I've been having a difficult time writing this week's post. It's not that I've been lacking in topics; it's that they all feel like too much to take on right now: the pandemic, the anniversary of the January 6th insurrection, my recent decision to move to southern California this coming summer, away from the place where I grew up and where I've lived for the past eight years. But it's the pandemic that's been on my mind the most.
With so much community transmission, so little public health and policy mitigation, and so many reports of breakthrough cases, I've found it difficult to calibrate both my risk and my anxiety. I don't feel all that worried about my personal health, though I don't dismiss the chances of long Covid, but the uncertainty over how effective the vaccines are against Omicron and the transparent wishful thinking involved in calling the variant "mild" make it hard to judge the risk to my parents. My dad especially has multiple risk factors, and he's scheduled to start a short series of cancer treatments in less than two weeks. It's not reassuring to hear public health officials cheerily talk about how among the vaccinated only people with pre-existing health problems are getting severe cases when so many people fit in that category and so little is being done at the community level to help them avoid exposure.
I don't miss the pre-vaccination period of the pandemic at all, but I did feel like there was a collective sense of clarity around what we needed to do to reduce infection and why, even while we ultimately failed to follow through on those responsibilities as a country. Now the response seems much more fragmented, with many attempts to separate out this or that group as one to blame, dismiss, or ignore.
Things seem bad. I've found myself wondering if any public health official who's been holding the line at "Omicron is mild" and "yep, cases are rising, but what are you going to do? [shrug]" is going to look back at this period, once the worst of it is over (whenever that may be) and think: "What have I done?" But few probably will.
They have plenty of stories they can tell themselves and us about why giving up on mitigation is better than any alternative. For purposes of self-justification, it doesn't matter if these stories are internally consistent or based on false dichotomies. They just need to be repeated. The economy is too strong to justify any provision of relief, but also too fragile to withstand even the most temporary of pauses. The isolation period for someone who has tested positive must be either 5 days or 10, not 6, 7, 8, or 9, and even though isolation starts with a test result testing should play only a peripheral role in determining its end. Our only policy choices are a total and complete lockdown without definite end, or doing essentially nothing.
Community spread is so high now it's easier to say there's no possible way to contain it. Contact tracing can't keep up so few infections have verified causes. If we can't see the transmission chains, how could anyone possibly intervene? Failure becomes its own justification; leadership becomes the regular delivery of updates on the consequences of failure.
I'm left wondering, in the absence of mitigation, what is going to stop the current wave? If "everybody" in a population of 300 million is going to get something, and that something is being distributed at a rate of 1 million people per day, you're looking at a long time before literally everyone has gotten it. In that scenario, a rolling average of a few million people would be home (or possibly worse, at work) sick at any given time.
But I doubt many people, even the loudest voices in the "everybody will get it" crowd, believes that literally everyone will get the current strain of Covid before cases start to drop. It's more likely that somewhere along the way a mixture of immunity and people staying home will eventually break enough chains to bring cases down. But if we're not trying to make that happen, when will it happen?1
A pandemic doesn't end just because you became unresponsive.
Fifteen years ago this January I rented a room in a house where five other guys lived. The kitchen was usually a mess and it got worse as winter turned into spring, bringing warmth, new odors, and insects. When you live somewhere with no collective sense of responsibility, cleaning up often falls to the person with the least tolerance for filth. To my surprise that person turned out to be me.
I wouldn't say I cleaned the kitchen daily, or even on a regular schedule. But I did occasionally wash all the dishes that had been left out, run the dishwasher, and put everything away. As the weather warmed, and as I got more fed up with the house, the landlord, and my housemates, I started to back off on cleaning. I remember coming home once on a hot spring day, walking into the kitchen, looking at the sink and counter, and walking right back out to make the half-mile walk to the nearest place I could buy a take-out meal.
The last straw was when someone started putting unrinsed bowls with cereal residue on them into the dishwasher. Maybe today's modern dishwashers can handle that level of grime but that's not what our cheap landlord had installed in the house. The spray of the dishwasher propelled bits of cereal from the bowls in the lower rack up into the cups and glasses on the upper rack. The cereal bits then dried in place. It got so that I couldn't assume any dish I didn't clean myself was actually clean.
I lived there only six months and by the time I left I'd settled into a new cleaning routine. I'd clean my own dishes after I used them. Beyond that, I'd only clean a dish if I was about to use it myself.
- I'd say this just about sums up the U.S. Covid situation right now.
South Africa, apparently everyone's favorite model for Omicron projections, appears to have had mitigation policies in place before, during, and after their Omicron wave. This included a mask mandate, capacity limits in public spaces, social distancing rules, 11 PM closing hours for bars and restaurants, and a curfew from 12-4 AM . The mitigations may not have prevented the rise in cases, but it's certainly possible they helped break up the wave.
It's becoming increasingly clear that the U.S. and many European countries are not going to see as short of a cycle as South Africa saw. South Africa's current public health regulations can be found here; they were recently updated after a sustained drop in cases.
Similarly, South Korea brought back restrictions when Omicron reached there, and so far they seem to be keeping cases down. Things might spiral out of control but so far I'd say it's hard to look at their example and conclude that mitigation simply can't work. Meanwhile, according to a reader of The Guardian (which is consistent with other stories I've read), keeping Covid-19 under control has allowed South Korea to avoid major disruptions in other aspects of life. ↩