Acceptable costs of living with the virus

 Last update: Sunday 10/24/21

The Covid-19 page on this blog characterizes the final phases of the pandemic as "Delta vs. mandates and vaccines" -- thereby warning readers that most of the reports linked to the page will discuss the Delta variant and our most powerful tools for addressing it. Unfortunately, this succinct phrasing provides no indications of the massive tectonic shifts in the underlying paradigms that govern our efforts to manage the pandemic.

Paradigm shifts

Throughout 2020 and in the first six months of 2021, our de facto goal was to mitigate the spread of the virus, i.e., to "flatten the curves" in order to prevent our hospitals and other key nodes of our healthcare systems from being overwhelmed. The widespread voluntary/mandatory adoption of highly effective vaccines has greatly reduced the likelihood that our healthcare systems will break down. 

But going forward, living as normally as possible will be our primary goal. We will come to terms with the fact that, despite our best efforts, some variants of the virus will hang around for many years via breakthroughs and vaccine holdouts. As consequence, some of us will become infected from time to time; a small fraction will be hospitalized; and a far smaller fraction will die; but the rest of us and our children will lead our lives as normally as possible ... getting booster shots every now and then, while wearing masks and maintaining social distancing in unusual circumstances.

Who's in charge???

These shifts in our governing paradigms will be accompanied by corresponding shifts in our management of the pandemic. The "doctors" provided guidance during the first eighteen months of the pandemic; but political leaders are likely to be the primary arbiters during the final phases. Communities that learn to live with the virus will do so by achieving a de facto consensus that some levels of hospitalizations and deaths are reasonable prices to pay for allowing most of us to return to normal living, especially our children. To be more specific:

• The primary role of the federal government will be to act as the high volume, low unit price purchaser and subsequent distributor of vaccines, rapid self-tests, and self-administered COVID treatments to the states.
  
  -- "How at-home coronavirus testing is becoming part of Biden’s plan for managing the pandemic", Derek Hawkins and Fenit Nirappil, Washington Post, 9/12/21 
  
  -- "Merck Says It Has the First Antiviral Pill Found to Be Effective Against Covid", Rebecca Robbins, NY Times, 10/1/21 
  
  
• Of course the president will continue to issue and urge mandates for vaccines and/or frequent testing, but federal agencies don't have sufficient staff to monitor these mandates that will be vigorously opposed by many Republicans .
  
  
• Republican governors and mayors will tend to accept higher levels of hospitalizations and deaths in exchange for normal living, and will oppose mandates.
  
  -- "As Covid Surges in Florida, DeSantis Refuses to Change Course", Patricia Mazzei, NY Tmes, 8/6/21    
  
  --  "Texas governor faces legal challenges on mask mandate ban as hospitalizations soar", Derek Hawkins, Bryan Pietsch, Adela Suliman, and Hannah Knowles, NY Times, 8/10/21
  
  -- "Red Covid", David Leonhardt, NY Times, 9/27/21 


• Democratic governors and mayors will tend to pursue lower levels of hospitalizations and deaths in exchange for normal living, and will support mandates
  
  -- "California to Mandate Covid-19 Vaccines for All Students as Soon as Next Fall", Shawn Hubler, NY Times, 10/1/21
  
  -- "New York City mandates vaccines for all city workers, with no testing option.", Emma G. Fitzsimmons, Azi Paybarah, Sharon Otterman and Joseph Goldstein, NY Times, 10/20/21
  
  

Voices of the peoples

These stark differences between the end-of-pandemic management policies that are advocated by the elected officials of the Democratic and Republican parties reflect corresponding differences between the views expressed by super-majorities of the Democratic and Republican voters in national exit polls that were published by the NY Times (11/3/20) after the 2020 elections. When voters were asked which of two policies they thought was more important for managing the pandemic, they responded as follows:

• The policy preferred by most Democrats involved extensive mitigation:
   "Containing the coronavirus now, even if it hurts the economy" ==> Dems(79%), GOP( 19%)
  
  In other words, most Democrats would accept more unemployment, personal distress, and business failures in order to contain the virus.
  
  
• The policy preferred by most Republicans involved minimal mitigation:
   "Rebuilding the economy now, even if it hurts efforts to contain the coronavirus" ==> Dems (20%), GOP (78%)
  
  In other words, most Republicans would accept higher hospitalization rates and death rates in order to rebuild the economy.

Other countries

Examples of other countries that are struggling to learn how to live with the virus are discussed in the following articles:

• World, "How Nations Are Learning to ‘Let It Go’ and Live With Covid", Sui-Lee Wee, NY Times, 7/21/21
  
  
• China, "After Months as a Covid Success Story, China Tries to Tame Delta", Sui-Lee Wee and Elsie Chen, NY Times, 8/4/21
  
  
• Australia, "Covid Zero Is No Longer Working for Australia", Edward Cliff and Brian Fernandes, NY Times, 9/8/21 
  
  
• New Zealand, "Battling Delta, New Zealand Abandons Its Zero-Covid Ambitions", Natasha Frost, NY Times, 10/4/21 
  
  
• Great Britain,  "Britons, Unfazed by High Covid Rates, Weigh Their ‘Price of Freedom’", Mark Landler and Stephen Castle, NY Times, 8/28/21 
  
  
• Great Britain, "Rise in Cases and Deaths Tests Britain’s Gamble on Few Virus Restrictions", Mark Landler and Stephen Castle, NY Times, 10/21/21 ... The essence of the British strategy is captured by the following quote:
  
  -- "At issue is the core trade off British officials made last summer: They decided they could tolerate a widely circulating virus as the price of reopening the economy, so long as only a small fraction of infected people ended up in the hospital. That laissez-faire approach has been watched by the United States and other European countries as a possible model for how to plot a way out of the pandemic" 

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Related notes on this blog:

• "Protecting ourselves as our 18 month pandemic fades into a "forever" endemic" -- Last update: 9/17/21