Our Familiar Endemic Flu

And as a counterpoint to the previous post, let's look at this tweet, the crux of which is that the normal flu has been endemic for all of our lives, and most of us never even think of it much.  Some of us get a flu shot (me, last year and going forward) or don't (me, before last year).  I'm assuming that in the typical year, most of us don't get the flu.  I've gotten it, I think, once in living memory.  "Actions are regularly taken by health depts & hospitals. You just don’t notice them because our threshold for action is low enough to allow those actions to be hyper-targeted."

I was surprised to learn that between 12,000 and 61,000 (2010-2019) Americans die of flu - normal flu - every year.  I don't know why it varies so much, but it probably has something to do with which variants show up each year, and whether that year's flu shot ends up being effective against them.  So it's a bigger deal than I thought.

But still... life has gone on without most people thinking about the flu at all.  Will that be the case in the new world, regarding COVID?   Over 60% of children in America and around 45% of adults got a flu shot each year before COVID, and in the last year, those numbers have gone up.  As time goes on, all the available COVID vaccines will win permanent approval (or fall by the wayside), and, one may only hope, the political polarization that keeps a large minority of Americans unvaccinated will fade from consciousness as the years go by.  The pandemic may, as one if its benefits, result in higher levels of vaccinations for all kinds of flu, which is good for individuals and for the herd itself.  Will COVID vax be integrated into your flu shot in years to come?  Early results suggest, maybe so!

Stay tuned.

One View of the New World

 “Aw, look at all these photos of us wearing masks, 

back when we were all able to live aboveground.”

                                                                                                     The New Yorker, August 27, 2021

A Big Miracle

After clearing up an error that "mispoke" six months of our lives, on Monday Dr. Anthony Fauci asserted that we could find "a degree of normality" in the spring of 2022 (not the fall, he assures us, but the spring).  That's two full years, for those of you who are counting.  How will that happen?  "An overwhelming majority" of the 90 million Americans who are unvaccinated today, need to get the shot.  

So - we begin in August of 2021, with wide swaths of the country - whole states - proclaimed as hot spots, schools closed, ICU's turning away patients.  90 million Americans adamantly refusing to give up their right to refuse this particular vaccination.

                                  

And in eight months, everyone's vaccinated and we can eat in a restaurant again.

I don't know.  If that's what it takes, we'll need a pretty big miracle.

The new world continues on hold.

What "Endemic" Looks Like "Now"

Back again!  After a really cool mini-vacation in the Hudson River School, then a lot of work, and then a visit from son, daughter-in-law, and The World's Cutest Grandbaby (who didn't sleep one night and so was a little less than cute), The New World is back.

Back in the new world, or at least talking about the new world which may, someday, emerge.  Just in time for Ed Yong's article in the Atlantic, with a compelling title:  "How The Pandemic Now Ends."  It seems like we've passed through a succession of "now"s, and this is the latest one.  

This "now" is the result (I'm sure you will not be surprised) of the Delta variant.  It is also the result of a fundamental change in how we see vaccinations.  "Vaccines remain the best way for individuals to protect themselves, but societies cannot treat vaccines as their only defense."  This is different.  The more we learn about breakthrough infections, the more it is clear that the virus, and especially Delta, can spread through the vaccinated population as well as the unvaccinated (although much more ineffectively.  Still.)

So we return to the concept of "endemic," which we discussed as long ago as May of this year.  There was general agreement among epidemiologists at that time, but Delta has sealed the deal.  I think it's worth reproducing a whole paragraph from the Atlantic article:

This means that the “zero COVID” dream of fully stamping out the virus is a fantasy. Instead, the pandemic ends when almost everyone has immunity, preferably because they were vaccinated or alternatively because they were infected and survived. When that happens, the cycle of surges will stop and the pandemic will peter out. The new coronavirus will become endemic—a recurring part of our lives like its four cousins that cause common colds. It will be less of a problem, not because it has changed but because it is no longer novel and people are no longer immunologically vulnerable. Endemicity was always the likely outcome... but likely is now unavoidable. “Before, it still felt possible that a really concerted effort could get us to a place where COVID-19 almost didn’t exist anymore,” Murray told me. “But Delta has changed the game.”

He goes on to talk about the average person getting COVID pretty much the same way we get a cold, and then living with the discomfort, getting over it, and moving on.  People who are vaccinated will, on the average (which does not guarantee anything for you or me), find their experience less intense. 

Yong doesn't talk about long COVID, except briefly, peripherally, and I think this is a blemish on what is generally a comprehensive and useful picture of our present and future.  And it leaves a question that must be addressed:  why would we reduce our mitigation efforts - ever - if we don't want the lifelong sentence of long COVID?  A cold comes and goes.  COVID can be forever.  We need a new definition of "endemic," and a new way of living in a world that can condemn us to pain and discomfort for a very long time.

Control and Ego?

I hoped not to come back to WFH for a little while, because I suppose everyone's heard enough about it for the moment, and then I stumbled across this piece in the Atlantic, by Ed Zitron (more on him in a moment) that made me sit up and take notice.

It's got a compelling title:  "Why Managers Fear a Remote-Work Future."  We've seen a lot of opposition to extending WFH indefinitely, from titans of industry to middle managers.  Here's the point he's making: 

Remote work lays bare many brutal inefficiencies and problems that executives don’t want to deal with because they reflect poorly on leaders and those they’ve hired. Remote work empowers those who produce and disempowers those who have succeeded by being excellent diplomats and poor workers, along with those who have succeeded by always finding someone to blame for their failures. It removes the ability to seem productive (by sitting at your desk looking stressed or always being on the phone), and also, crucially, may reveal how many bosses and managers simply don’t contribute to the bottom line.

Zitron is saying that  when everyone's remote, the only way to assess the value of an employee to the company is to examine the amount and quality of work produced.   "Remote work makes who does and doesn’t actually do work way more obvious."  When everyone is working from home, those who have gotten by on personality, and drama, and learning how to "look busy," have nothing to show for their days.  Oh, and also:  when everyone's at home, there's almost no room for "control and ego." 

Zitron makes the point that has been obvious to us who have been paying attention, that there are no good reasons to ship everyone back to the office.  There is no evidence that "workplace culture" or "face-to-face collegiality" or "the efficiency of working in the same room" has any effect on the bottom line.  They are phrases that are mouthed by those who are fearful that they will no longer be needed in a "culture" based on quality and quantity of work produced.

There is little doubt that WFH will be one of the more interesting developments in the new world.  Whether it develops naturally, and boosts productivity and worker happiness (and reduces traffic congestion and hydrocarbon burning), or whether it is squeezed out by those who need control and ego, and to avoid seeming redundant, only time will tell, as they say.  

ADDENDUM:  Even if you're only a little interested in this topic, I think Zitron's "tech and culture newsletter" is worth your time.  Thoughtful, and no punches pulled.

Accepted and Acceptable

...and so, being perverse, I Googled "When will the pandemic end?" and this came up right at the top:  "The End of the COVID-19 Pandemic."  Written by an ethicist. Published yesterday, by the University of Oxford, in a journal called Practical Ethics, which is such a great title that when I'm done with this post I'm going to go ahead and read more of it.

Before I go on, I'm asking you to just read all of the article.  It's short, it's concise, it's comprehensive, it's interesting. I'll probably do some kind of summary, but this article is rich enough to get us to stop and think down a whole bunch of new pathways.

We know the pandemic began on March 11, 2020, because the WHO told us so.*  But when does it end?   According to the authors, Alberto Giubilini and Erica Charters, "Historically, epidemics end not with the end of the disease,** but with the disease becoming endemic – that is, accepted and acceptable as part of normal life."

As you can imagine, this is the part of the article that stopped me in my tracks.  "Accepted and acceptable."  What will it take to get used to that?

The article has a lot more to say, mostly about how we decide when the pandemic is over:

If the end requires societal, cultural, and political agreement on what is a ‘locally acceptable level’ of disease, discussions should include input from those who specialise in understanding society, culture, and politics.  Such discussions will necessarily involve articulating social priorities and cultural values, and calculating risks and benefits, alongside epidemiological data.  Such discussions must therefore involve experts beyond the fields of medicine – ethicists, philosophers, and historians, as well as anthropologists, sociologists, economists, and political scientists.

And they've all got to agree on an end date; as you can imagine, much will change when the pandemic is officially over.  For instance, "AstraZeneca is distributing its vaccines at cost, with no profit, until the pandemic ends."  They'll want to know date and time.

There's a lot to think about in here.  How would you approach the question, as a historian?  a sociologist?  Or an ethicist?

But here's what I'll be thinking about:  "accepted and acceptable as part of normal life."  As part of my normal life?

We'll see.

 * - There were many, including me and a lot of other lay dilettantes, who thought, "Well, it's about time!"  To be fair (to us), cases had appeared in 114 countries by that point.

 ** - Only smallpox, of all the diseases inflicted on mankind, has been completely eradicated.  This includes the bubonic plague which, like all the other endemic diseases (in other words, all of them except smallpox), has become "accepted and acceptable as part of normal life."

Scurvy and Storms

I know, I know.  I'm not even going to look at the date of the last post.  I've been focused on a trip west that turned out a little differently than planned, and now that I'm back home, I find myself just entirely exhausted and, to be honest, a little depressed about politics - which up until recently, was the air I breathed - and life in general during... what?  The Pandemic That Never Ended?  The Oh, Look - It's The Consequences of Someone Else's Behavior?  [John Goodman racks slide] Am I The Only One Around Here Who Remembers Human Decency?

Sorry.  

The most proximate stimulus for a new post was an e-mail I got today, from Larry, our tour boss at Hyde Hall, a 200 year old English Country House outside of Cooperstown, where I am a docent/site interpreter/tour guide.  It seems it is time to mask up again.  All staff are vaccinated (required), as are most guests, but from today on everyone - staff and guests - will be wearing masks when inside.  Our tours begin at the Visitor's Center, which is, of course, inside, and then they go up to the house which, of course, is inside.  

This is not necessarily the worst thing that could happen.  The rest of the staff did it this way all last year, a year during which I took a "I don't want to get it" sabbatical.  But I'm so tired of this.  I do the job because I love it, and I get paid just over minimum wage, so, man, I do not want to argue with some moron who has rights and won't wear a mask. 

I'm sure we'll do fine.  I love showing off the house, and I really like all the folks I work with.  We'll get through it, I guess, as long as there's an end somewhere up ahead.

Which, of course, reminds me of the point of writing this blog.  I started with a voyage of discovery, on Columbus's ship the "Santa Maria," wondering what the new world would be like, after we were done with the virus.  I kept that going as long as I could, but really, the crew has all died of scurvy and the ghostly ships have gone down in one storm or another.  The Admiral of the Ocean Sea is a distant memory, a throwback to more innocent times, when we knew that persistence and a little heroism would pull us through in no time.

There may be no new world - it may be endless ocean, forever.  

Either way, I'll be looking for what other people say about the road ahead, and reporting back.