As of late February Covid had killed more than 930,000 Americans in two years. With two thousand people still perishing daily, the total is likely to pass 1 million sometime this spring. The death rate is higher in the United States [1] than in any other wealthy country, and its vaccination rate is among the lowest. These facts are not unconnected: Omicron may be a milder variant of the virus, but more people have died in the past three months than in all of last winter’s wave—the vast majority of them unvaccinated.
There are many reasons people choose not to get a vaccine, from anxiety to inconvenience to genuine moral or ethical concerns about medical treatment. But what cannot be denied is the role that right-wing politicians and media outlets have played in holding the numbers down—by spreading disinformation about vaccines, vociferously protesting mandates, attacking the medical science behind vaccinations, and making opposition to vaccines a marker of partisan political loyalty. Nor should we overlook the role of religious leaders and influencers who joined the effort to discredit the Covid vaccines. This cynical campaign has had its predictable effect: only about 60 percent of Republicans are vaccinated, compared with more than 90 percent of Democrats, and the rate of Covid cases and deaths in states and counties that vote Republican far exceeds the rate in those that vote Democrat. Some say the high rate of infection in those areas may lead to herd immunity, but if that’s the case it will have come at great cost: many thousands of needlessly lost lives.
In March 2020, we wrote [2] that the pandemic would challenge how we live in society with one another. We said it would further expose the inadequacies of our health-care system and the inequities of our economy. And we expressed hope for collective action and sacrifice. What actually happened speaks for itself. It is impossible to go back and undo the many mistakes that made the pandemic worse than it needed to be in the United States. Still, it’s natural to wonder what might have been different had the country been led at the time by a president who sought to build solidarity instead of one who deliberately stoked division and dysfunction—one who declared, “I don’t take responsibility at all” for the nation’s disastrous response to the crisis, and one who exhorted armed protestors in Michigan and elsewhere to “liberate” states that had enacted measures to slow the spread of the virus. Donald Trump’s poisoning of the country’s already weakened body politic not only exacerbated the greatest health crisis since the influenza pandemic a century ago, but also helped legitimize behavior that could destabilize American society for years.
Joe Biden faced an uphill climb when he took office in January 2021, and he arrived promising the calm leadership and competence many Americans were seeking. Unfortunately, far more deaths have occurred on his watch. The administration still seems several steps behind on managing the pandemic. Only after the new year did the federal government implement a comprehensive plan for delivering in-home test kits, something that could and should have been done much sooner. The performance of the Centers for Disease Control continues to puzzle. It has been slow to release data on testing and boosters that could help states and municipalities respond to spikes in cases. Guidance on masking and other preventive measures has been inconsistent and confusing. Now, even as many blue states relax restrictions and Americans declare themselves “done with Covid,” new cases still average close to 100,000 per day, and President Biden has had to extend the national emergency [3] declared at the outset of the pandemic in 2020.
At this point, weariness, frustration, and anger are understandable. But that shouldn’t be an excuse to breezily declare ourselves “done” with Covid. Here it might be helpful to recall the flu pandemic of 1918. After two years, three waves, and millions of deaths, Americans grew tired of measures meant to contain the virus and disregarded government recommendations. Then, in 1920, came a fourth wave [4] that killed many thousands more. We can hope that, like the flu, Covid will eventually become endemic, a virus both manageable and treatable. But as long as people all around the world remain unvaccinated, new and possibly more lethal variants will continue to emerge.
Vigilance will help, not hinder, the return to normalcy. Moving from controls and restrictions to preparation, containment, and recovery means implementing lessons learned over the past two years. There needs to be better monitoring of variants and faster approval and distribution of new treatments. We need to ensure the manufacture and availability of test kits, ventilators, and personal protective equipment. We need to address the deficiencies in our health-care system that put so many vulnerable people—the elderly, the poor, the immunocompromised—at such high risk. We must also offer federal paid sick leave (the United States is the only wealthy country that doesn’t already do so) and other benefits aimed at keeping businesses and schools open and helping workers recover from illness without losing a paycheck. All of these things are doable. What might be harder is restoring the social cohesion needed to deal with the next public-health crisis—for this will not be the last.
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