Hello again,
A pair of storms scoured the Midwest last week. The volatile weather was unusual not just because of its destructive power but because of its timing: traditionally we don’t shelter from tornadoes in December. But tradition isn’t what it used to be as a tool for helping you anticipate what will happen next. In this case lives were saved by detailed forecasting and extensive warning from the National Weather Service, to the extent that people heeded the warnings, and to the extent that their employers allowed them to stop working and move to safety.
That’s how we live now. Conditions change from day to day, and you adapt to meet them. And it’s often not enough any more to rely on rule of thumb, or intuition, or personal memory, to guess what those conditions will be, because increasingly you encounter things that haven’t happened to you before, at least not in this way. Regardless of where you are or how you live your life, your experiences more and more are shaped by human-made systems that extend outside your understanding or control and by natural systems that have been deranged by human activity on a massive scale. It can be traumatic to be caught off guard, to be suddenly trapped, with everyone around you, in a crisis you hadn’t even known was possible. These types of situations are common enough now that psychiatrists are starting to worry about how to treat community-level Post Traumatic Stress Disorder. They worry, as Andrea Stanley put it in her reporting on the lingering mental health wounds of the 2018 Camp Fire, that long before climate change affects most people physically, “it will likely drive many of us mad.”
So maybe to arm yourself against surprises like this you look to experts, who make informed guesses about the near future by observing and calculating and drawing on a vast library of data, disciplined experience, and specialized equipment. They aren’t always right, and the recommendations they give can be distorted by social biases and bureaucratic interference. And frankly, it’s sometimes hard to know who the experts are, because really any idiot or con artist can go through the motions of making claims about the world with a side of charts and pictures and anecdotes, and if you’re busy and under pressure, or aren’t a specialist, or maybe if you’re really committed to believing something, it’s easy to pick up someone’s magical thinking and use it to prop up your own.
But if in your personal experience the experts have been right enough often enough, and if the institutions they’re embedded in have earned your trust, you’ve got a more or less reliable guide through an unsteady world.
With all those qualifications, that’s where we are with the Omicron variant.
In the final regular issue of this newsletter, I said we should think of the pandemic not as an event from which we can return to normal, but as “a pervasive haze, an integral but not necessarily lethal feature of a permanently altered landscape.” This was the answer to a question I had back in March of 2020, in the second issue, when the epidemiologists at Imperial College London proposed that periodic lockdowns, broken up by periods of normal social circulation between Covid waves, might be our best strategy for weathering the pandemic. Back then the idea struck me as totally bizarre and unworkable:
the future social world [that the strategy] implies is completely unlike anything in the experience of modern life up until now. Is it economically or socially sustainable to lock everything down for three months, let everything go back to normal for a month or so, and then lock everything down again? We’re probably going to have to find out.
We did find out. We’re still finding out. Since the Omicron variant was first identified, and its spread was detected across South Africa and Europe, there have been weeks of warning that Omicron would likely drive a massive winter surge of infections here in the US. That surge is now well under way in New York and will sweep the rest of the country by the New Year. The weather’s getting strange. And when the sirens go off, you take shelter. Not forever, and not out of panic, but because it’s the pragmatic thing to do until the storm passes again.
// Some things to know about Omicron
The emerging scientific consensus around this new variant goes something like this: Sometime in mid-2020, an early descendant of the original SARS-CoV-2 virus got isolated from general circulation but went on replicating, compiling an unusually large number of mutations before re-emerging sometime in November and starting its rapid spread. Maybe this happened because the virus jumped into an animal reservoir and then jumped back into humans (SARS-CoV-2 is prolific in, for example, mink, mice, and deer). Maybe it developed stealthily in a remote community where testing and genomic sampling aren’t widely available. Maybe Omicron developed from a chronic infection in a single immunocompromised person, which gave the virus a prolonged opportunity to optimize itself.
However it evolved, the result is that the Omicron variant is two to three times as contagious as the Delta variant, which itself was twice as contagious as the original SARS-CoV-2 virus. Compared to the novel virus that swept the planet in 2020 Omicron spreads with unthinkable ease. It’s contagious enough that it routinely infects people who have been fully vaccinated or who have been previously infected, through it’s less likely to make these people sick enough to send them to the hospital. You can see in the data how effectively Omicron’s mutations allow it to out-compete Delta: having barely registered in the US at the beginning of the month, Omicron already accounts for 73% of new Covid infections nationwide.
In South Africa’s Gauteng province, the epicenter of that country’s Omicron surge, the variant burned so rapidly through the population that its spread seems to have already peaked. There, Omicron produced far fewer hospitalizations and deaths than earlier waves and, though nobody’s quite sure yet why, partial immunity through vaccinations and prior infections probably played a central role. In London and New York, exploding case loads have yet to produce corresponding surges in hospitalization, though it’s still early.
It’s hard to convey just how quickly this variant moves, even within communities that have been taking the virus seriously. Since this past Friday New York City has set and broken all-time records for new Covid infections nearly every day. At my university, I spent the semester teaching two in-person classes, including a 70-student lecture, without much Covid worry. I kept the windows cracked open for ventilation, everyone wore masks, was routinely tested, and overall more than 95% of students, staff, and faculty were vaccinated. Campus-wide our precautions were enough to keep the university’s test positivity rate well below 1% for the semester. Then last week Omicron suddenly infected more than 400 people, spiking the test positivity rate to 4.6%, the highest it’s been in the pandemic, shuttering the campus. We hadn’t been doing anything differently: it’s not as if in the final week of the semester the masks had come off, or everyone’s immunity had simultaneously waned. It’s just that this variant is that much better at spreading, even among the vaccinated.
There’s some good news, still. Vaccination is good at keeping people out of the hospital even if they contract the virus. There are more effective treatments for Covid now than there were at the start of the pandemic, and even better treatments — like the new Pfizer antiviral pill — are on the way.
The bad news is that the health care system is badly strained from the pandemic in general and the still-ebbing Delta wave in particular. One in five health care workers has quit their job since the pandemic began, and burnout and trauma are common among those who remain. State and local public health officials across the country have been hounded out of their jobs by partisan lunatics. Omicron hasn’t yet fully hit parts of the country where vaccination rates are low and public health precautions like masking have been not only relaxed but often prohibited.
The coming wave will be especially bad in undervaccinated communities. In October of 2021, the most recent full month for which data is available, unvaccinated people were 10 times more likely to contract Covid, and 20 times more likely to die from it, than were people who were fully vaccinated and had received a booster.
What’s more, we don’t yet know if Omicron is any less likely to leave people with Long Covid, a collection of chronic and sometimes completely debilitating symptoms that can last for months or longer. The scientific literature is mixed on whether or not vaccination protects against Long Covid in people who get breakthrough infections. But if the winter wave does produce tens of millions of new cases, and if even a small fraction of those lead to Long Covid, the outbreak could leave significant scars.
However severe it gets, this wave will pass, and conditions will improve again, maybe for the long term. I keep thinking about this passage from an interview with epidemiologist Michael Mina, from way back in August:
I’ve always said that we’re going to age out of this virus. People are going to keep getting exposed. And whether it’s to Delta or to a variant in five months from now, every time you or I or anyone else gets exposed — they’re really building up a decent cushion of immunity with each of those exposures. So it’s only a matter of time before we actually have not only vaccine-derived immunity but natural infection-derived immunity, too.
When you start coupling all that together, you can picture it kind of like a sandwich, just continuing to stack up. Then we can start to say, okay, now, you know, even if the virus changes a bit, I’ve built up so much protection already. I’ve got all these antibodies that not only recognize the spike proteins from the virus, which is what we see with the vaccines, but I’ve now been exposed three times. And so even if the virus mutates this part, I already recognize these other parts. That’s kind of how we’re going to get out of this. That’s how our immune system learns. It’s going to be maybe a couple-year-long endeavor still, and everyone who’s been vaccinated probably will get exposed — eventually, hopefully, without causing any symptoms. I think we’ll get there, but it’s going to be a longer road than we’d like to believe.
// Some things to do about Omicron
This isn’t March 2020 again, though it may feel that way. We have a better idea of how Covid spreads, and better tools to keep ourselves and the people around us safe. A few tips:
Improve your masking: It’s likely that people infected with Omicron breathe more virus into the air. That means you want to wear masks with improved filtration both for increased personal protection, and so that if you are infected yourself you’re protecting the people around you. Cloth masks don’t cut it under these conditions. Instead, wear an N95 or KN95 mask. You can buy certified masks through Project N95. They even have sizes for kids, which will be important for returning to the classroom after the winter break.
Use rapid tests just before gathering indoors: If you’re going to gather indoors with other people, everyone should take a rapid Covid test shortly beforehand. Ideally, they should test at the door. This should be easier in the new year, since the Biden administration has announced it will distribute 500 million rapid tests to US households. Rapid antigen tests are not perfect, but have a good chance of catching even asymptomatic infections in someone carrying a high load of virus. How good a chance? Well, it’s sort of a coin toss. In one recent study, antigen tests missed newly-developing Covid infections half the time. So testing isn’t a foolproof way of making an indoor gathering safe, and because Omicron’s incubation period is shorter than Delta’s, negative rapid test results more than a few hours old are basically worthless as indicators of a current infection. But remember that a layered strategy is best, and that no one prevention measure is completely effective.
Get a booster, if you’re due: If it’s been more than 6 months since your last Covid shot, you’re due for a booster. If you’re, like me, one of the unlucky few who got the J&J vaccine, you should sign up for a full course of either the Pfizer or Moderna vaccines if you haven’t already. Early data shows that boosters significantly reduce infection rates even with Omicron, and significantly reduce the severity of breakthrough infections.
If you catch an infection, isolate: Do your best to make sure that if you catch Covid, the transmission chain stops with you. Stay at home for 10 days, if you’re able. Even if your bout with Covid isn’t any worse than brain fog, fatigue, and a cough, you’re never more than a few degrees of separation from someone who could become seriously ill or die from the virus. If you have any symptoms, get tested and stay home until you know your status. If at any point you test positive, notify the people you’ve been in contact with recently, so they can get tested too. This part can be uncomfortable but is extremely important. The CDC has pretty good guidance for what to do if you’re infected, here.
Pay attention to case counts in your area and act accordingly: This is maybe the most crucial thing. Check the status of the pandemic in your community the way you check the weather, and change your plans accordingly. There are all kinds of venues for this, but the CDC’s Covid Data Tracker has detailed information down to the county level.
Your holiday plans are riskier than they were a week ago: There’s no easy, universal answer to the question of what to do with holiday plans as Omicron washes over the country. Whatever your plans are, they’re riskier now than they were in a Delta-dominant environment. How much riskier depends on your age and underlying health conditions, your vaccination status, the behavior and conditions of the people in your social network, the condition of the hospitals near you, and how much transmission there is in your community.
All that said, tips will only get you so far. A pandemic is something that happens to societies, not to individuals. Personal responsibility has only a marginal effect on whether or not you get sick, and how sick you get. Plenty of people have and will continue to “do everything right” and still catch this disease. Plenty of others are going to be completely reckless and come to the other side of this with no consequences at all. The choices we make are bounded by our social conditions, as different as they are: by the jobs we work, by the neighborhoods where we live, by the networks of friends we build, by the amount of wealth our parents were able to accumulate and pass down to us, by the way we’re treated by others on the basis of personal characteristics over which we have no influence. By chance and by the rhythm of social life around us.
That’s the paradox that clouds our understanding of society, W.E.B. Du Bois wrote. We can see the “vast and bewildering,” incalculable range of human activity, and the same time easily uncover “lines of rhythm” that produce regular patterns across individual lives. It’s the duty of sociology, he concluded, “to measure carefully the limits of chance in human conduct.” Economic class makes up one set of those limits; race, ethnicity, and gender constitute others, and these lines intersect in sometimes surprising ways. But the lesson is that this winter wave, like the rest of the pandemic before it, will disproportionately kill and disable people who are held in positions of vulnerability in spite of their best efforts. It will spare others who will, as Andy Horowitz wrote in his history of hurricane Katrina, “celebrate themselves for beating the odds, without acknowledging the ways that history had loaded the dice in their favor.”
// Covid’s shadow
There are huge, unbridgeable gulfs that separate the ways Americans understand this pandemic. Those gulfs will not close when the pandemic inevitably ends. It’s hard to see now, while we’re still facing down the immediate crisis, but Covid will cast a long shadow in history. It will shape, in unpredictable ways, events that unfold years and decades from now. How people remember this pandemic will shape how they act in the next crisis. It will influence who they turn to and who they turn against.
Over the past two years the pandemic has changed the way people think about why they work and what their labor is worth; about where we work, and with whom; it’s made us rethink what we owe to one another in society and what we can expect from our government; it’s made us rethink how we see ourselves, since we’ve spent so much time looking at ourselves in a Zoom window; it has made significant changes in the distribution of wealth, with government assistance temporarily cutting the country’s poverty rate nearly in half, even as other economic forces slightly accelerated the concentration of the country’s wealth in the hands of the already-richest.
By the end of 2022, Covid will have killed more than a million Americans. It will have left more than five million children without one or both of their parents. Because of the way the pandemic has been politically polarized, on a per capita basis the cumulative death toll will likely continue to be highest in the country’s most conservative counties, a trend visualized starkly by sociologist Kieran Healy (you can see it here). It’s hard to know what effects this polarization of death will have on our politics. People generally don’t have their minds changed by sudden traumas. Confronted with horrible ruptures in our lives, we tend to interpret them through the same ideological and cultural lenses through which we saw the world beforehand. Change comes more slowly, as the effects of those traumas linger. The people who’ve died are gone, and their absence will resonate for years to come. The people who suffer long-term disability because of Covid will carry these scars into the post-pandemic world.
There will be some more institutional capacity to predict, track, and fight future disease outbreaks. But preparedness alone will not save us, as sociologist Sheila Jasanoff writes. Without significant efforts to shore up our public spirit, without rolling back the pernicious notion that narrow self-interest should be our highest ideal, we’ll fail the test of the next pandemic, and of whatever other strange crises we face in the future.
Recently I re-watched Werner Herzog’s documentary The Cave of Forgotten Dreams, about the Chauvet cave, where for thousands of years early humans came to conduct rituals and to paint spectacular representations of animals on the walls, before a rock slide sealed the cave for 20,000 years. It’s an imaginative landscape of another time, captured just as humans were beginning to distinguish themselves from the rest of nature. Of all the figures painted on the cave walls, only one depicts a human. The most significant things these people saw around them, what they found most important to represent, were the wild creatures that animated their world.
Humans would eventually drive many of the animals represented in the Chauvet Cave to extinction. We would eventually bring so much of the planet under our influence that it would become nearly impossible to escape the effects of our activity. And everywhere we looked, we’d sense some trace of our industry, even if these traces were things we set in motion that got out of hand. That’s why, in this anthropocene, we have to think and act socially. We’re all we have left.