The Partisan Plague

Is the pandemic back?

The Centers for Disease Control just announced new guidelines recommending that we wear masks again. But I hear a lot of people asking: Weren't the vaccines supposed to prevent this?

The short answer is: They would, if only people would take them.

As for the long answer, let's take this step-by-step.

David Leonhardt at the New York Times has been pretty good at clearly and objectively presenting information on COVID-19, and he sums up the new recommendations.

"In its updated guidance yesterday, the agency did not recommend that all vaccinated people again begin wearing masks indoors. The CDC said that only those vaccinated people living in 'an area of substantial or high transmission' should do so and published a map online showing which areas qualify.

"As you can see, most of the Northeast and upper Midwest, as well as much of the West, have only 'moderate' or 'low' transmission. If that stays true, vaccinated residents in those places can generally remain unmasked, the CDC says."

Here in Virginia, I find myself on the borderline. You can see a big chunk of low-transmission blue in Central Virginia that I presume is Charlottesville and Albemarle County—but then a big wedge of red coming up from what they call Southside, the heartland of Virginia's Trump Country—and as we shall see, that political affiliation is going to be relevant.

What is driving the new recommendations? The spread of the delta variant of COVID-19, a mutation that emerged from India and has turned out to be about twice as infectious as the original virus.

"Coronavirus cases are now at their highest point since early May, according to CDC data, with the US average nearly quadrupling since June to 47,000 new cases a day, largely driven by the highly infectious delta variant, which now accounts for more than 83% of new cases nationwide....

"'The transmissibility of the delta variant raises the likelihood of sporadic "super spreader" events among vaccinated people, especially when indoors and in close proximity without masks. These events raise the risk to those unvaccinated while the vast majority of the breakthrough cases will be mild or asymptomatic,' Brownstein added."

This can be a little confusing, so let me break it down. The delta variant is so infectious that even the vaccinated are capable of spreading it.

"CDC officials were persuaded by new scientific evidence showing that even vaccinated people may become infected and may carry the virus in great amounts, perhaps even similar to those in unvaccinated people, Dr. Walensky acknowledged at the news briefing."

But to be clear, the rationale for the vaccinated to wear masks is not primarily to protect themselves; the vaccine does that. It is primarily to prevent the vaccinated from spreading COVID-19 to the unvaccinated. In effect, the CDC is asking vaccinated people in these areas to give up some small amount of the advantage of being vaccinated, in order to give the unvaccinated some of the protection they won't give themselves.

Online, people are doing their usual terrible job interpreting all of this information, so I am seeing a lot of people complain that this means that the vaccines have failed or ask why we bothered getting vaccinated if we just have to wear masks again. Well, I'll tell you what difference getting vaccinated makes: It's so you won't die.

Vaccinated people can be infected by the delta variant, and it's looking like they can become infectious to others. But their own infections are generally asymptomatic and very, very rarely serious.

"With more than 156 million Americans fully vaccinated, nationwide, approximately 153,000 symptomatic breakthrough cases are estimated to have occurred as of last week, representing approximately 0.098% of those fully vaccinated, according to an unpublished internal Centers for Disease Control and Prevention document obtained by ABC News.

"According to the White House COVID-19 Task Force, severe breakthrough infections remain rare, and nearly all of these hospitalized patients—97%—are unvaccinated."

An article on these "breakthrough infections" provides a good analogy. An unvaccinated body is like a castle that is lightly guarded, with its troops on low alert and therefore vulnerable to a surprise attack. A vaccinated body is like a castle guarded by trained troops on high alert. It can still be attacked, but it will rally its defenses much more quickly and is likely to avoid serious damage.

Leonhardt's bullet-point summary from last week pretty much captures the current situation.

- Vaccinated people are nearly guaranteed not to be hospitalized or killed by Covid.

- Among children under 12, who remain ineligible for the vaccine, serious forms of Covid are also extremely rare. Children face bigger risks when they ride in a car.

- The Delta variant does not appear to change either of those facts.

- Millions of unvaccinated American adults are vulnerable to hospitalization or death from Covid.

By the way, just for my own ease, I am not changing my sources' usage when it comes to capitalizing "covid." A friend recently made a good case to me that COVID-19 should be in all caps because it's an acronym, but just plain "covid" shouldn't be, in the same way we don't capitalize "polio" or "measles." (I'm trying to avoid "coronavirus" altogether because that is a whole class of viruses that includes the common cold.) But the usage is not yet standardized, and the New York Times is among the outlets still capitalizing "Covid."

Note, by the way, that children are not any more susceptible to the delta variant than they are to the original virus, so that the CDC's recommendation to continue masking in schools may be legitimately criticized as overkill. As Matt Welch argues, "We are masking vaccinated people who will probably not contract COVID, to protect a population that gets it the least and suffers from it less than it suffers from the flu."

For myself, I'll be watching the local numbers and may go back to masking until my youngest is able to get vaccinated, which will be sometime in the next few months. But if I do it, I will do it knowing that this level of caution is probably unnecessary.

Leonhardt also notes the probable futility of the new CDC guidelines.

"The parts of the country that would benefit most from a new crackdown on Covid-19—including more frequent mask wearing—are also the places least likely to follow CDC guidance. Many of these communities have been rejecting the advice of medical experts for months, on both masks and vaccines. Another CDC announcement won't change that.

"Yet these are the communities that the CDC is trying to influence the most."

Leonhardt puts some blame on the CDC for poor messaging, and much as I am inclined to criticize federal bureaucracies for inefficiency and incompetence, I'm not really sure that makes a difference here.

The same goes for the vaccine disinformation you are likely to find in abundance online. The problem is not social media.

"[L]ate last week, Senator Amy Klobuchar of Minnesota introduced a bill that would strip away Section 230 immunity for vaccine content promoted by social media algorithms. The Klobuchar bill is an apt mascot for the confused state of discourse over misinformation. Because it would direct the government to decide what counts as misinformation and then treat content differently on that basis, it would probably violate the First Amendment. Of course, Klobuchar's proposal will never become law; it is what's known as a messaging bill. And the message seems to be that, in order to close the vaccination gap and finally bring the pandemic to a close, social media platforms just need to do something....

"At least in the US, vaccine hesitancy appears to be a largely top-down partisan phenomenon, in which public behavior is influenced by elite messaging. As of last month, just over 10 percent of adult Democrats had not been vaccinated, compared to nearly 50 percent of Republicans, according to multiple surveys.... The country's most influential Republican, Donald Trump, relentlessly played down the risk of the disease from the start (including during his own hospitalization), and millions followed his cue. Research has found that the biggest predictor of whether Americans view Covid-19 as a threat is not their scientific literacy or demographics, but whether they trust Fox News and Breitbart over CNN and The New York Times. Viral rumors on social platforms may have widened the divide, but it seems clear that Republican Party messaging, amplified by its traditional media architecture, created it."

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.

"A year ago, Backwater Jack's made national news after photos went viral of partiers packed inside the pool area, ignoring guidelines to avoid crowds and keep a distance from others. Today, as revelers laugh and toss back drinks in shallow pool water, some 600,000 deaths later, they aren't just forgoing masks, they are forgoing the vaccine.

"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. It is also common among other groups who tend to be less educated and more suspicious of authority, which is generally considered to be the reason why black people have been vaccinated at relatively low rates—though no one is all that eager to talk about this, lest they be accused of "white privilege."

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.