America once again broke its own record last week for daily confirmed cases of COVID-19, with over 90,000 new cases on a single day. That's almost certainly not as many cases as we actually had back in the worst days of March when testing capacity was almost nonexistent and the virus had been raging essentially unchecked for weeks through the Northeast. But it is clearly worse than the summer surge through the Southeast and Southwest. And while the current wave is hitting Midwestern states like Wisconsin hardest, in every part of the country, from Texas to Massachusetts, numbers are rising, and in an accelerating fashion.
It's a terrible and depressing state of affairs. So imagine how we'd feel if the numbers were more than two and a half times worse — if, instead of 90,000 new cases a day, we had nearly 250,000. Because that's what America would look like if we had the same number of new cases per capita as France.
The ferocious return of the virus across Europe is not exactly an underreported story. But it has been under-assimilated to the dominant narratives of both sides in America's COVID culture war. This past summer, advocates of stringent measures — aggressive lockdowns, universal mask-wearing, etc. — could point to Europe's success as proof that the virus could be beaten with sufficient determination, organization, and social solidarity. If America would only get its act together, we could emulate the approach of countries like France and have some semblance of our normal lives back by Thanksgiving.
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Meanwhile, advocates of a less-stringent response could point to Sweden, Europe's outlier country that never locked down, to say that ruthless suppression of the virus was unnecessary. With adequate protections for the residents of nursing homes (which Sweden failed to enact in the initial phase of the pandemic), and with restrictions on large gatherings, much of life could continue almost as normal and without massive economic and social dislocation. The virus would spread slowly through the population, taking a modest toll in life and health, but there would be no crisis, and eventually herd immunity would cause it to peter out.
Both views have now taken a serious hit. France successfully suppressed the virus to a level well below where states like New York got it, declared victory, and returned to something closely approaching normal. And it was precisely that return to normal that allowed the virus to return as well — and once it achieved a critical mass of infected individuals, the number of cases exploded.
Nor is France unique. The Czech Republic, a country that responded swiftly and forcefully in the spring, and thereby managed to avoid the first wave almost entirely, is now suffering one of the worst outbreaks in Europe. After doing surprisingly well through September, Sweden is facing its own surge, and abandoning its earlier lax approach to the virus. Meanwhile Belgium, arguably the worst-hit European country back in the spring, is also having a devastating fall, with two and a half times the number of daily cases per capita as France — over six times the U.S.'s rate. If Belgium hasn't benefited from herd immunity, it's hard to think of what country could.
Where does that leave all of us, staring down the barrel of a brutal winter?
Many may be tempted to take their prior views to new extremes, as if, like socialism, the only reason they haven't worked is that they've never been tried. So the advocates of lockdowns can point to the virus' resurgence and say they should never have ended — we should all have stayed maximally distanced until a vaccine is widely distributed. But this is neither a socially nor economically viable strategy. Indeed, one reason that the virus was able to surge back in France and elsewhere in Europe is precisely that European governments were loathe to crush their economies for a second time in only a few months and aware that the population was unlikely to comply in any case. If the only way to beat the virus is "lockdowns forever," most people are going to take their chances with the virus.
The "it is what it is" camp would seem to have the more plausible stance, in that case. If the virus is going to win regardless, why not just give in and get it over with? And while herd immunity hasn't quite panned out the way they hoped, they do have one other good talking point: though the virus appears to be as contagious as ever, it has had a markedly lower fatality rate lately than was estimated to be the case back in the spring. Indeed, even accounting for the younger population now being infected, the fatality rate has fallen to a fraction of what it was. It wasn't just the flu back in March, but maybe it is now?
The problem with this view is the same as it has been since the beginning of the pandemic when a certain segment of the American right first began to air it. Even at a lower fatality rate, the virus would prove devastating to vulnerable populations who cannot be ring-fenced if the virus is raging out of control in the general population. But further, that lower fatality rate is itself largely a function of improved therapeutic techniques. If the health-care system is overwhelmed with cases, that improvement will vanish. Now consider that in Belgium they are asking doctors with active COVID infections to continue working, and ask yourself whether you'd still take your chances with the virus if that was the case in your community. Once the virus is raging out of control, the government won't have to order a lockdown — people will lock themselves down, and take the economy with them.
Of course, there are still things we can do to improve overall outcomes. We can wear masks; we can take (and distribute) vitamin D; we can invest in testing infrastructure and contact tracing. It's still better to be Germany than France. But the unfortunate reality is that none of that will eradicate the virus. We have to live with it. And our only two alternatives for living with it are each deeply unsatisfying.
One choice is to adapt to the virus's new abnormal in which we prioritize the essential (e.g. education) even when it cannot be deemed wholly safe, but where many if not most of the pleasures and conveniences of life (eating in restaurants, attending a friend's wedding) are simply out of reach for many months to come. It's a gray and depressing prospect, where, regardless of how well the government cushions us from dire need, our lives are all persistently poorer. Unsurprisingly, no country I'm aware of has freely chosen this path. I haven't chosen it myself.
The other choice — the one the Western world has largely made — is for a manic-depressive cycle of opening and locking down with economic gyrations to match. The tougher we crack down at first, the harder it will be to resume cracking down later after a respite brings the virus back. But the laxer we are at first, the more ephemeral any period of respite will be. The death rate will almost certainly be higher in this world, but we'll likely tolerate it better than persistent misery. Indeed, in the context of so much volatility, with dread alternating with euphoria and plans subject to continuous revision, perhaps we'll barely notice.
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