I have, throughout the pandemic, been something of a COVID moderate.
I supported strong restrictions at the start of the pandemic, on both practical and moral grounds. But as early as May of 2020, I saw America wasn't going to take the steps necessary to truly contain and crush the virus. That meant the real question was how to live with it with as much normalcy and as little loss of life as possible — which in turn meant applying a rigorous cost-benefit calculation to restrictions until vaccines arrived. Since then, my overwhelming focus has been, simultaneously, how to maximize their uptake and how to get the still-anxious accept that the emergency phase of the pandemic has truly ended, and, with it, the rationale for most if not all the restrictions I'd embraced at the start.
Throughout, I've tried to remain cognizant of both the seriousness of the pandemic and the very real costs of restrictions (particularly to children and parents). I've tried make arguments from evidence in a calm and reasoned manner. But I'm starting to lose patience with calm, reasoned argument. It feels like we're caught in a doom loop of COVID hysteria, and people aren't listening.
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This is likely a familiar frustration for those who've confronted vaccine holdouts. The evidence of the vaccines' safety is at this point overwhelming, and the evidence of their efficacy nearly as definitive. Those who refuse to get vaccinated are putting themselves at risk, but in consequence also adding stress to a health care system that at times has come close to the breaking point. What will it take to get through to these people?
It's not particularly controversial to say that sort of thing in mainstream circles. But it's far less common to point out that, at this point in the pandemic, there are almost no non-pharmaceutical interventions that make any sense at all. And if mask mandates, physical distancing, capacity restrictions, and other rules put in place before widespread vaccination don't make sense, they should be dropped — not reluctantly, but enthusiastically. It's past time for healthy, vaccinated adults and children to resume living normal lives.
Mind you, I'm not saying the pandemic is over. The Delta variant is incredibly contagious and has powered a surge of cases, hospitalizations, and deaths even in the most COVID-conscious parts of the country, predominantly among the immunologically naive (those who have neither been vaccinated nor infected). Indeed, the pace of deaths has been accelerating in recent months, a testament to Delta's extraordinary infectiousness. Meanwhile, the Omicron variant looks likely to be Delta on steroids when it comes to how fast it spreads. Even if, as the initial evidence suggests, it usually causes milder disease, Omicron will cause a huge wave of cases in vaccinated people who could pass it on.
Why isn't that an argument for tightening restrictions? For three reasons.
First, because many — likely most — people simply won't observe a lockdown at this point. Indeed, many people are no longer willing to abide by even more modest restrictions like masking. If your policy is to do something that won't be done, you don't really have a policy. Moreover, the unvaccinated-by-choice are in many cases less likely to limit their behaviors in other ways. The COVID-conscious, in other words, are mostly protecting people who don't really need it, because they can do little to protect those who do.
Second, even if there were a high rate of compliance, Delta and Omicron are so contagious there is no plausible non-pharmaceutical intervention that could contain them. The measures we used earlier in the pandemic were only partially effective then. They would be completely overwhelmed now. At best, we might modestly slow the spread while it continues to scythe its way through the population.
And third, we no longer need to flatten the curve. Early in the pandemic, we needed to buy time to understand the virus better, to develop treatments, and to stand up a full-fledged testing-and-tracing infrastructure to facilitate containment, which we never did. Since containment has comprehensively failed, most everyone on earth will either be vaccinated or infected eventually. We now have enough vaccines domestically to cover everyone multiple times over. So what exactly are we buying time for?
One common answer, which I've given myself in the past, is to protect the health-care system. A surge of COVID cases coming into ICUs would not only lead to worse outcomes for them but worse outcomes for other people who need those beds for non-COVID reasons. This is a very real problem. But as noted, other than vaccination, the strategies being proposed will not materially blunt the coming predictable wave. If we want to shore up the hospital system, we need to be thinking on the supply side, and not deluding ourselves that we can really control demand.
Mine is not a counsel of despair. Nor is it denialism. It's a counsel of reality. We have extraordinary vaccines that are still hugely effective at preventing serious disease and death. We have boosters that make that efficacy even more impressive and will stop many infections outright, even Omicron. Most of the country has already returned to normal life — big chunks of it have been back to normal since the summer of 2020, well before they should have been. It's past time for the cautious among us to join them.
So why are multiple jurisdictions once again tightening restrictions? Why are kids in school eating outside when adults eat inside all the time and the virus was never very dangerous for children or even young adults in the first place? The costs of restrictions aren't as high as they were during 2020, when children experienced substantial learning loss and both children and adults suffered significant spikes in anxiety and depression. But they remain quite meaningful, socially, economically and politically, and there is far less reason to continue them.
So why are our authorities catering to neurosis and fear rather than explaining the truth: that the virus is never going away, and the way to protect yourself and others is to get vaccinated and boosted. Why isn't that the only message?
I really don't know the answer. And yet I myself still feel the need to put a "to be sure" sentence or two in here. I feel the need to say that masks are still helpful (minimally at this point, but in situations like stores or theaters or airplanes — not schools — they also don't cause much inconvenience). I feel the need to say that testing is still important (if you're seeing a vulnerable individual, like a relative in a nursing home, it definitely is; otherwise, with the virus so manifestly not contained, not so much). I feel the need to say that we need circuit breakers to protect the health care system from coming under extreme stress (but what would those circuit breakers be, exactly, when the people most likely to wind up in the hospital are those who are determined not to get vaccinated?).
But my heart isn't in those "to be sure" sentences anymore. They're not false, but they're really there to reassure people I'm not some crazy COVID-denier. And I worry the due-diligences drown out my actual message and wind up sustaining rather than weakening a perspective that, while well-intentioned, can be quite harmful and destructive.
I am a naturally pro-social person. I wear a mask when required. I get tested when required. I try to accommodate and respect people's differing risk preferences. But I'm very privileged when it comes to COVID; doing these things is easy for me. I don't have little kids in school. I work from home. None of the extant restrictions materially impact my life.
Yet even I feel myself being radicalized, starting to think: maybe it's not enough to make reasoned arguments against rules that are little more than hygiene theater. Maybe it's time to break them.
And if I'm feeling that way, how on earth must normal people feel?
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