You’re tired. I get that. Believe me, more than 600 articles (yes, really) into this pandemic, the last thing I want to talk about is COVID-19. I don’t want to talk about shots. I don’t want to talk about masks. The only variants I want to hear about are on Loki, and I could go about 1,000 years before ever visiting another site to check “daily deaths in the United States.” We are all so, so tired.
Well, buck up soldier. Whether you like it or not, you’ve been drafted. You are a member of the Army of People Capable of Making Rational Decisions. And we can’t afford to be tired.
Two months ago, it looked like we might actually get out of this thing in time to have something like a normal summer. When the CDC recommended that kids need not wear masks as they return to school in August, it was surprising, but not so unreasonable. Hell, it was even hopeful. Remember hopeful? But we didn’t count on two things. First, we didn’t count on how quickly the Delta variant would take over as the dominant variant in the United States. That’s because we didn’t really conceptualize the difference between the basic reproductive rate (R0) of this variant and everything that’s come before. We failed—and the “we” here definitely includes me—to really understand how this change would completely screw the small steps already taken toward normality.
The other things we failed to calculate was just how badly 30% of the population could destroy the nation if they dedicated themselves to being aggressively malicious.
The march of variants
When it comes to the virus itself, what’s been happening is what should be expected—it’s increasing in its ability to infect humans. This is a brand-new virus. That means both that no one has a natural immunity to this virus and the virus itself has just stumbled into the combination of proteins that allows it to attach to human cells. So it should not be a surprise that, as quadrillions of new copies of the virus are produced, some will refine that ability.
When the original strain of COVID-19 rolled through the area around Wuhan, it had an R0 value just a little worse than that of seasonal flu. That rate of transmission, paired with a rate of serious outcome two orders of magnitude greater than flu, was enough to sound every alarm that this was a serious disease. A couple of months later, the version of the virus that rolled through Italy and France, then took up residence as the primary variant in the United States, had a reproductive rate that was about 25% higher. That variant was swept aside in the fall by the alpha variant, which was a full two times more contagious than the original version and formed the bulk of cases during the massive spike of cases that occurred around the start of the year. Now alpha has been dislodged by the delta variant. Best estimates put its R0 at numbers from 5.7 to 8.0.
Now the lambda variant is making gains in South America and appears to be displacing delta in some areas. That almost certainly means that this variant has a higher R0 value. And not only is lambda almost certainly more contagious, it contains a specific change in the spike protein that could make it much more evasive of both vaccines and the immunity generated following previous SARS-CoV-2 infections. It’s particularly concerning that Chile saw a huge wave of cases in May and June that appear to be connected to the growing dominance of lambda, in spite of one of the world’s highest vaccination rates.
How high can the R0 number go? We don’t know. What’s clear is that COVID-19 is still making large jumps. It’s not just a matter of how well the spike protein attaches to human cells, other changes in the virus can be just as important. For example, one new study indicates that people who are infected with the delta variant carry as much as 1000x as much virus in their nasal passages as those infected with the variants that were dominant over the summer. With that kind of load being pumped into the air, the virus could actually be worse, on a virus vs. cell basis, and still be much more contagious.
We should assume that new COVID-19 variants will continue to be kicked up which are more contagious and more vaccine evasive. How fast those variants appear is directly related to how many cases of the disease are kicking around the planet.
The march of obstinance
At the same time that the variants are getting worse, so are behaviors of the people who are spreading the disease. It should come as no surprise that the same people who were first in line to get vaccinated were also among those most likely to regularly wear a mask in public areas. And those who said they would not get vaccinated were always down at the bottom when it came to putting on a mask. But the extent to which this has gotten worse in the last three months is hard to exaggerate.
Over 60% of the people whose response to questions about vaccine is “I will not get vaccinated” also respond to questions about masks by saying they “never” wear a mask. The latest Civiqs data shows that, far from falling as the delta variant generated a surge in some of the reddest, Trump-loving counties of the nation, Republican vaccine hostility has actually hardened.
Over the last couple of days, Sean Hannity has reversed some of his anti-vaxx positions and actually spoken favorably about getting the vaccine. That’s given some impression that perhaps, just perhaps, Fox is stepping back from their role as a disseminator of bioterrorism. Don’t bet on it.
Immediately before Hannity, Fox viewers got a full hour of Tucker Carlson saying that the vaccine was ineffective, made people sicker, that the government was engaged in “vaccine coercion,” and to “ignore people giving medical advice on TV.” Somehow, Carlson did not disappear into a puff of logical contradiction. Immediately after Hannity, Laura Ingraham was up to tell Foxists that there was “every reason to doubt” the vaccine, and to insist that the efficacy was much lower than health experts would admit. The effect was to bookend even the slightest admission that vaccines were a good thing with a double injection of vaccine scorn.
In the last week, some Republican politicians who had been holdouts have finally, and publicly, been vaccinated. On the other hand, there are still jackasses like Rand Paul doing everything they can to make things worse. There may be a day when Republicans finally realize that losing a significant portion of their voting base would be a bad thing. That day isn’t here yet.
Just like Donald Trump when he cancelled plans for national testing facilities, Republicans are still in a position where they believe that spreading the disease is better for their poll numbers than taking action. If they didn’t believe that, they—and Carlson—would be singing a different tune.
So what are we going to do about it?
Every time I write about this, everyone seems to get the impression that I’m saying “pass a law that everyone has to get vaccinated, no exceptions.” And I absolutely confess there would be some righteous joy in watching the anti-vaxx crew mumble and snarl their way to getting jabbed. Putting on their masks with a hot glue gun also seems like a decent idea (Just watch. That sentence will be pulled out of context.)
But neither of those things is going to happen. So what do we do?
- Send vaccines overseas
The United States is, thanks to President Joe Biden, blessed not just with an abundance of vaccine, but with the mRNA vaccines that have proven to be most effective in combatting the latest variants. Multiple studies have now shown that several other vaccines, including Johnson & Johnson, AstraZeneca, and SinoVac (the vaccine most common in Chile, as well as many other nations) are far less effective against delta. Similar numbers can be expected when looking at lambda. The way to save the maximum number of lives and to do the maximum amount of good in slowing the pandemic and slowing the development of future variants is to get vaccine into the arms of as many people as possible. So send those vaccines now to South America, to Africa, to Asia, and to everywhere there are people who are willing to do the right thing. Dropping intellectual property laws to allow broader vaccine manufacture is also a great idea, but the biggest thing now is to get out the vaccines that are already waiting to be used.
- Restore mask mandates
Republican governors in some of the hardest-hit states—including new epicenter of steaming hot delta, Missouri—have passed laws that now make it all but impossible for county and city officials to create local mask mandates. Many of these states have also put in place rules that prevent schools or businesses from requiring either masks or proof of vaccination. Because of course they have. But where those mandates are possible, they should be restored. Where mandates are not possible, businesses should still put up signs asking that people wear masks and local officials should still insist that masks are necessary to stop the spread, even if it can’t be enforced. Look at San Francisco. Despite one of the highest rates of vaccination in the nation, it’s still experiencing a new “pandemic of the unvaccinated” that is also generating illness, if not deaths, among the vaccinated. There is no place currently vaccinated at a level to break community spread without also using masks.
- Use what we’ve learned
One thing that the current anti-vaxx/anti-mask crew loves to bring up is “Even St. Fauci said that masks didn’t work!” He did. He’s since apologized multiple times and encouraged the use of masks. That’s because in a reality-based society there is a thing called new evidence. Over the course of the pandemic, we’ve learned that the SARS-CoV-2 virus is spread primarily through fine aerosols that linger in indoor air rather than larger droplets that spray from speaking, coughing, or sneezing (though those definitely can spread the disease, as well). Based on what we know now, we have a better understanding of which activities are most dangerous and how situations can be improved. That means moving events outside when possible, and that air volume and circulation is a large factor in the danger level of an indoor environment. We’ve also spent a year warming up those Zoom skills and learning that many jobs really can be done from home. None of that should be thrown away because some executive decides that he really misses being able to lord his authority over people in person.
- Crack that nut
Ultimately, we cannot live with COVID-19 as a recurring, endemic disease. This is not the flu. The million Americans who have already died is just a part of the price we’ve paid for the mistakes made to this point. We have no idea how many millions are going to face long-term, life-altering, debilitating effects from their exposure to this disease. We don’t know what COVID-19 does to people, even those whose symptoms are light. But here’s one reminder from back in June—“Even mild cases of COVID-19 may lead to loss of brain tissue.” Yeah, keep that in mind. Because I have notes on two upcoming studies that associate the delta variant and biomarkers generally associated with Alzheimer's. There is no way that we can stay economically, socially, or politically stable unless this thing gets squashed. Ultimately that means gaining a much higher level of vaccine acceptance. That’s very unlikely to happen through some must-get-jabbed law. It may be boosted by schools and employers who require vaccination (in places where Republicans don’t pass laws against it). But mostly that’s going to have to come down reasoning with, guilting, shaming, or simply wearing down those people who are currently refusing vaccines. Because you can’t run a society where a quarter of the population is reveling in their role as living bioweapons.
I know this is a lot. I know that even many of those are were once in the “gee, thanks for pointing out that this is going to be bad” camp have now climbed on the “would you please just shut up” bus. We are on the same page. I want to shut up. I want to never write about this topic again. None of us is getting what we want.
Because the hard work is still ahead.