Live and Let Die
Top Stories of the Year: #3
The pandemic was my top story for 2020, which I dubbed The Plague Year. It gets downgraded to #3 this year primarily for one reason: the development and distribution of highly effective vaccines that have partially blunted its impact. Or rather, the vaccines have blunted the impact of the pandemic for those who chose to take them.
Half of this year's pandemic story is the unprecedented speed and effectiveness with which we developed a vaccine, which might have made it possible to cut off the pandemic entirely by now. Historically, it has always taken so long to develop a vaccine for a new disease that by the time we have one, the original pandemic has run its course, and the vaccine only serves to prevent its re-emergence. For the first time, we managed to outrun the pandemic and provide a vaccine that can put it to a swift end. It is an astonishing achievement of science and industry.
But that leads us to the other half of this year's story: A significant percentage of the American people—about a quarter to a third—simply refused to take advantage of this. They dug into anti-vaccine conspiracy theories and doubled down on last year's social-distancing culture war, rejecting not just one but every preventive measure against the virus.
So the result has been a two-tier pandemic: a relatively safe and normal environment that is available for the fully vaccinated, alongside a "pandemic of the unvaccinated" which continues to kill tens of thousands in America and will probably get much worse again over the next few months, as the omicron variant spreads through the country and the attempts to mandate protective measures largely fail.
The grim rule for this stage of the pandemic has been, "live and let die."
I mentioned in March how amazing the new vaccines are.
The bottom line is that the vaccines work. They are highly effective at preventing deaths, hospitalizations, and transmission. They're already being delivered to the portion of the population that is most at risk, and production is ramping up so that we will see a huge surge in supply that will make them available to everyone in the Spring.
It is just shy of a year since everything shut down in response to the pandemic, and we can now confidently say that this is the beginning of the end.
Oh, and there's one other piece of good news. I had mentioned before that the mRNA vaccines offer the promise of a new, faster, better way of making vaccines, and here's some new evidence for that: the development of the first really effective vaccine against malaria....
If it works out, this has the potential to save a lot more lives, over the long term, than the COVID-19 vaccines. "In 2019 alone, there were an estimated 229 million cases of malaria and 409,000 deaths worldwide. Of those deaths, 94% were in Africa, with children being the most vulnerable."
As I put it before, "A new vaccine is great. What's even better is a whole new way of making vaccines."
In last year's roundup, I wrote about the concept of the "Metaphysics of Normal Life."
With vaccines now approved and being distributed, 2021 will be the year in which we return to the metaphysics of normal life, and the only question is how soon in the year it will happen. It will definitely take longer than we would like, and it will probably take longer than it has to.
Even with that caveat, it turned out I was way too optimistic. I didn't realize the degree to which opposition to vaccines and other preventive measures would become a source of personal identity and command a continuing irrational loyalty.
William Saletan (the only writer left at Slate who is worth reading) recently rounded up the evidence for how Donald Trump undermined his own administration's response to the pandemic. Or see a shorter, sharper presentation of the evidence from Jonathan last.
But nothing the Trump Administration did in terms of actual government policy was as damaging as the way he and his supporters turned the pandemic into just another skirmish in the culture war, which I called The Stupidest Culture War.
There will still be many deaths from this virus, and many unnecessary deaths, but from now on, that will not be a condition caused by the virus itself. It will primarily be a choice made by those who, for various reasons, are resisting getting the vaccine.
The partisan gap here is wide. The COVID pandemic may be winding down, but the COVID Culture War is forever....
We'll know the pandemic is really over when people stop feeling the need to have angry, useless arguments over it.
By this measure, the pandemic is definitely not over. I wrote that passage, by the way, in a moment of optimism in May as cases were trending rapidly down toward a trough in June that made it look like a return to normal was already here and all that would be left was the obsolete culture-war wrangling. In early June, I got so carried away as to predict that "my commentary on the pandemic will be winding down, except for a few retrospectives."
Then came the delta variant and a massive new wave of infections and deaths in the late Summer.
The one big thing that the vaccine did achieve, however, was the de-collectivization of the pandemic.
Up until this time, the methods for preventing the spread of COVID-19 and reducing the number of deaths largely required collective action. It wasn't enough for you to wear a mask; it was important that the person next to you in the grocery store is also wearing one. It's not enough for you to shelter yourself and reduce your contact with other people, because if the pandemic is raging at high intensity all around you, it's impossible to actually keep yourself isolated. So everybody else had to reduce their contact with other people, too.
You could say, as some did, that every individual could make their own decisions about how much risk they were willing to take, but this was wishful thinking, because the risks you take would spill over unwillingly to others. That's just how a pandemic works.
The vaccine, by contrast, individualizes the pandemic. It (largely) seals you off from the decisions of others—and seals others off from you.
The "largely" is important, because there are still vulnerable people for whom the vaccines are not as effective. Vaccines work by priming your immune system, but those with weak immune systems (due to age or a pre-existing condition) will have less protection.
But the pandemic definitely has changed along the lines I expected.
[T]he pandemic will not go away but split into two tracks, based on...different attitudes toward risk. The vaccinated will go back to living normal life, with a few of them continuing to take unnecessary precautions.... The stubbornly unvaccinated will find their own new normal, taking few precautions and simply accepting the much higher level of risk that comes with it, the same way they do with cigarettes. I don't like that decision, partly for their own sake and partly because a minority of unvaccinated people provides scope for the evolution of new COVID variants. So we should still be trying to get more people vaccinated through education and by offering incentives. But we pretty much have to accept that this is their own business and be thankful that the vaccinated can now go about our own business.
This two-track pandemic has resolved largely along a partisan divide.
Consider this profile of life in a resort area in Missouri, where the next wave of the pandemic is raging all around them, but people are determined to ignore it.
"Talk of the vaccine draws scoffs, laughs, and even cussing among the clientele. Mask-wearing, which is recommended for those not vaccinated, was virtually non-existent—and, in conversations with a flow of customers over two days, it's clear that many are not vaccinated....
"In the Lake of the Ozarks region, where Missourians and out-of-staters pour in to boat, fish, sunbathe, and party, to be unvaxxed is a source of identity and—at times—pride, a totem of one's independence and politics....
"Like other places with low vaccination rates, there is a deep distrust of authority that exists among those at the Lake of the Ozarks. Politicians have agendas, the press loves controversy, even data can't be believed. Some here cast hospitalization spikes as fictionalized. Others spin conspiracy theories about microchips....
"While conspiracy theories, misinformation, and paranoia may be playing catalyzing roles in discouraging vaccinations, it's impossible to escape the reality that politics is too. In the current vaccine push, some people see an attempt to diminish the former president they love."
This is not the only reason for vaccine hesitancy.... But the concentration of the current COVID-19 wave is in the South and correlates pretty well with voting preferences, so it's clear that what we are getting is largely a partisan pandemic.
Will this mean that the pandemic is back and we will widely return to practices like masking and shutdowns that characterized the early days of the pandemic? Probably not. At this point, my sense is that those who are most likely to embrace strong measures against the pandemic have already been vaccinated and feel relatively safe from it—while those who are most vulnerable are vulnerable precisely because they have resisted even the simplest measures. So there will be little enthusiasm on either side for masking and shutdowns.
In the meantime, whole regions of the country will pay a price for choosing to react to a deadly pandemic through the irrational reflexes of our normal bitter partisan politics.
I should note that in the closing days of the year, Donald Trump has finally made an active attempt to reverse this partisan approach to the vaccines (and his own position from a few months ago). He declared himself to be vaccinated and boosted and encouraged everyone else to do so. The whole video is worth watching. But notice that Trump was met with boos from his own supporters. It's a genuine effort—but probably too little, too late.
Yes, I know there is a Libertarian Debate Club fallback position in which some claim that they are not against vaccines, just against mandating them. But as I pointed out, I'm not very convinced by a bunch of conservatives suddenly embracing the radical libertarian position on this one issue only.
[T]he libertarian anti-mandate position has been seized upon opportunistically as intellectual cover for opposition to one vaccine in particular. For this reason, conservatives have not been content to stick to the strictly principled libertarian position. The piece above mentions an attempt to actively curtail vaccination efforts. And then there is Texas, where the governor banned mandates by private companies, too. So their anti-mandate position is turning into an anti-vaccine position.
The wider problem, in other words, is that you can't borrow an esoteric libertarian argument for a populist authoritarian party.
So where does that leave us? Where I ended up in September: a policy of live and let die.
After a rapid rollout that outperformed most other large nations, the COVID vaccines are widely and easily available at no cost. Yet the unvaccinated have actively resisted a preventive measure that could save their lives, as well as the lives of others around them, and they are doing so with increasing belligerence.
There is a cantankerous streak in Americans that leads us to defy authority and want to make decisions for ourselves. But what do we do when that ethos of "live and let live" turns into an insistence that we live and let die?...
As the vaccination numbers have slowly ticked upwards in recent weeks, we're reaching the point of firm and total resistance from people who view any attempt to save them as tyranny. At some point soon, everyone who is even theoretically open to getting vaccinated will be. That percentage probably won't be high enough to quash circulation of the Delta variant. Yet there will still be a significant percentage of people left who will not, under any circumstances, take the vaccine. Eventually we're going to have to accept this fact.
The practical end-point we're moving toward is a two-tier pandemic: One pandemic, inconvenient but mostly not deadly, for those who protect themselves with vaccines. And another pandemic, raging all around us, for those who would literally rather die than admit they are wrong about politics.
We'll just have to get over the sickening irony that this policy of live and let die is imposed, not by the callous indifference of the living, but by the reckless stubbornness of the dying.
It's not yet certain whether the omicron variant will change any of this. So far, it appears to be a lot more infectious, but it's not clear whether it's any less deadly.
It is only reluctantly that I accept this policy of live and let die. A lot of people have died unnecessarily, and that will probably continue for another few months. As much as they are responsible for their own fates, they will leave behind a trail of tragedy for those who love them.
That's the pandemic story for this year—but let's keep the longer term in mind. I've been a big advocate for the larger story of human progress, long before those Johnny-come-latelies like Steven Pinker. One of the most striking things I've noticed is that if you look at progress over the long term, you find that big catastrophic events like the 1918 Spanish Flu or World War II barely make a dent in the larger story of rising wealth, knowledge, freedom, and longevity. The same will be true of this pandemic—at least, for those who survive it.
Hence, the big long-term story is still that of increasing lifespans.
What we haven't gotten in growing population, we have gotten in increased lifespan.
"The period from 1916 to 1920 marked the last point in which a major reversal in global life expectancy would be recorded. (During World War II, life expectancy did briefly decline, but with nowhere near the severity of the collapse during the Great Influenza.) The descendants of English and Welsh babies born in 1918, who on average lived just 41 years, today enjoy life expectancies in the 80s. And while Western nations surged far ahead in average life span during the first half of the last century, other nations have caught up in recent decades, with China and India having recorded what almost certainly rank as the fastest gains of any society in history. A hundred years ago, an impoverished resident of Bombay or Delhi would beat the odds simply by surviving into his or her late 20s. Today average life expectancy in India is roughly 70 years.
"In effect, during the century since the end of the Great Influenza outbreak, the average human life span has doubled. There are few measures of human progress more astonishing than this. If you were to publish a newspaper that came out just once a century, the banner headline surely would—or should—be the declaration of this incredible feat. But of course, the story of our extra life span almost never appears on the front page of our actual daily newspapers, because the drama and heroism that have given us those additional years are far more evident in hindsight than they are in the moment. That is, the story of our extra life is a story of progress in its usual form: brilliant ideas and collaborations unfolding far from the spotlight of public attention, setting in motion incremental improvements that take decades to display their true magnitude.
"Another reason we have a hard time recognizing this kind of progress is that it tends to be measured not in events but in nonevents: the smallpox infection that didn't kill you at age 2; the accidental scrape that didn't give you a lethal bacterial infection; the drinking water that didn't poison you with cholera. In a sense, human beings have been increasingly protected by an invisible shield, one that has been built, piece by piece, over the last few centuries, keeping us ever safer and further from death."
I find this amusing because...I recognize every part of this. It's what a lot of us have been pointing out for years.
I don't agree with the approach of the rest of the article; reflecting the biases of the New York Times, it focuses excessively on the role of government regulation rather than on technological innovation and increasing wealth. But I think "What are the sources of all this amazing progress?" would be a much more interesting and productive debate to be having than most of what we're arguing about now.
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