The Great Pause Week 104: How the 2020 Pandemic will end
So long as there are humans on the Earth there's going to be Covid-19.
This short retrospective on the Pandemic began at week 100.
This week the latest CoV-2 variant, with all the lethality of Delta and several times the transmissible stickiness of Omicron scaled the Great Zero Tolerance Wall. At this writing it had reached 17 of China’s 31 provinces. After just six cases were reported in Xi’an, a northwestern city of 13 million people, the city locked 13,000 people in their homes. While it is still too soon soon to say, I doubt China will be able to contain the outbreak and will find out how effective their widely-adopted Sinopharm vaccines are against these newer variants.
Coronaviruses can infect many different mammalian and avian hosts so they’ve many potential avenues to reach humans. They mutate and recombine in different hosts, producing a steady stream of variants. They’re all over the world. There are thousands of species of bats, rodents, and small wild mammals. Dense populations of different species, roosting or nesting together, provide plenty of opportunity for viral exchange and recombination.
Evolution is real, nature is inventive, and we live at the indulgence of things we cannot see.
— Joel Achenbach, Washington Post Magazine
How this will end, and it may not be this year or next, is that Covid-19 is going to follow the path of the three previous coronaviruses that we have to deal with year in and year out. So long as there are humans on the Earth there’s going to be Covid-19. Covid will lose its ability to cause severe disease, not because the virus changes but because we gain immunity via vaccines or from prior infections, and that we’ll have ever-improving tools like antivirals and monoclonal antibodies. For the next couple of seasons Covid may still have an outsized influence but it’s increasingly going to be decoupled from hospitalizations and become more like the other coronaviruses.
As we move into this endemic phase we should focus on healthcare preparation, making sure that hospitals are able to deal with surges, because there may be hot spots that flare — like Hong Kong, South Korea and China today — and when that happens it gets particularly dangerous for front-line workers.
Governments should also educate people that this is not a virus that’s going to go away. This is going to be with us and so we each have to learn the principles of risk calculation and harm reduction — that if there are people that have very low risk tolerances they should continue to wear a mask, use rapid tests, be booster-vaccinated, and have antivirals at the ready. Others need to conduct themselves to protect the weakest and most vulnerable.
What Happens Next?
If the 10 richest people on the planet were to surrender 99 percent of the money they made just during the pandemic, “we would have enough money to vaccinate the world; we would have the money to invest in having universal health care,” Gabriela Bucher, the executive director of Oxfam International, told Yasmeen Serhan, a London-based staff writer for The Atlantic. Hanging on to just 1 percent of their pandemic gains would still leave the ten most deep-pocketed humans $8 billion better off than they were at the beginning of March 2020, Serhan discovered. This will not end while rich people get four or five doses of the vaccines and billions of poorer people cannot even get one.
Among USAnians ages 40 to 64, 1 in 300 Whites and Asians have died of Covid, compared to 1 in 480 Blacks and 1 in 390 Hispanics.
While it should have been seen as a last line of defense (after masking, distancing, testing, contact tracing and isolation), the US pushed vaccine development to the fore, insisting that universal vaccination should solve everything. In many ways, they produced a modern medical miracle, and is rightly celebrated. Unvaccinated individuals are 44 times more likely to require hospitalization. For those over 65, the risk is 49 times higher.
Up to half of unvaccinated children who require hospitalization go on to have long Covid.
When I was growing up in the 50s and 60s I was oblivious to lead, which I was inhaling or ingesting from gasoline fumes and wall paint. Forty-five percent of children in my generation had brain damage from lead poisoning before the government finally woke up and acted. Today up to half of unvaccinated children who require hospitalization go on to have long Covid but long Covid is not the only thing they need to worry about. According to a March 6 study in Nature, Covid shrinks brain grey matter by 2% even in the most mild cases. It found that in addition to, or perhaps because of, shrinkage and brain tissue damage, there was an on-average larger cognitive decline.
… exposure to car exhaust from leaded gas during childhood stole a collective 824 million IQ points from more than 170 million Americans alive today, about half the population of the United States. — Duke University
Ninety percent of New Zealanders are vaccinated. That did not protect them from the latest Omicron wave. In the US, immunization rates are striking lower — below 50 percent in many localities, despite free vaccination. Reluctance to use masks, immunize children, and accept what was actually happening stems from mass-disinformation and the more general decline over decades of the public education system in the United States, and perhaps in no small measure from lead poisoning in baby boomers. Like everything else, public health divides into haves and have-nots; those with money and connections and those without — a self-propagating and perpetuating class system. But even beyond that, little did public health authorities grok the viral TikTok and Telegram appeal of Robert F. Kennedy Jr. or the power of MAGA antivax memes. The pandemic was a preventable mental disease.
Just six nations — Canada, Germany, Kuwait, Norway, Saudi Arabia and Sweden — met or exceeded their fair-share commitments to the WHO’s 2020/21 ACT-Accelerator program budget, which includes the Covax vaccination effort that delivered more than 1 billion doses to low- and middle-income countries. The USA gave just 64% of what was asked of it. China gave just 3%. Tedros Adhanom Ghebreyesus, WHO’s director general, said what was asked of these countries would have been just a rounding error in their annual budgets. Of the $16.8 billion needed from wealthy countries for the 2022 global immunization program, only about $800 million has been raised so far. A former Director of Health Services at the WHO told Bloomberg: “If we don’t do a better job of raising immunity levels we will definitely get another variant.”
The Next Three Years
Lately the spread of the virus seems to be diminishing, but it could still become much worse. Imagine giving the job of handling the pandemic back to Cobblepot or one of his MAGA surrogates. As unlikely as that seems, it could be just three years away. 42 percent of Democrats say they are displeased with the job Biden is doing. That is an opening for the lead-poisoned MAGAdiots.
Who is in the White House may not matter all that much. Pfizer went to the government and revealed it had Paxlovid in trials. Five Pfizer pills per day for five days knocks out 90% of the viral infection (but also speeds up mutation rates). Did the White House Covid task force put in an order for hundreds of millions of doses? No. They decided to wait until it was FDA approved. Israel put in a large order. Merck and Roach now also have pills in clinical trials. They have not been ordered into production either. If Pfizer’s pill gets emergency approval by November, it will be another six months before it is generally available.
Just imagine, a dozen years from now, all those millions of new voters with permanent cognitive impairment from smaller brains.
This pandemic will end eventually. It might be in 2022. It might be in 2025. But it also might go on for 20 years. A lot of bats are leaving caves and biting the people cutting down their forests.
The crisis of public health will not end that quickly. The dysfunctionality that characterize US politics is mirrored in its public health policy. Will a President Romney or a President Cheney fare any better against future variants or new viruses? In the USA, those who died first and foremost were the vulnerable — those of color, those in poverty, the elderly, the prisoners, the infirm, the uninsured, the unprotected. They will all be forgotten by the next election cycle.
This was a national face-plant. The smart way for leaders to respond to a pandemic is to calculate the scope of the threat; communicate the dangers clearly to the general public; roll out tests to provide timely surveillance of the pathogen; track viral mutations through extensive genomic sequencing; share public health data seamlessly among local, state and federal agencies; find common strategies to contain the virus and mitigate the disease; and, finally, develop vaccines.
Well … we did develop vaccines.
— Joel Achenbach, Washington Post Magazine
All the Big Pharma companies have refused to release all or portions of their data from the human trials to the medical community for peer review. Thousands of epidemiological researchers around the world have asked for access and been denied. WHO, FDA, CDC and other regulators are apparently powerless to compel release, as are NIH, EU and other billion-dollar funders. That too may all be forgotten by the next election cycle.
Being prepared for the next outbreak, wherever in the world it comes, and rushing a special team there to knock it down before it spreads, is less likely now than it was 3 years ago.
A friend of mine in Denmark said she looks at the USA and wonders why they are so sick, and so crazy. I know why. They are sick because they are crazy.
“It’s a dumpster fire,” says Lisa Abbott, senior vice president of Lifespan, a Rhode Island health system with over 1,200 beds. “It’s a pandemic wrapped in a labor crisis. Omicron is the accelerant on the dumpster fire.”
“Hospitals are maxed out and near the breaking point.” says Doug White, a professor of critical care at the University of Pittsburgh School of Medicine. Across the country, he says, horrifying stories have been circulating within the medical community of patients found dead in their hospital room bathrooms after they took off their oxygen supply to get out of bed. “The alarms went off and there was no one there to take care of them,” White says.
— The New York Times 1/26/22
Widely held beliefs that are simply wrong:
The Pandemic is almost over
New variants will be progressively milder
Young people are less at risk than adults
Natural immunity after recovery protects against future infection, hospitalization and death
Naturally acquired immunity is as good as vaccination
To summarize, the world is into its third year of the Covid pandemic. The virus is under no evolutionary pressure to become less virulent. There is no evidence that the latest editions — the three Omicron variants — are any less virulent than their predecessors. SARS-CoV-2 mutates every other time it passes from one host to another. As it gathers mutations some may produce a milder Covid while others may produce a stronger Covid. Some will evade earlier vaccines and acquired immunity.
Did the United States learn anything from its disastrous response to the outbreak? Probably not. If not, as many as one million lives will have been wasted for nothing. In pandemic scales this was a Category 4. But there is a foreshadowing to contemplate.
The world’s response to climate change is shaping up to be a much greater failure than the US response to Covid. Climate change is presently on track to extinguish all humans from the Earth and very little — almost nothing — has been done to awaken to that threat. If there is a silver lining here, maybe it will be that wake-up call.
The COVID-19 pandemic has destroyed lives, livelihoods, and economies. But it has not slowed down climate change, which presents an existential threat to all life, humans included. The warnings could not be stronger: temperatures and fires are breaking records, greenhouse gas levels keep climbing, sea level is rising, and natural disasters are upsizing.
As the world confronts the pandemic and emerges into recovery, there is growing recognition that the recovery must be a pathway to a new carbon economy, one that goes beyond zero emissions and runs the industrial carbon cycle backwards — taking CO2 from the atmosphere and ocean, turning it into coal and oil, and burying it in the ground. The triple bottom line of this new economy is antifragility, regeneration, and resilience.
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“There are the good tipping points, the tipping points in public consciousness when it comes to addressing this crisis, and I think we are very close to that.”
— Climate Scientist Michael Mann, January 13, 2021.
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