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The Pandemic Isn’t Over, But We’re Over It

The Pandemic Isn’t Over, But We’re Over It

Monday, 12 April, 2021 - 04:30

Joe Nocera: I've just finished a couple of weeks in Delray Beach, Florida, and I have to tell you: It's a whole different pandemic down here. The restaurants are full; the stores are hopping. Waiters and salespeople wear masks, but most other people don't, not even in crowded bars. South Floridians are acting as if the pandemic is over, even though it plainly isn't.

Most of my friends in New York tend to view Floridians as idiots, at least when it comes to Covid-19. They're convinced that Governor Ron DeSantis is hiding the true number of fatalities, and that his refusal to impose a mask mandate and his insistence on keeping the economy relatively open are the irresponsible acts of a Trump wannabe.

But what you hear from many Floridians — even liberal ones — is a kind of grudging respect. Whether DeSantis was smart or lucky, they don't care. All they know is that Florida's cases and deaths per 100,000 is in the middle of the pack, well below some states that have followed the CDC playbook faithfully. They're happy with the way things are in Florida.

Which has got me thinking about how pandemics end — maybe what happens is not that the virus goes away or is rendered impotent by the vaccine but that people simply decide they have to go on with their lives despite the risk.

Faye, you live in my home state of Rhode Island, a state that tried to do everything by the book. Tell me: Are people still playing by the rules in Little Rhody?

Faye Flam: Yes, Joe, Rhode Islanders are still playing by the rules — and then some. Masks are everywhere — people wear them running and walking the dog and strolling on the beach.

What’s heart-breaking is that despite everything, Rhode Island has had a terrible time with Covid-19. Per capita, we’ve had many more deaths than Florida — 248 per 100,000 people versus 157. Our cumulative death rate is almost the highest in the country. The only states that have done worse are New York, New Jersey and Massachusetts.

Over the past year I’ve learned that the morality tale many people like to tell themselves — that lives saved are proportional to sacrifices made — doesn’t necessarily reflect reality. Sometimes the sacrifices can be, well, dumb.

Last April, for instance, I was jogging on a path in Providence, when I saw a police cruiser speeding toward me with the lights flashing. I wondered what kind of an emergency they were responding to. Then suddenly they were screaming at me through the bullhorn. I was the emergency.

Apparently, a new rule had been decreed that we were not supposed to be outside in any public space. This was crazy. Multiple experts were telling me the one place where you pose no threat is outdoors, far from other people. But the Rhode Island government’s response to the crisis was to close the parks, playgrounds and beaches.

One of the most insightful people I’ve interviewed through the pandemic is an infectious disease doctor in the UK named Muge Cevik. She gathered copious information from studies all around the world, and from her own patients, to try to decipher who was getting sick.

What she found was that Covid-19 in the UK was concentrated among people whose jobs offered no sick leave and who couldn’t afford to miss work, as well as people living with multiple family members in crowded apartments. Those same conditions exist in Rhode Island. Effective interventions would focus on helping those people.

A wise friend once suggested a concise definition of science — a method for seeing the world as it is, not as we’d like it to be. Science-based rules are ones that take human needs into account. Stricter rules aren’t always better rules.

There’s still so much that’s not understood about why case counts rise and fall when they do, and where they do. What role does climate play? Why did cases fall everywhere from mid-January to late February? Science doesn’t support attributing all these changes to outdoor masking or lack of it. But it’s easy for the media to generate outrage with footage of unmasked people on a Florida beach.

Joe: I just took a look at the latest list of the states with the most cases per capita over the last seven days. The top ten are all what I like to call (somewhat facetiously) the law-abiding states: Michigan, New Jersey, New York, Connecticut, Delaware, Pennsylvania etc. Talk about proof that we really don’t understand why case counts rise and fall! I’m now back in New York, where I’ve been a little less vigilant about wearing a mask because I’m vaccinated, and boy do I get dirty looks, even when I’m in the safe outdoors with my dog.

One recent article you pointed out to me talked about Rhode Island’s population density and its poverty — but also the fact that “people were still holding get-togethers of 15 to 20 even as the virus spread.” The author quoted one doctor as saying, “People weren’t willing to live differently during the pandemic.”

I think the way I’d put it is: After a year of dealing with the pandemic, people aren’t willing to live differently anymore. Restaurants are filling up again; some music venues are opening; people are booking air travel in numbers not seen since before the pandemic.

There are lots of reasons for this, I think. One is that the human species can adapt to almost any circumstance — think of the British enduring daily bombings during World War II. At some point, people decide that they will carry on with their lives, pandemic or no pandemic. Another reason is that despite restrictions that have taken a terrible economic and social toll, the pandemic hasn’t been contained — which makes continuing to follow restrictions feel a little pointless.

The third reason, I think — and I would love to hear your thoughts — is that the messaging we’ve been getting from the Centers for Disease Control and Prevention has been so contradictory that many people simply don’t trust the government’s advice anymore. And therefore, they’re much more willing to just ignore it.

Faye: The signs are everywhere that the pandemic is winding down. Even if the virus persists and the CDC keeps preaching doom, the pandemic will end for social reasons.

There can be a social ending to pandemics while the biological risk still lurks. People just start to accept a certain risk and go on with their lives. That even happened during the 14th Century, when the Bubonic plague ravaged Europe.

The Covid-19 pandemic may already have had a social ending in Florida, and it will end soon in the rest of the country because people were told vaccines would end it, and they planned to go back to normal after every adult who wants a vaccine can get one.

I’ve had some great talks this year with risk communication consultant Peter Sandman. He sent me an email recently that summed up our current situation perfectly:

“[People] have spent the year complying as best they can with recommended precautions: wearing masks, staying six feet away from others, avoiding indoor events and crowds, canceling travel plans. All along, they have assumed that vaccines … would replace this menu of burdensome non-pharmaceutical interventions … Now they’re told that after they’re vaccinated they should nonetheless keep taking most of the precautions they’ve been taking for a year already. That doesn’t just feel like a betrayal. It feels like an exercise in futility.”

Unless the vaccines start to fail in a spectacular way, Rhode Islanders and New Yorkers will probably start to act like Floridians soon.

Joe: I agree — vaccine optimism is going to overwhelm any and all cautionary advice. Which I think is fine. In the end it is the role of the scientist to tell us what the risks are and how to mitigate them. But it is the role of the politician to make the risk-reward calculus, to decide how much risk is worth taking to keep a society functioning. At this point, even if there is a fourth or fifth or sixth wave, no governor is going to call for a lockdown. The citizens have made their own risk-reward calculation.

I’ve been vaccinated for about a month now, and it feels liberating. I’m ready to go back to the office, eat in a crowded restaurant, hear some live jazz and visit a museum. I’m yearning for some measure of normality. I even gave someone a hug the other day. (He was vaccinated too.)

It still amazes me that vaccines were ready to go less than a year after Covid-19 hit our shores. That was no small thing. For all my — our, everyone’s — kvetching about the government’s response to the pandemic, vaccines are something it got very right.


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