of time. So instead of maintaining precautions, we simply become inured to the consequences and accept deaths at a level we would have regarded as an emergency in the Spring of 2020.

I watched this happening with some dismay in January and February of this year—even as the Winter wave of covid was cresting and about 50,000 people died over a period of a month. As I warned in February:

If you go onto conservative Twitter, you could imagine that the pandemic must be over and done with, and it’s ridiculous to think we still need to do anything to mitigate it. But if you look at the actual numbers, you realize that the pandemic is not over at all. Thousands of Americans are dying from it and tens of thousands more are going to die.

On the great collective hive mind of Twitter, you could see the consensus on the right and center-right flipping against taking any covid precautions. And more: It flipped from opposing them in the future to retroactively opposing all of them from the beginning of the pandemic.

This has persisted as a partisan effect. A recent set of not-so-exciting blockbuster revelations about content moderation decisions on Twitter revealed efforts to quash the distribution of tweets by Stanford professor Jay Bhattacharya. But the reason for it? Among other things, Bhattacharya had denounced as “lockdown by stealth” the practices of “mass asymptomatic testing & quarantines.” As a similar sign of the times, Florida Governor Ron DeSantis just announced that he will be convening a grand jury to “petition the state’s Supreme Court to convene a grand jury to investigate ‘any and all wrongdoing’ with respect to the COVID-19 vaccines,” hinting that “In Florida, it is illegal to mislead and misrepresent, especially when you are talking about the efficacy of a drug.” It is a transparent attempt to appeal to the anti-vax crackpot fringe that is becoming mainstream in the Republican Party. And there is a growing constituency for this, as evidenced by the many conservatives who celebrated the Canadian trucker protests, which as I argued in February, were largely built around fear and suspicion of the vaccines. As I warned:

It is possible to adopt a pro-vaccine and anti-mandate position…. But this is a sophisticated and nuanced position, and that’s not the mental style of most conservatives these days. Hence, the anti-mandate position tends to collapse into an anti-vax position. From there, it becomes anti-mask, anti-social distancing, anti-quarantine, and pretty much opposed to any anti-pandemic measure.

So as the covid pandemic has been absorbed into the culture war, the right has turned against the most basic infectious disease measures going back 700 years, from quarantine to vaccination.

As for the actual efficacy of the vaccines, I found a great table compiled from studies on the efficacy of different vaccines across different strains of covid. Note that the main targets of the antivaxxers, the new and supposedly scary mRNA vaccines from Pfizer/BioNTech and Moderna, are also the most effective at preventing both infection and serious disease. They were at about 90% and above on both of these tasks for the earlier strains of covid; they are still about 50% effective at preventing infection from later strains and more than 70% effective at preventing severe disease.

According to one study, covid vaccines have so far prevented 18 million hospitalizations and 3 million deaths in the United States, and another study projects that vaccines could have prevented an additional 300,000 deaths if more people had taken them. These are just projections based on models, but they are very plausible given what we know about the efficacy of the vaccines.

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This explains the other reason no one wants to talk about covid anymore. Pandemic fatigue cuts both ways. Some people don’t want to hear anything about covid because they refuse to take any precautions—and the rest of us are just tired of arguing with them. This is the “live and let die” stage of the pandemic that I wrote about last year.

Partly, this represents the bifurcation of the pandemic. Those who are willing to take covid seriously and continue taking precautions against it—at minimum, getting vaccinations and all of the boosters—have done so and are not dying at high rates. Those who dismiss covid as a hoax and don’t want to take any precautions will die at higher rates but have already committed to accepting this.

Mostly, though, the debate has been shifted by the omicron variant and its subvariants like BA.5. The omicron variant still appears to be somewhat less deadly than the original strain of covid, since it tends to affect the respiratory system higher up, in the nose and throat rather than deep down in the lungs. But it makes up for that by being so much easier to spread. As I calculated early this year, “If half as many people need to be hospitalized, but twice as many people are infected as in the previous waves, you end up with the same number of people in the hospital.”

One effect of the omicron variant is that many of the anti-pandemic measures people were taking in the first year of the pandemic became less effective. Vaccines provided less protection, as did masking. So this has been one driver of the decision to drop precautions. After all, why bother if it’s not working, anyway? But as we saw in the chart above, a less effective mRNA vaccine is still very effective. And wearing a mask in public places may provide less protection than it used to, but there is still a case for doing it—even if, depending on where you live, a lot of people will look at you disapprovingly for it.

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At the beginning of the year, I had speculated that the omicron variant might be so infectious that everyone would just get covid, and we would finally reach “herd immunity.” But we are still far away from this point. The best estimates indicate that about 100 million people have had covid, roughly 30% of the population. And even those 30% are not fully protected, because the omicron variant also has the ability to reinfect, with each reinfection increasing your risk for “long covid,” a nasty disease caused by damage covid inflicts throughout the body, not just in the respiratory system.

There has been some talk about covid becoming “endemic,” which is less comforting than you might think. It turns out that the term “endemic” has not been that well defined. It is not the same thing as “herd immunity,” and it does not mean that a disease is no longer deadly. It means, at most, that the rate at which it kills becomes more predictable, but not necessarily lower.

The best way of describing covid in America is that it is a “controlled pandemic” or perhaps that it is “chronically epidemic.” It will continue to roll over the population in waves, killing significant numbers of people. By some estimates, it may continue to do so for a decade before the population is hardened enough, from repeated vaccination and repeated infections, to acquire the same resistance we have toward the ordinary flu, which is itself a vestige of the big, deadly Spanish Flu pandemic of 1919.

Speaking of which, there are warnings that this Winter season will be a “tridemic”: another covid wave, combined with a worse-than-usual flu season, combined with a surge in RSV, another respiratory virus.

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The part of the covid story I covered most as the year wore on is the collapse of China’s “Zero Covid” lockdown policy.

What we called “lockdowns” in the US were for the most part “stay at home” orders that were lightly enforced, with many exemptions. But in China, they take the “lockdown” part very literally. When a building is locked down, residents can be literally wired and bolted into their apartments. China’s lockdowns have ranged from house arrest to literal imprisonment, imposed sometimes for months at a time on cities with millions of people.

This is the authoritarian approach to a pandemic. A dictatorship is not good at a technological or administrative task like developing or deploying vaccines. (Notice the very low effectiveness numbers for Sinovax in the table above.) But it is very good at locking people up, and it is very good at suppressing all expressions of discontent, lulling the leaders of the regime into a false sense of security.

Over our Thanksgiving weekend, this illusion came crashing down.

The city of Urumqi, the capital of Xinjiang province, has been under lockdown since August. On Thursday, a fire in an apartment building there killed ten people, and it is widely believed that the lockdown rules made the fire harder to put out, causing the death toll to be much higher. In effect, the residents were locked into their building to die, while the firemen were locked out.

By Friday, this set off protests across China.

The protests ended up being about much more than covid and became a vehicle for opposition to Communist rule as such. More about that higher up in this countdown. But the Chinese regime is now attempting to deflate the protests, and prevent them from spilling over into a general rebellion against their rule, by loosening covid restrictions. Yet they still haven’t deployed an effective vaccine or other public health measures, so China is now bracing for a massive new covid wave as it loosens its controls.

In lifting covid restrictions, the regime will end up paying the price for never adopting non-authoritarian measures against the pandemic.

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So why did I choose the “chronically epidemic” covid virus as a top story of this year? It’s partly because a quarter of a million people dying, many of them preventably, is a big story in any year—especially if no one wants to talk about it. But it’s also because I expect this to set up an ugly trend for 2023.

A year ago, conservatives largely turned against all public health measures, back to the beginning of the pandemic. Now they are working toward the next step: retribution against anyone who ever advocated anti-pandemic measures.

Take Ron DeSantis’s proposed grand jury witch hunt against the pharmaceutical companies who developed the vaccines. This is widely seen as the Florida governor’s attempt to outflank Donald Trump, making a bid for the loyalty of the crackpot following that is so essential to Trump’s support.

I warned about this very early in the year.

[T]he conservative movement has gone even farther on this than Donald Trump, who is now getting booed at his own rallies for recommending the booster vaccine and complaining that Republican politicians won’t admit to getting it. Covid denialism was started to protect Trump by dismissing the pandemic as a media hysteria whipped up to sabotage his re-election campaign. Now he wants to claim credit for the development of the vaccines, but his supporters won’t let him.

This is one of the next stories to watch out for. This year, Republicans turned against all anti-pandemic measures. Next year, some of them will seek to punish anyone who supported those measures—including those who developed vaccines that saved millions of lives, here and around the world.

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