First thing most mornings, I take my medicines with a sip of coffee, and then I read my email which includes a number of newsletters -Punchbowl News, the Morning Brew, Robert Reich’s newsletter, and the New York Times “The Morning.” I especially enjoy the last of these because it has a pangram puzzle to tickle my aging synapses.
This morning, the NYT Morning featured the headline, “Omicron in retreat.” The section that addressed the (thankfully) declining numbers of Omicron COVID cases had the following paragraph.
““Let’s be clear on this — we are winning,” Mayor Eric Adams of New York said yesterday. Kathy Hochul, the governor of New York State, said during a budget speech, “We hope to close the books on this winter surge soon.”
I tend to look askance at such pronouncements. Permit me to explain. This wave of COVID does indeed seem to be subsiding just as Omicron waves in South Africa and the UK have subsided – precipitously in some regions. But this doesn’t mean that “we are winning.” Such statements suggest that there is something that we (the government, our politicians, our scientists, the public) are doing to cause the fall in COVID cases and the morbidity and mortality that the virus is inflicting on us. The misattribution is the result of a failure to understand the nature of communicable diseases and their associated epidemics and pandemics.
Pandemics do not go on forever. Inevitably, they resolve leaving in their wake the dead, the chronically disabled, and the healthy who have acquired immunity through infection or vaccination or both. Now, it is true that what we do matters in terms of hastening or delaying the resolution of a communicable disease. Unfortunately, in much of America, what we are doing is delaying the resolution of the pandemic and maximizing the toll in death and disability.
Standing against mandates for public hygiene measures and vaccinations, our governmental structures have delayed the resolution of the pandemic. As a society, we seem to have decided to accept preventable illness and death as part of the price for individual choice. This is always easiest when the adverse consequences of such behavior accrue to someone else – the death of some old person unrelated to the maskless yet caused by them is irrelevant to those who refuse to mask. Such preventable deaths are just an “externality,” economists would say. A case in point is that feckless dick, Neil Gorsuch. Such a loser!
The risk factors for COVID, as I see them, are either intrinsic or behavioral. The intrinsic risks are age, gender, BMI, various illness associated with impairment of the normal immune response, and certain treatments that attenuate the immune system’s robustness. The behavioral risks, I break down into those that are voluntary and those that are not. The voluntary behavioral risks include refusing to wear a mask, refusing vaccination, and choosing to attend indoor functions in congregate settings. I think that these occur disproportionately among folks with certain ideological proclivities and the young who consider themselves safe from serious consequences of COVID. The involuntary behavioral risks are living in a congregate setting such as nursing or assisted living facility or dormitories and barracks, having to work in a congregate indoor environment in a work situation where neither masking nor vaccination are conditions of employment (meat packing, manufacturing, and various “cube farm” settings).
I have no doubt that the good Mayor and Governor of New York city and state have done what he can to set a tone that encourages the reduction of behavioral risks, and those are the only measures that would justify the claim that, “we are winning.” Sadly, there are still too many states, including my own, where this is not so. Alas. The COVID Apocalypse will burn itself out; that is for certain.
But it seems that our societal choices all but ensure that it will take many more deaths and a great deal more suffering before that happens.