Coping With the Persistence of Covid-19

One year ago to the day I published a post titled ‘Coping With the Reality of COVID-19’. In a rational world that post would not have been necessary because every nation would have implemented strict policies to suppress the virus, but we humans do not live in a rational world. Instead, we live in a world constrained by our individual and collective narratives, and for the greater majority those narratives do not allow for intrusions. And a pandemic is an intrusion.  

From that post:

Following varying degrees of mitigation over several months, the federal government and the governors of America’s states and territories are now relaxing restrictions in service of economic recovery. Despite this easing of restrictions, however, the virus persists, and nothing about the biological threat posed by the pandemic has changed.

Incredibly, only a few months after COVID-19 arrived in the United States, efforts were already underway to ease lockdowns and restrictions. In Iowa, where I live, the virus arrived in early March. Over the next month or so the governor implemented a halting, faltering campaign of virus suppression, which she then suddenly abandoned in late April. Instead of attempting to slow transmission of the virus, and thus save lives through suppression, the governor transitioned to a halting, faltering campaign of mitigation focused solely on preventing hospital infrastructure from being overwhelmed. It didn’t matter how many Iowans ended up in intensive care for weeks or months, or how many died, the only thing that mattered was whether Iowa’s healthcare workers could keep up with the carnage.

Less that two months into the pandemic, with the worst in Iowa yet to come, the governor instituted policies which actively encouraged the spread of COVID-19:

04/27/20 — Gazette: Gov. Kim Reynolds eases coronavirus restrictions in 77 Iowa counties.

05/11/20 — Register: Gov. Kim Reynolds says Iowa will loosen additional restrictions on the economy this week.

05/20/20 — Register: Gov. Kim Reynolds announces more reopenings in Iowa, including movie theaters; bars to reopen next week.

Even as the coronavirus pandemic was still in its infancy, in Iowa the die of serial negligent governmental homicide was already cast. By focusing on a strategy of mitigation, and on protecting hospital infrastructure and economic factors, Iowa’s governor — who touts herself on social media as a “Mom, wife, grandma” — consigned thousands of Iowans to die who would otherwise be alive today. As a result, Iowa just passed 6,000 COVID-19 deaths two weeks ago, on May 15th. (Had Iowa acted aggressively to suppress transmission of the virus, as occurred in states like Vermont and Washington, then half to two thirds of those deaths — 3,000 to 4,000 Iowans, many of them old and unable to fend for themselves — would have been prevented.)

For the survivors in Iowa, across the country and around the world, the question on this grim anniversary is what to do next, and fortunately the answers are not complicated. If you are a rational person you will be — or already have been — vaccinated, and again from last year’s post this is why:

Despite this easing of restrictions, however, the virus persists, and nothing about the biological threat posed by the pandemic has changed.

If anything, the most-prevalent strains of COVID-19 today are more transmissible, and thus more dangerous, than the initial strains. In that context it is indeed a miracle of modern science that vaccines have become widely available in a little over a year, and widespread inoculations in the United States are clearly blunting both the spread of disease and consequent illness and deaths. On that basis alone everyone should seek vaccination as soon as possible, but it is also important to note that neither vaccination nor prior infection necessarily confers future immunity from infection.

There is in fact a great deal that medicine does not yet know about the COVID-19 vaccines, but their general safety is not one of those mysteries. There may be some people who have adverse reactions, but that simply means you should have your vaccination at a medical facility if you have a history of such reactions, or are concerned about such reactions. It does not mean you should avoid being vaccinated against a disease which could leave you debilitated or dead. (If you don’t care about getting sick with COVID-19 then I’m not sure why you would even be reading this post, but if you do care the choice is obvious. Get vaccinated as soon as you can.)

One of the things that is not conclusively known about COVID-19 vaccinations is how effective they are against preventing the disease. There seems to be evidence that there is such an effect — that once you are vaccinated you are less likely to become infected — but for obvious reasons it will take time to document that efficacy. We also don’t know how long the various vaccines remain effective, and again that will take a while to determine simply because the vaccines are so new. (Reports that a given vaccine has proven effective for an increased number of months are actually evolving in real time.)

As time passes we will learn more about the extent to which the current vaccines prevent infection, but there will always be so-called ‘breakthrough’ cases. Likewise, while the duration of effectiveness continues to grow as time passes, we don’t know how long that effectiveness will last. Are COVID-19 vaccines like flu vaccines — meaning good for less than a year? Will we need annual boosters?

While increasing vaccination rates in the United States have many Americans talking about ‘getting back to normal’, it is crucial to remember that ‘normal’ now means living with COVID-19 as an endemic disease. It didn’t exist in human beings prior to late 2020, it now exists almost everywhere, and the likelihood is that we will have to live with COVID-19 until some new medical advance allows for eradication. (To put that in context, if we do need annual boosters across all age groups, then COVID-19 will be unlike any disease that most Americans, and most human beings, have ever dealt with.)

Presuming successful vaccination, and coming off an entire year in which you determined you own personal comfort level with social distancing and masking, the question is whether to continue or decrease those personal suppression policies. And of course answering that question not only involves assessing your own personal comfort level with the risks involved, but also the cultural context, which is rapidly shifting. Specifically, as you may have gathered from media, social media, and/or conversations with family and friends, there is currently a lurid cultural conversation taking place about people who may choose to continue wearing a mask or socially distancing even after being vaccinated.

Here again it should not be necessary to point out that you are perfectly free to do whatever you want, even if your life choices seem irrational to others. That said, because human beings — and particularly a malignant third or so of the American people — are more concerned with protecting their delusional narratives than they are about protecting either their own health or the very freedoms they espouse in those delusional narratives, we are compelled to address this issue. Because we have already said that masking is perfectly acceptable if that’s what you want to do, however, here we will speak not to your behavior with regard to masks, but rather to the deranged behavior of those individuals who insist on aggressively concerning themselves with the masking behavior of others.

Bluntly, anyone who cares whether you wear a mask or not after you are vaccinated is announcing that they are mentally defective. To whatever extent vaccinations do provide a defense for most people, the virus still exists, and it will continue to evolve in ways that could prove dangerous even after vaccination. While your overall risk after vaccination will decrease substantially, and your risk of a catastrophic outcome will drop close to zero, as with financial investing you have the right to assess your own risk tolerance. (And if you are elderly, immunocompromised or cannot be vaccinated for medical reasons, then you should rightly continue to prevent infection with masking and social distancing.)

As to what you should say if someone asks why you continue to mask or socially distance after vaccination, you are not obligated to say anything at all. Indeed, no respectful person would ever ask such an impertinent question, let alone do so in the middle of an ongoing global pandemic which has already killed 590,000 Americans, and over three and a half million worldwide. As a practical matter, of course, the people most likely to ask such questions are pandemic denialists, whose only interest is reinforcing their own delusional narrative of existence, and that again frees you of any obligation to respond.

As a mentally stable individual you have more important things to do than debate your life choices with someone whose brain matter functions like a hair clog. Adding irony to insult, however, the people who were least likely to take the virus seriously over the past year or so are not only the people most likely to challenge you about masking and social distancing today, they are also the people who will most likely refuse vaccination and go on to incubate future variants of COVID-19. So not only are those people pathetic and annoying as individuals, but they also represent a very real risk to humanity, which is yet another good reason to stay as far away from them as possible.

— Mark Barrett