The era of the "COVID-19 Pandemic" is over

Last update: Wednesday 12/7/22 

Note: The quotation in the image is from Authur Miller, American playwright

The point of this note is that pandemics, as defined by epidemiologists, virologists, and other bio-experts, exist within cultural contexts. So the pandemic in the Chinese autocracy has been a strikingly different event from the pandemic in the American democracy. The World Health Organization (WHO) estimates that the virus only killed 30,000 people in China out of a population of about 1.4 billion.  The CDC estimates that over one million Americans have been killed by the virus out of a population of about 330 million, which is about one fourth of the population in China. Based on the American experience, one might have expected China to have lost 4 million people to the virus by now.

The American losses are shockingly high, whereas the Chinese losses are astoundingly low. Perhaps too low? No matter. Even the most cynical American doubters would have to concede that if the Chinese were only counting ten percent of their losses, their 300,000 "actual" deaths would still be a stunning achievement for a nation whose population was four times as large as ours. 

The "pandemic" era in both countries was managed by policy dogmas that had no factual basis despite loud claims by pandemic managers in both countries that their guidance was based on science. 

• The fundamental Chinese dogma asserted that their "Zero COVID" strategy would succeed against all variants of the virus ... then along came the Omicron family. 
  
  
• The fundamental American dogma declared that "one guidance fits all demographic groups because we are all in this together" ... also demolished by Omicron.

The Omicron family is forcing China's pandemic managers to substantially modify their Zero COVID policy.

• China, "China Eases ‘Zero Covid’ Restrictions in Victory for Protesters",  Keith Bradsher, Chang Che and Amy Chang Chien, NY Times, 12/6/22 

The rest of this note will focus on the unfounded American dogma that has misled us from one ineffective guidance to another, a dogma whose most recent "modification" could be interpreted as our de facto transition from a pandemic into an endemic era.

Demographics matter mightily ... but they don't tell the whole story

The American dogma that "we were all in this together" was an illusion that was flatly contradicted by the data gathered in the first few months of the pandemic. By the summer of 2020 at the latest, the CDC data disclosed the fundamental facts of COVID fatality that have pertained throughout the pandemic:

•  COVID mostly kills old people.  According to the CDC's "Death by Age Group" table on 11/30/22,, 81 Percent of all COVID deaths in 2020 were 65 or older, as were 69 percent in 2021, and 79 percent in 2022. The 65+ age group is only 16 percent of the U.S. population; nevertheless it suffered four to almost five times its expected share of COVID deaths.
  
  
• COVID rarely kills young people, i.e., people under 30 ... and if they are under 18, even the unvaccinated rarely die.
  
  
• Exception: COVID also kills young people who have co-morbidities, i.e., the kinds of health issues that make them especially vulnerable to severe illness and death from COVID, e.g., diabetes and compromised immune systems. Of course, older people who have these kinds of health problems are more liable to suffer hospitalization and death than those who don't.

The last comment provides a convenient segue to other important exceptions:

• On 11/30/22, according to the CDC's "Death by Age Group" table, 805,869 of the 1,076,026 COVID deaths since the beginning of the pandemic in the U.S..were in the 65+ age group. According to the U.S. Census Bureau's Table S0101, the estimated total population of this group is 52,362,817. 
  
  Therefore COVID has thus far killed 805,869 / 52,362,817 = 0.015 of the people in the 65+ age group, i.e., less than two percent of our nation's oldest residents. For the purposes of this discussion, we should rephrase this as "COVID has only killed less than two percent of our oldest residents". So why did the 2 percent die and why are the 98 percent still alive?
  
  
• Vaccinations definitely reduce the incidence of COVID deaths in the oldest age groups... but on 12/2/22, the CDC 's "COVID-19 Vaccinations in the United States"  table showed that only 94 percent of the 65+ group had received their primary vaccination jabs, which means that 6 percent of the total 52,362,817 = 3,141,769 have not been vaccinated yet. Why are these 3 million unvaccinated older people still alive? 
  
  
• The CDC's vaccination page also reported that only 17,855,207 people age 65+ have been fully boosted, which means that 52,362,817 - 17,855,207 = 34,507,610 are not up-to-date on their booster shots. How are these tens of millions surviving without boosters?
  
  The NY Times recently carried a report about the declining interest among older residents in boosters. Is this surprising, given that most survivors probably know far more survivors in the 98 percent who are not up-to-date on their boosters than they knew among the non-survivors in the other 2 percent?
  -- "Among Seniors, a Declining Interest in Boosters", Paula Span, NY Times, 10/22/22 
  
  
• Is it possible that most of the 2 percent who died had more serious co-morbidities than the 98 percent who lived? If so, which co-morbidities pose the greatest risks? 
  

The CDC, the FDA, and the White House should have focused most of their guidance on the most vulnerable. They should have discouraged the imposition of disruptive restrictions on young persons who were never at serious risk for severe illness or death. And they should have developed plausible answers to the questions raised in the preceding bullets.

Instead, they squandered their limited resources, positioning themselves as the "nation's doctors" who provided the same prescriptions for everyone, prescriptions that included boosters that don't seem to reduce the likelihood of infections and reinfections from Omicron.

The era of the COVID-19 endemic has begun

Our definition of "endemic era" is cultural, just as our definition of "pandemic era" was cultural. We begin with a statement by Dr. Dr. Ashish Jha, the White House COVID-19 Response Coordinator at a recent STAT conference:

• "We are now at a point where I believe if you’re up to date on your vaccines, you have access to treatments … there really should be no restrictions on people’s activities.” Jha went on to say, “I’m pretty much living life the way I was living life in 2019.” 

In other words, the White House now regards COVID in the same way that it regards seasonal flu. We have vaccines, tests, and treatments for both. We don't impose restrictions on people's activities during flu season, so we should not impose any restrictions on their activities because of COVID. No masks, no social distancing, no quarantines or other mitigations for anyone. The flu is endemic and so is COVID. Virologists, epidemiologists, and other bio-science experts may disagree; but people live in the context of their cultures. Our culture will now be treating COVID the same way that it treats the flu. 

This cultural shift matches the expiration of emergency COVID public health declarations in all but a few states:

• "States’ COVID-19 Public Health Emergency Declarations and Mask Requirements", NASHP, 11/23/22

This shift is also underscored by the evaporation of federal support for COVID treatments for the uninsured

• "For the Uninsured, Covid Care Has Entered a New Stage of Crisis", Noah Weiland and Sarah Kliff, NY Times, 12/6/22 

To be sure, the FDA will continue to monitor the effectiveness of vaccines and treatments, and it will continue to withdraw support for vaccines and treatments that are no longer effective against emerging sub-variants, as per the following examples:

• "FDA releases important information about risk of COVID-19 due to certain variants not neutralized by Evusheld", FDA, 10/4/22
• "FDA Announces Bebtelovimab is Not Currently Authorized in Any US Region", FDA, 11/30/22 ... Note: Bebtelovimab is a treatment, like Paxlovid

As for the CDC, it will continue to monitor COVID infections, hospitalizations, and deaths; and it will probably continue to issue one-size-fits-all guidance that most people will continue to ignore, guidance that does not address the heightened risks faced by the as yet unidentified subset of the 65+ age group, i.e., the people whose specific health deficiencies will place them in the future 2 percent of older COVID non-survivors.

Dr. Jha's new dogma asserts that we can all go back to normal living like in 2019 because none of us need to employ any restrictive mitigations against the most transmissible sub-variants to emerge since the beginning of the pandemic. Like the old dogma it replaces, it does not represent a bio-science consensus. It is merely another one-size-fits-all political decree that this is the way our pandemic managers are going to run things from now on.

"Four legs good, two legs better!!!" ... Animal Farm, George Orwell

 

 

____________________________________

Links to related notes on this blog:  

• "The simultaneous collapse of American and Chinese pandemic dogmas", Last update: 12/5/22