Issue 48: The Spring Gambit
3.6.21 | Threading the needle between vaccinations and a deadly 4th wave
Hello,
This week the Biden administration announced it had secured enough vaccine doses to inoculate all adults in the U.S. by the end of May, pushing up its original deadline by two months. The boost in supply comes in large part thanks to the FDA’s emergency use authorization for the Johnson and Johnson vaccine, along with a breakthrough deal brokered in part by the White House between Johnson and Johnson and Merck to collaborate on manufacturing the new one-shot vaccine. Meanwhile the 7-day average of new vaccinations has topped 2 million a day for the first time, with nearly 2.5 million shots administered on Friday. That’s a doubling of the pace from late January, and an incredibly good sign of the vigor of the vaccination campaign.
The rapid pace of vaccinations, along with the falling hospitalization numbers, seem to be on the minds of the nation’s governors this week. All eyes were on Texas and Mississippi, which this week rescinded statewide mask mandates and lifted nearly all capacity restrictions. But states across the country are rushing to reopen restaurants, movie theaters, offices, and other public venues, all against the stern warnings of public health officials.
The governors’ spring gambit seems to be this: announce reopenings now, and hope that the pace of vaccination — and more importantly the age distribution of the inoculated — will keep hospitalizations and deaths low even if cases spike as expected later in March into April. More than 95 percent of Covid deaths in the U.S. have been in people aged 50 and older, the same age group where we’ve been concentrating vaccinations. What’s more, public behavior does seem to meaningfully change in response to news of viral spread, so if these reopenings do contribute to renewed surges as expected, the public might recalibrate without the need to impose politically costly new lockdowns. And besides, surges take weeks to build, and by the time the consequences of the reopenings set in, maybe we’ll already be into May, when the country will be awash in vaccine doses, and we’ll simply have run out the clock.
It’s a risky strategy, and the costs of miscalculation are measured on a scale of thousands of lives, nationwide — nearly 2,000 people still die from the virus every day, a lingering consequence of the high infection rates in the winter wave. The decline in newly reported cases has recently leveled off into a high plateau, while the rate of testing is dropping, which reduces our ability to see where new outbreaks are occurring. Director of the CDC Dr. Rochelle Walensky warned this week that “at this level of cases, with variants spreading, we stand to completely lose the hard-earned ground we have gained.”
The biggest source of concern is the exponential spread of the B.1.1.7 variant, which is 40 to 50 percent more transmissible than other variants of the virus, and more lethal. This variant will become the dominant version of the virus circulating in the U.S. in the next few weeks, and that will make obsolete the ground rules on which the spring gambit was made — European countries where B.1.1.7 became dominant have had to reimpose strict lockdowns after the variant fueled devastating surges there, and the U.S. is now on path to see a similar B.1.1.7 surge.
It’s important to stress that not all lives are being held equally at risk by the spring gambit. Vaccine distribution is still full of barriers to equitable access, as this report by ProPublica illustrates. With these inequalities in vaccination, pushing people back into workplaces and venues where they might get sick produces lopsided gains for the already-comfortable. A line made famous by economist Joseph Stieglitz after the Great Recession comes to mind — the U.S. economy is a system that socializes losses and privatizes gains. That’s true for the late-pandemic economy as well, although there are encouraging signs that the latest Covid relief bill (warts and all) will blunt the harm.
We are so close to the end of the emergency phase of the pandemic, and the early reopening strategy is a depressing tempting of fate.
// Link Roundup
Vaccination as a treatment for Long Covid? Anecdotal reports suggest that people suffering persistent symptoms months after a Covid infection finally see relief after receiving a vaccination against the virus. More data is needed, but these early reports are encouraging as part of a suite of efforts to combat the long-term health effects of the virus.
— “Long Covid Patients Say They Feel Better After Getting Vaccinated.” Nicole Westman, The Verge.Hospital cyberattacks: Ransomware attacks on hospitals were a significant problem before Covid. Now, it’s a scourge costing the health care industry hundreds of millions a year.
— “Cyberattacks Cost Hospitals Millions During Covid-19.” Melanie Evans and Robert McMillan, The Wall Street Journal.How to buy a real N95 mask: It will be worthwhile to wear masks for some time to come, even once you’re vaccinated. And an N95 mask is the gold standard in terms of protection. But how can you know the mask you’re ordering online is the real deal? Rule 1: Don’t order them from Amazon. For more advice, check this guide from the Times.
— “How to Buy a Real N95 Mask Online.” Brian X. Chen, The New York Times.The culture crisis of the pandemic in miniature: One thing I’ve been thinking about a lot lately is how intensely this pandemic has deviated from a usual pattern in disaster — crises usually induce consensus within a community over the nature of the problem and collective action to solve it. With Covid, largely due to the influence of the former president, the nature of the crisis itself became a site of heated contention, with troubling ramifications across the country. For a local look at the toxic politics around Covid, read this profile of Minot, North Dakota, by the gifted medical writer Atul Gawande.
— “Inside the Worst-Hit County in the Worst-Hit State in the Worst-Hit Country.” Atul Gawande, The New Yorker.Lessons of a tragic year: Sociologist Zeynep Tufekci has been one of the most consistently insightful voices this past year, and this column on five lessons we should be taking away from the experience of the last 12 months is a must-read.
— “5 Pandemic Mistakes We Keep Repeating.” Zeynep Tufekci, The Atlantic.Revisiting a prescient panel one year later: I ended the first link roundup of this newsletter with a link to a Harvard panel about the pandemic that stood my hair on end. To mark the one-year anniversary of the panel, the participants — Helen Branswell, Juliette Kayyem, and Michael Mina — reconvened via Zoom to look back at the year we had and what’s to come. See below.
That’s it for this week. The next issue will be the one-year anniversary of this newsletter — thanks to you all for coming along for the ride. Share a link with a friend and subscribe if you’re a new reader, and I’ll see you next week in your inbox.