First in a four-part series.
The corona virus, and the COVID pandemic it spawned, have rapidly faded from view. There are some government health officials still trying to sound the alarm, as each new variant is much more infectious but seemingly less deadly. The danger of overwhelmed hospitals remains, but as the global herd gains immunity, the danger wanes. We might still have another wave, or a variant of concern; who knows? Eventually the virus will take its place alongside seasonal flu viruses, and one-hundred years from now somebody will write a story about the common corona virus and how it upended your great-grandmother’s life. And so it goes.
Since we now have Covid in the rearview mirror, I want to spend a few posts reviewing, in order, (1) What we learned, (2) Losers, (3) Winners, and (4) What happens next?. Staring with what we learned. Or perhaps I should say what we re-learned. Most of what follows is disturbingly of a piece: read any good history book about pandemics (especially John Barry’s The Great Influenza or Jared Diamond’s Guns, Germs & Steel) and you will be distressed to learn that humanity (even modern, technologically-advanced society) is always surprised by disease outbreaks, and always learns (and then forgets) the same lessons.
- Has there ever been a more hackneyed, ill-advised, or useless motto than “Follow the science” ? Spawned in response to skeptics who denied damn-near everything, this phrase responded not with simplicity but with simple-mindedness. Yes, indeed science points a way forward, but it does nothing to answer the philosophical and moral questions which a pandemic poses. Here’s a hypothetical: at any point, the corona virus could have been completely eradicated by a simple two-week, full-on quarantine by all humanity. Nobody leaves their home/apartment for two weeks. No transmission=end of virus. This was what science indicated. Yet tens or hundreds of millions would have died when they had no water, or food, or heat, or medicine, or emergency services or . . . you get the point. What was scientifically obvious was morally opprobious. Science can inform policy, but policy must go beyond science to make difficult choices.
- Science, especially medical science, takes time. And studies, often the kinds that don’t have proper controls when done in real time. It’s hard to get people to sign up to be in the control group to study how long one can go without treatment for a disease (think about it). Did you know that medical science found some volunteers who signed up for Covid challenge trials? That is, they were confirmed to have not had the virus, but volunteered to have it shot up the nose. Brave souls indeed! In the meantime, medical research looks at a variety of incomplete data and makes SWAGs: scientific wild-assed guesses (a term we used in military intelligence). They do it because they have to, because government officials are asking “what the hell do we do now?” and “wait until . . .” is not an acceptable answer. So you get guidance like “no, masks are not useful” later changed to “yes, masks are essential.” This is not evidence of incompetence, nor or conspiracy, just science and medicine seeking truth, a little at a time. Once upon a time, we put leeches on wounds and cut holes in skulls to let out bad spirits. Later we got so much more advanced and stopped doing such barbaric things. Later still we realized that leeches do stop the bleeding and opening the skull can prevent brain injury from swelling. Science marches on!
- You will be shocked to learn that during a global pandemic, being an island is an advantage. Also, having authoritarian leaders who will ruthlessly suppress the people is an advantage. And being an out-of-the-way place or one no-one-wants-to-visit is an advantage. Finally, having a society that is high-trust (i.e., people believe the government) or highly compliant (i.e., with strong social norms to act like others) is an advantage. Countries with any of these advantages performed better for a time during the pandemic. Not because they were smarter, or had better policies, or any other reason. All these advantages proved temporary. China delayed its pandemic by more than a year; now they are dealing with regional outbreaks that keep stalling the economy and infuriating a pandemic-weay public. In the end, different is just different, not better.
- Speaking of China, we will not know how the pandemic started until the Chinese Communist Party (CCP) is gone. I am sure you know the competing scientific hypotheses: a natural evolution starting from the wet market in Wuhan, and some kind of leak from the Wuhan virology center (I won’t include the intentional release of a manufactured virus, as there is no evidence for it). You may have seen some recent news releases by various groups claiming they have reviewed the data and proven it was a natural evolution, not a lab leak. They are being economical with the truth. The only available data on what happened during the Wuhan epidemic phase comes from China, and was released over a year after the pandemic phase began. They have released no new data, and prohibit any independent study effort to gather data. Reviewing that data will only confirm what the Chinese government has said all along: naturally-occuring disease. Once the CCP is gone, someone will be able to gather the actual data and piece together what really happened. Remember, we didn’t isolate the virus that caused the Spanish Flu (1918) until the late 1990s.
- The pandemic revealed social media in all its glory and gore-y. My dear wife and I wanted to get vaccinated. Mexico was only offering a Chinese vaccine: good enough, but who ever said they wanted a medical treatment that was “good enough?” We were willing to fly back to the States, but didn’t want to spend three weeks (minimum) waiting between the first and second doses of the mRNA vaccines. So we wanted the one-shot Jansen (aka Johnson & Johnson) vaccine. But how to find it? I found some vaccine-hunting FaceBook groups, and within hours of landing in Cincinnatti, we had appointments for our shots! Simply amazing, and impossible without social media. On the other hand, social media allowed every crackpot to fill the gap left by the evolving science with hare-brained schemes. Helpful hint: no scientific or medical research has EVER begun with the phrase “I know a friend who takes . . . “. Likewise, it is not legitimate to criticize potential treatments by exaggeration, like those who called Ivermectin a treatment for parasites in horses. Yes, it is that, and it is also used by humans. Nearly all antibiotics used by humans are also used for animals, so perhaps you want to stop using them, too? Being superstitious and unscientific is bad; being ridiculous in response is no better. And social media put all this nonsense on display worldwide, twenty-four hours a day.
- There is no such thing as a harmless comorbidity. Since modern medicine has made many serious conditions chronic, that is, conditions that you can live with and don’t kill you outright (but are still dangerous), people have started treating them as harmless. AIDS is now something people just take drugs for, and go on living as they had before. Ditto heart disease, type 2 diabetes, hypertension, obesity, and a raft of other conditions. But, when some new pandemic comes around, all these conditions make you far more likely to (1) get sick, (2) be hospitalized, and (3) die. Covid was a wake-up call that medicine’s amazing ability to pull people up just short of the the ledge is just that: they are still on the ledge, and all it takes is a small change in the environment like a new disease to push them over. Don’t think the ledge isn’t there; it is.
- It is called force majeure for a reason. If the phrase looks oddly familiar, it is because you have read it in every contract you’ve ever signed. It is Latin for Acts of God or literally unforeseen circumstances, and it invalidates the contract and relieves one party of liability. Pandemics are a classic force majeure. All kinds of trips, plans, weddings, sporting events, surgeries and parties got left in the dust. Sometimes people lost money, sometimes they just forever lost an opportunity. Plans are just the basis we make for the changes that will inevitably happen.
- Efficient supply chains only work in a perfect world. “Just in Time” delivery and concentrating supply providers makes great economic sense when the system as a whole operates normally. Throw a wrench into the system, and it collapses, since there is no slack. No local inventory means no way to respond to surge demand for low demand items (masks). Off-shoring most of your manufacturing to low-cost, high-volume producers in a single region in China works great until they have a lockdown. Maximized trade flows don’t work when all your shipping containers end up empty in the same port. These things were all obvious, but it took a little virus to remind us. Methinks we will accept a little more cost and a little less convenience in order to have a little more resiliency. Or at least me-prays!
- I have written on this before, but Covid was a great trial run for the end of the antibiotic era. Everybody reading this post grew up in a world where wonder-drugs called antibiotics meant every scratch or trip to the hospital was not a potential visit to the morgue. All of human history was like that until the mid-twentieth century. Now our antibiotics are gradually losing the battle with evolution against the deadly bacteria. Science is fighting back, but it seems we might revert to the distant past at least for a time. Public hygenic acts (masks, avoiding unnecessary physical contact, washing hands frequently) may be the norm in the near future.
- Finally, politics IS your reality. Some of the craziest things I mentioned above came out because one side or the other only saw things through a political lens. Oddly enough, this often resulted in the other side using a similarly political lens. “China must be the culprit.” “No, China must be totally innocent.” “Masks are necessary.” “No, masks are useless.” “Don’t gather in large groups” versus “unless you’re protesting the right thing.” “children are not at special risk” yet “schools must stay closed.” And on and on. Science, medicine, culture, education, international relations and even interpersonal relations all took a back seat to politics. Politics is supposed to be the art of compromising for a common good. I don’t think that word means what it used to.
Next up, Covid’s biggest losers.